IMPROVING PATIENT OUTCOMES

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Urban Shield 2015 Participation

Urban Shield is the largest full-scale exercise in the country with the mission to prepare local (and not local) First Responders for mass casualty acts of violence. The EMS Branch exercises the integration of EMS and medical responders with law enforcement to respond to these incidents to mitigate loss of life. This year we also have the opportunity to practice managing a treatment area of a large MCI to include triage, re-triage, treatment, reassessment, patient tracking, patient distribution and transport ingress/egress considerations.

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System Redesign RFP

The EMS Agency is in the process of choosing a consultant to help with EMS system redesign, development of a new RFP for a provider(s) and the negotiation of the resulting contract.

Those who are interested in reading about what we’re looking for with regard to that process are invited to review the consultant RFP documents here.

For those who wish to skip the detailed legal language regarding the selection process itself, information on the basic tenets of the EMS system redesign are contained in pages 4 – 10.

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AED-Locations

Alameda County EMS Public Access Defibrillation

Alameda County EMS has a comprehensive and proactive AED/PAD proram. The goal of the AED/PAD Program is to participate actively in strengthening the links in the chain of survival in the county.

THE CHAIN OF SURVIVAL

  • Early Recognition – witnessing an event
  • Early Access – calling 911
  • Early CPR
  • Early Defibrillation
  • Early Advanced Care – EMS responders begin advanced life support

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Does Magnesium Lead to Better Outcomes in Stroke?

 

Previous studies have shown that magnesium sulfate can act as a possible neuroprotective agent in stroke [1]. Magnesium seemed to be potentially beneficial if given in the first 3 hours, but lacked benefit when given after 7 hours [1]. “Prehospital Use of Magnesium Sulfate as Neuroprotection in Acute Stroke” is a study released in the New England Journal of Medicine this year that attempted to look at both the efficacy of magnesium sulfate as a neuroprotective agent as well as the feasibility of early administration of potential neuroprotective agents in the prehospital setting. The study found no difference in neurologic outcomes or mortality in stroke patients who received magnesium vs. those who received placebo. The study did demonstrate that it was possible to deliver magnesium within 2 hours of symptom onset in the prehospital setting [2]. Continue Reading…

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Benefit of Epinephrine in Cardiac Arrest

Epinephrine_1-10000A recent study in the Journal of American College of Cardiology [1] has shown worse neurologic outcomes for patients receiving epinephrine during cardiac arrest. The study, “Is Epinephrine During Cardiac Arrest Associated With Worse Outcomes in Resuscitated Patients,” looked at resuscitated patients who received epinephrine and those who did not during cardiac arrest.  Good neurologic outcome was defined as a Cerebral Performance Category (CPC) score of one or two.
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SMR Update

Spine Injury assessment and Spinal Motion Restriction (SMR) update and message from the Alameda County EMS Agency.

There has been an additional 28% decrease from the date of publication through 2014.

There has been an additional 28% decrease in the use of rigid backboards from the date of publication through 2014.

We have seen a tremendous reduction in the use of the hard backboard in Alameda County. As published in our Prehospital Emergency Care (PEC) peer reviewed journal, within four months of implementing our new spine injury assessment guidelines, we reduced the use of hard backboard immobilizations by 58%.  We want that trend to continue.

It all starts with a proper assessment. In emergency medicine it is important to figure out what is wrong with a patient. It is equally important to figure out what is NOT wrong with the patient and not subject them to unnecessary and potentially harmful treatments, including spine immobilization. It is clear that traditional spine immobilization causes more harm than good in subset of trauma patients. There has never been any study, or research that shows any benefit of spine immobilization. Continue Reading…

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Public Health – Measles Sit Stat

Current Alameda County Health Care Services Agency Response

  • The Alameda County Public Health Department’s (ACPHD) Department Operations Center (DOC) continues to remain acti ated to focus on Measles Outbreak Response. We also continue to work on Ebola planning and response for and with Al meda County healthcare partners. As of 1/26/15 we moved to 1 week operational periods.
  • As of 2/2/15 we have confirmed 6 confirmed cases of measles for 2015 in our county. (We had 4 for the whole year in Alameda County last year). Our county was the first Bay Area/Northern CA to confirm cases related to the Disneyland exposures. Other Bay Area Counties with confirmed cases as of 2/2/15 include Marin, San Mateo and Santa Clara and secondary measles exposures are likely occurring in the Bay Area.
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Community Paramedic

Community Paramedicine Takes its First Steps in Calif.

BY HOWARD BACKER, MD, MPH, FACEP ON JAN 28, 2015
SOURCE: CALIFORNIA EMS AUTHORITY

CPJanuary 13, 2015, was an important date for California EMS as the first class of community paramedics began their training. This was the culmination of more than two years of work by many EMS professionals across the state. Community paramedicine (CP), also known as Mobile Integrated Health Care, can be defined as:

“A locally determined, community-based, collaborative model of care that leverages the skills of paramedics and EMS systems to address care gaps identified through a community-specific health care needs assessment. CP utilizes paramedics outside their traditional emergency response and transport roles to work in new models of community-based healthcare that bridge primary and emergency care.” Continue Reading…