Austin-Travis County EMS System Office of the Medical Director » Uncategorized

YES I KNOW THE THUMBNAIL HAS EPISODE 4 and it’s episode 49. But we have a YouTube channel now so that’s why we have different episode numbers. It’s less confusing than renumbering everything. ANYwhomst, this is our takedown of the week long winter weather event that crippled the region starting around Valentine’s Day. The impacts… Continue reading Episode 49: Icepocalypse

Vaccines are finally available. I’m getting mine, and you should too. How do they work? Are they safe? What are the side effects? What are the particulars of administration?

Bamlanivimab is a monoclonal antibody for treating mild to moderate COVID-19. You’ve probably heard of it as it has rolled out here in Texas in force. What does it do and how is it given?

Operation Warp Speed is a public-private partnership that has helped speed development of vaccines and treatments for COVID-19. But what does that mean for safety of these treatments? TL;DR: The program does not cut safety corners. It supports industry to rapidly develop capability without the financial risk usually associated with experimental therapies.

This study looks at an intriguing concept: What happens when you give an acutely suicidal patient ketamine in the ED? This study intrigued me so I thought I’d cover it. This study will not change your practice but will hopefully interest you in participating in research on the topic. TL;DR/TL;DL: DON’T START DOING THIS YET.… Continue reading Episode 45: Ketamine for suicidal ideation

The Health Data Exchange allows the flow of information between EMS charts and the hospital chart, helping us to easily look at outcomes and how EMS care has affected the patient. The best way to check your own knowledge and understanding of prehospital care is to know how the patient turned out. Was your diagnosis… Continue reading Episode 44: Data and outcomes in EMS

“What if” can be anxiety provoking and can send you down a rabbit hole of undesirable futures. But it can also be a powerful tool for the clinical preceptor and the clinician who is looking to improve their performance.

SUPER short one today about COVID and ACE inhibitors (-pril) and Angiotenstin Receptors Antagonists, like Angio Recept Antag. Maybe ang rec ant. Or artan. Artans yeah, that’s it.

We talk about some of the things you’ve seen in the news lately about treatments that might help COVID. AND WHAT DO THEY MEAN I CAN’T TAKE IBUPROFEN? *sad Army Doc noises*

So, you caught the COVID. You have endured the fever, cough, sore throat, diarrhea, and abject boredom of being home. When can you be let out of this prison? In this micro episode we talk about the return to work criteria. BLUF: No, you don’t have to be in quarantine forever.

Covid is now a pandemic, the real kind, the not-the-zombie-kind. In this episode we talk about what the Office of the Medical Director, Austin Public Health, and Austin/Travis County EMS is doing to respond to what is now a declared disaster.

Buy in from the workforce is necessary to bring any useful change to an organization. While unions and leadership are often set against each other, the things they can accomplish when they work together far exceed those they can accomplish when moving in different directions. The union can give the MD valuable feedback on wants… Continue reading Ep 32: Talking with the Union Prez

Some causes of headache are benign, but the EMS provider would be wise to consider carefully some “bad actors” that cause headache. Here we will talk too about how to manage these patients in the prehospital setting.

Jessica Sasser, RN, is one of the amazing staff at our public safety wellness division which supports the physical and mental health of Austin/Travis County EMS and Austin Fire Department. In this episode she discusses meditation and how it can be useful to the first responder. Hint: it doesn’t just make you feel better, it… Continue reading Episode 30: Meditation and mindfulness for the first responder with Jessica Sasser, RN

Combat medic, paramedic, PA, and now medical student Andy Fisher talks about his journey. If you’ve thought about making the leap from #EMS, don’t miss this episode.

In patients with hemorrhage, nothing else can take the place of #blood. Andy Fisher talks about why, and how, you can bring #blood to your #EMS system.

Syncope, or fainting, is an incredibly common complaint seen by #EMS providers. This short episode discusses some of the exam findings and considerations. The Epsilon wave: https://litfl.com/epsilon-wave-ecg-library/ Wolff Parkinson White syndrome: https://www.youtube.com/watch?v=K098rnvqRE0 Lown Ganong Levine syndrome: https://ecglibrary.com/lgl.html

If you are not using #EtCO2 during airway management and monitoring, then you are wrong. Fix yourself. Dr. Pickett tells you why. #EMS #Prehospital #Paramedic #maybeifIsqueezethisbagashardandfastasIcanthepatientwillgetbetter #morewavylines #butIjustlearnedEKGs #Isawthetubegothroughthecords #sodideveryonewhoevermisplacedanETtube

Do you get nervous when you are faced with a patient with a tracheostomy tube? This short episode covers common problems and how to troubleshoot them. Be nervous no more.  #paramedic #EMS #prehospital #criticalcare In this episode, I make reference to a couple of great YouTube videos on the subject. One is from RT Clinic on the… Continue reading Episode 25: Tracheostomy Disasters

We undertook the unenviable task of revising our clinical operating guidelines to make them more usable, more manageable, and easier to read. We want to foster a clinician mindset and embrace the clinical flexibility medics need to take care of our patients in a very fluid environment. We also created new credentialing levels for medics… Continue reading Episode 24: New Clinical Operating Guidelines

Today we are covering some of the flight rules for those studying for their #FP-C exam.  #paramedic #EMS #prehospital #HEMS

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Today we are covering a bit of #flight physiology for those studying for their #FP-C exam. We broke this episode into 3 parts to make it a bit more manageable. #paramedic #EMS #prehospital #HEMS

Heat illness ranges from the benign and temporary to the life-threatening. We dive into management of heat cramps, heat syncope, heat exhaustion, and heat stroke. Rule #1: Stay on scene to cool them down.  

In person and on the radio, make the most of your concise patient report.  

If you felt the need to put a #cardiac monitor on at any point in the patient interaction, it should stay on as you walk into the ED. #EMS #paramedic #prehospital

We dug into our QA data and the literature to bring you some pearls on #prehospital #airway management. #EMS #paramedic

750,000 Americans will suffer from sepsis this year. Early recognition and treatment are key. Here we go into the field recognition of sepsis and treatment priorities.

For patients with #stroke outside of 4.5 hr #tPA window, they may benefit from thrombectomy up to 24 hours since last seen well. Take to comprehensive stroke center and perform MRI safety screen. #EMS #paramedic https://www.emsworld.com/news/220085/new-24-hour-window-stroke-treatment-proving-successful-some-patients

Quick and dirty estimation of weight for #pediatric #resuscitation: Birth: 5kg. Age 1: 10kg. Age 3: 15kg. Age 5: 20kg. Age 7: 25kg. Age 9: 30kg. #PALS #APLS

This is a short episode on the response to and care for bombing victims for #EMS, #Firedepartement and #Police. A longer episode will follow that covers #prehospital care in detail, but this is the initial response and considerations. #packagebombmurders #austinbombings @ATCEMS @Austin_police @austinfiredepartment @TxDPS @TravisCoSheriff @CommitteeTECC @CommitteeonTCCC @NTOATEMS Find us on @iTunes and @GooglePlay and… Continue reading Episode 14- Fast facts for response to bombing victims

From the National #Counterterrorism Center, this chart gives #evacuation distances for #explosives of different sizes. Time, distance, shielding. Minimize the TIME you are in a threat zone, increase DISTANCE between you and the device, and seek SHIELDING in the form of cover from hard buildings or terrain. #packagebombmurders #austinbombings #EMS #prehospital #paramedic #firedepartment Click to… Continue reading Safe evacuation distances from explosives

Neither rare nor mysterious, Cannabis Hyperemesis Syndrome causes pain and vomiting that can be difficult to treat. Marijuana use is growing for medical purposes and recreational abuse. With this has come a rise in Cannabis Hyperemesis Syndrome which is marked by recurrent, severe abdominal pain and vomiting that does not respond well to the usual… Continue reading Episode 13: Cannabis Hyperemesis Syndrome

Dr. Cynthia Griffin @CMGrffn wrote this great article on #CCT and how to handle orders that conflict with protocol or practice style. Doctor’s orders and intra-transfer modifications #EMS #paramedic #flightmedic #flightnurse

Fluid resuscitation, blood, acidosis, coagulopathy, hypothermia, TXA, intubation, push dose pressors! All the greatest trauma lit for your naughty bits.

Some tips to help differentiate #SVT with aberrancy and #vtach. #EMS #prehospital #paramedic https://www.aliem.com/2013/07/supraventricular-tachycardia-svt-with-aberrancy-versus-ventricular-tachycardia-vt/

What’s the right pressor for different types of shock? When should you pull the trigger? http://www.emdocs.net/evidence-based-approach-pressors-shock-part/

In this episode we sat down with Dr. Steven Warach the Director of the Clinical Research Institute and Vascular Neurologist from Dell Seton Medical Center to talk about acute MRI for stroke and how we might be able to reduce the time to treatment. 3 questions comprise the safety screen: Do you have any implanted… Continue reading Episode 11: MRI for acute stroke- screening in the field

Most asthma is pretty routine. Most. Dr. Pickett talks about tools for management of the severe asthmatic adult or child.  

https://twitter.com/atcemsomd/status/938148994521411584

Some people have the natural gift of teaching. For others it does not come easily. Teaching is all about connecting with your student, finding out their abilities and weaknesses, and helping build them into stronger clinicians. Teaching is a learned skill that can be molded and honed no matter how good a teacher you are.… Continue reading Episode 9: Bedside Teaching- Medic Mindset and ATCOMD joint podcast! Teaching at the bedside in the field or in the hospital.

Ever had that patient that you just weren’t sure what pathway they fit in? You have a 75 yo F who called 911 due to palpitations and increasing shortness of breath. She looks fairly comfortable with belies the rate of 180 seen on the monitor. She does endorse some chest discomfort. No previous drug use,… Continue reading ATCEMS OMD Podcast Episode 8: Atrial fibrillation!

NYT reconstruction of Vegas shooting This is a very well done reconstruction of the mass shooting in Las Vegas. Several things to note here: varying reactions in the crowd (you can see some individuals standing and staring in disbelief as others run to cover), care under fire and members of the crowd organizing others to… Continue reading Reconstruction of the Vegas shooting

Decided to address some reader comments with this one. Dextrose, hemostatic agents, chest seals. Little bit of medicine, little bit of trauma. Why did we change over from D50 to D10 for hypoglycemia? And should we be treating hypoglycemic diabetics the same way we did 30 years ago? Should I have a hemostatic gauze in… Continue reading ATCEMS OMD Podcast Episode 7: Mishmash! Dextrose, hemostatic agents, and chest seals.

Do you like it when your patient desaturates just as you are getting ready to intubate them? Of course not, nobody does. Here are some tricks to help keep the sat up while you secure the airway.