Do you know Medpack? system by IMP

 Medpack system by IMP 

Canal YOUTUBE 
https://www.youtube.com/c/RamonReyes2015

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias
https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA

“The Medpack system conceived by IMP – which I support – is going to become indispensible for all emergency services during their intervention in the field : il will meet a need which is not yet met in terms of safety and efficacity. When connected as envisaged, it will establish a link between the emergency staff and the hospital for a better treatment of patients.” – André Ulmann, M.D, Ph.d

http://www.imp-france.com/wp-content/uploads/2017/10/IMP-fiche-medpack-A4-VA.pdf

Fisiopatología del Transporte Sanitario Terrestre

Por la seguridad en el transporte sanitario. By Técnicos en Emergencias Sanitarias de la Sociedad Española de Medicina de Urgencias y Emergencias SEMES. Posters

MANUAL DE ATENCIÓN AL PARTO EN EL ÁMBITO EXTRAHOSPITALARIO. Ministerio de Sanidad, Servicios Sociales e Igualdad. España

Viajar y volar durante el embarazo. INFOGRAFIA

Facilitador de parto ODON Autorizado por la OMS. Video

DOCUMENTACIÓN ESTRATEGIA DE ATENCIÓN AL PARTO NORMAL. MINISTERIO DE SANIDAD, POLÍTICA SOCIAL E IGUALDAD

Plan de Parto y Nacimiento Consejeria de Salud JUNTA de ANDALUCIA España

Parada Cardio-Respiratoria "PCR" en Embarazadas "REANIMACION CARDIO-PULMONAR, RCP EN EMBARAZADAS 2015-2020

Posiciones de Traslado y asistencia de pacientes by SERRALCO.es

EMBARAZO, PARTO y PUERPERIO Recomendaciones para Madres y Padres. Junta de Andalucia, España

MANUAL BASICO DE OBSTETRICIA Y GINECOLOGIA Gratis PDF. Ministerio de Sanidad, Servicios Sociales e Igualdad. España

¿Qué es el parto velado "Parto Empelicado" o nacer con bolsa intacta? by NATALBEN.com

Balística de las heridas: introducción para los profesionales de la salud, del derecho, de las ciencias forenses, de las fuerzas armadas y de las fuerzas encargadas de hacer cumplir la ley http://emssolutionsint.blogspot.com/2017/04/balistica-de-las-heridas-introduccion.html

Guía para el manejo médico-quirúrgico de heridos en situación de conflicto armado by CICR http://emssolutionsint.blogspot.com/2017/09/guia-para-el-manejo-medico-quirurgico.html

CIRUGÍA DE GUERRA TRABAJAR CON RECURSOS LIMITADOS EN CONFLICTOS ARMADOS Y OTRAS SITUACIONES DE VIOLENCIA VOLUMEN 1 C. Giannou M. Baldan CICR http://emssolutionsint.blogspot.com.es/2013/01/cirugia-de-guerra-trabajar-con-recursos.html

Manual Suturas, Ligaduras, Nudos y Drenajes. Hospital Donostia, Pais Vasco. España http://emssolutionsint.blogspot.com/2017/09/manual-suturas-ligaduras-nudos-y.html

Manual CIERRE DE HERIDAS by ETHICON http://emssolutionsint.blogspot.com/2017/09/manual-cierre-de-heridas-by-ethicon.html

Manual de suturas. Menarini http://emssolutionsint.blogspot.com/2017/09/manual-de-suturas-menarini.html

Técnicas de Suturas para Enfermería ASEPEYO y 7 tipos de suturas que tienen que conocer estudiantes de medicina http://emssolutionsint.blogspot.com/2015/01/tecnicas-de-suturas-para-enfermeria.html

Cuaderno Enfermero.Cirugia Menor Heridas Suturas http://emssolutionsint.blogspot.com/2016/07/cuaderno-enfermerocirugia-menor-heridas.html

Manual Práctico de Cirugía Menor. Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http://emssolutionsint.blogspot.com/2013/09/manual-practico-de-cirugia-menor.html

Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana. Marzo 2016 http://emssolutionsint.blogspot.com/2016/09/protocolo-de-atencion-para-cirugia.html

Manual de esterilización para centros de salud. Organización Panamericana de la Salud http://emssolutionsint.blogspot.com/2016/07/manual-de-esterilizacion-para-centros.html

CURSO

Bleeding Control for the Injured Course "Stop The Bleed" / Control de Sangrados para el Herido

Curso TACMED Tactical Medicine España TECC Tactical Emergency Casualty Care

Tecnologia Alemana

6 años de Garantia

Libre de Mantenimiento 
El mas ECONOMICO
Vendemos en España y Rep. Dominicana
Hacemos entrega del Sistema Completo

eeiispain@gmail.com

“UNA VIDA NO TIENE PRECIO”

TELEFUNKEN AED DISPONIBLE EN TODA AMERICA 6 AÑOS DE GARANTIA (ECONOMICO) http://goo.gl/JIYJwk

Follow me / INVITA A TUS AMIGOS A SEGUIRNOS

Contactos:  eeiispain@gmail.com
LinkeIn https://es.linkedin.com/in/drramonreyes
Twitter: @DrtoleteMD
Instagram: https://www.instagram.com/drtolete/

¿Por qué el Desfibrilador TELEFUNKEN?

El DESFIBRILADOR de Telefunken es un DESFIBRILADOR AUTOMÁTICO sumamente avanzado y muy fácil de manejar.
Fruto de más de 10 años de desarrollo, y avalado por TELEFUNKEN, fabricante con más de 80 años de historia en la fabricación de dispositivos electrónicos.
El desfibrilador TELEFUNKEN cuenta con las más exigentes certificaciones.
Realiza automáticamente autodiagnósticos diarios y mensuales.

Incluye bolsa y accesorios.
Dispone de electrodos de "ADULTO" y "PEDIÁTRICOS".
Tiene 6 años de garantía.
Componentes kit de emergencias
Máscarilla de respiración con conexión de oxígeno.
Tijeras para cortar la ropa
Rasuradora.
Guantes desechables.

¿ Qué es una Parada Cardíaca?
Cada año solo en paises como España mueren más de 25.000 personas por muerte súbita.
La mayoría en entornos extrahospitalarios, y casi el 80-90 % ocasionadas por un trastorno eléctrico del corazón llamado"FIBRILACIÓN VENTRICULAR"

El único tratamiento efectivo en estos casos es la "Desfibrilación precoz".
"Por cada minuto de retraso en realizar la desfibrilación, las posibilidades de supervivencia disminuyen en más de un 10%".

¿ Qué es un desfibrilador ?
El desfibrilador semiautomático (DESA) es un pequeño aparato que se conecta a la víctima que supuestamente ha sufrido una parada cardíaca por medio de parches (electrodos adhesivos).

¿ Cómo funciona ?

SU FUNDAMENTO ES SENCILLO:
El DESA "Desfibrilador" analiza automáticamente el ritmo del corazón. Si identifica un ritmo de parada cardíaca tratable mediante la desfibrilación ( fibrilación ventricular), recomendará una descarga y deberá realizarse la misma pulsando un botón.

SU USO ES FÁCIL:
El desfibrilador va guiando al reanimador durante todo el proceso, por medio de mensajes de voz, realizando las órdenes paso a paso.

SU USO ES SEGURO:
Únicamente si detecta este ritmo de parada desfibrilable (FV) y (Taquicardia Ventricular sin Pulso) permite la aplicación de la descarga. (Si por ejemplo nos encontrásemos ante una víctima inconsciente que únicamente ha sufrido un desmayo, el desfibrilador no permitiría nunca aplicar una descarga).

¿Quién puede usar un desfibrilador TELEFUNKEN?
No es necesario que el reanimador sea médico, Enfermero o Tecnico en Emergencias Sanitarias para poder utilizar el desfibrilador.

Cualquier persona (no médico) que haya superado un curso de formación específico impartido por un centro homologado y acreditado estará capacitado y legalmente autorizado para utilizar el DESFIBRILADOR (En nuestro caso la certificacion es de validez mundial por seguir los protolos internacionales del ILCOR International Liaison Committee on Resuscitation. y Una institucion de prestigio internacional que avale que se han seguido los procedimientos tanto de formacion, ademas de los lineamientos del fabricante como es el caso de eeii.edu

TELEFUNKEN en Rep. Dominicana es parte de Emergency Educational Training Institute de Florida. Estados Unidos, siendo Centro de Entrenamiento Autorizado por la American Heart Association y American Safety and Health Institute (Por lo que podemos certificar ILCOR) Acreditacion con validez en todo el mundo y al mismo tiempo certificar el lugar en donde son colocados nuestros Desfibriladores como Centros Cardioprotegidos que cumplen con todos los estanderes tanto Europeos CE como de Estados Unidos y Canada

DATOS TÉCNICOS

Dimensiones: 220 x 275 x 85mm
Peso: 2,6 Kg.
Clase de equipo: IIb
ESPECIFICACIONES
Temperatura: 0° C – + 50° C (sin electrodos)
Presión: 800 – 1060 hPa
Humedad: 0% – 95%
Máximo Grado de protección contra la humedad: IP 55
Máximo grado de protección contra golpes:IEC 601-1:1988+A1:1991+A2:1995
Tiempo en espera de las baterías: 3 años (Deben de ser cambiadas para garantizar un servicio optimo del aparato a los 3 años de uso)
Tiempo en espera de los electrodos: 3 años (Recomendamos sustitucion para mantener estandares internacionales de calidad)
Número de choques: >200
Capacidad de monitorización: > 20 horas (Significa que con una sola bateria tienes 20 horas de monitorizacion continua del paciente en caso de desastre, es optimo por el tiempo que podemos permanecer en monitorizacion del paciente posterior a la reanimacion)
Tiempo análisis ECG: < 10 segundos (En menos de 10 seg. TELEFUNKEN AED, ha hecho el diagnostico y estara listo para suministrar tratamiento de forma automatica)
Ciclo análisis + preparación del shock: < 15 segundos
Botón información: Informa sobre el tiempo de uso y el número de descargas administradas durante el evento con sólo pulsar un botón
Claras señales acústicas y visuales: guía por voz y mediante señales luminosas al reanimador durante todo el proceso de reanimación.
Metrónomo: que indica la frecuencia correcta para las compresiones torácicas. con las Guias 2015-2020, esto garantiza que al seguir el ritmo pautado de compresiones que nos indica el aparato de forma acustica y visual, podremos dar RCP de ALTA calidad con un aparato extremadamente moderno, pero economico.
Normas aplicadas: EN 60601-1:2006, EN 60601-1-4:1996, EN 60601-1:2007, EN 60601-2-4:2003
Sensibilidad y precisión:
Sensibilidad > 90%, tip. 98%,
Especificidad > 95%, tip. 96%,
Asistolia umbral < ±80μV
Protocolo de reanimación: ILCOR 2015-2020
Análisis ECG: Ritmos cardiacos tratables (VF, VT rápida), Ritmos cardiacos no tratables (asistolia, NSR, etc.)
Control de impedancia: Medición9 de la impedancia continua, detección de movimiento, detección de respiración
Control de los electrodos : Calidad del contacto
Identificación de ritmo normal de marcapasos
Lenguas: Holandés, inglés, alemán, francés, español, sueco, danés, noruega, italiano, ruso, chino
Comunicación-interfaz: USB 2.0 (El mas simple y economico del mercado)
Usuarios-interfaz: Operación de tres botones (botón de encendido/apagado , botón de choque/información.
Indicación LED: para el estado del proceso de reanimación. (Para ambientes ruidosos y en caso de personas con limitaciones acusticas)
Impulso-desfibrilación: Bifásico (Bajo Nivel de Energia, pero mayor calidad que causa menos daño al musculo cardiaco), tensión controlada
Energía de choque máxima: Energía Alta 300J (impedancia de paciente 75Ω), Energía Baja 200J
(impedancia de paciente 100Ω)

Dr. RAMON REYES, MD, DMO, EMT-T 

Medical Doctor for complex and high-risk missions

eeiispain@gmail.com

+34 671 45 40 59

        

“Medicina Bona Locis Malis”

EU Medical Doctor / Spain 05 21 04184

Advanced Prehospital Trauma Life Support /Tactical Combat Casualty Care TCCC Instructor and Faculty 

ACLS EP / PALS American Heart Association and European Resucitation Council Instructor and Faculty

Member SOMA Special Operational Medical Association ID Nº 17479 

Corresponding Member Dominican College of Surgeons Book 1  Page M H10

Member Spanish Society of Emergency Medicine SEMES

Member European Society of Emengency Medicine EUSEM No. 1586

Board of International EMS Registry

DMO Diving Medical Officer- USA

Air Medical Crew Instructor DOT- USA

Tactical Medical Specialist and Protective Medicine -USA

TECC Tactical Emergency Casualty Care Faculty and Medical Director by C-TECC

My YouTube Channel 

My LinkedIn 

My Blog EMS SOLUTIONS INTERNATIONAL

https://www.eeti.training/    

Ask about TELEFUNKEN AED 

The Trip Report: Pediatric Education in EMS by EMSWORLD.com

The Trip Report: Pediatric Education in EMS by EMSWORLD.com

Grupo en TELEGRAM Sociedad Iberoamericana de Emergencias https://t.me/joinchat/FpTSAEHYjNLkNbq9204IzA

Download in PDF for free

The Trip Report: Pediatric Education in EMS

By Antonio R. Fernandez, PhD, NRP, FAHA Mar 24, 2017 

Turning Research Into Practice: Dr. Seth Brown and his coauthors recently published a manuscript examining pediatric education for EMS providers. This is a great opportunity to discuss a study design not often utilized in EMS or medical literature: the qualitative study. www.emsworld.com/12319193

REVIEWED THIS MONTH: Brown SA, Hayden TC, Randell KA, Rappaport L, Stevenson MD, Kim IK. Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study. Prehosp Disaster Med, 2017 Feb; 32(1): 20–26.

This month is dedicated to educational research. Dr. Seth Brown and his coauthors recently published a manuscript examining pediatric education for EMS providers. This is a great opportunity to discuss a study design not often utilized in EMS or medical literature: the qualitative study.

Most research published in EMS and other medical literature involves quantitative studies. Quantitative studies rely on numbers to examine statistical significance. Qualitative studies don't rely on calculations; they gather information from unstructured interviews, focus groups, diaries and other methods. The information is explained, contextualized and often grouped into categories. Qualitative studies often generate hypotheses that can be tested in future quantitative studies.

Examining Education

As we are all well aware, pediatric patients make up a very small number of 9-1-1 calls. While it's fantastic that children aren't often sick or injured enough to account for a large percentage of EMS calls, this does leave us at a disadvantage when we're asked to care for a child. Many EMS providers just don't have the field experience, which makes our initial and continuing education on pediatric care that much more important.

With that in mind, the authors of this study utilized focus groups to understand how EMS providers in Kentucky felt about deficits in EMS pediatric education. They also sought to come up with suggestions on ways to improve pediatric education and training. They worked with the state EMS system to identify focus group participants. Training officers were contacted by the study team and asked to invite potential participants from their agency.

The authors chose to have separate focus groups for EMS providers who worked in urban, suburban and rural areas. They also held separate focus groups for administrative and nonadministrative personnel. We all know there are urban and rural differences, and a paramedic might not be so open to identifying deficits (in other words, criticizing) the con ed provided by their agency with their boss in the room.

They had a total of six focus groups (one for administrators and one for field providers in each of the three community types). They limited the focus groups to a maximum of 10 participants. This was also a good idea; it can get very difficult to moderate a focus group with too many participants. The focus groups lasted a total of 90 minutes and were audio-recorded and professionally transcribed.

Now, you might be thinking a maximum of 10 participants each in six focus groups would mean the study drew conclusions from just 60 people. In fact, the total number of participants was 42. Yes, compared to most EMS literature we will review here, that is a very small number. You may remember a couple months ago we reviewed a study with over 2,000 cases. Qualitative studies don't need to rely on large numbers. Actually, they typically never have a study population that is very large. This study design allows you to get a lot of in-depth information from a small number of participants.

One really interesting part of this study was that they used a "professional moderator." This was a great way to prevent any bias the study team may have from their familiarity with EMS pediatric education from altering the opinions of the focus group participants. This often adds cost to the study.

Analyzing the Data

Now we'll discuss the most difficult part of qualitative research, data analysis. In quantitative research, when you are ready to analyze your data, what is probably the most difficult part of the study (obtaining enough data to analyze) is over. In qualitative research, you have to review every focus group meeting multiple times and read notes and transcripts to come up with consistent messages, themes and categories. Luckily this is a science, so there are tested methods and strategies to analyze qualitative data. We don't have enough space to review each of these here, but an overly simplified explanation is that the authors listened to every audio recording and read every transcript multiple times until they could identify overarching categories. They drilled down on these categories to combine ideas and thoughts that were very similar. Finally they took some steps to make sure that they all agreed on the results.

When all that work was done, they were left with four major themes for deficits in pediatric EMS education: 1) suboptimal previous pediatric training and training gaps in continuing education; 2) opportunities for improved interactions with ED staff, including case-based feedback on patient care; 3) barriers to optimal pediatric prehospital care; and 4) proposed pediatric training improvements.

Under the theme of suboptimal previous pediatric training and training gaps in continuing education, the authors found PowerPoint may be overused in pediatric education, and participants reported that educators are often not very familiar with the material or how care is provided to peds in the prehospital environment.

The theme of opportunities for improved interactions with ED staff focused largely on the desire of EMS providers to know the outcomes of the patients they cared for and the difficulty with obtaining that information from the ED.

The barriers to optimal pediatric prehospital care simply restated that EMS providers don't see children very often, and when they did the focus group participants didn't feel like they were provided enough guidance on how to care for complicated patient scenarios.

Finally, proposed pediatric training improvements included increasing the frequency of training, increasing hands-on time with pediatric patients, more shadowing and observation of pediatric emergency care providers, and increasing specific content areas of medication dose calculations and administrations, IV access, airway management and resuscitation.

From these four themes the authors came up with five hypotheses they felt could improve pediatric patient care:

• More online training may help fulfill training needs;
• Obtaining more feedback in the ED;
• Implementing a more standardized pediatric training;
• Increasing training in airway maintenance, IV access, drug calculations and medication administration;
• Targeted education on special-needs and medically fragile children.

Interestingly, the authors also stated that this study was the first to identify and publish that there are concerns regarding patient handoffs from EMS providers to ED staff. This is an unfortunate error and highlights the importance of a thorough literature review. Patient handoffs have been addressed in medical literature prior to the publication of this study. The American College of Emergency Physicians has discussed the importance of an appropriate patient handoff, and we even reviewed a paper on patient handoffs in this column last month. It is possible the authors' claim was true in 2013 when the focus groups took place, but in 2017, when this paper was published, this study is not the first to discuss the importance of patient handoffs.

Finally, the authors stated that they used a professional moderator and a professional to transcribe the meetings. Unless the group of MDs and PhDs that authored this study have had this professional training, they had to pay someone. Since they specifically state these services were used to reduce bias, it's unlikely the authors did this work. They do not list a funding source for the study. Specifying a funding source, if one was used, is extremely important to put these results into context. If this study was funded by a company that produces standardized online pediatric training, we might think differently about its conclusions. I am not suggesting the authors are trying to hide anything, but I am suggesting this information should have been included in the manuscript.

Antonio R. Fernandez, PhD, NRP, FAHA, is the research director at the EMS Performance Improvement Center and an assistant professor in the Department of Emergency Medicine at the University of North Carolina–Chapel Hill. He has been a nationally certified paramedic since 2005 and completed the EMS Research Fellowship at the National Registry of Emergency Medical Technicians.