Patient assessment is more than completing a checklist. Every patient encounter requires EMS clinicians to gather limited information, recognize life-threatening conditions, make timely decisions, and adjust their treatment plan as new findings emerge. Structured assessment tools such as the primary assessment, SAMPLE history, and OPQRST provide a consistent framework, but they are only part of […]
Shortness of breath is one of the most common complaints encountered in prehospital medicine. Most respiratory patients present somewhere along a spectrum ranging from mild distress to complete respiratory failure. One of the most important skills EMS providers can develop is recognizing when a patient is transitioning from respiratory distress to a true airway emergency. Early […]
Pulmonary embolism (PE) is one of the most challenging respiratory emergencies EMS providers encounter. Patients often present with nonspecific symptoms and relatively normal lung sounds, but their condition can rapidly progress to hemodynamic collapse if left untreated. Because definitive diagnosis requires hospital-based imaging and testing, prehospital providers must rely on assessment findings, patient history, and […]
Respiratory emergencies are among the most common and high-risk calls EMS providers encounter. Whether a patient presents with wheezing, crackles, hypoxia, or severe respiratory distress, effective treatment begins with understanding the underlying physiology. One of the most useful frameworks for evaluating pulmonary emergencies is distinguishing between restrictive and obstructive lung diseases. While both can produce […]
Most ambulance safety training focuses on avoiding crashes, EVOC, speed management, intersection clearing, and/or backing drills, which are all necessary. But very few agencies or departments train crews for what happens after the crash. Can your crew escape a rolled ambulance in smoke and darkness? Can they find the emergency release when the truck is […]
Ventilation-perfusion mismatch, commonly called V/Q mismatch, is one of the most important concepts in respiratory assessment. It explains why two patients with the same oxygen saturation can present with completely different underlying problems. For EMS providers, understanding V/Q mismatch helps move assessment beyond symptom and toward physiology. Instead of simply recognizing that a patient is […]
Not all sepsis starts with disease. Some of it starts with us. Iatrogenic sepsis, caused by healthcare interventions, accounts for a significant portion of sepsis cases. In emergency medicine, the environment, pace, and procedures create real risk. The good news: most of it is preventable. Environmental Risk EMS operates in uncontrolled environments: Trauma scenes Outdoor […]
Few debates in EMS are as persistent, or as misunderstood, as “scoop and run” versus “stay and play.” Many providers feel pressure to pick a side early in their careers, often based on how they were trained or what their agency culture promotes. In reality, this is not a fixed philosophy. It is a clinical […]
Eight seconds can feel like thirty minutes. Every experienced EMS provider knows that feeling. The rollover begins. The windshield tilts sideways. Somebody screams. The radio keeps playing. Your brain suddenly records tiny details with impossible clarity while time itself seems to slow down. Providers involved in catastrophic incidents often remember bizarrely specific details long after […]
The hardest part is not always the call. Sometimes it is returning home afterward. The silence. The moment somebody finally asks, “Are you okay?” and your brain suddenly realizes the call is over. EMS providers spend entire careers functioning inside chaos. But when catastrophic incidents happen — line-of-duty deaths, pediatric arrests, crew injuries, ambulance crashes […]
