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. Thankfully, the patient experienced an uncomplicated ICU stay and subsequently made a full recovery.

STEMI 130

STEMI ED EMS Firefighter 130

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. Despite the risk of hypotension and bradycardia, propofol has been shown in the ICU setting to be a safe and effective monotherapy intubation agent for hemodynamically unstable patients (19).

ED 92

ED Emergency Department ALS Paramedic 92

ACEP Now

DECEMBER 10, 2023

Though paramedics administered naloxone, he remained somnolent. Paramedics hand you a Physician Orders for Life-Sustaining Treatment (POLST) form. You ultimately begin a slow naloxone infusion and admit him to the medical ICU. He had a recent month-long hospital stay complicated by severe cancer-related pain.

Naloxone 52

Naloxone Life Support Paramedic ALS 52

Don't Forget the Bubbles

JUNE 30, 2023

T – He’s got a single grey cannula in situ, and we’ve given him a 5 mg bolus of IiV morphine on the way in The primary survey Thanking the paramedic team, you ask the T&O SHO to proceed with a primary survey. Temperature 36.8C.

E-9-1-1 139

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

EMDocs

APRIL 22, 2024

Paramedics reported that coworkers activated them after the patient was discovered unconscious with labored breathing. Marino’s the ICU book, Wolters Kluwer Health, pgs 105-109, 4th ed., Case A 25-year-old-female presented to the ED in cardiac arrest. 2014 May;145(5):950-957. doi: 10.1378/chest.13-1087. PMID: 24092475. Marino, P.

ED 98

ED NARCAN ALS OR 98

NAEMSP

FEBRUARY 15, 2023

The patient was dying while intubated in the ICU but was awake enough to engage in discussions with providers through writing about her wishes. Paramedics’ experiences and educational needs when participating end-of-life care at home: A mixed method study. Palliat Med. 2022 Sep;36(8):1228-1241. doi: 10.1177/02692163221110419.

Emergency Medical Services 52

Emergency Medical Services EMS CPR Paramedic 52

The Overrun

MAY 18, 2020

Nor does it improve ED throughput, ICU stay, acuity, or a half-dozen other measurements. If you trust paramedics to intubate, then for God’s sake give them the proper tools that are evidence based to work! I can bring a dozen random people in a dump truck to a call; I can’t guarantee they know what the hell they’re doing.

EMS 52

EMS Firefighter Paramedicine Paramedicine 52

FOAMfrat

NOVEMBER 28, 2024

Do pulmonologists ever sigh to themselves and think, "God, I wish paramedics would just start/stop doing ?" In most hospitals I’ve worked at, ventilator protocols tend to take over as soon as the patient arrives in the ICU. We don’t seem to see Ketamine infusions in the ICU often. "That’s an interesting point.

E-9-1-1 52

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

FOAMfrat

DECEMBER 4, 2024

You’re me, and you’re in paramedic school, in the thick of the cardiology section. LVEDP (measured in the ICU using a Swan-Ganz or pulmonary artery catheter) is the pressure inside the left ventricle at the end of diastole, when the LV is at its fullest. Let’s take a trip way back to 2016. LVEDP is a little more complex.

Coronary 65

Coronary STEMI Epinephrine Critical Care 65

Dr. Smith's ECG Blog

APRIL 9, 2025

The paramedics diagnosis was "Possible Anterolateral STEMI." As a result I got to witness first-hand how the incidence of primary VFib appeared to dramatically decrease in our ICU as a result of the new practice at that time of using prophylactic Lidocaine on acute MI patients.

Defibrillator 64

Defibrillator STEMI ED Coronary 64

Dr. Smith's ECG Blog

DECEMBER 23, 2024

Paramedics found her bradycardic, hypotensive, and tachypneic. She was resuscitated and admitted to ICU for presumed sepsis. Written by Willy Frick A woman in her 70s is hospitalized with undifferentiated shock after being found down at home. Her family had not heard from her and called EMS.

ICU 114

ICU OR Paramedic EMS 114

FOAMfrat

NOVEMBER 21, 2024

Today, increased mortality rates, higher transfusion requirements, and lengthened ICU stays are recognized as proximate effects of the Trauma Triad. EMS Tactical Paramedic Lethal Triad.” It was first dubbed the “bloody vicious cycle” by the American Trauma Society and was correlated with increased hemorrhage and death. Accessed 10 Oct.

ICU 119

ICU Emergency Department OR ED 119