In 2011, Gloucester became the first city in the state to have both police and firefighters carry Narcan. Other cities within the state, such as Amesbury, have started to adopt this practice and recently announced that Amesbury Police Department will start carrying narcan as well. [Read the full story…]

In response to the incident, Waymart will have a dozen radios programmed with identifiers so communication center dispatchers know the radio communication is authentic. Waymart is also conducting an investigation to see if it was one of their employees or possibly a disgruntled applicant who was rejected. [Read the full story…]

The decision is due to the drastic increase in heroin overdoses within the city. In addition, there was a recent change in the Department of Health’s regulations, which encourages all first responders to have access to the potentially life-saving medication. Gov. Deval Patrick recently declared a “heroin emergency” within the state as well.

The police department is working closely with Amesbury EMT’s who are already carrying Narcan on their units. The project is overseen by the Amesbury Fire Department, which is the lead EMS agency for the city. According to Amesbury Fire Department Deputy Chief David Mather, the police officers will be required to follow the same Advanced Life Support (ALS) guidelines as EMS personnel.

The use of Narcan by first responders is becoming more widespread. In October 2013, Jefferson County announced its BLS units may start carrying Narcan as well. [Read the full story…]

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National Registry certification is required for state licensure.

	EMR	EMT	I99	AEMT	Paramedic
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri

	EMR	EMT	I99	AEMT	Paramedic
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

The table below shows the most common medical abbreviations that are used for documentation.

A / B / C / D / E / F / G / H / I / J / K / L / M / N / O / P / Q / R / S / T / U / V / W / X / Y / Z

The SINCIAPCPDDD acronym serves as a guideline for emergency personnel during hazmat tactical operations. The table below shows which tactics each hazmat response level is able to conduct. Most EMT’s are only trained at the level of First Responder Awareness (FRA) and therefore can only participate in the SIN portion of tactical operations.

	Tactic	FRA	FRO	IC	Tech / Spec
S	Safety
I	Isolate and deny entry
N	Notifications
C	Command and management
I	Identification and hazard assessment
A	Action planning
P	Protective equipment
C	Containment and control
P	Protective actions
D	Decontamination and cleanup
D	Disposal
D	Documentation

Vital Signs

• Pulse: 128 bpm
• Respirations: 30 per minute
• Blood pressure: 188/102 mmHg
• Eyes: PERL @ 3 mm
• LOC: Alert
• Lung sounds: Crackles/Rales bilaterally
• Skin: Pale, cool and clammy

Quiz

Congestive heart failure (CHF) is indicative of which of the following:

Discussion

Use the comment system below to explain how you would handle this scenario.

Femur fractures can be successfully immobilized using a traction splint. A femur fracture is complicated due to the amount of bleeding that can occur from the broken bone. In addition, the thigh muscles will contract and pull the fractured ends so they overlap or pass each other. This increases the size of the thigh, which leads to more blood loss, pain and internal soft tissue injury.

Traction splints provide a counter-pull to reduce the size of the thigh and realign the fractured femur. This helps reduce blood loss, alleviate pain and minimize further injury. The most common traction splints you’ll see in the field are the Hare (bipolar) and the Sager (unipolar).

Hare Traction Splint (Bipolar Traction Splint)

The Hare is a bipolar traction splint, which means it uses two external poles to support the injured leg.

Indications

• Suspected femur fracture

Contraindications

• The injury is within 1-2″ of the knee or ankle
• The knee is injured
• The hip is injured
• The pelvis is injured
• There’s a partial amputation or avulsion with bone separation and the distal limb is connected by only marginal tissue

How to Apply

1. Assess distal PMS.
2. Stabilize the injured leg by applying manual traction.
3. Measure the splint on the uninjured leg and adjust the length accordingly.
4. Position the splint under the injured leg until the ischial pad rests against the bony prominence of the buttocks. Once the splint is in position, raise the heel stand.
5. Attach the ischial strap over the groin and thigh.
6. Secure the ankle strap with the patient’s foot in an upright position.
7. Attach the “S” hook to the “D” ring and apply mechanical traction; continue until it’s equal with the manual traction and the pain and muscle spasm are reduced.
8. Attach the leg support straps.
9. Recheck the ischial strap and ankle hitch to ensure both are securely fastened.
10. Reassess distal PMS.

For unresponsive patients, apply mechanical traction until the injured leg is the same length as the uninjured leg.

Sager Traction Splint (Unipolar Traction Splint)

The Sager is a unipolar traction splint, which means it uses one external pole to support the injured leg.

Indications

• Suspected femur fracture

Contraindications

• The injury is within 1-2″ of the knee or ankle
• The knee is injured
• The hip is injured
• The pelvis is injured
• There’s a partial amputation or avulsion with bone separation and the distal limb is connected by only marginal tissue

How to Apply

1. Assess distal PMS.
2. Position the splint on the inside of the injured leg and adjust the length so it extends approximately 4″ beyond the heel.
3. Attach the strap to the thigh.
4. Secure the ankle strap with the patient’s foot in an upright position and attach it to the splint.
5. Apply traction by extending the splint to 10% of the patient’s body weight.
6. Attach the leg support straps.
7. Recheck the ischial strap and ankle hitch to ensure both are securely fastened.
8. Reassess distal PMS.

Remember, you don't have to be certain the patient has a femur fracture. If the thigh is painful, swollen or deformed you should assume it's fractured and splint accordingly.

Vital Signs

• Pulse: Undetectable
• Respirations: Undetectable
• Blood pressure: 94/58 mmHg
• Eyes: 6 mm
• LOC: Verbal stimuli
• Lung sounds: Clear bilaterally
• Skin: Pale, cold and waxy

Quiz

If you cannot detect a pulse or respirations for a hypothermic patient, but they are able to move, you should:

Discussion

Use the comment system below to explain how you would handle this scenario.