SCA & Opioid Overdose, Pulmonary Embolism on EMS 1

Tweet Over at EMS 1 I have two clinical articles up. In How To Treat Sudden Cardiac Arrest and Opioid Overdose I wrote about how to tell the difference between ineffective breathing from sudden cardiac arrest versus opioid overdose and how the management is different. In 4 Things EMS Providers Need To Know About Pulmonary […]

The Logistics Of Managing a Patient With Anaphylaxis

Tweet This week I taught the immunology section for my paramedic class.  I broke the class into groups to do case studies, and one was for a 12-year-old with anaphylaxis with stridor and difficulty breathing.  Towards the end of their treatment plan on the white board, the group wrote that they would intubate if the […]

What Should I Teach About Anaphylaxis?

Tweet I’m seeking some advice from my educator friends about what to teach about anaphylaxis to my paramedic class next week.  The textbook we use, which for the most part I like, states in a “words of wisdom” box: Flushing (from vasodilation) and tachycardia are so characteristic of anaphylactic shock that it is very questionable […]

Rural Patients Deserve the Same EMS Care As Urban Ones

Tweet In June’s issue of EMS World, I wrote an article describing what communities deserve from their EMS system.   My position is that every call should have someone capable of administering a 12-lead EKG, CPAP, nebulized bronchodilators, pain medication, and chemical sedation.  This requires an ALS provider on every call, which sparked some discussion about responses in rural areas.  Here […]

A Patient-Centered EMS Manifesto

Tweet In the June, 2013 issue of EMS World, I wrote an article titled Things Your System Should Deliver.  It is a description of what I believe our patients deserve from their EMS system.  Each item is based on evidence, and systems fail when they do not deliver them to eligible patients. I have always […]

Less of That, More of This

Tweet Over at EMS 1, ambulance driving expert Kelly Grayson wrote an excellent column about how he became a “stand back, big picture, non-interventional paramedic.”  He describes how he would manage a crashing pulmonary edema patient at different phases of his career.  The interventions became less invasive at each phase, to the benefit of the […]

Who Will the Community Paramedics Be?

Tweet Last week I was in Washington DC for EMS on the Hill Day.  Unfortunately the meetings with our representatives were cancelled because a predicted but unrealized snow storm.  NAEMT anticipated that the government may close, and offered presentations about how healthcare reform will affect EMS reimbursement and the development of two Community Paramedic programs.  […]

EMS Psych Calls: An Area To Specialize?

Tweet Last Sunday I was able to join a discussion about psychiatric patients on EMS Office Hours.  A number of complicated issues came up, and many of them have no established best practices.  This is a topic I am particularly interested in. I was a psych major in college and interned as a crisis phone counselor. My […]

Safe Spinal Clearance Equals Better Care For Spinal Injuries: Part 2

Tweet In Part 1, I described why I believe EMS providers should have the same knowledge base that physician’s assistants do.  This would improve our ability to detect partial spinal cord injuries, and to not immobilize everyone else.  So what happens when we find an injury, or a patient who might have one?  Here’s what […]

Safe Spinal Clearance Equals Better Care For Spinal Injuries: Part 1

Tweet Dave Ross is at it again on EMS 1 about spinal immobilization.  In his previous column, Confessions of Recovering Field Spine Clearance Addict, he describes problems with implementing a C-spine clearance protocol at his service.  To summarize: For us, and specifically me in recovery, we’ve decided to minimize the risk of misses by continuing […]