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Commercial Tourniquet Use in Pediatrics

Article by Veronica “Vee” Smith, MD Case It’s 11 o’clock in the morning on a sunny autumn day. Your radio alerts you about a mass casualty event and you are then dispatched to what turns out to be a school shooting. The estimated casualty count is over 20 with an unknown number of injured victims

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Complexity

EMS Perspectives: An OpEd Page on the History and Future of EMS By Clayton Kazan, MD, MS, FACEP, FAEMS So we are about 54 years into the pilot project that is EMS and paramedicine.  That we would even exist, much less thrive, years later, was viewed by many as highly improbable at the time.  The

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Calcium in Out-of-Hospital Cardiac Arrest

Article by Erin Lincoln, MD Case Scenario: You are dispatched to a 68-year-old male in cardiac arrest.  His family has been performing bystander, and report that he suddenly collapsed just a few minutes ago. CPR is taken over by responding crews, and he is placed on a cardiac monitor/defibrillator. He is found to be in

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Why should quality improvement concepts be integrated into EMS education?

By Tiffany Pleasent, MD Case Review A 64-year-old female calls 911 for severe shortness of breath and chest pain. An ALS crew arrives on scene to find a woman who is tachypneic, hypoxic, tachycardic, and hypotensive, with diffuse rales and rhonchi throughout her lung fields. She becomes altered and severely hypoxic. The attending paramedics begin

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Palliative and Hospice Care in the Prehospital Setting

By Nicholas Maxwell, MD Case: You are bringing an elderly male with a DNR back to a living facility from a hospital. Approximately 10 miles away from the hospital, the patient suddenly decompensates. His pulse ox drops from 94% to 87% and his heart rate increased from about 110 beats per minute to approximately 180.

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Article Bites #45: Characteristics, Prehospital Management, and Outcomes in Patients Assessed for Hypoglycemia: Repeat Access to Prehospital or Emergency Care

Article Summary by James Li, MD Sinclair, Julie E., et al. “Characteristics, prehospital management, and outcomes in patients assessed for hypoglycemia: repeat access to prehospital or emergency care.” Prehospital Emergency Care 23.3 (2019): 364-376. Background: Diabetes is a common chronic medical condition. The Centers of Disease Control and Prevention report a total of 37.3 million

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IV versus IO: Does your Site of Access Matter in Cardiac Arrest?

By A.J. Meyer MD Clinical Scenario You are dispatched to a 57-year-old male with a witnessed cardiac arrest and bystander CPR being performed. On arrival to the scene, you find the patient pulseless and apneic. Your Fire Department colleagues take control of the airway and begin ventilating the patient with a BVM  and perform high

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Article Bites #44: Managing the Out-of-Hospital Extraglottic Airway Device

Article Summary by: Charles Hwang, MD, FAEMS, FACEP Article: Braude D, Steuerwald M, Wray T, Galgon R. Managing the Out-of-Hospital Extraglottic Airway Device. Ann Emerg Med. 2019 Sep;74(3):416-422. doi: 10.1016/j.annemergmed.2019.03.002. Epub 2019 May 3. Background Extraglottic airway devices (commonly referred to as supraglottic airway [SGA] devices) play an integral role in the prehospital airway algorithm

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