TL;DR TXA is used to stabilize clots by preventing fibrinolysis Dose: 1g over 10 minutes, then 1g over 8 hours CRASH-2 has shown an improvement in survival Even greater improvement if administered within 3 hours (earlier is better!) CRASH-3 has shown mortality improvement in mild-moderate isolated head trauma (GCS 9-15) TXA rate of vascular occlusive …
Article Bites #16: TXA: The Future for Stop the Bleed? Read More »
David Wright, PA-C, NRP & Bridgette Svancarek, MD, FAEMS “There should be a paramedic to Physician Assistant (PA) fast track!” “PAs and paramedics do about the same job!” “Isn’t a PA doing the same job as a paramedic, just in the hospital?” “Paramedics are just as good as nurses” “Why don’t we [paramedics] get paid …
EMS Physician Assistants: Are They the Next Paramedic Practitioner? Read More »
by Andra Farcas, MD and Hashim Zaidi, MD Is fatigue an expected work hazard for EMS providers? Based on experience from interacting with paramedics who make runs to the emergency department, it seems as if sleep on shift remains an uncommon occurrence. Many prehospital providers report getting little to no sleep in a 24 hour …
Article: Remick K, Redgate C, Ostermayer D, Kaji AH, Gausche-hill M. Prehospital Glucose Testing for Children with Seizures: A Proposed Change in Management. Prehosp Emerg Care. 2017;21(2):216-221. Background: Hypoglycemia is an easily identifiable and quickly reversible cause of seizures in the pediatric patient population. Current recommendations highlight the importance of identifying hypoglycemia prior to initiation …
Article: Benger JR, Kirby K, Black S, et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018;320(8):779-791. Background: The benefit of advanced life support measures in the management of patients with out-of-hospital cardiac arrest (OHCA) is controversial. …
Article Bites #14: To Tube or Not to Tube in Cardiac Arrest? Read More »
Should paramedicine require a minimum degree? In this post, two EMS physicians, Clayton Kazan (Medical Director for LA County Fire Department) and Hawnwan P. Moy (Medical Director for ARCH Air Methods in Missouri) , debate the Pros and Cons. CON: Raise the Roof, Not the Floor. by Clayton Kazan MD FACEP FAEMS Far be it …
The Pros and Cons of Degree Requirements for Paramedics: Kazan and Moy debate Read More »
by Mark Liao, MD, NRP (@EMSDocMark) Expert Peer Review by Dorothy Habrat, MD (@EMSDrDorothy) Clinical Scenario A 25-year-old male is brought to your Finish Line medical station. Bystanders noted that he was unsteady on his feet while running a half-marathon before he collapsed. The outside conditions are notable for an air temperature of 22.7 °C …
Klebacher R, Harris MI, Ariyaprakai N, et al. Incidence of Naloxone Redosing in the Age of the New Opioid Epidemic. Prehosp Emerg Care. 2017;21(6):682-687. Background & Objectives: The surging opioid epidemic has largely been combated with the use of intravenous and intramuscular naloxone administration. More recently, intranasal naloxone has been shown to be easily administered …
Article: Smith ER, Shapiro G, Sarani B. The profile of wounding in civilian public mass shooting fatalities. J Trauma Acute Care Surg. 2016;81(1):86-92. Background & Objectives: Civilian mass shootings are unfortunately on the rise and afflict the lives of many individuals and their families. Given the rising incidence and severity of these events, there has …
Article Bites #12: The Profile of Wounding in Civilian Public Mass Shooting Fatalities. Read More »
by Noah Tyler, EMT-P Peer Review by Aurora Lybeck, MD We’ve all seen the news stories and videos: Mass shootings, violent gang activity, and targeted assaults on first responders are on the rise. Fortunately, bullet and stab resistant vests have been effectively protecting most of our law enforcement officers for years. Today, we see EMS …
BSI, Scene Safe: Debating the Personal Protective Equipment of Today Read More »
