The Mistakes I’ve Made: Ventilation
Table of Contents Have you ever transported a patient that feels like a complete train wreck? No matter how much you try, it seems that nothing is going right, and the patient keeps getting worse. Let me tell you about a recent experience I had with a nothing-helps-patient-continues-to-deteriorate situation. It was a beautiful, summer day […]
“Modus Operandi” – Ventilator Modes
Once upon a time (reader, it was yesterday), I had a funny idea for comparing ventilator modes using Miss Trunchbull as assist control and Miss Honey as SIMV. My personal preference is SIMV, but I wanted to understand why SOME OF YOU WEIRDOS default to AC. So, like the astute researcher I am, I turned […]
ABC’s of The Ventilator
By: Justin Krantz, NRP, CCEMT-P, FP-C What was one of your biggest fears when starting critical care transport? Did I hear you say, “the vent?” That is ok it was mine as well. A few flight and critical care programs require little to no prior training on the ventilator. However, they usually provide formal […]
100% Silent
Chelsea Epling, BSN, RN, MCCN, EMT-P I figured I’d start this one out with a disclosure. This is going to be more geared towards the nurses than it is toward the medics. Let’s face it, you all are just initially better trained on ventilators than we are. Take a look at my experience. I started […]
Panic! At the airport
I had let my guard down, which was a mistake and it backfired. The first step after my mistake was to panic, and I think those around me at the time would say I did a pretty good job of it. 4 hours earlier I was relaxing at our crew house and probably arguing about […]
Neurogenic Pulmonary Edema
Neurogenic Pulmonary Edema Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant CNS insult. While there are a few theories, the etiology is unknown. Out of the ‘big 4’ theories, I’m going to go over two, neuro-cardiac and blast theory. Neuro-Cardiac Theory This theory characterizes […]
Paralyzing the COVID-19 Patient
The use of neuromuscular blocking agents (NMBA) during rapid sequence intubation (RSI) is arguably the cornerstone of the procedure. NMBA paralytics prevent gagging when utilizing a laryngoscope during intubation and allow for a more complete view of the glottis versus sedatives alone (Caro, 2020). NMBAs used in RSI can be categorized into two different types: […]
Minute Ventilation
Ventilator management strategies are all that glitters in the EMS community right now. ???? All the cool podcasters are talking about it; the bloggers are bloggin’ blogs about recruitment maneuvers and pronation of intubated patients. Vent management is the skinny jeans of EMS education. But I’m kinda dorky, and I take great care to not […]
Sudden Ambulance Death Syndrome
Stay and Play We’ve all had those critical patients: the ones circling the drain when we show up who bring the “pucker factor.” As EMTs and paramedics, our first reaction is to “grab and go” and get that patient to the familiar environment of our ambulance. It makes sense, right? That’s our office, all of […]
What’s “BRUE”-ing? Approaching a Pediatric Phenomenon
By Jaren Jarrell You’re 8 hours into your 24-hour shift. It’s been a grueling day and you have hit your critical thinking max. There it is…the tones drop once again! “EMS base, truck 12 respond to a 3-month-old male, reference patient not breathing.” The initial anxiety of a pediatric call hits you. This is not […]