In part 2 of this 3-part series, we discuss sodium and potassium imbalances, their causes, common signs and symptoms of these disorders, and how to treat these patients before arrival at the hospital ..read more

Point-of-care ultrasound (POCUS) is a safe diagnostic tool that clinicians use to rapidly evaluate critically ill patients.1 POCUS has expanded into the prehospital setting and has been demonstrated to be accurate, feasible, and helpful in guiding clinical decision making.2-4 Additionally, the American College of Emergency Physicians recommends the use of echocardiography to evaluate for ventricular activity in the setting of cardiac arrest.5 There is minimal evidence regarding the use of POCUS to confirm mechanical capture in patients undergoing transcutaneous pacing ..read more

The objective of this study was to assess the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on the self-reported rates of posttraumatic stress disorder (PTSD) among emergency medical services (EMS) clinicians in urban and suburban settings that were one of the primary epicenters during the first wave of the COVID-19 pandemic ..read more

In many fire departments, firefighters are also trained as emergency medical technicians or paramedics. This has obvious benefits because most of the calls for service to which fire units are dispatched involve a medical emergency. However, in some fire departments, especially volunteer departments, firefighters may have little to no medical training at all, meaning they can provide little to no patient care. This can create complications when these individuals are dispatched to medical calls. This is the case with the fire department in my hometown ..read more

The Romanian Mobile Emergency Services for Resuscitation and Extrication (SMURD) operates under the Romanian General Inspectorate for Emergency Situations. The acronym stands for Serviciul Mobil de Urgență, Reanimare și Descarcerare, and their first unit was established in Târgu Mureș, a city in Transylvania, in 1990.1 ..read more

The care of emancipated minors presents complex legal and ethical challenges. Emancipated minors are legally considered adults with the capacity to make their own medical decisions despite their youth. This article explores the legal and ethical dimensions of providing emergency care to these adolescents, including their rights, the responsibilities of health care providers, and the importance of clear guidelines. Although emancipated minors have autonomy in their medical care, navigating the unique legal, ethical, and practical issues is essential to ensure they receive appropriate care and s ..read more

The i-gel supraglottic airway device (Intersurgical, Berkshire, UK) is commonly used in the United States and worldwide for prehospital airway management. Previous research has suggested that a sex-based method of size selection (4.0 for female patients and 5.0 for male patients) is superior to a weight-based method in patients undergoing elective anesthesia. Our objective was to compare a sex-based i-gel size selection strategy with a weight-based strategy using real-world prehospital data ..read more

Emergency medical services (EMS) Code Lavender was developed to support EMS clinicians after stressful events via consistent recognition of events, informal peer support, and intentional acts of kindness. This study evaluated changes in burnout screening tool responses of EMS clinicians in response to program implementation and the coincidental start of coronavirus disease 2019 ..read more

Neuromuscular blocking agents (NMBAs) are classified into nondepolarizing (eg, rocuronium, vecuronium, and cisatracurium) and depolarizing (succinylcholine) agents, which have variable pharmacokinetic and pharmacodynamic profiles. NMBAs are frequently used in the prehospital and critical care transport setting to facilitate intubation. NMBA administration leads to improved intubating conditions and a higher percentage of first-pass success.1 The current literature in critical care transport in the prehospital environment has focused on variable sedation strategies that accompany intubation wit ..read more

We read with great interest the publication by Facchetti et al,1 which represents a significant addition to the evolving landscape of trauma care in Italy. Their study addresses a critical gap concerning the precise mapping of prehospital blood and blood product implementation, shedding light on the nuances, strengths, and challenges inherent in establishing prehospital blood programs across Italy. In alignment with the authors, we recognize the imperative for further research to comprehensively evaluate the efficacy of transfusions outside the hospital ..read more