In 2017, the AHA produced new guidelines for LVAD patients and other patients with mechanical circulatory support including total artificial hearts. SNGH has since updated their guidelines to reflect the changes. Please review the new flowsheet for EMS care and treatment as there are some changes including the provision of...
Sepsis-What is it?
Sepsis is defined as a systemic reaction to an infection. As you fight the infection in your lungs, bladder, or leg, your immune system reacts by activating white blood cells and antibodies to attack locally. At some point, in some cases, the inflammatory response becomes systemic which initiates a...
Miosis Differential Diagnosis-Causes other than Opiates
There are numerous reasons why pupils may be too small, too big, or inconsistent with each other. Today, we will mention a few causes of miosis or pinpoint pupils. If you search the internet, you can find numerous mnemonics that may help (“CPR ON SLIME” is even one!). The...
How to Elite: Advanced Airway Documentation Tips
Documentation tips: Ensure you list every procedure that was performed/used for the patient including BLS procedures and equipment. Each intubation attempt should be listed separately if you restarted bagging or another provider attempts. If you insert the blade into the mouth, remove, and reinsert, that is two attempts but...
Definition of Intubation Attempt and Difficult Airway/Intubation Changes
Effective on August 1, 2018, the definition of an intubation attempt is changing. In addition, VBEMS is redefining attempt counts and difficult intubation. These changes were submitted by the Medical Operations Review Board and approved by both the OMD and department leadership. The definitions were revised to be in...
Chest Pain and Aspirin-It is Really Important!
While looking at cases with a primary provider impression of “CV-Chest pain (cardiac, angina, non-STEMI)” and the three “CV-Chest Pain (STEMI) of xxxxx” versions, it is noted that many of these patients are not receiving aspirin by EMS. Review Aspirin is not administered for pain relief in the presence...
VBEMS wins 2018 Mission: Lifeline Gold Plus Award!
On May 11, 2018, Virginia Beach EMS received the American Heart Association 2018 Mission: Lifeline GOLD PLUS EMS Recognition Award at the Virginia Heart Attack Coalition (VHAC) State Meeting in Chesterfield, Virginia. Mission: Lifeline EMS Recognition recognizes EMS systems for their role in providing timely treatment for heart attack...
STEMI Receiving Centers and Reminders
Just like a Trauma criteria patient can be taken directly to a trauma center and stroke patients are taken directly to a stroke center, a known STEMI patient should be transported directly to a STEMI Receiving Center. STEMI Receiving Centers STEMI’s can be transported to VBGH, SLH and...
CPAP Notes and Reminders
VBEMS training documents indicate the physiological benefits of CPAP are an increase in alveolar pressure, reduced work of breathing and respiratory muscle fatigue, increased intrathoracic pressure and a decreased need for intubations. To receive CPAP, patients must be 8 years old or older and contraindications include: Unable to maintain...