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While doing some reading on pediatric respiratory distress, I found that there was some suggestion of using nebulized normal saline (and, in some places, hypertonic saline?) for croup and bronchiolitis. The national model clinical guidelines, interestingly, state "Insufficient data exist to...

Does your agency have standards or assessment requirements before a patient can be "downgraded" to BLS transport? I've only been in agencies where there is an ALS co-response or ALS resource assigned to all calls, and have seen various practices by various providers.

I’ve been doing some digging for online, synchronous (i.e., live) classes - curious if folks have any recommendations for EMS or EMS-adjacent ones. In particular, I’m looking to get an evening A&P class online. (I already have my routine CME covered with EMSConnect - live with a physician...

My agency is currently reviewing how we do a recurring clinical & physical competency assessment (think skills test & CPAT). How does your agency reassess clinical competency and physical ability to do the job? Do you do an annual skills reassessment?

Beyond the standard KKK-1822F requirements, are there any specific safety features you'd expect to see in a vehicle? I'm thinking about things like 360-degree external cameras, internal cameras, external rub rail lighting, four-point restraints. Anything critical you'd like to see?

Where can I obtain price quotes and historical price data for vehicle purchases? Working with a hybrid career/volunteer agency on structuring a plan for this.

https://www.hmpgloballearningnetwork.com/site/emsworld/news/new-orleans-ems-director-steps-down Looking at the story & the admin staff there, coupled with the comp issues they have, I have to wonder - is a physician really the right kind of person to helm your service?

In an interesting piece of news out of Rhode Island: Source: The Publics' Radio (Rhode Island's NPR station) I'm not, in theory, opposed to this idea -- just a little trepidatious because of the recent...incidents in Rhode Island surrounding municipal fire departments' EMT-Cardiacs, and the...

Is your service mandating respirators (e.g., N95 or better) on all calls? Eye protection? If so...are you in agreement? My service mandates N95 & eye pro on all calls - has been this way since March. I am rather pleased by the mandate, but I notice quite a few colleagues sticking with the...

Is there any reason to aspirate before IM injection into the anterolateral thigh? Is there really a risk of hitting the vasculature? I've seen some different guidance for this -- ACIP seems to say that it's not necessary for vaccines, period, and yet I see guidance that it is necessary for IM...

Looks like CMS is finally catching up... They're releasing a "voluntary, five-year payment model" in which Medicare "will pay participating ambulance suppliers and providers to 1) transport an individual to a hospital emergency department (ED) or other destination covered under the regulations...

Do any of you fine folks know if the NREMT will accept ALS CME (i.e. CME intended for AEMTs, Paramedics) for EMT recertification purposes? I wasn't able to find any guidance from them, other than what I can infer by saying I get hour-for-hour credit if I take ACLS.

For those who have done a recert via VILT, do you have a preference for Distance CME vs. Medic-CE vs. EMT & Fire Training, Inc. vs. National EMS Academy? (List of CAPCE accredited providers is here) Bit of a quandary as my NREMT expires before my state license, as I want to keep both I have to...

What's your protocol requirement for preoxygenation and/or apneic oxygenation (if any) prior to and/or during intubation attempts? What ought it be?

Posted without comment...

On a recent call, I had a (calm) disagreement with my partner - an early 30s female patient in custody s/p MVC (no trauma center criteria) wanted to refuse care (and law enforcement was OK with this). I was happy to oblige, given the clinical presentation: Alert and oriented (person...

Has anybody seen this in their protocols? CT just updated the protocols to reference the "new" term, Brief Resolved Unexplained Events.

What kind of method do you typically use to sanitize a site prior to obtaining a capillary blood sample for glucometry? Alcohol swab?

For your reading pleasure. Here's a highlight to ask yourself about (QA/QI folks): " Obviously, this could be due to incomplete data, but it certainly makes me wonder: Are EMS providers skipping steps (e.g.in protocols)?

Are NSAIDs a bad idea for muscle recovery? I just (re-)started a running program to try and lose some weight, but I'm finding that delayed onset muscle soreness is giving me more trouble than I'd like. I thought NSAIDs would be ok, but I remember something about how COX2 inhibitors impair muscle...