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In this special data-driven edition of the EMS One-Stop podcast, host Rob Lawrence is joined by Dr. Brent Myers, chief medical officer, ESO, and Dr. Remle Crowe, ESO's director of clinical and operational research, to unpack the newly released 2025 ESO EMS Index. This annual report provides a powerful, real-world snapshot of national EMS trends — drawing on more than 14 million anonymized records to surface opportunities for clinical and operational improvement. The conversation dives into key metrics that move beyond response times and into areas like pain management, opioid overdoses, airway confirmation, obstetric emergencies, whole blood use, pediatric behavioral health and high-utilization patient populations. Throughout the episode, Drs. Myers and Crowe share the motivation behind each metric, explain how the data was gathered and analyzed, and reflect on how EMS agencies can use these insights to guide better care delivery and system design. From confronting equity in pain management, to pushing forward innovations like buprenorphine administration and whole blood programs, this is a compelling call to turn data into meaningful change. Timeline 01:08 – Overview of the ESO EMS Index and its intent 02:59 – Origins of the report and data methodology 05:46 – Database scale: 14M+ records, 3,000+ agencies 07:14 – Metric 1: Pain management for long bone fractures 10:53 – Documentation, AI in EMS, and future documentation tools 14:30 – Metric 2: Suspected opioid overdose and buprenorphine use 18:51 – Best practices, COWS scoring, and naloxone delivery strategy 21:31 – Metric 3: Invasive airway confirmation using waveform capnography 28:06 – Metric 4: Obstetric emergencies (postpartum hemorrhage & hypertension) 34:34 – Metric 5: Prehospital whole blood surveillance 40:22 – Metric 6: Pediatric behavioral health and substance use disorder cases 44:54 – Metric 7: High utilization patient group (HUG) 52:48 – Final thoughts, calls to action, and Rob's reflections 55:47 – Episode wrap-up and subscription reminder
CoROM cast. Wilderness, Austere, Remote and Resource-limited Medicine.
This week, we have another MiM25 presentation. Dr Trevor Abela discusses the unique role of nurses in Malta's emergency services, the historical context of nursing in the region, and the importance of holistic care and building trust in nursing practice. Dr Abela emphasises the need for nurses to focus on the patient as a person rather than just a set of medical needs and highlights the significance of context in providing effective care.TakeawaysMalta has a unique nurse-led ambulance service.Historical context is crucial for understanding current nursing practices.Nurses should focus on the person, not just on medical tasks.Building trust with patients is essential for effective care.Holistic care includes addressing social and psychological factors.Emergency care must go beyond basic medical priorities.Nursing education should emphasise patient-centred care.The relationship between nurse and patient impacts treatment outcomes.Nurses play a vital role in community health beyond hospitals.Clinical outcomes do not solely define success in nursing.Chapters00:00 Introduction to the Quorum Podcast00:44 Nursing in Malta: A Unique Perspective03:11 Historical Context of Nursing in Malta06:34 The Role of Nurses in Emergency Services11:37 Understanding Nursing: Capital N vs. Small n18:02 The Importance of Context in Nursing Care25:42 Holistic Care in Pre-Hospital Settings34:19 Building Trust and Relationships in Nursing40:48 Conclusions and Reflections on Nursing Practice
In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Christine Carico and Dr. Matt Levy to discuss the peer-reviewed paper, “Nationwide Trends in Prehospital Blood Product Use After Injury.” The paper, published in “Transfusion” in April 2025, explores the use of blood products in prehospital trauma care. Despite the proven benefits of blood transfusion in the field, their research uncovers the alarming reality that less than 1% of eligible patients receive prehospital blood products. This conversation dives into the study's methodology, key findings and the significant barriers EMS systems face in implementing blood transfusion protocols. The discussion also touches on the evolving role of EMS in trauma care, regional variations in blood product access, and the future of prehospital blood transfusion programs. Dr. Carico and Dr. Levy break down their work and reflect on the data, explaining how the study used National Emergency Medical Services Information System (NEMSIS) data to identify trauma patients who would have benefited from blood transfusions. The episode delves into the operational challenges EMS systems face in obtaining and administering blood products in the field, the financial and logistical obstacles, and the potential life-saving impact of more widespread adoption of these protocols. Timeline 00:00 – Intro and welcome: Rob Lawrence introduces Dr. Matt Levy and Dr. Christine Carico, setting up the discussion on prehospital blood product use 03:00 – Study overview: Dr. Carico explains the methodology of the study, focusing on the use of NEMSIS data and the inclusion criteria for the patient population 07:00 – Key findings: Dr. Carico reveals the key findings of the paper, including the low percentage of eligible patients receiving prehospital blood products 11:00 – Barriers to implementation: Dr. Levy discusses the main barriers to the widespread implementation of blood transfusion protocols in the field, including access to blood, logistics and training 17:00 – Regional variations: The speakers touch on the regional disparities in blood product availability and the differences in protocols across the country 23:00 – Data challenges: Dr. Levy and Dr. Carico discuss the challenges related to data accuracy, particularly in terms of blood product documentation 27:00 – Cost and reimbursement: Dr. Levy addresses the financial aspects of blood product programs, including cost, reimbursement challenges and funding opportunities 32:00 – The future of blood transfusion in EMS: Dr. Levy envisions the future of prehospital blood transfusion programs, including the potential for shelf-stable blood products and regional blood supply systems 37:00 – Closing thoughts: Both guests offer their final thoughts on the importance of continued research and data collection, and the need for EMS to embrace a more integrated role in acute care Additional whole blood resources Carico C, Annesi C, Clay Mann N, Levy MJ, et al. “Nationwide trends in prehospital blood product use after injury,” 2025. Transfusion – Wiley Online Library Tracking the whole blood landscape as updated guidelines allow EMS to carry and administer whole blood EMS One-Stop: Stop the bleed, fill the tank – The New Orleans EMS blood program Insider analysis: Delaware's statewide whole blood rollout sets a new EMS standard Whole blood in EMS promises a revolution in resuscitation: How one county agency is saving lives with prehospital transfusions Matthew Levy | LinkedIn Christine Carico | LinkedIn
Ready for the latest insights in prehospital care? In this episode, we're diving into an eye opening question in emergency medicine: could giving just a single dose of epinephrine during cardiac arrest be more effective than the standard approach? This topic isn't just about changing a drug protocol—it challenges the way we think about resuscitation itself. We're spotlighting a new study that's sparking important conversations in the field, and it's part of a broader theme in the latest issue of Prehospital Emergency Care, which also features articles on pediatric emergencies, compelling case studies, and new insights into cardiac arrest care. Join Niko and Michael as they speak with authors Dr. Tyler George and Dr. Nick Ashburn about their study - you don't want to miss it. Check out PEC Podcast Episode 149 today! Available now on your favorite podcast platform. As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaelkim_md) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD
As our team is out saving lives, we're excited to revisit one of the most harrowing episodes in our archives from January 2023. This remarkable story has a multitude of valuable lessons and insights you're going to love. See you next month with fresh content! It's a different type of episode today on AMPED. We're joined by Ridley Barron, a Senior Pastor at Grove Hill Church in Chapel Hill, TN, and motivational speaker. He tells an incredible story about how his life was changed in a split second via car accident, shares the harrowing journey in the hospital that happened with his youngest son, and the aftermath that followed. Our hosts also discuss Air Methods' MACC Checklist, which stands for Medication Administration Cross Check. It's a story of tragedy, of forgiveness, and of making the most out of the impossibly difficult situations life presents you with. Ridley Barron, Senior Pastor and Motivational Speaker. You can learn more about him at his website. Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Joseph Hill RN BSN CMTE CFRN
Today, we're diving into one of the most challenging and high-stakes procedures in trauma medicine—prehospital resuscitative thoracotomy (RT) for traumatic cardiac arrest (TCA). Joining me is Dr Mike Christian, the senior author of a recent study published in JAMA Surgery, which examines the impact of prehospital RT in London's Air Ambulance (LAA) system over two decades. TCA is often seen as a condition with a poor prognosis but for select patients—particularly those suffering from cardiac tamponade—prehospital RT has been shown to improve survival rates when performed within minutes of arrest. This study is the largest of its kind, analysing over 600 cases and shedding light on the effectiveness of RT, the critical time windows, and the factors that influence outcomes.In this episode, we'll explore the study's key findings, discuss the operational and ethical challenges of performing RT in the field, and consider what this means for the future of prehospital trauma care. The paper can be found here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2830622A review and appraisal of the paper can be found here: https://www.stemlynsblog.org/laa-resuscitative-thoracotomy/This is an advertisement from BetterHelp.Stress and anxiety affect all of us—whether it's the daily pressures of work, life, or the unexpected moments that throw us off balance. As pre-hospital professionals, we see firsthand how mental health can impact lives, yet we often neglect our well-being.Anxiety can manifest in ways we don't always recognise—headaches, sleepless nights, or even feeling constantly on edge. In a world that demands more, sometimes the best thing you can do is pause, reflect, and seek support. Therapy isn't just for those in crisis—it's about learning coping strategies, setting boundaries, and becoming the best version of yourself.BetterHelp is the world's largest online therapy platform, connecting you with professionals specialising in anxiety and more. Take control of your mental health today. Our listeners get 10% off their first month at BetterHelp.com/CAREPODThis podcast is sponsored by PAX.Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:https://www.pax-bags.com/en/
On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence. What they found should motivate us all to be skeptical when it comes to determining if TCP is actually working. REFERENCES 1. https://www.mchd-tx.org/wp-content/uploads/2025/03/TCP-Podcast-Figures.pdf 2. Kimbrell, J., Kreinbrook, J., Poke, D., Kalosza, B., Geldner, J., Shekhar, A. C., Miele, A., Bouthillet, T., & Vega, J. (2024). False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series. Prehospital emergency care, 28(7), 928–936. 3. https://www.ems12lead.com/post/tcp-in-transit-part-i 4. https://www.ems12lead.com/post/transcutaneous-pacing-part-2 5. https://www.ems12lead.com/post/transcutaneous-pacing-part-3
Our team is dispatched to a scene where they understand a pregnant woman is experiencing footling breech during the birthing process. When they arrive, they find the baby already delivered and being tended to with Basic Life Support practices, although she is in rough shape. How does the team pivot? What steps do they take as the baby is in cardiac arrest? The answer, as it frequently is, is to go back to basics. Listen in on this incredible story with an unexpected ending. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Breanna Bingel RN, BSN, PHRN, TNS, CFRN, CEN, TCRN, CTRN Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it's possible they could be having a stroke.The Cincinnati Prehospital Stroke Scale. There are several conditions that can mimic a stroke. Identification & Treatment of hypoglycemia or hyperglycemia. Identification & Treatment of hypoxia using a pulse oximeter. Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell's Palsy can also mimic a stroke. Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols. Hospital providers should active their stroke team to ensure rapid assessment and treatment.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInOther Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Save money on prescription medications for you and your pets: https://nationaldrugcard.com/ndc3506*Commissions may be earned from the above links.Good luck with your ACLS class!
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What if the key to advancing military medicine lies in a small shift from opioids to ketamine for battlefield pain management? Join us as we unlock the groundbreaking research of Dr. Ted Melcer, a pioneer in military psychological studies, whose work challenges the conventional use of morphine for wounded soldiers. Recognized by Military Medicine Journal as the 2024 article of the year, Dr. Melcer's investigation into pre-hospital ketamine therapy offers fresh insights into its potential to alter PTSD prognosis, shifting the landscape of tactical combat care. As we delve into Dr. Melcer's journey, we explore the evolution of his research since before 9/11, highlighting the urgent need for data-driven medical care enhancements for troops in conflict zones. Discover how the Naval Health Research Center's innovative database initiative has informed new treatment protocols, possibly reducing psychological repercussions for soldiers. This episode promises a thorough exploration of the strategic, long-term benefits of ketamine use in military medicine and the broader implications for operational readiness. Dr. Melcer's research publication was selected as the AMSUS Journal Military Medicine Article of the Year for 2025. Article Citation: Is Prehospital Ketamine Associated With a Change in the Prognosis of PTSD? Ted Melcer, PhD, G Jay Walker, BA, Judy L Dye, NP, Benjamin Walrath, MD, MPH, Andrew J MacGregor, PhD, Katheryne Perez, MPH, Michael R Galarneau, MS, NRERMT Military Medicine, Volume 188, Issue 7-8, July/August 2023, Pages e2165–e2174, https://doi.org/10.1093/milmed/usac014 Take Home Messages: Revolutionizing Battlefield Pain Management: The transition from traditional opioids to low-dose ketamine for managing pain in combat situations shows promising results, potentially offering safer alternatives with fewer side effects, especially for soldiers who have sustained severe injuries. Impact on PTSD Prognosis: Preliminary findings suggest that the use of pre-hospital ketamine may be associated with lower odds of developing PTSD compared to opioids, indicating a protective psychological benefit for injured service members. Importance of Tactical Combat Casualty Care Guidelines: The research highlights the critical role of tactical combat casualty care guidelines in informing first responders and medics about effective pain management strategies that may also enhance long-term psychological outcomes. Value of Battlefield Data: The collection and analysis of battlefield casualty care data are invaluable for understanding the effects of medical interventions on long-term health outcomes, informing both military guidelines and broader medical practices. Continuous Need for Research: There is a pressing need for systematic studies on the long-term psychological effects of battlefield treatments, emphasizing the importance of ongoing research to improve rehabilitation outcomes and operational readiness for service members. Episode Keywords: Battlefield medicine, ketamine research, PTSD treatment, military healthcare, WarDocs podcast, pain management, soldier recovery, innovative medicine, combat healing, mental health, Dr. Ted Melcer, Naval Health Research Center, Military Medicine Journal, tactical combat casualty care, operational readiness, psychological effects, opioid alternatives, military medicine, AMSUS, trauma registry, pre-hospital care. Hashtags: #BattlefieldMedicine #KetamineResearch #PTSDTreatment #MilitaryHealthcare #WarDocsPodcast #PainManagement #SoldierRecovery #InnovativeMedicine #CombatHealing #MentalHealthRevolution Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation. Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms. Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast
Recorded at Evidence Based Perioperative Medicine (EBPOM) in London last year this presentation is part of a series of talks given under the session heading: “Implementation – what works and what doesn't?”. This piece is part one of four, with two more presentations to come and then a fascinating panel discussion to conclude. This first session focuses on the implementation of clinical trials, covering research methodologies, clinical implementations, and their challenges, and looking at the lengthy process of translating medical discoveries into clinical practice, emphasizing the ethical obligation to disseminate trial results effectively. The under-representation of certain demographics in trials, the gap between research findings and clinical practice, and the need for better communication strategies is stressed alongside solutions, including training for researchers, involving key stakeholders from the start, and the role of funders in supporting effective dissemination and implementation of research findings. Our presenter is, Joyce Yeung, Professor of Anaesthesia and Critical Care Medicine at the University of Warwick. She is Theme Lead of the Emergency, Prehospital, Perioperative and Critical Care Trials group within Warwick Clinical Trials Unit. Clinically she holds appointments as a Consultant in Critical Care Medicine at University Hospital Birmingham NHS Foundation Trust. Joyce is Director of UK Perioperative Medicine Clinical Trials Network. She is joint Clinical Speciality Lead for Anaesthesia, Perioperative Medicine and Pain for West Midlands Comprehensive Research Network. She is also the Chair of Resuscitation Council UK Immediate Life Support Subcommittee and is a member of Scientific and Education Committee at European Resuscitation Council. She serves as expert systematic reviewer and International Liaison Committee on Resuscitation taskforce member. Joyce is Chief Investigator for a major grant examining the impact of volatile versus intravenous anaesthesia in non-cardiac surgery (VITAL trial). Her research interests are applied health research and clinical trials including improving perioperative patient outcomes, chronic pain, post-operative cognitive dysfunction, and resuscitation. For more information about EBPOM and the conferences they are organising this year please go to www.ebpom.org
When two flight teams are dispatched to a scene, usually the first to arrive takes the sicker of the patients. What happens when circumstances on the ground change that? How do the teams tag in and tag out with one another? On this episode of the AMPED Podcast, a high speed highway collision sees patients with a litany of maladies including traumatic brain injuries. Our team identifies and handles Beck's triad, tension pnuemothorax, flail chest and a lot more in an eventful transport to the medical facility. Listen in on how our team, with a special guest ride along visitor, handles everything. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Breanna Bingel RN, BSN, PHRN, TNS, CFRN, CEN, TCRN, CTRN Kayce Thompson, BSN, RN, Flight Nurse Shawnee Trindle, ER RN Kayce, Shawnee and Breanna together Spenser Rich, RN-Paramedic, CFRN, FPC Christopher Wright, BSN, RN, CFRN, etc Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
Cardiac Arrest in pregnancy affects around 1: 12-30,000 women in the developed world. As you'd expect the risk of death for mother and child is extremely high, but some causes of arrest are reversible and we can make a real impact with our care and treatment of these cases Now it goes without saying that these are some of the most emotive, complex and technically challenging Resuscitations that you could think to be involved in; by definition young female arrest with unborn babies involved. Thankfully this is not going to be a case that many of us see, but with the stakes so high and potential to impact on the outcome of two patients, it's an area that's worth real consideration, preparation and mental rehearsal in case we are one of the few that may need to deal with it! In this episode we're going to run through all the same stuff that you'd expect; pathophysiology of pregnancy, aetiology and the way in which we should approach these arrests. But then we're lucky enough to be joined by Caroline Leech, an EM and Prehospital doctor who's an expert in the area having just published a key paper that's prompted loads of discussion in crew room and online on the topic of maternal arrest and Resuscitative Hysterotomy which will really challenges our perception on survival for both mum and the unborn baby if a RH is indicated. So we'll be running through that paper with some really valuable insights from Caroline and wrap up with some questions to her exploring experience from cases, along with potential strategies for how approach and manage these cases for those working both in prehospital and in-hospital settings. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
JEMS Editor-in-Chief Dr. Ted Lee speaks with Dr. Michael J. Carr about how telemedicine is saving lives in Georgia. Carr, the executive director of Prehospital & Ambulatory Virtual Emergency Services (PAVES) at Emory University, says patients in rural counties now have access to doctors and specialists even before they reach the hospital.
A pinkie promise is a promise you cannot break, and it's one our patient in this month's episode made to his wife when he was stricken with a life-threatening COVID infection. She made him promise that he would pull through the ordeal, and he did... but not without many bumps in the road. Our team not only battled our patient's COVID, but also a nasty case of pneumonia that ultimately led to him needing to be placed on ECMO, which, as you know, is usually a last resort. Listen in as they transported him prone, which our team had never done before in 20+ years of experience, dealt with an unexpected hailstorm during transport and find out how our patient ended up doing after a lung transplant. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Jeff Dickson, NRP, FP-C The Wilkins Family Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
A new potential treatment for patient agitation and safety intervention for EMS: oral risperidone. While the medication has been around since the early 1990s, it has only recently been used in EMS. Join us for this month's Prehospital Care Research Forum Journal Club as we explore this treatment's feasibility, safety, and potential!https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2361133#
This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release. This episode has been out in the world on Medic Mindset for a couple of months, but we wanted to offer it to our MCHD Paramedic Podcast listeners as well. Also, like, subscribe to and follow Medic Mindset wherever you listen to podcasts. REFERENCES 1. https://medicmindset.com 2. Elam, K., & Bolar-Softich, K. L. (1997). Dilemmas in the acute pharmacologic treatment of uncontrolled atrial fibrillation. The American journal of emergency medicine, 15(4), 418–419. 3. Abarbanell, N. R., & Marcotte, M. A. (1997). Prehospital use of intravenous diltiazem (cardizem Lyo-Ject) in the treatment of rapid atrial fibrillation. The American journal of emergency medicine, 15(6), 618–619. 4. Abarbanell, N. R., Marcotte, M. A., Schaible, B. A., & Aldinger, G. E. (2001). Prehospital management of rapid atrial fibrillation: recommendations for treatment protocols. The American journal of emergency medicine, 19(1), 6–9. 5. Wang, H. E., O'connor, R. E., Megargel, R. E., Schnyder, M. E., Morrison, D. M., Barnes, T. A., & Fitzkee, A. (2001). The use of diltiazem for treating rapid atrial fibrillation in the out-of-hospital setting. Annals of emergency medicine, 37(1), 38–45. 6. Luk, J. H., Walsh, B., & Yasbin, P. (2013). Safety and efficacy of prehospital diltiazem. The western journal of emergency medicine, 14(3), 296–300. 7. Rodriguez, A., Hunter, C. L., Premuroso, C., Silvestri, S., Stone, A., Miller, S., Zuver, C., & Papa, L. (2019). Safety and Efficacy of Prehospital Diltiazem for Atrial Fibrillation with Rapid Ventricular Response. Prehospital and disaster medicine, 34(3), 297–302. 8. Fornage, L. B., O'Neil, C., Dowker, S. R., Wanta, E. R., Lewis, R. S., & Brown, L. H. (2024). Prehospital Intervention Improves Outcomes for Patients Presenting in Atrial Fibrillation with Rapid Ventricular Response. Prehospital emergency care, 28(7), 910–919.
Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How much value should we on that piece of paper? And, regardless, how do we work towards obtaining and maintaining qualifications? In this podcast episode, we discuss it all including Dunning-Kruger Effect and Hierachy of Competence. We also delve into teaching strategies that can help newcomers gain their confidence after achieving whatever got them there in the first place. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment. -------------------------------------------- Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com
Show Notes for Episode 41 of “The 2 View” – reversible cerebral vasoconstriction syndrome, cerebral venous thrombosis, cardiopulmonary resuscitation and emergency cardiovascular care science, prehospital tourniquets, blood pressure, and more. Segment 1 – Reversible cerebral vasoconstriction syndrome and cerebral venous thrombosis Ropper AH, Klein JP. Cerebral Venous Thrombosis. N Engl J Med. Published June 30, 2021. https://www.nejm.org/doi/full/10.1056/NEJMra2106545 Spadaro A, Scott KR, Koyfman A, Long B. Reversible cerebral vasoconstriction syndrome: A narrative review for emergency clinicians. Am J Emerg Med. ScienceDirect. Published December 2021. https://www.sciencedirect.com/science/article/abs/pii/S0735675721008093 Segment 2 – Cardiopulmonary resuscitation and emergency cardiovascular care science, Prehospital tourniquets, and more Greif R, Bray JE, Djärv T, et al. 2024 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. Circulation. AHA | ASA Journals. Published November 14, 2024. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001288?utmcampaign=sciencenews24-25&utmsource=science-news&utmmedium=phd-link&utmcontent=phd-11-14-24 Roberts M, Sharma M. The Center for Medical Education. 36 - Marijuana, Sunburns, Pulse Oximetry, Lower UTI's. 2 View: Emergency Medicine PAs & NPs. Published May 31, 2024. https://2view.fireside.fm/36 Roberts M, Sharma M. The Center for Medical Education. The 2 View: Episode 2. 2 View: Emergency Medicine PAs & NPs. Published February 3, 2021. https://2view.fireside.fm/2 Smith AA, Ochoa JE, Wong S, et al. Prehospital tourniquet use in penetrating extremity trauma: Decreased blood transfusions and limb complications. J Trauma Acute Care Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published January 2019. https://pubmed.ncbi.nlm.nih.gov/30358768/ STB home page. Stop the Bleed. American College of Surgeons. https://www.stopthebleed.org/ Teixeira PGR, Brown CVR, Emigh B, et al. Civilian Prehospital Tourniquet Use Is Associated with Improved Survival in Patients with Peripheral Vascular Injury. J Am Coll Surg. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published May 2018. https://pubmed.ncbi.nlm.nih.gov/29605726/ Segment 3 – Blood Pressure Bress AP, Anderson TS, Flack JM, et al. The Management of Elevated Blood Pressure in the Acute Care Setting: A Scientific Statement From the American Heart Association. Hypertension. NIH: National Library of Medicine: National Center for Biotechnology Information. PubMed. Published August 2024. https://pubmed.ncbi.nlm.nih.gov/38804130/ Liu H, Zhao D, Sabit A. Arm Position and Blood Pressure Readings: The ARMS Crossover Randomized Clinical Trial. Jamanetwork.com. JAMA Network. JAMA Internal Medicine. Published October 7, 2024. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2824754 Recurring Sources Center for Medical Education. Ccme.org. http://ccme.org The Proceduralist. Theproceduralist.org. http://www.theproceduralist.org The Procedural Pause. Emergency Medicine News. Lww.com. https://journals.lww.com/em-news/blog/theproceduralpause/pages/default.aspx The Skeptics Guide to Emergency Medicine. Thesgem.com. http://www.thesgem.com Trivia Question: Send answers to 2viewcast@gmail.com Be sure to keep tuning in for more great prizes and fun trivia questions! Once you hear the question, please email us your guesses at 2viewcast@gmail.com and tell us who you want to give a shout-out to. Be sure to listen in and see what we have to share!
LISTENER DISCRETION IS ADVISED. Lavery MD, Aulakh A, Christian MD. Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2025 Jan 6;33(1) Other Citations: Bujak K, et al. Does the presence of physician-staffed emergency medical services improve the prognosis in out-of-hospital cardiac arrest? A propensity score matching analysis. Kardiol Pol. 2022;80(6) Fukuda T, et al.. Association of Prehospital Advanced Life Support by Physician With Survival After Out-of-Hospital Cardiac Arrest With Blunt Trauma Following Traffic Collisions: Japanese Registry-Based Study. JAMA Surg. 2018 Jun 20;153(6) Garner et al.. The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only. Emerg Med J. 2015 Nov;32(11) Den Hartog et al.. Survival benefit of physician-staffed helicopter emergency medical services (HEMS) assistance for severely injured patients. Injury. 2015;46(7) Hesselfeldt R,et al.. Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study. Acta Anaesthesiol Scand. 2013 May;57(5): Lyons J, et al. Impact of a physician - critical care practitioner pre-hospital service in Wales on trauma survival. Anaesthesia. 2021 Nov;76(11) Maddock A, et al. Prehospital critical care is associated with increased survival in adult trauma patients in Scotland. Emerg Med J. 2020 Mar;37(3):141-145. Moors XRJ, et al. A Physician-Based Helicopter Emergency Medical Services Was Associated With an Additional 2.5 Lives Saved per 100 Dispatches of Severely Injured Pediatric Patients. Air Med J. 2019 Jul-Aug;38(4) Yeguiayan JM, et al. Medical pre-hospital management reduces mortality in severe blunt trauma. Crit Care. 2011;15(1)
Dr. Lekshmi Kumar, Associate Professor of Emergency Medicine at Emory University / Grady Hospital system in Atlanta, Georgia and the EMS director or the city of Atlanta presents grand rounds to kick off the 2025 calendar year! She talks about their collaborative work to create a prehospital blood transfusion program to uplift the trauma care in their region. Tune in to learn about the method for handling the change, the specifics for implementation and to learn the difference that this is making for their patients. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com
On this episode of Providing Pediatrics, Charles sits down with flight nurse Matthew Whaley of Angel One Transport here at Arkansas Children's to discuss delivering newborns in the pre-hospital setting. They discuss when to stop and deliver versus when to transport, specific equipment needed for delivery, emergent concerns that may arise and what to do about them, as well as an in-depth discussion around the resuscitation of the neonate in the pre-hospital setting.
If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it's possible they could be having a stroke.The Cincinnati Prehospital Stroke Scale. There are several conditions that can mimic a stroke. Identification & Treatment of hypoglycemia or hyperglycemia. Identification & Treatment of hypoxia using a pulse oximeter. Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell's Palsy can also mimic a stroke. Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols. Hospital providers should active their stroke team to ensure rapid assessment and treatment.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES: Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour, R. B., Sims, S., Kellam, J. F., & Bosse, M. J. (2015). Type III open tibia fractures: immediate antibiotic prophylaxis minimizes infection. Journal of orthopaedic trauma, 29(1), 1–6. Johnson, J. P., Oliphant, B. W., Dodd, J., Duckworth, R. L., Goodloe, J. M., Lyng, J. W., Sagraves, S. G., & Fischer, P. E. (2024). Prehospital Antibiotic Administration for Suspected Open Fractures: Joint COT/OTA/ACEP/NAEMSP/NAEMT Position Statement. Prehospital emergency care, 28(8), 1063–1067. Muniz, A. D., Gregorio, D. J., Studebaker, S. A., Peth, A. M., Camacho, C. G., Williams, B., Kupas, D. F., & Brown, L. H. (2024). Time Savings and Safety of EMS Administration of Antibiotics for Open Fractures. Prehospital emergency care, 28(8), 1046–1052.
When every second counts in a medical emergency like a stroke, deciding on the right course of treatment can be life-changing. Strokes come in two main types—ischemic and hemorrhagic—each requiring very different treatment approaches. But what if a critical intervention, like lowering blood pressure, could be started right there in the ambulance? Could it improve outcomes for stroke patients before they even reach the hospital? These are some of the pressing questions tackled in the latest episode of EMS Research with Professor Bram. This discussion explores the complexities of early care for stroke patients and the role prehospital blood pressure management might play in recovery. Paramedic Mic Gunderson and Neurologist David Rose offer a specialist's perspective on stroke care. Together, they dissect groundbreaking research and share practical strategies that could transform how strokes are treated in the field.
The holidays are a time for hope, a time for believing in the extraordinary. Remember that classic holiday film, Miracle on 34th Street? Just when everyone's lost faith, a series of unexpected events bring about the impossible. Well, this week on the Air Methods Prehospital Education Podcast, we bring you a real-life story that echoes that same spirit. It's a case of resilience, determination, and the power of preparation in the face of a life-threatening pediatric emergency. Picture this: a child in cardiac arrest, the festive joy replaced by the urgent need to save a life. Our crew, faced with a medical mystery and a young life hanging in the balance, refused to give up. Like Kris Kringle himself, they needed more than just skill – they needed a touch of magic, a sprinkle of the extraordinary. Join us as our AMPED crew, Medical Director Dr. Wilmas, Flight Nurse Nyssa Hattaway, and I, delve into this heartwarming case, exploring how preparation, quick thinking, and a series of fortunate events intertwined to save a child's life. It's a story that reminds us that even in the darkest of moments, hope, like the spirit of the holidays, can prevail. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Nick Grindeland, RN, NREMT-P, CFRN Derek Hughes, Flight Paramedic/Clinical Base Lead Alberto Sauceda, Dad Logan Sauceda, our patient Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
In Part 3 we discuss the best of SANE and sexual assault patients, field termination and DOA, air medical care, neonatal resuscitation, event medicine and access routes, capnography, MCI and the new procedures, and ECPR.
In Part 2 we discuss sports medicine and the hyperthermic patient, importance of EMS documentation, anaphylaxis in pediatric care, dosing, shock, RSI, cardiac arrest care, STEMI care and EMS, and patient capacity in psychiatric emergencies
We take a look back at the best five minutes of our early episodes. In part 1 we discuss CPAP and better hand off care, the use of ketamine in assisted airways, toxicology, stroke, tactical medicine, innovations in resuscitation, steroids, and speak with a cardiac arrest survivor.
A gruesome head-on motorcycle accident causes this month's patient a litany of injuries. He has bilateral femur fractures, a large open wound on his abdomen and much more... and he's awake the whole time. He is cognizant, lucid, and chatting with our team through the entire ordeal. Is he experiencing neurogenic shock? And if he is experiencing neurogenic shock, can he be electrically paced? There's no standard guidance on this exact scenario. Tune into this episode of AMPED to find out what our team did and what the ultimate result is. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Veronica Huskey, RN, NREMT-P, CFRN, FP-C Alaina Armstrong-Cain, NREMT-P, FP-C Our team together Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
Join Iain Beardsell and Liz Crowe in an engaging discussion with Alice Hutton, an emergency physician from Paris, at Tactical Trauma 24 in Sundsvall, Sweden. The episode delves into the implementation and logistics of pre-hospital eCPR (Extracorporeal Cardiopulmonary Resuscitation) by SAMU in Paris. Alice shares insights from her PhD research on refractory cardiac arrest and discusses the use of therapeutic hypothermia, including experimental approaches like total liquid ventilation. Key topics include team composition, decision-making for patient eligibility, real-time management strategies, bypassing traditional emergency rooms for specialized facilities, and the challenges of scene management, family communication, and post-event debriefing. This conversation offers a comprehensive look at the latest innovations that could transform pre-hospital emergency medical services. Read more here... 00:00 Introduction and Guest Introduction 01:29 eCPR in Paris: Current Practices 02:35 Dispatch and Response Protocols 03:32 On-Scene Procedures and Challenges 04:23 Decision Making and Scene Management 05:53 Training and Handling Difficult Situations 06:59 Challenges of eCPR Decision-Making 08:07 Importance of Team Debriefing 08:52 Post-Resuscitation Procedures 10:12 Operational Logistics and Success Rates 11:20 Innovative Research in Therapeutic Hypothermia 13:13 Future of Pre-Hospital Cooling Techniques 13:46 Conclusion and Final Thoughts
The crew and special guest, Don Zimmerman, wind-up the discussion about the new approaches to MCI's in this live show. Special thanks to Chardon Fire for hosting us!
Podcast summary of articles from the September 2024 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include IV acetaminophen, naloxone in cardiac arrest, intracranial hemorrhage, pre-hospital blood gas analysis, POCUS in aortic dissection, and salicylate toxicity. Guest speaker is Dr. Matthew Carvey.
In Part 3 of the "new" MCI episode, we are talking about changing the "paradigm" no pun intended) of planning, and on-scene thinking. From tags, to staging, to determining accessibilty, all of it is changing and will continue to change by reviewing other agency's after-action reports.
Headpulse measurement can reliably ID LVO stroke in prehospital suspected stroke patients by SAEM
Headpulse measurement can reliably ID LVO stroke in prehospital suspected stroke patients by SAEM
It was an honor and a privilege to record an episode with Dr. Mark Piehl and Dr. Peter Antevy. They came on to discuss prehospital blood product administration and their recent letter to the editor in Academic Emergency Medicine.
A seemingly simple heart attack gives our team pause because the patient presents a litany of conflicting symptoms. Should our team send him to have a stent put in right away - as is standard procedure - or do they wait to address the other symptoms and risk muscle damage? What would you do if you were in their position? Our hosts consider the symptoms and give their own recommendations while our team shares what actually unfolded. The lesson is that if something feels a bit off, it's important to listen to your intuition. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Liz Lashley RN, CFRN Jorden Dick, OMS-1, NRP, FP-C Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS
If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it's possible they could be having a stroke.The Cincinnati Prehospital Stroke Scale. There are several conditions that can mimic a stroke. Identification & Treatment of hypoglycemia or hyperglycemia. Identification & Treatment of hypoxia using a pulse oximeter. Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell's Palsy can also mimic a stroke. Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols. Hospital providers should active their stroke team to ensure rapid assessment and treatment.Connect with me:Website: https://passacls.com@Pass-ACLS-Podcast on LinkedInGive Back & Help Others: Your support helps cover the monthly cost of software and podcast & website hosting so that others can benefit from these ACLS tips as well. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Make a difference in the fight against breast cancer by donating to my Men Wear Pink fundraiser for the American Cancer Society (ACS) at http://main.acsevents.org/goto/paultaylor Every dollar helps in the battle with breast cancer.Good luck with your ACLS class!
The team is still talking with Don Zimmerman, MCI subject matter expert and instructor. In this, part 2 of the New MCI episode, the group discusses what Don calls, “silly rules!” For example, does the first ambulance really have to be the ambulance that stays at the MCI?
In this month's episode, the team discuss the evolving strategies in handling mass casualty incidents (MCI). They are joined by Don Zimmerman, an expert with extensive experience in fire service, paramedicine, and education. The episode dives deep into the traditional and modern approaches to managing MCIs, particularly in the context of active shooter events and other dynamic situations.
Date: October 2, 2024 Reference: Paxton et al. Headpulse measurement can reliably identify large-vessel occlusion stroke in prehospital suspected stroke patients: Results from the EPISODE-PS-COVID study. AEM Sept 2024 Guest Skeptic: Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the UMass Chan Medical School – Baystate. She is the co-founder of FOAMcast and a pulmonary […] The post SGEM#455: Harmony 5000 – Prehospital Detection of Large Vessel Occlusion Strokes first appeared on The Skeptics Guide to Emergency Medicine.
A motorcycle accident victim faces dire circumstances and our team has to execute a new procedure that is rarely done in the field and has a high degree of risk if not done correctly. They are one of the only teams in the region equipped to even do such a procedure, and our team is concerned about doing it correctly because a lot can go wrong. Could you do a procedure you don't normally do with an audience? Because in addition to having to execute for the good of the patient, our team had the patient's family, other first responders and more watching them. Listen in as our team tackles another fascinating case on this episode of AMPED. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Veronica Huskey, RN, NREMT-P, CFRN, FP-C Alaina Armstrong-Cain, NREMT-P, FP-C Our team together Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS Nyssa Hattaway, BA, BSN, RN, CEN, CPEN, CFRN
LISTENER DISCRETION IS REALLY ADVISED. References: Meta-Analysis Civ Prehospital Transfusion: PMID 38517320 COMBAT: PMID 30032977 PamPER: PMID 30044935 RePhill: PMID 35271808 COMBAT/PamPER Post-Hoc Analysis: PMID 31851290
Presented with a patient whose symptoms seem contradictory then flip, change and remain unclear, our team must continue to work to keep the patient alive. What's causing the duress for our patient? Is it an aneurysm? Is it neoplastic process? Cardiac arrest? Some combination of these factors? Our team remains nimble, attentive, and diligent in their work. What lessons can we learn from this case? Tune in and find out. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Liz Lashley RN, CFRN Jorden Dick, OMS-1, NRP, FP-C Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS
In this episode, we delve into the critical role of neuroprotection in pre-hospital care, particularly in pediatric head injuries. Through a real-life case study of a 13-year-old boy who suffered a traumatic brain injury after being hit by a car, we explore the steps taken by paramedics and critical care teams to stabilize him and prevent further neurological damage. From airway management to advanced interventions, this episode highlights the challenges of pre-hospital neuroprotection and the incredible teamwork that led to the patient's remarkable recovery. There is more detail on the full blogpost here. This podcast was recorded live at the Hope Church in Winchester as part of the PREMIER conference. We are grateful to the organizing team for hosting us and allowing us to use the audio. The PIER and PREMIER websites are full of amazing resources for anyone working in Paediatric Emergency Medicine, and we highly recommend them. The Speaker Ed is a Speciality Trainee in Emergency Medicine in Wessex and a trainee Critical Care Practitioner with Dorset and Somerset Air Ambulance. Ed is also the co-founder and Managing Director of Enhanced Care Services, a Southampton-based company delivering enhanced and critical care to the event medical sector, providing frontline ambulance services across Hampshire and clinical education at all levels, employing over 200 clinicians. Ed holds the Diploma in Immediate Medical Care (RCSEd) and, having promised to not take on any more work, is currently undertaking a Masters in Resuscitation, Pre-hospital and Emergency Medicine at QMUL. Enhanced Care Services Enhanced Care Services' mission is to provide and influence excellent patient care, irrespective of injury, illness or location, through the delivery of high-quality clinical operations and education. Founded in 2015, ECS now provide frontline ambulance operations across the South, delivers extensive medical cover to some of the most prestigious events across the UK and provides education from its bespoke education centre in Southampton and beyond.
If a person suddenly develops symptoms such as weakness, slurred or garbled speech, loss of balance, or a massive & severe headache; it's possible they could be having a stroke.The Cincinnati Prehospital Stroke Scale. There are several conditions that can mimic a stroke. Identification & treatment of hypoglycemia or hyperglycemia.Identification & treatment of hypoxia using a pulse oximeter.Some seizures, electrolyte imbalance, sepsis, brain tumors, and Bell's Palsy can also mimic a stroke. Prehospital providers should transport suspected stroke patients to a stroke center following their local protocols. Hospital providers should active their stroke team to ensure rapid assessment and treatment.Connect with me:Website: https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back & help others. Your support will help cover the monthly cost of software and podcast & website hosting. Donations made via Buy Me a Coffee at https://buymeacoffee.com/paultaylor are appreciated.Good luck with your ACLS class!
Summer season has our clinicians busy and therefore we are re-sharing Episode 35 featuring the harrowing journey of a brave 10 year-old boy. See you next month with fresh content! As first responders, the odds of patient survival are not always in our favor. But that does not stop us from working quickly to provide the highest level of care for the chances of defying those odds. In this episode, a 10 year-old boy wrecks on his bicycle, a fairly common occurrence and one that rarely requires air transport, yet when our team arrives on scene, his vitals crash in front of their very eyes. What's going on? And what actions do they take to save his life? An inspirational, harrowing and odds-defying episode of AMPED awaits you this holiday season. Interested in obtaining CE credit for this episode? Visit OnlineAscend.com to learn more. Listeners can purchase individual episode credits or subscribe to the Critical Care Review Bundle and gain access to all episode CE Credits. We are joined by: Zachary Fica, MD Amy Marquez, RN, Air Methods Flight Nurse (pictured with Declan, our patient) Mercy Air Team Chris (our patient's father) and Declan (our patient) Click here to download this episode today! As always thanks for listening and fly safe! Hawnwan Moy MD FACEP FAEMS John Wilmas MD FACEP FAEMS
Contributor: Aaron Lessen MD Educational Pearls: A recent study assessed EMS treatment of high blood pressure in the field 2404 patients randomized to prehospital treatment (1205) vs. usual care (1199) Included patients with prehospital BP greater than 150 mm Hg The treatment arm's BP goal was 130-140 mm Hg The primary efficacy outcome was functional status 90 days out Stroke was confirmed by imaging upon hospital arrival On arrival, the mean SBP of the treatment arm was 159 mm Hg compared with 170 mm Hg in the usual care group No significant difference in functional outcomes between the treatment group and the usual care group (Common Odds Ratio of 1.00, 95% CI = 0.87-1.15) Post-imaging analysis revealed 46.5% of the undifferentiated patients had a hemorrhagic stroke Prehospital reduction in BP did reduce the odds of poor functional outcome in hemorrhagic stroke patients alone (Common Odds Ratio 0.75, 95% CI 0.60-0.92) Those with ischemic stroke had increased odds of poor functional outcome (Common Odds Ratio 1.30, 95% CI 1.06-1.60) Bottom line: it is challenging to identify the stroke type in the prehospital setting and therefore not necessarily helpful to treat the blood pressure References 1. Ren X, Zhang C, Xu P, et al. Intensive Ambulance-Delivered Blood- Pressure Reduction in Hyperacute Stroke. New England Journal of Medicine. 2024;390(20):1862-1872. doi:10.1056/NEJMoa2314741 Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce & Jorge Chalit