The JEMS Report

In this week’s episode of the EMS Handoff, Bradley, Eric and David come back together behind the EMS Handoff microphones after a much-needed week of rest to discuss those common “lift assist” calls. Ambulance services and fire departments have regular calls to help citizens  when they fall and are uninjured. Risk mitigation is not only something that should be done when looking at a community, it should be done when helping our patients. Are there aspects that we can advise on that would help those individuals in the future? 

- Risk Mitigation

- Does five minutes now help later?

Potential Recommendations:

- If you have a walker or a cane that you are supposed to use, then use it.            

- Don't get out of bed or up from a chair suddenly. Sit upright, pause, then push up from the bed or chair, while also standing up with the muscles in your legs. 

- Move cords for lights, TVs and other appliances out of walking paths.

- Know where your pets are before you move.

- Use railings when going up or down steps.

- Wear shoes instead of slippers or socks for better traction.

- Don't use slippery area or throw rugs in the kitchen, hallways or bathrooms.

- Install handholds in the tub and near the toilet.

- Don't walk and attempt to use or read your smartphone or tablet at the same time. Especially, if you are walking up or downstairs.

References

National Council on Aging: https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-falls-prevention-resource-center/falls-prevention-awareness-week

Journal Of the American Medical Association: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783628

What does nearly 40 years of a fire career look like? Hear the story of Chief Mark Romer and his self-reflection of how mental wellness has changed in the fire service – and in his own life.

In this week’s episode of the EMS Handoff, Eric takes the lead as David took the week off. Eric and Bradley are joined in the EMS Handoff Studio to discuss the process of delayed sequence intubation. This spirited discussion, which may have a little heckling of David, includes the current evidence in airway management, especially when using medication to support the process. Tune in and see what you think. 

Scot Phelps and Maria talk about the Elijah McClain indictment against three police officers and two paramedics.

The People of the State of Colorado vs.

https://www.pwwemslaw.com/sites/default/files/elijah-mcclain-grand-jury-indictment.pdf

Legal analysis: What the paramedic criminal charges in the Elijah McClain case mean for EMS

Hamilton, Ontario: Conviction of paramedics following the death of Yosif Al-Hasnawi

R. V. Christopher Marchant and Steven Snively, 2021 ONSC 3901 (CanLII)

2 paramedics found guilty in death of Hamilton teen Yosif Al-Hasnawi

Why the conviction of 2 Hamilton paramedics in Yosif Al-Hasnawi's death may change health care

"We don't have any options." - Brian Schaeffer

This week, Eric, Bradley and David welcome the Disaster Preparedness committee to celebrate National Disaster Preparedness Month. This conversation begins with the work of the Disaster Preparedness Committee and then moves into discussion of preparedness of the practitioner. 

Guests on the show: Anthony Scott, Debra Bell, William Tatum, Brian Schaeffer, Allison Knox

* EMS in disaster management

* Who pays for disaster preparedness

* ESF #8

* Disaster within a Disaster

* When the annexes run dry

* Practitioner preparedness

* Emergency equipment and ziploc bags

* Joining the NAEMT disaster preparedness committee

* FEMA IS - 520 Continuity of Operations Planning for Pandemic

* www.emergency.cdc.gov

U.S. Army Soldier Tony Cota started his first day of basic training on Sept. 11, 2001. Hear from a soldier's perspective of the impact of wartime and coming home with moral injuries and traumatic images. Cota entered the fire service and found the strength to attend the IAFF Center of Excellence where he was able to put his mental wellness first. "When I felt like everything was coming down on me at once, those were the worst times and I felt like I just can't do it anymore," he said. 

This week, Bradley, Eric and David come together for a conversation over a case study. In this case, study we take a look at the treatment and transportation of a 56 year old who is complaining of chest pain; and subsequent 12-lead confirms that. Would you administer the nitroglycerin or hold for another treatment?

References

Prehospital Nitroglycerin Safety in Inferior ST Elevation Myocardial Infarction

https://pubmed.ncbi.nlm.nih.gov/26024432/

• NTG administration to patients with chest pain and inferior STEMI is not associated with a higher rate of hypotension compared to patients with STEMI in other territories.

The Era of Reperfusion

https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-172

 JEMS

https://www.jems.com/training-videos/nitro-in-an-inferior-mi/

Inferior Wall Acute Myocardial Infarction: Not as Preload Dependent as Once Thought?

https://www.researchgate.net/publication/312102992_Inferior_Wall_Acute_Myocardial_Infarction_Not_as_Preload_Dependent_as_Once_Thought

https://pubmed.ncbi.nlm.nih.gov/28089058/

Effect of early treatment with anti-hypertensive drugs on short and long-term mortality in patients with an acute cardiovascular event

https://pubmed.ncbi.nlm.nih.gov/19821384/

On this week’s episode of The EMS Handoff, Tennessee EMS Medical Director Dr. Joe Holley, and Dr. Todd Heffern, emergency department director, EMS medical director and president of the Tennessee Chapter of the National Association of EMS Physicians, discuss the role of the EMS physician medical director in 2021 and beyond. 

* The "Active" Medical Director

* ASEP Position Statement

* NAEMSP Position Statement

* Pilot programs and new drugs

* Sparse data and medical decisions

* Medical director as conscience of EMS agency

* It's tough to a CQI process

* Top errors in EMS

* Most important approach for ANYONE in the field

* Abnormalities and notation

* Paint the picture of your decision making

* Difference between a clinician and technician

* Acronym courses as continuing education

* Bringing training from Okay to Great

* Patient Outcomes vs. Administrative Outcomes

"Nothing is done as an individual, not fighting and not dealing with trauma, life, war.... nothing." - John Spencer, U.S. Army Major (Ret.)

Retired U.S. Army Major John Spencer shares his story on his journey through war, family dynamics and his own perspectives of what "strength" means. Spencer has a book coming out that is referenced in the podcast in Spring 2022 called "Connected Soldiers; Life, Leadership, and Social Connections in Modern War."

This week, Bradley and David take a look at body cam footage and a presentation that was put out by the Sheriff of San Diego County, California, after a recent incident in which a deputy was face-to-face with a powder substance and suffered a medical emergency.

This video has received publicity on both sides of the conversation. With limited information, we recognize the actions of the partner who went into immediate action for his partner, as well as the attempts to develop material that will help officers everywhere.  What are your thoughts?