Sugar highs and lows: Rapid recognition

Sugar highs and lows: Rapid recognition

Firemedically by Mike McEvoy

Sugar highs and lows: Rapid recognition

By Mike McEvoy


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High Altitude Illnesses - EMSWorld.com

High Altitude Illnesses - EMSWorld.com

EMS Recap: High Altitude Illnesses

BY ROBERT E. SIPPEL, MS, MAED, NREMT-P, LP

High-altitude illness is the general term encompassing the syndromes affecting people traveling to higher elevations.

Spring is here and you’re off with your friends to Colorado for as much skiing as you can get in the next nine days. Departing Houston Intercontinental at 8 a.m., arriving in Denver at 11 a.m. and heading for the lodge, you arrive at the summit of Winter Park by 1 p.m. You and your entourage have gone from near sea level to over 12,000 feet in five hours, skied half the day, eaten a hearty dinner, had a couple beers and hit the rack to dream about the next full day of alpine adventuring.

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Diabetic emergencies: Ketoacidosis

Diabetic emergencies: Ketoacidosis

Diabetic ketoacidosis (DKA) results from severe insulin deficiency and leads to the disordered metabolism of proteins, carbohydrates, and fats

By DeWayne Miller

Our flight crew was dispatched to a small local hospital for a 58 year old male with an altered level of consciousness and elevated blood sugar.

Related Feature:  When sugar turns sour: A look at pediatric DKA In conjunction with the American obesity epidemic, pediatric diabetic ketoacidosis (DKA) is on the rise.

His son had found him unresponsive on the couch and called EMS for help.

While en route to the local hospital a bedside glucose was checked reporting "high." His respiratory rate was 36 and his heart rate was in the 150s. He was slow to respond, but woke to verbal commands and was orientated to person only.

At the hospital, another bedside glucose returned "high" and he received 10 units of insulin IV. A foley catheter was inserted draining 1400 ml of urine immediately.

The flight crew arrived to find our patient’s LOC without change. Pupils were equal at 3 mm, and sluggish in response to light. Mucous membranes were dry. He had a respiratory rate of 36 breaths per minute and shallow. His lung sounds were clear and equal bilateral. An incision at his right shoulder from a surgery one week ago appeared well healed with no redness or signs of infection.

...More at the link above.

Stroke: Time is brain in delivering EMS care

Stroke: Time is brain in delivering EMS care

The sooner treatment is started, the smaller the area of permanent damage will be

by DeWayne Miller

Stroke is the third leading cause of death in the United States and one of the leading causes of long-term disability. Stroke refers to the acute neurological impairment that follows an interruption in blood supply to a specific region of the brain¹.

It is beneficial to classify strokes as either hemorrhagic or ischemic. Ischemic strokes account for 87 percent of all strokes, and treatment that can dramatically improve outcome is available for a certain subset of carefully screened patients.

Time is brain. For every minute stroke is left untreated, an estimated 1.9 million neurons are destroyed². Each hour in which treatment fails to occur, the brain loses as many neurons as it does in almost 3.6 years of normal aging.

Research data indicate that 29 percent to 65 percent of patients with signs or symptoms of acute stroke access their initial medical care via local EMS.

Also, EMS is strongly associated with decreased time to initial physician examination, initial computed tomography (CT) imaging, and initial neurological evaluation³.

All of these are important when determining which treatment modality would provide the greatest benefit for the patient. The sooner treatment is started, the smaller the area of permanent damage will be and the better the quality of life the patient will have.

...more at the link above

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Cold and hurt: Motor vehicle accidents in the winter

Cold and hurt: Motor vehicle accidents in the winter

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Support for competitive ambulance contract grows in Calif.

Support for competitive ambulance contract grows in Calif.

By Duana W. Gang
The Press Enterprise

RIVERSIDE COUNTY, Calif. — A growing number of local officials are urging Riverside County supervisors to competitively bid the county's contract for ambulance services.

Radio Ramblings: The Art of Hospital Radio Reporting

Radio Ramblings: The Art of Hospital Radio Reporting

Rural Ramblings by Jules Scadden