EMS Today

Non-Respiratory Disease Pathologies That May Complicate Airway Management

Respiratory distress is one of the most common emergencies resulting in a 911 call. Whether it be an asthma attack, chronic obstructive pulmonary disease (COPD) exacerbation or complication of pneumonia, difficulty breathing is a symptom that prehospital providers encounter quite frequently.

Most patients that call for emergency medical services for breathing problems have known-disease pathologies that are respiratory in nature. For example, patients with asthma, an obstructive pulmonary disorder, often present with chest tightness, wheezing and difficulty breathing.

Nebulized albuterol and supplemental oxygen are normally first-line interventions for the typical asthma attack. Providers understand the mechanism of action for those medications since they aim to correct the impaired respiratory processes as a result of disease.

Read the full article here.

Hypoglycemia with a Comedian

This podcast discusses hypoglycemia research and practice in EMS with Eric Chase who is a comedian, paramedic and educator.

Article discussed: Li, J. (2023, September 6). Article Bites: Is it safe to treat and release patients with hypoglycemia? In EMS1 after previously being printed by NAEMSP. 

Team Mustang

Dan Griffiths, Chris Winger, Kimberlyn Tihen, Mark Selapack, Brent Osborne and Alex Pafford (Team Mustang from the Spring 2023 Ambulance Service Manager Course) join the podcast to discuss their research project, "Saving Our Medics: The Case for Early Intervention." The focus of their project was identifying mental health issues in providers before it becomes a crisis.

Supraglottic Airways: A Look From Above

Advanced airway management in EMS systems around the country ranges from surgical airways to laryngoscopy, either video or direct, to the use of a supraglottic airway (SGA) device. As a “blind” airway device, the King Airway has largely replaced the Combitube as the civilian and military SGA of choice due to its design and ease of use. However, over the past decade, there have been many other SGAs, particularly iterations of the laryngeal mask airway (LMA), that have come to market. It is the wide and varied options for an SGA that have necessitated this evaluation as we hope to provide guidance to EMS agencies in choosing a device for their service.

Read the full article here.

’Call Jumping’ in Rural EMS

Bram Duffee, PhD, EMT-P, discusses “call jumping” in rural EMS with Latimer Hoke, M.Ed, NR-AEMT, who is a first responder and educator.

Article discussed: Hoke, L. (2023, August 22). Not Truly Off-Duty: True ‘First’ Responders in Rural Areas. Journal of Emergency Medical Services. https://www.jems.com/operations/not-truly-off-duty-true-first-responders-in-rural-areas/

Connections: If you want to connect with the Latimer Hoke you can reach him at latimerhoke@gmail.com and to connect with the show, reach out through www.ProfessorBram.com.

Achieving Long-Term Goals

In this episode we talk with Devin Howell, DO, AEMT-CC, about his journey from EMT to EMS medical director.

Resuscitation of Acute Decompensated Pulmonary Hypertension

Pulmonary hypertension (PH) is a chronic disease associated with significant morbidity and mortality, responsible for approximately 15,000 deaths per year in United States.

The deleterious cardiac effects associated with PH (e.g. Right Ventricular disease) render this population particularly susceptible to decompensation. Hypoxemia, acidosis and hypercapnia are not well tolerated in PH and will acutely increase pulmonary artery pressures, leading to hemodynamic collapse.

Read the full article here.

’I Couldn’t Keep That a Secret Anymore’

Eric Chase sits down with Oklahoma City Fire Department Lieutenant Danny Brown as he shares his story of failure and brokenness and how support from his wife, fire family and counseling helped him to realize it's ok to let go.

Dr. Bryan Bledsoe on Traumatic Cardiac Arrest

On this episode, Dr. Bryan Bledsoe joins the podcast to discuss a January article from JEMS, which he co-authored with Dr. Jeff Salomone, titled "Traumatic Cardiac Arrest (TCA): Maybe We Could Do Better?"

Additionally, we discuss his introduction to writing textbooks and his views on EMS education moving into the future.

Proper Assessment and Treatment of Acute Respiratory Distress

Management of acute respiratory distress isn’t an exact science. Good patient outcomes rely on your ability to assess ventilation, oxygenation, work of breathing (WOB), lung function, airway resistance and air flow. The number of treatment choices is increasing, and they’re becoming more complex. Does your patient need medication, suctioning, airway management, ventilation, intubation, non-invasive ventilation or just close observation?

Some practices of the past served only to disguise deterioration. With everything available to today’s EMS provider, you need some pearls of wisdom for effectively assessing and successfully treating patients having difficulty breathing.

Read the full article here.