Canadian operational and emotional prehospital readiness for a tactical violence event.

Providing prehospital care poses unique risks. Paramedics are essentially the only medical personnel who are routinely at the scene of violent episodes, and they are more likely to be assaulted than are other prehospital personnel. In addition to individual acts of violence, emergency medical services (EMS) providers now need to cope with tactical violence, defined as the deployment of extreme violence in a non-random fashion to achieve tactical or strategic goals.

Chemical, biological, radiological and nuclear preparedness training for emergency medical services provider.

Objective: We assessed the self-reported theoretical and practical preparedness training of Canadian emergency medical services (EMS) providers in chemical, biological, radiological and nuclear (CBRN) events.

Methods: We designed an online survey to address the theoretical and practical CBRN training level of prehospital providers. Emergency medical services staff in British Columbia and Ontario were invited to participate.

The development of a national emergency medical services curriculum framework for physicians in Canada.

Background: As the role of emergency medical services (EMS) continues to expand, EMS physicians and medical directors require special skills and training to keep pace with the rapidly evolving subspecialty of EMS. In Canada, subspecialty training in EMS is still relatively new, and a standard national curriculum for physician EMS training does not exist.

Objective: To develop a national EMS curriculum for emergency medicine (EM) residents and fellows and an abbreviated curriculum for non-EM trainees and community physicians.

Aminophylline in bradyasystolic cardiac arrest: a randomised placebo-controlled trial.

Background: Endogenous adenosine might cause or perpetuate bradyasystole. Our aim was to determine whether aminophylline, an adenosine antagonist, increases the rate of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest.

Methods: In a double-blind trial, we randomly assigned 971 patients older than 16 years with asystole or pulseless electrical activity at fewer than 60 beats per minute, and who were unresponsive to initial treatment with epinephrine and atropine, to receive intravenous aminophylline (250 mg, and an additional 250 mg if necessary) (n=486) or placebo (n=485).

Tissue plasminogen activator in cardiac arrest with pulseless electrical activity.

Background: Coronary thrombosis and pulmonary thromboembolism are common causes of cardiac arrest. We assessed whether the administration of tissue plasminogen activator (t-PA) during cardiopulmonary resuscitation would benefit patients with cardiac arrest and pulseless electrical activity of unknown or presumed cardiovascular cause.

Methods: Patients who were older than 16 years of age and who had more than one minute of pulseless electrical activity that was unresponsive to initial therapy outside the hospital or in the emergency department were eligible.