6. Additional research is neededregarding the use of SCE in thefield, at both the ALS and BLSlevels. As research data be-come available, an evidence-based assessment should guidethe development and imple-mentation of training and edu-cation programs, the refine-ment of treatment protocols,and the methods by whichEMS systems implement the

use of SCE by providers at var-ious levels.

7. At the present time, NAEMSPdoes not support mandatedimplementation of SCE by BLSproviders through state legisla-tion or regulation.

8. There is currently no evidencedemonstrating the effective-ness of EAIs used by lay

responders on patients forwhom they were not pre-scribed.

References1. Goldhaber SZ. Administration of epi-

nephrine by emergency medical techni-cians [letter]. N Engl J Med. 2000;342:822.

2. Food Allergy Network. Emergencymedical services epinephrine policies: astate-by-state review. Fairfax, VA: FoodAllergy Network, 1999.

68 PREHOSPITAL EMERGENCY CARE JANUARY / MARCH 2002 VOLUME 6 / NUMBER 1

≡≡≡SIRENS

Side Show*

*Reprinted with permission from: Mediphors: A Literary Journalof the Health Professions, Bloomsburg, PA, Spring/Summer 1996,No. 7, p 66.

Come one, come all—See what awaits you—amazing DeathDefying Acts by Octogenariansand even Older....The barker in the white coat standsCenter-station, flipping his instrument:See the Pretzeled Womanliving on green drool,grass-snaked through her noseall the way to her gullet.And over here we have Vacant Man—Watch his chest rise and fall in perfectsyncopation with the mechanical sighs of loved ones who said “Do everything you can....”You be the judge:Thrill as poisons pummel Mr. Neoplasia—A race to the finish—see what’s eating his hairlesshapless hopeless carcass.Gasp at Grandma’s wire act, her heartstoppingspells of fatal fibrillation deftly thwarted by a thin strand threaded through amazed arteriesinto a heartsick ventricle shocked and dazzledby joules pulsed along its length.Death defying! Death denying!How long can this go on?Step right up,Don’t be the last in line.

JERALD WINAKUR, MDSan Antonio, Texas

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