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. Fever is common among patients with TBI.

ALS 117

ALS Life Support Critical Care OR 117

Chicago EMT Training

NOVEMBER 8, 2023

A quick breakdown on the differences between an EMT-B(asic) and an EMT-P(aramedic) Basic Life Support (BLS) vs Advanced Life Support (ALS) So there it is. The two main levels of care you would probably see in the prehospital setting. In a more rural setting, you might see EMT-I or A for intermediate or advanced.

BLS 130

BLS Advanced Life Support EMT EMT 130

ACEP Now

JULY 7, 2023

More recent literature and guidelines support the use of lidocaine as an alternative agent, and currently both are included in standard advanced cardiovascular life support. Out-of-hospital cardiac arrest is a commonly encountered entity in U.S. There are some differing guidelines as to what constitutes “refractory” VT or VF.

Defibrillator 98

Defibrillator OR ALS Epinephrine 98

The Skeptics' Guide to EM

SEPTEMBER 23, 2017

Prehospital advanced cardiac life support for out-of-hospital cardiac arrest: a cohort study. He is also the CME editor for Academic Emergency Medicine and the associate editor for emergency medicine simulation at the […] The post SGEM#189: Bring Me To Life in OHCA first appeared on The Skeptics Guide to Emergency Medicine.

Life Support 130

Life Support CPR Advanced Life Support Defibrillator 130

High Performance EMS

OCTOBER 18, 2024

Great OpEd published by AIMHI about how our industry is changing and leading to “EMS On Life Support: The Alarming Gap Between Expectations and Reality.” ” [link] I have been writing a lot this year that “ a stopwatch is not a valid instrument for summarizing the measure of care that a patient receives.

Life Support 100

Life Support Public Safety EMS OR 100

The Skeptics' Guide to EM

DECEMBER 7, 2018

This was a before and after study to see if advanced cardiac life support (ACLS) techniques, including IV epinephrine, would improve survival to discharge. While there was an improvement in return of spontaneous circulation (ROSC) and survival to hospital admission there was not an increased survival to hospital discharge.

Epinephrine 130

Epinephrine Life Support Advanced Life Support Defibrillator 130

REBEL EM

SEPTEMBER 14, 2023

Revascularization of the culprit lesion remains one of the few established treatments though there are numerous other unproven modalities including extracorporeal life support (ECLS). Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. bleeding, stroke, limb ischemia, and hemolysis). Zeymer HT et al.

Life Support 133

Life Support Coronary CPR ICU 133

ACEP Now

OCTOBER 9, 2023

Consent to a trauma evaluation is presumed when a patient presents as a trauma activation; implied consent applies to all life-threatening emergencies and is not unique to trauma activations. Advanced Trauma Life Support: Student Course Manual. Or even worse, against their verbal objection. Trauma is unique. 2017;152(9):843.

Heart Attack 126

Heart Attack Life Support Emergency Department Ambulance 126

The Skeptics' Guide to EM

SEPTEMBER 29, 2018

EMS arrives on scene and initiates high quality basic life support (BLS). One defibrillation for ventricular fibrillation (VF) is provided but the patient remains in VF. As part of their protocol, they attempt vascular access to administer epinephrine and an antidysrhythmic. Patients were also excluded if incarcerated or pregnant.

BLS 130

BLS Defibrillator Critical Care CPR 130

EMDocs

OCTOBER 9, 2023

2022 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces.

ED 103

ED Life Support Advanced Life Support CPR 103

The Skeptics' Guide to EM

SEPTEMBER 11, 2021

The paramedics achieve return of spontaneous circulation (ROSC) after CPR, advanced cardiac life support (ALCS), and Intubation. She arrives in the emergency department (ED) with decreased level of consciousness and shock. Half of these arrests are witnessed with the other half being un-witnessed.

EMR 130

EMR Coronary Defibrillator Life Support 130

The Skeptics' Guide to EM

OCTOBER 24, 2020

Background: Out of hospital cardiac arrest (OHCA) is something that we have covered many times on the SGEM. SGEM#64 : Classic EM Papers (OPALS Study) * SGEM#136 : CPR – Man or Machine? Unfortunately, most patients don’t receive these crucial interventions.

CPR 130

CPR Defibrillator Advanced Life Support Emergency Medical Services 130

The Skeptics' Guide to EM

FEBRUARY 2, 2019

Robert Edmonds is an emergency physician in the US Air Force in Virginia. This is Bob’s ninth visit to the SGEM. DISCLAIMER: THE VIEWS AND OPINIONS OF THIS PODCAST DO NOT REPRESENT THE UNITED STATES GOVERNMENT OR THE US AIR FORCE. This study expands upon that investigation to patients with other conditions as well.

Life Support 130

Life Support ALS STEMI Emergency Department 130

The Skeptics' Guide to EM

MARCH 11, 2023

The fire-based crew has basic life support (BLS) airway supplies including the King Laryngeal Tube, the paramedic crew carries iGel supraglottic airways (SGAs) in addition to their intubation equipment. Reference: Smida et al.

CPR 130

CPR Defibrillator BLS Paramedic 130

EMT Training Station

FEBRUARY 11, 2024

This could range from basic life support, typically managed by EMTs, to more advanced life support provided by paramedics and other medical specialists. EMTs, for example, are trained in basic life support, while paramedics receive more advanced training, including in pharmacology, cardiology, and trauma care.

EMT 98

EMT EMT Emergency Medical Technician Emergency Medical Services 98

Pediatric EM Morsels

JULY 21, 2023

We use the GCS score in both trauma and medical patients, but where did this score come from? When is it useful and what does it tell us? Is it actually validated in children, like the Ottawa Ankle Rules or are we using a tool for something other than that for which it was designed and validated, like using Kocher criteria for knee and ankle joints?

Critical Care 246

Critical Care ALS Life Support OR 246

Critical Care Scenarios

MARCH 29, 2020

A PA catheter is more useful for weaning ECMO than during the period of full support. Monitoring Hemostasis During Extracorporeal Life Support. .* “Hypoxemia” on VA ECMO is either regional hypoxemia/North-South syndrome/harlequin syndrome, or oxygenator failure. 2020;66(2):230–237.

Critical Care 100

Critical Care Life Support ALS OR 100

ACEP Now

DECEMBER 6, 2024

Advanced cardiac life support protocol was initiated, and the patient was intubated. Traditional Advanced Cardiovascular Life Support (ACLS) medications, namely epinephrine, have been known to exacerbate coronary vasospasm. Overall, cardiac arrest in the setting of coronary vasospasm is thought to be relatively uncommon.

Coronary 98

Coronary Life Support ALS Emergency Department 98

Critical Care Scenarios

NOVEMBER 15, 2020

Yes, temporize with supportive care while you go through the process, but do the work—find a legitimate representative or documentation of the patient’s wishes to determine what they’d want before you commit them to lengthy, aggressive life support. Emergency staff have limited bandwidth. .*

ICU 100

ICU Life Support Emergency Department ED 100

Don't Forget the Bubbles

AUGUST 7, 2023

Heart rate (HR) and respiratory rate (RR) are THE major vital signs used in Advanced Paediatric Life Support ( APLS) guidance , sepsis guidelines , and Paediatric Early Warning Scores (e.g., Our study supports previous work by Nijman et al. and two cohort studies, one performed in Australia by O’Leary et al. What is the problem?

Life Support 98

Life Support Advanced Life Support ALS Emergency Department 98

International Journal of Paramedicine

APRIL 3, 2024

Exclusion criteria were all non-primary studies, patients given an alternative provisional diagnosis or who received life supporting interventions, studies that examined only presyncope presentations or were limited to paediatric patients, or that examined syncope within highly specific non-generalisable settings.

Emergency Medical Services 75

Emergency Medical Services Life Support EMS OR 75

REBEL EM

APRIL 22, 2024

Lower vs higher oxygenation target and days alive without life support in COVID-19. Intervention: Target PaO2 = 60 mm Hg Control: Target PaO2 = 90 mm Hg Outcome (primary): Absolute number of days without life support in 90 days defined as the absence of mechanical ventilation, circulatory support, or kidney replacement.

Life Support 74

Life Support ICU EMS OR 74

FOAMfrat

MAY 17, 2024

At its most basic form, ECMO or Extracorporeal Membrane Oxygenation is a way to artificially support the patient’s heart and or lungs by removing the blood from the body, oxygenating it, and returning it to the patient in real-time. ECMO is somewhat similar. The basic components must remain the same to achieve the therapeutic goal.

Life Support 98

Life Support OR ALS EMS 98

International Journal of Paramedicine

OCTOBER 8, 2024

EMS responses (n = 4,375,568) were analyzed comparing patient acuity and CMS Service level, Advanced Life Support (ALS) vs Basic Life Support (BLS), to assess for associations in acuity and CMS Service level using logistic regression. Discussion.

BLS 52

BLS Advanced Life Support ALS Community Paramedicine 52

EMDocs

JUNE 22, 2024

A) Amniotic fluid embolism B) Eclampsia C) Placental abruption D) Pulmonary embolism Answer: A Amniotic fluid embolism (AFE) is a rare but potentially fatal complication of pregnancy. AFE should be considered in a patient who experiences cardiorespiratory collapse during labor or shortly thereafter.

EMS 111

EMS Ambulance FFP ICU 111

NHCPS Save a Life

APRIL 28, 2023

It is crucial for healthcare providers who are new to the Advanced Cardiac Life Support (ACLS) algorithm to understand the difference between pulseless electrical activity and asystole. ACLS is a set of protocols and interventions used to treat patients in cardiac arrest or other life-threatening medical emergencies.

Life Support 52

Life Support OR CPR 52

The Skeptics' Guide to EM

AUGUST 26, 2018

Styner plane crash in 1976 that inspired him to start what became the Advanced Trauma and Life Support ( ATLS ) program. Parry’s personal choices for the top 10 changes to ATLS and do not reflect the opinions of the ATLS committee, the Committee on Trauma of the American College of Surgeons, Western University or anyone else.

Critical Care 100

Critical Care Life Support OR 100

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

EMDocs

JANUARY 16, 2024

Cardiac surgery is immediately paged for consideration of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for active rewarming. His LMA is exchanged for an endotracheal tube without induction or paralytic agents. A right femoral arterial line and triple lumen catheter are placed. His point-of-care labs return with a potassium of 3.4

Defibrillator 106

Defibrillator CPR Epinephrine Life Support 106

EMDocs

APRIL 10, 2024

Supportive care includes: protecting the airway if necessary, supplemental oxygen if needed, and vasopressor support if the patient is hypotensive. For patients who in cardiac arrest standard Advanced Cardiac Life Support (ACLS) should be initiated. 2] This linking group can be either an amide (e.g., mL/kg/min. [2]

E-9-1-1 110

E-9-1-1 Plasma Epinephrine Life Support 110

The Skeptics' Guide to EM

NOVEMBER 13, 2021

You arrive and see that the Advanced Cardiac Life Support (ACLS) algorithm is being followed for adult cardiac arrest patients with pulseless electrical activity (PEA). This study provided weak evidence in support of using corticosteroids for IHCA as part of a VSE protocol. Cardiopulmonary resuscitation (CPR) is in progress.

Epinephrine 100

Epinephrine Critical Care Life Support Emergency Department 100

Mile High Ambulance

DECEMBER 11, 2014

Knowing who will provide Basic Life Support, such as CPR, First Aid, and Bleeding Control is a key precaution when planning events. Knowing who will provide Basic Life Support, such as CPR, First Aid, and Bleeding Control is a key precaution when planning events.

Advanced Life Support 52

Advanced Life Support First Aid Life Support Ambulance 52

Don't Forget the Bubbles

NOVEMBER 27, 2023

This recommendation is based upon the availability of PICU support, with lower fluid volumes and earlier vasoactive use being recommended, particularly if there are signs of fluid overload. Shock is defined as a type of circulatory failure where lack of oxygen leads to dysfunction of vital organs. This is beyond the scope of this blog post.

Advanced Life Support 143

Advanced Life Support ED ALS Life Support 143

Dr. Smith's ECG Blog

OCTOBER 18, 2023

Cardiac arrest was called and advanced life support was undertaken for this patient. The above ECGs show the initiation and continuation of a polymorphic ventricular tachycardia. Polymorphic ventricular tachycardia can be ischemic, catecholaminergic or related to QT prolongation. After about 90 seconds of chest compressions she awoke.

Defibrillator 124

Defibrillator Advanced Life Support Coronary Life Support 124

Utah's Paramedic and EMS Academy

OCTOBER 23, 2023

In contrast, Paramedics are trained to provide advanced life support care. This training covers basic medical care, such as how to conduct an emergency assessment, administer oxygen, and provide essential life support, and takes about six months in most cases.

EMT 52

EMT EMT Paramedic Emergency Medical Technician 52

FOAMfrat

JULY 3, 2024

Also, start a hazmat company and engine company as quickly as possible. Be prepared to take an advanced airway early. Monitor the patient for signs of worsening respiratory distress. Bronchodilators are appropriate for wheezing within your protocols or with OLMC. These symptoms can be delayed or immediate.

Life Support 105

Life Support ALS Emergency Response OR 105

EMDocs

JANUARY 8, 2024

Magnesium does not improve ROSC, survival, or neurologic outcomes, no matter the presenting rhythm (Level 3: no benefit). ECPR is reasonable for select patients with refractory cardiac arrest if performed by appropriately trained personnel in equipped systems (Level 2a: moderate). COR 2a, LOE B-R. COR 2a, LOE C-LD. COR 2b, LOE B-R. COR 2b, LOE B-R.

Epinephrine 98

Epinephrine Defibrillator Coronary CPR 98