Subject(s)
Syncope/etiology , Adult , Brugada Syndrome/diagnosis , Brugada Syndrome/drug therapy , Diagnosis, Differential , Electrocardiography , Emergency Medical Services , Heart Block/diagnosis , Heart Block/drug therapy , Humans , Long QT Syndrome/diagnosis , Long QT Syndrome/drug therapy , Male , Middle AgedSubject(s)
Emergency Medical Services , HELLP Syndrome/diagnosis , HELLP Syndrome/therapy , Antihypertensive Agents/therapeutic use , Diagnosis, Differential , Disseminated Intravascular Coagulation/etiology , Female , HELLP Syndrome/physiopathology , Humans , Magnesium Sulfate/therapeutic use , Pregnancy , Pulmonary Edema/etiology , Renal Insufficiency/etiologySubject(s)
Emergency Medical Services/methods , Travel , Virus Diseases , Chikungunya Fever/diagnosis , Chikungunya Fever/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Dengue/diagnosis , Dengue/therapy , Humans , United States , Virus Diseases/diagnosis , Virus Diseases/therapy , Virus Diseases/transmission , West Nile Fever/diagnosis , West Nile Fever/therapyABSTRACT
Evidence-based medicine will continually change the paradigm in which emergency medicine is practiced. Fifteen years ago tourniquets were a last resort and often considered a guaranteed way to lose a limb; today they are a gold standard in hemorrhage control. Believing in, and having practiced, medicine we later learn to be false doesn't make someone a bad provider, nor does it make them wrong. It simply means emergency medicine and EMS will continue to develop as a profession, and our body of evidence will continue to grow as we learn more about prehospital care. As we prepare to retire MAST, backboards and lidocaine, and realize the golden hour as a concept rather than a definitive 60 minutes, it's important to keep a critical eye out for the next intervention that truly will help patients during their prehospital care.
Subject(s)
Critical Care/methods , Emergency Medical Services , Evidence-Based Practice , Wounds and Injuries/therapy , HumansSubject(s)
Emergency Medical Services , Pulmonary Disease, Chronic Obstructive/drug therapy , Adrenergic beta-Agonists/therapeutic use , Cholinergic Antagonists/therapeutic use , Female , Glucocorticoids/therapeutic use , Humans , Male , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/physiopathologyABSTRACT
Managing the airway does not mean intubation, it means managing the airway. Allowing a patient to breathe on their own with appropriate positioning, bag-valve ventilation and blind insertion devices are all airway management options. The surgical cricothyrotomy is a rare and life-saving procedure when managing patients who are in a "can't intubate, can't ventilate" situation. These patients will die without aggressive and rapid intervention. While not all surgical cricothyrotomies provide a definitive airway, the needle cricothyrotomy is an ineffective means for ventilation and its use is discouraged. Understand the techniques used in your program and that are within your scope of practice as an EMS provider. Provide your patient the best opportunity for survival by knowing your program's surgical airway procedure thoroughly, and practice it regularly.
Subject(s)
Critical Care , Emergency Medical Services , Laryngeal Muscles/surgery , Airway Management , Humans , Surgical Procedures, Operative , Tracheostomy/methodsABSTRACT
Aortic dissections and aneurysms are seen with low frequency and have high risk for deterioration during prehospital care. It is essential to include both dissections and aneurysms in your differential diagnoses whenever evaluating patients with chest or abdominal complaints. Often a good history is the best indication of one of these grave vascular emergencies. Consider thoracic aortic dissection in your differential diagnosis for any patient who complains of chest pain and aortic aneurysm in patients who have any sort of abdominal discomfort or syncope with an unknown etiology. When either is suspected transport rapidly to a facility with cardiothoracic and vascular surgery capability, and provide care that prepares you to manage the patient quickly should a rupture occur.
Subject(s)
Aortic Aneurysm/diagnosis , Aortic Dissection/diagnosis , Emergency Medical Services , Aged , Aortic Dissection/etiology , Aortic Dissection/therapy , Aortic Aneurysm/etiology , Aortic Aneurysm/therapy , Diagnosis, Differential , Female , Humans , Male , Middle AgedABSTRACT
Reducing back injuries requires a holistic approach and investment by all interested parties, from front-line staff to leadership and supporting agencies. As a provider, take the time to ensure you are lifting and moving equipment and patients in a manner that protects both the patient and you.
