tag:blogger.com,1999:blog-62291651206057011262024-03-28T18:48:31.804-06:00mark tozer's blogembracing the elements in urban and wilderness settingsSea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.comBlogger805125tag:blogger.com,1999:blog-6229165120605701126.post-4404068926140259842024-03-28T18:48:00.011-06:002024-03-28T18:48:00.125-06:00EMS Endocrinological Emergencies - Diabetes Mellitus<p style="text-align: justify;"></p><div class="separator" style="clear: both; font-family: arial; font-size: large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRQ2x2tvt_4XR-J8wnjI7XycDeelP-honqvAfszWwG1i1dmw1_VsgE1tXOUD34D4T6Mseve8IxUTgT-LHXXkEeyo72lnX0X9H109qbXT1jaO86jkvLCMD_dahRAno_ebccGSh8iVXCQPhFGeQznCATDFiJHyBArJCPy7TqR7V3DC-PKTpOZ1s2PU21fCWk/s1200/diabetes-general-overview-and-symptoms.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1173" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRQ2x2tvt_4XR-J8wnjI7XycDeelP-honqvAfszWwG1i1dmw1_VsgE1tXOUD34D4T6Mseve8IxUTgT-LHXXkEeyo72lnX0X9H109qbXT1jaO86jkvLCMD_dahRAno_ebccGSh8iVXCQPhFGeQznCATDFiJHyBArJCPy7TqR7V3DC-PKTpOZ1s2PU21fCWk/w626-h640/diabetes-general-overview-and-symptoms.png" width="626" /></a></div><br /><span style="font-family: arial; font-size: medium;">EMS providers should have a comprehensive understanding of diabetes mellitus and its various manifestations, including prediabetes, type 1 diabetes, and type 2 diabetes, as well as potential endocrine emergencies associated with these conditions. </span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Here is an overview of each, along with potential issues as they relate to prehospital care:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Diabetes Mellitus (DM):</b> Diabetes mellitus is a chronic medical condition characterized by dysregulation of blood glucose levels. This occurs when the body either does not produce enough insulin (type 1 diabetes) or cannot effectively use the insulin it produces (type 2 diabetes). </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Prediabetes is a precursor to type 2 diabetes, where blood sugar levels are higher than normal but not yet high enough to be classified as diabetes. EMS providers should be familiar with the signs and symptoms of diabetes, which may include frequent urination, excessive thirst, unexplained weight loss, fatigue, and blurred vision.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hypoglycemia:</b> Hypoglycemia occurs when blood glucose levels drop below normal levels, typically defined as less than 70 mg/dL. This can happen in individuals with diabetes who take insulin or certain oral medications, especially if they miss meals, exercise excessively, or have an imbalance between insulin and carbohydrate intake. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Symptoms of hypoglycemia can range from mild (sweating, trembling, hunger) to severe (confusion, seizures, loss of consciousness). EMS providers should be prepared to recognize and treat hypoglycemia promptly with oral glucose or intravenous dextrose, depending on the severity of the episode.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Diabetic Ketoacidosis (DKA)</b>: Diabetic Ketoacidosis is a life-threatening complication of diabetes, most commonly seen in individuals with type 1 diabetes but can also occur in type 2 diabetes under certain circumstances. DKA develops when there is a severe shortage of insulin, leading to the accumulation of ketones (acidic byproducts) in the blood. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Symptoms of DKA may include excessive thirst, frequent urination, abdominal pain, nausea, vomiting, fruity breath odor, rapid breathing, and confusion. EMS providers should recognize the signs of DKA and initiate appropriate treatment, which typically involves intravenous fluids, insulin therapy, and correction of electrolyte imbalances.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hyperglycemic Hyperosmolar Non-Ketotic Syndrome (HHNS)</b>: Hyperglycemic hyperosmolar non-ketotic syndrome is another severe complication of diabetes, primarily seen in individuals with type 2 diabetes. HHNS develops when blood glucose levels rise to extremely high levels, leading to dehydration and hyperosmolarity (increased concentration of solutes in the blood) without significant ketone production. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Symptoms of HHNS may include extreme thirst, dry mouth, confusion, weakness, and coma. EMS providers should be vigilant for signs of HHNS in patients with diabetes, particularly older adults or those with other comorbidities, and initiate prompt treatment with intravenous fluids and insulin therapy.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In summary, EMS providers should be well-versed in the management of common endocrine emergencies associated with diabetes mellitus, including hypoglycemia, diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar non-ketotic syndrome (HHNS). Prompt recognition and appropriate intervention are essential for optimizing patient outcomes and preventing further complications in these potentially life-threatening situations.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ooo</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The term "diabetes mellitus" has its roots in ancient Greek and Latin:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Diabetes</b>: The word "diabetes" originates from the ancient Greek word "diabētēs," which means "siphon" or "to pass through." The ancient Greek physician Aretaeus of Cappadocia, who lived in the 1st century CE, used this term to describe a condition characterized by excessive urination, likening it to water passing through a siphon.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Mellitus</b>: The word "mellitus" is derived from the Latin word "mel," meaning "honey" or "sweet." This term was added to distinguish diabetes mellitus from another condition known as diabetes insipidus, which is characterized by excessive urination but does not involve high levels of sugar in the urine. The addition of "mellitus" reflects the presence of sweet-tasting urine in individuals with diabetes mellitus due to the excretion of glucose in the urine.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Therefore, the term "diabetes mellitus" refers to a condition characterized by excessive urination with sweet-tasting urine, reflecting the classical symptoms observed by ancient physicians such as Aretaeus of Cappadocia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Alexander, M. & Belle, R. (2017)</b> <i>Advanced EMT: A Clinical Reasoning Approach</i> (2nd Ed). Hoboken, New Jersey: Pearson Education</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b> <i>Paramedic Care: Principles and Practice</i> Volume 2 (6th Ed) Pearson.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Mistovich, J. J. & Karren, K. J. (2014)</b> <i>Prehospital Emergency Care</i> (11th Ed). Hoboken, New Jersey: Pearson Education</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-70540781141128177982024-03-26T19:16:00.048-06:002024-03-26T19:16:00.241-06:00EMS Particular Patient Presentations - Crohn's Disease<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpwmzh_8npupRBcVrA8L4tkyf5a0o6Tx1OI_cgYKikUcN4TfyATgIH0PsUUlRo7A2YIL-lgpoFpdprylN-fx_h03kxrZbRHJzcEeyIQT_PZ3sTuXRGaNwRt3umJzL_RMv8gbWeU9HEjMapg5QHVsZiUJqx1_eKXNUwrdFys74bCBVyCz_aVIWPtIct6MfI/s710/Crohn's_disease_symptoms__infographic_680x_-_Designua%20(1)%20copy.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="710" data-original-width="673" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpwmzh_8npupRBcVrA8L4tkyf5a0o6Tx1OI_cgYKikUcN4TfyATgIH0PsUUlRo7A2YIL-lgpoFpdprylN-fx_h03kxrZbRHJzcEeyIQT_PZ3sTuXRGaNwRt3umJzL_RMv8gbWeU9HEjMapg5QHVsZiUJqx1_eKXNUwrdFys74bCBVyCz_aVIWPtIct6MfI/w606-h640/Crohn's_disease_symptoms__infographic_680x_-_Designua%20(1)%20copy.jpg" width="606" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS Providers should have an understanding of Crohn's Disease and its potential implications for prehospital care. </span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Crohn's disease is a chronic inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, from the mouth to the anus. It is characterized by inflammation, ulceration, and thickening of the intestinal wall, leading to a variety of symptoms and complications.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of prehospital care, EMS providers should be aware of the signs and symptoms of Crohn's disease, which may include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Abdominal Pain</b>: Patients with Crohn's disease often experience abdominal pain, cramping, and discomfort, which may be intermittent or persistent and can vary in severity.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Diarrhea: Chronic diarrhea is a common symptom of Crohn's disease, which may be accompanied by urgency, frequency, and passage of bloody or mucus-containing stools.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Weight Loss</b>: Patients with Crohn's disease may experience weight loss due to malabsorption of nutrients, reduced appetite, or increased metabolic demands associated with chronic inflammation.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Fatigue</b>: Chronic inflammation and malnutrition associated with Crohn's disease can lead to fatigue, weakness, and decreased energy levels.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Extraintestinal Manifestations</b>: Crohn's disease can affect other organs and systems outside the gastrointestinal tract, leading to extraintestinal manifestations such as arthritis, skin rashes, eye inflammation, and liver involvement.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of potential issues for prehospital care, EMS providers should consider the following:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Dehydration & Electrolyte Imbalances</b>: Chronic diarrhea and fluid loss can lead to dehydration, electrolyte imbalances, and metabolic disturbances. EMS providers should be prepared to assess and manage dehydration, including fluid resuscitation and electrolyte replacement as needed.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Pain Management</b>: Abdominal pain and discomfort associated with Crohn's disease can be severe and debilitating. EMS providers should be equipped to provide appropriate pain management interventions, such as analgesics or non-pharmacological techniques, to alleviate patient discomfort.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Inflammatory Flare-Ups: Patients with Crohn's disease may experience periods of disease exacerbation or flare-ups characterized by worsening symptoms and complications. EMS providers should be prepared to assess and manage acute exacerbations of Crohn's disease, including supportive care and prompt transport to a medical facility for further evaluation and treatment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ooo</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The discovery of Crohn's disease is credited to Dr. Burrill B. Crohn, an American gastroenterologist, along with his colleagues Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In 1932, they published a landmark paper titled "Regional Ileitis: A Pathologic and Clinical Entity" in the Journal of the American Medical Association, describing a distinct inflammatory bowel disorder affecting the terminal ileum and other parts of the gastrointestinal tract. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">This condition, later named Crohn's disease in honor of Dr. Crohn, represented a significant contribution to the understanding of inflammatory bowel diseases and revolutionized their diagnosis and management.</span></p><p><b style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Further Reading:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Alexander, M. & Belle, R. (2017)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Advanced EMT: A Clinical Reasoning Approach </i><span style="background-color: #fefdfa; color: #333333;">(2nd Ed). Hoboken, New Jersey: Pearson Education</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b><span style="background-color: #fefdfa; color: #333333;"> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Mistovich, J. J. & Karren, K. J. (2014)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Prehospital Emergency Care </i><span style="background-color: #fefdfa; color: #333333;">(11th Ed). Hoboken, New Jersey: Pearson Education</span></span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-90059006227204207292024-03-24T14:02:00.055-06:002024-03-24T14:02:00.170-06:00EMS Particular Patient Presentations - Addison's Disease<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1zkCoTY5vll6Nj-PYNtkcoTECLWRYBOONm4brFZAaZwNzmlWleVCgBOCqCxLcQJht9H00ElKMx9-OTugu4TTcIQuLc93L3UuOjiFnCKmUjn1Oh7MSRD6jpeuiPm-pYNCrsrVCdR02BXVa6RUHX8Xy7ezJMDZfrtg4tI2cTRCYXR68EIExajMM_zCLEBiA/s673/shutterstock_295238312.webp" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="673" data-original-width="673" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1zkCoTY5vll6Nj-PYNtkcoTECLWRYBOONm4brFZAaZwNzmlWleVCgBOCqCxLcQJht9H00ElKMx9-OTugu4TTcIQuLc93L3UuOjiFnCKmUjn1Oh7MSRD6jpeuiPm-pYNCrsrVCdR02BXVa6RUHX8Xy7ezJMDZfrtg4tI2cTRCYXR68EIExajMM_zCLEBiA/w640-h640/shutterstock_295238312.webp" width="640" /></a></div><span style="font-family: arial; font-size: medium;"><br /></span></div><span style="font-family: arial; font-size: medium;">EMS providers should have a basic understanding of Addison's Disease and its potential implications for prehospital care. </span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Addison's disease, also known as primary adrenal insufficiency, is a disorder characterized by insufficient production of adrenal hormones, particularly cortisol and aldosterone, due to damage to the adrenal glands. This damage can result from autoimmune processes, infections, or other underlying conditions.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of prehospital care, EMS providers should be aware of the signs and symptoms of Addison's disease, which may include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Weakness & Fatigue</b>: Patients with Addison's disease often experience severe fatigue and weakness due to inadequate cortisol levels, which play a crucial role in energy metabolism.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hypotension</b>: Low blood pressure (hypotension) is a hallmark feature of Addison's disease, resulting from decreased aldosterone levels and impaired fluid and electrolyte balance.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hyponatremia</b> & <b>Hyperkalemia</b>: Insufficient aldosterone production can lead to abnormalities in sodium and potassium levels, resulting in hyponatremia (low sodium) and hyperkalemia (high potassium).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Gastrointestinal Symptoms</b>: Patients may experience nausea, vomiting, abdominal pain, and weight loss due to gastrointestinal disturbances associated with adrenal insufficiency.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Skin Changes</b>: Hyperpigmentation of the skin, particularly in sun-exposed areas and creases, is a characteristic feature of Addison's disease, resulting from elevated levels of adrenocorticotropic hormone (ACTH) stimulating melanin production.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of potential issues for prehospital care, EMS providers should consider the following:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Adrenal Crisis</b>: Patients with Addison's disease are at risk of adrenal crisis, a life-threatening condition characterized by severe adrenal insufficiency and systemic decompensation. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Adrenal crisis can be precipitated by stress, infection, trauma, or abrupt cessation of glucocorticoid therapy. EMS providers should be prepared to recognize and manage adrenal crisis promptly, including administration of intravenous fluids and glucocorticoid replacement therapy.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hypoglycemia</b>: Patients with Addison's disease may experience hypoglycemia (low blood sugar) during adrenal crisis or as a result of inadequate cortisol production. EMS providers should be prepared to assess and treat hypoglycemia with appropriate interventions, such as administration of intravenous dextrose.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ooo</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The discovery of Addison's disease is credited to Dr. Thomas Addison, a British physician. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dr. Addison first described the condition in 1855 in a paper titled "On the Constitutional and Local Effects of Disease of the Supra-Renal Capsules." </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In this seminal work, he provided detailed clinical observations of patients with adrenal insufficiency and emphasized the association between adrenal gland pathology and clinical manifestations. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dr. Addison's pioneering research laid the foundation for understanding and diagnosing Addison's disease, and he is recognized as a key figure in the history of endocrinology.</span></p><p><b style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Further Reading:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Alexander, M. & Belle, R. (2017)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Advanced EMT: A Clinical Reasoning Approach </i><span style="background-color: #fefdfa; color: #333333;">(2nd Ed). Hoboken, New Jersey: Pearson Education</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b><span style="background-color: #fefdfa; color: #333333;"> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Mistovich, J. J. & Karren, K. J. (2014)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Prehospital Emergency Care </i><span style="background-color: #fefdfa; color: #333333;">(11th Ed). Hoboken, New Jersey: Pearson Education</span></span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-40800413850947450002024-03-22T13:49:00.045-06:002024-03-22T13:49:00.140-06:00EMS Particular Patient Presentations - Graves' Disease <p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWhe-FcebcPQUqR5SyDo_tudNhayrySdhSw3wIcyYoNpzNQBGQ0frk6HJhv5ZJ7rT4w5zPs4EyzDOkmXkLkeiwjjS7d5Jwg3y3oK56A4oJWUYhLygCaL3q_kDFuQi92OD_gY5ljTJfWogWnorKaiXgwLHaRkWDnPYFIbUeNLzpeUVg48QaVjXPADFX_cWr/s924/Hypothyroidism-symptoms.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="680" data-original-width="924" height="470" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWhe-FcebcPQUqR5SyDo_tudNhayrySdhSw3wIcyYoNpzNQBGQ0frk6HJhv5ZJ7rT4w5zPs4EyzDOkmXkLkeiwjjS7d5Jwg3y3oK56A4oJWUYhLygCaL3q_kDFuQi92OD_gY5ljTJfWogWnorKaiXgwLHaRkWDnPYFIbUeNLzpeUVg48QaVjXPADFX_cWr/w640-h470/Hypothyroidism-symptoms.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS providers should have an understanding of Graves' Disease and its potential implications for prehospital care. </span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Graves' disease is an autoimmune disorder characterized by overactivity of the thyroid gland, leading to hyperthyroidism. This condition is caused by autoantibodies that stimulate the thyroid gland to produce excessive amounts of thyroid hormone.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of prehospital care, EMS providers should be aware of the signs and symptoms of Graves' disease, which may include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hyperthyroid Symptoms</b>: Patients with Graves' disease may exhibit symptoms such as rapid heartbeat (tachycardia), palpitations, tremors, heat intolerance, excessive sweating, weight loss despite increased appetite, and fatigue.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Ophthalmic Manifestations</b>: Graves' disease can also cause eye-related symptoms known as Graves' ophthalmopathy or thyroid eye disease. These symptoms may include bulging eyes (exophthalmos), eye irritation, redness, double vision, and vision changes.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Thyroid Gland Enlargement</b>: Some patients with Graves' disease may have a visibly enlarged thyroid gland (goiter) due to thyroid hyperplasia or nodular growth.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Psychological Symptoms</b>: Patients may experience anxiety, irritability, mood swings, and difficulty concentrating due to the effects of excess thyroid hormone on the nervous system.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of potential issues for prehospital care, EMS providers should consider the following:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Cardiovascular Complications</b>: Patients with Graves' disease may be at increased risk of cardiovascular complications such as atrial fibrillation, heart failure, or cardiac arrest due to the effects of excess thyroid hormone on heart function.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Thyroid Storm:</b> In severe cases, Graves' disease can lead to a life-threatening condition known as thyroid storm, characterized by severe hyperthyroidism and systemic decompensation. EMS providers should be prepared to recognize and manage thyroid storm promptly, including supportive measures and administration of medications to control thyroid hormone levels.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Ophthalmic Emergencies</b>: Patients with Graves' ophthalmopathy may present with severe eye symptoms requiring immediate attention, such as corneal ulceration, optic nerve compression, or vision loss. EMS providers should be prepared to provide appropriate eye care and ensure prompt transport to a facility capable of managing ophthalmic emergencies.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ooo</span></p><p><span style="font-family: arial; font-size: medium;"><span style="text-align: justify;"></span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The discovery of Graves' disease is credited to Dr. Robert J. Graves, an Irish physician. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dr. Graves first described the condition in 1835 in a paper titled "New Observations on the Diseases of the Thyroid Gland," where he detailed the clinical features of patients with hyperthyroidism associated with goiter and ophthalmic manifestations. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dr. Graves' pioneering work laid the groundwork for understanding and diagnosing Graves' disease, and he is recognized as a key figure in the history of endocrinology.</span></p><p><b style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Further Reading:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Alexander, M. & Belle, R. (2017)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Advanced EMT: A Clinical Reasoning Approach </i><span style="background-color: #fefdfa; color: #333333;">(2nd Ed). Hoboken, New Jersey: Pearson Education</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b><span style="background-color: #fefdfa; color: #333333;"> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Mistovich, J. J. & Karren, K. J. (2014)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Prehospital Emergency Care </i><span style="background-color: #fefdfa; color: #333333;">(11th Ed). Hoboken, New Jersey: Pearson Education</span></span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-72998403668208823092024-03-18T08:00:00.009-06:002024-03-18T12:43:32.890-06:00EMS Particular Patient Presentations - Cushing's Disease <p style="text-align: justify;"></p><div class="separator" style="clear: both; font-family: arial; font-size: large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJA8b6Rc3dg3V0jRtzjEgJHw6iwkQxI9h6OEaO4FLYSkxXtm4QcYorrAnUY5EDW4ZM7Uid_9uLkHGiGQKM9C4qbqUWs3-9tmj-TBILMJ-sOuG57h-pmg06p-UhVfchSLyw3LDG9L3NqYSYA0OPiFkHTTZqPvuu3xrPklxAYysv_dp7Joyz7ehyphenhyphen7eZrs2pB/s1679/07-Cushings-Syndrome-diagram-of-symptoms.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1679" data-original-width="1616" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJA8b6Rc3dg3V0jRtzjEgJHw6iwkQxI9h6OEaO4FLYSkxXtm4QcYorrAnUY5EDW4ZM7Uid_9uLkHGiGQKM9C4qbqUWs3-9tmj-TBILMJ-sOuG57h-pmg06p-UhVfchSLyw3LDG9L3NqYSYA0OPiFkHTTZqPvuu3xrPklxAYysv_dp7Joyz7ehyphenhyphen7eZrs2pB/w616-h640/07-Cushings-Syndrome-diagram-of-symptoms.jpg" width="616" /></a></div><br /><div style="text-align: justify;"><span style="font-family: arial; font-size: large;">EMS providers should have a understanding of Cushing's Disease and its potential implications for prehospital care. </span></div><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Cushing's disease is a condition caused by prolonged exposure to high levels of cortisol, often due to a tumor in the pituitary gland that leads to excessive secretion of adrenocorticotropic hormone (ACTH). This, in turn, stimulates the adrenal glands to produce excess cortisol.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of prehospital care, EMS providers should be aware of the signs and symptoms of Cushing's disease, which may include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Hypertension</b>: High blood pressure is a common feature of Cushing's disease due to the effects of excess cortisol on blood vessel function.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Weight Gain and Obesity</b>: Patients may exhibit central obesity, particularly in the abdomen, along with increased fat deposits in the face (moon face) and neck (buffalo hump).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Muscle Weakness & Wasting</b>: Excess cortisol can lead to muscle weakness and atrophy, which may affect the patient's mobility and ability to cooperate during assessment and treatment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Skin Changes</b>: Patients with Cushing's disease may have thin, fragile skin that bruises easily. They may also develop stretch marks (striae) on the abdomen, thighs, and breasts.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Glucose intolerance & Diabetes</b>: High cortisol levels can impair glucose metabolism, leading to insulin resistance and, ultimately, diabetes mellitus.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Psychological Symptoms</b>: Patients may experience mood swings, irritability, depression, or cognitive disturbances due to the effects of excess cortisol on the brain.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In terms of potential issues for prehospital care, EMS providers should consider the following:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Cardiovascular Complications</b>: Patients with Cushing's disease may be at increased risk of cardiovascular events such as heart failure, myocardial infarction, or stroke due to hypertension and other metabolic disturbances.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Fluid & Electrolyte Imbalances</b>: Excess cortisol can disrupt fluid and electrolyte balance, leading to conditions such as hypokalemia (low potassium levels) or hypernatremia (high sodium levels).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Adrenal Crisis</b>: In some cases, abrupt withdrawal of cortisol due to treatment or other factors can precipitate an adrenal crisis characterized by hypotension, dehydration, and shock. EMS providers should be prepared to recognize and manage adrenal crisis promptly.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Communication Challenges</b>: Patients with Cushing's disease may have physical or cognitive impairments that affect their ability to communicate effectively. EMS providers should employ clear communication techniques and be patient and empathetic when interacting with these patients.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ooo</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The discovery of Cushing's disease is credited to Dr. Harvey Cushing, an American neurosurgeon. Dr. Cushing first described the condition in 1912 in a detailed report titled "The Pituitary Body and its Disorders: Clinical States Produced by Disorders of the Hypophysis Cerebri." </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In this seminal work, he provided comprehensive observations of patients with pituitary tumors, including those exhibiting symptoms of hypercortisolism, now recognized as Cushing's disease. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dr. Cushing's pioneering research laid the foundation for understanding and diagnosing this disorder, and he is regarded as a key figure in the history of endocrinology and neurosurgery.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Alexander, M. & Belle, R. (2017)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Advanced EMT: A Clinical Reasoning Approach </i><span style="background-color: #fefdfa; color: #333333;">(2nd Ed). Hoboken, New Jersey: Pearson Education</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b><span style="background-color: #fefdfa; color: #333333;"> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Mistovich, J. J. & Karren, K. J. (2014)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Prehospital Emergency Care </i><span style="background-color: #fefdfa; color: #333333;">(11th Ed). Hoboken, New Jersey: Pearson Education</span></span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-14869679244251906132024-03-16T15:00:00.024-06:002024-03-16T15:00:00.248-06:00EMS Anatomy & Physiology - The Pituitary Gland<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3e7qFPmqp5MmR9583BijsJYQG3YGKCqxsFGU6MwBVi8A8S6x-RrmsMRwiBJ8j-2c90C-_vySgHLhhjo4_Dl6A4epHwK5jngF0Rhu6UJujITUgG2sW8HD0kIb8Do4vILBpcvOZM0FCW1ODZ7yRvdOyBOMMoI8m-SEJY9yWdtQQkJS30_ns-sB0muaPeIyQ/s1007/433141307_10159308523876230_5814342194096722297_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1007" data-original-width="1007" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3e7qFPmqp5MmR9583BijsJYQG3YGKCqxsFGU6MwBVi8A8S6x-RrmsMRwiBJ8j-2c90C-_vySgHLhhjo4_Dl6A4epHwK5jngF0Rhu6UJujITUgG2sW8HD0kIb8Do4vILBpcvOZM0FCW1ODZ7yRvdOyBOMMoI8m-SEJY9yWdtQQkJS30_ns-sB0muaPeIyQ/w640-h640/433141307_10159308523876230_5814342194096722297_n.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS providers should recognize the pivotal role of the pituitary gland in orchestrating various bodily functions through hormonal regulation.</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Often hailed as the "master" gland, the pituitary gland exerts profound control over the body's functions through the secretion of hormones.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Comprising two primary segments, the pituitary gland consists of the anterior pituitary and the posterior pituitary.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The anterior pituitary gland secretes several crucial hormones with wide-ranging effects on the body. These hormones include growth hormone (GH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), prolactin, follicle-stimulating hormone (FSH), and luteinizing hormone (LH).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In contrast, the posterior pituitary gland serves as a reservoir for two hormones produced by the hypothalamus: antidiuretic hormone (ADH) and oxytocin.</span></p><p style="text-align: justify;"><span style="font-size: medium;"><span style="font-family: arial;">Antidiuretic hormone (ADH)</span><span style="font-family: arial;">, also known as vasopressin, modulates water balance by prompting the kidneys to reabsorb water, thus reducing urine output. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Oxytocin contributes to various functions, including aiding childbirth by inducing uterine contractions, facilitating milk ejection during lactation, and influencing certain emotional and behavioral responses.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS providers must be vigilant regarding acute pituitary issues, such as pituitary apoplexy (sudden hemorrhage or infarction of the gland), which can precipitate life-threatening conditions like adrenal insufficiency and hypopituitarism.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Chronic conditions affecting the pituitary gland, such as pituitary tumors or disorders like acromegaly or Cushing's Disease, can disrupt hormone production and regulation over time.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Within the prehospital setting, EMS providers should remain attentive to potential signs and symptoms of pituitary gland dysfunction, including altered mental status, electrolyte imbalances, hypotension, and shock.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Comprehending the ramifications of acute and chronic pituitary issues on hormone regulation and overall patient stability is imperative for delivering appropriate care and ensuring prompt transport to a medical facility equipped to manage endocrine emergencies. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Alexander, M. & Belle, R. (2017)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Advanced EMT: A Clinical Reasoning Approach </i><span style="background-color: #fefdfa; color: #333333;">(2nd Ed). Hoboken, New Jersey: Pearson Education</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b><span style="background-color: #fefdfa; color: #333333;"> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b style="background-color: #fefdfa; color: #333333;">Mistovich, J. J. & Karren, K. J. (2014)</b><span style="background-color: #fefdfa; color: #333333;"> </span><i style="background-color: #fefdfa; color: #333333;">Prehospital Emergency Care </i><span style="background-color: #fefdfa; color: #333333;">(11th Ed). Hoboken, New Jersey: Pearson Education</span></span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-74632218984821700102024-03-14T13:23:00.001-06:002024-03-16T13:24:28.920-06:00Images of EMS - In The Midnight Hour<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJFIyH_rURd7a5RXzWBkP6Pgb2futOOV1g1D9W4AHjagPc3F1ETkegmIV-UsSZY88uagvRQ36rel1kKPR1QfSkEx8mBMMX94KR3_ty9PGDC3_2jFHEvHuptal7pou7HrwH7dMEvsCGpVYIauVqsWBl_L9r6ebg0udEXhfNECjeiNe3JSCpDSXkz3Enm1In/s2048/432641005_10159308543291230_1113136399160740399_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1536" data-original-width="2048" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJFIyH_rURd7a5RXzWBkP6Pgb2futOOV1g1D9W4AHjagPc3F1ETkegmIV-UsSZY88uagvRQ36rel1kKPR1QfSkEx8mBMMX94KR3_ty9PGDC3_2jFHEvHuptal7pou7HrwH7dMEvsCGpVYIauVqsWBl_L9r6ebg0udEXhfNECjeiNe3JSCpDSXkz3Enm1In/w640-h480/432641005_10159308543291230_1113136399160740399_n.jpg" width="640" /></a></div><br /><p></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-11763744174903097522024-03-12T13:14:00.012-06:002024-03-16T13:22:19.254-06:00EMS Education - Cultivating Curiosity <p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsSbqzWQVSbYdc5UKDj5GXoVTUCtD3qVwPCxxvkcNcwxHkr5soQnXrE-V0XfMjpl14MHHxkMf8NNr88BxZEQH6vd9_A8B_4eHEvVQM-IIOoraUTQRAu-Z7DY00nHGdH0CM4ZWiA3RhYTmMk_9WFu3VUqAz9Wsc2f4mC-N7mIFLda7j_yYfoiI48qkW4oWi/s1182/Quote+posts-06.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1182" data-original-width="1182" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsSbqzWQVSbYdc5UKDj5GXoVTUCtD3qVwPCxxvkcNcwxHkr5soQnXrE-V0XfMjpl14MHHxkMf8NNr88BxZEQH6vd9_A8B_4eHEvVQM-IIOoraUTQRAu-Z7DY00nHGdH0CM4ZWiA3RhYTmMk_9WFu3VUqAz9Wsc2f4mC-N7mIFLda7j_yYfoiI48qkW4oWi/w640-h640/Quote+posts-06.png" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />As EMS Providers, cultivating curiosity and open-mindedness is not only possible but also crucial for our professional growth and development.</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Here are some strategies we can adopt to foster curiosity and open-mindedness in our daily practice:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Exposure to Diverse Perspectives</b>: Actively seek out information, viewpoints, and experiences that differ from our own. This might involve learning from colleagues with different backgrounds, studying cases from various medical specialties, or engaging with patients from diverse communities.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Ask Questions</b>: Develop a habit of curiosity by asking questions about our practice and the patients we serve. Don't hesitate to seek clarification or explore alternative approaches. Asking questions can lead to deeper insights and better patient care.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Challenge Assumptions</b>: Be willing to question our own beliefs and assumptions about medical treatment and patient care. Recognize that there may be multiple valid perspectives and remain open to new ideas and evidence-based practices.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Practice Active Listening</b>: Truly listen to our patients, colleagues, and other healthcare professionals without judgment or interruption. Pay attention to their concerns, perspectives, and insights, and strive to understand their point of view. Active listening fosters empathy and collaboration, leading to better patient outcomes.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Engage in Critical Thinking</b>: Develop our ability to critically evaluate medical information and treatment options. Learn to recognize biases, consider alternative diagnoses, and weigh the evidence objectively. Critical thinking is essential for making sound clinical decisions and adapting to new challenges in the field.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Embrace Uncertainty</b>: Accept that medicine is inherently uncertain and that not all cases will have clear-cut solutions. Be comfortable with ambiguity and use it as an opportunity for continued learning and growth.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Continuously Learn & Grow</b>: Commit to lifelong learning and professional development. Stay up-to-date on the latest research, attend conferences and workshops, and seek out mentorship opportunities. By continuously learning and growing, we can provide the best possible care for our patients and advance our careers in EMS.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">By incorporating these strategies into our daily practice, we can cultivate a mindset of curiosity and open-mindedness that will enable us to deliver high-quality care, challenge our assumptions, and ultimately improve patient outcomes.</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-32610709812577747162024-03-10T13:03:00.000-06:002024-03-16T13:09:31.926-06:00 EMS Education - Growth Mindset Development<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8OYlwl_aiU1zTxm_uevzmhvjSlC-0XgrIj7mqvn-8-Bx5OvjXwABKZBPYOx1fQ1rsy3gq5zds0xGac3wMn_C_KDUeBP36gxNEsBuFrsPrwaR5N0LuXqSBMbK6N9aw1ACuAsT6gkCbP7EMp-jxcOpmYaJWQ1Yvh2Ll6I4HpXj-1nPB02hVJ1RESOJL2IbG/s995/1652414094779.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="720" data-original-width="995" height="464" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8OYlwl_aiU1zTxm_uevzmhvjSlC-0XgrIj7mqvn-8-Bx5OvjXwABKZBPYOx1fQ1rsy3gq5zds0xGac3wMn_C_KDUeBP36gxNEsBuFrsPrwaR5N0LuXqSBMbK6N9aw1ACuAsT6gkCbP7EMp-jxcOpmYaJWQ1Yvh2Ll6I4HpXj-1nPB02hVJ1RESOJL2IbG/w640-h464/1652414094779.jpeg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS Providers can benefit greatly from cultivating a growth mindset, which is the belief that one's abilities and intelligence can be developed through dedication and effort. Here's what EMS providers should know about cultivating a growth mindset:</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Embrace Challenges</b>: Encourage EMS providers to see challenges as opportunities for growth rather than obstacles. Facing difficult situations in the field can be daunting, but approaching them with a mindset of growth can help providers see them as chances to learn and improve.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Persistance</b>: Encourage resilience and perseverance when things don't go as planned. EMS providers may encounter setbacks or failures, but it's important for them to understand that setbacks are a natural part of the learning process and can lead to valuable lessons.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Criticism Becomes Constructive Feedback</b>: Teach EMS providers to see feedback, whether positive or negative, as an opportunity for growth. Constructive criticism can help providers identify areas for improvement and develop their skills further.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Learn From Mistakes</b>: Emphasize the importance of reflecting on mistakes and using them as learning opportunities. Instead of dwelling on failures, encourage EMS providers to analyze what went wrong, identify lessons learned, and use that knowledge to improve their performance in the future.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Celebrate Growth & Progress:</b> Recognize and celebrate the efforts and achievements of EMS providers as they work to develop their skills and expertise. By acknowledging their progress, you reinforce the idea that growth is possible through effort and dedication.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The concept of a growth mindset was originally proposed by psychologist Carol Dweck in her research on achievement and success. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dweck's groundbreaking work, outlined in her book Mindset: The New Psychology of Success and published in 2006, contrasts the growth mindset with the fixed mindset, which is the belief that abilities and intelligence are innate and unchangeable. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Dweck's research demonstrates the power of mindset in shaping individuals' attitudes toward learning and achievement, with implications for personal and professional development across various fields, including EMS.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Dweck, C. S. (2006)</b> Mindset: The New Psychology of Success. New York: Random House Publishing</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-91145421300311163642024-03-08T17:20:00.006-07:002024-03-09T17:23:25.281-07:00 EMS Celebrations - International Women’s Day<p style="text-align: justify;"><span style="background-color: white; color: #050505;"></span></p><div class="separator" style="clear: both; font-family: arial; font-size: large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkgA9ZtxElO3fimYKLK-zUvrKwcADKcVriFURvWFwQ3JDzwj4S-b2leBEI0mBS4FdOBEL7oQ0-tDIhmu8Wwu7PBqx-HW68ZxRc-IXpc8STAKDdbznCiz6M7Y67fhjW8oq8rDzpfwXA6C5D4kItHmebpxyLdCIDZYP1A5sizqZQVyoxI7hRe4NO6C-iAXsD/s1200/432288967_10159299009101230_4618808740484334135_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="630" data-original-width="1200" height="336" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkgA9ZtxElO3fimYKLK-zUvrKwcADKcVriFURvWFwQ3JDzwj4S-b2leBEI0mBS4FdOBEL7oQ0-tDIhmu8Wwu7PBqx-HW68ZxRc-IXpc8STAKDdbznCiz6M7Y67fhjW8oq8rDzpfwXA6C5D4kItHmebpxyLdCIDZYP1A5sizqZQVyoxI7hRe4NO6C-iAXsD/w640-h336/432288967_10159299009101230_4618808740484334135_n.jpg" width="640" /></a></div><br /><span style="font-family: arial; font-size: medium;">Did you know that women make up around 30% of EMS Providers in the USA?</span><p></p><p style="text-align: justify;"><span style="background-color: white; color: #050505;"><span style="font-family: arial; font-size: medium;">Let’s take a moment to recognize the incredible females of EMS. Their unwavering dedication, leadership, and role modelling play a crucial role in prehospital emergency care.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505;"><span style="font-family: arial; font-size: medium;">Raise a cheer to all the strong and resilient women saving lives on the frontlines as we celebrate International Women's Day.</span></span></p><span style="font-family: arial; font-size: medium;"><span style="background-color: white; color: #050505;"><div style="text-align: justify;"><a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/internationalwomensday?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#InternationalWomensDay</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/ems?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#EMS</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/womeninhealthcare?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#WomenInHealthcare</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/nremt?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#NREMT</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/emr?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#EMR</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/emt?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#EMT</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/aemt?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#AEMT</a> <a class="x1i10hfl xjbqb8w x1ejq31n xd10rxx x1sy0etr x17r0tee x972fbf xcfux6l x1qhh985 xm0m39n x9f619 x1ypdohk xt0psk2 xe8uvvx xdj266r x11i5rnm xat24cr x1mh8g0r xexx8yu x4uap5 x18d9i69 xkhd6sd x16tdsg8 x1hl2dhg xggy1nq x1a2a7pz xt0b8zv x1fey0fg xo1l8bm" href="https://www.facebook.com/hashtag/paramedic?__eep__=6&__cft__[0]=AZV8jPi-Jacf0bcJtXsQH3Ya-FFNZ9AT8CwwA4saJLYIJlwqhG5mj8qpCm5SpmNjDKAwh2y8IUIuSl7WpWbw-QaCFQNf62SmRURvgiV5wF3wh1yPg3YYl67Kj0GfXFxaTB09yavAG_nEO3FnEn_k_y5H&__tn__=*NK-R" role="link" style="-webkit-tap-highlight-color: transparent; background-color: transparent; border-style: none; border-width: 0px; box-sizing: border-box; cursor: pointer; display: inline; list-style: none; margin: 0px; outline: none; padding: 0px; text-align: inherit; text-decoration-line: none; touch-action: manipulation;" tabindex="0">#Paramedic</a></div></span></span>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-12070984404314777202024-03-06T14:00:00.001-07:002024-03-06T14:00:00.153-07:00 EMS Medication Administration - The Six Rights in EMS Practice<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbJ6T5CgKDgac5VUsgiTClVtUgZz1sjWWUplWZ76-GuDKLRDgivjDLlq8DQxxHpjCqIvOljqSG4t2LgYaJlxqwHJU2W4yKj3kF6Uc35_4XZb1jvW3ww2B0xwlz2DmnPSqmLOYasXLc2rBHQXgpfN-CHZkCQisR3MiAyTcxelmKsOP05EBrDLlikWOA3px4/s1280/WS282250__42189.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1280" data-original-width="964" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbJ6T5CgKDgac5VUsgiTClVtUgZz1sjWWUplWZ76-GuDKLRDgivjDLlq8DQxxHpjCqIvOljqSG4t2LgYaJlxqwHJU2W4yKj3kF6Uc35_4XZb1jvW3ww2B0xwlz2DmnPSqmLOYasXLc2rBHQXgpfN-CHZkCQisR3MiAyTcxelmKsOP05EBrDLlikWOA3px4/w482-h640/WS282250__42189.jpg" width="482" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS Providers frequently encounter situations where prompt administration of pharmacologic agents can be life-saving for patients in the pre-hospital environment. Despite often operating under less than optimal conditions, EMS providers play a crucial role in delivering timely and appropriate medications to address life-threatening emergencies. </span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">However, to ensure patient safety and uphold professional standards, it is imperative for EMS practitioners to adhere to best practices in medication administration throughout their careers.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">One fundamental framework for safe medication administration is the concept of the Six Rights. Be aware that in some healthcare texts these rights have expanded to cover close 15 rights.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">The Six Rights of Drug Administration:</span></b></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right Patient:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In the dynamic environment of EMS, ensuring the right patient receives the right medication is paramount. This involves not only confirming the patient's identity but also verifying allergies and contraindications to medications. Even in scenarios involving multiple patients, meticulous attention must be paid to prevent medication errors.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right Rx:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Selecting the appropriate medication for the patient's condition is essential to achieve desired therapeutic outcomes. EMS providers must be knowledgeable about the indications, contraindications, and potential adverse effects of each medication in their formulary. Additionally, confirming the integrity and expiration date of the medication before administration is crucial for patient safety.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Right Dose:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Medications must be administered in precise doses as determined by medical control protocols. EMS practitioners should be proficient in calculating dosages accurately, particularly considering variations based on patient demographics such as weight and age. Additionally, ensuring the correct interpretation of medical orders and understanding any dosage adjustments based on patient-specific factors is essential.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right Time:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Timeliness in medication administration can significantly impact patient outcomes. EMS providers must assess the urgency of medication administration based on the patient's condition and clinical presentation. Furthermore, consideration of potential drug interactions, including recent medication history, is vital to avoid adverse effects and optimize therapeutic efficacy.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right Route:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Selecting the appropriate route of medication administration is crucial for ensuring optimal drug absorption and efficacy while minimizing the risk of complications. EMS providers must be proficient in various administration routes, such as intravenous, intramuscular, subcutaneous, and oral, and understand the specific indications for each route based on the medication and patient's condition.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right Documentation:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Accurate documentation of medication administration is essential for maintaining continuity of care, facilitating communication among healthcare providers, and ensuring legal compliance. EMS practitioners must document the medication administered, dosage, route, time of administration, patient response, and any adverse reactions or complications. Timely and comprehensive documentation is critical for ongoing patient assessment and quality improvement efforts.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Conclusion:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Adhering to the Six Rights of Drug Administration is fundamental to promoting patient safety and optimizing outcomes in EMS practice. By following these principles rigorously, EMS providers can mitigate the risk of medication errors, enhance the quality of care delivered, and uphold professional standards throughout their careers. Continuous education and training in medication administration are essential to ensure proficiency and competence among EMS practitioners, ultimately benefiting the patients they serve.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Addendum:</span></b></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Right To Refuse Medication:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In the realm of medication administration in EMS, it's essential to acknowledge and respect the patient's right to refuse treatment, including medication. While EMS providers are trained to prioritize patient safety and offer appropriate interventions, they must also recognize and honor the autonomy of the individual. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Understanding the circumstances under which a patient may refuse medication is crucial, as it may stem from various factors such as personal beliefs, cultural considerations, or concerns about potential side effects. EMS practitioners should engage in effective communication with the patient, explaining the rationale behind the recommended treatment and addressing any questions or concerns they may have. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">However, if a patient refuses medication despite being informed of the potential risks and benefits, their decision should be respected, documented, and communicated to appropriate medical personnel for further evaluation if necessary. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Upholding the patient's right to refuse medication reinforces the principles of patient-centered care and ethical practice in EMS.</span></p><p style="text-align: justify;"><b><span style="font-family: arial; font-size: medium;">Further Reading:</span></b></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bledsoe, B. E., Cherry, R. A. & Porter, R. S (2023)</b> Paramedic Care: Principles and Practice Volume 1 (6th Ed) Pearson. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bledsoe, B. E. & Clayden, D. (2018)</b> Prehospital Emergency Pharmacology (8th Ed). Pearson. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Coughlin, C. (2019)</b> Paramedic Crash Course (1st Ed) Research & Education Association </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Guy, J. S. (2019)</b> Pharmacology for the Prehospital Professional (2nd Ed) Jones & Bartlett Learning. </span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com1tag:blogger.com,1999:blog-6229165120605701126.post-51331475815406488432024-03-04T12:24:00.047-07:002024-03-18T12:46:07.748-06:00EMS History - The Evolution of CPR<div style="text-align: justify;"><div class="separator" style="clear: both; font-family: arial; font-size: large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaS75hF0VGfAfWM99j6iKTG4vCv-QfCvEBAoBnyAWPsTpJXX0XtZUyEhWNTbOumnRe3hHkyy0SfPHgB5pGoQiVqpWRv4yOe16Wguj9fcuGN1G8YKNMnSiHgm4b7JrHXki8sCc7UP8XGyG6AhWw3JbOFPUxvoNxfTxpl38gsYGmN4n5t5hotS5xkHfzd4XB/s1000/CPR-072204-body.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="799" data-original-width="1000" height="512" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaS75hF0VGfAfWM99j6iKTG4vCv-QfCvEBAoBnyAWPsTpJXX0XtZUyEhWNTbOumnRe3hHkyy0SfPHgB5pGoQiVqpWRv4yOe16Wguj9fcuGN1G8YKNMnSiHgm4b7JrHXki8sCc7UP8XGyG6AhWw3JbOFPUxvoNxfTxpl38gsYGmN4n5t5hotS5xkHfzd4XB/w640-h512/CPR-072204-body.jpg" width="640" /></a></div><br /><span style="font-family: arial; font-size: medium;">CPR is a lifesaving skill that has been performed on presidents, celebrities and regular people alike. Knowing about CPR, and its associated history, equips individuals with life-saving skills. In emergency situations, performing high-quality CPR could mean the difference between life and death for a loved one, a colleague, or even a stranger.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS providers should have a solid understanding of the evolution of cardiopulmonary resuscitation (CPR) as it provides the foundation for their life-saving interventions.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">For instance, the term "cardiopulmonary resuscitation" was first coined in 1960, signifying the integration of chest compressions and artificial ventilation to revive individuals in cardiac arrest.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">However, documented efforts to revive a person who has suffered a heart attack date back 600 years. That said, it wasn't until the early 20th century that more systematic approaches were developed.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The methods we use today may be considered far more efficient than those originally attempted as far back as the 1500s, such as whipping the patient, rolling them back and forth over a barrel, placing them on a galloping horse, or inflating them with a bellows.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Knowing about the development of CPR is valuable for several reasons:</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Historical Context:</b> Learning the history of CPR provides valuable context. It illustrates the progression of medical knowledge and techniques over time, highlighting the importance of scientific advancements in improving healthcare outcomes.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Life-Saving Skills:</b> Understanding CPR and its history equips individuals with life-saving skills. In emergency situations, knowing CPR could mean the difference between life and death for a loved one, a colleague, or even a stranger.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Empowerment:</b> Learning about CPR empowers individuals to take action in emergencies. It gives them the confidence and knowledge to intervene effectively until professional medical help arrives.</span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Community Resilience:</b> A well-informed community with CPR knowledge contributes to overall community resilience. When more people are trained in CPR, the likelihood of survival from cardiac arrest increases, creating a safer environment for everyone.</span></div><span style="font-family: arial; font-size: medium;"><div style="text-align: justify;"><br /></div><div style="text-align: justify;">As Dr. Peter Safar stated "CPR is the most effective first-aid treatment for sudden cardiac arrest. It buys time until further medical help arrives, increasing the chances of survival” while Dr. Mickey Eisenberg expressed the sentiment that "CPR is the ultimate act of kindness and compassion. It shows that we're willing to step in and help someone in their darkest moment.”</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Further Reading:</b></div><div style="text-align: justify;"><b><br /></b></div><div style="text-align: justify;"><div style="text-align: left;"><b>American Heart Association (ND)</b> History of CPR - Highlights from the 16th Century to the 21st Century. Retrieved from <a href="https://cpr.heart.org/en/resources/history-of-cpr">https://cpr.heart.org/en/resources/history-of-cpr</a></div><div style="text-align: left;"><br /></div><div style="text-align: left;"><b>American Heart Association (2022, June 28)</b> ‘Father’ of CPR: Guy Knickerbocker Obituary. Retrieved from <a href="https://cprblog.heart.org/2022/06/28/father-of-cpr-guy-knickerbocker-who-helped-pioneer-a-lifesaving-technique-dies-at-89/">https://cprblog.heart.org/2022/06/28/father-of-cpr-guy-knickerbocker-who-helped-pioneer-a-lifesaving-technique-dies-at-89/</a></div><div style="text-align: left;"><br /></div><div style="text-align: left;"><b>American Heart Association (2024, February 15)</b> The Presidential Heart Attack That Changed America. Retrieved from <a href="https://www.heart.org/en/news/2024/02/15/the-presidential-heart-attack-that-changed-america">https://www.heart.org/en/news/2024/02/15/the-presidential-heart-attack-that-changed-america</a></div><div style="text-align: left;"><br /></div><div style="text-align: left;"><b>Hazzard, K. (2022) </b>American Sirens. New York: Hachette Books</div><div><br /></div></div></span>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-35347358070445040922024-03-02T12:17:00.034-07:002024-03-16T13:42:49.931-06:00EMS History - The American Heart Association<p style="text-align: justify;"><span style="font-family: arial; font-size: large;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXw3AM6yncf7TDuwP3P5ahQzJzMOoc9ubLGl61NTwRmmQ4eFjctyc0i7fdyIxbi7J3btetsh2DRGca_-aS-KjKf6Wn0necBPkhyweZxYpOR3hGwAX2teKWhM7hFDJ0x-WDArsiiVlxB2D9mQC0dwKaQYdG0wCTKKi4y-gIX8QCQdb7PvZXI3pDEOlkLMQ5/s850/AHA_LOGO-RGB_rk_LG_hero.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="564" data-original-width="850" height="424" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXw3AM6yncf7TDuwP3P5ahQzJzMOoc9ubLGl61NTwRmmQ4eFjctyc0i7fdyIxbi7J3btetsh2DRGca_-aS-KjKf6Wn0necBPkhyweZxYpOR3hGwAX2teKWhM7hFDJ0x-WDArsiiVlxB2D9mQC0dwKaQYdG0wCTKKi4y-gIX8QCQdb7PvZXI3pDEOlkLMQ5/w640-h424/AHA_LOGO-RGB_rk_LG_hero.jpg" width="640" /></a></div><br /><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The American Heart Association (AHA) was established in 1924 by a group of six cardiologists in response to the growing concern over the lack of research and information about heart disease. At the time of its founding, heart disease was becoming a leading cause of death in the United States, yet there was limited understanding of its causes and prevention methods.</span></div><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The rationale behind the establishment of the AHA stemmed from the need to address this gap in knowledge and to advocate for increased awareness, research, and education about heart health. The founders recognized the urgent need for a centralized organization dedicated to combating heart disease, promoting cardiovascular research, and disseminating information to both healthcare professionals and the general public.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The AHA's mission focuses on reducing disability and death caused by cardiovascular diseases and stroke. To achieve this mission, the association engages in various activities, including funding research grants, developing guidelines for the treatment and prevention of heart disease and stroke, advocating for public policies that promote heart health, and providing educational resources and programs to communities and healthcare professionals.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Over the years, the AHA has played a crucial role in advancing cardiovascular science and improving public health outcomes. Its initiatives have led to significant advancements in the prevention, diagnosis, and treatment of heart disease and stroke. Through partnerships with medical professionals, policymakers, advocacy groups, and the public, the AHA continues to work towards its goal of building healthier lives, free of cardiovascular diseases and stroke.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>American Heart Association (ND)</b> History of CPR - Highlights from the 16th Century to the 21st Century. Retrieved from <a href="https://cpr.heart.org/en/resources/history-of-cpr">https://cpr.heart.org/en/resources/history-of-cpr</a> </span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-20640579455294975712024-02-29T11:16:00.102-07:002024-02-29T11:16:00.127-07:00 EMS Discussion - Use of Lights & Sirens<p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;"></span></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyyAmWWVIzCLU69eP5Sx6qtDO4Ab7m8gmAJwe-rBIcljcLM2uHYnUMz3YVaiJC1IJqe61nfwxeAwpVkQRbyR-39DB619ArvagDXB0lg56Sl6xP66wreKmRqqB57xSWPPwxKmv_lKHQ0cJ5J8YFprVZ8-3NyJ_pLYd41wX4R3tfvH1JGkiX73nNt8hKbJAs/s1000/download.webp" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="563" data-original-width="1000" height="360" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyyAmWWVIzCLU69eP5Sx6qtDO4Ab7m8gmAJwe-rBIcljcLM2uHYnUMz3YVaiJC1IJqe61nfwxeAwpVkQRbyR-39DB619ArvagDXB0lg56Sl6xP66wreKmRqqB57xSWPPwxKmv_lKHQ0cJ5J8YFprVZ8-3NyJ_pLYd41wX4R3tfvH1JGkiX73nNt8hKbJAs/w640-h360/download.webp" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS Providers should be aware of the ongoing discussion surrounding the use of lights and sirens during emergency calls. There is a growing concern about the risks associated with their use, such as an increased likelihood of accidents and harm to patients.</span><div><span style="background-color: white; color: #050505; text-align: justify; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;"><br /></span></span></div><div><span style="background-color: white; color: #050505; text-align: justify; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">EMS Providers should stay updated on local and national guidelines regarding when to use lights and sirens to ensure the safety of both themselves and the public.</span></span><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">Those operating emergency vehicles must consider alarming statistics showing that ambulance crashes significantly impact clinicians, patients, and the public, with the risk of a crash increasing by over 50% when lights and sirens are activated.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">It is crucial for EMS Leaders to implement well-researched guidelines supporting the restricted use of lights and sirens to enhance the safety of all individuals involved in emergency responses.</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><span data-offset-key="41hh0-0-0" style="background-color: white; color: #050505; white-space-collapse: preserve;">In an outstanding demonstration of collaboration on provider, patient, and community safety, 13 national and international associations have partnered on the release of a </span><span data-offset-key="41hh0-0-1" style="background-color: white; color: #050505; font-style: italic; white-space-collapse: preserve;">Joint Statement on Lights and Siren Vehicle Operations in Emergency Medical Services (EMS) Responses </span><span data-offset-key="41hh0-0-1" style="background-color: white; color: #050505; white-space-collapse: preserve;">(NAEMT, 2022).</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">The statement articulates principles guiding the use of lights and sirens during emergency vehicle responses to medical calls and initiatives to decrease their use safely. EMS vehicle operations using lights and sirens pose significant risks to both providers and the public. Therefore, their use should be limited to situations where time saved is expected to be clinically important to a patient’s outcome (Merill, 2022).</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">Communication centers should utilize structured call triage and categorization to identify subsets of calls based on the response resources needed and medical urgency. Physician oversight is crucial in developing response configurations and modes for these protocols. </span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><span data-offset-key="a9738-0-0" style="background-color: white; color: #050505; white-space-collapse: preserve;">Agency Leadership should monitor the rates of lights and sirens use, appropriateness, compliance, and outcomes related to their use. </span><span style="background-color: white; color: #050505; white-space-collapse: preserve;">Municipal Leaders should be aware of the increased crash risks, and quality care metrics should drive contract agreements. </span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">States and provinces should monitor and report on emergency vehicle crashes to better understand the risks associated with lights and sirens use.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">Collaboration between EMS and Fire Agency Leaders is essential in understanding public perceptions and improving education about the risks associated with lights and sirens to create safer expectations.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">According to a recent presentation by NEMSQA, 87% of EMS responses were made with the use of lights & sirens, while transports nationally used them 51% of the time. The time savings averaged 102-216 seconds during a response and between 42-228 seconds for transports (from multiple recent studies); yet life-saving interventions are being done in only 6.9% of responses (according to an ESO study of 7.5M records). </span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">At the same time, our odds of being involved in an accident increase by 53% in responses and 184% during transports (not to mention accidents in our wake that do not involve an EMS unit). Furthermore, litigations that involve ambulance incidents are 86% when using L&S.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">The data presented highlights concerning statistics surrounding the use of lights and sirens in EMS responses and transports. While time savings are evident, life-saving interventions are performed in only a small percentage of responses. </span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">The increased risk of accidents during both responses and transports underscores the need for a shift towards safer practices. Litigations involving ambulance incidents predominantly occur when lights and sirens are used.</span></span></p><p style="text-align: justify;"><span style="background-color: white; color: #050505; white-space-collapse: preserve;"><span style="font-family: arial; font-size: medium;">It is crucial to view the use of lights and sirens as a clinical treatment and to follow the guidance to "use only as needed" to ensure the safety of patients, the community, and EMS providers. Prioritizing safe ambulance operations is vital for everyone's well-being and to ensure a safe return home after each shift.</span></span></p><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></div><div><span style="font-family: arial; font-size: medium;"><br /><b>Merrill, L. (2022)</b> 14 Groups Issue Joint Statement on EMS Use Of lights, Sirens <a href="https://www.ems1.com/ambulance-safety/articles/14-groups-issue-joint-statement-on-ems-use-of-lights-sirens-AAfswfKx2gaog3dy/">https://www.ems1.com/ambulance-safety/articles/14-groups-issue-joint-statement-on-ems-use-of-lights-sirens-AAfswfKx2gaog3dy/</a><a href="https://www.ems1.com/ambulance-safety/articles/14-groups-issue-joint-statement-on-ems-use-of-lights-sirens-AAfswfKx2gaog3dy/ "> </a>Accessed February 28, 2024<br /><br /><b>National Association of Emergency Medical Technicians (2022) </b>Joint Statement on Lights & Siren Vehicle Operations on Emergency Medical Services (EMS) Responses <a href="https://naemt.org/docs/default-source/advocacy-documents/positions/joint-statement-on-red-light-and-siren-operations-with-logos---final.pdf?sfvrsn=e586e893_4">https://naemt.org/docs/default-source/advocacy-documents/positions/joint-statement-on-red-light-and-siren-operations-with-logos---final.pdf?sfvrsn=e586e893_4</a> Accessed February 28, 2024</span></div><div><span style="font-family: arial; font-size: medium;"><br /><b>National EMS Quality Alliance (2024)</b> Improving Safety in EMS: Reducing the Use of Lights and Siren <a href="https://nemsqa.memberclicks.net/assets/LSChangePackage/Improving%20Safety%20in%20EMS%20Reducing%20the%20Use%20of%20Lights%20and%20Siren.pdf">https://nemsqa.memberclicks.net/assets/LSChangePackage/Improving%20Safety%20in%20EMS%20Reducing%20the%20Use%20of%20Lights%20and%20Siren.pdf</a><a href="https://nemsqa.memberclicks.net/assets/LSChangePackage/Improving%20Safety%20in%20EMS%20Reducing%20the%20Use%20of%20Lights%20and%20Siren.pdf "> </a>Accessed February 28, 2024</span></div><div><span style="font-family: arial; font-size: medium;"><br /><b>Zavadsky, M. (2023)</b> Culture Shift: Reducing Lights and Siren Vehicle Operation <a href="https://www.ems1.com/safe-transport-point-b/articles/culture-shift-reducing-lights-and-siren-vehicle-operation-XDonsygscixIghQT/">https://www.ems1.com/safe-transport-point-b/articles/culture-shift-reducing-lights-and-siren-vehicle-operation-XDonsygscixIghQT/</a> Accessed February 28, 2024</span></div>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-50781605542403384972024-02-27T10:45:00.005-07:002024-02-28T11:02:15.236-07:00EMS Patient Assessment - Referred Pain (2)<div style="text-align: justify;"><span style="font-family: arial;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimRF_0at_KNGdsrrvBvB4z21ak1EqLw3kbwaaqbJJLBdDnzECwtgvKI5faSkQMfKLyVfH6Lv0emQt6ptN2gIShHnCRD8l9-eJS-FxooEQaZ68by9XGhRy3-mxRnx-5syz84EGLZiSWLrZdzOOz9qjMSyj2cysQ4A-hhxIlw9zUj2Br_APrVVF1PUiHTfTV/s722/shutterstock_790940857.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="691" data-original-width="722" height="612" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEimRF_0at_KNGdsrrvBvB4z21ak1EqLw3kbwaaqbJJLBdDnzECwtgvKI5faSkQMfKLyVfH6Lv0emQt6ptN2gIShHnCRD8l9-eJS-FxooEQaZ68by9XGhRy3-mxRnx-5syz84EGLZiSWLrZdzOOz9qjMSyj2cysQ4A-hhxIlw9zUj2Br_APrVVF1PUiHTfTV/w640-h612/shutterstock_790940857.jpg" width="640" /></a></div><div class="separator" style="clear: both; font-size: x-large; text-align: center;"><br /></div><span style="font-size: medium;">Referred pain is a phenomenon where pain is perceived at a location different from the actual site of the underlying problem or injury. This occurs because the same nerve pathways that carry pain signals from one area of the body can overlap or converge with the nerve pathways from another area. </span></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">As a result, when pain signals are generated in one region, they can be misinterpreted by the brain as originating from a different area that shares nerve connections.</span></div><span style="font-family: arial; font-size: medium;"><div style="text-align: justify;"><br /></div><div style="text-align: justify;">Referred pain can be confusing because it can lead to the misdiagnosis of the source of pain.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Cardiac Referred Pain:</b> One of the classic examples of referred pain is related to the heart. When the heart muscle (myocardium) is deprived of oxygen and nutrients, such as during a heart attack, the brain often interprets this pain as originating in the left side of the chest, left arm, or even the jaw.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>- Levine's Sign:</b> Named after Dr. Samuel Levine, this sign is related to cardiac referred pain. It's a characteristic clutching of the chest seen in patients experiencing angina or a heart attack.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Gallbladder Referred Pain:</b> Gallbladder issues, like gallstones or cholecystitis, can cause referred pain to the right shoulder or between the shoulder blades. This is because the same nerves that supply the gallbladder also connect to these areas.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>- Murphy's Sign:</b> Named after Dr. John Benjamin Murphy, this sign is used to diagnose gallbladder-related pain. It involves the patient experiencing increased pain or discomfort when the doctor palpates the area beneath the ribcage on the right side during deep inspiration.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Spleen Referred Pain:</b> Referred pain from the spleen typically presents as discomfort in the left upper abdominal quadrant, just beneath the ribcage. Conditions that can cause spleen-related referred pain include splenomegaly and conditions that lead to trauma or rupture of the spleen.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">- <b>Kehr's Sign</b>: Named after Dr. Hans Kehr, this sign relates to pain in the left shoulder that can occur due to irritation of the diaphragm, often resulting from conditions like a ruptured spleen or other sources of abdominal bleeding. In such cases, Kehr's Sign is used to describe both the referred pain and its association with spleen-related issues.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Appendicitis</b>: Inflammation of the appendix can often cause pain around the navel or the upper abdomen before it eventually migrates to the right lower quadrant, which is the classic location for appendicitis pain.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">- <b>McBurney's Point</b>: Named after Dr. Charles McBurney, this is a location used to diagnose appendicitis, which corresponds to the location of the base of the appendix.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Kidney Stone Pain</b>: Pain caused by kidney stones can be felt not only in the lower back and side, where the kidneys are located but also radiate down to the groin area or the abdomen.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">- <b>Costovertebral Angle (CVA) Tenderness:</b> While not named after a specific individual, this is an important sign to check for when evaluating kidney-related pain, such as kidney stones. Tenderness in the CVA, located on the back, just below the ribcage, is indicative of renal issues.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Diaphragm Referred Pain</b>: Irritation of the diaphragm muscle can cause pain in the shoulder, especially the left shoulder. This is because it shares nerve connections with the shoulder area.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Liver Referred Pain</b>: Liver inflammation or congestion can lead to referred pain in the right shoulder or upper back due to the shared nerve pathways.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">Understanding referred pain is important for healthcare professionals as it can sometimes make diagnosing the underlying condition more challenging. It's crucial to consider referred pain in the diagnostic process to identify and treat the actual source of the problem accurately.</div></span>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-6174311431604579282024-02-25T10:34:00.044-07:002024-02-28T10:44:36.530-07:00EMS Patient Assessment - Referred Pain (1)<div style="text-align: justify;"><span style="font-family: arial;"><div class="separator" style="clear: both; font-size: x-large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0GY6wpRSshNmYl_d7EDs4Lty2x6gshp3n3Iia6bwdvzcI7VVgY0ZxEfuDiglFX3WL5FWfTlLSRTblLB7VD0nYIIJ56kxVTDqEweHm1YFvKP6cF1a0nRafs-0XL4Pt9sA5uX2S0Ve8QB6bfPukg6dpnbXcD7E5h_9LnN5KRGS-eLSAXsG7WcfApmd7Bs4-/s1644/Referred%20Pain.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1050" data-original-width="1644" height="408" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh0GY6wpRSshNmYl_d7EDs4Lty2x6gshp3n3Iia6bwdvzcI7VVgY0ZxEfuDiglFX3WL5FWfTlLSRTblLB7VD0nYIIJ56kxVTDqEweHm1YFvKP6cF1a0nRafs-0XL4Pt9sA5uX2S0Ve8QB6bfPukg6dpnbXcD7E5h_9LnN5KRGS-eLSAXsG7WcfApmd7Bs4-/w640-h408/Referred%20Pain.jpg" width="640" /></a></div><br /><span style="font-size: medium;">EMS Providers should have a comprehensive understanding of referred pain to effectively assess and manage patients in the field. </span></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><br /></span></div><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Here are key points they should know:</span></div><span style="font-family: arial; font-size: medium;"><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Definition and Mechanism: </b>A phenomenon where pain is felt in an area of the body that is different from the actual source of the pain. It occurs due to the convergence of nerve pathways, where signals from one area of the body are interpreted as originating from another area that shares nerve connections.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Common Examples:</b> EMS providers should be familiar with common examples of referred pain, such as cardiac referred pain (e.g., chest pain radiating to the left arm or jaw during a heart attack), gallbladder referred pain (e.g., pain in the right shoulder or between the shoulder blades with gallstones or cholecystitis), and spleen referred pain (e.g., left shoulder pain with spleen-related issues).</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Recognition</b>: Recognizing patterns of referred pain can aid EMS providers in diagnosing the underlying cause of a patient's symptoms. Understanding the characteristic locations of referred pain associated with specific conditions can help differentiate between different potential diagnoses.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Clinical Signs</b>: Some conditions have specific clinical signs associated with referred pain, such as Levine's Sign for cardiac referred pain (clutching of the chest) or Murphy's Sign for gallbladder-related pain (increased pain during palpation beneath the ribcage on the right side).</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Diagnostic Considerations</b>: Referred pain can complicate the diagnostic process by masking the true source of the pain. EMS Providers should be aware of this possibility and consider a broad range of differential diagnoses when assessing patients presenting with symptoms of referred pain.</div><div style="text-align: justify;"><b><br /></b></div><div style="text-align: justify;"><b>Treatment Implications</b>: Understanding referred pain can influence the treatment approach for patients. EMS Providers should consider the underlying cause of the pain when administering interventions and be prepared to manage the primary condition contributing to the referred pain.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Communication</b>: Effective communication with receiving facilities is crucial when transferring patients with suspected referred pain. Providing a clear and accurate description of the patient's symptoms, including any associated referred pain, can help guide further evaluation and treatment at the receiving facility.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">By being knowledgeable about referred pain and its clinical implications, EMS Providers can enhance their ability to assess, manage, and provide appropriate care for patients experiencing this phenomenon in the prehospital setting.</div></span>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-88639839836478606702024-02-23T10:09:00.074-07:002024-02-28T10:23:09.497-07:00 EMS Gastrointestinal Emergencies - Particular Patient Presentations<p style="text-align: justify;"><span style="font-family: arial; font-size: large;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiorSKYzd7veHC3-7bHh2nVQOaH2B1e1oninSAhPDduvsfGuMKstOdGNQ99qctrf78r5M7cGsmbHFy5-g11jwNCYSOYSyh7wjKr4cfbh3J0LAq6361qOBCNRdp0MhRmsvsE8TNdKL4uJVAVYSLHW65L7YeqbGTVgC-vArQLXHH0GQBI392UC8KpDsidRCMf/s1000/Gastrointestinal-Disorders-Treatment-in-Ghaziabad.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="475" data-original-width="1000" height="304" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiorSKYzd7veHC3-7bHh2nVQOaH2B1e1oninSAhPDduvsfGuMKstOdGNQ99qctrf78r5M7cGsmbHFy5-g11jwNCYSOYSyh7wjKr4cfbh3J0LAq6361qOBCNRdp0MhRmsvsE8TNdKL4uJVAVYSLHW65L7YeqbGTVgC-vArQLXHH0GQBI392UC8KpDsidRCMf/w640-h304/Gastrointestinal-Disorders-Treatment-in-Ghaziabad.jpeg" width="640" /></a></div><br /><div style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In the realm of emergency medical service provision, encountering gastrointestinal emergencies is not uncommon. From gastrointestinal bleeding to acute appendicitis, EMS Providers must be prepared to assess, manage, and provide timely intervention for these critical conditions. Understanding the signs, symptoms, and underlying causes of such emergencies is essential for swift and effective patient care.</span></div><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Here are some examples of gastrointestinal emergencies an EMT might encounter:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Gastrointestinal Bleeding:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Hematemesis (vomiting blood), Melena (black, tarry stools), Hematochezia (bright red or maroon-colored stools), weakness, lightheadedness, and abdominal pain.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Examples</b>: Peptic ulcers, Esophageal varices, Gastritis, Diverticulosis, colorectal cancer.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Appendicitis</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Right lower quadrant abdominal pain, nausea, vomiting, low-grade fever, rebound tenderness.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: Inflamed or infected appendix.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Gastroenteritis</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Diarrhea, vomiting, abdominal cramps, fever, dehydration.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: Viral or bacterial infection of the gastrointestinal tract.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bowel Obstruction</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Abdominal pain and distension, nausea, vomiting (may be feculent), constipation, inability to pass gas.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: Blockage of the intestines, often due to adhesions, hernias, or tumors.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Pancreatitis</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Severe abdominal pain radiating to the back, nausea, vomiting, abdominal tenderness.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: Inflammation, often due to gallstones or excessive alcohol consumption.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Cholecystitis</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Right upper quadrant pain, nausea, vomiting, fever, tenderness.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: Inflammation of the gallbladder, often due to gallstones.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Diverticulitis</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Left lower quadrant abdominal pain, fever, nausea, change in bowel habits.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example:</b> Infection or inflammation of small pouches (diverticula) in the colon.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Gastrointestinal Perforation:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Signs and Symptoms:</b> Sudden, severe abdominal pain, rigid abdomen, guarding, rebound tenderness.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b><span>: A hole or tear in the gastrointestinal tract, often due to trauma or ulceration.</span></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Gastrointestinal (GI) emergencies pose significant challenges for EMS Providers in the field and can vary widely in terms of severity and presentation. Whether managing cases of GI bleeding or identifying and responding to appendicitis, quick and accurate assessment is essential for ensuring positive patient outcomes.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS Providers should follow local assessment protocols and communicate effectively with the receiving facility to ensure the best possible care for the patient. Additionally, maintaining good infection control practices and ensuring proper hygiene is essential when dealing with gastrointestinal emergencies, as many are infectious in nature.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">By familiarizing themselves with the signs, symptoms, and potential causes of these emergencies, EMS providers can better navigate these critical situations and provide timely and effective care to those in need.</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-6464107302263689682024-02-21T09:56:00.001-07:002024-02-25T10:44:44.834-07:00EMS Gastrointestinal Emergencies - Patient Assessment <p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdg_cwhJ7tHmDdZ8ugnEqZ8EWp5EFIykuDF3htJ4-T47k9tw8FJt3ngktpeE5U_9QeGKXCiBqB_z2XmXe5i1qvCdjsx9IUznxEH_oDNBW9DJR7KbfKWC1aZOm0HJ3ja0ULEUtlwXxIRMYFQscSItv6HILYSvjO5DsHPQX40it-1v3Zyusd1DSZva9i3uLz/s1200/Treatment-for-gastrointestinal-cancers.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="585" data-original-width="1200" height="312" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdg_cwhJ7tHmDdZ8ugnEqZ8EWp5EFIykuDF3htJ4-T47k9tw8FJt3ngktpeE5U_9QeGKXCiBqB_z2XmXe5i1qvCdjsx9IUznxEH_oDNBW9DJR7KbfKWC1aZOm0HJ3ja0ULEUtlwXxIRMYFQscSItv6HILYSvjO5DsHPQX40it-1v3Zyusd1DSZva9i3uLz/w640-h312/Treatment-for-gastrointestinal-cancers.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />EMS Providers should be prepared to recognize and respond to gastrointestinal (GI) emergencies, as they are relatively common and can range from mild to life-threatening. Here are some key points and examples of gastrointestinal emergencies that EMTs need to be aware of:</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>1. Signs and Symptoms</b>: Be familiar with the common signs and symptoms of gastrointestinal emergencies, which may include abdominal pain, nausea, vomiting, diarrhea, constipation, blood in vomit or stool, and abdominal distension.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>2. Dehydration:</b> Many GI conditions can lead to dehydration due to fluid loss from vomiting or diarrhea. EMTs should be skilled in assessing a patient's hydration status by checking vital signs (e.g., blood pressure, pulse, skin condition) and mucous membrane moisture.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>3. Abdominal Pain Assessment:</b> Learn how to perform a thorough abdominal pain assessment, which includes identifying the location, intensity, and radiation of pain, as well as any aggravating or alleviating factors.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><span> </span>- Visceral pain originates from internal organs and is often described as a diffuse, deep, and aching sensation.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><span> </span>- Parietal pain originates from the parietal peritoneum and is typically sharp, well-localized, and easier to identify.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>4. Gastrointestinal Bleeding:</b> Understand the signs of gastrointestinal bleeding, such as hematemesis (vomiting blood), melena (black, tarry stools), and hematochezia (bright red blood in stool). Be prepared to manage bleeding and provide appropriate interventions.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>5. Infection Control:</b> Gastrointestinal emergencies can often be related to infectious causes. EMTs should practice strict infection control measures to prevent the spread of infection, including wearing appropriate personal protective equipment (PPE).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>6. Medication Allergies:</b> Ask about medication allergies or intolerances, as patients with gastrointestinal conditions may be taking medications or have allergies to specific drugs.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>7. Abdominal Trauma:</b> Consider the possibility of trauma, especially in cases of severe abdominal pain. Assess for signs of external trauma and be prepared to manage accordingly.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>8. Patient History:</b> Obtain a detailed patient history, including any pre-existing gastrointestinal conditions, previous surgeries, and current medications.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>9. Vital Signs:</b> Monitor vital signs regularly, paying close attention to changes in blood pressure, heart rate, and respiratory rate. These can indicate the severity of the condition.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>10. Transport and Communication:</b> Determine the need for transport to a medical facility based on the severity of the condition. Communicate effectively with higher-level medical providers to provide a smooth transition of care.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>11. Patient Comfort:</b> Help alleviate discomfort and anxiety in patients with gastrointestinal emergencies. Position the patient comfortably and provide reassurance.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>12. Documentation:</b> Maintain accurate patient care documentation, including the patient's history, assessment findings, interventions performed, and the patient's response to treatment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS Providers should perform a thorough patient assessment, obtain a medical history, and note any pre-existing gastrointestinal conditions. </span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In cases of GI bleeding or severe abdominal pain, initiate prompt transport to a healthcare facility. Monitoring vital signs, assessing for signs of shock, and providing appropriate interventions such as intravenous fluids can be life-saving.</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-63902514076985194392024-02-19T20:03:00.023-07:002024-02-28T10:25:18.419-07:00EMS Equipment - Traction Splints Addendum<p style="text-align: justify;"><span style="font-family: arial;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhudVR8aPbAxh2PLuXjvYc_ZUL-cRTdkhLxVk_9wPfEyNX4YmIiBH9W8Uwwce93nE4O8alAdcMkjy6iGCo7CGRcN61fPnH1pxHtBoDhdAuZLuSE4lzXnJBhg56ggmuREXN5q1PciJslHIxNVK3h56pXdnJb0b-6mEhWFMisBrOWOMI2CqefECC_ktZTBuhX/s450/orthodx092117image101_1293334.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="348" data-original-width="450" height="494" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhudVR8aPbAxh2PLuXjvYc_ZUL-cRTdkhLxVk_9wPfEyNX4YmIiBH9W8Uwwce93nE4O8alAdcMkjy6iGCo7CGRcN61fPnH1pxHtBoDhdAuZLuSE4lzXnJBhg56ggmuREXN5q1PciJslHIxNVK3h56pXdnJb0b-6mEhWFMisBrOWOMI2CqefECC_ktZTBuhX/w640-h494/orthodx092117image101_1293334.jpg" width="640" /></a></span></div><span style="font-family: arial;"><br /><div style="text-align: justify;"><span style="font-size: medium;">For open femur fractures, it is essential to follow the principles of advanced trauma life support (ATLS) and local trauma management protocols.</span></div></span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">These protocols typically recommend initial hemorrhage control, wound care, and expedited transport to a trauma center for definitive care.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">According to the organization, International Trauma Life Support (ITLS), they advocate for the use of traction devices for open midshaft femur fractures.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">ITLS reports the use of a traction device for open midshaft femur fractures can help reduce the risk of neurovascular injuries and alleviate patient pain. It highlights the importance of considering the patient's extrication and transportation needs when selecting a traction device.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">In situations where the patient will be transported by air, the ITLS update suggests that a HARE traction splint may be preferred over a Sager traction splint. This is likely due to the design and ease of application of the HARE traction splint, which may be better suited for air transport scenarios.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">It's important to note that guidelines and recommendations can vary across different organizations and regions. Therefore, it's crucial to consider the specific guidelines and protocols established by your local EMS authority or trauma organization when managing open midshaft femur fractures.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bibliography</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Alexander, M. & Belle, R. (2017)</b> <i>Advanced EMT: A Clinical Reasoning Approach </i>(2nd Ed). Hoboken, New Jersey: Pearson Education</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Davis, D. D., Ginglen, J. G., Kwon, Y. H., & Kahwaji, C. I. (2023)</b> <i>EMS Traction Splint</i>. StatPearls. <a href="https://pubmed.ncbi.nlm.nih.gov/29939619/">https://pubmed.ncbi.nlm.nih.gov/29939619/</a> Accessed February 19, 2023</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>International Trauma Life Support (2011)</b> <i>Utilization of Traction Splints with Open Femur Fracture.</i> <a href="https://www.itrauma.org/wp-content/uploads/2014/04/UtilizationofTractionSplintswithOpenFemurFracture_Nov2011.pdf?fbclid=IwAR1V8YOMea6P4O4AOKSpe3N2hpmhz569cOdC7bFPF6L4vVRSU0HWiBLMNt8" target="_blank">https://www.itrauma.org/.../UtilizationofTractionSplintsw...</a> Accessed November 14, 2023</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Mistovich, J. J. & Karren, K. J. (2014)</b> <i>Prehospital Emergency Care </i>(11th Ed). Hoboken, New Jersey: Pearson Education</span></p><p style="text-align: justify;"><span style="font-size: medium;"><span style="font-family: arial;"><b>The Bone School (ND)</b> <i>Femoral Shaft Fractures.</i> </span><span style="text-align: left;"><span style="font-family: arial;">http://www.boneschool.com/lower-limb/hip/femur-fractures/femoral-shaft-fractures </span></span><span style="font-family: arial;">Accessed February 19, 2024</span></span></p><div style="text-align: justify;"><br /></div>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-81172230383362399392024-02-17T19:58:00.005-07:002024-02-28T10:24:58.050-07:00 EMS Equipment - Traction Splints<p style="text-align: justify;"><span style="font-family: arial;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdaMHVrAvIjM04UdYop-4XToR_VmdY9Q3dply0X2XsZB_kzGsKyPj5RpPxHXIJ3jPbWeZlcbZSfqPR8Z73ns6MOuEdG1SnlzoV7-ozZOTN_bEKsqKF21VMifhsVBnfPptoUBAVaeOCjB7ZArADCUAm1q8CBXOspyrDIQjIkh5GwUiehOY3PAFeOrnfuc_y/s960/traction%20splint.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="686" data-original-width="960" height="458" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdaMHVrAvIjM04UdYop-4XToR_VmdY9Q3dply0X2XsZB_kzGsKyPj5RpPxHXIJ3jPbWeZlcbZSfqPR8Z73ns6MOuEdG1SnlzoV7-ozZOTN_bEKsqKF21VMifhsVBnfPptoUBAVaeOCjB7ZArADCUAm1q8CBXOspyrDIQjIkh5GwUiehOY3PAFeOrnfuc_y/w640-h458/traction%20splint.jpeg" width="640" /></a></div><br /><div style="text-align: justify;"><span style="font-family: arial; font-size: large;">Traction splints are devices used in prehospital settings to provide stabilization and immobilization for certain types of fractures, specifically femur fractures.</span></div><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Their purpose is to help alleviate pain, reduce bleeding, and prevent further damage to surrounding tissues.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Some common brands of traction splints include the HARE traction splint, Sager traction splint, and Thomas traction splint.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">These brands have variations in design and application method, but they all serve a similar purpose.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Recommendations for using traction splints typically include cases where there is a suspected or confirmed mid-shaft femur fracture.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The use of traction splints can help align the fractured bone ends and provide relief by reducing muscle spasm and restoring limb length.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Femur fractures are serious injuries that we often encounter in the field.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Recognizing Femur Fractures</b>: Look for signs like severe pain, swelling, deformity (leg may appear shorter or rotated), inability to move the leg, and sometimes, bruising.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>High-Impact Injuries</b>: Remember, the femur is the strongest bone in the body. A fracture usually results from high-impact trauma, like motor vehicle accidents or significant falls.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Check for Complications</b>: Be vigilant for potential complications such as bleeding (femoral artery damage), fat embolism, or shock, especially in high-impact traumas.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Immobilization is Key</b>: Stabilize the leg with a traction splint if indicated. Proper immobilization reduces pain, bleeding, and the risk of further injury.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Monitor Vitals</b>: Keep a close eye on the patient’s vital signs. Femur fractures can cause significant pain and shock, which may lead to changes in pulse, blood pressure, and respiratory rate.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Transportation Considerations</b>: Handle with care during transport. Smooth movements and careful handling can prevent further injury and pain.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Communication with Hospital</b>: Inform the receiving facility about the nature of the injury, your interventions, and the patient's response to treatment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">However, there are certain contraindications and situations where traction splints should not be used.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">These include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Proximal or Distal Femur Fractures</b>: Traction splints are designed for mid-shaft femur fractures and may not be effective or appropriate for fractures closer to the hip or knee joint.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Pediatric Patients</b>: Traction splints are generally not recommended for pediatric patients due to differences in bone anatomy and the risk of causing additional injury.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Inability to Apply Properly</b>: If the EMS provider is unable to properly apply or use the traction splint, it should not be used. In such cases, alternative methods of immobilization will need to be considered.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Therefore, it is important to note that the decision to use a traction splint should be based on the specific circumstances of the patient and the availability of appropriate resources.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS providers should consider factors such as the mechanism of injury, the location and type of femur fracture, and the patient's overall condition.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">It's always advisable for EMS providers to adhere to local protocols and guidelines, as they may vary depending on the region and specific healthcare system.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">These protocols are typically established based on current evidence, best practices, and expert consensus to ensure optimal patient care.</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-22294489512434866512024-02-15T10:59:00.028-07:002024-02-20T11:04:40.285-07:00EMS Patient Monitoring - Capnography 4<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPEwZ7mfUcpMUAJ7pIDCcrg5QNfvtC5IFHKq6V_iijhSsuBM5pibskrlX3OcXFqMM6qwzGnGer3Wxff4lSfajjYmDjZTiJ4fbCUjqNiW18BD12-cLEvn4eXrcQtNn1hab7xgUIY7mPDKNcic_NYMpfCmDZLnSUA-8k5zhKuioRsLGDjv-2kSfKnkc9tWaO/s1440/420846069_10159238071986230_2055994979634260697_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="810" data-original-width="1440" height="360" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPEwZ7mfUcpMUAJ7pIDCcrg5QNfvtC5IFHKq6V_iijhSsuBM5pibskrlX3OcXFqMM6qwzGnGer3Wxff4lSfajjYmDjZTiJ4fbCUjqNiW18BD12-cLEvn4eXrcQtNn1hab7xgUIY7mPDKNcic_NYMpfCmDZLnSUA-8k5zhKuioRsLGDjv-2kSfKnkc9tWaO/w640-h360/420846069_10159238071986230_2055994979634260697_n.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />Understanding the capnography waveform is essential. A consistent waveform indicates proper ventilation, while irregularities may signal airway or respiratory issues.</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Considerations</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Equipment Calibration</b>: Regular calibration of capnography equipment is essential to maintain accuracy in CO2 measurements.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Interference with Nasal Cannula</b>: Nasal cannulas may result in lower ETCO2 readings due to air dilution. Consider using an alternative sampling method if necessary.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Low Perfusion States</b>: In low perfusion states, such as during cardiac arrest, capnography may be less reliable in reflecting true ETCO2 levels.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Temperature Compensation</b>: Capnography measurements are temperature-dependent. Providers should be aware of the need for temperature compensation to ensure accurate readings.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Limitations</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Airway Anomalies</b>: Some airway anomalies or pathologies may affect capnography readings. Providers should be cautious in interpreting results in such cases.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Equipment Malfunction</b>: Malfunctions in the capnography equipment can lead to inaccurate readings. Regular maintenance and checks are necessary.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Rebreathing</b>: Rebreathing or partial rebreathing masks can result in elevated ETCO2 levels, affecting the accuracy of monitoring.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Sampling Rate</b>: Inadequate sampling rates may result in delayed detection of changes in ETCO2 levels. Ensure the capnography device has an appropriate sampling rate.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Pulmonary Embolism</b>: In cases of massive pulmonary emboli, capnography may show a decrease in ETCO2 due to reduced perfusion to the lungs.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">EMS providers should undergo proper training to interpret capnography data accurately and be aware of the limitations and special considerations in various clinical scenarios.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Regular education and updates on capnography technology are crucial to providing optimal patient care.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography</b>: Principles and Practice by Michael K. Copeland</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography, King of the ABC’s</b>: A Systematic Approach for Paramedics" by Troy Valente</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Paramedic Care</b>: Principles & Practice: by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry</span></p><div style="text-align: justify;"><br /></div>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-14642227570986923222024-02-13T10:56:00.012-07:002024-02-20T10:59:12.986-07:00EMS Patient Monitoring - Capnography 3<div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyLvRNQk4cXia9QyUpm4QRq84pSHtCbWmJr_yCEGgyReax665QOID1lwE1HZ0Vgn1TdKSWqyWUjzRCRMGp1KJa9_loQgEneCRYB8zVBAnnfive3L17voozg6UhnJfJs22IE-m_UVyOtNZPZI-w6oSGDexizT9rKMu5Khyphenhyphenoo1Oe_WUFB9Ea8X4tsAyp9b2Y/s1440/420398016_10159235599941230_7419136718363540539_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="810" data-original-width="1440" height="360" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyLvRNQk4cXia9QyUpm4QRq84pSHtCbWmJr_yCEGgyReax665QOID1lwE1HZ0Vgn1TdKSWqyWUjzRCRMGp1KJa9_loQgEneCRYB8zVBAnnfive3L17voozg6UhnJfJs22IE-m_UVyOtNZPZI-w6oSGDexizT9rKMu5Khyphenhyphenoo1Oe_WUFB9Ea8X4tsAyp9b2Y/w640-h360/420398016_10159235599941230_7419136718363540539_n.jpg" width="640" /></a></div><br />ETCO2 monitoring is a valuable tool for EMS Providers as it provides real-time information about a patient's respiratory status and overall physiological condition. Here's how ETCO2 is useful for EMS providers:</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Ventilation Assessment:</span> ETCO2 levels reflect the adequacy of ventilation. Monitoring ETCO2 helps EMS providers assess whether a patient is effectively eliminating CO2 through ventilation.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Confirmation of Airway Placement:</span> ETCO2 is commonly used to confirm proper placement of an endotracheal tube or other advanced airway devices. A sudden increase in ETCO2 during intubation indicates successful placement within the trachea, whereas low or absent readings may suggest esophageal or misplaced airway.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Circulatory Status Indicator: </span>Changes in ETCO2 levels can provide insight into the patient's circulatory status. A sudden decrease in ETCO2 may indicate reduced cardiac output, potentially signaling cardiac arrest or severe shock.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Monitoring During CPR:</span> ETCO2 monitoring is crucial during cardiopulmonary resuscitation (CPR). A sudden increase in ETCO2 levels during CPR may indicate return of spontaneous circulation (ROSC), while persistently low levels may suggest poor perfusion and the need for intervention.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Detection of Respiratory Distress or Failure:</span> ETCO2 is a sensitive indicator of respiratory distress or failure. A sudden decrease in ETCO2 may signal respiratory compromise, allowing providers to intervene promptly.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Prognostic Tool:</span> Persistent low ETCO2 levels during CPR are associated with a poorer prognosis. Monitoring ETCO2 trends can help providers make informed decisions about the effectiveness of resuscitative efforts.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Guidance During Procedural Sedation:</span> EMS providers can use ETCO2 monitoring to ensure adequate ventilation during procedural sedation. This is particularly important when administering sedatives or analgesics that may depress respiratory function.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Trauma Assessment:</span> In trauma patients, ETCO2 monitoring can aid in identifying respiratory distress due to thoracic injuries or other traumatic conditions.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;">Early Detection of Respiratory Complications: Monitoring ETCO2 allows for the early detection of respiratory complications, such as hypoventilation or respiratory depression, enabling timely intervention.</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-weight: 600;"><span style="font-family: arial; font-size: medium;">Further Reading:</span></span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Capnography:</span> Principles and Practice by Michael K. Copeland</span></span></div><div class="x1e56ztr" style="background-color: white; color: #050505; margin-bottom: 8px; text-align: justify;"><span class="x193iq5w xeuugli x13faqbe x1vvkbs xlh3980 xvmahel x1n0sxbx x6prxxf xvq8zen xo1l8bm xzsf02u" style="-webkit-font-smoothing: antialiased; color: var(--primary-text); line-height: 1.3333; max-width: 100%; min-width: 0px; overflow-wrap: break-word; word-break: break-word;"><span style="font-family: arial; font-size: medium;"><span style="font-weight: 600;">Capnography, King of the ABC’s:</span> A Systematic Approach for Paramedics" by Troy Valente</span></span></div><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><span style="background-color: white; color: var(--primary-text);"><span style="font-weight: 600;">Paramedic Care:</span></span><span style="background-color: white; color: var(--primary-text);"> </span><span style="background-color: white; color: var(--primary-text);">Principles & Practice" by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry</span> </span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-17581060105617647092024-02-11T10:53:00.026-07:002024-02-20T10:56:33.384-07:00EMS Patient Monitoring - Capnography 2<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEita6Y07pPkhlH-xvKOb6Xp9rhFQj46gDWg6wjCdjv7XbF8ujv23Q7NfqbTlgkHG48NwpPfiWRTDk0MTQ7RCoKxHXWqVBSs_X1u33fBr-QpgM2oFxFsAYh2NhxTN2sEOZOsqt4XGI0BSlA0WahRT8Z6UzjlRpDBopxWxEySAhF82r_D6rOxJySuXOfnXCFD/s800/420027253_10159233278276230_164825077518609238_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="280" data-original-width="800" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEita6Y07pPkhlH-xvKOb6Xp9rhFQj46gDWg6wjCdjv7XbF8ujv23Q7NfqbTlgkHG48NwpPfiWRTDk0MTQ7RCoKxHXWqVBSs_X1u33fBr-QpgM2oFxFsAYh2NhxTN2sEOZOsqt4XGI0BSlA0WahRT8Z6UzjlRpDBopxWxEySAhF82r_D6rOxJySuXOfnXCFD/w640-h224/420027253_10159233278276230_164825077518609238_n.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />The choice of monitoring device depends on factors such as the patient's condition, the level of invasiveness required, and the specific clinical scenario.</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Mainstream and sidestream capnography are the most commonly used methods for continuous ETCO2 monitoring.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The devices used to measure end-tidal CO2 (ETCO2) typically include:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnometers</b>: These are basic devices that measure and display the numerical value of ETCO2. They are commonly used in various medical settings.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnographs</b>: More advanced devices that not only display the numerical value of ETCO2 but also provide a continuous graphical representation known as the capnogram.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The capnogram displays the CO2 concentration over time, showing inhalation, exhalation, and the phase where little or no CO2 is present (representing the end-tidal point).</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Mainstream Capnography</b>: With mainstream capnography, the sensor is placed directly in the patient's airway, usually at the end of an endotracheal tube or an adapter connected to a ventilation device.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">This type of capnography provides immediate and accurate measurements but may add dead space to the breathing circuit.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Sidestream Capnography</b>: With sidestream capnography, a sampling tube diverts a small portion of the patient's exhaled air to a separate sensor away from the patient.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">This method is less invasive and reduces the dead space in the breathing circuit. It is commonly used in non-intubated patients and during procedural sedation.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Colorimetric Devices</b>: These devices provide a color change based on the CO2 concentration. They are often used as a quick and cost-effective method for verifying endotracheal tube placement but may not provide continuous monitoring.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Portable Capnography Devices</b>: There are compact and portable capnography devices designed for prehospital and emergency use by EMS providers. These devices are lightweight, battery-operated, and provide essential monitoring capabilities in various environments.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography</b>: Principles and Practice by Michael K. Copeland</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography, King of the ABC’s</b>: A Systematic Approach for Paramedics" by Troy Valente</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Infinium (ND) What is a Capnograph <a href="https://infiniummedical.com/what-is-capnography/ " target="_blank"><i>https://infiniummedical.com/what-is-capnography/ </i></a>Accessed January 16, 2024</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Paramedic Care</b>: Principles & Practice" by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry</span></p><div style="text-align: justify;"><br /></div>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-9098730134900350432024-02-09T10:49:00.003-07:002024-02-20T10:52:45.554-07:00EMS Patient Monitoring - Capnography 1<p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQvTG65FmEmencfxZSu1IWgmRIU7b2tg0QKiKrqGZvHVwqqqiIMwEwLYrwXNajqpsLNnGhmFAofQog6XQqEbVXrSv9S96HRsD5w_WdQP0XaSVU5bIDrguReaSQrvTauCnYhh78FaqXRrvtE0eed-Pa-9DHp1Iel43ufRvAsJWZoTD_ElRV764WnSPWd_UW/s734/418483403_10159229920656230_429240284418641059_n.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="484" data-original-width="734" height="422" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQvTG65FmEmencfxZSu1IWgmRIU7b2tg0QKiKrqGZvHVwqqqiIMwEwLYrwXNajqpsLNnGhmFAofQog6XQqEbVXrSv9S96HRsD5w_WdQP0XaSVU5bIDrguReaSQrvTauCnYhh78FaqXRrvtE0eed-Pa-9DHp1Iel43ufRvAsJWZoTD_ElRV764WnSPWd_UW/w640-h422/418483403_10159229920656230_429240284418641059_n.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br />Widely embraced across diverse medical settings, including the exigencies of emergency medical services, the precision of intensive care units, the intricacies of operating rooms, and the nuanced demands of procedural sedation, capnography emerges as a multifaceted sentinel for healthcare providers.</span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">Capnography is an indispensable asset within the realm of prehospital and emergency medical care, serving as a dynamic window into a patient's physiological landscape. This monitoring technique engages in the continuous, real-time measurement and graphical representation of carbon dioxide (CO2) concentration, specifically known as end-tidal CO2 (ETCO2), within a patient's exhaled breath.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">By offering an unbroken stream of insights into both respiratory and circulatory dynamics, capnography provides a comprehensive understanding of a patient's evolving physiological status.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">End-Tidal CO2 (ETCO2), the focal point of capnography, unveils the partial pressure or concentration of carbon dioxide at the culmination of each exhaled breath. This metric, expressed in millimeters of mercury (mmHg) or as a percentage, furnishes EMS providers with real-time, actionable information regarding a patient's respiratory well-being.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">As a consequence, ETCO2 monitoring emerges as a linchpin in the delivery of timely and informed interventions, ensuring the optimization of patient care in critical and time-sensitive situations.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">The word ‘capnography’ has its roots in Greek. The term is derived from the Greek word ‘kapnos’ meaning ‘smoke’, and the suffix ‘-graphy’, which refers to the process of recording. The name reflects its focus on the measuring of carbon dioxide which, historically, has been associated with the term ‘smoke’ due to its visible presence in combustion processes</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading:</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography</b>: Principles and Practice by Michael K. Copeland</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Capnography, King of the ABC’s</b>: A Systematic Approach for Paramedics" by Troy Valente</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Paramedic Care</b>: Principles & Practice" by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry</span></p><div style="text-align: justify;"><br /></div>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0tag:blogger.com,1999:blog-6229165120605701126.post-70823209561257450432024-02-07T19:42:00.058-07:002024-02-20T09:53:11.297-07:00 EMS Trauma Emergencies - Amnesia <p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-family: arial; font-size: medium;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEho5s9drpluwgYvtugKkspLMPJJg_pMm8BFhWhhyphenhyphenqZ79aRW0rDWJ4_j1K5p8Sc1CCrtygtP2yH2R17gAAFZdjBw2ywVIRJ4kadw7YDbJh7ETORouY8QhbGcY6UNuivpRkoGzlniY9txckp2DF0MhgP5vi9k9V1hPS_0E6Gu3sU5MEMwET2uRBdITLTuxwSj/s2560/amnesia.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1369" data-original-width="2560" height="342" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEho5s9drpluwgYvtugKkspLMPJJg_pMm8BFhWhhyphenhyphenqZ79aRW0rDWJ4_j1K5p8Sc1CCrtygtP2yH2R17gAAFZdjBw2ywVIRJ4kadw7YDbJh7ETORouY8QhbGcY6UNuivpRkoGzlniY9txckp2DF0MhgP5vi9k9V1hPS_0E6Gu3sU5MEMwET2uRBdITLTuxwSj/w640-h342/amnesia.jpg" width="640" /></a></span></div><span style="font-family: arial; font-size: medium;"><br /><div style="text-align: justify;">EMS Providers should have a solid understanding of the causes and types of amnesia to effectively assess and manage patients presenting with memory disturbances. Here's what they need to know:</div></span><p></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Causes of Amnesia</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Head Trauma</b>: Traumatic brain injury (TBI) is a common cause of amnesia, especially retrograde amnesia (RA), where memory loss occurs for events preceding the injury.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Stroke</b>: Lack of blood flow to the brain can lead to transient global amnesia (TGA), characterized by sudden onset memory loss.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Seizures</b>: Particularly prolonged or severe seizures can cause memory impairment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Neurodegenerative Diseases</b>: Alzheimer's disease, dementia, and other conditions can lead to progressive memory loss.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Psychological Trauma</b>: Emotional shock or severe stress can result in dissociative amnesia, where memories are blocked due to psychological distress.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Drug or Alcohol Abuse</b>: Substance abuse can lead to blackouts or memory gaps.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Infections</b>: Encephalitis, meningitis, and other brain infections can impair memory function.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Brain Tumors</b>: Tumors can affect memory centers in the brain, leading to amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Metabolic Disorders</b>: Conditions like vitamin B12 deficiency or thyroid disorders can cause memory impairment.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Medications</b>: Certain medications, such as benzodiazepines, can cause memory problems as side effects.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Types of Amnesia</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Retrograde Amnesia (RA)</b>:</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Definition</b>: Memory loss for events that occurred before the onset of amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Causes</b>: Typically associated with head trauma, brain injury, or neurological conditions.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: A patient may not remember events leading up to a car accident due to retrograde amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Anterograde Amnesia (AA):</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Definition</b>: Inability to form new memories after the onset of amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Causes</b>: Often seen in cases of head trauma, stroke, or neurodegenerative diseases affecting the hippocampus.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Example</b>: A patient may repeatedly ask the same question or fail to recall recent conversations due to anterograde amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Differential Diagnosis</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Differentiating Retrograde vs. Anterograde Amnesia</b>: Assessing the patient's ability to recall events before and after the onset of symptoms helps distinguish between the two types.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>History and Physical Examination</b>: Detailed history-taking, including information from family members or witnesses, and a thorough physical examination can help identify potential causes of amnesia.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Neuroimaging</b>: CT scans or MRI scans may be necessary to detect structural abnormalities in the brain, such as tumors or lesions.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Laboratory Tests</b>: Blood tests can help rule out metabolic causes of amnesia, such as vitamin deficiencies or infections.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Management</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Stabilization</b>: Ensure the patient's vital signs are stable and address any immediate life-threatening issues.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Supportive Care</b>: Provide reassurance and support to the patient and their family members.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Referral</b>: Depending on the underlying cause, patients may require further evaluation and management by neurologists, psychiatrists, or other specialists.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;">By understanding the causes and types of amnesia, EMS providers can effectively assess and manage patients experiencing memory disturbances, providing appropriate care and ensuring the best possible outcomes.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Further Reading</b></span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Alexander, M. & Belle, R (2012)</b> <i>Advanced EMT: A Clinical Reasoning Approach</i> (2nd Ed). New Jersey: Pearson.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Bledsoe, B. E., Cherry, R. A. & Porter, R. S. (2023)</b> <i>Paramedic Care: Principles and Practice Volume 1</i> (6th Ed). New Jersey: Pearson.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Brown, C. A., III., & Walls, R. M. (2023)</b> <i>The Walls Manual of Emergency Airway Management </i>(6th Ed). Pennsylvania: Lippincott Williams & Wilkins.</span></p><p style="text-align: justify;"><span style="font-family: arial; font-size: medium;"><b>Mistovich, J. J. & Karren, K. J. (2014)</b> <i>Prehospital Emergency Care</i> (11th Ed). New Jersey. Pearson Education.</span></p>Sea Kayak Markhttp://www.blogger.com/profile/12372699464975270081noreply@blogger.com0