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 […]
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
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 […]
Assessment of a Critically Ill Child
So, as you all know we have had the opportunity to have Dr. Peter Antevy join us a couple of times and talk about pediatrics. When it comes to kids let’s face it, we all tend to get scared, our nerves shoot through the roof and it becomes the most stressful call of our career. […]
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. […]