EMS A to Z: Stroke Screening Scores

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Follow your Stroke Administrative Guideline!

If a stroke is suspected, first perform a Cincinnati Prehospital Screening Scale:

If positive perform a VAN.

VAN positive

Greater than 4 hours of symptom onset: transport to Comprehensive Stroke Center (Banner UMC or TMC).

Within 4 hours of symptom onset: transport to nearest Stroke Center (patient may still be tPA candidate).

VAN negative

Transport to the nearest Stroke Center.

See this reference from CoreEM for performing a VAN screen.

Don’t forget to consider and evaluate for stroke mimics (like hypoglycemia).

EMS A to Z: Narcan in Cardiac Arrest

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Narcan is a competitive opiate receptor antagonist, meaning that it competes with opiate drugs (fentanyl, morphine, heroin) to bind to those receptors and essentially kicks them off.

Narcan is indicated for respiratory depression thought to be caused by an opiate.

Narcan doesn’t help in cardiac arrest, because the problem – or cause of the arrest – is usually hypoxia, which requires ventilation to correct.

The most important aspects of cardiac arrest care due to an opiate overdose are: good ventilations, good CPR, shocking shockable rhythms, and administering epinephrine early in non-shockable rhythms.

EMS A to Z: Introduction

Show Notes:

From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn

Hello and welcome to EMS A to Z! This is a weekly podcast hosted by Dr. Rachel Munn, featuring Dr. Josh Gaither, the medical director of Tucson Fire, as well as Dr. Amber Rice, the medical director of Northwest Fire here in Tucson, AZ.

Each week we’ll release a 5 to 10 minute episode on a topic ranging from cardiac arrest to refusal of care. Our goal is to provide free, accessible, high yield education on common and potentially challenging cases encountered in the field. We’ll feature guests from our local agencies to provide some boots on the ground perspective, as well as discuss interesting cases.

Feel free to shoot us an email with questions that may arise from the episodes or with suggestions for topics you’d like to hear about ([email protected])!

 

*Disclaimer – the opinions, recommendations, and guidelines discussed in this podcast belong to the individual medical directors and the University EMS Administrative Guidelines. They should not replace or substitute for following your own agency protocols and guidelines.