April, 2025

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What do Paramedics need to know about Chickenpox?

Don't Forget the Bubbles

Paramedics are increasingly required to assess patients and determine whether they can be safely managed at home with self-care or primary care or if they need to be transferred to the hospital. In line with HCPC requirements, paramedics must use evidence-based practice to make informed clinical decisions. This post explores the key information needed to support sound, evidence-based, and patient-centred decision-making in managing chickenpox in children.

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Agitated with a head injury: Will Ketamine make it worse?

NAEMSP

Author : Katie Stuart MD; Washington University Emergency Medicine Residency Editors : Sarah Fabiano MD, FACEP, FAAEM & Michael DeFilippo DO You are a second-year emergency medicine resident physician doing a ride along with a helicopter-based EMS (HEMS) agency. You are dispatched to the scene of a golf cart versus tree. The air crew successfully identifies a safe landing place near where the ambulance is staged.

EMS
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An Assessment of Prehospital Provider Education and Sequelae Around the Experience of Breaking Bad News

International Journal of Paramedicine

Objectives Emergency Medical Services clinicians are often tasked with the delivery of bad news including making death notifications and informing loved ones about the termination of resuscitations. Existing trainings for breaking bad news are based around palliative care conversations in dramatically different clinic or hospital settings. We hypothesize that pre-hospital clinicians are not receiving formal training in the skill of breaking bad news and the delivery of bad news can have harmful

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SGEM#473: Did You Ever Have To Make Up Your Mind – Midazolam or Ketamine for Acute Agitation in the Pre-Hospital Setting

The Skeptics' Guide to EM

Reference: Muldowney et al. A Comparison of Ketamine to Midazolam for the Management of Acute Behavioral Disturbance in the Out-of-Hospital Setting. Ann Emerg Med. 2025 Date: April 24, 2025 Guest Skeptic: Dr. Howie Mell received his Medical Doctorate (MD) from the University of Illinois at Chicago, College of Medicine at Rockford. Prior to that, he received a Master of Public Health (MPH) degree emphasizing Environmental and Occupational Health from the University of Illinois at Chicago, School

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Intranasal!

Peter Canning

The call is for a seizure. A 9-year-old boy with epilepsy falls off the couch and is observed seizing, with full tonic-clonic activity. His mom shouts for the boys older sister to call 911, and then she goes to her purse and takes out the medicine his doctor prescribed for him. She sticks the nozzle of the device in the boy’s nose and pushes the plunder.

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ECG Pointers: Blocks

EMDocs

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, APD, Geisinger Wyoming Valley, PA) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations. This week, we feature a post from Dr. Tannenbaums ECG Teaching Cases , a free ECG resource. Please check it out.

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Can Kids Have Strokes??

FOAMfrat

When you think about strokes, you probably picture a slurred speech, middle-aged hypertensive smoker with half their face drooping. You dont picture atoddler in a car seat or a baby in a crib. But the reality is that strokes happen to kids, too.As paramedics, we thrive on pattern recognition, but pediatric strokes are theultimate zebra in the room. They dont present like adult strokes; theyre incredibly rare,and the clock is still ticking as fast.

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Prehospital Extra-Corporeal Cardiopulmonary Resuscitation

International Journal of Paramedicine

Introduction Out-of-hospital cardiac arrest remains a global health problem. There is emerging evidence that the use of extra-corporeal membrane oxygenation during resuscitation [ECPR], may help to improve outcomes. Several prehospital services around the world are now able to provide on-scene ECPR. However, the early identification of patients is a key factor in enabling this level of response to OOHCA.

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Episode 86: EEGs in the ICU with Carolina Maciel

Critical Care Scenarios

We discuss the basics of EEG in the ICU, including when to do it, selecting the appropriate study, and the basics of bedside interpretation, with Carolina B Maciel, MD, MSCR, FAAN, triple boarded in neurology, neurocritical care, and critical care EEG. Learn more at the Intensive Care Academy! Find us on Patreon here! Buy your Continue reading "Episode 86: EEGs in the ICU with Carolina Maciel" We discuss the basics of EEG in the ICU, including when to do it, selecting the appropriate study, and

ICU
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No, I Say

Peter Canning

“We need a lot more naloxone than ever before. Some people need 20 milligrams” I hear this or versions of it in many of the opioid task force meetings I attend around the state. No, I say. The research I have based on over 20,000 EMS run forms shows naloxone has remained effective over the years. Which is not to say some people arent getting 20 milligrams.

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The Pediatric EMS Podcast: Prehospital Pediatric Traumatic Cardiac Arrest – Priorities for Care

EMDocs

Originally published at The Pediatric EMS Podcast on March 5, 2035. Reposted with permission. Please visit their site HERE to see all the amazing podcasts or subscribe to their RSS HERE. This is the Pediatric EMS Podcast with the mission to provide case-based discussion with evidence-based recommendations by content experts in prehospital pediatric medicine in order to advance the care of children outside the hospital.

EMS
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Alcohol Use and Trauma in First Responders 

First Responder Wellness

By Stephen Odom, PhD, Founder and Chief Clinical Officer, FR Health Family of Companies As we recognize Alcohol Awareness Month this April, its an important time to shine a light on the complex relationship between alcohol use and trauma in first responders. These are the men and women on the front lineslaw enforcement officers, firefighters, correctional officers, EMS personnel, 911 dispatcherswho routinely witness tragedy and stress in their work.

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Emergency Care for All People in All Countries

ACEP Now

Did you know that by merely being an ACEP member, you are automatically a member of the International Federation of Emergency Medicine (IFEM)? IFEM is a federation of 70 emergency medicine organizations from around the world. The member organizations (i.e., ACEP) pays the membership fee, so you dont have to. IFEMs vision is a world where all people, in all countries, have access to high-quality emergency medical care.

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From Ambulance to Admission

International Journal of Paramedicine

OBJECTIVE: Vasopressors are critical for patients experiencing shock. This observational study aims to describe the usage of vasopressors by EMS, and to assess how vasopressor usage differs between transport and hospital environments. The information gathered in this study can help determine which vasopressors should be available in an EMS system and guide the management of patients requiring vasopressors during EMS transport.

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[Paramedic Chiefs of Canada] Paramedic Services Week – May 18th – 24th, 2025

Paramedic Chiefs of Canada

PCC Members, Paramedic Services Week is quickly approaching. This year’s theme, ‘We Care. For Everyone’ depicts the diverse roles that Paramedics play in an ever-changing environment, from community paramedicine to preventative healthcare, Paramedics stand ready to respond to challenges whenever they are needed. We hope that you will join us in recognizing the below themes each day of Paramedic Services week this year.

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When to Perform Nasotracheal Suctioning

SSCOR

We all know the important role suctioning plays in airway management. Imagine treating a respiratory, trauma, or cardiac arrest patient without the aid of suction. Impossible, right? Effective nasotracheal suctioning can mean the difference between a patent and a non-patent airway. It can also mean the difference between life and death for your patient.

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Start Where You Stand.

Medic Mindset

Dr. Faroukh Mehkri walks us through a mindset-reframe for the undifferentiated crashing patient. He theorizes that the pervasive language of stay and play versus load and go has conditioned and narrowed our thinking. Dr. Mehkri describes the evidence-based, predictable & preventable pattern of patients going into cardiac arrest shortly after EMS arrival.

EMS
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Close the Gaps: Smarter EMS Information for Hospitals

ESO

A typical hospital produces about 137 terabytes of data per day, more than twice the data housed in the Library of Congress. Yet, up to 97% of hospital data are unused. But what if all that data helped you improve patient outcomes, streamline operations, and support performance initiatives? What could you achieve if you had a patient’s prearrival care information in hand when they arrived at the emergency department (ED)?

EMS
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Podcast – Monthly Round Up February 2025 – Skills Fade, Resusciation Targets and more

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed In this episode of the St Emlyns Podcast, Iain and Simon reflect on IncrEMentuM 2025, skills fade in rare procedures, arterial line placement, and emerging evidence in cardiac arrest and resuscitative hysterotomy. Essential listening for emergency clinicians. The post Podcast – Monthly Round Up February 2025 – Skills Fade, Resusciation Targets and more appeared first on St.Emlyn's.

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Ep. 149 Special Edition: Achieving Equity in EMS Care and Patient Outcomes Through Quality Management Systems

Prehospital Emergency Care Podcast

Ready for the latest insights in prehospital care? Improving health and safety in our communities starts with a commitment to equity. We explore how systemic disparities in Emergency Medical Services (EMS) affect patient care, outcomes, and trust. Join our guests - Remle Crowe, Andra Farcas, and Ameera Haamid -as we unpack the National Association of EMS Physicians recommendations for making equity a strategic priority, published in Prehospital Emergency Care Journal , Volume 28, Number 6.

EMS
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PCC Summit June 10th-12th, 2025

Paramedic Chiefs of Canada

PCC Members, Our annual leadership Summit is less than two months away! In addition to the Summit sessions, you will have the opportunity to meet with sector partners, network with colleagues, and engage in conversations with Paramedic leaders from around the globe. A reminder to register for our upcoming Summit and reserve your guest room at our reduced rate by May 9th, 2025.

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5 Things to Know About Suction Canister Management

SSCOR

Whether youre performing routine suctioning during surgical procedures, suctioning a patient on a ventilator, or performing life-saving procedures to prevent or reduce aspiration, diligent suction canister management is critical to proper patient care. Particularly in the face of bird flu and other infectious diseases, your agency must work proactively to reduce the risk of transmitting disease via equipment such as suction machines.

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The Friends and Family Guide to the Opioid Overdose Epidemic

Peter Canning

I am proud to announce my latest book, The Friends and Family Guide to the Opioid Overdose Epidemic: Including How to Recognize and Treat an Overdose , will be published on August 26, 2025 by Johns Hopkins University Press. You can preorder at this link: Order Now Here’s the description from the publisher’s site: A practical and compassionate guide to understanding and addressing the opioid crisis.

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Visual Dx Answer: c) Large Bowel Obstruction

ACEP Now

Answer : The correct answer is d) large bowel obstruction. Large bowel obstructions may be partial or complete. Patients present with severe abdominal distension and inability to pass stool or flatus. Patients presenting secondary to colorectal malignancy often have a history of alternating diarrhea and constipation over the preceding weeks to months and may have had bleeding per rectum.

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The Museum of Modern Airway: How the Protected Airway Collaborative Cultivates Joy in Learning

The EMS Educator

Does your classroom have a joyful buzz? Jonathan St. George has it figured out--as the founder of the Protected Airway Collaborative (PAC), Jonathan was inspired by a museum visit to create a learning environment like no other. Join us as we dive into his innovative world of airway management education. Prodigy EMS team members Maia Dorsett and Shane O'Donnell report from the PAC as they experienced the self-directed learning approach firsthand.

EMS
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Special Edition: Crafting a Plan

EMS 20/20

Chris is given the mother of all scenarios where a pediatric patients takes. well, all the medications. PLUS! We introduce the coveted DICE ROLL to spice things up! Just because Chris asks for it doesn't mean he'll get it! Luck of the draw is at play in this week's episode. VOTE ON INSTAGRAM! Chris is given the mother of all scenarios where a pediatric patients takes. well, all the medications.

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ECG Cases 55 The Art of Occlusion MI Part 3 – Impression

Emergency Medicine Cases

In this ECG Cases blog Dr. Jesse McLaren guides us through 6 illustrative cases delving into overall impression in identifying occlusion MI. He discusses how using multiple OMI findings such as acute Q wave, subtle STE, reciprocal STD, hyperacute T waves, and reciprocal TWI to contribute to your overall impression, can double the sensitivity of STEMI criteria for acute coronary occlusion.

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ECG Pointers: Slow and Steady Wins the … Pacemaker?

EMDocs

Authors: Lloyd Tannenbaum, MD (EM Attending Physician, APD, Geisinger Wyoming Valley, PA); Christian Daniello, MD (Staff Physician, Geisinger Wyoming Valley) // Reviewer: Brit Long, MD (@long_brit) Hello and welcome back to ECG Pointers, a series designed to make you more confident in your ECG interpretations. This week, we feature a post from Dr. Tannenbaums ECG Teaching Cases , a free ECG resource.

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An overview of hypopituitarism

Don't Forget the Bubbles

What is the pituitary gland? The thyroid may be known as the queen of hormones, but the pituitary gland is the true master controller of the endocrine system. Sitting at the base of the brain, this tiny gland orchestrates the function of key endocrine organs, including the thyroid, adrenal glands, and reproductive system. Its influence extends across growth, puberty, metabolism, and the bodys response to stress, making it essential for normal development and homeostasis.

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April 2025 News from the College

ACEP Now

Still Time for LAC, Registration Open for ACEP25 Registration is open for ACEP25 in Salt Lake City. Get $100 off when you register by April 30. Join your emergency medicine friends in Salt Lake City from September 7-11 for ACEP25, the worlds largest emergency medicine conference. The Section Hall Crawl is back. The ACEP25 Block Party is set for 5 p.m. on September 9, and Olympic gold medalist Scott Hamilton will share his inspiring journey of resilience – from childhood illness to canc

ED
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Law and Order: Navigating Medicolegal risk in Emergency Medicine Part 2

EMOttawa

In part 1 of this 2-part series on medicolegal risk in Emergency Medicine, we looked at two legal cases, with a primary focus on civil litigation and college complaints. In this section, we focus on risk assessment, documentation, and advice from lawyers and CMPA experts, with some frequently asked questions to conclude. Check out part […] The post Law and Order: Navigating Medicolegal risk in Emergency Medicine Part 2 appeared first on EMOttawa Blog.

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Honoring first responders and public safety professionals

FirstNet Authority

Honoring first responders and public safety professionals Blog joseph.rey@fir Tue, 04/08/2025 - 09:56 By First Responder Network Authority Learn more about how FirstNet is transforming public safety communications contact your local FirstNet Authority Public Safety Advisor and sign up for our discipline newsletters. Follow us on Twitter , Facebook , Instagram , and LinkedIn for the latest FirstNet Authority updates.

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How Accurate are Blood Gas Electrolyte Measurements?

REBEL EM

Bottom Line Up Top: Blood gas electrolytes closely correlate with serum measurements and can be used under most circumstances to guide clinical care. Clinical Scenario: A 62 year old woman with a history of HTN, ESRD on MWF dialysis presents to the Emergency Department with generalized weakness. Her vital signs are HR = 82, BP 153/72, O2 Sat 95%, Temp 98.7.

ALS
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emDOCs Podcast – Episode 118: Lisfranc Injury

EMDocs

Today on the emDOCs cast with Brit Long ( @long_brit) , we cover the Lisfranc injury. Episode 118: Lisfranc Injury What is it? The Lisfranc joint complex is a tarso-metatarsal articulation named for Jacques Lisfranc (1790-1847), one of Napoleons battlefield surgeons. A Lisfranc injury is any injury/disruption to this joint complex. Exist along a spectrum: minor subluxation to fracture and dislocation.

ED
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Pediatric front of neck access (the surgical tracheotomy)

First 10 EM

Case It is the scenario of nightmares: a young child with an airway obstruction. They came in with stridor, and although you were initially thinking severe croup, the story doesnt quite fit, there is no response to medical therapy, and this patient is incredibly sick. There is significant hypoxemia despite a nonrebreather. You cant wait […] The post Pediatric front of neck access (the surgical tracheotomy) appeared first on First10EM.

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Rekindling the Fire in Emergency Medicine

ACEP Now

On a recent shift, I cared for a stroke patient with a story that, on the surface, was one that we hear all too often in Emergency Medicine. Mrs. A, as well call her, arrived hypertensive and aphasic with a hemiparesis and left-sided neglect. Family told EMS that she had no known past medical history, yet the paramedics suspected that she likely hadnt seen a doctor in many years.

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SGEM#471: Are ESI Levels Accurate for Triage of Pediatric Patients?

The Skeptics' Guide to EM

Reference: Sax DR, et al. Emergency Severity Index Version 4 and Triage of Pediatric Emergency Department Patients. JAMA Pediatrics, October 2024 Date: February 12, 2025 Dr. Brandon Ho Guest Skeptic: Dr. Brandon Ho is a graduating pediatric emergency medicine fellow at Childrens National Hospital in Washington DC and soon to be attending physician at Seattle Children's.