By Daniel Johnson, DO and Jordan Schooler, MD, PhD Clinical Case You arrive on the scene of a cardiac arrest. You find a middle-aged male with CPR in progress by bystanders. You find that he is in ventricular fibrillation. After quality CPR and defibrillation, you obtain ROSC. The patient remains comatose. You obtain a definitive
The Limitations of Lung Auscultation and Pulse Oximetry By Adrien Quant LP, Hashim Q. Zaidi MD “Depending on a patient’s needs and/or system resources, EMTs are sometimes the highest level of care a patient will receive during an ambulance transport” National EMS Scope of Practice Model (2019) Under the National EMS Scope of Practice Model
by Maia Dorsett, MD PhD FAEMS When we teach about patient safety and medical errors, we put up pictures of the Swiss cheese model (1, 2) and demonstrate how harm occurs as errors fall through serial holes of imperfect systems. When I examine this model, in many ways it rings true for the examples it
Article Summary by Elizabeth Stevens, MD, MA Article: Belval, L. N., Casa, D. J., Adams, W. M., Chiampas, G. T., Holschen, J. C., Hosokawa, Y., … & Stearns, R. L. (2018). Consensus statement-prehospital care of exertional heat stroke. Prehospital Emergency Care, 22(3), 392-397. Background: Exertional heat stroke (EHS) is end organ dysfunction due to hyperthermia
By Kenneth Dumas MD, Johnathon Elkes MD, Rachel Semmons MD THE CASE 78 year old male with a past medical history of COPD, DMII, HTN, and ESRD currently on hemodialysis calls 911 for complaints of shortness of breath not relieved by his home inhaler. On arrival, the patient is seated on his couch with notable
by Clayton Kazan, MD We live in a scary time in the practice of medicine, though I am not sure that there has been a time in which medicine was relatively un-challenged. We make a lot of errors, and those errors hurt a lot of people. It’s as true in EMS as anywhere else in
Article Summary by Emerson Franke, MD, EMT, FAAEM, (@EmersonFrankeMD) Article: Sobieraj, D. M., Martinez, B. K., Miao, B., Cicero, M. X., Kamin, R. A., Hernandez, A. V., … & Baker, W. L. (2020). Comparative effectiveness of analgesics to reduce acute pain in the prehospital setting. Prehospital Emergency Care, 24(2), 163-174. Background: Pain control in the prehospital setting
Patrick C, Ward B, Anderson J, Rogers Keene K, Adams E, Cash RE, Panchal AR, Dickson R. Feasibility, Effectiveness and Safety of Prehospital Intravenous Bolus Dose Nitroglycerin in Patients with Acute Pulmonary Edema. Prehosp Emerg Care. 2020 Nov-Dec;24(6):844-850. An author’s summary by Casey Patrick, MD Background The broad teaching of “CHF Exacerbation” as a singular
By Alison Leung, MD Setting the Scene EMS is dispatched to the scene of a motorcycle collision. The patient is unconscious, but breathing and has a rapidly expanding hematoma to the right flank. The patient’s airway is intact, he has equal breath sounds, but his pulses are rapid and thready. What is your diagnosis? What
by Emily Fitzgerald, MD Just your Average Case of Undifferentiated Respiratory Distress Your ALS crew is dispatched to a local nursing home for the 74-year-old female with shortness of breath, priority 2. You arrive on scene to find an elderly woman in respiratory distress. She is tripoding in bed, has marked accessory muscle usage and
