The Skeptics' Guide to EM

JANUARY 9, 2021

Date: January 5th, 2021 Reference: Grunau et al. JAMA 2020 Guest Skeptic: Mike Carter is a former paramedic and current PA practicing in pulmonary and critical care as well as an adjunct professor of emergency medical services […] The post SGEM#314: OHCA – Should you Take ‘em on the Run Baby if you Don’t get ROSC?

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EMS Emergency Medical Services CPR Critical Care 130

The Skeptics' Guide to EM

JANUARY 15, 2022

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial. Intensive Care Med 2021 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a professor of Emergency Medical Services at Tacoma Community College’s paramedic program. Reference: Matchett, G.

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Emergency Medical Services Firefighter Critical Care Paramedic 109

The Skeptics' Guide to EM

AUGUST 14, 2021

Date: August 12th, 2021 Reference: Daya et al. Circulation 2020 Guest Skeptic: Missy Carter is a PA practicing in emergency medicine in the Seattle area and an adjunct faculty member with the Tacoma Community College paramedic program. Date: August 12th, 2021 Reference: Daya et al. Reference: Daya et al.

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The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Date: September 8th, 2021 Reference: Desch et al. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. first appeared on The Skeptics Guide to Emergency Medicine. Date: September 8th, 2021 Reference: Desch et al.

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EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

FEBRUARY 17, 2018

[display_podcast] Date: February 14th, 2018 Reference: Alam N et al. Guest Skeptics: Jay Loosley is the Superintendent of Education at Middlesex-London Paramedic Service. Jenn Doyle is a paramedic educator at Middlesex-London Paramedic Service. first appeared on The Skeptics Guide to Emergency Medicine.

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Paramedic Ambulance Emergency Medical Services ALS 100

The Skeptics' Guide to EM

JANUARY 8, 2022

Date: December 28th, 2021 Reference: Kulvatunyou et al. Guest Skeptic: Dr. Chris Root is a second-year resident physician in the Department of Emergency Medicine at the University […] The post SGEM#355: Bigger Isn’t Better When It Comes to Chest Tubes first appeared on The Skeptics Guide to Emergency Medicine.

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ALS Emergency Department Paramedic OR 130

The Skeptics' Guide to EM

JULY 9, 2022

Great emergency care takes a team from the prehospital setting, emergency department, inpatient and outpatient all working together. That is why we have had paramedics, nurses, physiotherapists, pharmacists and a wide spectrum of physician specialists on the SGEM. What are your thoughts on this commissioned report?

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ALS Emergency Department Paramedic EMS 130

The Skeptics' Guide to EM

DECEMBER 25, 2021

” Reference: Vallentin et al. The paramedics performed high-quality CPR and follow their ACLS protocol. The patient is transported to the emergency department with vital signs absent (VSA). Reference: Vallentin et al. Bystander CPR is being performed. The monitor is hooked up.

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Epinephrine CPR ALS Emergency Department 130

NAEMSP

OCTOBER 9, 2024

In the emergency department, a lack of awareness about Addison’s disease led to delayed steroid administration. The secondary paramedic stated “My mom has this, she needs to take that medicine”, preventing a full-blown crisis. In the emergency department, the patient was evaluated and safely discharged.

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EMS Crisis Prevention Emergency Department BLS 122

The Skeptics' Guide to EM

JANUARY 25, 2020

Date: January 9th, 2020 Reference: Casey et al. NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. Date: January 9th, 2020 Reference: Casey et al. Case: A 60-year-old male is in your emergency department with sepsis from pneumonia.

EMS 100

EMS Critical Care Paramedic ALS 100

EMS 12-Lead

APRIL 14, 2022

Madden, Paramedic. An interesting comment provided by Paramedic Madden is that a few team members initially interpreted the T wave presentation as hyperkalemia, as opposed to occlusive hyperacuity. Let's revisit the deWinter occlusion provided by Paramedic Madden. link] [1] Zachary et al. Many thanks for sharing!

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ACS Paramedic Coronary ALS 130

The Skeptics' Guide to EM

JUNE 18, 2022

Date: June 18th, 2022 Reference: Crombie et al. The Lancet Haematology 2022 Guest Skeptic: Dr. Casey Parker is a Rural Generalist that includes in his practice emergency medicine, anaesthesia and critical care. first appeared on The Skeptics Guide to Emergency Medicine. Date: June 18th, 2022 Reference: Crombie et al.

Plasma 100

Plasma Critical Care Paramedic ALS 100

The Skeptics' Guide to EM

DECEMBER 16, 2017

[display_podcast] Date: November 27th, 2017 Reference: Legriel et al. NEJM Dec 2016 Guest Skeptic: Dr. Neal Little is an Emergency Physician who works at Chelsea Hospital in Chelsea, Michigan. He is also a Faculty member of the Emergency Medicine and Acute Care Series 1986 to present. Reference: Legriel et al.

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ALS ICU Emergency Department Paramedic 100

The Skeptics' Guide to EM

FEBRUARY 6, 2021

It is a German emergency medicine and intensive care podcast. Their mission is to share knowledge with paramedics, nurses, medical student and also young doctors as they take their first steps in the field of emergency medicine. Reference: Ruberto et al. Reference: Ruberto et al. Annals of EM 2020.

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ALS Emergency Department Paramedic OR 100

ACEP Now

JANUARY 5, 2025

The PREOXI trial compared oxygen mask pre-oxygenation versus noninvasive positive-pressure ventilation (NIPPV) in patients requiring intubation in emergency departments (EDs) and intensive care units. Two trials were published together on this topic, PARAMEDIC-3 and IVIO. References Gibbs KW, Semler MW, Driver BE, et al.

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ALS E-9-1-1 ED Emergency Department 40

EMDocs

SEPTEMBER 25, 2023

Medications: FI has a long history of use in the prehospital world, as many agencies were/are reluctant to provide paralytics to paramedics. References: Heffner AC et al. Incidence and factors associated with cardiac arrest complicating emergency airway management. PMID: 23911630 Kim WY et al. Int J Emerg Med.

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ED Emergency Department ALS Paramedic 92

ACEP Now

OCTOBER 9, 2023

The doors slid open and above the rain I heard a woman yelling repeatedly in mixed English and Dari, “No, I do not consent,” while paramedics relayed their concern for a spinal injury after she fell down concrete steps. Dr. Lebold is an emergency medicine resident and physician scientist at Stanford University in Stanford, Calif.,

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Heart Attack Life Support Emergency Department Ambulance 126

ACEP Now

JUNE 6, 2023

When considering an optimized environment for compassionate patient communication, the chaotic emergency department (ED) probably gives some clinicians pause. 9) Tell Me More, or What Else, Statements Admittedly, this proficiency can be difficult in the busy emergency department. Visser M, et al. J Grad Med Educ.

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Emergency Department ED OR Paramedic 98

Broome Docs

DECEMBER 22, 2024

PARAMEDIC 3 randomized 6,000 (but they were supposed to get to 15,000) patients with out of hospital arrest from multiple EMS agencies in the UK to either an IO or IV to start. Piroxicam and paracetamol in the prevention of early recurrent pain and emergency department readmission after renal colic: Randomized placebo-controlled trial.

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E-9-1-1 ACS Paramedic Emergency Department 52

Dr. Smith's ECG Blog

NOVEMBER 30, 2022

This case was provided by Spencer Schwartz, an outstanding paramedic at Hennepin EMS who is on Hennepin EMS's specialized "P3" team, a team that receives extra training in advanced procedures such as RSI, thoracostomy, vasopressors, and prehospital ultrasound. Reference on Troponins: Xenogiannis I, Vemmou E, Nikolakopoulos I, et al.

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Emergency Department E-9-1-1 Coronary STEMI 52

Dr. Smith's ECG Blog

APRIL 18, 2024

Written by Jesse McLaren A 70 year old with prior MIs and stents to LAD and RCA presented to the emergency department with 2 weeks of increasing exertional chest pain radiating to the left arm, associated with nausea. Paramedics provided another 3 sprays of nitro, and 6mg of morphine, which reduced but did not resolve the pain.

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STEMI Coronary ALS CAD 121

EMS 12-Lead

MAY 20, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review and commentary by Dr. Steve Smith [link] @SmithECGblog It is early-summer, approximately 1330 hours, no cloud cover overhead, and 86 degrees with high humidity. A 59 y/o Female calls 911 for crushing chest discomfort and difficulty breathing.

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Coronary STEMI ED Firefighter 130

NAEMSP

FEBRUARY 1, 2023

“Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” ” Prehospital Emergency Care 23.3 43 patients (5.4%) had repeat access to prehospital or emergency department care. ” Prehospital Emergency Care 22.6

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OR Emergency Department Emergency Medical Services Paramedic 52

Don't Forget the Bubbles

JUNE 30, 2023

You ask your anaesthetist to get ready to sedate or intubate depending on their status – Significant risk to the department – you make sure security is aware And your patient arrives. Interim results presented earlier this year show that REBOA performed within the Emergency Department increased mortality. Emerg Med J.

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E-9-1-1 FFP Plasma Emergency Department 139

ECG Medical Training

JUNE 11, 2016

Paramedics attempt a postural modification to the Valsalva maneuver as described in the REVERT Trial. The patient briefly considered refusing transport to the Emergency Department. However, this was a beyond the comfort level of the treating paramedics, especially since the patient continued to feel breathless.

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Paramedic Defibrillator ALS Emergency Department 52

Irish College of Paramedics

SEPTEMBER 26, 2018

Whilst we respect the opinion of other professions we feel it is important to provide an Irish perspective on behalf of members of the Irish College of Paramedics - Emergency Medical Technicians (EMTs) Paramedics, and Advanced Paramedics (APs). 2000, Stiell et al. 2004, Jayaraman et al.

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Emergency Medical Technician Paramedicine Paramedicine Advanced Life Support 52

Dr. Smith's ECG Blog

MAY 23, 2023

But the paramedic and the ED physician in this case did not subscribe to this idea. It is far too premature to say that paramedics and physicians should not be bothered to interpret ECGs labelled as "normal" or "otherwise normal" by the computer algorithm. Am J Emerg Med. 2022 Jan;51:384-387. doi: 10.1016/j.ajem.2021.11.023.

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STEMI Coronary Paramedic OR 98

ACEP Now

DECEMBER 10, 2023

A middle-aged male with squamous cell carcinoma and extensive metastases is brought to the emergency department (ED) after being found unresponsive following a believed suicide attempt (SA) by methadone ingestion. Though paramedics administered naloxone, he remained somnolent. References Nowland R, Steeg S, Quinlivan L, et al.

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Naloxone Life Support Paramedic ALS 52

FOAMfrat

DECEMBER 28, 2023

Ok, here we go… Lots of controversy over the recent article titled, “Comparing Intubation Success Between Flight Nurses and Flight Paramedics in Helicopter Emergency Medical Services”, published by the Air Medical Journal in their November/December 2023 issue. Recently, I became a Paramedic Instructor for my local college in January.

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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. Within the United States, due to paramedic shortages, this dual-medic setup does not exist in many EMS systems. N Engl J Med.

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Defibrillator Paramedic CPR EMS 52

NCOAE

AUGUST 12, 2022

Here, we present them in alphabetical order: ABC – Airway, Breathing and Circulation – “This is the Golden Rule of emergency medical professionals” AED – Automated External Defibrillator – The device that delivers electric shock to the heart of patients experiencing sudden cardiac arrest A-EMT – Advanced EMT ALS – Advanced Life Support Anaphylaxis— (..)

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EMS EMT EMT Emergency Medical Technician 52

FOAMfrat

AUGUST 15, 2024

Here is the case: You are dispatched to a private residence (Paramedic/EMT crew configuration) for a female patient who gave birth at home and is now hemorrhaging. When I reflect on my EMT education (14 years ago) and my paramedic education (10 years ago), I genuinely don’t remember learning about postpartum hemorrhage (PPH).

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Plasma Ambulance ALS Emergency Department 69

The Overrun

NOVEMBER 28, 2022

Whether it be at a college party or in the nursing home at 3 AM, managing an acute psychosis patient is something EMTs and Paramedics encounter with frequency during their tenure. Sources Perälä J, Suvisaari J, Saarni SI, et al. 2 Olfson M, Lewis-Fernández R, Weissman MM, et al. Emerg Med Clin North Am, vol. 7 Barbic, D.,

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EMT EMT Emergency Department Paramedic 52

Don't Forget the Bubbles

JULY 26, 2023

Prioritise listening to the first 30 minutes which given a good overview of aetiology and treatment (53 mins) Basics of cardiac rhythm problems in the ED Palpitations are a common reason for children to present to the emergency department, the majority of these will be benign from a cardiac perspective and instead related to stress or anxiety.

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ALS ED OR CPR 98

EMDocs

APRIL 22, 2024

4 In an emergency department (ED) presentation of cardiac arrest, the diagnosis of PE is challenging without the use of CT angiography. Point-of-Care-Ultrasound (POCUS) is a bedside modality that can assist Emergency Physicians (EPs) in differentiating PE from other causes of cardiac arrest. 10,11 Vid 1. TAPSE motion normal.

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Dr. Smith's ECG Blog

OCTOBER 3, 2018

This was shown to me by a very astute Hennepin paramedic. Although this comes from a Hennepin paramedic, the patient was not brought to Hennepin County Medical Center. It is important for cardiologists to realize that a paramedic may see something they do not. Khan AR, Golwala H, Tripathi A, et al. of this post.

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Coronary STEMI Paramedic ALS 52

ACEP Now

JULY 7, 2023

Carvey (@MATTCARVEY123) is a second-year resident through the MetroHealth and Cleveland Clinic Foundation emergency medicine residency program in Cleveland, Ohio. References Prekker ME, et al. The process of prehospital airway management: challenges and solutions during paramedic endotracheal intubation. Acad Emerg Med.

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Emergency Medical Services ALS EMS OR 45