EMS 12-Lead

MARCH 30, 2024

As this case shows, electrical capture isn't always possible at lower currents, especially with pads placed in a standard anterolateral "defibrillation" position. Learning points: TCP is primarily recommended for bradycardia that does not respond to atropine, or other agents. It cannot be emphasized enough: You must be very skeptical of TCP.

CPR 312

CPR Paramedic Ambulance Epinephrine 312

The Skeptics' Guide to EM

OCTOBER 22, 2022

Case: You are the Chief of your local Fire and EMS Department, and an individual contacts you saying […] The post SGEM#380: OHCAs Happen and You’re Head Over Heels – Head Elevated During CPR? Head and thorax elevation during cardiopulmonary resuscitation using circulatory adjuncts is associated with improved survival.

CPR 130

CPR Epinephrine Defibrillator Firefighter 130

The Skeptics' Guide to EM

OCTOBER 24, 2020

You abandon your coffee order and quickly head next-door, where you are able to start cardiopulmonary resuscitation (CPR) and direct a bystander to find the store’s automated external defibrillator (AED) while waiting for emergency medical services (EMS) to arrive.

CPR 130

CPR Defibrillator Advanced Life Support Emergency Medical Services 130

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado. Annals of EM May 2018 Guest Skeptic: Andrew Merelman is a critical care paramedic and first year medical student at Rocky Vista University in Colorado.

BLS 130

BLS Defibrillator Critical Care CPR 130

Dr. Smith's ECG Blog

JANUARY 2, 2025

Dodd KW, Elm KD, Dodd EM, Smith SW. T-waves are quite tall and possibly peaked (HyperK?), but potassium returned normal. I do not see OMI here and all trops were only minimally elevated, consistent with either chronic injury from cardiomyopathy or with acute injury from sepsis. What is the QT interval? Bogossian et al. (1) 2014;11:22732277.

Coronary 116

Coronary OR Defibrillator ALS 116

EMDocs

SEPTEMBER 23, 2023

We’ll keep it short, while you keep that EM brain sharp. A 36-year-old female presents to the ED after experiencing an episode of sudden syncope. The patient has no significant past medical history, and reports that she was walking to the end of her driveway to retrieve her mail when she suddenly collapsed to the ground.

E-9-1-1 105

E-9-1-1 EMS ALS Defibrillator 105

Dr. Smith's ECG Blog

JULY 25, 2024

EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. See these related cases: Cardiac arrest, defibrillated, diffuse ST depression and ST Elevation in aVR. This patient was witnessed by bystanders to collapse.

Defibrillator 124

Defibrillator Coronary Epinephrine ACS 124

The Skeptics' Guide to EM

MARCH 11, 2023

He is a former New York City paramedic and this summer will be starting fellowship training in EMS medicine at UNM. A fire company is on scene providing high-quality cardiopulmonary resuscitation (CPR) and has defibrillated twice with an automated external defibrillator (AED). Reference: Smida et al.

CPR 130

CPR Defibrillator BLS Paramedic 130

ESO

DECEMBER 18, 2024

After reviewing over 12 million EMS incidents that took place in 2023 , the 2024 ESO EMS Index highlights two critical areas that demand attention: Early CPR and Opioid Use Disorder (OUD). Bystander CPR has been shown to double survival rates compared to cases where no CPR is performed prior to EMS arrival. Want to learn more?

Naloxone 52

Naloxone CPR Overdose Defibrillator 52

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Case: You are the medical director of an EMS system in a large city deciding on whether to respond to all out of hospital cardiac arrests (OHCA) with ACLS capabilities, or if resources should be directed to those candidates for extracorporeal CPR. You need to recognize an arrest and activate your EMS system.

CPR 130

CPR Life Support Advanced Life Support Defibrillator 130

The Skeptics' Guide to EM

DECEMBER 7, 2018

You are the first provider on scene with Emergency Medical Services (EMS) and start high-quality Cardiopulmonary Resuscitation (CPR). A cardiac defibrillator is hooked up and the patient is in ventricular fibrillation. Case: A 51-year-old man experiences a cardiac arrest on the street. He is unsuccessfully shocked.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

Handtevy

MARCH 13, 2024

A recent case has highlighted the extraordinary potential of a novel intervention: triple-sequential defibrillation. The Case Unfolds Despite 82 minutes of high-quality CPR and Advanced Cardiovascular Life Support (ACLS) management, standard and dual-sequential defibrillation failed to restore the patient’s heartbeat.

Defibrillator 52

Defibrillator CPR Life Support EMS 52

Dr. Smith's ECG Blog

APRIL 2, 2024

He was defibrillated, but they also noticed that he was being internally defibrillated and then found that he had an implantable ICD. He was unidentified and there were no records available After 7 shocks, he was successfully defibrillated and brought to the ED. There was no bystander CPR. Here is the initial ED ECG.

Defibrillator 133

Defibrillator Coronary Epinephrine CPR 133

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. Guest Skeptic: Dr. Stephen Meigher is the EM Chief Resident training with the Jacobi and Montefiore Emergency Medicine Residency Training Program. The TOMAHAWK Investigators.

EMR 130

EMR Coronary Defibrillator Life Support 130

EMT Training Station

FEBRUARY 11, 2024

In the realm of emergency healthcare, the terms EMS (Emergency Medical Services) and EMT (Emergency Medical Technician) are often used interchangeably, yet they represent distinct aspects of medical response and care. Though they are closely related and often work together, EMS and EMT have distinct roles, training, and responsibilities.

EMT 98

EMT EMT Emergency Medical Technician Emergency Medical Services 98

The Skeptics' Guide to EM

MARCH 2, 2019

Case: EMS arrive to your emergency department with a 68-year-old man post cardiac arrest patient. Key to survival is high-quality CPR and early defibrillation. They had a difficult time getting a definitive airway pre-hospital. It required multiple attempts which caused several prolonged interruptions in CPR.

CPR 130

CPR Firefighter Paramedic Epinephrine 130

EMDocs

JANUARY 16, 2024

Authors: Christian Gerhart, MD (EM Resident Physician, Washington University in St. Louis); Dr. Jessica Pelletier, DO (EM Attending Physician, Washington University in St. You receive a page for a cardiac arrest and take report from emergency medical services (EMS). Per EMS he was very cold to touch.

Defibrillator 109

Defibrillator CPR Epinephrine Life Support 109

Dr. Smith's ECG Blog

JUNE 21, 2023

EMS was called, and they recorded the following ECG on scene at 13:16: What do you think? In this medical system, the EMS provider can then be routed to the ED or to a type of urgent care facility that is open 24 hrs/day and staffed by a primary care provider. In this case, the EMS provider was routed to the urgent care facility.

STEMI 98

STEMI Coronary Defibrillator EMS 98

Dr. Smith's ECG Blog

JULY 21, 2024

The patient in today’s case is a previously healthy 40-something male who contacted EMS due to acute onset crushing chest pain. He required multiple defibrillations within a period of a few hours. This time, the arrhythmia did not spontaneously terminate — but rather degenerated to VFib, requiring defibrillation.

Defibrillator 131

Defibrillator Coronary ALS STEMI 131

REBEL EM

JUNE 1, 2023

Known cardiac defibrillator. appeared first on REBEL EM - Emergency Medicine Blog. Design: Prospective, observational, before and after implementation of a protocol study. Excluded: Obvious cause for OHCA prior to SDCT or on hospital arrival. Known obstructive coronary artery disease or known coronary stent. Pre-existing DNR order.

Coronary 145

Coronary Defibrillator CPR ALS 145

The Skeptics' Guide to EM

DECEMBER 2, 2017

SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine? Cardiac Arrest: Pulselessness requiring chest compressions and/or defibrillation, with a hospital wide or unit based emergency response. He is currently deployed, practicing emergency medicine in an undisclosed location.

CPR 100

CPR Defibrillator ALS Emergency Response 100

EMS 12-Lead

MARCH 19, 2023

Fire/EMS crews found him clammy and uncomfortable. Despite immediate chest compressions, and multiple rounds of defibrillation, he could not be resuscitated. Vital signs were noted to be unremarkable with respect to any hypo-hypertensive crisis, hypoxia, etc. Breath sounds were clear in all lung fields. No appreciable skin pallor.

Coronary 130

Coronary STEMI Paramedic Defibrillator 130

Dr. Smith's ECG Blog

JULY 14, 2010

A 56 yo f with h/o HTN and hypercholesterolemia called EMS from home after onset of L chest pain radiating to the left arm. Before EMS arrived, she had "seizure activity" and became unresponsive. She was defibrillated successfully from ventricular fibrillation and developed a perfusing rhythm. She was intubated.

Defibrillator 52

Defibrillator OR EMS 52

NCOAE

AUGUST 12, 2022

Today we’re taking a more serious look at language, this time highlighting the terminology used by members of the Emergency Medical Service (EMS) community. The post Most EMS Terminology Comes Down to Initials, Abbreviations and Acronyms appeared first on National Center for Outdoor & Adventure Education.

EMS 52

EMS EMT EMT Emergency Medical Technician 52

Dr. Smith's ECG Blog

SEPTEMBER 27, 2023

This was written by Magnus Nossen, from Norway, with comments and additions by Smith A 50 something smoker with no previous medical hx contacted EMS due to acute onset chest pain. Upon EMS arrival the patient appeared acutely ill and complained of chest pain. An ECG was recorded immediately and is shown below. The patient is unstable.

Defibrillator 133

Defibrillator OR Coronary EMS 133

EMDocs

FEBRUARY 9, 2024

Authors: Adam Roussas, MD, MBA, MSE // Reviewed by: Jamie Santistevan, MD ( @jamie_rae_EMdoc, EM Physician, Presbyterian Hospital, Albuquerque, NM); Manpreet Singh, MD ( @MPrizzleER ); and Brit Long, MD ( @long_brit ) Case A 40-year-old female presents to the emergency department for palpitations and lightheadedness. She denies chest pain.

Defibrillator 96

Defibrillator OR ED ALS 96

Dr. Smith's ECG Blog

OCTOBER 23, 2023

Edited by Bracey, Meyers, Grauer, and Smith A 50-something-year-old female with a history of an unknown personality disorder and alcohol use disorder arrived via EMS following cardiac arrest with return of spontaneous circulation. She was successfully revived after several rounds of ACLS including defibrillation and amiodarone.

ICU 131

ICU OR Defibrillator EMS 131

Dr. Smith's ECG Blog

SEPTEMBER 2, 2024

Her husband called EMS when the patient experienced new onset seizures accompanied by micturition. The ECG below was recorded by EMS. This episode self terminated before defibrillation was possible. Written by Magnus Nossen — with edits by Grauer. The patient in today’s case is a 30-something female. What is your assessment?

E-9-1-1 113

E-9-1-1 ALS Defibrillator OR 113

Paramedics Unlimited

APRIL 19, 2018

In Basic Life Support (BLS) emergencies, a single EMS provider can not deliver optimum care, such as when trying to hold direct pressure on a bleeding wound, while preparing bandages, to stop bleeding. In Advanced Life support (ALS) emergencies, a “single” paramedic or ER doctor can not deliver necessary care.

BLS 52

BLS ALS Emergency Medical Technician Advanced Life Support 52

EMS 12-Lead

AUGUST 22, 2022

We can, therefore, put down the defibrillation pads, set aside the amiodarone, and look further at the ECG. A 12 Lead ECG was recorded secondary to bizarre telemetry findings at bedside. Said differently, it’s a mess. Paradoxically, though, the third green arrow identifies a QRS that is more narrow than the RBBB complexes surrounding it.

E-9-1-1 130

E-9-1-1 Coronary ALS ICU 130

EMT Training Station

FEBRUARY 10, 2024

They learn to operate sophisticated life-saving tools, from defibrillators to advanced airway management devices. My name is Mike, and I am thrilled to be able to share my extensive EMS experience with you. Climbing the Ladder A career as an EMT is a gateway to numerous opportunities within the medical field.

EMT 98

EMT EMT Emergency Medical Technician First Responder 98

REBEL EM

SEPTEMBER 19, 2022

Background: There are only two interventions that have been proven in the medical literature to improved outcomes in cardiac arrest: high-quality CPR and early defibrillation. Population: Patients > 18 years of age w/ OHCA treated by 10 EMS systems in in the US. Head Up (HUP) CPR may be the next critical improvement.

CPR 52

CPR Defibrillator EMS Epinephrine 52

Broome Docs

OCTOBER 31, 2022

PMID: 34904190 Not surprisingly, this paper has been covered by basically everyone who talks about research, so if you want to hear some other opinions, check out the SGEM , REBEL EM , or St. PMID: 35490863 Hands on defibrillation: Even if it’s safe, would it actually help? 2018 Sep 11;362:k3843. doi: 10.1136/bmj.k3843.

E-9-1-1 52

E-9-1-1 Defibrillator ICU Critical Care 52

Dr. Smith's ECG Blog

FEBRUARY 25, 2009

EMS was activated and recorded the following ECG (scanned from a prehospital ECG, so the quality is not perfect): Notice the small Q wave in V1 followed by a very large R-wave, with a prolonged QRS. This patient is 38 years old with hyperlipidemia. He was at the gym when he had the onset of chest pain. There is a wide S-wave in V6.

Defibrillator 52

Defibrillator STEMI Paramedic EMS 52

ECG Medical Training

DECEMBER 4, 2016

Alongside tracheal intubation , response times , and fire-based EMS, this is one of the most controversial topics in prehospital medicine. This is important because too many EMS systems look at mechanical CPR as a way to avoid having to become experts in resuscitation or having to send additional resources to the scene.

CPR 52

CPR E-9-1-1 Defibrillator Ambulance 52

Peter Canning

JANUARY 14, 2024

For all the fancy changes over the year, the bottom line has always been to provide good CPR compressions and timely defibrillation. EMS may transport children with behavioral emergencies aged 4 to 18 directly to urgent crisis centers, provided they meet criteria and the service has sponsor hospital approval.* mg via syringe.*

CPR 52

CPR Naloxone EMT EMT 52

Utah's Paramedic and EMS Academy

OCTOBER 23, 2023

Upon arrival, you quickly assess the situation and spring into action, working to save a man's life through CPR and defibrillation. This includes checking monitors, defibrillators, airway management equipment, and other essential tools for stabilizing and transporting critically ill patients. And the best part?

EMT 52

EMT EMT Emergency Medical Technician Defibrillator 52