Unitek EMT

FEBRUARY 28, 2024

Explore the educational pathway, skills, and opportunities in community paramedicine. Community Paramedicine represents a transformative approach to healthcare delivery, particularly in underserved or rural areas where access to healthcare services is often limited. By extending the traditional role of emergency medical services (EMS) personnel, Community Paramedics are instrumental in bridging gaps within the healthcare system, […] The post How to Become a Community Paramedic appeared fir

Community Paramedicine 97

Community Paramedicine Paramedic Paramedicine Paramedicine 97

Pulsara

JANUARY 3, 2024

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin , for FireRescue1 BrandFocus Staff. Departments can play a large role in supporting the health and safety of underserved residents The inherent nature of the fire service means that responses to community needs are usually reactive.

Community Paramedicine 52

Community Paramedicine Paramedicine Paramedicine Mobile Integrated Health 52

International Journal of Paramedicine

OCTOBER 8, 2024

Introduction - Internationally, prehospital workers practice in a wide range of community paramedicine roles. It can be unclear where community paramedics fit within existing paramedicine career structures and their professional capabilities are sometimes ill-defined or misunderstood. This study aimed to clarify some of these questions through the development of a community paramedic career structure and descriptions of their professional capabilities at different levels of practice.

Paramedic 98

Paramedic Community Paramedicine Paramedicine Paramedicine 98

NAEMSP

FEBRUARY 6, 2024

Article by Karlee De Monnin CASE During my first ambulance ride-along as a fourth-year medical student on an EMS elective, my unit responded to a call for abdominal pain. On arrival to the apartment building, we stepped inside to find a tearful, but otherwise well-appearing young woman lying on the floor of her living room. She was an otherwise healthy 23-year-old who called us for abdominal pain and vomiting.

Paramedicine 52

Paramedicine Paramedicine Paramedic Ambulance 52

International Journal of Paramedicine

JANUARY 5, 2024

Objective: The aim of this scoping review is to determine how feedback is used in paramedicine. Introduction: Feedback is widely recognised as essential for clinician growth in healthcare however there is limited research on its use within paramedicine. Paramedics place high value on effective feedback and different types and methods are used depending on context.

Paramedicine 52

Paramedicine Paramedicine Paramedic OR 52

Emergency Medicine Cases

APRIL 2, 2024

In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing asthmatic

Epinephrine 349

Epinephrine EMS 349

EMS 12-Lead

MAY 15, 2024

TCP in the ROSC Patient: False Electrical Capture at 75mA Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the second installment of a blog series showing how transcutaneous pacing (TCP) can be difficult and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.

Epinephrine 331

Epinephrine Paramedic CPR EMT 331

Pediatric EM Morsels

MARCH 29, 2024

Often our job requires us to consider the presence of needles of significant illness in the haystack of nonspecific symptoms. With the help of our favorite geneticist , Dr. Liz Baker, we will dive into the haystack headfirst and find those needles. Hopefully, without getting poked. Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organom

ED 294

ED Plasma OR EMS 294

The Skeptics' Guide to EM

FEBRUARY 11, 2024

Reference: McLatchie et al and DAShED investigators. Diagnosis of Acute Aortic Syndrome in the Emergency Department (DAShED) study: an observational cohort study of people attending the emergency department with symptoms consistent with acute aortic syndrome. EMJ Nov 2023. Date: February 11, 2024 Guest Skeptic: Nirdosh Ashok Kumar, Emergency Medicine Specialist – Aga Khan University Hospital, Karachi, Pakistan. […] The post SGEM#430: De Do Do Do, De Dash, Dash DAShED – Diagnosing Acute Aortic Sy

ED 296

ED Emergency Department ALS OR 296

Critical Care Scenarios

APRIL 24, 2024

We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, and champion of nephrology-focused ultrasound. Find us on Patreon here! Buy your merch here! Takeaway lessons References Episode 4 with … Continue reading "Episode 73: POCUS for nephrology, with Abhilash Koratala" We discuss the role of point-of-ca

OR 285

OR 285

American Ambulance Association

JULY 23, 2024

To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.

Ambulance 278

Ambulance 278

Core EM

APRIL 25, 2024

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280

High Performance EMS

MARCH 8, 2024

There is plenty of data in the world, the key to improving performance is to discover the right information and make an appropriate decision, based on facts, in time to change outcomes for the better. Computers are quite useful in aggregating and processing data to distill information in support of the decision-making process, but artificial intelligence and machine-learning has increased our expectations of cyber assistance.

Public Safety 278

Public Safety OR 278

Core Ultrasound

APRIL 16, 2024

We identify the presence of kidney stones using ultrasound with a pretest suspicion of kidney stones then identifying the presence or absence of hydronephrosis.

OR 190

OR 190

Don't Forget the Bubbles

DECEMBER 31, 2024

The Childrens Emergency Department is a busy, challenging, and dynamic environment. The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. They involve a mixture of clinical, communication, and leadership traits. Having recently moved from a leadership position within the Childrens Emergency Department to a more system-based role involving children of all ages, its apparent to me how transferable my experiences on the shop

Emergency Department 140

Emergency Department OR 140

Emergency Medicine Cases

APRIL 2, 2024

In this ECG Cases blog, Jesse McLaren and Rajiv Thavanathan explore how ECG and POCUS complement each other for patients presenting to the emergency department with shortness of breath or chest pain. They explain complementary diagnostic insights into pericardial effusion and cardiac tamponade, occlusion MI and RV strain. The post ECG Cases 49 – ECG and POCUS for Dyspnea and Chest Pain appeared first on Emergency Medicine Cases.

Emergency Department 324

Emergency Department OR STEMI EMS 324

EMS 12-Lead

MARCH 30, 2024

TCP In Transit: A case reviewing transcutaneous pacing, false electrical capture, and re-arrest. Josh Kimbrell, NRP @joshkimbre Judah Kreinbrook, EMT-P @JMedic2JDoc This is the first installment of a blog series showing how transcutaneous pacing (TCP) can be difficult, and how you can improve your skills. We will be using redacted information from different cases where paramedics attempted TCP in the field.

CPR 312

CPR Paramedic Ambulance Defibrillator 312

ALiEM

MARCH 18, 2024

A 30-year-old female with a past medical history of Crohn’s Disease presented to the ED for evaluation of an acutely bruised right 4th finger. She stated she was typing on a computer keyboard approximately 10 minutes prior to presentation and she noticed a sudden popping sensation at the base of her right ring finger. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger.

Emergency Department 306

Emergency Department ED OR 306

Pediatric EM Morsels

JULY 19, 2024

Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.

E-9-1-1 286

E-9-1-1 Epinephrine Emergency Department OR 286

The Skeptics' Guide to EM

MARCH 2, 2024

Reference: Gibbons et al. The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study. AEM February 2024. Date: February 28, 2024 Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department at Nassau University […] The post SGEM#432: SPEED, Give Me What I Need – To Diagnose Acute Aortic Dissections first appeared on Th

Operating Room 292

Operating Room Emergency Department ALS ED 292

Critical Care Scenarios

JANUARY 31, 2024

We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Takeaway lessons References We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr.

OR 286

OR 286

American Ambulance Association

OCTOBER 10, 2024

FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 10, 2024 Congressman Mike Bost Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance […] The post Congressman Mike Bost Honored with Legislative Recognition Award appeared first on American Ambulance Association.

Ambulance 263

Ambulance 263

Core EM

JANUARY 25, 2024

Patient Case: History: A 60-year-old male with history of schizophrenia and depression on multiple unknown antipsychotic medications presents with unresponsiveness x 1 day. One week prior to ED arrival, the patient was becoming progressively despondent, less interactive with peers, exhibiting slow speech and movements, and was not eating. Physical exam: Vital signs – febrile, tachycardic, hypertensive General – posturing with arms stretched out in front, eyes open without blinking, akinetic, no

MICU 246

MICU Emergency Department ED OR 246

High Performance EMS

AUGUST 9, 2024

Dispatching the right unit to an EMS call was much simpler when all resources had the same capabilities and a response time was the primary measure of success. It was a matter of determining which crew was available closest to the scene. 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.

BLS 264

BLS CAD Advanced Life Support Life Support 264

Core Ultrasound

MARCH 25, 2024

Old IVC Vid (2021) TEE VTI Here are Dr. Spiegel’s Notes: 1. The discussion of what an IVC tells you is a fairly nuanced discussion but essentially it is telling you the difference in the RA pressure compared to the intra-abdominal pressure. It is our job as clinicians to interpret what that means. I find if you teach IVC US from that perspective than all the variability in techniques make a whole lot of sense.

ICU 189

ICU ED OR 189

Don't Forget the Bubbles

NOVEMBER 11, 2024

One-liner… Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in paediatric populations, and fever is associated with worse outcomes. Should we aim to prevent fever, or should we cool patients? A 12-year-old boy presents with a significant head injury following a road traffic accident. At the scene, his lowest GCS was 5 (E1V2M2).

ALS 116

ALS Life Support Critical Care OR 116

Emergency Medicine Cases

NOVEMBER 12, 2024

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

EMS 282

EMS OR 282

EMS 12-Lead

APRIL 9, 2024

David Didlake @DidlakeDW EMS personnel responded to the residence of an 81 y/o Male with syncope. His spouse had called 911 after she heard a loud “thud” in the adjacent room. He was found altered, hypotensive, and with a large hematoma to the left periorbital region. No 12 Lead ECG was captured, but telemetry did reveal the following: The spouse offers a pertinent medical history to include HTN and HLD, and furthermore states that he hasn’t previously complained of any chest discomfort, or shor

Coronary 290

Coronary ACS CAD ED 290

ALiEM

JUNE 24, 2024

With some things in life, speed is everything. Adenosine is one of those things. With an ultrafast half-life estimated to be between 0.6 to 10 seconds [1], parenterally administered adenosine needs to reach the cells of the AV-node and cardiac pacemaker cells in an expedited fashion to facilitate the termination of supraventricular tachycardias (SVTs).

ALS 286

ALS 286

Pediatric EM Morsels

APRIL 19, 2024

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. We see all different flavors of upper extremity injuries. Yes, we’re talking about your clavicular , proximal humeral, supracondylar, lateral condylar , scaphoid and metacarpal fractures.

ALS 286

ALS ACS Emergency Department ED 286

The Skeptics' Guide to EM

APRIL 13, 2024

Reference: Albers GW et al. TIMELESS Investigators. Tenecteplase for Stroke at 4.5 to 24 Hours with Perfusion-Imaging Selection. NEJM Feb 2024 Date: April 12, 2024 Guest Skeptic: Dr. Vasisht Srinivasan is an Emergency Medicine physician and neurointensivist at the University of Washington and Harborview Medical Center in Seattle, WA. He is an assistant professor in Emergency […] The post SGEM#436: For the Longest Time – To Give TNK for an Acute Ischemic Stroke first appeared on The Skeptics Guid

ALS 278

ALS Emergency Department OR EMS 278

Critical Care Scenarios

OCTOBER 16, 2024

We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC (@HomeIcu), host of the Walking Home from the ICU podcast, and consultant to ICUs working on these issues. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your merch here! We discuss the practical barriers to implementing the A-F ICU liberation bundle, with Kali Dayton, ACNP-BC ( @HomeIcu ), host of the Walking Home from the ICU podcast, and consultant to ICUs working

ICU 208

ICU 208

American Ambulance Association

OCTOBER 8, 2024

FOR IMMEDIATE RELEASE Contact: Tristan North tnorth@ambulance.org October 8, 2024 Senator Jerry Moran Honored with Legislative Recognition Award from the American Ambulance Association Washington, D.C. — The American Ambulance Association […] The post Senator Jerry Moran Honored with Legislative Recognition Award appeared first on American Ambulance Association.

Ambulance 263

Ambulance 263

Core EM

JANUARY 25, 2024

Prehospital Narrow Pulse Pressure Predicts Need for Resuscitative Thoracotomy and Emergent Intervention After Trauma J Surg Res., 2021 Background Prehospital trauma team activation criteria allow for prompt mobilization of personnel and resources. Prehospital hypotension is one of those criteria. Pulse pressure is the difference between systolic and diastolic blood pressure.

Operating Room 246

Operating Room EMS ED ICU 246

High Performance EMS

JUNE 20, 2024

Sadly, this is not an adventure story of heroic first responder actions on the scene of an emergency incident but rather about how current EMS operations are failing us and their missions. Across the country, a quarter of positions in the dispatch center , the folks we rely on to keep resources coordinated, are going unfilled. Recent annual surveys also show that over 10% of EMS clinicians will leave the field entirely each year.

EMS 240

EMS First Responder Emergency Response OR 240

FOAMfrat

DECEMBER 26, 2024

TRIGGER WARNING: TOPICS OF SUICIDE MAY BE HARD FOR SOME PEOPLE TO READ ABOUT. THIS ARTICLE IS COVERING THE MEDICAL ASPECTS OF CHEMICAL SUICIDES. IF YOU OR A LOVED ONE NEEDS HELP, CALL 988 OR SEEK CARE AT A LOCAL EMERGENCY DEPARTMENT. REMEMBER, IF YOU ARE TREATING A SUICIDE ATTEMPT SURVIVOR, DO NOT PASS JUDGMENT. WE, AS EMS PROFESSIONALS, SHALL PROVIDE COMPASSIONATE, APPROPRIATE CARE TO ALL PATIENTS.

Epinephrine 116

Epinephrine First Responder OR Emergency Management 116

EMergucate

DECEMBER 29, 2024

PH = 7.39, that is within the normal range. pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis. Next, we should look at the compensation for respiratory acidosis.

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