PHOENIX, Ariz. (Ivanhoe Newswire) — The excellence in pre-hospital injury care, or “EPIC” project turned traumatic brain injury training upside down for paramedics and EMT’s in Arizona. Now, 11,000 of them use the simple procedure, which has doubled survival rates, according to a study report out in May.
“I thought my son was dead, just based on the impact. I thought, there’s no way that he could have survived because the whole back end was crushed up to our backs,” said Arizona paramedic Alexandria Matthews.
But Matthews had her “EPIC” training the week before and turned from mom to first responder.
“By not allowing my son to be hypoxic as soon as he was in my arms, I started breathing for him, I think plays a huge factor in how he is today and that he doesn’t have the deficits that he probably would,” said Matthews.
“EPIC” is the first major pre-hospital intervention project for TBI and it shows that early treatment is critical.
Daniel Spaite, MD, Endowed Research Professor of Emergency Medicine, College of Medicine-Phoenix at The University of Arizona said, “To have survival not just change by ten percent, but by 100 percent increase in survival is really remarkable.”
The protocol prevents the three h’s: hypoxia, hypotension or low fluid, and hyperventilation.
That’s the opposite from what’s been taught for decades.
Dr. Spaite said, “The reason it dropped intercranial pressure is unfortunately, it causes constriction in the arteries, so you don’t get good flow to the brain when you hyperventilate.”
Paramedic Sean Culliney has trained thousands of EMT’s and paramedics.
“When the patient would talk to the surgeon, and the surgeon said this all happened before you got here, this happened pre-hospital, that’s when our guys really started to grab hold of it,” Culliney said.
Alexandria Matthews believes: “My little boy, I get to go home to him every single day, so I want to give people the opportunity to do that as well.”
The EPIC study was funded with a 3.6 million dollar NIH grant. Dr. Spaite says many EMS systems in other states are implementing the protocol, which is available online. He’s even getting calls from Europe and Australia. You can find more information at www.arizona.edu
Contributors to this news report include: Wendy Chioji, Field Producer; Bruce Maniscalco, Videographer; Cyndy McGrath, Supervising Producer; Ken Ashe, Editor.
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TOPIC: MOM’S EPIC TRAINING SAVES HER SON’S LIFE
REPORT: MB #4632
BACKGROUND: Traumatic brain injury or TBI is most often caused due to a blow or jolt to the head or body. Anything that penetrates the brain tissue, such as a bullet or shattered piece of skull can also cause TBI. A mild TBI may only affect cells in the brain temporarily, making it easier to recover, but a severe TBI can result in bruising, torn tissues, bleeding and other physical damage to the brain which can result in long-term complications or death. Everyone is at risk for TBI.
Symptoms: Symptoms of a mild TBI include loss of consciousness for a few seconds, no loss of consciousness but a state of being dazed, headache, vomiting, fatigue, problems with speech, trouble sleeping, sleeping more often, and dizziness. Moderate to severe TBI symptoms include loss of consciousness for minutes or hours, persistent headache, repeated vomiting, seizures, dilation of pupils, fluids draining from nose or ears, not being able to wake up, numbness in fingers and toes, and loss of coordination. Both TBI’s also have other sensory and cognitive symptoms.
EPIC: Daniel Spaite, MD, Endowed Research Professor of Emergency Medicine, College of Medicine-Phoenix at The University of Arizona explains a new program called EPIC, “About 15 years ago, most EMS systems used “hyperventilation” (ventilating the patient who has had a tube put in their windpipe, too fast and too deeply) to treat severe TBI. However, recent evidence made it appear that hyperventilation is actually detrimental to the brain and the TBI Guidelines (which EPIC implemented statewide in Arizona) recommend NOT hyperventilating but ventilating the patient at a normal rate. Also, there is evidence that limited IV fluid volume given to trauma patients may improve their outcome. However, this is not true in trauma patients who have brain injury. This is another “reversal” of what EMS has been hearing about what to do in trauma.” said Dr. Spaite. He adds that the results of the program have been remarkable, saying, “In patients with severe traumatic brain injury, it doubled survival in the entire state of Arizona and the severe group among all of the patients is over three-quarters of the patients.”
(Source: Daniel Spaite, MD)
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