Sharing Emergency Medical Service informations

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ERC guidelines 2005

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Depuis plus de 10 ans, les formateurs de l’Institut Européen de Formation en Santé participe à la formation des médecins et des paramédicaux à la prise en charge des Urgences. Issus des structures de secours pré-hospitalières (SAMU, Pompiers), de la médecine libérale, des structures militaires, ces experts ont travaillé ensemble sur un nouveau de concept de formation qui se veut, afin de répondre à la demande des Institutions et des Formés, simple et essentiellement pratique : l’URG’APP ou urgences appliquées. Cette formation peut s’adapter facilement à des projets institutionnels et des modules spécifiques peuvent venir compléter la formation (mise en application des protocoles, spécificités opérationnelles,…).

Un des atouts de l’Institut Européen de Formation en Santé, c’est de disposer de l’ensemble du matériel pédagogique de l’enseignement de la médecine d’Urgence et ainsi de permettre à chaque formé de réaliser l’ensemble des gestes techniques de l’Urgence (Gestes de survie, abords veineux, oxygénothérapie, monitorage…). De plus, la logistique mise en place au sein de l’Institut Européen de Formation en Santé permet de réaliser ces formations sur l’ensemble du territoire français et à l’étranger.

 Tous les acteurs de l’Urgence (secouristes, ambulanciers, infirmiers, médecin) sont rassemblés sur une même formation et travaillent dans un premier temps en ateliers spécifiques par groupe professionnel afin d’améliorer leurs compétences techniques. Chaque groupe (maximum 10 personnes) est encadré par un formateur expert. A l’issue de chaque atelier, une évaluation permet de reprendre les messages essentiels à retenir.

 A l’issue de la réalisation de ces gestes techniques, les formés réalisent ensemble des mises en situation professionnelles sur mannequins informatisés. Ces mises en situation sont animées afin de développer le concept de la réponse graduée à l’Urgence : secouriste, ambulanciers, infirmier protocolé ou non, médecin.

 C’est par le biais de ces mises en situation que chaque acteur de l’Urgence peut, à la fois appliquer un schéma opératoire simple et des gestes et attitudes réflexes, se positionner en fonction de ses compétences et de ses missions et optimiser ainsi, en équipe, la prise en charge de l’Urgence.

 Au cours de ces 4 journées de formation, l’ensemble des pathologies médicales et traumatologiques rencontrées le plus souvent dans l’Urgence sont abordés à partir des consensus des sociétés savantes européennes.

Un module spécialisé permet, sous la même forme, d’aborder sur 4 jours, les Urgences récurrentes en Obstétrique-pédiatrie, Cardiologie et traumatologie.

Les photos des formations sont disponibles sur le site www.iefsante.com

Au niveau de la reconnaissance:
IEFS fait parti de la Fédération Europeene des Ecole FEDE.
Elle a mis en place un Master Europeen des Techniques de Médecine Appliquée METMA
(programme commplet sur:  http://www.iefsante.com/index.php?page=urgapp )

Cette reconnaissance n'est pas encore validé par l'éducation nationale francaise mais en générale, les Master de la FEDE sont reconnus en France au bout de 2 à 3 ans
Elles sont donc reconnue comme une année universitaire comme un D.U.
Cela à une incidence sur le déroulement d'URGapp puisqu'il faut sanctionner par un examen : 40 Questions et QCM en 45min

URG’APP® Base : Urgences Médicales Appliquées
Maîtriser l’ensemble des gestes de survie et gestes techniques nécessaires à la prise en charge d’une Urgence
(notamment utiliser le défibrillateur en respectant le cadre législatif en vigueur)
S’approprier un schéma opératoire de prise en charge de l’Urgence
Participer, en fonction de ses compétences et des besoins, à la prise en charge d’une Urgence

URG’APP® Spécialisé : Urgences Médicales Appliquées
· Maîtriser l’ensemble des gestes techniques nécessaires à la prise en charge de l’Urgence pédiatrique et
obstétricale , de l’Urgence cardiologique et de l’Urgence traumatologique
· Appliquer les schémas opératoires et les protocoles de la prise en charge des Urgences à la prise en charge
spécifique de la parturiente et de l’enfant de moins de 8 ans, du patient cardiaque et du polytraumatisé.

URG’APP® Urgences collectives : Urgences Médicales Appliquées
· Maîtriser les principes permettant d’optimiser la prise en charge d’un afflux massif de victimes
· Participer à la mise en place d’une chaîne de secours et s’y intégrer en fonction de ses compétences
· Adapter ses pratiques professionnelles à la situation d’exception

URG’APP® Maintien des Acquis : Urgences Médicales Appliquées
§ Maintenir sa performance dans l’exécution de l’ensemble des gestes de survie et gestes techniques nécessaires à
la prise en charge d’une Urgence
§ Actualiser ses connaissances théoriques et pratiques

URG’APP® Détresses Vitales et Défibrillation semi-automatique : Urgences Médicales Appliquées
Maîtriser l’ensemble des gestes de survie et gestes techniques nécessaires à la prise en charge d’une Urgence (notamment utiliser le défibrillateur en respectant le cadre législatif en vigueur)
S’approprier un schéma opératoire de prise en charge de l’Urgence
Prendre en charge une urgence en attendant l’intervention des équipes spécialisées

URG’APP® Détresses Vitales : Urgences Médicales Appliquées
Maîtriser l’ensemble des gestes de survie et gestes techniques nécessaires à la prise en charge d’une Urgence
S’approprier un schéma opératoire de prise en charge de l’Urgence
Prendre en charge une urgence en attendant l’intervention des équipes spécialisées

URG’APP® Pédiatrie : Urgences Médicales Appliquées
Maîtriser l’ensemble des gestes de survie nécessaires à la prise en charge d’une urgence chez un enfant
S’approprier un schéma opératoire de prise en charge de l’Urgence
Prendre en charge une urgence chez un enfant en attendant l’intervention des équipes spécialisées

 

Text from Vincent Berthoz, Sylvain Wlodarczyk pour l'IEFS

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PEDIATRIC PREHOSPITAL CARE



Pediatric emergency care has traditionally been the most challenging facet of prehospital medicine.  This difficulty has often been attributed to insufficient content and depth of material by initial education programs for emergency medical services (EMS).  In various surveys students have expressed the need for additional training to better understand the anatomical, physiological, and communication challenges surrounding the treatment of children.  In response to these concerns the National Association of Emergency Medical Technicians (NAEMT) introduced Pediatric Prehospital Care (PPC) at Outlook 2000 in Reno, Nevada.
 
PPC instructs prehospital providers in the approach of sick and injured children, affords a practical understanding of respiratory, cardiovascular, medical, and traumatic emergencies, and educates about the treatment of children with special health care requirements (such as tracheal ventilation, central venous line management, and gastric feeding tube maintenance).  The program is available in one or two-day educational formats for basic and advanced life support providers.  Its goal is to expand EMS knowledge of emergent pediatric health care through hands-on instruction using case-based scenarios, thus improving patient outcomes.

http://www.naemt.org/PPC/

ADVANCED MEDICAL LIFE SUPPORT

Advanced Medical Life Support (AMLS) is a two-day (16-hour) in-depth study of medical emergencies. This course emphasizes a pragmatic approach and format, based on teaching providers what they need to know. The curriculum is designed to allow for a minimal amount of lecture and an ample amount of actual hands-on physical assessment of patients. Therefore, students must purchase a copy of the AMLS textbook, published by Brady/Prentice Hall, in advance of the course in order to adequately prepare for it. After successfully completing the course, each student will be awarded a certificate of successful completion. Because medicine is every changing, periodic revisions and updates will be required as the scientific and medical fields uncover new advanced and techniques. The certificate of completion is valid for three years.
The hands-on AMLS course gives each provider/student the ability to integrate the knowledge presented into a practical format for use in his or her current practice. This course is directed at the prehospital treatment of medical emergencies, but can be altered to encompass the initial emergency department assessment and management of the medical patient. The format and administrative policies set forth are those of the National Association of Emergency Medical Technicians (NAEMT).
The major goals of the AMLS course are to:
• Apply critical thinking skills to integrate pathophysiology with the assessment findings of a medical patient;
• Determine and differentiate between actual and potential patient problems;
• Advance the provider's ability to conduct a competent medical examination that utilizes proper diagnostic skills, critical thinking, and interventions;
• Advance the provider's ability to utilize problem-solving strategies in interventions and management alternatives; and
• Advance the provider's ability to communicate the pertinent findings and interventions to the receiving facility
http://www.naemt.org/AMLS/

PREHOSPITAL TRAUMA LIFE SUPPORT


PHTLS picks up where other educational programs leave off. The course focuses on trauma patients in the prehospital environment-how to identify, manage, and transport them with the highest level of care and give them the greatest chance of survival.
PHTLS students learn to:
• Identify the mechanism of injury
• Recognize life-threatening injuries
• Relate pathophysiology to injuries
• Assess and manage trauma patients
• Perform appropriate interventions
• And a whole lot more? The skills stations in the PHTLS course include:
• Airway Management & Venitlation
• Assessment & Management
• Rapid Extrication
• Spinal Immobilization
• Pediatric Assessment
• Pediatric Immobilization
• Evaluation Scenarios
http://www.naemt.org/PHTLS/

for french PHTLS courses go to other formation
on France formation's page

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Basic Life Support + Automatic External Defibrilator

A certified first responder is a person who has completed forty to sixty hours of training in providing care for medical emergencies. They have more skill than someone who is trained in first aid but are not emergency medical technicians.
The American Red Cross conducts a course titled "Emergency Response" that fits this definition.

Basic Trauma Life Support

Emergency Medical Technician BASIC

Basic life support (BLS) is a specific level of prehospital medical care provided by trained responders, including emergency medical technicians, in the absence of advanced medical care.
Basic Life Support consists of a number of life-saving techniques which are focused on the "ABC"s of prehospital emergency care:
• Airway: the protection and maintenance of patient airway including the use of airway adjuncts such as an oral or nasal airway
• Breathing: the actual flow of air through respiration, natural or artificial respiration, often assisted by emergency oxygen
• Circulation: the movement of blood through the beating of the heart or the emergency measure of CPR
BLS may also include considerations of patient transport such as the protection of the cervical spine and avoiding additional injuries through splinting and immobilization.
BLS generally does not include the use of drugs or invasive skills, and can be contrasted with the provision of Advanced cardiac life support (ACLS). Most lay person can master BLS skill after attending a short course. Fire fighter, police officers and lifeguards are required to be BLS certified. BLS is also immensely useful for many other professions, such as daycare providers, teachers and security personnels.
CPR provided in the field buys time for higher medical responders to arrive and provide ACLS. For this reason it is essential that any person starting CPR also obtain ACLS support by calling for help via radio using agency policies and procedures and/or using an appropriate emergency telephone number. An important advance in providing BLS is the availability of the automated external defibrillator or AED, which can be used to deliver defibrillation. This improves survival outcomes in cardiac arrest cases, sometimes dramatically.
EMT-B skills include CPR, first aid, airway management, oxygen administration, spinal immobilization, bleeding control and traction splinting

Emergency Medical Technician INTERMEDIATE

EMT-I's handle advanced airway management like Paramedics, they do not have as in-depth cardiac training and usually administer fewer medications. EMT-I skills add IV therapy, endotracheal intubation and initial cardiac drug therapy. Both EMT-I (Intermediate) and EMT-P require something similar to a residency to attain;

Emergency Medical Technician PARAMEDIC

There are great disparities from nation to nation and within the U.S. as to what training level and skills are required of Paramedics. The National Registry of Emergency Medical Technicians, a private certifying body, has attempted to set a national standard of care for Paramedics in the US, but this has not been fully accepted by all states and even many who have continue to modify slightly the practices allowed to be performed by Paramedics.
Paramedic training programs can last as little as 8 months or as long as 4 years. The national average of curriculum time is 2 years. Many universities now offer four-year degrees in emergency medical services, but as a relatively young industry, professional standards and training levels are still evolving. Regardless of educational path, the paramedic student must meet the same state requirements (course hours) to be eligible to take the certification exams as well as the National Registry exams.In addition, most locales require paramedics to attend an ongoing schedule of refresher courses in order to maintain their license and/or certification.
EMT-P skills include the use of Anti-Shock trousers, IV fluids and establishing IVs in Medical and Trauma situations, Pharmacology to administer 1:1000 Epi and EpiPen in Anaphylaxis, Nitroglycerine in Chest Pain, Activated Charcoal in Poisonings, Metered Dose Inhalers, and Nebulized Albuterol and other nebulizer medications, and finally Glucose testing and Administration of Oral and IV Dextrose to bring blood sugar up.

Paramedics are trained to evaluate and manage the acute stages of nearly all medical conditions. Special emphasis is placed on recognizing and treating potentially life- treatening conditions such as myocardial infarction (heart attack), stroke, breathing problems, overdoses, traumatic injuries, and childbirth.
Specifically, paramedics are trained in airway management, such as intubation, including pharmacologically assisted intubation and increasingly in rapid sequence induction, advanced cardiac life support, including cardiac monitoring, 12-lead electrocardiograms, synchronized cardioversion and transcutaneous (through the skin) pacing; pediatric advanced life support, intravenous cannulation, needle chest decompression, needle cricothyroidotomy, and the administration of a wide range of medications such as morphine sulfate, benzodiazepines such as lorazepam, opioids and dextrose. In addition to certification (both state and National registry), most paramedics are required to be certified in PALS (Pediatric Advanced Life Support) or PPC (Pediatric Prehospital care) or PEPP (Pediatric Emergencies for the Prehospital Provider), PHTLS (Prehospital Trauma Life Support), and ACLS (Advanced Cardiac Life Support).

 

books on

other books

 

French book from French Fire Federation who shows with many pictures and interesting texts fire vonlonteers works

with

French book from Loic Cadiou who explain how take in charge an out or in hospital emergency, but not emergencies first gest but how to manage death, murder, faith, violence, terrorism in emergency situations...a really good book.


French book from Xavier Fleurançeau, to explain what is the life of a French red cross volunteer in the emergency services that have the French red cross.


Belgium Book, dictionnary of the most common pathologies that a basic ambulanceman can thake in charge, for them to understand what's happen and why their action is important with a lot of explaining draws.

et les beaux livres, ici
and beautiful emergency books here

with

more BOOKS Here & Here

Text from & pages

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