ALS, Ambulance and CPR - Paramedicine Now

Transcutaneous Pacing: Part I

EMS 12-Lead

MARCH 30, 2024

The patient is re-assessed once secured in the ambulance. The paramedics begin CPR. CPR is performed with manual compressions as no mechanical CPR device is available. Two paramedics are in the rear of the ambulance managing resuscitation (another crew had arrived and provided support with a driver). Current 85mA.

CPR

CPR Paramedic Ambulance Defibrillator

Transcutaneous Pacing: Part 2

EMS 12-Lead

MAY 15, 2024

In this call, paramedics arrived on scene to find a patient apneic and pulseless with CPR in progress by first responders (AED had an unknown unshockable rhythm). Patient had an unwitnessed cardiac arrest without bystander CPR performed. The crew transferred the patient to the ambulance and noticed weak radial pulses (BP unobtainable).

Epinephrine

Epinephrine Paramedic CPR EMT

Episode 72: CPR-induced consciousness with Jack Howard

Critical Care Scenarios

MARCH 27, 2024

We discuss the phenomenon of CPR-induced consciousness (i.e. 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.

CPR

CPR Paramedicine Paramedicine Ambulance

SGEM#392: Shock Me – Double Sequential or Vector Change for OHCAs with Refractory Ventricular Fibrillation?

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 confirms pulselessness, initiates CPR, gets a colleague to call 911, and intubates the patient on the floor. Reference: Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation.

Defibrillator

Defibrillator Medical Transportation OR CPR

SGEM#181: Did You Ever Have to Make Up Your Mind, Pan Scan or Leave Other Scans Behind?

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

OR ALS CPR ICU

Cardiac Care Show – Episode 1: Mechanical CPR

ECG Medical Training

DECEMBER 4, 2016

Cardiac Care Show – Episode #1: Mechanical CPR Hello, and welcome to the Cardiac Care Show. In today’s episode I’d like to talk about mechanical CPR, which is a frequent topic of conversation in the Resuscitation group on Facebook and the #FOAMed community on Twitter. So, mechanical CPR is a no-brainer, right?

CPR

CPR E-9-1-1 Defibrillator Ambulance

Dr. Elsburgh Clarke Was Among First to Specialize in Emergency Medicine

ACEP Now

JANUARY 4, 2025

Firsthand Account An ambulance bay at the LA County-USC Hospital in 1978. ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in C booththe main trauma roomwith an ED tech administering CPR. 2 Parked Los Angeles Fire Department rescue ambulance in 1978. Nelson DAF, Nelson MA, Shank JC, et al.

ED

ED Emergency Department Ambulance CPR

STREAM-2: Half-Dose Tenecteplase vs Primary PCI in Older Patients with STEMI?

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

STEMI Allergic Reaction Coronary Ambulance

Three Ways for Emergency Medicine Docs to Practice Mindfulness

ACEP Now

AUGUST 15, 2023

Staff interrupt you while you’re in Room 3 with a patient you’ve placed on BiPAP, “We have an incoming patient with CPR in progress in five minutes,” the nurse says before adding, “Room 4’s family really wants to talk with you again.” Lu DW, et al. Chisholm CD, et al. Chisholm CD, et al. Burton A, et al.

ALS

ALS Emergency Department OR CPR

EMS vs. EMT: Clarifying Roles in Emergency Healthcare

EMT Training Station

FEBRUARY 11, 2024

It focuses on essential lifesaving skills, such as CPR (cardiopulmonary resuscitation), controlling bleeding, and managing shock. This network includes more than just ambulance services; it incorporates a range of resources such as specialized medical equipment, emergency response vehicles (ambulances, helicopters, etc.),

EMT

EMT EMT Emergency Medical Technician Emergency Medical Services

Cardiac Care Show – Episode 2: Post-Resuscitation Care

ECG Medical Training

MAY 25, 2017

This is an extremely important topic especially for EMS systems that are implementing High Performance CPR , because it is very predictable that you are going to see a lot more patients with return of pulses in the field, and if you don’t have a plan, lots of things can go wrong before arriving at the hospital.

CPR

CPR STEMI EMS Ambulance

Rookieworld: Death, Learning, (and life) in EMS

The Overrun

DECEMBER 13, 2021

We moved them onto the stretcher and brought them out to the ambulance so we could start CPR and using a BVM. We can’t start CPR on the stairs! I remember as we were bringing the patient out to the ambulance to do CPR, the family was standing in the doorway. It was the scariest thing I’ve ever seen.

EMS

EMS EMT EMT BLS

REBEL Cast Ep113: Defibrillation Strategies for Refractory Ventricular Fibrillation

REBEL EM

DECEMBER 19, 2022

REBEL Cast Ep113 – Defibrillation Strategies for Refractory Ventricular Fibrillation Click here for Direct Download of the Podcast Paper: Cheskes S, et al. In fact, 4000 paramedics in total were not only trained in the study protocol but also given a rigorous evaluation of their ability to perform CPR. N Engl J Med.

Defibrillator

Defibrillator Paramedic CPR EMS

IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

NAEMSP

JANUARY 5, 2023

Meyer MD Clinical Scenario You are dispatched to a 57-year-old male with a witnessed cardiac arrest and bystander CPR being performed. Your partner deploys the cardiac monitor and while CPR is continued you turn your attention to establishing vascular access. 1] Table from Hamam et al. 9] Figure from Clemency et al.

E-9-1-1

E-9-1-1 Advanced Life Support Epinephrine Life Support

Why should quality improvement concepts be integrated into EMS education?

NAEMSP

MARCH 13, 2023

An ALS crew arrives on scene to find a woman who is tachypneic, hypoxic, tachycardic, and hypotensive, with diffuse rales and rhonchi throughout her lung fields. Upon arrival to the ambulance, the EMT notices that the patient’s heart rate is 22 bpm. She becomes altered and severely hypoxic. Crowe RP, Jarvis JL. Elsevier; 2022:18-21.

EMS

EMS Emergency Medical Services EMT EMT

Major Trauma – Injuries by Assault

Don't Forget the Bubbles

FEBRUARY 5, 2025

Ali, a 12-year-old male, is pre-alerted by ambulance to ED. The pre-alert from the ambulance states his GCS is 12 (E3V4M5), moving all 4 limbs with an obvious large haematoma to the back of his head. David is a 15-year-old male who has been pre-alerted by the ambulance with a wound to his abdomen from an unknown weapon.