COMMITTEE REPORTS
EMS/Trauma
By Desmond Fitzpatrick, MD EMS/Trauma Committee Member
Heat, trauma and envenomation, oh my! The summer season is upon us, and with it comes a slew of patients that are spending more time outdoors and in cars. As you prepare yourself and your ED for the sultry summer months, keep a few important points in mind: Old or Young – Heat’s No Fun! Pediatric and geriatric patients are much more susceptible to critical heat-related illness and it is on all of us to ensure their safety. As the CDC points out, “When temperatures outside range from 80 to 100 degrees, the temperature inside a car parked in direct sunlight can quickly climb to between 130 to 172.” That is not only incredible, but incredibly dangerous. It’s not just cars that pose a risk— elderly at home or in care facilities with inadequate air conditioning also suffer from heat-related illnesses. Keep First Responders Hydrated! Our prehospital providers respond to patients in all types of weather, but during these periods of very high temperatures, it is even more important to stress their hydration and ability to take relief from the heat. Between their gear and high humidity environments, sweat no longer provides evaporative cooling, leading to quick rises in core temperatures. Crew safety is paramount so we don’t create more patients while responding in the extremes of heat. Remember your XABCs! As far as trauma goes, most are familiar with the “Stop the Bleed” campaign. It is also important to stress that the ABCs of trauma have become the XABCs. “X” is for exsanguination, which should receive the highest priority in our trauma responses.
Dr. Abo’s Do’s & Dont’s of Snake Bites It is that time of year where we are more active outside, and so are crawling critters. Not to mention, storm season has time and time again proven to result in more envenomations before and after storms. Do not rely on hearsay, wives’ tales or even little blurbs that get you by for board certification! DO: • Stay calm & calm patient • Immobilize above the heart at 60 degrees if possible; otherwise, at level of heart • Mark fang or scratches and leading edge of skin changes and tenderness every 10 min • Call venom specialist or poison control • Provide analgesia (it hurts!) • Leave the snake alone and alive! DO NOT: • Kill or bring the snake for ID • Taze, shock or use electricity • Tourniquet • Suck or extract • Excise • Ice • Wait for symptoms or assume dry bite • Prophylactically give NSAIDs or antibiotics
MAY EMS/TRAUMA COMMITTEE MEETING QUICK HITS: • Encourage statewide response
to opioids, including appropriate use of Narcan and ED-initiated Buprenorphine. Form connections with local treatment programs, as well as social work and psychiatric assistance
• Support the use of Dispatcher-
initiated Bystander CPR following No-No Go line of questions
• Drs. Antevy and Scheppke have expanded their resuscitation academies to include multiple areas across the state
• Encourage using or establishing
registry standards, such as Florida Stroke Registry or CARES
NEXT MEETING:
August 1, 2019 | 1:00-2:00 pm Boca Raton Resort & Club Grand G Room
Stay Up-to-Date! The EMLRC is finishing up its MCI, LCI, Oh My!: A Review of Prehospital Hemorrhage Control series with some great speakers and interesting topics. Dr. Abo lectured on “Mass Casualty Overview” and “Wilderness Considerations for MCIs.” Dr. Christopher Hunter of Orange County lectured on the medical response to the Pulse Nightclub shooting in “#OrlandoUnited.” If you missed these free webinars, rest assured they’ll be available via EMLRC Online soon. ■ emlrc.org/education/mci
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EMpulse Summer 2019