Article Summary by Robert Skinner, MD Knapp, J., Haeske, D., Boettiger, B. W., Limacher, A., Stalder, O., Schmid, A., … & Bernhard, M. (2019). Influence of prehospital physician presence on survival after severe trauma: systematic review and meta-analysis. Journal of Trauma and Acute Care Surgery, 87(4), 978-989. Background: The leading cause of death in the
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
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.
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
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
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
Article Bites Summary by Kristopher Bianconi, MD Hoyle Jr, J. D., Ekblad, G., Hover, T., Woodwyk, A., Brandt, R., Fales, B., & Lammers, R. L. (2019). Dosing errors made by paramedics during pediatric patient simulations after implementation of a state-wide pediatric drug dosing reference. Prehospital Emergency Care. Background The administration of medications to pediatric patients
Article Summary by James Li, MD Article: Spaite, D. W., Bobrow, B. J., Keim, S. M., Barnhart, B., Chikani, V., Gaither, J. B., … & Hu, C. (2019). Association of statewide implementation of the prehospital traumatic brain injury treatment guidelines with patient survival following traumatic brain injury: the excellence in prehospital injury care (EPIC) study.
What’s the Big Picture? By Adrien Quant LP, Hashim Q. Zaidi MD As discussed in Part 1 and Part 2, current EMT standards of lung auscultation and pulse oximetry have critical limitations in the evaluation of ventilation and perfusion (Brown et al., 1997; DeMeulenaere 2007; Chan et al., 2013). However, the introduction of waveform capnography
The Benefits of Waveform Capnography for Patient Care By Adrien Quant LP, Hashim Q. Zaidi MD As discussed in Part 1, under the National EMS Scope of Practice Model (2019), EMTs are expected to initiate several critical airway and breathing interventions for a variety of medical and traumatic conditions. However, in order to evaluate ventilation
