Category: Uncategorized

Article Bites Summary by Clare Wallner MD Infographic by Jeffrey Stirling MSc(c), PCP, @jeffrey_stirlin Article: Sacramento County Prehospital Research Consortium. Out-of-hospital triage of older adults with head injury: a retrospective study of the effect of adding “anticoagulation or antiplatelet medication use” as a criterion. Ann Emerg Med 2017 Aug;70(2):127-38. Background and objectives: The CDC Field trauma triage

The Article: Wang HE, Schmicker RH, et al. (2018). Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest. JAMA, 320(8), 769. doi:10.1001/jama.2018.7044 Background & Objectives: Airway management has long been one of the first steps in the ABC’s of cardiac arrest management, but there

by Erin Brennan, MD, MPH Recently on twitter, one of our colleagues, Joshua Stilley, an EMS Physician, tweeted the following: His description suggests an important change in our lexicon.  The way we describe things assigns value – and basic implies that it is easy to do and sounds much less attractive that “advanced”.  But there

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

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

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.

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

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