September 2008 Archives

Pain is a distinctly unpleasant experience that all humans undergo periodically. It may range from a simple annoyance to excruciating and unbearable. Almost every study that examines the outcomes of every type of healthcare provider shows that we as a group have become insensitive to the suffering of our patients and ineffective at using the drugs and techniques that are available to us.

A high percentage of the patients transported by EMS systems each year have pain as one of or their chief complaint. How well do we do at providing relief? One of the most dramatic EMS studies to date was conducted in Akron in the late 90s. At that time the EMS system had standing orders for either morphine 2-5 mg IV push or 50% self administered nitrous oxide. During the study period 1073 patients from suspected extremity fractures were entered into the study. How many of these patients do you think had morphine or nitrous oxide administered? Was it 800, 600 perhaps only half of the patients 500? It was 18 patients!!!! Almost the same chance one would have of hitting the daily number. Some systems and many providers are certainly much better than this but all of us could probably do better. Before UPMC initiates a major effort to improve prehospital and ED treatment of acute pain we would like to hear your thoughts. What are your experiences as a patient, parent, spouse, friend, or as a caregiver? What do you think we need to do as a profession?

I first heard wind of this a couple of years ago in one of my many public health courses. It seems that there is growing scientific evidence that kids are germ spreaders. (No big surprise to this or any other parent to be sure). The theory is that if you give kids the flu shot, both they and their family members are less likely to get sick. The CDC is now recommending that we give all kids the flu shot up until they turn 18, at which point they are no longer kids and they should get the flu shot because they are adults.

UPMC and Emed Health have been running EMS-based flu programs for more than 10 years. Dr. Vince Mosesso and C. Richard Packer (now with the Pennsylvania Department of Health) launched the first program during the 1997-1998 flu season, thanks in large part to the cooperation and vision of Michael Huff. Some of you will recognize Mr. Huff as Joe Schmider's (Director of the Bureau of EMS) boss at the PA Department of Health. At the time Mr. Huff was with the Allegheny County Department of Health, and we are forever indebted to him not only for his willingness to let EMS providers help distribute the vaccines, but also for several years' worth of free flu shots that he provided to help launch the program.

If your EMS agency is interested in providing a flu program to its members or your community, please give Emed Health a call. While the flu shots are no longer free, this remains an incredibly valuable service that you can provide your hometown. It's a great tool to increase the recognition of your service in the community, and gives your medics a great opportunity to brush up on their IM skills. (BTW, EMS toddlers, that's intramuscular not instant messaging skills).

See the AP story here.