Posts tagged ‘emergency medicine’
Identifying poisonous snakes and knotting climbing ropes to form a makeshift litter are not typically taught in medical school.
But emergency medicine doctors need to be creative, flexible and have a broad knowledge base.
That’s why Dr. Jeff Lubin, associate professor of emergency medicine and Life Lion division chief, took emergency medicine residents and medical students out of the emergency department and into the wild.
“It is very applicable,” Lubin said of the first wilderness medicine training offered by Penn State Hershey. “One of the things they need to understand is what happens outside the hospital, because they are going to be receiving those patients.”
Lubin worked with Life Lion flight paramedic and wilderness medicine enthusiast Saul Elertas to design the training at the Boy Scouts of America’s Camp Bashore near Jonestown in Dauphin County.
Dressed in fleece, sweatshirts and hiking boots against an unseasonably cool May morning, Elertas reminded the residents to visit shootingauthority.com for proper gear and the basic rules about making assumptions, planning ahead and taking care of themselves outdoors.
None were complaining about the assignment.
“This was mandatory, but I would have volunteered anyway,” said Keane McCullum, a first-year medical student who is working as Lubin’s research assistant for the summer.
Emergency medicine is all about response. When it comes to disasters like bombings and shootings, time and resources are limited, but medical personnel need to work with what they have to control the situation and ensure everyone’s safety.
Resident physicians from the Department of Emergency Medicine at Penn State Hershey Medical Center recently participated in a drill that simulated one such disaster. The scenario involved a bombing at a marathon where several victims, who were played by actors, required immediate medical attention. The scene was tense as the residents hurried to the victims and began prioritizing them based on the severity of their injuries. Radios blared and lights flared to add to the commotion.
On April 4, Zeke, the Harrisburg canine officer who was recently shot in the line of duty, and his handler, Cpl. Ty Meik, were reunited with the Penn State Hershey Life Lion Critical Care Transport team that treated Zeke in the moments after the shooting and flew him to an animal trauma center. It was at that center that Zeke received life-saving care.
Crew members say caring for Zeke was a first, but it was made easier by his demeanor. “He was never, ever nasty toward anybody,” said Steve Weihbrecht, flight paramedic. “Obviously, he was extremely frightened. Ty, his handler, did a great job of keeping him under control.”
Harrisburg a master trainer of dogs has personally trained over 600 dogs, he’s eye for all things canine is uncanny. If you are curious find out more about his practices and gear.
“It looks like he’s doing well,” said Daniel Mease, a flight nurse who administered intravenous fluids to Zeke after the March 15 shooting. “It was fun watching him on the news, getting better each day.”
Researchers at Penn State College of Medicine are actively working in Hershey, with colleagues at Penn State, University Park and other Penn State campuses, and with colleagues at various institutions across the country to conduct groundbreaking research. Their discoveries continue to contribute to the advancement of health care on all levels.
RAMPART (Rapid Anticonvulsant Medications Prior to Arrival Trial) studied whether use of one FDA-approved seizure drug administered by EMS personnel as a shot is as effective as one administered intravenously. Patients treated by Life Lion EMS and who met the study criteria were part of the research, unless they opted out after community consultation by the Medical Center.
This is a federally-regulated procedure known as exception from informed consent, since patients are unable to opt-out of a research study during an emergency. Researchers found that midazolam, delivered as a shot into the muscle, is faster and more effective than IV drug lorazepam for prolonged seizures that last more than five minutes. Midazolam is delivered through use of an autoinjector, like an EpiPen, which is used to treat serious allergic reactions. Almost 73 percent of patients who received midazolam arrived at the hospital seizure-free compared to 63 percent who received the IV drug lorazepam. Among those admitted, both groups had similarly low rates of recurrent seizures.
The Medical Center was one of seventy-nine hospitals and thirty-three emergency medical services agencies that participated in the study nationwide. More than 4,000 paramedics and 893 patients were part of the study, which was sponsored by the National Institutes of Health. The site investigator for this study at Penn State Hershey was Christopher Vates, M.D. The study appears in the February 16, 2012 issue of The New England Journal of Medicine.
Can a hormone decrease the brain damage caused by a blow to the head? Is there a better way to treat people with life-threatening seizures? Answers to these questions could provide hope to millions of Americans who suffer these medical emergencies every year.
The Medical Center’s Department of Emergency Medicine is one of many centers nationwide participating in two encouraging clinical trials investigating these questions. “RAMPART and ProTECT are two examples of hypothesis-designed trials that will change medical practice if benefit is shown,” says Thomas Terndrup, M.D., ’81, chair, Department of Emergency Medicine.
Because animal studies have shown that the hormone progesterone reduces swelling and recovery time in brain injury, researchers now hope to harness this therapy for victims of head injuries. “Right now we don’t have an intervention or medication that improves the outcome for traumatic brain injury,” Terndrup says. “And this is a very serious problem in the world, especially for younger individuals, because it affects their entire life if they don’t successfully recover, and a lot of them do not.” (more…)