EMS 12-Lead

MAY 15, 2024

After 13 minutes of ALS resuscitation, pulses were palpated indicating a return of spontaneous circulation. The crew transferred the patient to the ambulance and noticed weak radial pulses (BP unobtainable). Crew obtained intravascular access and intubated the patient on the second attempt, confirmed with capnography.

Epinephrine 331

Epinephrine Paramedic CPR EMT 331

American Ambulance Association

OCTOBER 30, 2023

The American Ambulance Association is proud to announce the winners of the 2023 AAA Legislative Awards. Each Member of Congress is being recognized for their strong advocacy for emergency medical services […] The post 2023 AAA Legislative Awards appeared first on American Ambulance Association.

Emergency Medical Services 130

Emergency Medical Services Ambulance ALS OR 130

The Skeptics' Guide to EM

OCTOBER 5, 2019

Date: September 25th, 2019 Reference: Bath PM et al. Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomized, sham-controlled, blinded, phase 3 trial. Date: September 25th, 2019 Reference: Bath PM et al. The Lancet March 2019. The Lancet March 2019.

Ambulance 130

Ambulance Paramedic EMS ALS 130

The Skeptics' Guide to EM

MAY 15, 2021

Reference: Fatima et al. Reference: Fatima et al. Their local EMS service arrives quickly with a conventional ambulance. He has heard about these special ambulances with CT Scanners and wonders if that will make an important difference for his partner. Reference: Fatima et al.

Emergency Medical Services 130

Emergency Medical Services Ambulance ALS EMS 130

The Skeptics' Guide to EM

FEBRUARY 11, 2023

Date: February 7, 2023 Reference: Cheskes et al. Date: February 7, 2023 Reference: Cheskes et al. He is found to be in ventricular fibrillation and receives two defibrillation attempts with an automatic external defibrillator (AED) at the clinic, and subsequently three more with a primary care ambulance crew enroute to the hospital.

Defibrillator 142

Defibrillator Medical Transportation OR CPR 142

The Skeptics' Guide to EM

MAY 2, 2020

Date: April 24th, 2020 Reference: Watanabe et al. Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? Date: April 24th, 2020 Reference: Watanabe et al. Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? Reference: Watanabe et al.

ED 100

ED Ambulance Medical Transportation EMS 100

The Skeptics' Guide to EM

FEBRUARY 17, 2018

[display_podcast] Date: February 14th, 2018 Reference: Alam N et al. Prehospital antibiotics in the ambulance for sepsis: a multicentre, open label, randomised trial. display_podcast] Date: February 14th, 2018 Reference: Alam N et al. per hour (Kumar et al). Reference: Alam N et al. The Lancet Nov 2017.

Ambulance 100

Ambulance Paramedic Emergency Medical Services ALS 100

ACEP Now

NOVEMBER 7, 2024

The pain makes it difficult for him to ambulate unassisted through his home. References Nussbaum SR, Carter MJ, Fife CE, et al. During the first visit, he was diagnosed with cellulitis and placed on cephalexin. Today, he notes worsening swelling and a blister forming near his left ankle. Value in Health.

ED 97

ED OR Emergency Department Ambulance 97

The Skeptics' Guide to EM

JUNE 4, 2017

[display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. display_podcast] Date: June 3rd, 2017 Reference: Sierink et al. Case: A 53-year-old woman in good health is brought in by ambulance after a motor vehicle collision. Reference: Sierink et al. Lancet August 2016. Lancet August 2016.

OR 130

OR ALS CPR ICU 130

The Skeptics' Guide to EM

FEBRUARY 23, 2019

Date: February 22nd, 2019 Reference: Lane et al. Date: February 22nd, 2019 Reference: Lane et al. The study by Alam et al took adult patients with a diagnosis of suspected infection and randomized them to ceftriaxone 2g IV started pre-hospital or usual care with a primary outcome of all-cause mortality at 28 days.

Paramedic 130

Paramedic ALS Ambulance EMS 130

The Skeptics' Guide to EM

JANUARY 1, 2022

Reference: Grotta JC et al. Reference: Grotta JC et al. NEJM 2021 Case: The Mayor of your community consults you as an expert in public health, EMS and as an EM physician on whether they should purchase a mobile stroke unit (MSU) ambulance. Reference: Grotta JC et al. Howie also has a Master of Public Health.

Emergency Medical Services 130

Emergency Medical Services Firefighter Paramedic ALS 130

The Skeptics' Guide to EM

JANUARY 19, 2019

Date: January 17th , 2019 Reference: Clemency et al. Date: January 17th , 2019 Reference: Clemency et al. This teaching has been challenged by a systematic review by Willman et al 2017. We reviewed the Willman et al publication on SGEM#179 and generally agreed with the authors’ conclusions. Reference: Clemency et al.

Naloxone 130

Naloxone Overdose Emergency Medical Services Emergency Department 130

Critical Care Scenarios

MARCH 27, 2024

patients demonstrating awakeness during resuscitation) with Jack Howard, Intensive Care Paramedic at Ambulance Victoria in the northern suburbs of Melbourne, Australia, and first author on a recent literature review and Delphi-derived expert guideline on CPRIC management. References * The guideline: Howard J, Grusd E, Rice D, et al.

CPR 122

CPR Paramedicine Paramedicine Ambulance 122

The Skeptics' Guide to EM

MARCH 22, 2019

You have ambulances ramping and patients queuing at triage. You have ambulances ramping and patients queuing at triage. Research by Hill et al (1) demonstrated that an ED shift can have 4,000 clicks. Date: March 20th, 2019 Guest Skeptic: Dr.Katie Walker is an emergency physician in Melbourne, Australia.

EMR 130

EMR Emergency Department Ambulance ED 130

EMDocs

JUNE 22, 2024

A 37-year-old G5P4 at 33 weeks presents to the ED after being brought in by ambulance. She had a precipitous delivery while the ambulance was pulling in. According to EMS, she was in labor at home and delivered the newborn shortly after they had loaded her into the ambulance. RR 28, SpO2 89% on 6L NC. Electronic address, p.

EMS 111

EMS Ambulance FFP ICU 111

High Performance EMS

JUNE 12, 2023

As more agencies move from exclusive ALS capabilities to tiered responses, there must also be a growing concern with ensuring the most appropriate resources are responding to each call. That ideal response might be within, say, 15 minutes. The impact of posting schemes on response capabilities cannot be overstated.

BLS 130

BLS UHU Paramedic ALS 130

Dr. Smith's ECG Blog

JUNE 17, 2024

Written by Bobby Nicholson, MD 67 year old male with history of hypertension and hyperlipidemia presented to the Emergency Department via ambulance with midsternal nonradiating chest pain and dyspnea on exertion. In fact, Kosuge et al. Stein et al. This is a paper worth reading : Marchik et al. Kosuge et al.

E-9-1-1 139

E-9-1-1 ACS Emergency Department Coronary 139

REBEL EM

SEPTEMBER 28, 2023

Paper: Van de Werf, F et al. References: Van de Werf, F et al. PMID: 37439219 Armstrong P et al. Based on this, the authors did a literature review and found that there is an increasing rate of ICH and major non-intracranial bleeding starting at ≈60 years of age. Primary PCI: 95.7% Stents Placed: Pharmaco-Invasive Treatment: 97.4%

STEMI 138

STEMI Allergic Reaction Coronary Ambulance 138

ACEP Now

JANUARY 4, 2025

Firsthand Account An ambulance bay at the LA County-USC Hospital in 1978. 2 Parked Los Angeles Fire Department rescue ambulance in 1978. References Huecker MR, Shreffler J, Platt M, et al. Nelson DAF, Nelson MA, Shank JC, et al. Click to enlarge.) Click to enlarge.) West J Emerg Med. 2022;23(3):418-423. J Fam Pract.

ED 52

ED Emergency Department Ambulance CPR 52

The Skeptics' Guide to EM

APRIL 8, 2023

This is something that has only happened once since 2006 ( Ottawa Citizen March 28, 2023 ) The study referred to in the editorial looks at the experience in Denmark with a reconfiguration of their emergency healthcare services ( Flojstrup et al 2023 ). This was not the only study to come out of the Danish reconfiguration initiative.

Emergency Department 142

Emergency Department ED Ambulance ALS 142

Core EM

JANUARY 25, 2024

This is a motor sparing block – so it will allow your patients to ambulate. link] [3] Morrison RS, Magaziner J, Gilbert M, et al. PENG Nerve Block: This block will target the pericapsular nerve group (PENG), which innervates the pelvis. These are branches of the femoral and obturator nerve. J Emerg Trauma Shock. 2012;5(1):28-32.

Epinephrine 246

Epinephrine ED Emergency Department OR 246

Pediatric EM Morsels

APRIL 28, 2023

References: Cole, rd et al. Shogan, et al. Anterior knee pain is not always Osgood Schlatter’s. The Athlete is at risk of both Osgood Schlatter’s disease as well as Tibial Tubercle Avulsion Fracture. Epidemiology, Diagnosis, and Management of Tibial Tubercle Avulsion Fractures in Adolescents.” JBJS reviews 8.4

ALS 130

ALS Ambulance OR EMS 130

The Skeptics' Guide to EM

APRIL 24, 2021

Reference: Martel et al. AEM April 2021 Case: You are sitting minding your own business charting on shift when you become aware of shouting and banging from your ambulance bay. Reference: Martel et al. Kirsty is also the creator of the wonderful infographics called #PaperinaPic.

Emergency Department 100

Emergency Department ALS Ambulance ED 100

FOAMfrat

MARCH 4, 2025

As youre loading her into the back of the ambulance, her father tells you that she was recently discharged from an inpatient facility that specializes in eating disorders for non-compliance. Hambleton, Ashlea, et al. Mokhtar, Mushira Che, et al. How much do you know about eating disorders? Journal of Eating Disorders , vol.

Ambulance 95

Ambulance ALS OR EMS 95

FOAMfrat

JUNE 3, 2024

It’s a Fall night in the middle of nowhere, you’re staffing a Paramedic Ambulance in a combination system. You show up on scene, the volunteer ambulance has beaten you on scene, as you get out of the truck and walk up towards them you see the patient being briskly whisked to their unit on a stretcher. link] Padovano, Martina, et al.

Overdose 98

Overdose Ambulance First Responder ALS 98

FOAMfrat

MAY 19, 2024

The patient’s mother accompanied me in the patient compartment of the ambulance on our 30-minute ride to the children's hospital. The patient will thank you for it; we are only human. References 1. Ostergaard E, Moller LB, Kalkanoglu-Sivri HS, et al. Parikh S, Goldstein A, Koenig MK, Scaglia F, Enns GM, Saneto R, et al.

E-9-1-1 98

E-9-1-1 ALS Emergency Department EMT 98

The Skeptics' Guide to EM

JANUARY 7, 2023

Date: January 4th, 2023 Reference: Hasbrouck et al. Date: January 4th, 2023 Reference: Hasbrouck et al. Case: A 62-year-old male with a past medical history of heart failure with reduced ejection fraction presents to your emergency department (ED) via ambulance for palpitations and shortness of breath that started earlier that day.

OR 100

OR Emergency Department ALS Ambulance 100

EMDocs

NOVEMBER 21, 2023

Could not ambulate. References: Statland JM, Fontaine B, Hanna MG, et al. Venance SL, Cannon SC, Fialho D, et al; CINCH investigators. Miller TM, Dias da Silva MR, Miller HA, et al. Fournier E, Arzel M, Sternberg D, et al. Tan SV, Matthews E, Barber M, et al. Muscle Nerve. 2018;57(4):522-530. Muscle Nerve.

E-9-1-1 95

E-9-1-1 ALS ED OR 95

EMS 12-Lead

JUNE 1, 2022

It was during this time that a sudden increase in pulse rate was noted, so another 12 Lead ECG was recorded upon docking the stretcher in the ambulance: There is now 1:1 P:QRS ratio with LBBB. Attending crews then brought the stretcher close and further assisted him to a reclined position of comfort. Hospital transport was unremarkable.

Coronary 130

Coronary ALS ED ACS 130

ACEP Now

OCTOBER 9, 2023

The other night I stood in the trauma bay, listening to rain patter against the automatic doors, awaiting an ambulance. Kaufman EJ, Richmond TS, Wiebe DJ, et al. These days, I attempt to balance a less morally injurious trauma resuscitation with the need for rapid stabilization and treatment. 2017;152(9):843.

Heart Attack 126

Heart Attack Life Support Emergency Department Ambulance 126

EMDocs

MARCH 30, 2024

Stable : mild pain, able to ambulate, no neurological deficits Potentially Unstable: mild to moderate pain, minor radicular symptoms, none to mild neurological deficits Unstable: severe pain, little to no ambulation, significant neurological deficits. Most patients will regain ambulation and contralateral motor function.

EMS 105

EMS E-9-1-1 Emergency Department Ambulance 105

Irish College of Paramedics

SEPTEMBER 26, 2018

Crewing Models: There are varying models of pre-hospital care ranging from paramedic provision of care through the mix of First Aid (Tanigawa and Tanaka 2006) Basic Life Support (BLS), immediate care, Advanced Life Support (ALS) and the many associated specialist paramedicine grades. 2000, Stiell et al. 2004, Jayaraman et al.

Emergency Medical Technician 52

Emergency Medical Technician Paramedicine Paramedicine Advanced Life Support 52

NAEMSP

OCTOBER 9, 2024

Steroids such as methylprednisolone (Solu-Medrol) and dexamethasone (Decadron) are commonly available in ALS ambulances and are appropriate for preventing or treating adrenal crisis. EMS Treatment of Adrenal Crisis Fortunately, treating adrenal insufficiency in the field aligns closely with standard care.

EMS 122

EMS Crisis Prevention Emergency Department BLS 122

High Performance EMS

DECEMBER 27, 2023

Figure 2 Sample data demonstrating ALS (green) and BLS (blue) call volume comparisons by hour-of-the-day and day-of-the-week. It is also common for ambulances to be busy longer than an hour in our post-pandemic world. The unique business hours and personal behaviors on the weekend also make these days unique from the rest of the week.

UHU 130

UHU BLS Emergency Medical Services Unit Hour 130

Don't Forget the Bubbles

NOVEMBER 8, 2023

Always consider acute appendicitis when these features are present in the context of abdominal pain. The Rovsing, Obturator and Iliopsoas signs – although potentially of use in older children and adolescents – are rarely present and often difficult to elicit in younger children. NHS Digital 2021-22; Available from: [link]. Bachur, R.G., 129 (5): p.

Emergency Department 105

Emergency Department ALS OR Ambulance 105

ACEP Now

MAY 10, 2024

Patients often seek care in the emergency department (ED) setting when flares of pain affect their ability to ambulate, climb stairs, or even stand up from sitting. In our experience, patients have been able to ambulate comfortably with no motor deficits in approximately 30 minutes. Chronic knee pain is common and debilitating.

Emergency Department 92

Emergency Department Ambulance ED OR 92

ACEP Now

JULY 7, 2024

A 40-year-old woman with a history of untreated hypertension presented by ambulance after she was thrown from an ATV at unknown speeds and then crushed by the vehicle. She was emergently transferred to a Level 1 trauma center by air ambulance, accepted by trauma surgery, and followed closely by vascular surgery. Click to enlarge.)

ALS 59

ALS Ambulance OR Critical Care 59