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Article:  Spaite DW, Hu C, Bobrow BJ, Chikani V, Barnhart B, Gaither JB, et al.The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury. Ann Emerg Med 2017 Jan;69(1):62-72. Background:  Hypoxia and hypotension are known to independently increase mortality in patients with severe traumatic brain injury, but their combined effects

Article: Kupas, D. F., Melnychuk, E. M., & Young, A. J. (2016). Glasgow coma scale motor component (“patient does not follow commands”) performs similarly to total glasgow coma scale in predicting severe injury in trauma patients. Annals of emergency medicine, 68(6), 744-750.  Background: Trauma patients are often triaged to trauma centers based on their GCS.  Indeed, a

Article:  Jarvis, J. L., Gonzales, J., Johns, D., & Sager, L. (2018). Implementation of a clinical bundle to reduce out-of-hospital peri-intubation hypoxia. Annals of Emergency Medicine, 72(3), 272-279.  Background:  Peri-intubation hypoxia is an important quality measure for EMS agencies performing rapid sequence intubation, as it is associated with poor patient outcomes including peri-intubation cardiac arrest and death

Article: Peter E. Fischer, Debra G. Perina, Theodore R. Delbridge, Mary E. Fallat, Jeffrey P. Salomone, Jimm Dodd, Eileen M. Bulger & Mark L. Gestring (2018) Spinal Motion Restriction in the Trauma Patient – A Joint Position Statement, Prehospital Emergency Care, 22:6, 659-661, DOI: 10.1080/10903127.2018.1481476 Podcast on this position statement: https://pecpodcast.libsyn.com/prehospital-emergency-care-podcast-24 Background:  Immobilization of a

Article:  Bosson, N., Sanko, S., Stickney, R. E., Niemann, J., French, W. J., Jollis, J. G., … & Koenig, W. (2017). Causes of prehospital misinterpretations of ST elevation myocardial infarction. Prehospital Emergency Care, 21(3), 283-290.  Background:   Prehospital STEMI identification plays a critical role in ensuring appropriate destination decision and shortening times to reperfusion for patients with acute

Article: Patterson PD, Higgins JS, Van Dongen HPA, Buysse DJ, Thackery RW, Kupas DF, et al. Evidence-based guidelines for fatigue risk management in emergency medical services. Prehosp Emerg Care 2018 Feb;22(sup1):89-101. Background: There is not a large amount of evidence in the EMS literature that guides how to mitigate workplace fatigue, which affects over half of

 by David Rayburn MD, MPH Scenario: A crew is dispatched for OB/Childbirth. The baby, delivered as the EMS crew arrives, is  pale, limp, and apneic. What are the next steps of care for this patient?  How do we prepare to manage this scenario? Review: Delivery of a baby by a prehospital provider is not an

by Aaron Farney, MD Case Presentation EMS is dispatched priority 1 for an 86-year-old female unconscious/fainting call.  Despite 911 center implementation of the Medical Priority Dispatch System (MPDS) 36 pandemic card, this incident is coded via the 31 card – unconscious/fainting. On arrival, EMS discovers family in an upstairs bathroom surrounding an elderly female who

by Brent Olson, NRP & Hashim Zaidi, MD Clinical Scenario You answer a call for on-line medical control for a 28-year-old male patient refusing transport to the hospital. The paramedics report that he was initially cyanotic with pinpoint pupils and snoring, shallow respirations. The paramedics administered a single dose of 2 mg intranasal naloxone. The

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