This Week in EMS: A Recap for September 29 - October 5, 2007

Three fictional "dirty bombs" will go off this month in Portland, Oregon; Phoenix, Arizona; and Guam, during the fourth installment of the nation's largest terrorism preparation exercise.

The fourth Top Officials exercise - dubbed TOPOFF 4 - will take place during the week of Oct. 15. The program costs about $25 million a year and involves top officials at every level of government. Congress has required the exercise since 2000.

However, even as the latest drill begins, details from the previous exercise held in 2005 have yet to be publicly released. This information is supposed to help officials prepare for the next drill, and the next real attack. According to a brief summary of the 2005 exercise - marked For Official Use Only, but obtained by the Associated Press - problems arose when officials realized the federal government's law for providing assistance does not cover biological incidents.

A 2006 White House report on Hurricane Katrina criticized the DHS for not having a system to address and fix the problems discovered in the TOPOFF exercises.

To read the full article and to link to the Department of Homeland Security's TOPOFF 4 page, visit Nation's Biggest Terrorism Exercise Readied.

In a major new North American study of nearly 15,000 emergency patients, researchers will examine the benefits of defibrillating cardiac arrest victims within 30 seconds of their collapse, versus first performing three minutes of CPR before the shock.

The study will involve the co-operation and extra training of about 36,000 emergency medical service workers.

"Most of us who do this kind of research are very excited, because (we'll be able to) answer questions we could never answer before," says Dr. Paul Dorian, a cardiologist at St. Mike's Hospital in Ontario, Canada, and one of the hospital's key investigators for the study.

The study is expected to wrap up next year and is being funded by the Canadian Institutes of Health Research and the U.S. National Institutes of Health, along with other foundations in both countries.

Read more about the study in the article, Should Rescuers Give CPR Before Defib?

The practice of rapid sequence intubation by paramedics, which has been questioned periodically by some communities and emergency medical service authorities, is now at issue in Colorado Springs, Colorado.

The procedure came into the spotlight when the state began investigating its use on a patient treated this summer by American Medical Response paramedics in El Paso County.

In a related article, it was reported that state medical officials will not take disciplinary action against the paramedic accused of misusing the procedure. The paramedic reportedly went against doctors' orders in electing to intubate a patient. The attempt was unsuccessful until an anesthesiologist entered the room and took over the procedure.

"This patient suffered significant damage from prolonged hypoxia," wrote Marilyn Gifford, head of emergency medicine at Memorial Health System. "I think this is the most clear cut case of paramedics out of control I have heard of."

To read more visit the following articles:

• Colorado Springs Debates Paramedic Use of RSI
• Colorado Medic Won't Be Disciplined for Unauthorized RSI

Clark County, Nevada fire department officials have replaced their entire stock of narcotics after a department firefighter/paramedic was arrested for allegedly burglarizing fire stations and ambulances to steal drugs.

Officials were concerned that firefighter/paramedic Samuel Bond might have tampered with vials of medicine and refilled them with some other substance. Although he is accused of targeting AMR and Medic West ambulances as well, neither company plans to change out their drugs, as he had little to no access to them.