Traumatic cardiac arrest (paramedic prehospital) There are many ways to become pulseless and without signs of life. Whilst the end result might appear the same, all pathways to get there are not the same. Consistent with that, if the pathway […]
Continue ReadingA pain in the guts Paramedic prehospital ambulance abdominal pain Ask yourself, honestly, is attending to a callout for ‘adult patient complaining of abdominal pain’ anywhere near your top ten of ‘let’s go partner’? Maybe not quite in the basement […]
Continue ReadingAcute spinal cord injury vital signs Having determined that a patient cannot be prehospital cleared from suspicion of spinal injury, we have to think about the other vital sign changes that might be present. Some of these will be slightly […]
Continue ReadingAcute spinal injury movement and transport Having determined that a patient cannot be prehospital cleared from suspicion of spinal injury, we have to provide effective spinal care until ED arrival. Primary SCI happens at the time of trauma and not […]
Continue ReadingAcute Prehospital Spinal Injury Assessment and Clearance Spinal injuries are divisible into two categories: spinal column (bones, muscles, ligaments) and spinal cord (the CNS part). When thinking spinal injury, think whole of spine. Most responders talk about cervical collar and […]
Continue ReadingOne prehospital pain and analgesia strategy Pain is one of the most frequent complaints amongst the patients we attend as paramedics. In managing pain, the intention for paramedics always is to exercise clinical judgement. Patients with serious pain will probably […]
Continue ReadingSedate or not to sedate, that is the prehospital question You are attending to an elderly man who has dementia. He is in an aged care residence and, looking at him, doesn’t have much of the muscle strength he may […]
Continue ReadingHow does AVPU work? Conscious state is a fundamental part of the vital sign assessment. Unlike perfusion, there are no parameters that are directly measurable in an objective way. Rather, conscious state is assessed through interpretation of what is observed […]
Continue ReadingCOPD and oxygen administration for emergency paramedics For many years, the management of COPD patients was governed by the hypoxic drive theory. Patients who were administered high flow supplemental oxygen therapy during acute illness frequently deteriorated by becoming increasingly acidotic […]
Continue ReadingAnaphylaxis prehospital emergency: management You have assessed the patient and found them to be an acute allergic reaction. Worse, they have systemic signs and symptoms that have increased the provisional working diagnosis to be anaphylaxis. A management plan has to […]
Continue ReadingAnaphylaxis prehospital emergency: recognition You find yourself attending a twenty year old woman presenting with what appears to be an allergic reaction. She has a very itchy rash over her chest and arms with a few welts visible. Her face […]
Continue ReadingGHB illicit drug overdose for pre-hospital responders You find yourself in a bedroom at the back of a house where a young man is supine on the bed. A quick initial assessment finds the man to be unresponsive to shaking and loudly […]
Continue ReadingThe severe headache emergency – part 3 The patient we are attending is complaining of a severe headache and photophobia. She does not have fever or signs of meningism. The two major threats of subarachnoid haemorrhage and meningitis are possible causes […]
Continue ReadingThe severe headache emergency – part 2 So you have been called to attend to a young lady complaining of severe headache. She has photophobia and is lying in bed in her darkened room. She has a history of migraine and […]
Continue ReadingThe severe headache emergency – part one “A patient with a severe headache….,” the dispatcher goes on but you have heard enough. You frown to your partner. You were hoping that the good luck could have brought you something a […]
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