Pragmatic Paramedics

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Pragmatic Paramedics PragMed is a podcast and IG page for EBM and information relevant to EMS professionals.
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In this episode, Aaron and Jason sit down with James Boomhower (Boomer) from StayFit4Duty and talk about mental health a...
10/06/2024

In this episode, Aaron and Jason sit down with James Boomhower (Boomer) from StayFit4Duty and talk about mental health and resources for first reponders. Boomer has been involved in EMS for over 20 years in a variety of health systems throughout New England. He currently functions in the role of Critical Care Transport Specialist-Paramedic/ Lead Peer Support Director and is working on obtaining his Masters in clinical psychology.

We discuss the different aspects of mental health, what signs to look for when someone or yourself needs mental health help, and organizations that can help first responders with improving their mental health. Boomer has been a great advocate for improving first responders mental health and is passionate in helping those that need help. Check out the episde and remember that it is okay to not be okay!

Boomer can be found on Instagram and his website is a great resource for those looking for help improving their mental health. If you are looking for a provider or someone to talk too, check out 988 Su***de and Crisis Lifeline.

Follow the PragMedics on Instagram, Facebook, and Twitter. http://pragmaticparamedics.libsyn.com/pragchat-mental-health-with-boomer?tdest_id=3889197

In this episode, Aaron and Jason sit down with Mustafa, Josh and Ken from Alert Medic 1. We discussed the interview they...
21/05/2024

In this episode, Aaron and Jason sit down with Mustafa, Josh and Ken from Alert Medic 1. We discussed the interview they had with the oncoming NAEMT President-Elect Chris Wray. The discussion covered our differing views on education, pay, reimbursement, and our feelings about the NAEMT. There was also an indepth discussion on the Advanced Paramedic Practioner concept as well. We had a great time with Alert Medic 1 crew and they are throughtful, intelligent medics who are willing to have professional conversations. Check out the episode and let us know your thoughts!

Please give the Alert Medic 1 crew a like on IG, Twitter, and check out their podcast. They cover a wide range of topics and have some great and interesting guests.

Follow the PragMedics on Instagram, Facebook, and Twitter.

EMS Advocacy, the Paramedic Practitioner Controversy, and other Topics in EMS w/ Christopher Way, President-Elect, NAEMT Podcast Episode:
https://podcasts.apple.com/us/podcast/ems-advocacy-the-paramedic-practitioner-controversy/id1465198214?i=1000652348045 http://pragmaticparamedics.libsyn.com/pragchat-with-alert-medic-1-about-naemt-interview?tdest_id=3889197

In this episode, Aaron and Jason sit down with Sam, the PrepMedic. Sam is a current flight medic, has a popular YouTube ...
17/04/2024

In this episode, Aaron and Jason sit down with Sam, the PrepMedic. Sam is a current flight medic, has a popular YouTube channel, and is the PrepMedic. We discuss scene times and why they are important, education, and other topics in this episode. Sam brings a ton of different, life experience and thought into this conversation that shows why our profession is extremely nuanced. This is a great episode that presents the topic in a way that is not frequently discussed and hopefully gets you to reevaluate your position on not only scene times but our delivery of patient care.

Sam has a wealth of information on his YouTube page and check it out if you want to get informative, entertaining education. He is also on Instagram and Facebook. Go give him some love and check out his content, it will definitely be worth your time!

Follow the PragMedics on Instagram, Facebook, and Twitter. http://pragmaticparamedics.libsyn.com/pragchat-scene-times-with-the-prepmedic?tdest_id=3889197

In this episode, Aaron and Jason sit down with Nick Nudell from the American Paramedic Association and discuss EMS educa...
08/04/2024

In this episode, Aaron and Jason sit down with Nick Nudell from the American Paramedic Association and discuss EMS education. Nick is a current paramedic, a Ph.D student, and a founder of the only advocacy group that is made up of paramedics. We chat about the different ways the APA advocates for paramedics and the ways that we can improve the current education model. This is a lively discussion with a variety of ideas discussed and what the model may look like in the future. http://pragmaticparamedics.libsyn.com/pragchat-about-education-with-the-apa?tdest_id=3889197

AbstractBackground The ‘Golden Hour’ emphasizes the importance of rapidly providing definitive care to trauma patients. ...
29/03/2024

Abstract

Background The ‘Golden Hour’ emphasizes the importance of rapidly providing definitive care to trauma patients. Dispatch time, defined as the time it takes the Helicopter Emergency Medical Service (HEMS) to dispatch from their base and reach the patient, and on-scene time, defined as the time spent with the patient prior to departure to a trauma center, can impact how quickly the patient will reach definitive care. We evaluated HEMS dispatch and on-scene times by investigating the survival rates among patients transported by air to a level 1 trauma center. We hypothesize that longer HEMS dispatch and on-scene times are associated with worse patient outcomes.

Methods A retrospective, single institution analysis was performed on patients transported by HEMS. Inclusion criteria were air transported patients aged 18 years and above admitted to a level 1 trauma center from January 1, 2005 to January 1, 2015. Total dispatch time and on-scene times were divided into five incremental groups and mortality data were analyzed. Mortality was defined as death during initial hospital admission. A Pearson’s correlation was used to analyze relationship between dispatch times, on-scene times, and mortality. Simple binary logistic regression was used to run a multivariate analysis on confounding variables of Injury Severity Score (ISS), gender, age, and Glasgow Coma Scale.

Results There was a strong positive linear correlation between HEMS on-scene time and mortality, R=0.962, p=0.038. Additionally, there was a positive trend between HEMS dispatch time and mortality. ISS was found to be a significant confounder of mortality in our cohort with on-scene times >20 min, with mortality increasing by 7.5% for every 0.1 increase in ISS score (p=0.01).

Conclusion Longer HEMS on-scene and dispatch times appeared to be associated with increased mortality in trauma patients. However, those with higher ISS require longer on-scene times, increasing mortality. Regardless, efforts should focus on reducing on-scene and dispatch times.

Level of evidence and study type Level III; Therapeutic/Care Management.

Scary situation in Baltimore. Prayers to all those affected by this tragic incident. Thoughts to the safety of those res...
26/03/2024

Scary situation in Baltimore. Prayers to all those affected by this tragic incident. Thoughts to the safety of those responding and providing care.

In this episode of PragChat, Aaron and Jason sit down with Dr. Schauer () to discuss research papers and his thoughts on...
11/03/2024

In this episode of PragChat, Aaron and Jason sit down with Dr. Schauer () to discuss research papers and his thoughts on some trauma topics. Understanding research and how to interpret research papers is valuable to improving our practices and Dr. Shauer does a great job of breaking down how to interpret data and research. Dr. Schauer also discusses some trauma topics as well that is backed up by evidence based medicine.

This was one of the most informative episodes on how to effectively evaluate research, that is constantly evolving, and implement that knowledge into your current practice. Dr. Schauer gives a master class on how to understand and evaluate research and we truly enjoyed discussing these topics with him!

Thanks to Dr. Schauer for taking time out of his busy schedule to talk with us and if you’re not following him, check out his Instagram. Also check out his Twitter and YouTube page that he is constantly updating with new information and videos.

Follow the PragMedics on Instagram and Twitter. http://pragmaticparamedics.libsyn.com/pragchat-with-dr-schauerarmyemdoc?tdest_id=3889197

n this episode of PragChat, Aaron and Jason sit down again with  and discuss IV's. Dennis is an interventional vascular ...
26/02/2024

n this episode of PragChat, Aaron and Jason sit down again with and discuss IV's. Dennis is an interventional vascular access RN and comes to the show with a wealth of valuable information concerning IV access. We discuss a variety of topics that include psychology of starting IVs, best practices, and variety of additional topics.

We had a blast talking with Dennis again and he is a great guest with lots of applicable knowledge. We know he is a RN but he is a friend to EMS and if you want to better your patient care, check this episode out and start with improving how you gain access to your patients.

Thanks to Dennis for taking time out of his busy schedule to talk with us and if you’re not following him, check out his Instagram and TikTok. Also check out his Twitter and YouTube page that has videos on how different ways to obtain vascular access.

Follow the PragMedics on Instagram and Twitter. http://pragmaticparamedics.libsyn.com/pragchat-ivs-with-the-vascular-guy-part-2?tdest_id=3889197

AbstractIntroductionPelvic fractures are serious and oftentimes require immediate medical attention. Pelvic binders have...
12/02/2024

Abstract
Introduction
Pelvic fractures are serious and oftentimes require immediate medical attention. Pelvic binders have become a critical tool in the management of pelvic injuries, especially in the prehospital setting. Proper application of the pelvic binder is essential to achieve the desired result. This study evaluates the effectiveness of prehospitally applied pelvic binders in improving outcomes for patients with pelvic fractures.

Methods
This retrospective cohort study analyzed 66 patients with unstable pelvic ring fracture classified as AO61B or 61C, who were treated at a Level I hospital in the emergency room between January 2014 and December 2018. The ideal position for a pelvic binder was determined, and patients were divided into three sub-groups based on whether they received a pelvic binder in the ideal position, outside the optimal range, or not at all. The primary outcome measure was the survival rate of the patients.

In this episode of PragChat, Aaron and Jason sit down with  and discuss IV's. Dennis is an interventional vascular acces...
05/02/2024

In this episode of PragChat, Aaron and Jason sit down with and discuss IV's. Dennis is an interventional vascular access RN and comes to the show with a wealth of valuable information concerning IV access. We discuss a variety of topics that include ED and EMS relationships, why IV's are important, selecting the best catheter, and other topics.

We had a blast talking with Dennis and this is only Part 1 since we barely touched on all the topics we wanted to chat with him about. We know he is a RN but he is a friend to EMS and if you want to better your patient care, check this episode out and start with improving how you gain access to your patients.

Thanks to Dennis for taking time out of his busy schedule to talk with us and if you’re not following him, check out his Instagram and TikTok. Also check out his Twitter and YouTube page that has videos on how different ways to obtain vascular access.

Follow the PragMedics on Instagram and Twitter. http://pragmaticparamedics.libsyn.com/pragchat-ivs-with-the-vascular-guy-part-1?tdest_id=3889197

The last time we discussed “just in case IVs” I got a few people who made it clear that starting IVs isn’t for the patie...
04/02/2024

The last time we discussed “just in case IVs” I got a few people who made it clear that starting IVs isn’t for the patient. It’s to make the life of the nurse easier - because “we are all one team”.

There’s one glaring issue with that theory. We don’t do any of this for each other. Patient care is for the patient and if the intervention you’re performing isn’t for the patient and instead to appease a nurse or because it’ll make the life of a nurse easier a couple hours down the road. Then you should probably rethink that intervention.

IVs like most things have consequences- and some of those consequences can be detrimental to the patient. Even if you think it’s in good faith. Not to mention the damn thing may not even work when it’s time to use it. If that time comes.

A just in case IV in my opinion is a little different than an IV being place because you understand that this patient will definitely need something soon.

Like a massive transfusion- if you’re not carrying blood and you have a trauma patient that will more likely than not get blood - I see that as an OKAY indicator for an IV.

I’ve been wrong before. And will be again. But I’d like to hear your thoughts.

Also BOLO for an episode drop tomorrow with our homie the talk all things IV access. It’s a good episode. Trust me

The FDNY has ordered all firetruck and ambulance personnel to mask up while rendering patient care due to outbreaks of i...
14/01/2024

The FDNY has ordered all firetruck and ambulance personnel to mask up while rendering patient care due to outbreaks of infectious diseases, The Post has learned.

The department-wide directive, issued Friday, comes amid an increase in COVID-19, flu and respiratory virus cases, officials said.

Effective immediately, all those who provide pre-hospital emergency treatment in NYC must wear a surgical mask, preferably an N95.

The FDNY last required masks during the COVID-19 pandemic in early 2020, but relaxed the rule last February after state health officials stopped mandating masks and face coverings inside health care facilities.

Thanks

It’s absurdly long and when done correctly time consuming. Not saying you shouldn’t take it. But instead take it on a co...
09/01/2024

It’s absurdly long and when done correctly time consuming. Not saying you shouldn’t take it. But instead take it on a computer screen when you have more than 20 minutes to spare.

AimsThe PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with...
06/01/2024

Aims
The PARAMEDIC-3 trial evaluates the clinical and cost-effectiveness of an intraosseous first strategy, compared with an intravenous first strategy, for drug administration in adults who have sustained an out-of-hospital cardiac arrest.

Methods
PARAMEDIC-3 is a pragmatic, allocation concealed, open-label, multi-centre, superiority randomised controlled trial. It will recruit 15,000 patients across English and Welsh ambulance services. Adults who have sustained an out-of-hospital cardiac arrest are individually randomised to an intraosseous access first strategy or intravenous access first strategy in a 1:1 ratio through an opaque, sealed envelope system. The randomised allocation determines the route used for the first two attempts at vascular access. Participants are initially enrolled under a deferred consent model.

The primary clinical-effectiveness outcome is survival at 30-days. Secondary outcomes include return of spontaneous circulation, neurological functional outcome, and health-related quality of life. Participants are followed-up to six-months following cardiac arrest. The primary health economic outcome is incremental cost per quality-adjusted life year gained.

Conclusion
The PARAMEDIC-3 trial will provide key information on the clinical and cost-effectiveness of drug route in out-of-hospital cardiac arrest.

Prehospital Noninvasive Ventilation: An NAEMSP Position Statement and Resource DocumentNoninvasive ventilation (NIV), in...
05/01/2024

Prehospital Noninvasive Ventilation: An NAEMSP Position Statement and Resource Document

Noninvasive ventilation (NIV), including bilevel positive airway pressure and continuous positive airway pressure, is a safe and important therapeutic option in the management of prehospital respiratory distress.

NAEMSP recommends:

NIV should be used in the management of prehospital patients with respiratory failure, such as those with chronic obstructive pulmonary disease, asthma, and pulmonary edema.

NIV is a safe intervention for use by Emergency Medical Technicians.

Medical directors must assure adequate training in NIV, including appropriate patient selection, NIV system operation, administration of adjunctive medications, and assessment of clinical response.

Medical directors must implement quality assessment and improvement programs to assure optimal application of and outcomes from NIV.

Novel NIV methods such as high-flow nasal cannula and helmet ventilation may have a role in prehospital care.

Also. You have protocols for a reason. Just saying. If it recommends using it. Why are you not asking the question to your educator or medical director and leaving it to Reddit to determine your treatment.

GREENSBORO, Guilford County EMS officials say they respond to over 200 calls a day, but there is one that will forever s...
04/01/2024

GREENSBORO, Guilford County EMS officials say they respond to over 200 calls a day, but there is one that will forever stick with them. 
On Saturday, Greensboro Police Sergeant Philip Dale Nix was shot and killed after trying to stop a crime from happening at a Sheetz gas station. 

Coincidently, a Guilford County Paramedic was at the scene and responded along with other emergency services personnel.
GCEMS PIO Scott Muthersbaugh, said when tragic situations happen like this, there are plans in place to help those on the call to cope.

“We’ve got peer support network in our services, so a lot of times in situations like this, that team will reach out and ask what they need and also that team will reach out to the people on the call that day to see what they may need. That’s where we really jump in and keep our providers both physically and mentally healthy,” Muthersbaugh said. 

Muthersbaugh said all six emergency personnel are continuing to work despite what has recently happened. However, Muthersbaugh said it has been an adjustment for the first responder community.

According to city data, Austin-Travis County EMS saw a decline in response times last year.Comparing December of 2022, t...
03/01/2024

According to city data, Austin-Travis County EMS saw a decline in response times last year.

Comparing December of 2022, to December of 2023, ATCEMS saw a 5% decrease in on-time responses in Austin and Travis County combined.

“I absolutely think that our longer response times are due to our staffing shortage,” said Selena Xie, Austin Travis County EMS Association President. “On some days we have shut down up to ten ambulances, and that means that we have fewer ambulances to run more calls. So of course, our response times are going to be longer.”

After the pandemic, emergency medical responders across the nation saw a spike in staff vacancies, and experts say we’re still facing those effects today. But here in Austin, Xie said the reasoning is dollars and cents.

“What are the other barriers to get people here? At first, it was wages, and what we’re hearing now is that, these people who are [applying, are] coming from very low-wage jobs. Yes, our wages are fine, but we can’t get people to move here because they literally cannot afford to do so,” she said.

With the cost of living in Austin at an all-time high, Xie said they’re calling on the City of Austin to help, “We are asking Council to think about hiring bonuses or relocation bonuses.”

She added, “We talked to a lot of our union counterparts and some of them have raised their wages to about the same as Austin, but they live in places where the cost of living is so much lower. So comparatively, it’s a much more attractive place to work outside of Austin.”

Council Member Mackenzie Kelly said she’s drafting a plan that could help. “I authored a resolution that is moving through the process in our legislation related to cadet housing, that would work for police, fire, and EMS, and it would help EMS workers get their feet on the ground and save up some money while they’re a cadet,” she said.

LAUREL Miss. (WDAM) - A 30-year-old emergency medical technician was struck and died Saturday at the scene of a traffic ...
02/01/2024

LAUREL Miss. (WDAM) - A 30-year-old emergency medical technician was struck and died Saturday at the scene of a traffic accident in Mobile, Alabama, that her ambulance crew just had happened upon and stopped to volunteer assistance.

A release from Laurel-based ASAP EMS Sunday said that EMT Mary “Katie” Pipkins had been attending to one of the accident’s injured when both were struck by another vehicle.

The Mobile Police Department told WALA-TV that fatal collision occurred at an earlier accident site, westbound on Moffett Road near Shelton Beach Road.

ASAP EMS said that Pipkins and her crew were returning to Mississippi from transporting a patient to Mobile and came upon the accident.

Shortly after, another vehicle, operated by Michael Thomas, 35, struck both the female driver of one of the vehicles and Pipkins.

Pipkins was pronounced at the scene.

The 28-year-old driver sustained non-life-threatening injuries and was subsequently taken to the hospital.

MPD said Thomas exhibited signs of impairment and was taken into custody.

Michael Thomas faces charges of manslaughter, assault and felony driving under the influence...
Michael Thomas faces charges of manslaughter, assault and felony driving under the influence in the death of an EMT Saturday.(WALA-TV)
Thomas was charged with manslaughter, assault and felony driving under the influence.

The case remains an ongoing investigation.

ASAP EMS Operations Manager Rusty Hembree said Pipkins’ loss was a blow.

“Miss Pipkins was a hero in every way,” Hembree said in the release. “Miss Pipkins set a standard in EMS for others to follow. Her love and compassion knew no bounds.

“ ... Rest easy, Katie. We have the watch from here.”

A dangerous precedent is fire/medics not performing a basic assessment, listening to PD for medical orders, administerin...
23/12/2023

A dangerous precedent is fire/medics not performing a basic assessment, listening to PD for medical orders, administering a medication based on small medium and large, and being a poor patient advocate.

23/12/2023
She isn’t wrong…
22/12/2023

She isn’t wrong…

Medics on trial for manslaughter- this is something that has the potential to set new legal precedents.
26/11/2023

Medics on trial for manslaughter- this is something that has the potential to set new legal precedents.

.dodge83
16/11/2023

.dodge83

Thank you to all who have served.
11/11/2023

Thank you to all who have served.

10/11/2023
 for the article. One of the interdisciplinary roles in EMS that frequently is considered a position that should have mo...
08/11/2023

for the article.

One of the interdisciplinary roles in EMS that frequently is considered a position that should have more education requirements, are community paramedics. Which just so happens to be one that requires us as clinicians to think proactively.

Far from the comfort of the back of an ambulance that you not only have standing orders for but also a plan B - that’s an accepted plan B.

For instance, the goal of most CP programs are to reduce ED visits and in a traditional role it’s expected to transport.

CP medics are attempting to avoid the ED which means it’s frowned upon by many when we take our patients to the ED or call for a truck.

The role of community paramedics varies but I think it’s one that should have a degree requirement?

How about you?

Just so everyone knows I hate everyone equally…
03/11/2023

Just so everyone knows I hate everyone equally…

It’ll happen again because that’s how it goes. Let’s just say I’ve seen enough to make an informed investment. Things to...
26/10/2023

It’ll happen again because that’s how it goes.

Let’s just say I’ve seen enough to make an informed investment.

Things to invest in:

Rip it energy drinks

Otis Spunkmeyer

Port A Potty manufacturers

US Mail

Boost Mobile

Legal Zoom (anyone who recently was married)

These are my top investments

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