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Defining Appropriate Responses in a Tiered System

High Performance EMS

Some computer-aided dispatch (CAD) software did better than others by considering the average travel time of an actual route instead of allowing nearness to be determined by a straight-line distance. If available, the supervisor is added to effectively create an ALS transport ambulance.

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Where Do We Go Next?

High Performance EMS

Your existing historical CAD records contain the necessary information to build such dynamic views in real-time. The existence of identifiable causes explains the ability to properly forecast the vicinity of calls in addition to their timing.

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Syncope and ST Elevation on the Prehospital ECG

Dr. Smith's ECG Blog

A 75 yo with h/o CAD, CABG, and HFrEF presented after a syncopal episode. He rehydrated and had no orthostatic symptoms prior to discharge, ambulated well. - There was no prodrome and no associated symptoms such as SOB or CP. The medics recorded an ECG: There is STE in V1-V3 and aVL, with reciprocal ST depression in II, III, aVF.

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My First Delivery

My Paramedic Blog

I hop into the ambulance, and log onto the CAD (Computer Assisted Dispatch) device. The call pops up onto our CAD. I look at the notes on the CAD it read: Crowning. I explain the gravity of the situation to the parents when the second ambulance crew arrives to help out. Me: “Sure, that’s all good with me.”

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An Odd Place

My Paramedic Blog

Of course we get called early in the evening and as we sit inside our ambulance, I hear dispatch announce over the radio… “Code 3 for a testicular bleed…” I remember looking at Jessica thinking… Oh nooo! ” We quickly got back into our ambulance and drove back to the main road.

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A man in his 30s with cardiac arrest and STE on the post-ROSC ECG

Dr. Smith's ECG Blog

He reportedly told his family "I think I'm having a heart attack", then they immediately drove him to the ED, and he was able to ambulate into the triage area before he collapsed and became unresponsive. CPR was initiated immediately. It was reportedly a PEA arrest; there was no recorded V Fib and no defibrillation.

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Management of STEMI (ST-Elevation Acute Myocardial Infarction)

ECG & Echo Learning

I B Ambulance personnel must be trained and equipped to identify STEMI and administer fibrinolysis if necessary. IIa C During hospital stay (after primary PCI) Either stress echo, CMR, SPECT, or PET may be used to assess myocardial ischaemia and viability, including in multivessel CAD.

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