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PCC Members, As Canadians face the disruption and uncertainty of our countrys financial stability as a result of the trade war initiated earlier this week, we collectively have concerns impacting our personal situations as well as our professional role as leaders delivering critical health services to Canadians. With the true impact of the current and any future tariffs and counter-tariffs notyetclearly understood, what is certain is that the downstream effect will significantly challengeparamed
Objective: To describe the program and associated outcomes of an innovative medication safety and opioid risk screening program delivered by community paramedics Methods: The study was conducted within a health system community paramedic program in North America. Community paramedics employed a medication safety questionnaire and opioid risk assessment tool during home visits, offering tailored interventions based on individual patient risks.
We already know that nasal high-flow (NHF) apnoeic oxygenation is safe and effective in the controlled environment of elective theatre intubation and that it improves first-attempt success rates in neonates. But does it hold up in the unpredictable world of emergency paediatric intubation ? Thats exactly what Shane George et al. set out to explore in the Kids THRIVE study investigating whether NHF apnoeic oxygenation could improve intubation outcomes in critically unwell children needing emergen
In this episode of The EMS Show, Dr. Hayden Smith joins us to discuss the recent resurgence of measles cases, particularly focusing on the outbreak in Texas that has affected over 150 individuals and resulted in the tragic death of a child. Dr. Smith delves into the factors contributing to this uptick, including declining vaccination rates and public health challenges.
We often tend to spend more time on pediatric resuscitation and CPR compared to adults. However, the question remains: what is the optimal duration of resuscitation efforts in these patients before considering termination? A recent retrospective study from Japan addressed this issue and found that fewer than 1% of children achieved favorable neurological outcomes (defined as moderate disability or better at one month) when CPR exceeded 64 minutes.
By: Valentina Graci, PhD – Chair of the Education Program Subcommittee 2024 was a strong year for our AAAM webinar series. We hosted seven online webinars, which were highly rated and, in some cases, reached up to 200 registrants. AAAMs Scientific Program Committees Education Program Subcommittee hosted these interactive and educational events not just for members but for all those interested in automotive safety.
PCC Members, Further to the bulletin issued on March 6, 2025 Member Messages regarding the impact of tariffs and counter-tariffs on equipment, supplies and services used to provide paramedic services across Canada, we want to provide an update on our advocacy activities and share resources to members as our messaging is expanding across government and the public.
Medicare Ambulance Extender Bill Introduced in House Yesterday, March 18, Representatives Claudia Tenney (R-NY), Terry Sewell (D-AL), Cliff Bentz (R-OR), Paul Tonko (D-NY), Mike Carey (R-OH), Danny Davis (D-IL), Carol […] The post House Reintroduces Vital Medicare Extender and EMS Workforce Bills appeared first on American Ambulance Association.
Medicare Ambulance Extender Bill Introduced in House Yesterday, March 18, Representatives Claudia Tenney (R-NY), Terry Sewell (D-AL), Cliff Bentz (R-OR), Paul Tonko (D-NY), Mike Carey (R-OH), Danny Davis (D-IL), Carol […] The post House Reintroduces Vital Medicare Extender and EMS Workforce Bills appeared first on American Ambulance Association.
Kids get hurt. And they get sick. Its inevitable. Whether their fingers get caught accidentally in a car door or bedroom door slamming closed, or they trip and fall while running on their uncooperative little toddler legs , or catching all the germs as their immune systems slowly struggle to fight off every known virus to mankind. While most of the time, the injuries and illnesses are minor and self-resolving, every once in a while, there is major injury or illness, and significant bleeding is i
I started this blog over 20 years ago. At the time I wrote mainly about the interesting calls I was doing. Nowadays, besides writing about the opioid epidemic, it seems I write mostly about being an old medic trying to keep up, beating back father time. This is another one of those posts. I worked a 12-hour shift last Friday. All my patients were younger than me, even the old and infirm ones ones.
Background : Paramedicine education faces challenges in aligning curricula with evolving practice. Despite updates, our study reveals minimal change since 2018, especially post-transition from the Council of Ambulance Authorities to Paramedicine Board of Australia accreditation. Updates in cultural competency and interprofessional education are noted, but primary healthcare integration remains inadequate, showing a critical gap between education and practice needs.
-Case- A 30-year-old woman at 34 weeks gestation arrives at the ED complaining of a pounding headache, blurry vision, and swelling in her hands and face over the past few days. Her blood pressure reads 168/102 mmHg, has bilateral 2+ pitting edema of the lower extremities, and she has 3+ proteinuria on urine dipstick.
Methodology: 4/5 Usefulness: 3.5/5 Gibbs KW, et al. N Engl J Med. 2024 Jun 20;390(23):2165-2177. Question and Methods:The PREOXI trial aimed to determine whether noninvasive ventilation (NIV) via BiPAP reduces hypoxemia compared to standard oxygen masks for preoxygenation in critically ill adults undergoing emergency intubation through a multicenter, randomized controlled trial.
St.Emlyn's - Emergency Medicine #FOAMed This epiode of the St Emlyns Podcast features Dr. Dan Dworkis discussing high-performance teams, excellence in crisis, and how emergency clinicians can continuously improve under pressure. The post Podcast – High Performing Teams with Dan Dworkis at Tactical Trauma 24 appeared first on St.Emlyn's.
Yesterday evening, March 14, the United States Senate by a vote of 54 to 46 passed the Full-Year Continuining Appropriations and Extensions Act, 2025 (H.R. 1968) to fund the federal […] The post Congress Extends Ambulance Add-On Payments Through September 30 appeared first on American Ambulance Association.
Proper hydration is critical to the health and safety of firefighters when responding to wildfires and other emergencies. Yet many volunteer fire departments have limited budgets, forcing them to choose between needed resources. To help combat this issue and free up department funds for other necessities, Anheuser-Busch is partnering with the National Volunteer Fire Council (NVFC) for the seventh consecutive year to donate emergency drinking water to volunteer fire departments across the country
Chris is in the hotseat and his patient is in respiratory distress and making alllll the sounds. How does Chris hold up to this onslaught of respiratory trouble? Vote on our Instagram at @ems2020podcast! Chris is in the hotseat and his patient is in respiratory distress and making alllll the sounds. How does Chris hold up to this onslaught of respiratory trouble?
The treatment of patients with pulmonary embolism (PE) has evolved substantially over the past few decades. Many patients with PE can be discharged directly from the emergency department (ED). Advanced therapies such as catheter-directed treatments (CDT) are now available in many centers, and anticoagulants such as low-molecularweight heparins (LMWH) and direct oral anticoagulants (DOACs) have been developed, which obviate the need for frequent laboratory monitoring and dose titration in many pa
Reference: Pessano S, et al. Positioning for lumbar puncture in newborn infants. Cochrane Database Syst Rev. December 2023 Date: February 7, 2025 Dr. Lauren Rosenfeld Guest Skeptic: Dr. Lauren Rosenfeld is a PGY-3 emergency medicine resident at George Washington University. She is also a new podcast host for Emergency Medicine Residents Association (EMRA) Cast Series.
St.Emlyn's - Emergency Medicine #FOAMed Recorded at the London Trauma Conference 2024, Richard Lyon shares insights from his powerful presentation on the importance of detailed case learning and debriefing both in hospital and pre-hospital settings. The post Podcast – Excellence in Debriefing with Richard Lyon at LTC appeared first on St.Emlyn's.
This content is for AAA members only. Please either Log In or Join! The post Joint Position Statement on Criminal Liability for Alleged Deviations from Clinical Standards of Care in Emergency Medical Services appeared first on American Ambulance Association.
Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the literature on evaluation and management of massive hemoptysis. Episode 116: Massive Hemoptysis Definition: Hemoptysis is expectoration of blood from the respiratory tract; ranges from mild with small streaks of blood to cardiopulmonary compromise (1-5). Massive hemoptysis: no clear definition, ranges from 50 mL in a single expectoration to 100 mL in 24 hours to over 1 L in 48 hours.
Challenging working conditions in health services, especially in emergency departments (ED), lead to high levels of stress and burnout. This contributes to the staff retention problem recognised by professional associations such as RCEM and ACEM. As well as being a practice and policy priority, there have been repeated calls for research to better understand the problem.
TheOttawa DVT PoCUS Handbookis a peer-reviewed, practical guide designed to support emergency clinicians in the bedside diagnosis of deep vein thrombosis using point-of-care ultrasound (PoCUS). Developed by emergency medicine physicians at The Ottawa Hospital, this resource is tailored for learners and practitioners at all levels including medical students, residents, and staff physicians who […] The post Ottawa DVT PoCUS Handbook appeared first on EMOttawa Blog.
You work as the medical director at a suburban, community emergency department (ED). At your monthly meeting with the chief medical officer (CMO) and chief nursing officer (CNO), they inform you of the hospitals plan to start a Sexual Assault Nurse Examiner (SANE) Program. They ask you if you would be willing to serve as the teams medical director. As expected, you have several questions.
St.Emlyn's - Emergency Medicine #FOAMed Should ketamine be used for opioid-dependent patients in acute pain? A recent randomized controlled trial explores the effectiveness of low-dose ketamine (LDK) as an adjunct to morphine in emergency settings. Results show significant short-term pain reduction and reduced opioid requirements, with manageable side effects.
Bottom Line Up Top: A negative D-Dimer likely excludes significant pulmonary embolism (PE) in all patients but the low chance of getting a negative result makes a D-Dimer first approach of low clinical utility in the high pre-test probability group. Clinical Scenario: A 45-year-old man with malignant melanoma presents with right-sided pleuritic chest pain for 3 days.
Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the literature on evaluation and management of the adult patient with meningitis. Episode 115: Adult Meningitis Background: Meningitis is an inflammation of the subarachnoid space, the leptomeninges, and cerebrospinal fluid. Associated with a variety of causes, but a bacterial infection is one of the more dangerous ones.
Reference: Bannelier et al. Failure rate of D-dimer testing in patients with high clinical probability of pulmonary embolism: Ancillary analysis of three European studies. AEM Feb 2025 Date: February 27, 2025 Guest Skeptic:Dr. Lauren Westafer an Assistant Professor in the Department of Emergency Medicine at the University of Massachusetts Medical School Baystate.
Methodology: 4/5 Usefulness: 2/5 Arleth T, et al. JAMA. 2025;333(6):479489. doi:10.1001/jama.2024.25786 Question and Methods: This multicentered randomized control trial allocated trauma patients to a liberal or restrictive oxygen strategy for 8 hours to examine outcomes of death and/or respiratory complications. Findings: The study found there was no difference between the groups with outcome of death […] The post Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Rando
A 28-year-old man presented with agitation. He was brought in by police and was restrained because of threats of biting and hitting police. The patient refused any additional medical care and stated, I know my rights! You cant hold me against my will. When the emergency physician recommended vital signs, a history, and physical examination, the patient began hitting and biting staff, yelling obscenities, and threatening legal action.
St.Emlyn's - Emergency Medicine #FOAMed The St Emlyns Podcast features Dr. Jeff Kerrie discussing hyperbaric medicine. Discover how HBOT works, its role in treating dive-related injuries, and its expanding applications in emergency and critical care. The post Podcast – Hyperbaric Medicine with Jeff Kerrie at LTC appeared first on St.Emlyn's.
Humidified Non-Invasive Ventilation versus High-Flow Therapy to Prevent Reintubation in Patients with Obesity Hernndez et al. AJRCCM 2025. DOI: 10.1164/rccm.202403-0523OC Clinical Question In obese adult patients at intermediate risk for hypoxaemic extubation failure, does non-invasive ventilation (NIV) therapy with active humidification compared to use of high-flow nasal oxygen (HFNO or HFNC) reduce all-cause reintubation within 7 days after extubation?
Authors: Kamoga Dickson, MD (EM Resident Physician, Makerere College of Health Sciences, Kampala, Uganda); Jessica Pelletier, DO, MHPE (APD/Assistant Professor of EM/Attending Physician, University of Missouri-Columbia) // Reviewed by: Alex Koyfman, MD (@EMHighAK); Brit Long, MD (@long_brit) Case A 17-year-old male presents to the emergency department (ED) for sexually transmitted infection (STI) testing.
Are patients allowed to eat in your department? Do you field endless phone calls from nurses asking whether a patient is allowed to eat? Have you ever witnessed a confrontation between a nurse and a patient or family member over NPO status? The concept of forcing emergency patients to remain nil by mouth on the […] The post Let them eat: Emergency department patients should be encouraged to eat and drink appeared first on First10EM.
We’ve all seen it—or maybe even been guilty of it ourselves. A quick glance at a text, adjusting the GPS, or sipping that morning coffee behind the wheel. Distracted driving is a dangerous habit that can have devastating consequences. But what exactly is distracted driving, and how can we break the cycle?
Satonofuji Hisashi has been a career sumo wrestler since 1996. He is no champion wrestlerin fact, he is far from it. His highest attained rank was in the Makushita division in 2005, the third highest of six sumo divisions. Traditionally, the most elite wrestlers sat in a curtained area at the arenamakushita did not and the name thus translates to below the curtain.
St.Emlyn's - Emergency Medicine #FOAMed Cannabis edibles are raising concerns in emergency medicine due to delayed effects, high THC potency, and inconsistent labeling. A recent study highlights increased ED admissions and resource use among edible users compared to those who inhale cannabis. This analysis explores key findings, clinical implications, and the need for regulatory measures.
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