GUIA DE ACTUACION EN URGENCIAS 4ta Edicion Mayo 2012

GUIA DE ACTUACION EN URGENCIAS 

4ta Edicion Mayo 2012

MANUEL JOSE VAZQUEZ LIMA / JOSE RAMON CASAL CODECIDO

Enlace para bajar Guia en formato pdf

DESASTRES AEREOS Dr. Javier Vásquez Salas, Peru

Enlace para visualizar presentación en pdf desde reeme.arizona.edu

CINEMATICA DE TRAUMA BASADA EN PHTLS-ATLS. Dr. Osvaldo Rois. Videos

CINEMATICA DEL TRAUMA 
Autor Dr. Osvaldo Rois 
Coordinador Latinoamericano de PHTLS
Presidente Fundación EMME


Enlace para bajar documento en pdf

Crearían Sangre a gran escala para transfusiones

Científicos de cuatro universidades en Escocia están trabajando en un proyecto pionero para producción a gran escala de sangre para transfusión en seres humanos.

Enlace en BBCmundo.com

CAPNIOGRAFÍA, INTUBACIÓN ENDOTRAQUEAL Y RCP 2010

CAPNIOGRAFÍA, INTUBACIÓN ENDOTRAQUEAL Y RCP 2010

• Presencia de CO2 posterior a la Intubación Endotraqueal nos indica la correcta colocación del   tubo
• PETCO2 entre 12.5-25mmhg indica que las compresiones cardíacas son correctas durante una RCP (gracias a un aumento del flujo sanguineo por la reanimación en curso).
• PETCO2 en unos 40mmhg indica regreso de circulación espontanea por tanto se pueden detener las compresiones.

 Mas Informacion en la Guia RCP 2010 adjunta en formato pdf pagina 13

Cambios de Tratamiento General Inmediato en Sindrome Coronario Agudo (Morfina y Oxigeno) AHA 2010-2015

Cambios en el tratamiento general inmediato(incluidos oxígeno y morfina)

2010 (nuevo): En ausencia de dificultad respiratoria no es necesario administrar oxígeno adicional a los pacientes si la saturación de oxihemoglobina es igual o superior al 94%. La morfina debe administrarse con precaución a los pacientes con angina inestable.

2005 (antiguo): El oxígeno se recomendaba en el caso de pacientes con edema pulmonar manifiesto o con un nivel de saturación de oxihemoglobina arterial inferior al 90%. También era razonable administrar oxígeno a todos los pacientes con SCA durante las primeras 6 horas de tratamiento. La morfina
era el analgésico elegido si el dolor no respondía a los nitratos, pero no se recomendaba en el caso de pacientes con posible hipovolemia.

Motivo: Los profesionales de los servicios de emergencia médica administran oxígeno durante la evaluación inicial de los pacientes con sospecha de SCA. Sin embargo, no hay suficiente evidencia para avalar un uso rutinario en el SCA sin complicaciones. Si el paciente presenta disnea, hipoxemia o signos evidentes de insuficiencia cardíaca, los profesionales deben ajustar la dosis del tratamiento con oxígeno para mantener una saturación de oxihemoglobina igual o superior al 94%. La morfina está indicada en el IMEST cuando las
molestias torácicas no responden a los nitratos. La morfina debe emplearse con precaución en caso de angina inestable/ IMSEST, ya que la administración de morfina se ha asociado con un aumento de la mortalidad en un amplio registro de casos.

Guia RCP 2010 de la American Heart Association

BIBLIOTECA Union de Tecnicos en Emergencias Sanitarias de Andalucia

BIBLIOTECA

Guias de RCP 2010-2015 Plan Nacional de RCP

Guia Farmacologica  EPES 2012

Manual de Procedimientos 2012 Samur -Madrid

Guia de Seguridad Clinica EPES

Consejos Sanitarios para las Principales Emergencias

Procesos Trauma EPES

Procesos Respiratorios EPES

Procesos Neurologicos EPES

Procesos Cardiologicos EPES

Protocolos de Urgencias y Emergencias en el Adulto. EPES

Los Servicios de Emergencias Medicas en España

Enlace a pagina Oficial UTESAN

PLAN OPERATIVO SEMANA SANTA 2012. Republica Dominicana

Enlace para bajar documentos del Plan Operativo Semana Santa 2012 
Centro de Operaciones de Emergencias Rep. Dominicana

PHTLS Rep. Dominicana

Homenaje Servicios Sanitarios de Emergencias de Madrid

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

 Enlace para ver el VIDEO desde RTVE

2010 AMERICAN HEART ASSOCIATION and AMERICAN RED CROSS FOR FIRST AID

Please Follow the link to download in pdf

COAST GUARD AVIATION MEDICINE MANUAL

COAST GUARD AVIATION  
MEDICINE MANUAL 

U.S. Department of
Homeland Security
 United States  
Coast Guard 

Enlace para bajar manual en pdf

Vinculo mayor Riesgo de Muerte con Pildoras para Dormir

SALUD

Las píldoras para dormir vinculadas a un mayor riesgo de muerte

AFP

Londres

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.

"Cough CPR". AHA position

The American Heart Association does not endorse "cough CPR," a coughing procedure widely publicized on the Internet. As noted in the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, “cough CPR” is not useful for unresponsive victims and should not be taught to lay rescuers.

During a sudden arrhythmia (abnormal heart rhythm), it may be possible for a conscious, responsive person to cough forcefully and repetitively to maintain enough blood flow to the brain to remain conscious for a few seconds until the arrhythmia is treated. Blood flow is maintained by increased pressure in the chest that occurs during forceful coughs. This has been mislabeled "cough CPR," although it's not a form of traditional resuscitation.

Why isn't "cough CPR" appropriate in CPR training courses? should not be taught in lay-rescuer CPR courses because it is generally not useful in the prehospital setting. In virtually all lay-rescuer CPR courses, the finding that signals an emergency is the victim's unresponsiveness. Unresponsive victims will not be able to perform "cough CPR."

Are there situations when "cough CPR" is appropriate?“Cough” CPR may be considered in settings such as the cardiac catheterization laboratory where patients are conscious and constantly monitored (for example, with an ECG machine). A nurse or physician is also present who can instruct and coach the patients to cough forcefully every one to three seconds during the initial seconds of a sudden arrhythmia. However, as this is not effective in all patients, it should not delay definitive treatment.

AHA Recommendation The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them by calling 9-1-1. If you're driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the Internet article), pull over and flag down another motorist for help or phone 9-1-1 on your mobile phone.

Link http://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/Cough-CPR_UCM_432380_Article.jsp#.TyOM1Fyn_44

Snake Bite Emergency

Coghlan`s Snake Bite Kit
A complete, compact kit for the treatment of snake bite using the constrictor/suction method. Kit includes detailed instructions, three pliable suction cups, easy to use with one hand lymph constrictor, scalpel, and antiseptic swab. Measures only 5.7cm in length, weighs only 28g.

Items in above mentioned kit are meant for cutting and sucking!! WTF!
No where in the world is it recorded to use the cut and suck method. NOT even 

for Professional Rescuers!!

It is important to remember the following when treating or responding to a snake bite invenomation!!!

Snake Bite Invenomations - Symptoms depend on the type of venom injected:

Most adder venom (such as from puffadders) is toxic to tissue (cytotoxic), especially blood vessels. It causes extreme pain, swelling of the limb and blistering. An untreated bite may cause death due to loss of blood, dehydration and secondary infection.
Mamba and cobra venom are toxic to the nervous system (neurotoxic). Symptoms include “pins and needles”, dizziness, poor co-ordination, slurred speech, excessive salivation and drooping eyelids. This is followed by difficulty in breathing.
Boomslang and vine snake venom are toxic to blood cells and the blood loses its ability to coagulate (haemotoxic). Early symptoms include headaches, nausea, diarrhoea, lethargy, mental disorientation, bruising and bleeding at the site and all body openings.

The FIRST-AID Treatment for Snake Bite Invenomations are as follows, and only as follows!!

First Aid for snakebite

DON'TS:

-Don't use antivenom except in a hospital environment. Some patients react against antivenom and may go into anaphylactic shock, a serious condition that requires emergency medical treatment. Antivenom also needs to be kept refrigerated, injected correctly (into the bloodstream, not the muscle, and not into the bite site), and given in sufficiently large quantities to be effective.

-Don't cut and suck the wound, or use suction cup devices or electric shocks
-Don't give the patient anything to eat or drink
-Don't rub potassium permanganate into the wound or soak the limb in home remedies

Don't try to catch and kill the snake


DO'S:

-Get everyone well away from the snake.
-Try to obtain a clear description of the snake. However, this isn't essential, and you shouldn't waste time looking for it. The symptoms will give the doctor a good idea of the kind of snake (neurotoxic etc.), and the severity of the bite.
-Stay calm, and reassure the person who has been bitten. Fear and anxiety cause an increase in heart rate, and thus a more rapid spread of venom throughout the body.
-For neurotoxic and haemotoxic snake bites, it may help to wrap a crepe or pressure bandage firmly around the area of the bite, covering the entire limb (from fingertip to armpit; from toe to groin). Apply hand pressure at the site of the bite until a bandage or strips of fabric can be obtained.
Keep the person as still as possible and immobilise the affected limb by binding splints (e.g. straight branches) to either side of the limb.
If a snake spits into someone's eyes, rinse with large amounts of water, preferably by holding the head under a running tap. This will also require treatment at hospital: a drop of antivenom is placed in the eye.
Observe the person closely and record any symptoms and the time taken for them to appear.
If the patient stops breathing, you will need to breathe for them until they can get expert medical help.

A complete, compact kit for the treatment of snake bites using the constrictor/suction method. Kit Contains: detailed instructions, 3 pliable suction cups, easy-to-use with one hand lymph constrictor, scalpel, and antiseptic swab.

Weight: 1 oz (28 g)

Instructions Download pdf

Related Information
Deadly Dilema: Do Snake-Bite Kits Help

Snake antivenoms in southern Africa

Many thanks 

Michel Botha from Petroria South Africa   & The Group on Facebook Remote Medical Rescue

New Google Public Alerts. For Emergency

 

Link to Google Public Alerts

1. What is Google Public Alerts?

   Google Public Alerts is Google’s new platform for disseminating emergency messages such as evacuation notices for hurricanes, and everyday alerts such as storm warnings. We’re starting by showing relevant weather, public safety and earthquake alerts from US National Oceanic and Atmospheric Administration (NOAA), the National Weather Service, and the US Geological Survey (USGS) when you search on Google Maps.
   Google Public Alerts is a project of the Google Crisis Response team, supported by Google.org, which uses Google's strengths in information and technology to build products and advocate for policies that address global challenges. We hope Google Public Alerts provides the public with information it needs to make better decisions in times of crisis.
   This is a new product and we’re learning all the time about when and how we should show this important information. While we can’t guarantee that you’ll see every alert when searching on Google Maps we’re doing our best to show what’s important when you need it, and hope that Google Public Alerts is a useful additional source of information. We’re working hard to improve what you see and appreciate your feedback which you can provide using the “Feedback” links on alert details pages and on www.google.org/publicalerts.
   

2. Why is Google building a public alerting service?

   We want to make it easy for people to find critical emergency information during a crisis through the online tools they use every day. By incorporating public alert data from authoritative sources in to Google Maps, we aim to simplify the process of searching for emergency information.
   

3. What kinds of alerts does Google Public Alerts show?

   Google Public Alerts currently shows weather, public safety and earthquake alerts from US National Oceanic and Atmospheric Administration (NOAA), the National Weather Service, and the US Geological Survey (USGS).
   

4. How does Google decide which alerts are available?

   The Google Public Alerts service uses alerts provided by our authoritative, trusted partners. What alert you see (if any) depends on what alerts are active at a given location, on their severity, and on what you search for and where. To see all alerts go to the Google Public Alerts homepage.
   

5. How does Google work with official alerting services like the National Oceanic and Atmospheric Administration (NOAA)?

   Google partners with alert providers to show relevant alerts to Google users. The US National Oceanic and Atmospheric Administration, the National Weather Service, and the US Geological Survey provide alert feeds and our goal is to enable Google users to see them when they’re relevant. We’ve also built an Alert Hub that aggregates alerts and allows others to develop ways to re-distribute them online.
   

6. I can already see weather on Google Maps or on another site. Why do I need this?

   We’re just getting started, but over time Google Public Alerts will become even more unique as a platform for disseminating many different kinds of emergency alerts, beyond just weather. We’re working hard to make this information appear across many more of Google’s services when it’s relevant.
   

7. Why don't I see any alerts when I search on Google Maps?

   What alert you see (if any) depends on what you search for and where, as well as on the severity of any alerts that might be active at a given location. To see all alerts go to the Google Public Alerts homepage.
   

8. Will you be putting Google Public Alerts on Google Web Search?

   We’re excited to have released a way to show you the alerts from various agencies on Google Maps. We hope this is just the beginning and we plan on making relevant alerts visible on other Google products in the future.
   

9. How do I report inaccurate or inappropriate content?

   Please use the send feedback link on the bottom right of our Google Public Alerts homepage or on the details page for an individual alert. Make sure to give us as much detail as you can.
   

10. The National Weather Service is great, but why don’t you have alerts from my city or state agency?

    We’re just getting started! We’re beginning with a few key partners but plan on expanding this service where there’s relevant data.
    There are a couple of things you can do to make it more likely you’ll see locally produced alerts, including contacting your local emergency management agency and asking them to follow the steps outlined below to get their data in the right format and to let us know they’d like to be included.
    

11. Why are you using the Common Alerting Protocol (CAP)?

    CAP is an international standard for publishing and sharing alerts. We need to use a common standard, otherwise we have no consistent way to automatically receive and re-use alerting information. We strongly encourage all agencies to adopt international standards like CAP for sharing public alerts, and publish them securely using open web formats like Atom and RSS.

12. I'm from a Public Safety agency and I'd love to see our alerts on Google Public Alerts. How do I make that happen?

    Google is starting with US-based alerts, then adding international content. We're being careful about the sources and quality of alerts and when we show them to our users. We are still learning the best way to do this with new sources. Contact us if you are interested in participating. You can get a head start by following these 4 steps:
    
    • Get your alerts into the Common Alerting Protocol (CAP 1.2) standard. Here are some resources we created to help you with this process. Most commercial alert publishing tools support CAP already.
    • Validate that you've set-up your feeds correctly and that your CAP is correct.
    • Subscribe your alerts to Alert Hub and check that they're working.
    • Let us know when you're ready so we can start on the next steps.

10 PAÍSES QUE MAS VISITAN NUESTRO BLOG

10 PAÍSES QUE MAS VISITAN NUESTRO BLOG México, España, Colombia, Perú, Argentina, Venezuela, Rep. Dominicana, Chile, Estados Unidos y Ecuador. Gracias por su apoyo,,, http://emssolutionsint.blogspot.com/

The Chameleon by EMSled / Bici-Camilla

Link to the official Web

Back Raft Novedad: Dispositivo de estabilización de la columna sobre la camilla de trauma

Enlace pagina oficial de BACK RAFT


Tema Relacionado: en formato pdf

Pre-Hospital Care Management of a Potential
Spinal Cord Injured Patient: A Systematic Review
of the Literature and Evidence-Based Guidelines



Publicado por
DR. RAMON REYES DIAZ, MD, DMO, EMT-T

http://emssolutionsint.blogspot.com/

Skype drtolete

facebook.com/drtolete

www.eeii.org

COLCHON DE VACIO INMOVILIZACION

Pre-Hospital Care Management of a Potential
Spinal Cord Injured Patient: A Systematic Review
of the Literature and Evidence-Based Guidelines

BOAT CREW SEAMANSHIP MANUAL

BOAT CREW SEAMANSHIP MANUAL
“Train, Maintain, Operate”
COMDTINST M16114.5C