EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.
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VOL. 41 | ISSUE 2 COVER REPORT 44 Understand the Trauma Triad of Death Know its components to help protect patients By Paul Murphy, MSHA, MA, Chris Colwell, MD, & Gilbert Pineda, MD, FACEP CE ARTICLE 36 Managing Unstable Musculoskeletal Injuries By Kevin T. Collopy, BA, FP-C, CCEMT-P, NREMT-P, WEMT, Sean Kivlehan, MD, MPH, & Scott R. Snyder, BS, NREMT-P Sponsored by COLUMNS 18 CASE REVIEW When It Rains, It Pours By James J. Augustine, MD, FACEP 20 BEYOND THE BOOKS If You Aren't Reading, You're Rusting! By Mike Smith, BS, MICP 21 EMS RERUNS Small Talk By Thom Dick FEATURES 26 How to Develop Tactical EMS Protocols Paramedics operating in this unique prehospital specialty face many challenges that cannot be resolved through the application of standard prehospital protocols By Elliot D. Carhart, MHS, RRT, EMT-P, EMT-T 32 Information Technology Resource Guide Nontraditional Marriage: How to Write Electronic Reports by Hand High-Tech Training Preps Agency Improving the Information Flow Electronic Records: 21st Century EMS By John Erich, Jason Busch & James Careless 26 John Erich EMS World® 36 Fran Milner, www.franimation.com 22 SKILLS STATION Concussion Management By Doug Edenburn, NREMT-P 24 LEADERSHIP BEST PRACTICES Learning from History By Troy M. Hagen, MBA, EMT-P 58 LIFE SUPPORT Coach Class By Mike Rubin, BS, NREMT-P DEPARTMENTS 8 EMS World Online 10 From the Editor 12 Letters 14 News Network 52 Product Showcase 55 Classifi ed Ads 57 Advertiser Index About the cover: On December 18, 2011, units from CAL FIRE, the North County Fire Protection District and the Pala Fire Department responded to a vehicle accident over the side of Highway 76 just east of Fallbrook, CA. Upon arrival it was determined the vehicle went approximately 25 feet over the side landing on its roof with three people trapped inside. The incident required the utilization of stabilizing struts, extrication equipment and rope rescue equipment. All three patients were tranported to local trauma centers with moderate injuries. ISSN 1946-9365 (print) and ISSN 1946-4967 (online) is published monthly by Cygnus Business Media, 1233 Janesville Ave., Fort Atkinson, WI 53538. For subscription information or change of address call: 877/382-9187 or 847/559-7598 or fax: 800/543-5055. The publisher reserves the right to reject nonqualified subscribers. One-year subscriptions for nonqualified individuals: U.S. $45; Canada and Mexico $65; all other countries $90. Payable in U.S. funds drawn on a U.S. bank. EMS World is published monthly. POSTMASTER: Please send change of address to EMS World, P.O. 3257, Northbrook, IL 60065-3257. Canada Post PM40612608. Return undeliverable Canadian Addresses to: EMS World, PO Box 25542, London, ON N6C 6B2. Printed in U.S.A. GST #131910168. CHANGE OF ADDRESS notices should be sent promptly. Provide old mailing label as well as new address; please include ZIP code. Allow 2 months for change to take effect. PUBLICATION OFFICES: Address all communications to EMS World, P.O. Box 7248, Mission Hills, CA 91346-7248. Telephone: 800/547-7377. Internet: EMSWorld.com. The views and opinions in the articles herein are not to be taken as official expressions of the publishers, unless so stated. The publishers do not warrant, either expressly or by implication, the factual accuracy of the articles herein, nor do they so warrant any views or opinions offered by the authors of said articles. © Copyright 2012 by Cygnus Business Media. All rights reserved. No part of this publication may be reproduced in any form or by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from EMS World. Periodicals postage paid at Fort Atkinson, WI, and additional mailing offices. EMSWORLD.com | FEBRUARY 2012 7 TABLE OF CONTENTS Photo by Dan Limmer