2024

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How to Become a Community Paramedic

Unitek EMT

Explore the educational pathway, skills, and opportunities in community paramedicine. Community Paramedicine represents a transformative approach to healthcare delivery, particularly in underserved or rural areas where access to healthcare services is often limited. By extending the traditional role of emergency medical services (EMS) personnel, Community Paramedics are instrumental in bridging gaps within the healthcare system, […] The post How to Become a Community Paramedic appeared fir

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Community Paramedicine: Where Does The Fire Service Fit In?

Pulsara

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin , for FireRescue1 BrandFocus Staff. Departments can play a large role in supporting the health and safety of underserved residents The inherent nature of the fire service means that responses to community needs are usually reactive.

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An International Community Paramedic Career Structure

International Journal of Paramedicine

Introduction - Internationally, prehospital workers practice in a wide range of community paramedicine roles. It can be unclear where community paramedics fit within existing paramedicine career structures and their professional capabilities are sometimes ill-defined or misunderstood. This study aimed to clarify some of these questions through the development of a community paramedic career structure and descriptions of their professional capabilities at different levels of practice.

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Can Situational Awareness Be Taught?

NAEMSP

Article by Karlee De Monnin CASE During my first ambulance ride-along as a fourth-year medical student on an EMS elective, my unit responded to a call for abdominal pain. On arrival to the apartment building, we stepped inside to find a tearful, but otherwise well-appearing young woman lying on the floor of her living room. She was an otherwise healthy 23-year-old who called us for abdominal pain and vomiting.

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Feedback Use in Paramedicine

International Journal of Paramedicine

Objective: The aim of this scoping review is to determine how feedback is used in paramedicine. Introduction: Feedback is widely recognised as essential for clinician growth in healthcare however there is limited research on its use within paramedicine. Paramedics place high value on effective feedback and different types and methods are used depending on context.

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Ep 199 Trauma Airway and Airway Trauma

Emergency Medicine Cases

In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck trauma, the head injured patient, the agitated patients and the soiled airway. The critical question is: when should we deviate from, delay or modify RSI, and how do we navigate the unique challenges presented by trauma airways and airway trauma?

EMS 316
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SGEM Xtra: The 12 Days of Christmas the SGEM Gave to Me

The Skeptics' Guide to EM

Date: December 15, 2024 Guest Skeptics: Dr. Chris Carpenter, Vice Chair of Emergency Medicine at Mayo Clinic. Today, were sleighing through the holiday season with a special episode filled with statistical cheer, a dash of skepticism, and a hint of eggnog-flavoured nerdiness. This is an SGEM Xtra like the one we did on What I Learned from Top Gun. Its fun to mix it up and not do a structured critical appraisal of a recent publication and have a more philosophical chat.

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More Trending

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What makes a T-wave Hyperacute? And: 30 Examples of Hyperacute T-waves, 10 in each of 3 myocardial territories.

Dr. Smith's ECG Blog

Pendell and I and the geniuses at Powerful Medical (Producers of the PMCardio Queen of Hearts OMI AI app ) are working on an objective, mathematical definition of hyperacute T-waves , based on real OMI outcomes and hyperacute T-wave annotation that has excellent interrater agreement (between me and Pendell), and it will end up being a logistic regression using these 3 variables: 1) area under the curve (AUC) relative to the QRS size 2) increased symmetry , as defined by time from T-wave onset to

STEMI 136
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Communic8: Eight Universal Leadership Lessons from the Children’s Emergency Department

Don't Forget the Bubbles

The Childrens Emergency Department is a busy, challenging, and dynamic environment. The skills needed to deliver the best possible outcomes for children and young people are multifaceted and constantly evolving. They involve a mixture of clinical, communication, and leadership traits. Having recently moved from a leadership position within the Childrens Emergency Department to a more system-based role involving children of all ages, its apparent to me how transferable my experiences on the shop

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NREMT Psychomotor Exam for BLS

Chicago EMT Training

We are ready to begin hosting psychomotor exams for BLS providers that successfully completed their written NREMT requirement. Assessments include: Medical Assessment (Neuro) Trauma Assessment (Head to Toe) Airway Management (with iGel) CPR//AED/choking for adults, pediatrics, and infants Bleeding Control (tourniquet) Penetrating Chest Trauma Spinal Motion Restriction OB Delivery Please schedule an appointment with Victor at info@chicagoemttraining.com To prepare, you can utilize our study guide

BLS 130
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Elbow Dislocations

REBEL EM

Elbow Dislocation Definition: Disarticulation of the proximal radius & ulna bones from the humerus Epidemiology: Incidence Second most common joint dislocation (after shoulder) in adults Most commonly dislocated joint in children Accounts for 10-25% of all injuries to the elbow ( Cohen 1998 ) Posterolateral is the most common type of dislocation (80%) Demographics Most commonly affects patients between ages 10-20 years old As age increases, elbow dislocation rates tend to d

E-9-1-1 106
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Building a Learning Culture in the ED: Why It Matters and How to Make It Happen.

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Creating a learning culture in the emergency department (ED) fosters psychological safety, open communication, and continuous improvement. This approach supports team resilience, enhances patient care, and reduces burnout. Learn practical steps to build a strong learning culture in your ED, promoting growth and collaborative excellence in emergency medicine.

ED 130
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Rebaked: Inborn Errors of Metabolism presenting in the ED

Pediatric EM Morsels

Often our job requires us to consider the presence of needles of significant illness in the haystack of nonspecific symptoms. With the help of our favorite geneticist , Dr. Liz Baker, we will dive into the haystack headfirst and find those needles. Hopefully, without getting poked. Let’s consider Inborn Errors of Metabolism Presenting in the ED : Inborn Errors of Metabolism: Basics Common Presentations, Uncommon Kiddos For the child with lethargy, vomiting, acidosis, hypoglycemia , organom

ED 300
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EMS Wellness: Program Uptake and Roadblocks [2024 EMS Trend Survey]

Pulsara

Editor's Note: In August 2024, EMS1 and Fitch & Associates released their annual EMS trend survey, What Paramedics Want, proudly sponsored by Pulsara. Because the articles and advice found within contain such critical subject matter, we've elected to publish each segment one at a time here on our blog. Read, enjoy, share, and take to heart the following information brought to you by the most prestigious thought leaders in EMS.

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Elder Male with Syncope

EMS 12-Lead

David Didlake @DidlakeDW EMS personnel responded to the residence of an 81 y/o Male with syncope. His spouse had called 911 after she heard a loud “thud” in the adjacent room. He was found altered, hypotensive, and with a large hematoma to the left periorbital region. No 12 Lead ECG was captured, but telemetry did reveal the following: The spouse offers a pertinent medical history to include HTN and HLD, and furthermore states that he hasn’t previously complained of any chest discomfort, or shor

Coronary 290
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ECG Cases 52 – The Art of Occlusion MI, part 1: Mirror Image

Emergency Medicine Cases

In this month's ECG Cases Jesse McLaren takes us through 6 cases highlighting important mirror concepts in ECG interpretation including: which leads are reciprocal to each other, how to identify which is the main ST/T change and which is the mirror, reciprocal changes highlighting subtle inferior, lateral and posterior OMI, ST elevation in aVR as a mirror to widespread ST depression and more.

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SGEM#462: Spooky Scary Access – IV or IO for OHCA

The Skeptics' Guide to EM

Date: November 10, 2024 Reference: Couper et al. The Paramedic 3 Trial: A randomized clinical trial of drug route in out-of-hospital cardiac arrest. October 31, 2024 NEJM Access to the SGEM Podcast episode at this LINK. Guest Skeptic: Missy Carter is a PA currently practicing in critical care after having attended the University of Washington's MEDEX program.

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SAEM Clinical Images Series: Rectal Bulge

ALiEM

A 13-month-old, full-term male presented due to intermittent emesis over a 3-week period. He and his parents had COVID one week prior to presentation. He had multiple episodes of non-bloody, non-bilious vomit the day before and the day of presentation. Parents noted he had been listless and unable to tolerate food. The mother was also concerned that he was straining to have bowel movements and that a mass was coming out of his bottom on the ride to the hospital.

ED 183
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What can you find with continuous ST monitoring in the ED?

Dr. Smith's ECG Blog

This was written by one of our fine residents, who will soon be an EMS fellow: Michael Perlmutter Case A mid-50s male came to the ED with a burning sensation that was acutely worse while at home. He had recently returned from overseas travel where these symptoms had been intermittently bothersome over the preceding weeks and had been attributed to heartburn.

ED 116
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Episode 73: POCUS for nephrology, with Abhilash Koratala

Critical Care Scenarios

We discuss the role of point-of-care ultrasound in evaluating the patient with kidney injury and assessing volume status, with Abhilash Koratala (@nephroP), nephrologist, Director of Clinical Imaging for Nephrology at the Medical College of Wisconsin, and champion of nephrology-focused ultrasound. Find us on Patreon here! Buy your merch here! Takeaway lessons References Episode 4 with … Continue reading "Episode 73: POCUS for nephrology, with Abhilash Koratala" We discuss the role of point-of-ca

OR 289
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EM@3AM: Murine Typhus

EMDocs

Authors: Grant Gerstner, DO (EM Resident Physician, San Antonio, TX); Kyle Smiley, MD (EM Resident Physician, San Antonio, TX) // Reviewed by: Sophia Görgens, MD (EM Physician, BIDMC, MA); Cassandra Mackey, MD (Assistant Professor of Emergency Medicine, UMass Chan Medical School); Alex Koyfman, MD (@EMHighAK) Welcome to EM@3AM, an emDOCs series designed to foster your working knowledge by providing an expedited review of clinical basics.

E-9-1-1 97
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Rethinking Fluid Resuscitation in Vaso-Occlusive Crisis: Is Lactated Ringer’s the Superior Choice?

REBEL EM

Background: Sickle cell disease (SCD) affects an estimated 300,000 infants born worldwide each year and has a total estimated prevalence of 100,000 in the United States alone ( Piel 2017 ). Within this population, over 90% of healthcare encounters are due to painful vaso-occlusive episodes (VOE) ( Kidwell 2021 ). VOE is often complicated by hypovolemia, making fluid administration a common intervention ( Lovett 2017 ).

ALS 122
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JC: Small versus Large-Bore Thoracostomy for Traumatic Hemothorax.

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed Traditionally, large-bore chest tubes have been standard for managing hemothorax, but smaller tubes are now proving just as effective in stable patients, with added benefits like reduced pain and fewer tube days. This review explores outcomes in drainage efficacy, complication rates, and patient comfort, showing that small-bore thoracostomy may be a reliable alternative for non-emergent cases.

OR 115
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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

Previously, we covered Post-Tonsillectomy Hemorrhage and how we hope that “all bleeding eventually stops: ideally, by means that we have imposed rather than by exhaustion of the patient’s RBC resources.” Since the original morsel ( way back in 2012 ), the literature has shown that there are a few extra ingredients that we can add to our morsel recipe when we care for children with post-tonsillectomy hemorrhage.

E-9-1-1 293
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Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatment of Acute Traumatic Pain: A Randomized Clinical Trial

EMOttawa

Methodology: 4/5 Usefulness: 2/5 McMullan JT, et al. Ann Emerg Med. 2024 Oct;84(4):363-373. doi: 10.1016/j.annemergmed.2024.04.018. Question and Methods: This out of hospital, placebo-controlled, blinded, parallel group RCT compared reduction in pain scores between Fentanyl + IN Placebo and Fentanyl with IN Ketamine. Findings: There was no significant difference in reduction of pain scores or adverse […] The post Out-of-Hospital Intranasal Ketamine as an Adjunct to Fentanyl for the Treatme

ALS 123
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IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO)

First 10 EM

In the most recent BroomeDocs podcast, we talk about an attempt to use the IM route to give cardiac arrest victims epinephrine faster. (The podcast and Research Roundups blog post might actually come out next week.) I was skeptical about the outcomes, partly because the evidence that epinephrine helps at all in cardiac arrest is […] The post IV versus IO for cardiac arrest (PARAMEDIC3 and IVIO) appeared first on First10EM.

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Ep 193 The Crashing Asthmatic – Recognition and Management of Life Threatening Asthma

Emergency Medicine Cases

In this part 2 of our 2-part podcast on asthma with Dr. Sameer Mal and Dr. Leeor Sommer, we dig into the recognition and management of life-threatening asthma. We answer such questions as: what are the key elements in recognition of threatening asthma? What are the most time-sensitive interventions required to break the vicious cycle of asthma? What are the best options for dosing and administering magnesium sulphate, epinephrine, fentanyl and ketamine in the management of the crashing asthmatic

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SGEM#458: Hurt So Good –Ketamine Can Make the Hurt so Good – If used as an Adjunct to Opioids for Acute Pain in the Emergency Department

The Skeptics' Guide to EM

Date: October 29, 2024 Reference: Galili et al. Low dose ketamine as an adjunct to morphine: a randomized controlled trial among patients with and without current opioid use. AEM Oct 2024. Guest Skeptic: Dr. Neil Dasgupta is an emergency medicine physician and ED intensivist from Long Island, NY. He is the Vice Chair of the Emergency Department and Program Director of the EM residency program at Nassau University Medical Center in East Meadow, NY, the safety net hospital for Nassau County.

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SAEM Clinical Images Series: An On-Target Diagnosis

ALiEM

A 25-year-old female with no pertinent past medical history presented to an emergency department in Massachusetts with four days of generalized malaise, myalgias, congestion, low-grade fever, and a rash behind her left knee. The patient denied cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, and diarrhea. She lives with three roommates, none of whom were sick, and she denied any other known sick contacts.

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What The Guardian Missed About US Ambulance Balance Billing

American Ambulance Association

To the Editor of The Guardian, On July 21, The Guardian published Jessica Glenza’s “Plan to end exorbitant ‘surprise’ ambulance bills heads to Congress.” The inflammatory title and lack of […] The post What The Guardian Missed About US Ambulance Balance Billing appeared first on American Ambulance Association.

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Episode 70: Airway evaluation for non-anesthesiologists, with Jed Wolpaw

Critical Care Scenarios

We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr. Jed Wolpaw, anesthesiologist and intensivist from Johns Hopkins, anesthesiology residency program director, and host of the ACCRAC podcast. Find us on Patreon here! Buy your merch here! Takeaway lessons References We discuss assessing patients prior to intubation or other airway management, including both elective and emergent circumstances, with Dr.

OR 290
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PLEASE UPDATE THE RSS FEED

Core EM

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Decision Engines to Improve Performance

High Performance EMS

There is plenty of data in the world, the key to improving performance is to discover the right information and make an appropriate decision, based on facts, in time to change outcomes for the better. Computers are quite useful in aggregating and processing data to distill information in support of the decision-making process, but artificial intelligence and machine-learning has increased our expectations of cyber assistance.

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Work-Life Balance During the Holidays

California Casualty

Balancing work and personal life during the holidays can feel like a juggling act. That’s especially true for shift workers on the front line—EMTs, nurses, police officers, and firefighters. While others are wrapping gifts or planning holiday feasts, you’re often working long shifts, answering urgent calls, or preparing for the next day’s challenges.

EMT 130
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Rebaked Morsel: Pediatric Buckle and Greenstick Forearm Fractures

Pediatric EM Morsels

Trauma season is at hand and like all other pediatric emergency departments in the country, we find our ED breaking ( pun intended ) at the seams with orthopedic injuries. We see all different flavors of upper extremity injuries. Yes, we’re talking about your clavicular , proximal humeral, supracondylar, lateral condylar , scaphoid and metacarpal fractures.

ALS 293
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National Emergency Response Information System Launched to Modernize Incident Data Collection for American Fire Departments

NVFC

The National Emergency Response Information System (NERIS) launched on November 4 to modernize incident data collection and provide vital intelligence for local fire departments across the United States. NERIS is a secure, cloud-based platform developed in collaboration with the American fire service to capture all-hazards incident data and provides analytic tools for local fire and emergency service leaders in near-real time.

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Imaging decisions in paediatric trauma. RCR update 2024

St. Emlyn's

St.Emlyn's - Emergency Medicine #FOAMed The blog highlights the updated 2024 guidelines from the Royal College of Radiologists (RCR) on imaging in pediatric trauma. It emphasizes critical changes from the previous 2014 guidelines, focusing on the judicious use of imaging to minimize ionizing radiation exposure in children. Key updates include algorithms for blunt trauma, penetrating trauma, and blast injuries.

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