In this episode, Dan Rauh & Mike Boone from Heavy Lies The Helmet join me to hash out our workflows and drugs of choice for four particular scenarios you may come across.   The combative head injury patient that needs to be intubated but has five firefighters holding them down and is actively trying to rip off his collar and IV.   The septic hypotensive patient is no longer protecting their airway but also needs resuscitation prior to induction.   The snoring head bleed with a BP of 220/140   The "almost dead, but needs a tube" population (induction med?)

Moments after the heart stops the entire circulatory system finally has a chance to bring venous and arterial pressures to equilibrium. Cardiac arrest resuscitation requires the provider to have a strong mental model of physiology and the logistics to carry out a series of interventions crucial to preserving life. This class will serve not as a routine basic life support model, but as a deeper understanding and framework to guide resuscitation during your next cardiac arrest.

AI will be integrated into everything we do in medicine, perhaps sooner than we think. It will help keep our patients safe, our providers informed, and our communications connected, and change how we think about how we care for patients (if implemented correctly).  Systems like ChatGPT are only the beginning, and many companies are already working on or have already integrated with other healthcare specialties. We will see the same integration happen with EMS. While the response to this might be fear of losing our knowledge base, over-automating decision-making, cheating on tests and papers, and the like, we could adopt a very different outlook. We could view this as an opportunity to improve patient safety, offload menial work, automate documentation and communications, and always have an intelligent partner in our pockets we can bounce ideas off of.  One day, we'll wonder how we ever lived without it.

In this episode, Tyler is joined by Shaylah Montgomery to discuss decision-making, human factors, and mental shortcuts utilizing pattern detection. Shaylah is a flight nurse and paramedic for Pafford Air One and a member of the FOAMfrat team.

0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.","type":"unstyled","depth":0,"inlineStyleRanges":[],"entityRanges":[],"data":{}}],"entityMap":{},"VERSION":"9.3.6"}"> What aspects of temperature-targeted management are most important to EMS, and how should EMS guide sedation for the patient with a return of spontaneous circulation? Check out this interview w/ Dr. Leon Eydelman! The ROSC class referenced in this video can be found in FOAMfrat Studio!   Highlights   ROSC + FEVER = Bad. Trust a high temperature and question a low one.   While most EMS agencies likely do not carry propofol, it is the most commonly used sedation medication in the ED because it washes out quickly and allows for neuro eval. Benzodiazepines are associated with higher rates of ICU delirium and complications. Running levophed to counteract the vasodilation aspect of propofol. Don't have propofol; hemodynamic-dosed ketamine is a good option as well.   The sedation dose should be reduced when the shock index is > 0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.