PHANTASi Trial: Prehospital Antibiotics vs Sepsis
Background Antibiotics are one of the cornerstones of therapy in the treatment of sepsis/septic shock, however, according to the Surviving Sepsis Campaign (SSC) guidelines, time to antibiotics is a core measure, though there is weak evidence in support of this. Most of the evidence supporting this is based off retrospective studies that showed delays in […]
On Ketamine; In Defense of Excited Delirium
Recently I worked a week-long special event as an ALS/CC capable transport unit. Posted in the middle of nowhere and surrounded by thousands of people taking more drugs than a pharmacy carries, I knew it was bound to be quite the week. On our second day, my partner and I were cruising along people-watching when […]
Hands Down, Our Best Tool
Whether you work in the back of an ambulance, a helicopter, or a hospital, you likely have many tools to assist you in assessing and treating your patient. Tools such as monitors, a stethoscope, dopplers, thermometers, ultrasound units, glucometers and iStat machines, TOCO monitors, and endless imaging devices. Healthcare has created advanced technology for looking […]
Cause of Death: A Broken Heart…
By: Jaren Jarrell FP-C, CCEMT-P, NRP From country lyrics to inspirational quotes, “dying from a broken heart” is a widespread line. But, who would have thought that you can actually die or suffer from heartache? I am not talking about the type of despair that Spencer and Heidi from “The Hills” caused us in 2010. […]
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 […]
Ammonia on the Brain: Breaking Down Hepatic Encephalopathy
Tones Drop and dispatch tells EMS that they are going to visit a 55-year-old male with abdominal discomfort and altered mental status. After a few minutes, the ambulance arrives on scene to an apartment and the PT’s wife tells you that her husband not only has abdominal pain but isn’t making sense, is irritable, and […]
COVID-19: Coronavirus Resources
As providers continue to battle COVID-19 on the front lines, IMPACT EMS stays committed to bring you the most up to date information to help guide your care and keep you safe. In addition to our weekly Facebook Live Events and the CME Collective, this page will be updated weekly with current best practices and […]
It’s too Sweet to be Complicated! A Diabetic Ketoacidosis Case Scenario
*The following is an actual patient scenario where I will review a complicated DKA patient, dissect some key points regarding labs and treatment protocol, and discuss what could have been done better for this patient. You are activated to a small regional hospital for a 25-year-old female. She has a history of Type […]
Paralyzing the COVID-19 Patient
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 […]
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 […]