Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.2 (focal adhesion kinase)
 44,029 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The problems posed by terrorism to not only the emergency response community, but to national security at large can be overwhelming. Adoption of what would be considered prudent and effective business practices by implementing a disciplined and effectively structured central strategy cannot be overencouraged. The emerging strategy must take into account the existing emergency response infrastructures and build upon existing capacity in an effort to achieve greater readiness. This technique is no different than the training and issuance of radiological response equipment to emergency responders in the 1950s by the then Civil Defense Agency. The training that is offered, especially to EMS providers, needs to be institutionalized to ensure that our peers, on a regular basis, revisit curriculum content. Incorporating a training module within the existing DOT NHTSA initial and refresher EMT and paramedic educational curricula could easily achieve this goal. Implementing fiscal support to the local emergency response agencies in a sustainable manner is a must. The costs associated with training, equipping and servicing the equipment and medication stores are budget-busters. This is a threat to national security and, as such, the federal government needs to rise to the challenge of supporting the local response organizations that will meet this threat head-on during the aftermath of an attack. As previously mentioned, when the U.S. faced its last large national security threat (Soviet nuclear missiles), we witnessed the materialization of a comprehensive agenda that provided most of the attributes we desire with the contemporary problem of terrorism. There is no single solution to the problem of terrorism. In fact, it will take many individuals and functional areas to come together and stop viewing the threat as a "cash cow." The improved response capacity for acts of terrorism will have an inevitable "spillover benefit" of better trained and equipped emergency responders for everyday emergencies; which will inevitably be our "payday."
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PMID:Domestic preparedness: the grand illusion. 1138 66

The primary and fundamental responsibility of a local EMS system is to provide prehospital care to the citizens of the community. Therefore, each community must have a system in place to ensure continual, efficient prehospital care. There are a variety of levels of EMS education, which include first responder, EMT-Basic, EMT-Intermediate and EMT-Paramedic, along with other components, including the emergency medical dispatcher, other healthcare providers and specialty care centers. In order for a community to provide and ensure continual, efficient prehospital care, the components must work together in a well-planned and coordinated effort. If lifeguard personnel are expected to respond to respiratory, cardiac and spinal-injury incidents within their aquatic facilities, they must be included within this comprehensive community EMS system. Therefore, fire, rescue and other prehospital EMS agencies must coordinate their efforts and training responsibilities with the local lifeguard services in their area.
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PMID:Responding to aquatic facilities. 1145 39

The most appropriate airway device for use in EMS systems staffed by basic skilled EMTs with (EMT-Ds) or without (EMT-Bs) defibrillation capabilities is still a matter of debate. The purpose of this study was to assess the feasibility, safety and effectiveness of the Esophageal Tracheal Combitube (ETC) when used by EMT-Ds in cardiorespiratory arrest patients of all etiologies. The EMTs had automatic external defibrillator (AED) training but no prior advanced airway technique skills. The prehospital intervention was reviewed using the EMTs cardiac arrest report, the AED tape recording of the event and the assessment of the receiving emergency physician. The patients' hospital records and autopsy report were reviewed in search of complications. Eight hundred and thirty-one adult cardiac arrest patients were studied. Placement was successful in 725 (95.4%) of the 760 patients where it was attempted and ventilation was successful in 695 (91.4%). Immediate complications encountered, but not necessarily related to the use of the ETC, were; subcutaneous emphysema (18), tension pneumothorax (5), blood in the oropharynx (15), and swelling of the pharynx (three). An autopsy was done in 133 patients; no esophageal lesions or significant injury to the airway structures were observed. Our results suggest that EMT-Ds can use the ETC for control of the airway and ventilation in cardiorespiratory arrest patients safely and effectively.
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PMID:Use of the esophageal tracheal combitube by basic emergency medical technicians. 1180 52

The EMS provider often encounters the elderly patient at home, where a comprehensive medication history can be obtained. Because of the aging process, the older patient may not be able to tolerate drug therapy as well as a younger adult. When obtaining a medication history, look and ask for detailed information, including the use of dietary and herbal supplements, especially if the signs and symptoms do not match existing or known conditions. The astute EMT or paramedic may be able to recognize drug-induced illness and alert the emergency department physician. Early intervention may save the elderly patient's life.
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PMID:Geriatrics and their meds: problems and perils. 1261 47

Every EMT, paramedic, supervisor and EMS medical director must stress that our job is to treat every patient the way we'd like to be treated or the way we'd want one of our family members treated. Those charged with supervision must ensure that EMTs and paramedics receive the support and training necessary to allow adherence to the 10 objectives outlined in this article. Quality-assurance reviews, quality-improvement programs, provider comments and complaints from the public must all be used to improve the care we deliver. Prehospital care should be constantly improving the delivery of excellent, life-saving care.
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PMID:EMS Bill of Rights: what every patient deserves. 1265 78

The 8p11 myeloproliferative syndrome (EMS) is an aggressive hematological malignancy caused by the fusion of diverse partner genes to fibroblast growth factor receptor 1 (FGFR1). The partner proteins promote dimerization and ligand-independent activation of FGFR1-encoded tyrosine kinase, deregulating hemopoiesis in a manner analogous to BCR-ABL in chronic myeloid leukemia. Here, we describe the identification of a new FGFR1 fusion gene in a patient who presented with T-cell lymphoblastic lymphoma in conjunction with an acquired ins(12;8)(p11;p11p22). Initial FISH analysis and Southern blotting confirmed that FGFR1 was disrupted. Using 5'-RACE PCR, we identified part of a novel gene, FGFR1OP2, at chromosome band 12p11 that was fused to exon 9 of FGFR1.FGFR1OP2 is predicted to be translated into an evolutionarily conserved protein containing coiled-coil domains but no other recognizable motifs. The presence of the chimeric gene was confirmed by RT-PCR, genomic DNA PCR, and FISH. These data further support the central role of deregulated FGFR1 in the pathogenesis of EMS.
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PMID:Identification of a novel gene, FGFR1OP2, fused to FGFR1 in 8p11 myeloproliferative syndrome. 1503 73

As EMS professionals, you influence others every day by your actions, knowledge and the way you communicate. You lead teams in critical moments in people's lives; you make a difference. Your attitude, the manner and effect of your communication and your actions will determine whether you will influence people and become a true leader. Become a better paramedic/EMT and leader by ensuring that your influence on others is positive rather than negative. No matter who you are or your position, start today to build your team, put others first and follow your vision.
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PMID:Everyday EMS leadership. 1521 2

Prehospital analgesia can be safely provided with only three agents: fentanyl, morphine and the mixed-gas nitrous oxide/oxygen. Of these three, fentanyl is by far the best agent for general EMS analgesic therapy by paramedics. However, to initiate prehospital analgesia earlier in the EMS response time frame, EMT's should administer nitrous oxide/oxygen. This protocol can easily be added to the EMT education program or through a continuing education session. All of the other agents discussed have absolutely no role in modern prehospital care.
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PMID:Simplifying prehospital analgesia. Why certain medications should or should not be used for pain management in the field. 1602 66

This case study represented a patient with a relatively uncomplicated myocardial infarction that, after prompt prehospital care and transport, was successfully halted in the emergency department with fibrinolytic therapy. This patient was provided excellent care in the prehospital setting because the paramedic and his EMT-B partner worked together effectively as a team. Although ECG monitoring, IV therapy and medication administration are beyond the usual scope of practice of an EMTB, many EMS systems are training their EMT-Bs to assist with these important procedures and interventions. This involves preparing IV equipment and supplies, applying the cardiac monitor, and recognizing and handling the various paramedic medications. This enhanced role of the EMT-B allows the paramedic to perform a more focused and careful patient assessment. A cohesive working relationship between BLS and ALS personnel is absolutely crucial to the outcome of the patient. Although each level of prehospital provider possesses a different knowledge of pathophysiology and patient management, it is the combined contributions and efforts of each provider that will afford patients the high quality of care they deserve.
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PMID:Cardiac case study. 50-year-old male with chest pressure. 1627 74

Six national experts formed an Ambulance Safety Roundtable at the 25th Annual EMS Today Conference & Exposition in March 2007 in Baltimore to discuss safety concerns, from current poor ambulance design to methods for improving driving skills. The event--sponsored by Wheeled Coach and moderated by Rick Patrick, MS, EMT-P, a safety expert and deputy fire chief for the Estero (Fla.) Fire Rescue District--highlighted issues regarding personal and patient safety. Patrick led the discussion by noting that available data indicates an increase in the number of ambulance crashes each year. In addition to the personal toll these collisions inflict, more and more ambulance operators are being held accountable for incidents they cause. Charges of negligent homicide and costly lawsuits are becoming more common. As a result, the care and safety of prehospital providers while traveling to and from calls has become a critical issue for many emergency service providers.
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PMID:Ambulance safety first: experts convene to discuss personal & patient safety issues. 1754 26


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