Drive-thru continuing education to meet learners' needs.

Background: Continuing education is a requirement for emergency medical services practitioners in Ohio, and simulation-based learning has been effective for this purpose. Limitations to providing simulation for emergency medical services practitioners include a lack of simulation resources or equipment and a lack of trained simulationists to adequately use existing equipment, such as high-fidelity manikins. Here, we sought to provide simulation-based learning in the ambulance bays of our local hospitals to meet these needs.

Teaching about the Wild: A Survival Course as a Novel Resident Educational Experience.

Audience: Emergency medicine residents.

Introduction: Wilderness medicine (WM) is the practice of resource-limited medicine under austere conditions. Emergency physicians in training should gain additional exposure to wilderness medicine knowledge and outdoor skills to allow for the development of problem solving and improvisation abilities.

A Step in the Right Direction: Point-of-Care Ultrasound as an Evaluation Tool of Achilles Tendon Injuries in the Emergency Department.

This report describes the diagnosis of an Achilles tendon tear in a female patient with an inconclusive physical exam, which was limited by the patient's body habitus. Expedient use of point-of-care ultrasound supported the diagnosis of an Achilles tear with findings of a tendinous defect, fibrous stranding, and surrounding anechoic fluid, suggestive of localized hemorrhage. The patient was splinted in plantar flexion and had prompt orthopedic referral with MRI that verified Achilles tear.

Sex, Drugs, and Seizures: Subarachnoid Hemorrhage in a Young Patient.

A 17-year-old male patient presented to the emergency department (ED) with seizures after sexual intercourse. The patient was found to have an intracerebral hemorrhage (ICH) likely secondary to sexual intercourse and concomitant amphetamine use, an extremely rare finding in this patient population. In this case review, we will discuss the presentation, management, and disposition of subarachnoid hemorrhage (SAH), a well-known emergency diagnosis within the ED, while highlighting a case that is clearly uncommon.

Administration of Naloxone by Prehospital Personnel: A Retrospective Analysis.

Introduction Patient-specific discrepancies in prehospital naloxone administration have been documented. As the opioid epidemic continues to evolve, further evaluation of prehospital naloxone administration practices is needed. The objective of this study was to compare patients who received prehospital naloxone and received an emergency department (ED) diagnosis of opioid overdose with patients who received prehospital naloxone and received an alternative ED diagnosis.

Curated Collections for Clinician Educators: Five Key Papers on Graduated Responsibility in Residency Education.

Introduction The Accreditation Council for Graduate Medical Education calls graduated responsibility "one of the core tenets of American graduate medical education." However, there is no clear set of resources for programs to implement a system of progressively increasing responsibilities for trainees. This project aimed to identify a set of high-yield papers on graduated responsibility for junior faculty members.

Prehospital Stroke Assessment for Large Vessel Occlusions: A Systematic Review.

Background And Objective: Stroke is the leading cause of disability in the United States and new evidence shows interventional procedures provide better outcomes for large vessel occlusions (LVO). We performed a systematic review of the literature on prehospital stroke scales used to identify LVOs comparing the scales with analysis of the sensitivity, specificity, and predictive values. The goal was to determine if emergency medical services (EMS) are able to accurately identify LVO in the field.

The Effect of Ambulance Staffing Models in a Metropolitan, Fire-Based EMS System.

Unlabelled: Introduction The staffing of ambulances with different levels of Emergency Medical Service (EMS) providers is a difficult decision with evidence being mixed on the benefit of each model. Hypothesis/Problem The objective of this study was to describe a pilot program evaluating alternative staffing on two ambulances utilizing the paramedic-basic (PB) model (staffed with one paramedic and one emergency medical technician[EMT]).

Methods: This was a retrospective study conducted from September 17, 2013 through December 31, 2013.

Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest.

Introduction: Survival from out of hospital cardiac arrest (OHCA) is highest in victims with shockable rhythms when early CPR and rapid defibrillation are provided. However, a subset of individuals present with ventricular fibrillation (VF) that does not respond to defibrillation (refractory VF). One intervention that may be a possible option in refractory VF is double sequential external defibrillation (DSD).

Clinical Outcomes in Cardiac Arrest Patients Following Prehospital Treatment with Therapeutic Hypothermia.

Introduction: Recent studies have brought to question the efficacy of the use of prehospital therapeutic hypothermia for victims of out-of-hospital cardiac arrest (OHCA). Though guidelines recommend therapeutic hypothermia as a critical link in the chain of survival, the safety of this intervention, with the possibility of minimal treatment benefit, becomes important. Hypothesis/Problem This study examined prehospital therapeutic hypothermia for OHCA, its association with survival, and its complication profile in a large, metropolitan, fire-based Emergency Medical Services (EMS) system, where bystander cardiopulmonary resuscitation (CPR) and post-arrest care are in the process of being optimized.

Supraventricular Tachycardia Cardioverted by an Automated External Debrillator in a 9-year-old Male with a History of Wolff-Parkinson-White Syndrome.

Early defibrillation for cardiac arrest patients is a formidable link in the chain of survival promulgated by the American Heart Association. Automated external defibrillators (AEDs) provide public access defibrillation for out-of-hospital cardiac arrests and improve survivability. AEDs are only approved for use in patients in cardiac arrest; defibrillation may be inadvertently advised if utilized on a patient not experiencing cardiac arrest.

The ultrasound challenge 2.0: introducing interinstitutional competition in medical student ultrasound education.

The Ultrasound Challenge was developed at The Ohio State University College of Medicine to introduce focused ultrasound to medical students. The goal was to develop experience in ultrasound through practice and competition. Initially this competition was held between Ohio State University College of Medicine students from years 1 through 4.

The Use of Prehospital Ketamine for Control of Agitation in a Metropolitan Firefighter-based EMS System.

Abstract Introduction. Prehospital personnel frequently encounter agitated, combative, and intoxicated patients in the field. In recent years, ketamine has been described as an effective sedative agent to treat such patients; however, a paucity of research exists describing the use of prehospital ketamine.

High-dose insulin and intravenous lipid emulsion therapy for cardiogenic shock induced by intentional calcium-channel blocker and Beta-blocker overdose: a case series.

Background: Recently, high-dose insulin (HDI) and intravenous lipid emulsion (ILE) have emerged as treatment options for severe toxicity from calcium-channel blocker (CCB) and beta blocker (BB).

Objective: Our aim was to describe the use and effectiveness of HDI and ILE for the treatment of CCB and BB overdose.

Case Reports: We describe 2 patients presenting to the emergency department after intentional ingestions of CCBs and BBs.

The ultrasound challenge: a novel approach to medical student ultrasound education.

Undergraduate ultrasound education is becoming increasingly important to medical student development; as a result, innovative training methods are being designed and implemented. The Ultrasound Challenge was created to help students learn core ultrasound techniques and apply them in a friendly competition where they showcase their abilities. The Ultrasound Challenge consisted of 6 events: focused assessment with sonography for trauma, cardiac ultrasound, aortic ultrasound, pelvic ultrasound, vascular access, and musculoskeletal ultrasound.

Ban Tu Wan hepatotoxicity.

Medications are thought to contribute to approximately 50% of the cases of acute liver failure in the USA. This number includes some herbal medications and supplements. However, little regulatory oversight of these later substances occurs.