EMS Nation Podcast
EMS Nation - Evidence Based Medicine in EMS Weekly Style Podcasts: Monday - Interview with a Leader in EMS Tuesday - ALS Simulation Wednesday - EMS Journal Club Thursday - BLS Simulation Friday - Health & Wellness Follow us on Twitter! www.twitter.com/EMS_Nation Like us on Facebook! www.facebook.com/PrehospitalNation www.emsnation.org
A lecture by Rachel Liu, MD FACEP on the ResUScitation in Critical Care during the 2nd Annual ResusCon 2019 at the Grandview, September 4, 2019 @VassarCME @VBMCEMS @2019ResusCon
A lecture by Timothy P. Collins, DO, FCCP on the Innovations in the Treatment of Shock during the 2nd Annual ResusCon 2019 at the Grandview, September 4, 2019 @VassarCME @VBMCEMS @2019ResusCon
Evie Marcolini, MD is an Assistant Professor of Emergency Medicine and Neurocritical Care. She has clinical appointments in the Department of Emergency Medicine and the Department of Neurology; and is core faculty in the Emergency Department as well as the Division of Neurocritical Care and Emergency Neurology at Yale. She has board certifications in Emergency Medicine and Neurocritical Care, and is fellowship-trained in Surgical Critical Care from the R Adams Cowley Shock Trauma Center in Baltimore, Maryland. Evie is Medical Director for the SkyHealth Critical Care helicopter transport service that is shared between Yale-New Haven Health System and Northwell Health.
She is a Fellow of the American College of Critical Care Medicine, American Academy of Emergency Medicine (AAEM) and American College of Emergency Physicians (ACEP), and is a member of the Board of Directors for AAEM. She is the past Chair of the Critical Care Section of ACEP, and active in all three societies, with a goal of bringing emergency physicians to the forefront of critical care in all realms.
Evie is an active educator and speaker, with an interest in neurocritical care topics as they relate to emergency medicine and bioethics as it relates to emergency medicine and critical care patients. She has, and continues to lecture nationally and internationally, and has won the ACEP Junior Faculty Teaching Award.
Evie is very active in bioethics, as a member of the Yale-New Haven Health Ethics Committee and the Society for Critical Care Medicine (SCCM) Ethics committee, and teaches ethics seminars in the ethics of neuroscience and of emergency medicine annually for the Sherwin B. Nuland Summer Institute in Bioethics at Yale. She has been awarded the Grenvik Family Ethics Award from SCCM.
Evie is a co-editor of the textbook: Emergency Department Resuscitation of the Critically Ill, which is now in its second edition, is a co-author of an upcoming book on mechanical ventilation in emergency medicine.
She has been active as faculty for Wilderness Medical Associates International since 1992, and teaches wilderness medical courses to medical students, residents, faculty and allied health professionals nationally and internationally, as well as having served as Faculty Advisor to wilderness medicine interest groups at the University of Maryland and Yale.
When not involved in academic pursuits, Evie loves to spend her time running and skijoring with her two Siberian Huskies.
Please leave us your thoughts and comments, we'd love to dig further into this topic. Make sure to leave @EMS_Nation a 5 star review wherever you listen to podcasts and to share the episode with friends and colleagues to pass along this #FOAMed resource.
Checkout the blog at EMSNation.org and say hello to Dr. Faizan H. Arshad on Twitter and Instagram @emscritcare.
Wishing everyone a safe tour!
Dr. Mark Merlin Chair of the NJ EMS Council. He is the Founder of the of the New Jersey EMS Fellowship. He is the Medical Director of Medway Air Ambulance which has 10 fixed wing planes transporting hundreds of medical patients each month
throughout the world. He has authored over 100 peer-reviewed manuscripts and abstracts in Emergency Medicine and EMS. Dr. Merlin is the CEO of MD1 which provides Emergency Medical Services in a mobile Emergency Department/Operating Room at no charge to citizens of New Jersey.
Please leave us your thoughts and comments, we'd love to dig further into this topic. Make sure to leave @EMS_Nation a 5 star review wherever you listen to podcasts and to share the episode with friends and colleagues to pass along this #FOAMed resource.
Checkout the blog at EMSNation.org and say hello to Dr. Faizan H. Arshad on Twitter and Instagram @emscritcare.
Wishing everyone a safe tour!
Perseverance, or more simply stated, Grit, is a common trait amongst EMS providers. It grants us the ability to endure in the face of hardship when others may consider quitting or failing. In regards to COVID 19, we are all playing the long game, it is a marathon (unfortunately) rather than a sprint. We must stay united as a group and stay true to our mission of supporting and protecting our communities despite the pandemic. That is not to say that we are not human ourselves. While perseverance is one of the characteristics I value most in EMS providers, another virtue I’d care to juxtapose it to is vulnerability. In any situation that presents a threat — be it physical or emotional — our natural instinct is to protect ourselves. That's just basic survival. We try to defend, hide or deny our own insecurities and weaknesses. Being vulnerable involves letting yourself feel all things — the good, the bad and the not-so-pretty — and then also letting someone else see it all. Trying to be invulnerable can be exhausting, as much as we’d like to be super heroes protecting the population from medical maladies we must also acknowledge our own humanity. This is not easy and it’s okay to express that and seek support. When we numb feelings like fear, embarrassment and pain, we also numb excitement, hope, gratitude and happiness. Allowing vulnerability into our lives can rejuvenate our senses and actually foster, build and restore our community and make us more connected. I’m including the link to Brene Brown’s TED talk on vulnerability that has nearly 50 million views. Thank you all again for always being in service and a very happy EMS Week.
https://www.ted.com/talks/brene_brown_the_power_of_vulnerability
Today’s episode brings us 2 EMS physicians from Stanford on the topic, “Where have all the STEMIs gone?” where we dive into the literature and statistics on cardiac arrest, dying at home, emergency department volume and numerous other items related to COVID19. Interestingly both domestically and abroad there has been a dramatic reduction in heart attacks, strokes and traumas that have been presenting via EMS to the ED. We discuss potential hypotheses into this phenomenon and also explore other salient details related to COVID.
Bryan David Sloane, MD – Is the current EMS fellow at Stanford University. He did his residency at Harbor UCLA where he lived out his EMERGENCY! Dreams. He was an EMT in LA for 6 years before medical school and considers himself an EMT first and a physician second. He hopes to take an attending position at Kaiser South Sacramento where he will also be working on many local EMS initiatives.
Gregory H. Gilbert, MD - Clinical associate Professor of Emergency Medicine at Stanford University. Medical Director of San Mateo County and EMS Fellowship Director at Stanford University. He grew up in New York State and received his MD, from SUNY Downstate with distinction for investigative scholarship. He completed his emergency medicine training in Atlanta, Georgia at Emory University and is dual boarded in EM and EMS.
Please leave us your thoughts and comments, we'd love to dig further into this topic. Make sure to leave @EMS_Nation a 5 star review wherever you listen to podcasts and to share the episode with friends and colleagues to pass along this #FOAMed resource.
Checkout the blog at EMSNation.org and say hello to Dr. Faizan H. Arshad on Twitter and Instagram @emscritcare.
Wishing everyone a safe tour and a "happy" EMS Week!
Unfortunately due to the current situation and ongoing pandemic, it's difficult for us to wish you a "Happy" EMS Week, nevertheless, thank you to all the pre-hospital professionals for always being in service. Today's episode is with EMS Chief Juan Cardona, from the Coral Springs - Parkland Fire Department in Florida.
He explores the operational and logistical challenges in responding to an out of hospital cardiac arrest during the age of COVID19 starting from issues related to dispatch, PPE, the ideal location of BLS/ACLS, How to interact with the family, Infection control maneuvers and also the psychological impact on families and providers to have their loved ones pass during the pandemic.
Please leave us your thoughts and comments, we'd love to dig further into this topic. Make sure to leave @EMS_Nation a 5 star review wherever you listen to podcasts and to share the episode with friends and colleagues to pass along this #FOAMed resource.
Checkout the blog at EMSNation.org and say hello to Dr. Faizan H. Arshad on Twitter and Instagram @emscritcare.
Wishing everyone a safe tour and a "happy" EMS Week!
This episode is a wrap up covering the highlights from the Tactical Trauma international conference on pre-hospital critical care and trauma. This conference emphasizes tactical medicine, with a panel of experts speaking throughout the 2 days.
0:10 – Introduction to day 2 wrap up
0:40 – Introduction of the panel
1:15 – Mike Abernethy wraps up his session as a moderator on Day 2. Takeaways include Michael Lauria’s discussion on the preoccupation with protocols and guidelines.
2:45 – Three basic concepts include speed, simplicity, and coordination of care. Tactical medicine boils down to how efficiently one can perform these three tasks using evidence based medicine. Take the lessons learned from the military medicine, and a lot of them can be applied to civilian EMS and in-hospital care.
5:30 – One thing to add, is being able to do the basics very well. These basic skills will lay the foundation for new advanced technologies and interventions.
7:00 – Discussion on Mike Klumpner’s talk on medical best practices at MCI’s. The phrase “Just because you can, doesn’t mean you should” is discussed among the panel members. Being able to look at these mass casualty events, their injuries, and intervention with simplistically is the key. An example here includes an anecdote regarding a vascular neck injury, and the ability to ask “Am I making a difference, or am I delaying definitive care?”
9:30 – The panel discusses the criticism of triage in an MCI setting during day 2. One example given is that during most MCI’s, the triage tags were not used including the Boston Marathon bombing, where triage had to ‘go out the door’. Another example is the way the walking wounded are huddled into a corner and sometimes forgotten, while they may be gravely injured as evidenced in the Manchester bombing.
11:40 – FDNY’s new triage protocols include any penetrating injuries between the clavicle and the pelvis are immediate red tags.
12:15 – Breakout sessions with LEO’s who discussed the medical care of the K9’s.
13:30 – The point on situational awareness with the K9 colleagues is discussed. This includes muzzling them early if gravely injured and in danger.
13:45 – Anesthesiology talks about how dogs have a fenestrated chest cavity, and its importance with a tension pneumothorax. The end result is that the resulting obstructive shock may be worse in dogs.
15:00 – Ketamine takes a hit when it comes to pain control with K9’s for multiple physiologic reasons. Morphine IM 30-50mg was preferred for K9 pain control.
15:35 – Currently, it is a felony in the USA to provide ALS to animals if you are not a veterinarian. Propositions for exclusions for EMS workers trained in animal care are in the works right now. One anecdote is during a NC MCI, kid pools were filled with ice for the explosives K9’s, drawing a parallel to firefighter rehabilitation.
18:05 – Psychosocial aspects when providing medical care is discussed along with PTSD learning points. While feelings of anger and hostility towards your patient may be natural, providers must be able to accept that and continue to give medical care.
19:35 – Learning points in PTSD. One interesting finding was that those with minor injuries who received early intervention developed worse PTSD when compared to those with severe or no injuries. This raises questions on mandatory Critical Incident Stress Management, and how it should always be voluntary.
21:05 – Best practices after tough calls in EMS. Debriefing, assessing for safety, and assuring readiness for the next job are the top priorities. Being able to spend time with your colleagues, who have been through similar experiences versus mandatory CISM is discussed as well.
23:15 – The longer people stay in lockdown during MCI’s, the more likely they are to develop PTSD. Data coming out is showing that school lockdowns are causing PTSD in pediatrics.
24:50 – ‘Just culture’ is discussed, as is the importance of making system level changes to prevent errors. Most of the time, it is organizational culture that leads to mistakes, and not just individual mistakes.
26:10 – No non-discoverable mistakes exist in EMS, as opposed to hospital-based medicine.
26:55 – Takeaways from afternoon lectures including penetrating trauma with Dr. Tom Koenig, tactical medicine in mass casualty events with Dr. Matthew Lengua, OB trauma, and blast injuries.
27:30 – Resuscitative hysterotomies in Finland, and other advanced procedures done quickly and in austere environments. Discussing the decision gap, which the is the time from when the decision to perform a critical procedure is made until when that procedure is performed.
33:30 – Advances in resuscitative hysterotomies and thoracotomies, and there are now clear indications for both. However, this does not mean that Top Cover should be eliminated.
34:00 – Takeaways from blast injuries and penetrating trauma, specifically to the head and neck region. Major points include how EMS Physicians can treat some of these patients in the warm zone with critical interventions.
36:00 – Learning points from the lecture on burn care, and the unpredictability of the burn patient. One takeaway is that due to the current school of thought, providers are over-intubating patients with harm. Studies have also shown that escharotomies performed outside of burn centers are often performed incorrectly and incompletely.
39:30 – Use of vehicles as a weapon of mass destruction has become more common recently. A takeaway is that the extent of injury tends to be worse when the attack is intentional, whether using vehicles or other weapons. Logistically, the scene tends to be complex as it generally encompasses are large area. The discussion is brought up again about how as medical personnel, we can empower and train the general public to help.
48:55 – Next steps include teaching our communities the basic skills that have been proven to save lives, and working together to minimize these threats in the future.
49:15 - Conclusion
This episode is a wrap up covering the highlights from the Tactical Trauma international conference on pre-hospital critical care and trauma. This conference emphasizes tactical medicine, with a panel of experts speaking throughout the 2 days.
0:10 - Introduction of the conference
0:45 – Introduction of the expert panel
1:25 – Reflecting on the Las Vegas Shooting. Description of the original triage station which was not setup for an MCI with major trauma. Severely injured patients were kept on scene for approximately 45 minutes, due to unknown location of gunshots being fired.
2:45 – A big takeaway from this session is to assign a civilian to each patient, as many are willing to help. This way there is someone watching every patient who could report on their overall status (ie. Doing well vs deteriorating), freeing up medically trained resources for the most critical patients. Included in this talk was a discussion in how to involve and empower bystanders, as the first responders may not be on scene within minutes.
4:30 – The concept of an “immediate threat vacuum” is discussed, and defined as a period of time where victims are not being treated by EMS. Currently, this remains an opportunity for improvement.
5:00 – Military success rests on the fact that everyone is trained on tactical casualty care, thus allowing that vacuum to be filled.
5:45 – Hemorrhage control for the bystander needs to continue to be emphasized. A major campaign in America is Stop the Bleed, which emphasizes basic bleeding control techniques for the general public. This has also raised awareness for bleeding control kits, which are now readily available in certain public locations (ie. Schools, airports) Link: https://www.stopthebleed.org
6:15 – Studies into casualties were not done until quite recently, where experts were able to analyze drills and incidents to create real timelines for casualties. It was found that victims were not surviving with current protocols, indicating a need for change. There is now widespread access to data regarding specific wounds and their prognostic factors.
7:15 – A reflection of the Pulse nightclub shooting shows that there may have been fatalities due to decisions that came under fire, as there was previously not much data available to study and prepare adequately.
8:00 – A quick discussion on how pre-hospital providers must be prepared for anything that can occur out of hospitals. There is a quick reminder that not all hot-zones are created equal, therefore every environment is different and professionals must train and adapt to this.
8:35 – Some internet searches have revealed that terrorists are using response tactics to learn and improve their terror plans.
9:30 – Brief reminder on how expanding on experience can come in the form of extensive training, along with length of service.
10:00 – Summary of Michael Lauria’s presentation on Emergency Action Drills. This is adapting the way we train to optimize response and link that to subsequent patient outcomes. One way is to look at how other fields train for high risk scenarios, such as the military and the aviation industry. This presentation looked at the medical side of training, and the opportunity for improvement in training
11:00 – Discussed here are the steps for developing ERADs. 1. Identifying time sensitive threats that need to be addressed first (ie. Massive exsanguination, difficult airway). 2. Looking to literature, and coming up with solutions to these threats. 3. Engraining those steps in our mind during training. This has worked well for other professions in their high-risk trainings (aviation, military combat). This shows the importance of training like you fight, so you can fight like you trained when it comes time for that initial reaction.
15:30 – Wrap-up of Mark Forrest’s preventable deaths by exsanguination. The presentation revisited the topics that had no research, including Hydrogel technology and others that need further research. The bottom line takeaway is stopping the bleed with basic techniques has been proven to save lives, while other technologies may be in the horizon.
17:12 – iTClamp use in head and neck trauma has been shown to be fairly effective in studies, while it performed poorly compared to CAT Tourniquet in the lower extremities. However, 7.5% of military wounds are above the neck and result in very high mortality. The iTClamp has shown success in these situations. One link to a study on animal models: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3786550/
18:05 – Brief update on Junctional hemorrhages. Multiple devices have been shown to be effective in the lab, however their field application has been limited by weight, time, training. SAM has seemed to be the most popular anecdotally. Wound packing and close monitoring is likely the most effective method at the moment.
18:50 – Dr. Kate Prior’s presentation on leadership in a team-based setting with Inclusive Leadership practice. A deeper anecdotal discussion regarding inherent bias in the team environment is discussed here as well.
21:30 – Discussion on the timing of intubation in hypotensive poly-trauma patient. Two main reasons prevailed, the instability that comes with induction, and the negative effects of ventilation.
22:10 – Discussion on the resuscitation of the bleeding pediatric patient. Using the adult knowledge in the pediatric patient, just changing based on weight has more evidence behind it now.
22:55 – Discussion on Damage Control Resuscitation. This depends highly on the setting, and resources available in that setting. Examples of this include consistent hypotension prior to trauma surgery, the use of whole blood, and following the blood pressures being less ideal than signs of perfusion and blood flow using ultrasound. One key point is that each person has a different shock tolerance, and predicting this is virtually impossible.
25:45 – Conclusion of Day 1 Wrap-up.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
As EMS Medical Directors we value the incorporation of best practice and evidence-based medicine into delivering high quality prehospital care. The Statewide protocols present a historic opportunity for us to collectively take our game to the next level. We have worked hard to make these videos worth your while. We value your time as an EMS provider and using simulation videos as scaffolding to help bridge your knowledge of the new protocols can be invaluable. There is, however, no substitute for reviewing the new protocols you will be exercising in depth.
It is challenging to produce something for a wide range of providers from new CFRs and new EMS physicians to experienced providers; nevertheless BLS is the keystone of all of our practice and we set out to give it the attention it deserves.
New providers will notice language and terms that may be challenging but understandable from the context or definitions provided within. We encourage providers who have participated in our educational initiatives in the past to view this video series with a critical eye. Experienced providers are likely also teachers and field training officers. In that role, look for things that you could use to teach your students. Also, look for things that the actors could do differently in their scenarios and think about how you would address them if they were your trainees. As a note, while these videos all have lessons and take away learning points, many are intentionally designed to present patient care that could in fact be provided better.
Whether paid or volunteer, we wish you the best of luck in your EMS career. It is a noble field filled with many challenges. Be safe and never stop learning. We also wanted to specifically thank our partner in production of these videos - Laerdal Medical Corporation. Their mission – Helping Save Lives – could not be more tantamount when discussing the nature of BLS care. Learning to incorporate simulation into one’s regular practice can initially be challenging; however, a consistent well-designed program can be invaluable to providers in advancing multiple modalities of care from specific skills to psychosocial training and empathic communication.
The second iteration of FlightBridgeED's prehospital conference does not disappoint. The second day brought thought provoking concepts and a great review of critical syndromes that we don't often encounter. The challenging topics of shame in EMS and process improvement were also tackled.
For more information on this year's conference check out the website: https://www.flightbridgeed.com/index.php/fast-19
@FlightBridgeED #FAST19
Per usual, we assembled an all star panel to discuss the highlight's of the day's event. The panel included:
Michael Perlmutter @DitchDoc14
Cynthia Griffin @CMGrffn
Samuel Ireland @ireland_sam1
Billie Sell @flight_sell
And your guest host, Andrew Merelman @amerelman
Please subscribe to the podcast on your favorite podcast platform, iTunes, Spotify, Google Play, etc.
Check out the website at www.emsnation.org and follow us on Twitter @EMS_Nation
If a topic or idea you heard on the podcast ignited some curiosity or deeper thought we'd we'd love a 5 star review on iTunes to help spread our mission of EBM in EMS!
The second iteration of FlightBridgeED's prehospital conference does not disappoint. The first day was filled with not only thought provoking lectures on the bleeding edge of prehospital medicine but also insightful discussions about mental health, peer support and decision fatigue.
For more information on this year's conference check out the website: https://www.flightbridgeed.com/index.php/fast-19
@FlightBridgeED #FAST19
Per usual, we assembled an all star panel to discuss the highlight's of the day's event. The panel included:
Rebekha Spratt (aka Bex) @medibrat
Michael Perlmutter @DitchDoc14
Andrew Merelman @amerelman
Michael Brown @FireMedicFPC
And your host, Faizan H. Arshad @emscritcare
Please subscribe to the podcast on your favorite podcast platform, iTunes, Spotify, Google Play, etc.
Check out the website at www.emsnation.org and follow us on Twitter @EMS_Nation
In dealing with the critically ill, some will require an advanced airway. Many of these patients will be challenging to oxygenate and ventilate and also have underlying pulmonary pathology and physiologic shunt. The ideal approach to pre-oxygenation and denitrogenation has been controversial. Using standard equipment in parallel to optimize our patients’ hemodynamics has also been controversial (eg. Nasal Canula + BVM with separate oxygen sources as part of pre-oxygenation protocol) and not universally accepted. In addition, apneic oxygenation with a nasal canula at high flow rates has not been universally adopted despite advocacy by emergency airway experts. This year, the ENDAO trial – EmergeNcy Department use of Apneic Oxygenation Versus Usual Care During Rapid Sequence Intubation: A Randomized Controlled Trial - showed no difference in lowest mean oxygen saturation between the two groups. To quote the authors, “application of AO during RSI did not prevent desaturation of patients in this study.” Despite this, many continue to recommend the use of AO for emergent airways. In this lecture we will review the protocols, various application techniques , study the objective evidence behind these practices and discuss best practices for our patients to optimize the airway prior to laryngoscopy.
Presentation Objectives:
- The Definition of Pre-oxygenation and Denitrogenation
- The various means to achieve ideal pre-oxygenation: Ventilator with BVM Mask, Oxylator with BVM Mask, BiPap Machine with BVM Mask, BVM with PEEP Valve and Pressure gauge
- Review of the ENDAO and Fellow Trials
- Ultimate understanding of out-of-hospital best practices for approach to the hypoxic patient requiring advanced airway
An in depth and personal interview with Brian LaCroix, president of Allina health who has helped develop the EMSgrit.org website. Bringing a toolkit to mental health and helping develop the core attributes of Resilience and Self care while mitigating social stigma.
Join us as we dig into this controversial conversation on paramedic degree programs. This is a joint position statement from the National Association of EMS Educators, The National EMS Management Association, and the International Association of Flight and Critical Care Paramedics. Please find the position paper here:
https://www.emsworld.com/sites/emsworld.com/files/2018-10/joint_position_statement_on_.pdf
EMS Nation and crew wrap up the World Trauma Symposium's dynamic speaker panel and take away lessons for you to integrate into your medical response today!
#NAEMT #EMSWorldExpo18 #EMSNation
Join our distinguished Panel Discuss the Highlights of Day 2!
@CMGrffn Dr. Cynthia Griffin
@87MD1 Dr. Chris Fullagar
@MattRoginski Dr. Matt Roginski
@ALatimer13 Dr. Andrew Latimer
@ChuckSheppard Dr. Chuck Sheppard
@LuigisDad Sam Matta RN, East Coast Heli Ops
@UCAirCareDoc Dr. Bill Hinckley
@Crit_Care_Excel Michael C. Berrier NRP, FP-C, NPT, AAS
@AshleyLiebig Ashley Liebig (all around badass)
Dr. Damon A. Darsey
AND your Host
@EMSCritCare Dr. Faizan H. Arshad
Hosted by @AmpaDocs #CCTMC18
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Join our distinguished Panel Discuss the Highlights of Day 1!
@87MD1 Dr. Chris Fullagar
@ktcollopy Kevin T. Collopy, BA, FP-C, CCEMT-P, NRP, CMTE
@UCAirCareDoc Dr. Bill Hinckley
@CMGrffn Dr. Cynthia Griffin
@LuigisDad Sam Matta RN, NRP
@AshleyLiebig Ashley Liebig (all around badass)
@EMSCritCare Dr. Faizan H. Arshad
Hosted by @AmpaDocs #CCTMC18
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
The World Trauma Symposium:
https://www.naemt.org/events/world-trauma-symposium
NAEMT:
EMS World Expo:
Episode #66 Latest on Pelvic Binders from Both Military and Civilian Perspectives #WTS17 #PHTLS #EMSWorldExpo17 with Col. Stacy Shackelford, MD
Col. Shackelford is the chief of performance improvement at the Joint Trauma System Defense Center of Excellence for Trauma Joint Base in San Antonio, Texas. She is also an attending trauma surgeon at the San Antonio Military Medical Center. Col. Shackelford is a member of the Committee on Tactical Combat Casualty Care, led the TCCC guideline review and update for pelvic binders, and has deployed four times as a combat surgeon and as the director of the Joint Theater Trauma System. Col. Shackelford was commissioned through the U.S. Air Force Academy, attended medical school at Tulane University and general surgery residency at the University of Utah. After completing a Trauma and Critical Care fellowship at the University of Southern California, Col. Shackelford was assigned as Director of Education at the Air Force Center for Sustainment of Trauma and Readiness Skills at the R. Adams Cowley Shock Trauma Center. She is an instructor for the Defense Institute for Medical Operations.
Query us on Twitter:
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
The World Trauma Symposium:
https://www.naemt.org/events/world-trauma-symposium
NAEMT:
EMS World Expo:
Episode #65 Controversies in Needle Decompression #WTS17 #PHTLS #EMSWorldExpo17 with Julie Chase, MSED, FAWM, TP-C @ISDMedic
Julie Chase is a tactical medicine instructor in Berryville, Va. She has worked in public and private venues as a firefighter, paramedic, educator and administrator, and has taught in many countries, assisted with remote clinics and emergency services and is a National Disaster Medical System Response Team Member. She was an operational and tactical medicine instructor at a federal agency, a curriculum developer, contributing author, and reviewer for publication and accreditation organizations. Julie holds a Master in Postsecondary and Adult Education, a Bachelor in Paramedicine, and an Associate in Applied Arts and Sciences in Fire Science.
Query us on Twitter:
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
The World Trauma Symposium:
https://www.naemt.org/events/world-trauma-symposium
NAEMT:
EMS World Expo:
Ep #64 Nuances and Challenges to Modern Day Disaster Triage #WTS17 #NAEMT #EMSWorldExpo17 with Brad Newbury, MPA, NRP, I/C @nmetc911
Brad Newbury is the founder, president and CEO of the National Medical Education & Training Center in Massachusetts. He has been involved in EMS for over 30 years as a volunteer firefighter, paramedic and instructor. He has taught for the Massachusetts Fire Academy and lectured nationally. Brad managed the application process for full national accreditation of NMETC’s paramedic program and developed a hybrid paramedic program, which educates and trains students from around the world. He has worked as a faculty educator, content writer, and has been published by a national journal. He is also a principle author and speaker for NAEMT’s All Hazards Disaster Response course. Brad hold a Bachelor’s Degree in Fire Science and a Master’s Degree in Public Administration.
Query us on Twitter:
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
The World Trauma Symposium:
https://www.naemt.org/events/world-trauma-symposium
NAEMT:
EMS World Expo:
ATLS 10th Edition Updates and the Implications of Prehospital Care and PHTLS v9 with Dr. Andrew Pollak @AndyPollak
Dr. Pollak is the James Lawrence Kernan Professor of Orthopedics and chair of the Department of Orthopedics at the University Of Maryland School Of Medicine. He also serves as Chief of Orthopedics for the University of Maryland Medical System and was previously at the University of Maryland R. Adams Cowley Shock Trauma Center. Dr. Pollak has extensive experience in prehospital emergency care as a volunteer firefighter/EMT, EMS flight physician and fire surgeon. He serves as medical director of the Baltimore County Fire Department, Special Deputy US Marshal, and Commissioner for the Maryland Health Care Commission, and as an editor of EMS publications. Dr. Pollak has served on the American Academy of Orthopedic Surgeons Board of Directors, Orthopedic Trauma Association and the Maryland Orthopedic Association.
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Join our all star international panel as we discuss the highlights of the Day 2 program from the first ever Tactical Trauma 2017 conference recorded live in Sundsvall, Sweden. The conference was hosted by Dr. Fredrik Granholm @TotalResus
Link to the Tactical Trauma Website:
Panel Participants:
Dr. Mark Forrest @ObiDoc
Dr. Rick Dutton @TraumaDinosaur
Dr. Kasia Hamptom @KasiaMD
Professor Susan Brundage @TraumaMasters
Dr. Leilani Doyle @DoyleLeilani
Mike Lauria @ResusPadawan
Dr. Andy Johnston @armycritcare
And your host Dr. Faizan H. Arshad @emscritcare
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Join our all star international panel as we discuss the highlights of the day's program from the first ever Tactical Trauma 2017 conference recorded live in Sundsvall, Sweden. The conference was hosted by Dr. Fredrik Granholm @TotalResus
Link to the Tactical Trauma Website:
Panel Participants:
Dr. Kate Prior @doctorwibble
Dr. Leilani Doyle @DoyleLeilani
Mike Lauria @ResusPadawan
Dr. Mark Forrest @ObiDoc
Matt Libby @MatLibby
Dr. Thomas D @thomas1973
And your host Dr. Faizan H. Arshad @emscritcare
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Continue along for the New York State Collaborative Protocol series with Dr. Chris Fullagar @87MD1 as he reviews the indications, ideal pre-oxygenation strategies, laryngoscopy techniques, confirmation of tube placement as well as guidelines for post-intubation sedation for prehospital providers operating in New York State.
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Anne Creaton – An Emergency Physician & retrievalist HQ’d in Melbourne Australia. She spent the last 4 years in Fiji establishing emergency medicine training in a low resource environment while building capacity in pre-hospital care and disaster response. While living in Fiji she experienced Cyclone Winston first hand and was part of the in-country response. She is an educator in mass gathering medicine and the MIMMS system and was part of the instructor team for a multiagency tabletop simulation of a multi-site terrorist attack in Melbourne.
Lionel Lamhaut – An anesthetist with critical care and emergency training and an associate professor of the SAMU de Paris (excuse my French - Service d'Aide Médicale Urgente), Dr. Lamhaut is not only a disaster response physician but an academician of the highest caliber with recent publications on the prospective deployment of ECPR for refractory cardiac arrest in the Paris area with a multicenter study well underway. He responded directly to the deadly terror attack of Charlie Hebdo and was instrumental in the after action analysis in the coordinated multi-site terror attack that struck Paris on Friday the 13th of 2015.
Raed Arafat – Put a warm round of applause together for the Secretary of State and Minister of Internal Affairs of Romania! Tasked with development of emergency medical care in the country, he is the founder of SMURD – the Mobile Emergency Service for Resuscitation and Extrication. In his current position he leads the Department for Emergency Situations including fire and rescue, civil protection, prehospital emergency medical services, air rescue as well as emergency departments. Ladies and gentleman… a Knight and Grand Officer of the National Order of Merit in Romania, he has overcome both politics and prejudice in his sterling career as a champion of the highest quality prehospital care.
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Happy Friday of #EMSWeek2017!
https://emcrit.org/wp-content/uploads/push-dose-pressors.pdf
Resuscitation - beginning from initial patient contact to the emergency department to the intensive care unit is a continuun of care - though the first few minutes of patient contact with a critically ill patient can have tremendous repercussions on the patient's ultimate outcome. Whether in critical care transport or in 911 emergency response, patient's may require a medication in small aliquots immediately that would be either unfeasible or cumbersome to administer via infusion on a dedicated pump.
While circumstances in which a patient needs a push dose medication may be uncommon, the administration of these drugs can be potentially lifesaving. There are two prehospital scenarios in which the paramedic carries the necessary medication in their armamentariam and with appropriate instruction and training can safely reconstitute into an appropriate dose for use in out-of-hospital resuscitation for the critically ill patient.
Push dose pressors are often employed in profoundly hypotensive patients that will require endotracheal intubation. Rapid Sequence Intubation and Positive Pressure Ventilation are both associated with hypotension, thus in the patient that requires advanced airway and is hypotensive upon EMS arrival, push dose pressors may be employed to effectively "resuscitate before you intubate". Typically Epinephrine is diluted to an appropriate dose and adminstered in small aliquots (10mcg/ml) for inotropoic support to optimize hemodynamics prior to RSI or intubation. There is also anaesthesia literature supporting the use of neosynephrine as well as phenylephrine for this purpose, though these medications are less readily available prehospitally. Even brief episodes of relative hypotension can cause effects seen days later; in critically hypotensive patients these may be even more pronounced. By using push dose pressors, a field provider can safely and effectively resuscitate their patient in order to mitigate the risks associated with endotracheal intubation prior to securing an advance airway.
Conversely, a separate and distinct class of patients who suffer from decompensated heart failure may present with respiratory distress due to volume overload with pathophysiology associated with marked systemic hypertension. While CPAP is the mainstay of therapy for these patients prehospitally and has significantly reduced intubation of the CHF patient over the past several years, IV Lasix and topical Nitroglycerin play little role in the EMS management of the decompensated heart failure patient. Nevertheless, these patients often require preload and afterload reduction to manage their symptomatology; it is common to initiate nitroglycerin infusions in critical care transport as well as in the emergency department for management of this hypertension.
Nitroglycerin lowers preload via venous vasodilation at low doses and lowers after load via arterial vasodilation at higher doses, making the patient's vascular container larger lowering the systemic pressure. Aggressive, high dose NTG paired with the recruitment of the alveoli using CPAP & PEEP make up the mainstay of pre-hospital treatment of APE and decompensated heart failure. Bolus doses as high as 2 mg (2000 mcg) of nitroglycerin have been given safely and effectively in previous studies.
In emergent resuscitations we need to focus on bolus dose medications in the acute phase versus starting and titrating critical care infusions while a patient is in extremis. The goal is to achieve clinical end points of treatment faster with bolus dosing at the bedside and then begin maintenance infusions once resuscitation goals are met and the hemodynamics are stable. Similar to push dose pressors in the acutely hypotensive EMS patient requiring resuscitation, patients with decompensated heart failure may benefit acutely with push dose nitroglycerin, a potent vasodilator.
@AmpaDocs #CCTMC17
Mark your calendars for #CCTMC18
April 9-11th 2018
Wyndham Riverwalk - San Antonio Texas
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Happy Thursday of #EMSWeek2017!
David Olvera, AAS, FP-C, EMT-P
LinkedIn: https://www.linkedin.com/in/david-olvera-36048a1b
World Health Organization Human Factors PowerPoint-
www.who.int/patientsafety/activities/technical/who_mc_topic-2.ppt
Glucometer that monitors blood sugar via phone-
Checklist Articles:
Development of a standard operating procedure and checklist for RSI in the critically ill.( Scandinavian journal of trauma, resuscitation, and emergency medicine, Sept 11th 2014)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172951/
A pre-procedural checklist improves the safety of emergency department intubation of trauma patients. (Academic Emergency MedicineAug, 2015)
https://www.ncbi.nlm.nih.gov/pubmed/
Greater Sydney Area HEMS Checklist-
Failed Attempts at Intubation Associated With More Adverse Events
@AmpaDocs #CCTMC17
Mark your calendars for #CCTMC18
April 9-11th 2018
Wyndham Riverwalk - San Antonio Texas
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Happy Wednesday of #EMSWeek2017! Definitive airway management in the prehospital sphere for critically ill patients is often forced upon EMS providers especially when encountering failure of traditional challenging airway algorithms. Failure to ventilate and intubate a patient can results in immediate sphincter tightening for providers. Being facile with a surgical airway based on one's specific kit and armamentarium is paramount for providers in whom the surgical airway falls within their scope of practice. Adequate training and skills maintenance are perpetual challenges in this HALO (high acuity low occurrence) procedure.
His Bio & Credentials:
Kevin T. Collopy, BA, FP-C, CCEMT-P, NR-P, CMTE, WEMT, is an educator, e-learning content developer and author of numerous articles and textbook chapters. He is also the clinical education coordinator for AirLink/VitaLink in Wilmington, NC. Contact him at ktcollopy@gmail.com.
LinkedIn: https://www.linkedin.com/in/ktcollopy
Kevin's #CCTMC16 Podcast: Taking a "Time Out" before Initiating RSI Improves Patient Safety and First Pass Success
http://emsnation.libsyn.com/ep-30-taking-a-time-out-before-initiating-rsi-improves-patient-safety-1st-attempt-success-with-kevin-collopy-ktcollopy
NYS Collaborative Training Video for Surgical Airway:
http://emsnation.libsyn.com/ep-48-surgical-cricothyroidotomy
@AmpaDocs #CCTMC17
Mark your calendars for #CCTMC18
April 9-11th 2018
Wyndham Riverwalk - San Antonio Texas
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Checkout EMS Today 2018!
http://www.emstoday.com/index.html
Happy Tuesday of #EMSWeek2017! You've asked and you shall receive... Optimizing your patient's airway prior to pulling the trigger for RSI. Delayed Sequence Intubation in the prehospital realm to prevent Rapid Sequence Death. Dr. Jeff Jarvis, a paramedic from Williamson County Texas turned EMS Medical Director of Williamson County Texas challenges traditional thought processes to bring the best possible medical care to 911 patients. "It's medical decision making that saves lives... not a plastic tube through the trachea!!!!" Here is story from conception of the idea, to education and roll out, to challenges experienced interfacing with local emergency departments as well as preliminary results for prospectively collected data.
His Bio & Credentials:
https://www.wilco.org/Departments/EMS/Leadership/Jeff-Jarvis (Williamson County)
http://www.sw.org/Dr-Jeffrey-L-Jarvis (Baylor Scott & White)
@EMSToday #EMSToday2017
Mark your calendars for #EMSToday2018
February 21-23, 2018
Charlotte, NC Convention Center
Registration Link: http://www.emstoday.com/register.html
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
http://www.atacc.co.uk/
Happy Monday of #EMSWeek2017! Roll up your sleeves and mentally prepare for getting your hands dirty. Chief Flight Physician of University of Wisconsin MedFlight, Dr. Mike Abernethy @FLTDOC1, gives an honest assessment of the current state of discongruity in EMS in America. An honest assessment of the intricacies of American Prehospital Care and efforts we can take to improve outcomes for all our patients.
His Bio & Credentials:
http://www.emed.wisc.edu/content/mike-abernethy-md
@AmpaDocs #CCTMC17
Mark your calendars for #CCTMC18
April 9-11th 2018
Wyndham Riverwalk - San Antonio Texas
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
http://www.atacc.co.uk/
Join our distinguished Panel Discuss the Highlights of Day 2!
@MedFlightDoc Dr. Ryan Wubben
@BritFltDoc Dr. David Hindle
@DrewCathers Dr. Andrew Cathers
@CMGrffn Dr. Cynthia Griffin
@TotalResus Dr. Fredrik Granholm
@MikeSteuerwald Dr. Mike Steuerwald
@87MD1 Dr. Chris Fullagar
@UCAirCareDoc Dr. Bill Hinckley
@FLTDOC1 Dr. Mike Abernethy
@emeddoc Dr. Zaf Qasim
@MattRoginski Dr. Matthew Roginski
@EMSCritCare Dr. Faizan H. Arshad
Sponsored by @AmpaDocs #CCTMC17
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Join our distinguished Panel Discuss the Highlights of Day 1!
@MedFlightDoc Dr. Ryan Wubben
@DrewCathers Dr. Andrew Cathers
@CMGrffn Dr. Cynthia Griffin
@TotalResus Dr. Fredrik Granholm
@MikeSteuerwald Dr. Mike Steuerwald
@87MD1 Dr. Chris Fullagar
@UCAirCareDoc Dr. Bill Hinckley
@FLTDOC1 Dr. Mike Abernethy
@EMSCritCare Dr. Faizan H. Arshad
Sponsored by @AmpaDocs #CCTMC17
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
PerfectCPR for Apple Watch
Metronome devices have been shown to improve the quality of compressions during CPR. This module reviews the importance of high quality CPR and provides a solution to optimize compression rate for those who have an Apple Watch. This free Apple Watch App, PerfectCPR, provides haptic feedback so the provider can accurately time their compressions with the best-practice rate that is reflected in the protocols.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Avulsed Tooth
This micro learning module reviews the avulsed tooth protocol. We discuss indications and contraindications for re-implantation as well as strategies to manage both scenarios.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Eye irrigation / Morgan Lens
This micro learning module demonstrates techniques for ocular irrigation in the field. Included in this video are the use of the Morgan Lens and the administration of tetracaine, an ocular anesthetic.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Surgical Cricothyroidotomy (Bougie Assisted)
A surgical cricothyroidotomy is indicated by the 2017 NYS EMS collaborative protocols to be performed by paramedics when the patient cannot be adequately ventilated and oxygenated by any other method. In these “can’t intubate, can’t oxygenate” (CICO) situations, a rapid, effective surgical cricothyroidotomy may be lifesaving. This module depicts a simple and effective technique for emergent field surgical cricothyroidotomy utilizing equipment commonly found on the ambulance.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Complications of Delivery (Including Postpartum Hemorrhage, Shoulder Dystocia, Breech, Etc.)
This module demonstrates the field management of a number of complications of delivery as outlined in the 2017 NYS collaborative EMS protocols.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Massive Bleeding (With Hemostatic Wound Packing and Clot Removal)
This micro learning module demonstrates the approach to a patient with peripheral exsanguinating hemorrhage. Direct pressure, tourniquet application, and would packing with hemostatic gauze after clot removal are depicted.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Double Sequential Defibrillation
Double sequential defibrillation is a procedure that may be helpful in the treatment of refractory ventricular fibrillation (RVF) in the out of hospital environment. This module demonstrates the procedure of double sequential defibrillation which is included as a medical control consideration for instances in which ventricular fibrillation persists after five shocks. Further research will be required to determine the optimal treatment strategies for RVF. Double sequential defibrillation is not considered part of the minimum standard of care at this time. Nonetheless, providers will be instructed on how to properly perform this procedure in the event that a medical control order is granted for this treatment option.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Formal Debrief of Critical Patient Management Scenario (Critiques Scenario and Models Formal Call Review Sessions)
Previously, in episode 42, we demonstrated how debriefing can occur in an informal situation. In this video we model a more formal quality improvement session that involves the agency medical director and continuous quality improvement (CQI) director. We strongly believe that these sessions should be educational in nature and anything that requires “disciplinary” action should be handled via a different process entirely. This episode encompasses a critique of the “Management of the Critical Patient / RSI” scenario; episode 43.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Critical Patient Management with RSI
RSI is often regarded as the pinnacle of advanced life support skills. Indeed, this skill can be beneficial in the right circumstances. That said, like any advanced intervention, performing a particular skill must be done in the context of the overall situation. The procedure itself is fairly straightforward. The judgement, experience, and education of the provider dictate how he or she will manage the nuances of treating a critical patient. Expertise involves not only performing a skill correctly but performing the skill in the right situation at the right time, anticipating the potential complications before they occur, and mastering the basic skills that are requisite for advanced care.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Informal Debrief of Neonatal Resuscitation (Critiques Scenario and Models Informal Call Review)
Informal debriefing with your colleagues is an important part of continuous quality improvement and should be a regular part of your practice. In addition, being able to reflect on your own performance in a productive manner is an important skill to hone for personal growth. Fostering a culture that is supportive of these discussions allows providers to benefit from the experience and perspective of their colleagues. This video provides an example of how we would conduct such a debriefing in the context of the protocols and how we would address some of the issues and concerns that you may have identified regarding the patient care delivered in the previous two episodes.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Neonatal Resuscitation Simulation - NYS Collaborative
Uncomplicated delivery in the field is fairly straightforward. Unfortunately, things do not always go as planned. Thankfully, resuscitating a neonate in distress is a rare event but something that requires acute clinical acumen. This video depicts a newborn that is not responding to initial interventions. Review the neonatal resuscitation protocol along with this video. The next episode will depict an informal debrief of both this scenario as well as the OB field delivery scenario covered in the previous episode.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
OB Field Delivery Simulation - NYS Collaborative
Delivery of a neonate in the field environment poses a number of challenges. This video depicts a scenario that involves EMS field delivery. The delivery is fairly quick and uncomplicated but the neonate is in distress. The video covers the uncomplicated delivery process. Episode 47 will review complications of delivery and how they are managed by EMS in the context of the current protocols. The resuscitation of the neonate will be covered in the next episode.
Cast in Alphabetical Order:
Michael T. Benenati, BS, AAS, EMT-P
Tyler F. Cominsky, NRP
Seth Goldstein, BA, AS, AEMT-P/CIC
Susie Surprenant, BBA, BS, NRP
David Violante, MPH, MPA, AEMT-P
Faizan H. Arshad, MD @emscritcare
Christopher J. Fullagar, MD, EMT-P, FACEP @87MD1
Ep #36 Advanced GEMS - @NAEMT_ Beta Course #AGEMS
NAEMT’s groundbreaking Geriatric Education for Emergency Medical Services (GEMS) Advanced course builds on the GEMS core course, delving into more complex, realistic scenarios and the unique technology EMS practitioners are likely to encounter when assessing, treating, and transporting older adults.
-Highly interactive, immersive educational format focuses on integrating critical thinking into real world application.
-Topics covered include caring for and transporting patients on home ventilators, LVADs (left ventricular assist devices), tracheostomies, PICC lines/invasive lines and feeding tubes.
-Prepares EMS practitioners for the array of medical, mobility, psychosocial and communications issues found in older patients.
-Students are guided through a series of scenarios involving increasingly complex symptoms and situations.
Lance Villers, PhD @LVillers
Keith Widmeier @MICUParamedic
Wayne Burdette @WayneBurdetteJr
Wayne.burdette@gwinnettecounty.com
Tray Reynolds
reynoldsta@juno.com
AMSL and GEMS instructors will be eligible to become Advanced GEMS instructors after an online module and training!
Sponsored by the @PerfectCPR app designed to provide High Quality CPR Feedback
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Message us on Twitter!
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #35 All Hazards Disaster Response – @NAEMT_ Beta Course #AHDR
All Disasters are Local. First responders, regardless of the type of incident, need to be prepared to respond to mass casualty events and disasters of varying types with changing conditions and hazards. While the FEMA Incident Command Courses offer a primer on organizational structure of a response as well as insight into general operations at events, there is no course specifically aimed at prehospital providers which simultaneously codifies the medical knowledge required to care for critically ill and injured patients at a multitude of events. More so, this course targets boots on the ground providers from EMTs, Paramedics as well as EMS Response & Rescue physicians and provides the necessary skills, knowledge and insight to integrate seamlessly within the overarching ICS framework from the bottom up. This course focuses on the initial response to a wide range of possible events and is designed to scale perfectly to your operational area with topics including Structural Fires, Radiologic Events, Natural Disasters and critical Infrastructure Failure, Transportation events, Infectious Disease Outbreaks and of course Active Shooter Events. There are a bevy of well honed exercised, drills and tabletops to keep the pace of the 8hr day brisk and engaging.
It was a sincere pleasure to lead a distinguished group of authors in developing this new course which we Beta’d for the very first time in New Orleans at #EMSWorldExpo16. The official debut will be at @EMSTODAY conference in Salt Lake City Utah as a preconference on February 22nd 2017. Hope to see you all there!
Brad Newbury, MPA NRP @nmetc0911
Sean Britton NRP @SeanBritton
Craig Manifold, MD @DrCraigManifold
We hope to add the #AHDR course to the suite of Prehospital Trauma courses including PHTLS, TCCC & TECC and encourage all instructors for this course to keep an eye out for the online training module which will allow you to become an instructor for AHDR!
Sponsored by the @PerfectCPR app Designed to provide High Quality CPR Feedback
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Message us on Twitter!
Like us on Facebook!
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Wishing everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #34 A Case Series of Double Sequence Defibrillation w/ @emscritcare & @ccareanywhere
Dr. Phil Moy of the @PECPodcast expertly interviews me regarding our recent publication in this month’s Prehospital Emergency Care. We dive into the inspiration behind the study, the challenges behind the protocol and the development and deployment of our treatment algorithms. We conclude with our overall experience and directions for future research.
Article Link: http://www.ncbi.nlm.nih.gov/pubmed/26848018
PEC Podcast: http://pecpodcast.libsyn.com/
PEC Journal: http://naemsp.org/Pages/pecjournal.aspx
NAEMSP Website: http://naemsp.org/Pages/default.aspx
Also find my friends and fellow prehospital physician podcasters on Twitter:
Joelle Donofrio @PEMEMS
Jeremiah Escajeda @JerEscajeda
Scott Goldberg @EMS_Boston
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #33 Double Sequence Defibrillation - A Journey through the Literature with Dr. Phil Moy @PECPodcast
Check out Dr. Phil Moy weave this elegant tale on the evolution of prehospital double sequence defibrillation. He interviews 3 different author groups who recently published their work in Prehospital Emergency Care, the journal of the NAEMSP (National Association of EMS Physicians).
PEC Podcast: http://pecpodcast.libsyn.com/
PEC Journal: http://naemsp.org/Pages/pecjournal.aspx
NAEMSP Website: http://naemsp.org/Pages/default.aspx
Also find my friends and fellow prehospital physician podcasters on Twitter:
Joelle Donofrio @PEMEMS
Jeremiah Escajeda @JerEscajeda
Scott Goldberg @EMS_Boston
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #32 Using Simulation to Troubleshoot the Logistics of a Complex Transport with @UCEmergencyEMS
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #31 Hypertonic Saline vs. Mannitol in the Transport Environment with Dr. Drew Cathers @DrewCathers
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #30 Taking a "Time Out" before Initiating RSI Improves Patient Safety & 1st Attempt Success with Kevin Collopy @ktcollopy
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #29 Operationalizing REBOA and Prehospital Implications w/ Dr. Justin McClean @WildernessMD
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #28 The Extraglottic Device - A Nuanced Approach to the Advanced Airway @MikeSteuerwald
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #27 Prehospital Transfusion in Trauma What Does The Literature Say w/ Dr. Michael Jasumback @Jasumback
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #26 Mind of the HEMS Resuscitationist #smaccDUB @AMPADocs
Mental Resilience, Cognitive Offloading and Clinical Debriefing
#smaccDub
@AMPADocs – Air Medical Physicians Association
https://www.ampa.org/
A Roundtable Discussion With:
@JGlash – John Glasheen HEMS Physician with Sydney HEMS
@87MD1 – Chris Fullagar HEMS Physician President of AMPA
@HEMSonICE – Vidar Magnusson HEMS Physician and former EMS Medical Director of Iceland
@KimGeybels - Kim Geybels Prehospital Physician MD, FEBEM & EMS Medical Director in Belgium
@FltDoc1 – Mike Abernethy HEMS Physician PGY-30 Chief Flight Physician
And your host @emscritcare!
The Headspace App – 10 minute guided meditations
https://www.headspace.com/headspace-meditation-app
@TaraBrach – Guided Meditation Podcast
https://www.tarabrach.com/talks-audio-video/
Sponsored by @PerfectCPR
Apple Watch App with Audio and Taptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
www.PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #25 Prehospital Resuscitation & Retrieval Workshop Wrap Up #smaccFORCE #smaccDUB
#smaccFORCE
http://www.smacc.net.au/program/pre-conference-workshops/
#smaccDub
A Roundtable Discussion With:
@ParamedicHen
@drbear13
@David_Menzies
@VikingOne_
@JamesTooley
@FltDoc1
@AshleyLiebig
@WestCorkRR
@ObiDoc
And your host @emscritcare!
ATACC – Anaesthesia Trauma & Critical Care
http://www.atacc.co.uk/
Sponsored by @PerfectCPR
Apple Watch App with Audio and Taptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
www.PerfectCPR.com
Query us on Twitter:
Like us on Facebook:
www.facebook.com/prehospitalnation
Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #24 The EMS Gathering Wrap Up from Killarney Ireland #EMSG16
EMS Gathering!
Follow Glen Ellis on YouTube. Twitter @obicpcnights #obicpc run by @EllisGlen & @rescuegirlie
Anaesthesia Trauma and Critical Care
Round Table Discussion with:
@Medibrat
@AshleyLiebig
@Shorty_med
@Parabrod
@stevefla
@paramedickiwi
@EoghanCon11
@rescuegirlie
@JonEMTP
@Bmiesemer
@madmedic809
And your host @emscritcare
Sponsored by @PerfectCPR
Apple Watch App with Audio and Taptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
www.PerfectCPR.com
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #23 EMS Based Fire Systems - Challenging Tradition with Dr. Craig Manifold
Happy #EMSWeek #EMSStrong #EMSNation
Dr. Craig Manifold
http://emergencymedicine.uthscsa.edu/faculty/manifold.asp
https://www.linkedin.com/in/craig-manifold-75218052
NAEMT Position Statement on House Bill HR4365:
HR4365 - Sponsor - Rep Hudson, Richard {R-NC-8} Introduced 1/12/16
https://www.congress.gov/bill/114th-congress/house-bill/4365
Congressional EMS Caucus:
https://www.naemt.org/advocacy/ems-caucus
REBOA:
http://lifeinthefastlane.com/ccc/resuscitative-endovascular-balloon-occlusion-aorta-reboa/
NAEMSP Selective Spinal Immobilization:
Fire-Based EMS - The Myth of the Perfect model @EMSWorldExpo
http://www.emsworld.com/article/10322477/the-myth-of-the-perfect-model
Sponsored by @PerfectCPR
Apple Watch App with Audio and Taptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
www.PerfectCPR.com
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #22 Pediatric Prehospital Intubation - Journal Club from UCSD w/ @PEMEMS & Dr. Jim Dunford (San Diego)
Happy #EMSWeek #EMSStrong #EMSNation
UCSD EMS Fellowship: Chris Khan and John Serra, MDs
http://healthsciences.ucsd.edu/som/emergency-med/education/fellowships/ems/Pages/default.aspx
Dr. Jim Dunford – EMS Medical Director for San Diego & Eagle
http://healthsciences.ucsd.edu/som/emergency-med/faculty/Pages/jamesdunford.aspx
Articles:
Pediatric Intubation by Paramedics in a Large Emergency Medical Services System: Process, Challenges, and Outcomes
https://www.ncbi.nlm.nih.gov/pubmed/26320522
Two Hundred Sixty Pediatric Emergency Airway Encounters by Air Transport Personnel
https://www.ncbi.nlm.nih.gov/pubmed/23974713
Intubation in Pediatric/Neonatal Critical Care Transport: National Performance
https://www.ncbi.nlm.nih.gov/pubmed/25664667
Endotracheal Intubations in Rural Pediatric Trauma Patients
https://www.ncbi.nlm.nih.gov/pubmed/15359393
An observational study of paediatric pre-hospital intubation and anaesthesia in 1933 children attended by a physician-led, pre-hospital trauma service
https://www.ncbi.nlm.nih.gov/pubmed/24145041
San Diego RSI Studies Editorial:
http://www.emsworld.com/article/10323216/prehospital-rapid-sequence-intubation
Sponsored by @PerfectCPR
Apple Watch App with Audio and Taptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
www.PerfectCPR.com
Query us on Twitter:
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD @emscritcare
Ep #21 Ketamine Induced Rapid Sequence Intubation with Faizan H. Arshad, MD @emscritcare
Happy #EMSWeek #EMSStrong #EMSNation
SKEPTIC = Safety & Efficacy of Ketamine in Emergent Prehospital Tracheal Intubation – a Case Series
Brand new paper from Sydney HEMS on Ketamine and Shock Index in Annals of EM!
http://www.annemergmed.com/article/S0196-0644(16)30002-6/abstract
Additional References:
- Carlson JN, Karns C, Mann NC, et al. Procedures performed by emergency medical services in the united states.Prehosp Emerg Care. 2015.
- Jacobs PE, Grabinsky A. Advances in prehospital airway management.International Journal of Critical Illness & Injury Science. 2014;4:57-64.
- Prekker ME, Kwok H, Shin J, Carlbom D, Grabinsky A, Rea TD. The process of prehospital airway management: Challenges and solutions during paramedic endotracheal intubation.Crit Care Med. 2014;42:1372-1378.
- Wang HE, Kupas DF, Greenwood MJ, et al. An algorithmic approach to prehospital airway management.Prehospital Emergency Care. 2005;9:145-155.
- Mace SE. Challenges and advances in intubation: Airway evaluation and controversies with intubation.Emerg Med Clin North Am. 2008;26:977-1000.
- Combes X, Jabre P, Jbeili C, et al. Prehospital standardization of medical airway management: Incidence and risk factors of difficult airway.Acad Emerg Med. 2006;13:828-834.
- Drummond GB. Comparison of sedation with midazolam and ketamine: effects on airway muscle activity. Br J Anaesth. 1996;76:663-667.
- Jackson APF, Dhadphale PR, callaghan ML, Alseri S. Haemodynamic studies during induction of anaesthesia for open-heart surgery using diazepam and ketamine. Br J Anaesth. 1978;50:375-378.
- Price B, Arthur AO, Brunko M, et al. Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting. Am J Emerg Med. 2013;31:1124-1132.
- Scherzer D, Leder M, Tobias JD. Pro-Con Debate: Etomidate or Ketamine for Rapid Sequence Intubation in Pediatric Patients. J Pediatr Pharmacol Ther. 2012;17:142-149.
- Bruder Eric A, Ball Ian M, Ridi S, Pickett W, Hohl C. Single induction dose of etomidate versus other induction agents for endotracheal intubation in critically ill patients.Cochrane Database of Systematic Reviews. 2015
- Thompson Bastin ML, Baker SN, Weant KA. Effects of Etomidate on Adrenal Suppression: A Review of Intubated Septic Patients.Hospital Pharmacy. 2014;49:177-183.
- Arnold C. The promise and perils of ketamine research Ketamine began its life as an anaesthetic , but has enjoyed a recent renaissance as a potential. Lancet Neurol. 2013;12:940-941.
- Craven R. Ketamine. Anaesthesia. 2007;62:48-53.
- Perkins ZB, Gunning M, Crilly J, Lockey D, O’Brien B. The haemodynamic response to pre-hospital RSI in injured patients. Injury. 2013;44:618-623.
- Aroni F, Iacovidou N, Dontas I, Pourzitaki C, Xanthos T. Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug. J Clin Pharmacol. 2009;49:957-964.
- Manthous CA. Avoiding circulatory complications during endotracheal intubation and initiation of positive pressure ventilation.J Emerg Med. 2010;38:622-631.
- Kohrs R, Durieux ME. Ketamine. Anesth Analg. 1998;87:1186-1193.
- Moy RJ, Clerc S Le. Trends in Anaesthesia and Critical Care Ketamine in prehospital analgesia and anaesthesia. Trends Anaesth Crit Care. 2011;1:243-245.
- Reich DL, Silvay G. Ketamine: an update on the first twenty-five years of clinical experience. Can J Anaesth. 1989;36(2):186-197.
- Porter K. Ketamine in prehospital care. Emerg Med J. 2004;21:351-354.
- Svenson JE, Abernathy MK. Ketamine for prehospital use: new look at an old drug. Am J Emerg Med. 2007;25:977-980.
- Johansson J, Sjöberg J, Nordgren M, Sandström E, Sjöberg F, Zetterström H. Prehospital analgesia using nasal administration of S-ketamine--a case series. Scand J Trauma Resusc Emerg Med. 2013;21:38.
- Filanovsky Y, Miller P, Kao J. Myth: Ketamine should not be used as an induction agent for intubation in patients with head injury. Can J Emerg Med. 2010;12:154-201.
- Himmelseher S, Durieux ME. Revising a Dogma: Ketamine for Patients with Neurological Injury? Anesth Analg. 2005;101:524-534.
- Kropf J a., Grossman MD, Genzlinger M a., Stoltzfus J, Stehly CD. 328 Ketamine versus Etomidate for Rapid Sequence Intubation in Traumatically Injured Patients: An Exploratory Study. Ann Emerg Med. 2012;60:S117.
- Angus DC, van dP. Severe sepsis and septic shock.N Engl J Med. 2013;369:840-851.
- Jabre P, Avenel A, Combes X, et al. Morbidity related to emergency endotracheal intubation-A substudy of the KETAmine SEDation trial. Resuscitation. 2011;82:517-522.
- Shafi S, Gentilello L. Pre-Hospital Endotracheal Intubation and Positive Pressure Ventilation Is Associated with Hypotension and Decreased Survival in Hypovolemic Trauma Patients: An Analysis of the National Trauma Data Bank. The Journal of Trauma: Injury, Infection, and Critical Care. 2005;59:1140–1147.
- Seymour CW, Band RA, Cooke CR, et al. Out-of-hospital characteristics and care of patients with severe sepsis: A cohort study.J Crit Care. 2010;25:553-562.
- Williams E, Arthur a., Price B, Banister NJ, Goodloe JM, Thomas SH. 175 Ketamine versus Etomidate for Use in Helicopter Emergency Medical Services Endotracheal Intubation. Ann Emerg Med. 2012;60:S63-S64
- Bruns, B, Gentilello, L, Elliott, A, Shafi, S. Prehospital Hypotension Redefined. The Journal of Trauma: Injury, Infection, and Critical Care. 2008;65:1217–1221.
- Seymour, CW, Cooke, CR, Heckbert, SR, et al. Prehospital Systolic Blood Pressure Thresholds: A Community-based Outcomes Study. Acad Emerg Med Academic Emergency Medicine. 2013;20:597–604.
- Kristensen AKB, Holler JG, Mikkelsen S, Hallas J, Lassen A. Systolic blood pressure and short-term mortality in the emergency department and prehospital setting: a hospital-based cohort study.Critical Care. 2015;1:158.
- Heffner AC, Swords DS, Neale MN, Jones AE. Incidence and factors associated with cardiac arrest complicating emergency airway management. Resuscitation. 2013;84:1500-1504.
- Salt PJ, Baranes PK, Beswick FJ. Inhibition of neuronal and extraneuronal uptake of noradrenaline by ketamine in the isolated perfused rat heart. Br J Anaesth. 1979;51:835-838.
- Sprung J, Schuetz SM, Stewart RW, Moravec CS. Effects of Ketamine on the Contractility of Failing and Nonfailing Human Heart Muscles in Vitro. Surv Anesthesiol. 1999;43:230-231.
- Kunst G, Martin E, Graf BM, Hagl S, Vahl CF. Actions of Ketamine and Its Isomers on Contractility and Calcium Transients in Human Myocardium. Anesthesiology. 1999;90:1363-1371.
- Lundy PM, Lockwood PA, Thompson G, Frew R. Differential Effects of Ketamine Isomers on Neuronal and Extraneuronal Catecholamine Uptake Mechanisms. Anesthesiology. 1986;64:359-363.
- Selde W. Push dose epinephrine. A temporizing measure for drugs that have the side-effect of hypotension.JEMS. 2014;39:62-63.
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
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~Faizan H. Arshad, MD @emscritcare
Ep #20 Designing High Performing Systems of Prehospital CPR w/ Tom Bouthillet @tbouthillet
Happy #EMSWeek #EMSStrong #EMSNation
Tom Bouthillet
LinkedIn / Facebook / Twitter / Google+
EMS 12-Lead
ECG Medical Training
ACLS Medical Training
Adult Pit Crew CPR – The Explicit Details
http://www.ems12lead.com/2014/06/20/pit-crew-cpr-the-explicit-details/
The Science of CPR with Peter Kudenchuk, M.D.
https://www.youtube.com/watch?v=irHXrNqRbcY
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
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Ep #19 Equanimity, Puni & Parachuting: Evolving Concepts in Optimizing Resuscitation Performance w/ Mike Lauria @ResusPadawan
Happy #EMSWeek #EMSStrong #EMSNation
AMPA – Air Medical Physicians Association
#CCTMC17 Training Announcement – Critical Care Transport Medicine Conference
http://www.iafccp.org/events/EventDetails.aspx?id=177507
| 4/10/2017 to 4/12/2017 | |
| When: | April 10 - 12, 2017 |
| Where: | Map this event » |
| Contact: | Pat Petersen |
Sponsored by @PerfectCPR
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~Faizan H. Arshad, MD @emscritcare
Ep #18 The Resuscitation Workshop - Designing High Performance Teams @LaerdalMedical
Happy #EMSWeek #EMSStrong #EMSNation
Laerdal Medical:
http://www.laerdal.com/us/
Resucitation Workshop:
http://www.laerdal.com/us/News/49290950/Building-High-Performance-Teams-to-Tackle-Sudden-Cardiac-Arrest-Are-you-Providing
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery
PerfectCPR.com
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~Faizan H. Arshad, MD @emscritcare
Ep #17 A Primer on Intrathoracic Pressure Regulation & The Physiology of CPR with Dr. Keith Lurie Happy #EMSWeek #EMSStrong #EMSNation
Sponsored by @PerfectCPR
Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR
PerfectCPR.com
Dr. Keith Lurie is a practicing cardiac electrophysiologist and resuscitation scientist who, over the past 25 years, has devoted himself to study novel ways to resuscitate patients experiencing sudden cardiac arrest. Dr. Lurie earned his bachelors degree at Yale University and his medical degree at Stanford University. He studied cardiovascular medicine at the University of California in San Francisco and later joined the faculty there. He has been on the faculty at the University of Minnesota since 1991. As one of the leading innovators in the field, he has helped to develop new devices and methods that optimize cardio-pulmonary resuscitation (CPR) and, in turn, improve survival chances following cardiac arrest. In addition, he has become a respected thought leader in developing and implementing a systems-based approach to managing and treating sudden cardiac death events. Some of his most notable contributions include the development and assessment of various resuscitative techniques such as the impedance threshold device (ITD), active compression-decompression (ACD) CPR and the use of intra-thoracic pressure regulation to modulate cerebral and systemic circulation in states of severe hypotension and head injury. He has also helped to develop devices to treat heart failure and abnormal heart rhythms. He has mentored scores of research and clinical fellows over the past 30 years and he actively collaborates with multiple scientist colleagues worldwide. A professor of Emergency Medicine and Internal Medicine at the University of Minnesota, Dr. Lurie also directs an NIH-funded research laboratory at Hennepin County Medical Center in Minneapolis and he is a consultant for Zoll Medical.
Selected Peer-Reviewed Publications (Selected from over 200 publications):
- Lurie KG, Nemergut EC, Yannopoulos D, Sweeney M. The physiology of cardiopulmonary resuscitation. Anesth Analg. 11/2015
- Kwon Y, Debaty G, Puertas L, Metzger A, Rees J, McKnite S, Yannopoulos D, Lurie K. Effect of regulating airway pressure on intrathoracic pressure and vital organ perfusion pressure during cardiopulmonary resuscitation: A non-randomized interventional cross-over study. Scandinavian journal of trauma, resuscitation and emergency medicine. 2015;23:83
- Debaty G, Metzger A, Lurie K. Evaluation of zoll medical's resqcpr system for cardiopulmonary resuscitation. Expert review of medical devices. 2015;12:505-516
- Smith G, Dwork N, O'Connor D, Sikora U, Lurie K, Pauly J, Ellerbee A. Automated, depth resolved estimation of the attenuation coefficient from optical coherence tomography data. IEEE transactions on medical imaging. 2015
- Lurie KL, Gurjarpadhye AA, Seibel EJ, Ellerbee AK. Rapid scanning catheterscope for expanded forward-view volumetric imaging with optical coherence tomography. Optics letters. 2015;40:3165-3168
- Debaty G, Metzger A, Rees J, McKnite S, Puertas L, Yannopoulos D, Lurie K. Enhanced perfusion during advanced life support improves survival with favorable neurologic function in a porcine model of refractory cardiac arrest. Crit Care Med. 2015;43:1087-1095
- Salzman JG, Frascone RJ, Burkhart N, Holcomb R, Wewerka SS, Swor RA, Mahoney BD, Wayne MA, Domeier RM, Olinger ML, Aufderheide TP, Lurie KG. The association of health status and providing consent to continued participation in an out-of-hospital cardiac arrest trial performed under exception from informed consent. Acad Emerg Med. 2015;22:347-353
- Metzger A, Rees J, Kwon Y, Matsuura T, McKnite S, Lurie KG. Intrathoracic pressure regulation improves cerebral perfusion and cerebral blood flow in a porcine model of brain injury. Shock. 2015;44 Suppl 1:96-102
- Debaty G, Shin SD, Metzger A, Kim T, Ryu HH, Rees J, McKnite S, Matsuura T, Lick M, Yannopoulos D, Lurie K. Tilting for perfusion: Head-up position during cardiopulmonary resuscitation improves brain flow in a porcine model of cardiac arrest. Resuscitation. 2015;87:38-43
- Bartos JA, Matsuura TR, Sarraf M, Youngquist ST, McKnite SH, Rees JN, Sloper DT, Bates FS, Segal N, Debaty G, Lurie KG, Neumar RW, Metzger JM, Riess ML, Yannopoulos D. Bundled postconditioning therapies improve hemodynamics and neurologic recovery after 17 min of untreated cardiac arrest. Resuscitation. 2015;87:7-13
- Gold B, Puertas L, Davis SP, et al. Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation. Feb 2014;85(2):211-214.
- Metzger A, Rees J, Segal N, et al. "Fluidless" resuscitation with permissive hypotension via impedance threshold device therapy compared with normal saline resuscitation in a porcine model of severe hemorrhage. The journal of trauma and acute care surgery. Aug 2013;75(2 Suppl 2):S203-209.
- Frascone RJ, Wayne MA, Swor RA, et al. Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device. Sep 2013;84(9):1214-1222.
- Yannopoulos D, Segal N, Matsuura T, et al. Ischemic post-conditioning and vasodilator therapy during standard cardiopulmonary resuscitation to reduce cardiac and brain injury after prolonged untreated ventricular fibrillation. Aug 2013;84(8):1143-1149.
- Sarraf M, Sharma A, Caldwell E, McKnite S, Aufderheide T, Lurie K, Neumar R, Riess M, Yannopoulos D. Postconditioning with inhaled sevoflurane at the initiation of cpr improves hemodynamics and mitigates post-cardiac arrest myocardial injury after 15 min of untreated ventricular fibrillation. Crit Care Med. 2012;40:1-328
- Yannopoulos D, Segal N, McKnite S, Aufderheide TP, Lurie KG. Controlled pauses at the initiation of sodium nitroprusside-enhanced cardiopulmonary resuscitation facilitate neurological and cardiac recovery after 15 mins of untreated ventricular fibrillation. Crit Care Med. 2012;40:1562-1569
- Segal N, Matsuura T, Caldwell E, Sarraf M, McKnite S, Zviman M, Aufderheide TP, Halperin HR, Lurie KG, Yannopoulos D. Ischemic postconditioning at the initiation of cardiopulmonary resuscitation facilitates functional cardiac and cerebral recovery after prolonged untreated ventricular fibrillation. Resuscitation. 2012;83:1397-1403
- Convertino VA, Parquette B, Zeihr J, Traynor K, Baia D, Baumblatt M, Vartanian L, Suresh M, Metzger A, Gerhardt RT, Lurie KG, Lindstrom D. Use of respiratory impedance in prehospital care of hypotensive patients associated with hemorrhage and trauma: A case series. The journal of trauma and acute care surgery. 2012;73:S54-59
- Yannopoulos D, Matsuura T, Schultz J, et al. Sodium nitroprusside enhanced cardiopulmonary resuscitation improves survival with good neurological function in a porcine model of prolonged cardiac arrest. Crit Care Med. Jun 2011;39(6):1269-1274.
- Yannopoulos D, Kotsifas K, Lurie KG. Advances in cardiopulmonary resuscitation. Heart Fail Clin. Apr 2011;7(2):251-268, ix.
- Lurie KG, Coffeen P, Shultz J, McKnite S, Detloff B, Mulligan K. Improving active compression-decompression cardiopulmonary resuscitation with an inspiratory impedance valve. Circulation 1995;91(6):1629-32.
- Plaisance P, Lurie KG, Vicaut E, Adnet F, Petit JL, Epain D, Ecollan P, Gruat R, Cavagna P, Biens J and others. A comparison of standard cardiopulmonary resuscitation and active compression-decompression resuscitation for out-of-hospital cardiac arrest. French Active Compression-Decompression Cardiopulmonary Resuscitation Study Group. N Engl J Med 1999;341(8):569-75.
- Lurie KG, Voelckel WG, Zielinski T, McKnite S, Lindstrom P, Peterson C, Wenzel V, Lindner KH, Samniah N, Benditt D. Improving standard cardiopulmonary resuscitation with an inspiratory impedance threshold valve in a porcine model of cardiac arrest. Anesth Analg 2001;93(3):649-55.
- Lurie KG, Zielinski T, McKnite S, Aufderheide T, Voelckel W. Use of an inspiratory impedance valve improves neurologically intact survival in a porcine model of ventricular fibrillation. Circulation 2002;105(1):124-9.
- Aufderheide TA, Sigurdsson G, Pirrallo RG, Yannopoulos D, McKnite S, van Briesen C, Sparks C, Conrad CJ, Provo CA, Lurie KG. Hyperventilation-induced hypotension during CPR. 2004;109:1960-65.
- Aufderheide TP, Pirrallo RG, Provo TA, Lurie KG. Clinical evaluation of an inspiratory impedance threshold device during standard cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest. Critical Care Medicine. 2005, Apr;33(4):734-40.
- Pirrallo RG, Aufderheide TP, Provo TA, Lurie KG. Effect of an inspiratory impedance threshold device on hemodynamics during conventional manual cardiopulmonary resuscitation. 2005 Jul;66(1):13-20.
- Aufderheide T, Alexander C, Lick C, Myers B, Romig L, Vartanian L, Stothert J, S. M, Matsuura T, Yannopoulos D and others. From laboratory science to six emergency medical services systems: New understanding of the physiology of cardiopulmonary resuscitation increases survival rates after cardiac arrest. Crit Care Med 2008;36(Suppl):S397-S404.
- Lurie KG, Yannopoulos D, McKnite SH, Herman ML, Idris AH, Nadkarni VM, Tang W, Gabrielli A, Barnes TA, Metzger AK. Comparison of a 10-breaths-per-minute versus a 2-breaths-per-minute strategy during cardiopulmonary resuscitation in a porcine model of cardiac arrest. Respir Care 2008;53(7):862-70.
- Metzger A, Yannopoulos D, Lurie KG. Instrumental Management of CPR. Severe Acute Heart Failure Syndromes: A Practical Approach for Physicians. Mebazaa, A., Gheorghiade, M., Zannad, F., Parrillo, J.E. (eds.). Springer-Verlag, London Ltd. 2008, pp. 43-51.
- Metzger A, Lurie K. Harnessing Cardiopulmonary Interactions to Improve Circulation and Outcomes After Cardiac Arrest and Other States of Low Blood Pressure. In: Iaizzo PA, editor. Handbook of Cardiac Anatomy, Physiology, and Devices: Springer Science; 2009. p 583-604.
- Nichol G, Aufderheide TP, Eigel B, Neumar RW, Lurie KG, Bufalino VJ, Callaway CW, Menon V, Bass RR, Abella BS and others. Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association. Circulation;121(5):709-29.
- Yannopoulos D, Matsuura T, McKnite S, Goodman N, Idris A, Tang W, Aufderheide TP, Lurie KG. No assisted ventilation cardiopulmonary resuscitation and 24-hour neurological outcomes in a porcine model of cardiac arrest. Crit Care Med;38(1):254-60.
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Join our esteemed Panel Discuss the Highlights of Day 3!
@TotalResus Dr. Fredrik Granholm
@MikeSteuerwald Dr. Mike Steuerwald
@87MD1 Dr. Chris Fullagar
@UCAirCareDoc Dr. Bill Hinckley
@FLTDOC1 Dr. Mike Abernethy
@EMSCritCare Dr. Faizan H. Arshad
Sponsored by @AmpaDocs #CCTMC16
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~Faizan H. Arshad, MD @emscritcare
Join our esteemed Panel Discuss the Highlights of Day 2!
@EMSCritCare Dr. Faizan H. Arshad
@CbatesMD Dr. Craig Bates
@MikeSteuerwald Dr. Mike Steuerwald
@ResusPadawan Student Doctor Mike Lauria
@UCAirCareDoc Dr. Bill Hinckley
@FLTDOC1 Dr. Mike Abernethy
Sponsored by @AmpaDocs #CCTMC16
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~Faizan H. Arshad, MD @emscritcare
https://ampa.org/
Ep #13 – Introduction to Tablet US Devices @Yale_EUS & @EM_Informatics
Terason t3200: http://www.terason.com/usmart-3200t/
GE V-scan: http://www3.gehealthcare.com/en/products/categories/ultrasound/vscan_portfolio
Philips Lumify: https://www.lumify.philips.com/web/
Also mentioned- SonoSite iViz: https://www.sonosite.com/uk/product/sonosite-iviz
For more on Yale’s Emergency Ultrasound Program: http://medicine.yale.edu/emergencymed/ultrasound/
For more information on the Prehospital Pilot Program, scheduled to launch at our CC US conference in Newport, RI this September: http://medicine.yale.edu/emergencymed/ultrasound/courses/
Check out our prehospital friends & POCUS bloggers: http://emspocus.com/
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~Faizan H. Arshad, MD @emscritcare
Ep #12 @JavaDrake – Trauma US and the E-FAST exam
For more on Yale’s Emergency Ultrasound Program: http://medicine.yale.edu/emergencymed/ultrasound/
For more information on the Prehospital Pilot Program, scheduled to launch at our CC US conference in Newport, RI this September: http://medicine.yale.edu/emergencymed/ultrasound/courses/
Check out our prehospital friends & POCUS bloggers: http://emspocus.com/
There are a tremendous amount of #FOAMed Ultrasound resources out there and it’s only natural to want to consume it all! Trust me when I say nobody will blame you for getting excited about point of care US. Resources are very nicely summarized and linked by @sandnsurf on the LITFL blog: http://lifeinthefastlane.com/ultrasound-in-emergency-medicine/. Lot’s of additional links also in the comments section.
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~Faizan H. Arshad, MD @emscritcare
Ep #11 @CodeGreenEMS - Mental Health & MOS Suicide Prevention
For more of the Code Green Campaign, visit: http://codegreencampaign.org/
President: Ann Marie Farina
Ann Marie is one of the founders of Code Green and is the driving force behind the campaign. Ann Marie helped develop the idea for Code Green after the suicide of a coworker in March of 2014. One thing lead to another, and Code Green was born.
Ann Marie was born and raised in rural Alaska to a firefighting family and has been in EMS since 2003. She attended the University of Alaska Fairbanks where she obtained her Paramedic certification in 2006. While in Alaska she worked as a rural transport EMT, a wildland fire medic, an oilfield medic, and a volunteer firefighter. Since 2009 Ann Marie has worked as a full time field Paramedic in Spokane, WA for the primary 911 transport agency. She also worked part time for EMSconnect, writing entertaining and sometimes slightly inappropriate continuing education for EMS providers.
In addition to being the President of the board, Ann Marie serves Code Green as the treasurer, graphic designer, website admin, Facebook admin, and general jack-of-all trades. She also serves on the EMS1 Editorial Advisory Board. If she had free time she would spend it at the gym and using her camera for something besides a paperweight.
Secretary: Fiona Campbell
Fiona has been in public safety for 15 years, initially as a volunteer firefighter/EMT in 2000 before transitioning to her current position as a paramedic for Austin-Travis County EMS in 2012, where she is on the department Honor Guard and peer support team.
She’s the other main admin of the Code Green Facebook page, and is our primary statistics person. She’s also the southern half of our instructor base for our mental wellness course. Fiona is also the reason coffee was invented, and no, you can’t have her cup. It’s hers. Don’t even ask.
Her other passions include mentoring and educating future EMS providers – done via her department’s Explorer Post – photography, and editing fiction novels. She is owned by several rather over-sized Maine Coon cats and a large pack of dogs, all of whom think she spends too much time on the computer and not enough time paying attention to them.
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~Faizan H. Arshad, MD @emscritcare
Ep #10 – Prehospital Care Research Forum – Annual Summit Recap with @davidpage.
For more with Dave Page & the PCRF podcast: http://www.pcrfpodcasts.org/
FISDAP Research: http://www.fisdap.net/research
For a quick introduction to research instructors can send students to www.fisdap.net/research101 a free online course.
Round Table PCRF Summit:
Alan Batt - Critical Care Paramedic
Keith Widmeier BA, NRP, FP-C
University of Cincinnati College of Medicine
Christiana Corrado EMT-P
Adjunct Professor
Westchester Community College
Ron Lawler BUS NRP
Director
Sanford Health EMS Education
North Dakota State College Sciences
Kelly Walsh, RN BSN PHRN
EMS Academy Program Director
Creighton University-Advanced Medical Transport of Central Illinois Paramedic Consortium
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~Faizan H. Arshad, MD @emscritcare
Ep #9 - Simulation - Double Sequential Defibrillation in refractory VF & Lecture by @ccareanywhere on #DSED
Hot off the press! Our case series on #DSED just accepted for publication in Prehospital Emergency Care:
http://www.tandfonline.com/eprint/ZQsRHp54MWXAIkCsUiAi/full
REBEL EM: Beyond ACLS
http://rebelem.com/beyond-acls-dual-simultaneous-external-defibrillation/
EMS World: Hold the Coroner
http://www.emsworld.com/article/10318805/double-sequential-defibrillation
PEC: Cabanas et al
http://www.ncbi.nlm.nih.gov/pubmed/25243771
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~Faizan H. Arshad, MD @emscritcare
Ep #8 - EMSJC - Prehospital Ultrasound and Mechanical CPR in OHCA
- PEEPS Study:
Prehospital Evaluation of Effusion, Pneumothorax, and Standstill (PEEPS): Point-of-care Ultrasound in Emergency Medical Services
West J Emerg Med. 2015 Jul;16(4):503-9. doi: 10.5811/westjem.2015.5.25414. Epub 2015 Jul 14.
http://www.ncbi.nlm.nih.gov/pubmed/26265961
- Cardiopulmonary Resuscitation using electrically driven devices: A review
J Thorac Dis. 2015 Oct;7(10):E459-67. doi: 10.3978/j.issn.2072-1439.2015.10.40.
http://www.ncbi.nlm.nih.gov/pubmed/26623121
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~Faizan H. Arshad, MD
Ep #7 – Simulation Episode – Selective Spinal Immobilization with Dr. Joe Bart
(Full HD video on YouTube) https://www.youtube.com/watch?v=Lh44vQHpQvk&feature=iv&src_vid=PkNRiJm6FRY&annotation_id=annotation_4084272705
Joseph A. Bart DO – EMS division – Operations Medical Director, Deputy Fellowship Director
University of Buffalo Profile Page: https://medicine.buffalo.edu/content/medicine/faculty/profile.html?ubit=jabart
National Center for Security & Preparedness: http://www.albany.edu/ncsp/
-- Eliminate the Standing Take Down
-- Selective use of the C-collar
-- The Backboard as an Extrication Device
-- The Role of Alternate Devices
-- Q&A with Dr. Bart
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
Ep #6 - It's a Mick-Tatorship with Dr. Mick Molloy @drmickmolloy
Former Past President Irish Medical Association and current board member of the Irish PHECC (Prehospital Emergency Care Council)
-- Medicine In Ireland - Emergency Medicine and EMS / Disaster Preparedness
-- Challenging road to Disaster Preparedness & Stealing a Police Care
-- BestBETs: http://www.bestbets.org/
-- How to foster high quality research and mitigate Inertia
-- Papers App: http://www.papersapp.com/mac/
-- Manuscript App: http://www.manuscriptsapp.com/
-- Current Policy Challenges of PHECC: https://www.phecit.ie/
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
Learn more about the #EMSWolfpack on emswolfpack.com
Check them out on twitter: twitter.com/emswolfpack
Wolfpack Support on Twitter:
@paramedic_al
@winkler
@kablammoNick
@MediBrat
@tingles005
@DaveWeekly
@Medic4900
@ashleyliebig
@cherylcookie21
@Shorty_Med
@_Matt_Simpson
@parabrod
@NoDesat
@madmedic809
@bmiesemer
@EMS_Junkie
@paramedickiwi
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
BLS CPAP / JEMS:
http://www.jems.com/articles/print/volume-38/issue-11/patient-care/argument-bls-cpap.html
Optimizing Preoxygenation, Delayed Sequence Intubation:
Must read: http://emcrit.org/preoxygenation
Paper in Annals @emcrit @mdaware: http://www.annemergmed.com/article/S0196-0644(14)01365-1/abstract
LITFL DSI: http://lifeinthefastlane.com/ccc/delayed-sequence-intubation/
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
www.emsnation.org
Saving life and brain with extracorporeal cardiopulmonary resuscitation: A single-center analysis of in-hospital cardiac arrests
http://www.ncbi.nlm.nih.gov/pubmed/26383007
Tranexamic acid as part of remote damage-control resuscitation in the prehospital setting: A critical appraisal of the medical literature and available alternatives
http://www.ncbi.nlm.nih.gov/pubmed/26002268
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
www.emsnation.org
Ep. 2 - ALS Simulation - Creating a Push-Dose Pressor and Calculating Shock Index
Interview with Dr. Paul Pepe
http://www.jems.com/authors/l-p/paul-e-pepe-md-mph.html
-- How Research Launched Dr. Pepe's Prehospital Career
--"The earlier the intervention in the critically ill patient, the better the outcome."
--The beginning of physician response programs
--History of the Anti-Shock Garment: The Instrument of the Devil
--Challenging the Sacred Cow - Modern Day Dogma-lysis
-- OLMC --> NAEMSP --> EAGLES
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Wishing Everyone a safe tour!
~Faizan H. Arshad, MD
www.emsnation.org
