A short little episode in which Viv talks about Abdominal Pain & Assessment in the prehospital setting.

Join @stevefla for Decembers episode on Hypothermia.    see the emcrit blog post on hypothermia for more information on the stages and effects of hypothermia.  https://emcrit.org/ibcc/hypothermia/

Part 2 of this month's episode has focused on the mental health and support available to the First responder. Steve chats to Dr. Ann Payne about Acute stress disorder and when to seek help. Also Steve speaks with Brian Doyle from www.hugsathome.eu who talks about CISM in Dublin Fire brigade and how his experience there led to the Hugs at Home project funded by the Movember Charity. Brian and the rest of the team are actively recruiting participants in this interesting project to help first responders and their families during times of Acute stress.  For further information and to sign up check them out at www.hugsathome.eu

This Month's Episode for International Mental Health Month @stevefla sits down with Dr. Ann Payne, Consultant Psychiatrist to chat about mental health patients.    We discuss some of the different presentations, bust some myths and discuss how to assess risk in a patient presenting with a mental health disorder.  Show notes for the episode were compiled by Dr. Ann Payne and are contained here   https://drive.google.com/fi/d/1yGFByWLWKvNw-ot1TSXxO0anwZw2j5ix/view?usp=drivesdkle   Steve and Ann will be back for Part 2 to discuss stress with a focus on the responder, and our mental health on the 10th of October for Global Mental Health Day.  

This month we speak  a bit about Diabetes. We speak about what it is, hyper and hypo glycaemia as well as Diabetic Keto Acidosis (DKA).

Seeing as this month,  the 25th July is International Drowning Prevention Day, we decided to record an episode on Drowning. Viv, Steve and Joe speak about this topic which claims the lives of an estimated over a quarter of a million people each year globally.   World Health Organisation Drowning Statistic 27 April 2021 https://www.who.int/news-room/fact-sheets/detail/drowning#:~:text=Drowning%20is%20the%20process%20of,death%2C%20morbidity%20and%20no%20morbidity.   Water Safety Ireland Drowning Statistics https://watersafety.ie/statistics/   Clinical staging of accidental hypothermia:The Revised Swiss SystemRecommendation of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Martin E. Musi, Alison Sheets, Ken Zafren, Hermann Brugger, Peter Paal, Natalie Ho ̈lzli, Mathieu Pasquier Elsevier, Resuscitation 162 (2021) 182-187 https://doi.org/10.1016/j.resuscitation.2021.02.038   Prehospital Emergency Care Council Clinical Practice Guidelines Advanced Paramedic 2021 Edition https://www.phecit.ie/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=oGsVrspmiT0dOhDFFXZvIz0q5GYO7igwzB6buxHEgeDBS9BbdRZpZNKt9Y89hp%252bGEhGQslpxcyoYmdTLu78H9r76oZTnilm7mlbqDvzJntWlMW756bp2Sss33aOudBIeG7u3HIUnGBWa2plxYfgV6QyPTmWeB%252ff%252bOOyImbeSBq24mcIZtwFS%252fHI1d9DL61G9QbZ9GHMdoig%253d   Tipton, M. and Montgomery, H., 2021. The experience of drowning. Medico-Legal Journal, 90(1), pp.17-26. https://journals.sagepub.com/doi/full/10.1177/00258172211053127   Bierens, J., Lunetta, P., Tipton, M. and Warner, D., 2016. Physiology Of Drowning: A Review. Physiology, 31(2), pp.147-166. https://journals.physiology.org/doi/full/10.1152/physiol.00002.2015   https://en.m.wikipedia.org/wiki/Drowning    

This month, Kevin and Joe go through Obstetrics and Gynaecology..... the call everyone in prehospital care dreads!! Hopefully, this episode will help allay the fears and answer some questions you may have about these particular patient presentations.   https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/cord-prolapse-dr-mary-higgins.pdf   https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/diagnosis-and-management-of-pre-eclampsia-and-eclampsia.pdf   https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/the-management-of-breech-presentation.pdf   https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/bacterial-infections-specific-to-pregnancy.pdf   https://www.phecit.ie/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=oGsVrspmiT0dOhDFFXZvIz0q5GYO7igwzB6buxHEgeB9tL5FzugdQXbKHyzHzwFjFTcjaJqpifn%252bFqaQC0B46%252fwB4zpUvszsXwYziwDAIyXmZfhLMFFb4wAFs2ZFOUKaiwBcIBlIm3MENn%252fCITGvaJ3EJYDnqzSWoRg4Lf2HR8Ql1ZLvEopbb9acb6hSnEuw   https://www.phecit.ie/PHECC/Clinical_Resources/Clinical_Practice_Guidelines__CPGs_/2021_edition_CPGs.aspx

We talk about poisoning and overdoses this month and how to recognise and treat those that we can in the prehospital environment. 

In this episode we go through Organised Structured Clinical Examinations, better known as OSCEs for the EMT Level. Joe speaks with PJ Commins from EMT CPC Ireland about the exams and gets a few tips for those due to sit the OSCEs. Check out EMT CPC at  http://emtcpcireland.ie/ or on their Facebook Page. 

This month we talk about Telemedicine in Ireland. Telemedical support for Ireland's Statutory Services, Defense Forces and for all vessels on our waters is provided by Medico Cork out of The Emergency Department at Cork University Hospital (CUH). Viv will be speaking with Medico Cork's Clinical Lead, Dr. Jason van der Velde about this essential service. 

In this month’s episode we are exploring major and catastrophic bleeding. Death from haemorrhages represents approximately 35% of all traumatic deaths. Lessons learned from the experiences of the military, tragic mass shootings, violent crimes and terrorist attacks, have lead to the adoption of techniques, such as tourniquets, wound packing and the use of haemostatic gauze being adopted into civilian prehospital practice. These techniques have not only been adopted by Emergency Medical Services but by civilian programmes such as “Stop the Bleed” course and the Daniel Baird Foundation’s “Control the Bleed”. In this episode our first guests, Mick and Kieran will help us explore this topic and will hopefully build confidence in Irish practitioners in the use of tourniquets and Wound packing.     References:   https://handbook.bcehs.ca/clinical-practice-guidelines/pr-clinical-procedure-guide/pr04-wound-packing/    Donley ER, Loyd JW. Hemorrhage Control. [Updated 2021 Jul 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535393/   Chitosan-based dressing for the treatment of external/accessible bleedings in children with bleeding tendency, https://pubmed.ncbi.nlm.nih.gov/23588337/   https://www.cureus.com/articles/7905-pre-hospital-hemorrhagic-control-effectiveness-of-axiostat-dressing-versus-conventional-method-in-acute-hemorrhage-due-to-trauma      Antifibrinolytics in a rural trauma state: assessing the opportunities     https://pubmed.ncbi.nlm.nih.gov/29766102/   Spahn, D.R., Bouillon, B., Cerny, V. et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care 23, 98 (2019). https://doi.org/10.1186/s13054-019-2347-3   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjxnLWJwdX1AhVBUMAKHcHGBn4QFnoECAoQAQ&url=https%3A%2F%2Fwww.euro.who.int%2Fen%2Fhealth-topics%2Fdisease-prevention%2Fviolence-and-injuries%2Fnews%2Fnews%2F2020%2F7%2Fwho-report-on-violence-and-injuries-reveals-grim-statistics-on-preventable-deaths&usg=AOvVaw3_W_8Uzzq5Y23CuRPXiDdC   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiwpIGqwdX1AhXSgVwKHcGmBYIQFnoECAUQAQ&url=https%3A%2F%2Fwww.hse.ie%2Feng%2Fabout%2Fwho%2Facute-hospitals-division%2Ftrauma-services%2Ffurther-information-and-documentation%2Freport-of-the-trauma-steering-group.pdf&usg=AOvVaw1wjLDfsjPkHZ-XmfyRjaNh   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjk7qTCwdX1AhWKTsAKHTl-DRkQFnoECAcQAQ&url=https%3A%2F%2Fec.europa.eu%2Feurostat%2Fstatistics-explained%2Findex.php%2FAccidents_and_injuries_statistics&usg=AOvVaw2ViPnJuFdi19vALBwDorPf   https://www.youtube.com/watch?v=p41qvnFn--c     Stop The Bleed: Tourniquet Application   HaemorrhageContro   Stop the Bleed (Full Course) PrepMedic 165K views2 years ago            

We planned on releasing this as a Supplemental Episode to our upcoming Haemorrhage Control Episode, but we decided to release it as a Teaser Episode instead. Keep your eyes and ears out for the full episode on 1st February 2022!!!

In this episode, we go through some of the updates to The Prehospital Emergency Care Councils new Clinical Practice Guidelines. We will talk about some of these changes and speak about the new medications added to them. It’s important to point out that these new CPGs are not to be used until you have undergone training and have been privileged by  your PHECC Organisation, be that voluntary services or state prehospital providers. EMT CPGs Link https://www.phecit.ie/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=oGsVrspmiT0dOhDFFXZvIz0q5GYO7igwzB6buxHEgeDBS9BbdRZpZNKt9Y89hp%252bGEhGQslpxcyoYmdTLu78H9r76oZTnilm7mlbqDvzJntWlMW756bp2SpJvrdd59AwKjghcMgxg%252baL7Q4mhgOBetkyf7Z4CcxuK2Yxi6SCL0J%252f0jnChy4SHjBix4tYfFiZ4Fvz5FZZpvvQ%253d Paramedic CPGs Link https://www.phecit.ie/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=oGsVrspmiT0dOhDFFXZvIz0q5GYO7igwzB6buxHEgeDBS9BbdRZpZNKt9Y89hp%252bGEhGQslpxcyoYmdTLu78H9r76oZTnilm7mlbqDvzJntWlMW756bp2SiwLHTchpmEjSJkla05iww4DH8GQDvJatGOxRLqNEW7Q4XY3WM%252bbBTeWJ82lbF%252bJzKCzDlYJtCNiIWesB5W%252bHxE%253d Advanced Paramedic CPGs Link https://www.phecit.ie/Custom/BSIDocumentSelector/Pages/DocumentViewer.aspx?id=oGsVrspmiT0dOhDFFXZvIz0q5GYO7igwzB6buxHEgeDBS9BbdRZpZNKt9Y89hp%252bGEhGQslpxcyoYmdTLu78H9r76oZTnilm7mlbqDvzJntWlMW756bp2Sss33aOudBIeG7u3HIUnGBWa2plxYfgV6QyPTmWeB%252ff%252bOOyImbeSBq24mcIZtwFS%252fHI1d9DL61G9QbZ9GHMdoig%253d Procedural Sedation Links Predictors of airway and respiratory adverse events with ketamine sedation in the emergency department: an individual-patient data meta-analysis of 8,282 children https://pubmed.ncbi.nlm.nih.gov/19201064/ https://www.rcemlearning.co.uk/reference/procedural-sedation-emergency-medicine-2018/#1571048556060-300cb36c-1059   https://www.rcem.ac.uk/docs/College%20Guidelines/Pharmacological%20Agents%20for%20Procedural%20Sedation%20and%20Analgesia%20(Oct%202016).pdf   https://www.rcem.ac.uk/docs/RCEM%20Guidance/Ketamine%20procedural%20sedation%20for%20children%20in%20EDs%20(Feb%202020).pdf   Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/26801209/

Welcome to The Secondary Survey episode on Chest Pain. In this episode, we take a look at ACS and some of the Non-ACS causes of chest pain.  Think Aorta Global Meet Up https://www.youtube.com/watch?v=Pevx8zQY1bM  https://litfl.com/acute-aortic-dissection/ Bilateral blood pressure differential as a clinical marker for acute aortic dissection in the emergency department Sung Wook Um , Robert Ohle , Jeffrey J Perry  Emerg Med J 2018 Sep;35(9):556-558. doi: 10.1136/emermed-2018-207499. Epub 2018 Jul 18. https://www.thinkaorta.net/ Aortic Dissection Risk Assessment Tool (ADDRS) https://rebelem.com/the-advised-trial-a-novel-clinical-algorithm-for-the-diagnosis-of-acute-aortic-syndromes/   https://croi.ie/health/heart-conditions/heart-attack/ https://www.youtube.com/redirect?event=video_description&redir_token=QUFFLUhqbC16R0Q0WFVoQU54NENSeG90NkctLU5fc1Q4d3xBQ3Jtc0tsXzNFUHdFQm02RmhxNTlmVEVQWW9nQkNDZUVWTUdoZ01mWnQ3MGd4SXNic21YemV0SEZHY0xjVmpGdEZqQ3c1dWE5SGQ5Y3VzSTZGc3lOdG54VGR2NnphUmd6SjVjUllMcUhPai10ZWJuR2l2eUp2VQ&q=http%3A%2F%2Farmandoh.org%2F   https://armandoh.org/   https://dx.doi.org/10.7861%2Fclinmedicine.14-2-128   https://erj.ersjournals.com/content/44/Suppl_58/P2308   http://thrombosisireland.ie/wp-content/uploads/2017/10/irish-stats.pdf   http://bmjopen.bmj.com/chttps:ontent/9/6/e030059   https://www.hse.ie/eng/services/publications/clinical-strategy-and-programmes/management-of-pulmonary-embolism-presentation.pdf   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwihwZv30MD0AhWBY8AKHaGaBr0QFnoECAcQAQ&url=https%3A%2F%2Fgeekymedics.com%2Frespiratory-examination-2%2F&usg=AOvVaw0ciHT10mtiIh92BbpwqedE   https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiIi8_N08D0AhVbhlwKHXrVApYQFnoECBIQAw&url=https%3A%2F%2Fwww.merriam-webster.com%2Fmedical%2Fbronchophony&usg=AOvVaw2hRSxwGNKnx4u6rCs9u-M1  

Welcome to the Secondary Survey. This Month's episode looks at Scene Safety, something that all Pre-Hospital care providers, EMT, Paramedics and First Responders should appreciate and be mindful off. A phrase often uttered at the beginning of an OSCE but sometimes under appreciated.  Thanks for listening and stay safe.    please find some links to the material we discussed during this months episode.  https://smacc.net.au/2016/09/think-youre-resuscitationist/ https://play.acast.com/s/smacc/smaccforce-rant-scene-safety-is-bullshit   https://www.stemlynsblog.org/jc-the-zero-point-survey-optimising-resuscitation-teams-in-the-ed-st-emlyns/ Creative adapting in a fluid environment: an explanatory model of paramedic decision making in the pre-hospital setting Gudrun Reay1* , James A. Rankin1, Lorraine Smith-MacDonald1 and Gerald C. Lazarenko2 DOI https://doi.org/10.1186/s12873-018-0194-1   https://www.unitekemt.com/blog/5-most-common-emt-injuries/   https://www.irishexaminer.com/news/arid-30982838.html   https://www.irishtimes.com/news/health/no-prosecutions-in-any-attacks-on-paramedics-last-year-1.3082822   We all have Biases as part of the human condition and prehospital practitioners are no different. Paramedics tend to learn to diagnose through pattern recognition and that can lead us to make assumptions on cases on prearrival information. Add in stressors such as hunger, tiredness etc and this can lead to a confirmation bias which may lead us to miss a diagnosis or leave us ill prepared when we are faced with a case that might be far sicker than anticipated. The free radical paramedic podcast goes in to this in far more detail, as are these helpful guide to cognitive biases. https://podcasts.apple.com/ie/podcast/free-radicals-paramedic-podcast/id1437228859?i=1000428897089   https://first10em.com/cognitive-errors/   https://hbr.org/2015/05/outsmart-your-own-biases   https://www.simplypsychology.org/cognitive-bias.html