EMT & Fire and IA MED are now Impact EMS

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 […]

The Death of MONA in ACS: Oxygen

The Death of MONA in ACS: Oxygen by Salim R. Rezaie, MD   Background: The first report for supplemental oxygen for angina was in 1900, and since then oxygen therapy has been a commonly used treatment of patients with ST-Elevation Myocardial Infarction (STEMI).  The reason for this is the belief that supplemental oxygen will increase […]

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 […]

Intranasal: The Perfect Route?

Intranasal: The Perfect Route? Jeremy Singleton, RN, CEN Intranasal (IN) administration of medications is an excellent tool that serves a wide variety of situations that may be seen in the prehospital/emergency environment. The ability to deliver medication in seconds without a needle saves the patient from a potentially traumatic experience while allowing the clinician to […]

Ketamine and Roc: The Batman and Robin of RSI

Ketamine and Roc: The Batman and Robin of RSI Joshua Fountain, ASN, CFRN, CCRN, TCRN Like Batman, Ketamine is a kick-ass kind of drug that not only is an upscale, suave, pain management drug by day, but also a swift, bat-like induction agent by night. Ketamine also has a boy wonder paralytic sidekick named Rocuronium. […]