The EMS Lighthouse Project

What value does EtCO2 have when it comes to predicting survival from cardiac arrest? We all know a sharp spike in EtCO2 is associated with ROSC, but what about persistently elevated levels? What does this mean for decision making when it comes to termination of resuscitation? Join Drs. Jeff Jarvis, Remle Crowe, and Heidi Abraham for the first episode of “Between Two Nerds”, a s

The debate about which drug to use for sedation prior to RSI will.. just.. not… die. Advocates for both ketamine and etomidate approach the argument with near-religious zeal. There have been studies. We’ve even covered some here. What we need is a systematic review and meta-analysis, preferably using a type of analysis that recognizes that this likely isn’t a black and white

Atrial Fibrillation with rapid ventricular response is a common cause of EMS activations and ED visits. It is associated with chest discomfort, palpitations, and hypotension. Treatment is aimed at either rhythm control or rate control with rate control being the most common first line approach. EMS has the potential to treat this condition with medications such as diltiazem, metopr

Dr. Jarvis is joined by OG co-host Mike Verkest and Dr. Brent Myers from NAEMSP 2024. We talk about an intriguing concept in cardiac arrest… giving the initial dose of epinephrine IM instead of starting an IV or IO. They discuss a 2021 paper that compared this approach to standard dosing in a feasibility study done in Salt Lake City. Those authors released some additional data fr

Show Notes:EMS History is full of interventions we've rapidly adopted, often at great expense and withdisruption of existing processes, that later turned out to, how should I say this..... not work.Want examples? MAST and high-volume crystalloids in trauma. Mechanical compressiondevices, high-dose epinephrine, indiscriminate calcium administration in cardiac arrest. Do Ieven need t

What would you say if I told you that Black patients were less likely to receive pain medication compared with white patients? My guess is you’d either question the methods, assume it isn’t possible, or ask why. Regardless of what your answer is, you’re going to want to listen to this episode. Mikey V returns to co-host a live episode from the ESO PCRF research forum where we

Have you heard that you’re supposed to decrease the dose of your sedative when performing RSI on hypotensive patients? First, avoid the question about why you haven’t addressed the hypotension before intubating.. maybe there’s a reason. Maybe. But, regardless of why, intubate you will. What about those doses? I’ve been hearing for years that I should be dropping the dose of

Y’all know I have thoughts on epinephrine in cardiac arrest. And perhaps might have heard me say epinephrine “saves the heart at the expense of the brain”. I’ve also said I don’t have an issue with any epinephrine in arrest, just how we give it currently and have wondered if less epi might do the trick. We review the One and Done paper recently published from North Caroli

We’ve spoken a lot recently about intubation First Pass Success, including what the definition is. We’ve also discussed different papers about the impact the type of laryngoscope, video or direct, has on first pass success. There’s a new paper out that directly compares video vs direct laryngoscopy. Join us to discuss the DEVICE trial. Citations Prekker ME, Driver BE, Trent S

What even IS FPS? There's been a long running argument about the definition of FPS. And by argument, I mean mostly established in the literature with some people just not liking it. FPS is successful ET passage through the cords within 1 attempt at laryngoscopy or when the blade passes the teeth. That definition worked well when we were using direct laryngoscopy where the hard part