FirstWatch

NOVEMBER 11, 2024

There has been an increasing demand for paramedic services to respond to mental health-related calls, and it’s becoming even more important to respond appropriately to these calls. Areas for practice change include alternative care options (outside of ED), response team approaches, community paramedicine, and post-care follow up.

Paramedicine 40

Paramedicine Paramedicine Paramedic Community Paramedicine 40

FOAMfrat

APRIL 25, 2024

In this episode, we discuss a recent paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. Prehosp Emerg Care. 2024 Mar 15:1-9. doi: 10.1080/10903127.2024.2321287.

Paramedic 128

Paramedic ACS EMS ED 128

EMDocs

JUNE 22, 2023

The patient is not responsive and the paramedics cannot get a blood pressure. So I did what we as ED physicians are all so good at – I prepared. I meet the paramedics at the door. We had sent off a Type and Screen as soon as the patient arrived at the ED. We have a knife stab wound to the chest or abdomen coming.

ED 98

ED Paramedic OR EMS 98

EMDocs

SEPTEMBER 25, 2023

However, RSI has never been shown to reduce the risk of aspiration in the ED (13) or during emergent OR cases (14). While RSI should remain the gold standard in the vast majority of patients in the ED, FI presents an additional technique to mitigate anatomic or physiologic risk. To date, ketamine has been the agent of choice (12).

ED 93

ED Emergency Department ALS Paramedic 93

Chicago EMT Training

AUGUST 6, 2021

The majority of our students come from a premedical background but there are a few with other career choices such as firefighter, paramedic, law enforcement, etc. You get the benefit of working with a paramedic without going to medic school. This is a position that is also sought after by nursing assistants as well as paramedics.

EMT 130

EMT EMT Paramedic Plasma 130

International Journal of Paramedicine

APRIL 3, 2024

Background : Emergency Department (ED) overcrowding limits patient care in the prehospital and hospital system. A program was implemented to decrease the time to patient handoff from EMS arrival to ED staff, also known as the delivery interval and total turnaround interval.

Emergency Department 52

Emergency Department Ambulance Paramedic ED 52

Peter Canning

MARCH 25, 2025

At one of the hospitals, while my partner finished up the run form in the passenger seat –shed teched the call–I announced I was going back into the ED to the EMS room to see if they had any pizza. When I focused on her, she asked if I liked being a paramedic. I love being a paramedic for a lot of reasons.

Paramedic 52

Paramedic Ambulance EMS OR 52

Dr. Smith's ECG Blog

NOVEMBER 2, 2015

The first (and only) ED ECG is here: QTc 386. A prospective analysis of consecutive adult patients presenting to an urban/suburban two paramedic ambulance service fromJuly 15, 2006, to August 15, 2007, who have diagnostic ECGs for STEMI. A second ECG was done prior to arrival at the ED. Most ST elevation is resolved.

Paramedic 52

Paramedic STEMI ACS Ambulance 52

The Good, The Bad & The Ugly Paramedic

SEPTEMBER 30, 2021

Priorities are changing in prehospital care, with many paramedics now questioning career commitment for the future. National industry insight reporting from the Australian Industry and Skills Committee suggests that, in 2019 alone, Australia wide, there were over 4,500 enrolments in ambulance and paramedic qualifications1.

Paramedic 52

Paramedic Paramedicine Paramedicine Ambulance 52

Dr. Smith's ECG Blog

MAY 5, 2024

An undergraduate (not yet in medical school) who works as an ED technician (records all EKGs, helps with procedures, takes vital signs) and who reads this blog regularly arrived at work and happened to glance down and see this previously recorded ECG on a table in the ED. The young ED tech immediately suspected LAD OMI.

ED 124

ED STEMI Coronary Paramedic 124

International Journal of Paramedicine

OCTOBER 8, 2024

One barrier to including children in such programs is a lack of evidence regarding whether paramedics and emergency medical technicians (EMTs) can accurately identify children with low-acuity complaints. Our primary objective was to compare the accuracy of EMTs to that of paramedics in identifying low-acuity pediatric encounters.

Emergency Medical Technician 52

Emergency Medical Technician EMT EMT Paramedic 52

The Skeptics' Guide to EM

OCTOBER 19, 2019

JAMA May 2018 Guest Skeptic: Missy Carter, former City of Bremerton Firefighter/Paramedic, currently a physician assistant practicing in emergency medicine in the […] The post SGEM#271: Bougie Wonderland for First Pass Success first appeared on The Skeptics Guide to Emergency Medicine. Bougie use may be helpful in ED intubation.”

Firefighter 130

Firefighter Emergency Department Paramedic ALS 130

The Skeptics' Guide to EM

JANUARY 9, 2021

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?

EMS 130

EMS Emergency Medical Services CPR Critical Care 130

EMergucate

MAY 4, 2021

A 32 year old male presents to ED after cutting his right cubital fossa in a suicide attempt. According to the paramedics there was a large amount of blood on scene.

Paramedic 100

Paramedic ED 100

EMergucate

MAY 5, 2021

A 32 year old male presents to ED after cutting his right cubital fossa in a suicide attempt. According to the paramedics there was a large amount of blood on scene.

Paramedic 100

Paramedic ED 100

EMergucate

AUGUST 10, 2020

A 65 year old female is brought to ED via ambulance on a priority 1. According to the paramedics the patient has taken an overdose of benzodiazepines and alcohol. Her GCS is 3 and the team is prepa…

Overdose 100

Overdose Ambulance Paramedic ED 100

EMergucate

AUGUST 12, 2020

A 65 year old female is brought to ED via ambulance on a priority 1. According to the paramedics the patient has taken an overdose of benzodiazepines and alcohol. Her GCS is 3 and the team is prepa…

Overdose 100

Overdose Ambulance Paramedic ED 100

EMergucate

FEBRUARY 1, 2022

A 65 year old female is brought to ED via ambulance on a priority 1. According to the paramedics the patient has taken an overdose of benzodiazepines and alcohol. Her GCS is 3 and the team is prepa…

Overdose 100

Overdose Ambulance Paramedic ED 100

EMergucate

FEBRUARY 2, 2022

A 65 year old female is brought to ED via ambulance on a priority 1. According to the paramedics the patient has taken an overdose of benzodiazepines and alcohol. Her GCS is 3 and the team is prepa…

Overdose 100

Overdose Ambulance Paramedic ED 100

The Skeptics' Guide to EM

OCTOBER 5, 2019

Guest Skeptic: Clay Odell is a Paramedic/RN for New London Hospital EMS in New Hampshire, USA which provides 9-1-1 coverage and Mobile Integrated Healthcare […] The post SGEM#269: Pre-Hospital Nitroglycerin for Acute Stroke Patients? The Lancet March 2019. The Lancet March 2019. He has a history of hypertension.

Ambulance 130

Ambulance Paramedic EMS ALS 130

The Skeptics' Guide to EM

AUGUST 14, 2021

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. Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest.

BLS 130

BLS CPR Paramedic ALS 130

The Skeptics' Guide to EM

JUNE 18, 2022

He is also now a fully fledged “sonologist” Casey currently splits his time between Broome, a small rural hospital in the remote Kimberley region of Western Australia, and a large tertiary ED in sunny Perth. They have two large bore intravenous (IV) access and are planning to bring them to your ED as soon as possible.

Plasma 100

Plasma Critical Care Paramedic ALS 100

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

He is interested and experienced in healthcare informatics, previously worked with ED-directed EMR design, and is involved in the New York City Health and Hospitals Healthcare Administration Scholars Program (HASP). The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation.

EMR 130

EMR Coronary Defibrillator Life Support 130

Dr. Smith's ECG Blog

AUGUST 11, 2024

Below is the first ECG recorded by paramedics after 2 hours of chest pain, interpreted by the machine as “possible inferior ischemia”. In isolation this ECG does not show OMI, but following the paramedic ECGs this indicates spontaneous LAD reperfusion. It’s unclear if the paramedic ECGs were seen or missed in the ED.

STEMI 100

STEMI Paramedic Coronary EMS 100

The Overrun

JANUARY 23, 2023

We know instinctively that the years of running calls, driving incessantly, long hours posted, and inherent risks of being a paramedic or EMT will get us back in the end. Reflecting on my career and practice; and as I struggle with my place on the burnout continuum, I tried to remember the times when I like being a paramedic the most.

Paramedic 52

Paramedic EMT EMT EMS 52

The Overrun

NOVEMBER 2, 2018

Ed Bauter We’ve all been there. The design of the study allowed the paramedics to use discretion when placing an airway in the patients that were introduced to the study. It certainly is not representative of paramedic on the whole. What’s the right airway to use? On paper, this is an easy thing to do.

ED 52

ED Paramedic OR Ambulance 52

EMS 12-Lead

MARCH 19, 2023

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic (Ret) @DidlakeDW Expert contribution by Dr Robert Herman @RobertHermanMD @PowerfulMedical (Chief Medical Officer) An adult male called 911 for new-onset epigastric burning. To which the lead paramedic replied, “Not cardiac; his symptoms are atypical. Is this OMI?

Coronary 130

Coronary STEMI Paramedic Defibrillator 130

EMS 12-Lead

JULY 30, 2023

David Didlake, FF/EMT-P, AG-ACNP @DidlakeDW An elder female presented to the ED with worsening shortness of breath. Pharmacology Review Digoxin is probably one of those medications vaguely recalled from paramedic school. She was known to have a history of poorly controlled COPD, AFib, and multivessel coronary disease.

EMT 130

EMT EMT ACS Coronary 130

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. Chou's Electrocardiography in Clinical Practice, 6th ed.

ACS 130

ACS Paramedic Coronary ALS 130

GEDC

FEBRUARY 27, 2025

In-home nurse practitioner visits, same day specialist appointments and Community Paramedic check-ins represent examples of services that VBCOs can offer to better serve patients whose circumstances may not indicate admission but demonstrate a need for a higher level of care.

Emergency Department 52

Emergency Department Paramedic ED OR 52

ESO

APRIL 19, 2024

Due to this, it’s important for the industry to develop strategies for better supporting psychiatric patients while avoiding unnecessary ED visits and secondary EMS transports. For Eagle County Paramedic Services, turning to MIH was integral to helping them provide services for their underserved population while also saving millions in costs.

MIH 105

MIH EMS Paramedic Firefighter 105

EMS 12-Lead

MAY 8, 2022

David Didlake Firefighter / Paramedic Acute Care Nurse Practitioner @DidlakeDW Peer review provided by Dr. Steve Smith [link] @SmithECGBlog An adult female called 911 for chest discomfort and difficulty breathing. The following ECG was captured upon arrival at the receiving ED. The ED resulted an 8.7 The serum K returned 8.7,

STEMI 130

STEMI ED EMS Firefighter 130

Dr. Smith's ECG Blog

MARCH 1, 2024

The tachycardia was gone by the time paramedics arrived. First ED ECG is Wellens' (pain free). First responders found him to be very tachycardic , confused, perserverating and with no memory of the event. There was tongue biting. Lightheadedness continued. He had a prehospital ECG: What do you think? Interpretation.

First Responder 109

First Responder ED Ambulance Paramedic 109

Pediatric EM Morsels

OCTOBER 27, 2023

Sinha 2012] It is useful in the prehospital setting , correlating well with actual weight and ED Broselow weight. Accuracy of paramedic Broselow tape use in the prehospital setting. Good correlation to bed scale weight in trauma patients (Pearson coefficient 0.86), but there was some error in the highest weight category.

E-9-1-1 271

E-9-1-1 Emergency Medical Services Life Support ALS 271

Dr. Smith's ECG Blog

MARCH 13, 2023

An ED ECG, if recorded with pain, should show LAD OMI. Smith — in the setting of a patient with new chest pain — the initial ECG in today's case ( = ECG #1 — obtained by the EMS team prior to ED arrival ) — is diagnostic of ACS ( A cute C oronary S yndrome ) until proven otherwise.

ED 52

ED ACS Coronary Paramedic 52

The Skeptics' Guide to EM

JANUARY 8, 2022

Prior to earning his MD, he worked as a paramedic in the New York City 911 system. Case: A 43-year-old male presents to your emergency department (ED) the day after being involved in an all-terrain vehicle (ATV) accident. He is also a resident flight physician with UNM’s aeromedical service, UNM Lifeguard.

ALS 130

ALS Emergency Department Paramedic OR 130

EMS 12-Lead

AUGUST 14, 2022

David Didlake Acute Care Nurse Practitioner Firefighter / Paramedic @DidlakeDW A 50 y/o Male was taking his dog for a leisurely stroll through the park when he suddenly experienced new onset chest discomfort. He waited for it to subside, but after 30 minutes of persistence he called 911. However, when the Troponin I returned 8.4

MICU 130

MICU STEMI CAD Coronary 130