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We were called for nursing home to a severe hypotensive patient. Upon arrival, we found a 85 yo female severe pale, conscient but disorientated in space and time. The nurse state that the patient had a vomit episode 2 hours before, and had a severe diarrhea since yestarday. In the last 30...

We receive a call to a 67 yo male with possible seizure and syncope. When we arrive, we found a severe pale male, but with recovered mental status. GCS 15. Pupils equal and sluggish to light. His son, who is a nurse tell that his father had an absence seizure with some myoclonic moviments on...

What kind of crystalloid do you prefer to use in hypovolemic shock in trauma calls, when you are on an unit who have no blood units (ILS)?

A 57 yo f, complaining of chest pain, dyspneia and palpitations. P.S.: I was not on scene, so I did not a lot of details.

At my night shift on a ILS service (me-EMTB and a pre-hospital RN), we received a call at 7 am for a rural area. A 50 year old man with weakness, diaphoresis, and chest pain that radiates to the back and left arm. When we arrived, we found him lying in bed, being assisted by local firefighters...

I have this doubt. When to stop the resuscitation of drowning victims? I work on portuguese EMS for over 1 year, and I never seen an drowning case. Weird, but true. Whereas hypothermia can preserve neurological function, hence my question. I read an article wich shows drowning survivors were...

At ILS my shift, we were called to a rural area. A man of 70 years, unconsciousness and have periods of seizures. When we arrive, he was in recovery position, and his daughter was with him, very agitated. Physical assessment and vital signs: - pupils are dilated and have a small response...

Hi everyone, I’ll show you the Portuguese EMS. Once again, sorry about my English (English learned at school). What are the different levels of technicians? - Certified first responder: They have a 50 hours training, and can take vital signs (pulse, BP(manually and automatic), respiratory...

Hi everyone, A Regular and heavy consumption of coffee is related to hypertension? I have a family history of hypertension, CVD and type II diabetes, and so I do every year the following tests: Blood tests: - CBC - Glucose - Erythrocyte sedimentation rate - Cholesterol - HDL and...

As we all know, since the EMT-B's to EMT-P's, the interruption of chest compressions to ventilate the patient (according to the recommendation of 30:2), drastically decreases the coronary perfusion pressure, seriously decreasing the survival probability of the patient. We also know that the...

I got a new job as an EMT-B, but this time on a ILS unit, manned by an EMT-B and a critical care nurse. The other day we were dispatched to a 43 y/o male, was playing soccer with his friends, he felt a pain in the chest and fell on the ground, unresponsive. When we arrived, the patient had no...

Hi everyone, The number of cases of burnout syndrome in the EMS personnel is increasing exponentially in Portugal. Just in a few days ago, a portuguese psychologist told on a tv program, that all doctors, nurses, EMT-B and other professionals who "deal" and work with traumatic and shocking...

I learned 15 compressions and 2 ventilations, but there are some pediatricians who defend 30 compressions by 2 ventilations, as in the adults. What ratio do you use?

Our BLS unit was dispatched for an assault victim on a sidewalk. Male, 19 years old that was beaten several times in his belly, back and chest. He complains pain on his ribs, backaches, headaches and some shortness of breath. He's alert and orientated. BP: 130-85 Pulse: 98 RR: 15 temp...

What kind of analgesic do you use? Here in Portugal, I saw medical professionals using tramadol, morphine sulfate and fentanyl, but recently I saw a nurse using propacetamol IV. As I had never seen this analgesic, I questioned her and she told me that propacetamol was much safer to use in the...

Hi everyone! I will use this topic to introduce myself and ask you a big help. I'm 19 yo, I'm Portuguese EMT-B that always loved prehospital emergency area. Lately, due to the severe economic crisis in Portugal, I've been thinking about moving to the U.S. (I know, first I must improve my...

For some time I have been using the MicroSim inhospital and MicroSim pre-hospital simulator, as a form of fun and learning, because I always loved the pre-hospital emergency. Do you know other similar simulator? Thanks for the futures answers.

Im here to tell a weird case that I had: 15 yo male with dyspnoea, chest pain and lethargic. - BP: 105/60 - HR: 120 - RR: 30 - Spo2: 70% - Capilary refill is about 5 seconds - Normal breath sounds, there is no crackles or wheezes. - pupils normal and reactive to light. - There is...