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Stories from a paramedic, and education for the prehospital health provider.
Recent Posts Tagged With 'research'
Intravenous drug administration during out-of-hospital cardiac arrest: a randomized trial.
This study has received a lot of attention. I will interchangeably use the terms the IV (IntraVenous) group and the epinephrine group depending on the terminology I think is more relevant at the time. The distinction is not one that I believe is impo...
Video Laryngoscopy
With the advanced airway debate comes a need for solutions. Obviously increased training and QI/QA are at the top of the list. Another option is the Glidescope. This device is just one of a few video laryngoscopy devices that has shown phenomenal ...
Heart attack study looking at whether giving clot-buster in ambulance is best
Photo credit: The Canadian PressA recent story from the Canadian Press talks about the international STREAM study (Strategic Reperfusion Early After Myocardial Infarction). "It's widely recognized that the faster you treat a heart attack, the better...
Long QT Syndrome Part III
The most common arrhythmia associated with LQTS is torsades de pointes (TdP) [1]. This is more commonly associated with hypomagnesaemia, and is generally paroxysmal and benign. In LQTS TdP is usually preceded by abnormally large T-U waves and may ...
Airway Research
The following study is just another example, supporting my opinion on the outcome of properly trained prehospital personnel. Rogue Medic has been screaming this stuff from the blogshere rooftop. It takes much more training than you would probably t...
Induced Hypothermia Part V
More support for induced hypothermia:[Pubmed 1]Mild therapeutic hypothermia (32 degrees C-34 degrees C) is the only therapy that improved neurological outcome after cardiac arrest in a randomized, controlled trial. Induced hypothermia after successfu...
Pain Management
[Pubmed 1]Severe pain is a common presenting symptom for emergency patients. One major challenge in the management of severe pain is the objective measurement of pain. Due to the subjective nature of pain, it can be very difficult for clinicians to q...
Induced Hypothermia Part IV
Read below for more information on induced hypothermia for cardiac arrest. Most recent studies:[Pubmed 1]Background: Several investigators have emphasized the positive effect of hypothermia therapy on patients who have suffered from cardiac arrest. ...
Education: Pain Management
I have been procrastinating on approaching this topic. I will start off by reviewing a study that assesses pain management before and after continued education. The results are pretty interesting. I know this a subject of particular interest to Ro...
Induced Hypothermia Part III
Most recent studies from Pubmed:[1]Organ injury caused by ischaemia and anoxia during prolonged cardiac arrest is compounded by reperfusion injury that occurs when spontaneous circulation is restored. Mild hypothermia (32-35 degrees C) is neuroprotec...
C A S T and Narrative Fallacy
CAST (The Cardiac Arrhythmia Suppression Trial)[1] was a large scale randomized placebo controlled trial. This was to determine which of the antiarrhythmics would be able to claim the title as the most effective life saving drug on the planet. CAST w...
Narrative Fallacy II
In the comments to Why Can't Medics Resuscitate II, anonymous finishes up with this question. One question. The sole purpose of Epi during arrest is to act as a peripheral vasoconstrictor, thus increasing preload - correct?I cannot answer this questi...
Induced Hypothermia Part I
"Arctic Alert"* If you are in EMS and do any continuing education of your own, or subscribe to one of the few EMS magazines, you have probably heard of induced hypothermia. I first learned of induced hypothermia at a clinical conference in 2007. Br...
Why Can't Medics Resuscitate? I
I thought we were working on Why Can't Medics Intubate?We still are. This is just a change in perspective. A study,[1] not yet published, but available on line, shows part of the problem with resuscitation.What is that?As I have stated many times bef...
Why Can't Medics Intubate?
A study of prehospital intubation[1] was just published. The surprising result is that in the system studied they are able to intubate 3 out of 4 patients they try to intubate.I will write another post with more detail on this. From that study, there...
Prehospital Spinal Clearance Part III
The evidence is here...You have heard me mention the NEXUS study a few times, and in this post I am going to finally explain exactly what it is and ask if its the solution.NEXUS stands for National Emergency X-Radiography Utilization Study. This stu...
Prehospital Spinal Clearance Part II
A closer look at the research...With the start of this topic, I thought I would get by with some easy research and criticisms. As I dove into this subject I soon realized it wasn't going to be that easy. In part one, I explained what struck the que...
Prehospital Spinal Clearance Part I
It's no secret that I am a diehard advocate of progressive prehospital medicine. I am also a proponent of evidence-based medicine. Sometimes these two views can be conflicting because of the lack of evidence to back new medicine. I have often changed...
Precordial Thump - For Asystole? - ECG Strips
Last week I posted on some of the problems with this precordial thump study.[1] This week I will look at some of the positives. While the data do not suggest that we should start using precordial thump. The data suggest that we should be doing more r...
Precordial Thump - For Asystole?
In The Precordial Thump, Adam Thompson, EMT-P writes about an article[1] by Dr. Keith Wesley in JEMS. Dr. Wesley was reviewing a study of the use of precordial thump (PT is the abbreviation used in the study, but since PT is commonly used for other m...
