Hot Topics in EMS

For more on this topic check out Dr. Jeff Nusbaum's talk here.

IV Nitroglycerin CPGIV Pump CPG 

This is an update from our Mobile Integrated Health team including manager Avital Graves and our new MIH medics, Simon Marteli and Joseph Lee.

https://useagles.org/teammembers/robert-lowe-3/ 

Protocol Link

Dextrosehttps://www.ncbi.nlm.nih.gov/pubmed/2029097https://www.ncbi.nlm.nih.gov/pubmed/17763842https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415309/https://www.ems1.com/cardiac-care/articles/prove-it-administering-dextrose-during-cardiac-arrest-improves-outcomes-9FP6hslyU2OFNrCX/https://www.foamfrat.com/post/hypoglycemia-in-cardiac-arrestKetaminehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9014273/https://www.sciencedirect.com/science/article/abs/pii/S0300957217300394https://pubmed.ncbi.nlm.nih.gov/35586308/https://www.cfp.ca/content/64/7/514.shorthttps://pubmed.ncbi.nlm.nih.gov/15928464/https://www.webmd.com/heart-disease/what-to-know-agonal-breathinghttps://www.mdpi.com/1660-4601/20/4/3654

Click below to see:What the hospitals seeMCFRS 5-minute drill

Guide for the EMS Duty Officer

It's not as rare as you might think. We are joined by Camie Bruhweiler from Shady Grove who discusses a profound increase in incidence of this life threatening process that includes symptoms often written off by new moms.

Video – how to fill out an operational support reportTSR - to request an MDC keyWhat I read:Dr. Maia Dorsett - NAEMSPPEC articleJEMS articleSCTEMS blog

ProtocolAbstract: Exploring Competencies For the Family Facilitator During Resuscitation

Know the Risks - OpioidsGeneral Order 22-04 - Leave-Behind NaloxoneLeave behind naloxone program details 

Link to NEJM studyLink to MCFRS CPG

https://www.emra.org/emresident/article/naloxone-in-cardiac-arrest/https://criticalcarenow.com/naloxone-in-opioid-associated-cardiac-arrest-2/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982449/https://emergencymed.arizona.edu/faq/why-shouldn't-i-just-give-all-cardiac-arrests-narcan-it's-not-going-hurt-them-righthttps://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000958http://www.emdocs.net/sodium-bicarbonate-therapy-does-not-work-in-cardiac-arrest/https://emergencymedicine.wustl.edu/items/sodium-bicarbonate-administration-in-cardiac-arrest/https://rebelem.com/sodium-bicarbonate-in-cardiac-arrest-management/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780490/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864130/https://litfl.com/sodium-bicarbonate-use/https://www.sciencedirect.com/science/article/abs/pii/S0300957217303337https://www.sciencedirect.com/science/article/abs/pii/S0735675705003141https://www.sciencedirect.com/science/article/abs/pii/S0300957221000939https://pubmed.ncbi.nlm.nih.gov/33662526/https://pubmed.ncbi.nlm.nih.gov/36403820/https://rebelem.com/rebel-cast-ep106-the-coca-trial-calcium-in-cardiac-arrest/

Release memoComplete 2022 Protocols

Program overview

This is just the beginning... we're only looking at the rabbit hole. Grab some coffee. Start at the top.Summary of researchNAEMSP Position Statement - Cardiac Arrest NAEMSP Position Statement - Supraglottic AirwaysPART TrialAirways-2 TrialCAAM TrialFewer intubation attempts is associated with improved outcomes 

Here are several education resources targeting community clinicians / first responders:This is the link to the current PDF version of the EMS field guide document:  https://www.mylvad.com/sites/default/files/EMS%20Field%20Guides/2021%20Field%20Guides/ICCAC_Emergency_Guides_20_21-1.pdfThe Emergency care of a HM3 is a pamphlet created by the manufacturer.The MedStar ED LVAD Job Aid has the on call coordinator pager number. It is a challenge to use in the field if the scene is noisy. The call is “answered” by a computer that says, “enter your numeric message”. The action required is that the responder uses the phone key pad to put in the 10 digit phone number you want the vad coordinator to call. Turn around time is 2 – 3 minutes. We have patients and caregivers practice paging. If you or someone on your team would like to practice so the first time using the system is not during an emergency, please do so but say quickly when we answer that it is just a test.

We are joined by Paramedic Robert Gold to tell us about his first time using telehealth

Crashing patient care announcement

Link to Clinical Practice Guideline 2021-03

We are joined by BC Dave Sabat and Dr. Matt Levy from Howard County to discuss cardiac arrest care during the Covid era.

2021 MMPDr. Galvagno's slides

Link to the field resource guideThese two videos show me connecting to telehealth with a Sonim phone. The connection method is up to doctor and depends on the device she/he is using:Text method videoInput method videoAnd... we got music!

LAMS VisualMIEMSS MemoMCFRS EMIHS LVO Transport AnnouncementGIS Map - 30 Minutes to Suburban Hospital

This podcast provides an overview of the MCFRS MIH team and the great work they are doing through innovative programs.

In this episode BC Kaufman and MFP Touzeau review troubleshooting measures to improve first pass success when using the Airtraq video laryngoscope. Process checklistHere's the 5 minutes airway article - really cool videos and it won't take long, we promise.Here's a glimpse at some of the great work that's being done.Video 1 - Midline insertion, great view of the hyoepiglottic ligament, great view of the glottis, successful tube placement. This would have been even better if a tube introducer had been used.Video 2 - Look how easy the bougie makes it! The  Coude tip affords so much flexibility and forgiveness if blade placement isn't absolutely perfect.

We discuss the ALS to BLS downgrade process in the context of Fire Chief's General Order 20-07.

In this episode BC Kaufman and MFP Touzeau review techniques to improve first pass success when using the Airtraq video laryngoscope. Check out the Airtraq training module prior to listening to the podcast, if possible.Here's the 5 minutes airway article - really cool videos and it won't take long, we promise.Here's a glimpse at some of the great work that's being done.Video 1 - Midline insertion, great view of the hyoepiglottic ligament, great view of the glottis, successful tube placement. This would have been even better if a tube introducer had been used.Video 2 - Look how easy the bougie makes it! The  Coude tip affords so much flexibility and forgiveness if blade placement isn't absolutely perfect. 

In this episode BC Kaufman and MFP Touzeau review techniques to improve first pass success when using the Airtraq video laryngoscope. Check out the Airtraq training module prior to listening to the podcast, if possible.Here's the 5 minutes airway article - really cool videos and it won't take long, we promise.You'll find a READ-DO checklist on page three of the training file. 

Check out the Appendix and infographic!IRP Appendix U – Cardiac Arrest ManagementSPASM Infographic

This is reposted from the original distribution back in July 2020 right before we added Toradol.Obtain 0.75 hours of ALS continuing education by taking this quiz.Click here to view completed podcost con ed.

This is reposted from the original distribution back in July 2020 right after we added ketamine.Obtain 0.5 hours of ALS continuing education by taking this quiz.Click here to view completed podcost con ed.