We have begun reviewing our guidelines again at our regional EMS Medical Advisory meetings and I am quite excited by early discussions. Among the issues we are looking at are:
1. Revising our seizure guidelines in light of the recent RAMPART study that showed the benefits of IM Midazolam over IV Ativan in patients in status epilepticus.
2. Revising our spinal immobilization guidelines to take into account recent and not so recent literature that suggests immobilizing a patient to a long back board in certain instances may cause more harm than benefit.
3. Revising of CHF guidelines to increase our dosages of nitroglycerine.
4. Addressing our cardiac arrest practices to emphasize working nontraumatic arrests on scene for at least 20 minutes prior to transporting in order to maximize the patient’s chances at resuscitation by limiting interruptions in quality CPR.
It is thrilling to see a group of doctors and paramedics get together, review the medical literature and make changes based on the best interests of their patients.
I will keep you all updated on the committee’s progress.