EMS Training Research Articles

STUDI IMPLEMENTASI STANDAR SISTEM MANAJEMEN LINGKUNGAN (ISO 14001:2004) DALAM PENGELOLAAN WISATA ALAM DI TAMAN NASIONAL BROMO TENGGER SEMERU (Studi Kasus Pelaksanaan Sertifikasi dalam Pengelolaan Wisata Alam)

High nature potency, strategic location, and accessible have made TNBTS as one of most visited national parks, thus the potency cause negative impact to the ecosystem. To anticipate, the Management of TNBTS has applied environment management system/EMS based on ISO 14001 : 2004. The study aimed to investigate the EMS applied by the management of TNBTS, implementation process of ISO 14001 : 2004, evaluate the phase and percent of EMS application on natural tourism management. Method used was descriptive explorative with frequent descriptive analysis and SWOT analysis. The result showed that the most inuencing factor in the EMS application in TNBTS was visitor aspect and facilities establishment. Implementation process of ISO 14001 : 2004 in TNBTS was started with EMS training by an external consultant, agreeing the certification scope, conducting early review, and identifying environmental impact aspect also the regulation. Then set the environmental policy, management, conduct inspection and review of the management. To support successfulness of the implementation of ISO 14001 : 2004, requires management and personal commitment. Compliance degree of the EMS implementation based on ISO 14001 : 2004 was 3.86 and 79.95% with the category of close to consistent. Result of SWOT analysis showed that the strategic position of TNBTS in applying EMS to manage their natural tourism was in quadrant/ cell 1 (1.18; 0.65). Therefore, the strategy that can be developed is growth strategy, with the strategy form increasing service to visitors, increasing management work in maintaining the EMS quality.

Electrical Muscle Stimulation for Heart Failure: where do we Stand?

Several small studies of EMS, with varying protocols, mainly in patients with mild to moderate heart failure have been reported in the last decade showing modest benefit in exercise capacity and quality of life. Although modest when compared to conventional exercise training, this benefit appears real and will be probably quite crucial in those patients that cannot undertake exercise training for orthopaedic or other reasons, and perhaps in the symptomatic patients in NYHA Class III and IV as they often find physical exercise extremely difficult to undertake. We are launching a new EMS study on those with severe heart failure with great anticipation. The time for EMS training to be included in routine clinical prescription in heart failure is fast approaching but a large clinical trial of EMS for all comers with chronic heart failure is needed to seal the issues of the exact indications, protocol selection and the how much benefit to expect.

Prehospital Medical Care and the National Ski Patrol: How Does Outdoor Emergency Care Compare to Traditional EMS Training?

The purpose of this study was to identify the differences between the educational curricula, skill sets, and funds of knowledge required for certification as an Outdoor Emergency Care Technician (OEC-T), Emergency Medical Technician (EMT), and Emergency Medical Responder (EMR). We directly and in detail compared topics and skills presented in the OEC-T curriculum with those presented in the EMT and EMR education and training curricula. The information and skills taught in the OEC-T curriculum are in general more extensive than those taught in EMR training but are not equivalent to EMT. The OEC-T program has more depth in environmental medical issues, such as altitude illness, hyperthermia and hypothermia. Completion of the EMR program is 112 hours shorter and constitutes 30% of the duration of the EMT program. Completion of the OEC-T program (for certification only and not including additional "on-hill" patroller training) is 80 hours shorter and is half the duration of the EMT program. The OEC-T curriculum includes a skill set and fund of knowledge that exceeds those of the EMR program, but does not include all the knowledge needed for an EMT program. The OEC-T program prepares out-of-hospital providers to care for patients in the wilderness, with special emphasis on snowsports pathology. The EMT program places a greater emphasis on medical disease and emergency medication administration. These differences should be considered when determining staffing requirements for agencies caring for patients with snowsports pathology.

Understanding of Sepsis among Emergency Medical Services: A Survey Study

BackgroundEmergency medical services (EMS) personnel commonly encounter sepsis, yet little is known about their understanding of sepsis. Study ObjectivesTo determine the awareness, knowledge, current practice, and attitudes about sepsis among EMS personnel. MethodsWe performed an anonymous, multi-agency, online survey of emergency medical technicians (EMTs), firefighter-emergency medical technicians (FF-EMTs), and paramedics in a metropolitan, 2-tier EMS system. We compared responses according to the level of EMS training and used multivariable logistic regression to determine the odds of correctly identifying the definition of sepsis, independent of demographic and professional factors. ResultsOverall response rate of study participants was 57% (786/1390), and was greatest among EMTs (79%; 276/350). A total of 761 respondents (97%) had heard of the term “sepsis.” EMTs and FF-EMTs were at significantly reduced odds of correctly defining sepsis compared to paramedics, independent of age, sex, and years of experience (EMTs: odds ratio 0.44, 95% confidence interval 0.3–0.8; FF-EMTs: odds ratio 0.32, 95% confidence interval 0.2–0.6. Overall, knowledge of the clinical signs and symptoms and recommended treatments for sepsis was typically>75%, though better among paramedics than EMTs or FF-EMTs (p<0.01). The majority of respondents believed sepsis is not recognized by EMS “some” or “a lot” of the time (76%, 596/786). ConclusionsEMS personnel demonstrated an overall sound awareness of sepsis. Knowledge of sepsis was less among FF-EMTs and EMTs compared to paramedics. These results suggest that paramedics could be integrated into strategies of early identification and treatment of sepsis, and EMTs may benefit from focused education and training.

(A278) Preliminary Successes and Challenges in the Creation of an Emergency Medical Care Training Program in the Wake of the 2010 Earthquake

BackgroundThe earthquake in January 2010 killed more than 250,000 Haitians and caused traumatic injury to tens of thousands of survivors. In the aftermath of the earthquake, Haitian civilians assisted in various medical roles. Many of the civilians requested training, and 8 months after the earthquake, a team of American clinicians, EMTs and health educators returned to Haiti to teach a course in basic lifesaving and emergency care.MethodsUsing a modified French-language EMS training curriculum, 60 community members with no previous medical experience were trained during an intense 2-month period. Trainings were held to teach basic lifesaving and stabilization skills. The Gwoup Ayisyen pou Ijans was formed and is preparing to take the French-language EMS exam. A follow-up study is being conducted to assess the capabilities of the students.DiscussionPreliminary challenges included securing safe places for training and teaching in both French and Kreyol. Successes were the willingness of trainers to volunteer time and equipment, and the high motivation of the students, despite the inability of the government to promise consistent work for an EMT force.

Effects of an Electrostimulation Training Program on Strength, Jumping, and Kicking Capacities in Soccer Players

The present study investigated the influence of a 5-week electrostimulation (EMS) training program on muscular strength, kicking velocity, sprint, and vertical jump performance in soccer players. Twenty amateur soccer players participated in the study, 10 in the electrostimulated group and the remaining 10 in a control group. Electrostimulation was applied on the quadriceps muscles over 5 weeks. Subjects were tested before, during (wk-3), and after (wk-5) the EMS training program. Maximal voluntary contraction using different contraction mode (i.e., eccentric, concentric, and isometric), vertical jump height, sprint running for 10 m, and ball speed were examined. We observed an increase in isometric and eccentric maximal knee extension torques and also a gain in ball speed performance without run up at wk-3. After 5 weeks of EMS training, eccentric, isometric, and concentric torques and ball speed had significantly improved. It appeared appropriate to conduct EMS training during at least 3 weeks to observe beneficial effects in specific soccer skills such as ball speed.

EMS certification requirements for flight nurses

Introduction Emergency medical technician (EMT) or paramedic (EMTP) certification requirements for flight nurses (FNs) providing on-scene patient care vary. We surveyed those requirements and evaluated the relationships between flight team composition or program location and FN EMS certification. Methods Telephone survey of all 184 rotor-wing programs responding with a nurse to scenes Results The overall EMS training requirement for FNs was: none—57.6%, EMT—21.7%, EMTP—14.7%, local credential (not EMT or EMTP)—6.0%. Second team members were EMTP, RN, physician, or respiratory therapist (RRT). Overall, team configuration related significantly to FN EMS certification ( P = .01). FN/EMTP and FN/RRT teams were individually significant ( P < .01), with FN/EMTP teams tending not to require certification and all FN/RRT teams tending toward a certification requirement. Neither FN/FN nor FN/physician pairings related significantly with FN EMS certification requirements. Regional patterns emerged to both crew configuration and FN EMS certification requirements. Conclusion Most flight programs do not require FN EMT/EMTP certification. Team configuration and geography are related to those requirements.

The front lines of domestic violence. Training model for rural EMS personnel.

1. Domestic violence is a major public health problem requiring committed, coordinated community response. 2. Domestic violence is a significant cause of morbidity and mortality for women and children in the United States. 3. EMS personnel play a frontline role in the critical response and prevention of domestic violence. 4. EMS education and training are requisite for safe, effective responses to domestic violence in rural communities.

Emergency Medical Services in Ghana

Feature Editor's Note: Michael Tiska worked as an EMT in Seattle for three years and has taught CPR and first aid for the American Red Cross. He is currently pursuing a master's degree in public health and physician assistant studies at George Washington University, Washington, D.C. Last summer he had the opportunity to travel to Ghana and collaborate with others to develop a unique EMS training program. Mike's contributions, and those of other PA students in the area of international outreach, demonstrate once again the unique talents of our future colleagues. Authors desiring to contribute to “Global Perspectives” should forward submissions to Lisa Mustone Alexander, MPH, PA-C, Director, Clinical Leadership Program for Health Professionals, The George Washington University, 2300 K Street, #316, Washington, DC 20037; telephone: 202–994–0659; fax: 202–994–0895; e-mail: [email protected]. Both visual and written media will be considered for publication. Visual media should be accompanied by a brief narrative.

Supplemental EMS and Dynamic Weight Training: Effects on Knee Extensor Strength and Vertical Jump of Female College Track &amp; Field Athletes

Supplemental EMS and Dynamic Weight Training: Effects on Knee Extensor Strength and Vertical Jump of Female College Track &amp; Field Athletes

Integration of United States Emergency Medicine Concepts Into Emergency Services in the New Independent States

At this writing, a collaborative partnership has been in place for 30 months between the Boston University Medical Center, the University of Massachusetts Medical Center, the Armenian Ministry of Health, and the Emergency Hospital of Yerevan, Armenia, to improve emergency and trauma care in that city. Fifty-five individuals have traveled to and from the Emergency Hospital, the partner hospital. The collaboration has led to the creation of the Emergency Medical Services Institute (EMSI) at Emergency Hospital, an 800-bed facility that serves as a trauma center and as base for the Yerevan ambulance system. A curriculum (text and slides) has been developed and translated into Armenian and Russian. To date, the Armenian EMSI has trained nearly 300 emergency medical personnel: physicians, nurses, drivers, and first responders. The Armenian EMSI faculty have received training in directing instruction of emergency care providers. Plans are in place to begin training in Armenian cities outside of Yerevan and in neighboring republics. An emergency medicine residency program received ministry approval and was begun with six resident physicians in January 1995. To date, 45 nurses have graduated from a 400-hour training program. This partnership program chose an education initiative as the vehicle for interaction between the United States and the formerly Soviet-directed Armenian health care system. Officials of the partner hospital requested assistance in upgrading the skills of its abundant emergency care workforce, citing cardiovascular disease, trauma, and accidents as leading causes of death and disability in Armenia. Because the Armenian partners' needs in emergency medicine and trauma coincided with the US partners' areas of greatest expertise, it was clear that meaningful progress was possible. The centralized emergency medical system designed by the former Soviet Union produced nearly identical systems in the republics (including Armenia) that now form the New Independent States (NIS). The opportunity of reaching a broad base by means of development of a standardized curriculum was presented and acted on. In this report we describe and discuss our experience and provide an interim report of the effort. This project has demonstrated the feasibility of out-of-hospital emergency medicine training efforts in the NIS. The transfer of clinical knowledge, skills, systems approaches, and pedagogic techniques between unlike health care settings is possible if ministerial, municipal, and provider institutions themselves participate in the effort. The EMSI provides a model for EMS advancement and training that can be extended to other areas in the NIS.[Aghababian RV, Levy K, Moyer P, Mottley L, Ciottone G, Freitas R, Minasian A: Integration of United States emergency medicine concepts into emergency services in the New Independent States. Ann Emerg Med September 1995;26:368-375.]

Education about Prehospital Care during Emergency Education Residency Training: The Results of a Survey

AbstractThe Society of Teachers of Emergency Medicine's, EMS Educators Committee performed a mail survey of emergency medicine residency training directors regarding their curricula for EMS. The Committee was interested in determining the quality and quantity of EMS training in emergency medicine residencies. Out of 66 programs, 48 responded (73%). The programs reported that they provide medical control for a mean of 4837 calls per year (range 0–20,000) and interact with a mean of eight EMS agencies. Ten programs (21%) do not offer any formal EMS administrative experience, while 42 (87%) programs require residents to participate in paramedic training, and 31 (65%) require participation in EMT training. Both the type and the amount of “in-field” experience reported by programs varied considerably, with some programs offering it only as an elective. Similarly, there was great diversity in the type and amount of experience with helicopter ambulances. In conclusion, there is wide disparity among the offerings from all residency programs. Each training program must evaluate its own EMS curricula and expand it to fill existing gaps. Specific topics to be covered are suggested.

ABOUT BURNS

Chairperson, EMS Training Director, Burn Center Ripps-Miesler Professor of Surgery University of South Alabama Mobile, Alabama

The International Society of Emergency Medical Services (ISEMS)

In September 1980 at the International Aeromedical Evacuation Congress held in Munich, West Germany, the International Society of Emergency Medical Services (ISEMS) was formed. The purpose of this new society is to develop, promote, and improve EMS throughout the world. The founding members came from sixteen nations and represented such regions as Africa, the Americas, Europe, and the Middle East.This new organization, ISEMS, provides a permanent, ongoing focal point for studies and serves as a global clearinghouse for EMS technical assistance, training, management, and evaluation. The Society remains on an international level, and its eligible membership consists of all persons who participate in EMS throughout the world. The publication of a scientific journal for all EMS personnel is planned. Through ISEMS, International Centers of Excellence will be established to provide technical assistance to countries for improvement of their EMS programs; training seminars and educational programs will also be sponsored. In addition, annually sponsored meetings in key cities in various countries of the world are planned.

Meeting report on the second EMS workshop

Environmental MutagenesisVolume 2, Issue 3 p. 431-432 Meeting Report Meeting report on the second EMS workshop David J. Brusick, David J. Brusick Chairperson, EMS Training CommitteeSearch for more papers by this author David J. Brusick, David J. Brusick Chairperson, EMS Training CommitteeSearch for more papers by this author First published: 1980 https://doi.org/10.1002/em.2860020314AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume2, Issue31980Pages 431-432 RelatedInformation