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Day 4 of @DallasFireRes_q Medical Director Bootcamp is all about “Resus Academy” and Crit Care in AM, intense simulation in the PM. No more “scoop and run” with critical medical pts. Intervene and stabilize first for optimal outcomes. #EMS #FOAMems #Resuscitation @BLM_2014
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Station #1 - Witnessed VF arrest, focusing on high-quality pit crew CPR, high CCF, good airway mgmt, rhythm recognition, early pharmacotherapy and defib. #EMS #FOAMems #Resuscitation #CriticalCare #CPR
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Station #2 - Unstable bradycardia due to hyperK+ from missed dialysis. Importance of focused H&P. Don’t get the history, can’t intervene correctly, & your pt deteriorates. Know albuterol, calcium, & bicarb for hyperK+ mgmt; watch for SOB from volume overload #EMS #FOAMems
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Station #3 - If you run quickly to your “binky (aka ambulance) before stabilizing your pt, don’t be surprised if they deteriorate on you. Stabilize ABC’s before you scoop and run. This altered septic case just turned into a VF arrest. #Resuscitation #EMS #FOAMems
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Station 4 - Peds respiratory distress due to status asthmaticus. Don’t be afraid to use IM epi or escalate to CPAP on these patients. Use math-free tools for Peds med dosing when able. No wheezing in an asthmatic is a bad thing! #EMS #FOAMems #PedsEMS
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Station 5 - poly-trauma! All about BLS. ABCDE or MARCH? Which algorithm is better? Stop massive hemorrhage with tourniquet and manage ABC’s simultaneously. Decompress PTX in AAL for higher chance of success. Rapid transport, but reverse life threats first! #EMS #FOAMems
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Station 6 - Unstable SVT. Reinforcing ACLS principles, understand what makes them “unstable”. Continuous 12-leads during interventions (adenosine, electricity) are valuable. Put pads on before adenosine. Move them to supine before interventions. #EMS #FOAMems #Resuscitation
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7/x
Station 7 - Precipitous delivery. Female with abd pain, always ask LMP. Ask G’s and P’s. You have 2 patients, know how to manage shld dystocia, postpartum hemorrhage, and a hypoventilatory or bradycardic neonate. #MRSOPA #EMS #FOAMems
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Station 8 - Multiple sick pts with vague complaints. Headache, flu-like symptoms, altered? Focused history, pattern recognition, feeling sick while on scene? Suspect toxic environment, carbon monoxide in this case. Of course our firefighters nailed this case! #EMS #FOAMems
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9/9
Couldn’t have done this without the tremendous work and support of the faculty, EMS Fellows, and EM residents of @UTSW_EM and @DallasEMed and the facilities of @brookhaven College. Teamwork makes the dream work!
