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Aunque pueda contener afirmaciones, datos o apuntes procedentes de instituciones o profesionales sanitarios, la información contenida en el blog EMS Solutions International está editada y elaborada por profesionales de la salud. Recomendamos al lector que cualquier duda relacionada con la salud sea consultada con un profesional del ámbito sanitario. by Dr. Ramon REYES, MD

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.

Niveles de Alerta Antiterrorista en España. Nivel Actual 4 de 5.
Fuente Ministerio de Interior de España

lunes, 27 de febrero de 2012

Vídeo Técnico Transporte Sanitario España

Un espíritu, una meta - Transporte sanitario

Cada día en una gran ciudad se producen más de 300 emergencias. Para salvar vidas, hacen falta héroes y estos héroes deben estar bien preparados

sábado, 18 de febrero de 2012

New Seizure treatment for EMS

Seizure treatment study: Implications for EMS

Being able to use an auto-injector can simplify the procedure and speed up the delivery time

By Art Hsieh
Seizures are a common call for EMS systems. Often the physical manifestations of the seizure activity is over by the time we arrive; rarely do we have to manage the more serious condition of status epilepticus.
Because of its commonality, we might not consider the impact that seizures can have upon the patient, long after we managed their acute condition.
An advance like this has the potential to dramatically improve the overall health of the individual, and possibly reduce the need for emergency services.
There are also implications for EMS providers as well. It can be a challenge to administer an intravenous benzodiazepine when the patient is actively seizing.
Being able to use an auto injector can simplify the procedure and speed up the delivery time. It might also mean that terminating an active seizure might become a basic life support procedure. This can improve a system's overall ability to respond to these common calls.
That time might be some ways off. However, it's another interesting development in our business that benefits both patients and providers alike
About the author
EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. A Past President of the National Association of EMS Educators, former Chief Executive Officer of the San Francisco Paramedic Association, and a scholarship recipient of the American Society of Association Executives, Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at
Study: Injection offers faster help for seizure patients Results probably will change how seizures are treated by paramedics

Link to original information
By Erin Allday
The San Francisco Chronicle
SAN FRANCISCO —  Injecting patients in the thigh with a drug-loaded syringe is a safe and effective way to stop a seizure in an emergency, according to results of a national study released Wednesday, a finding that could pave the way toward making such syringes as widely available as EpiPens used to treat severe allergic reactions.
The two-year study, published in the New England Journal of Medicine, concluded that a single stab from an auto-injector was more effective in stopping a prolonged seizure than the traditional method of inserting an intravenous line and delivering the drug directly into the bloodstream.
The results probably will change how such seizures, which can be life-threatening if they're not stopped right away, are treated by paramedics. But they could have more long-term repercussions if doctors start giving the auto-injectors to epileptic patients, some of whom have several severe seizures a year, to use at home, much as people with severe allergies carry epinephrine syringes with them.
"I don't think we're ready to hand these out at epilepsy clinics for people to take home right now," said Dr. J. Claude Hemphill, chief of neurology at San Francisco General Hospital, who led the San Francisco arm of the study. "But that may be a follow-up some folks want to do."
The U.S. Department of Defense also has taken special interest in the study, because auto-injectors would be much more convenient than IV drug treatment in a large-scale bioterrorism attack involving seizure-inducing nerve gas.
"The advantage is you can give it the auto-injection faster," said Dr. Walter Koroshetz, deputy director of the National Institute of Neurological Disorders and Stroke. "If you have 100 people simultaneously seizing, no way can you do all those IVs. But you could just run around and inject everybody for their seizures."
Seizures are caused by a disruption in the brain's electrical system, and in most cases they resolve themselves after a minute or so. Roughly 2 percent of Americans have epilepsy, a condition marked by chronic seizures.
Some seizures, known as status epilepticus or prolonged seizures, can last several minutes or longer, and they may require drugs to stop them. More than 50,000 people in the United States die from prolonged seizures every year, either from brain damage due to the seizure itself or from accidents related to passing out mid-attack.
The study, which was funded primarily by the National Institutes of Health, involved 79 hospitals nationwide, including several in the Bay Area. More than 4,000 paramedics were trained to participate in the study and 893 patients were treated.
A drug and a placebo
Every patient was given both the auto-injector shot, usually to the thigh, and an intravenous injection. But in half the cases the auto-injector was filled with a placebo, and in the other half the IV drug was a placebo. Neither patients nor paramedics knew which treatment was the placebo in any given case.
Researchers found that 73 percent of patients who were given the auto-injector drug had stopped seizing by the time they reached the emergency room; 63 percent of patients who got the IV drug were seizure-free.
Patients who were given the auto-injector drug were less likely than the IV group to be admitted to the hospital after their seizure.
"This auto-injection should be the new standard of care," said Dr. James Quinn, a professor of surgery and emergency medicine at Stanford who led the study there. "It's great when you can do a study and it's probably going to change how we do things."
Although two different drugs were used in the trial - midazolam for the auto-injector and lorazepam for the intravenous injection - researchers don't believe that the drugs made a difference in how effective the treatments were. Rather, they said, the auto-injectors are simply easier to use.
It's much simpler to give a single shot than to try to start an intravenous line on a patient who is actively convulsing, doctors and paramedics said. In the study, 42 patients did not receive the intravenous treatment because the paramedic couldn't start the IV, whereas only five patients didn't receive the auto-injector shot because the syringe malfunctioned.
"It takes time to set up an IV. You have to find a vein that's going to be good, you have to isolate the arm and hold it still, you have to clean the arm, you have to insert the needle," said Judy Klofstad, a paramedic with the San Francisco Fire Department who participated in the study. "If you're really good, it can take 2 1/2 minutes."
Paramedics took on average just 20 seconds to use the auto-injector, according to the study. "You just hold their thigh down, target it, and it can go right through their clothing, through jeans even," Klofstad said.
Doctors said that because the auto-injection drug causes heavy sedation and can lead to respiratory problems and low blood pressure, more research is needed before the syringes are handed out to patients.
But Tiffany Manning, who has epilepsy and suffers a prolonged seizure every two or three months, said she's excited about someday being able to carry around an auto-injector. Her doctor at the UCSF epilepsy clinic has prescribed an oral drug that her parents can give her when she has a seizure, but it can be time-consuming and difficult to measure out the proper dosage and make sure she swallows it, she said.
"And when I wake up I have a funny taste in my mouth," said Manning, 30. "My doctor doesn't prescribe it very often. You can overdose someone on it. ... I'd rather just have a shot in the leg."

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martes, 7 de febrero de 2012



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Vinculo mayor Riesgo de Muerte con Pildoras para Dormir

Las píldoras para dormir vinculadas a un mayor riesgo de muerte
Las pastillas para dormir comúnmente recetadas están ligadas a un riesgo cuatro veces mayor de una muerte prematura, según un estudio estadounidense publicado en la revista British Medical Journal.
Esta medicación a grandes dosis está asociada con un 35% más de riesgo de padecer cáncer en comparación con personas que no las usan, pero las razones de este vínculo todavía no son claras, señala el estudio publicado el lunes.
Los doctores dirigidos por Daniel Kripke del Centro del Sueño de la Clínica de la Familia Scripps Viterbi en La Jolla, California, estudiaron el historial médico de 10.500 adultos que viven en Pensilvania y a los que se les había recetado medicación para dormir.
Los datos fueron cotejados con los de más de 23.600 personas, comparadas por edad, salud, y origen, que no tomaba esa medicación.
El estudio se alargó durante dos años y medio y estudió las píldoras comúnmente recetadas a amplios sectores de la población para dormir, lo que incluye benzodiazepinas, no benzodiazepinas, barbitúricos y sedativos.
El número total de muertes que ocurrió durante este período fue pequeño en ambos grupos, totalizando menos de 1000 muertes.
Pero hubo una sorprendente diferencia en la mortalidad, encontraron los investigadores.
Aquellos que tomaron entre 18 y 132 dosis anuales de medicación para dormir tenían 4,6 más posibilidades de morir que el grupo de control.
Incluso aquellos que tomaron menos de 18 dosis anuales tenían 3,5 más posibilidades de morir.
"Los cálculos a grandes rasgos sugieren que en 2010 los hipnóticos (pastillas para dormir) podrían estar asociados con entre 320.000 y 507.000 excesos de muertes en Estados Unidos únicamente", afirma el estudio.
Los detalles de cómo murieron los individuos no fueron desvelados, y los autores recalcan que encontraron una relación estadística pero no una causa.
Pero hicieron sonar la alarma debido al gran número de gente que toma esta medicación.
"Estimamos que, aproximadamente, del seis al 10% de los adultos en Estados Unidos tomaron estos fármacos en 2010 y los porcentajes podrían ser mayores en algunas partes de Europa", escriben.
La media de edad de las personas del estudio fue 54 años. Los investigadores afirmaron que tomaron en cuenta factores que pudieran hacer posible la comparación entre los dos grupos, como si el individuo fumaba o tenía una problema de salud pre existente.
Sin embargo, no fueron capaces de tener en cuenta factores como depresión, ansiedad u otras cuestiones emocionales, ya que los diagnósticos se mantienen en secreto bajo la ley de Pensilvania.
Las investigaciones previas en píldoras para dormir encontraron una relación entre accidentes de coche y caídas graves, síndromes relacionados con comer por la noche, darse atracones de comida, regurgitación en el esófago y úlcera péptica.