Nadine R Levick | PubMed Health

PubMed2005

A rapid noninvasive method of detecting elevated intracranial pressure using bedside ocular ultrasound: application to 3 cases of head trauma in the pediatric emergency department.

Managing pediatric head trauma with elevated intracranial pressure in the acute setting can be challenging. Bedside ocular ultrasound for measuring optic nerve sheath diameters has been recently proposed as a portable noninvasive method to rapidly detect increased intracranial pressure in emergency department patients with head trauma. Prior study data agree that the upper limit of normal optic nerve sheath diameters is 5.0 mm in adults, 4.5 mm in children aged 1 to 15, and 4.0 mm in infants up to 1 year of age. We report the application of this technique to 3 cases of head trauma in the pediatric emergency department.

Child↗

PubMed2005

An optimal solution for enhancing ambulance safety: implementing a driver performance feedback and monitoring device in ground emergency medical service vehicles.

A prospective study was conducted to determine if emergency vehicle driver risk behavior could be improved with an onboard computer-monitoring device, with real time auditory feedback. Data were collected over 18 months from 36 vehicles in a metropolitan EMS group, with >250 drivers. In >1.9 million recorded miles, performance improved from a baseline low of 0.018 miles between penalty counts to a high of 15.8 miles between counts. Seatbelt violations dropped from 13,500 to 4. There was a 20% saving in vehicle maintenance costs within 6 months. This technology demonstrated sustained cost savings in regards to vehicle maintenance as well as minimal retraining of drivers.

Ambulances↗

PubMed2002

Occupational fatalities in emergency medical services: a hidden crisis.

STUDY OBJECTIVE: We estimate the occupational fatality rate among emergency medical services (EMS) personnel in the United States. METHODS: We undertook descriptive epidemiology of occupational fatalities among EMS providers. Analysis was conducted by using data from 3 independent fatality databases: the Census of Fatal Occupational Injuries (1992 to 1997), the National EMS Memorial Service (1992 to 1997), and the National Highway Traffic Safety Administration's Fatality Analysis Reporting System (1994 to 1997). These rates were compared with the occupational fatality rates of police and firefighters and with the rate of all employed persons in the United States. RESULTS: The Census of Fatal Occupational Injuries database documented 91 EMS provider occupational fatalities. The National EMS Memorial Service database contained 70 fatalities, and the Fatality Analysis Reporting System identified 8 ground-transportation EMS occupational fatalities. There was also wide variation in fatality counts by cause of injury. Using the highest cause-specific count from each of the databases, we estimate that there were at least 67 ground transportation-related fatalities, 19 air ambulance crash fatalities, 13 deaths resulting from cardiovascular incidents, 10 homicides, and 5 other causes, resulting in 114 EMS worker fatalities during these 6 years. We estimated a rate of 12.7 fatalities per 100,000 EMS workers annually, which compares with 14.2 for police, 16.5 for firefighters, and a national average of 5.0 during the same time period. CONCLUSION: This study identifies an occupational fatality rate for EMS workers that exceeds that of the general population and is comparable with that of other emergency public service workers.

Accidents, Occupational↗