ECGs Online Module: Introduction to the 12-Lead ECG

Using and interpreting the standard 12-lead ECG By Barbara Aehlert, RN, BSPA,

This course meets NREMT paramedic refresher requirements for: 1A Airway, Breathing & Cardiology.

This course meets NREMT EMT refresher requirements for: Elective.

Lesson Abstract

In this lesson you will learn about using and interpreting the standard 12-lead ECG. We will explain and compare bipolar, unipolar, and precordial leads and describe correct anatomic placement of the precordial leads. We will describe the portion of the heart viewed by each lead of the 12-lead ECG. We will discuss ECG changes that may reflect evidence of myocardial ischemia and injury and identify the ECG changes characteristically seen during the evolution of an acute myocardial infarction.

We will also describe how to distinguish between right and left bundle branch block using leads V1 and V6 and explain what is meant by the terms dilatation, hypertrophy, and enlargement. Finally, we will identify the ECG changes characteristically produced by electrolyte imbalances and describe ECG changes produced by digitalis toxicity.

About the Author

Barbara Aehlert, RN, BSPA, president and CEO of Southwest EMS Education, Inc., Phoenix, has been involved in EMS education and care for more than 20 years. Aehlert has authored numerous Mosby texts for ACLS, ECGs and EMT software training.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

ECG Lesson: Basic Electrophysiology

How cardiac electrical activity is picked up by electrodes By Barbara Aehlert, RN, BSPA,

This course meets NREMT paramedic refresher requirements for: 1A Airway, Breathing & Cardiology.

This course meets NREMT EMT refresher requirements for: Elective.

Lesson Abstract

In this lesson, you will learn how cardiac electrical activity is picked up by electrodes placed on the skin and transmitted by wires and cables to an ECG monitoring device. You will learn where electrodes should be placed, the surfaces of the heart that can be viewed, and the coronary artery that supplies each area.

You will also learn how to measure time and voltage on ECG paper and relate that to electrical events in the heart. You will learn how to count atrial and ventricular rates and determine if a rhythm is regular or irregular. Finally, you will learn how to systematically approach interpretation of an ECG rhythm strip and evaluate the clinical significance of the patient’s cardiac rhythm.

About the Authors

Barbara Aehlert, RN, BSPA, president and CEO of Southwest EMS Education, Inc., Phoenix, has been involved in EMS education and care for more than 20 years. Aehlert has authored numerous Mosby texts for ACLS, ECGs and EMT software training.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

ECG Lesson: Anatomy and Physiology

ECG Lesson: Anatomy and Physiology The location of the heart in the human body and discuss its size and shape. By Barbara Aehlert, RN, BSPA,

This course meets NREMT paramedic refresher requirements for: 1A Airway, Breathing & Cardiology.

This course meets NREMT EMT refresher requirements for: Elective.

Lesson Abstract

This lesson will pinpoint the location of the heart in the human body and discuss its size and shape. It will cover the four chambers of the heart and their functions, and discuss the vessels that enter or leave each chamber. The lesson will also describe the different layers of the heart, discuss the cardiac muscle, and teach you about the heart’s valves. You will learn about how heart sounds are created and the clinical significance of the first and second heart sounds. You will discover how blood flows through the heart, and learn about the cardiac cycle and coronary circulation. The lesson will also discuss heart rate and explain how the heart functions as a pump.

About the Authors

Barbara Aehlert, RN, BSPA, president and CEO of Southwest EMS Education, Inc., Phoenix, has been involved in EMS education and care for more than 20 years. Aehlert has authored numerous Mosby texts for ACLS, ECGs and EMT software training.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Ethics in EMS

Between Black and White: The Gray Area of Ethics in EMS By Lee M. Van Vleet, NREMT-P

This course meets the NREMT EMT-Basic refresher requirements for: Elective.

This course meets the NREMT paramedic refresher requirements for: Flexible Core Content: Operational Tasks.

Lesson Abstract

Ethics deals with the gray areas of life, when clear moral lines fade and decisions must be made that may not always fit in with what you previously thought to be absolutely right. Having a basic understanding of what drives the decision-making process can help you to develop your own ethical principles and assist in making the decision that’s right for you-and your patient-in each case. This lesson is an overview of the major ethical concepts we should be familiar with as medical providers.

Learning Objectives

After completing this lesson, you will be able to:

• Describe two decision-making models that can be applied to medical ethics
• Explain the models of ethical theories
• Apply the principles of autonomy, justice, beneficence and nonmaleficence to EMS scenarios

About The Author

Lee M. Van Vleet, NREMT-P, is the regional disaster preparedness coordinator for the Capital Regional Advisory Committee with the Emergency Services Institute of WakeMed Health & Hospitals in Raleigh, N.C. He is also an EMS instructor with Wake Technical Community College and continues to work as a paramedic. Contact him at wtccems@nc.rr.com.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Deconstructing Airway Obstructions

Deconstructing Airway Obstructions: Several real cases where EMS personnel found creative ways to deal with refractory airway obstructions. By Paul Satterlee, MD, FACEP

This course meets the NREMT EMT-Basic refresher requirements for Airway.

This course meets the NREMT paramedic refresher requirements for Airway, Breathing and Circulation.

Lesson Abstract

Throughout training, EMS instructors have emphasized that nothing is more important the airway. One of the most frightening experiences for EMS personnel is having a patient with an obstructed airway, especially when the patient is not responded to conventional relief efforts. This CE module will guide the EMS provider through several real cases where EMS personnel found creative ways to deal with the problem.

Learning Objectives

After completing this lesson, you will be able to:

1. Identify airway-management techniques used for relieving airway obstructions.
2. Recognize less commonly used advanced airway-management techniques.
3. Identify complications related to advanced airway-management techniques.

About The Authors

Paul Satterlee, MD, FACEP, is the Associate Medical Director of Allina Medical Transportation in St. Paul, Minnesota and serves as the Chief Medical Officer of MN-1 DMAT. The author thanks David Page, EMT-P, and Daryl Doering, EMT-P, for their assistance with the development of this article.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Under Pressure

Under Pressure: Responding to SCUBA Emergencies By Ronnie Haddox

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets the NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

As the sport of scuba diving grows in popularity, emergency responders in all areas of the country may see an increase in their number of responses to scuba-related emergencies. In addition, EMS responders may be called on to provide emergency care for a member of a specialized emergency scuba rescue team. It’s therefore vital for responders at all levels of training to understand, recognize and correctly treat the many scuba-related injuries and illnesses.

Learning Objectives

After taking this lesson, you should be able to:

• Relate the four gas laws to the physics of diving
• List causes, signs and symptoms, and treatment for decompression sickness related to scuba diving
• Describe treatment for scuba emergencies related to barotrauma

About The Author

Ronnie Haddox, a PADI divemaster, has more than 10 years’ experience in EMS as a clinical education specialist for the Southland Division of AMR and with Simmons Ambulance Service in Monroe County, Ala. He currently teaches English in China.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

The Vague OD

The Vague OD The Symptomatic Patient with an Unknown Exposure By Dana Bartlett, RN, MSN, CSPI

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies.

This course meets the NREMT EMT refresher requirements for:  Medical/Behavioral.

Lesson Abstract

An overdose or poisoning case can be entirely different from a trauma call or other clinical situation because it may not be so straightforward. The key to overdose cases is obtaining a fast, accurate patient assessment and comparing your findings with signs of common toxidromes. This lesson discusses the various toxidromes of a drug or chemical overdose, along with the ways to use the toxidrome to determine the drug/toxin exposure of the patient.

Learning Objectives

• Describe the physical exam and vital sign changes that may help identify agents involved in an unknown exposure.
• Describe common drug and toxin toxidromes.
• Describe the four hazardous materials toxidromes.

About The Author

Dana Bartlett is a registered nurse and a certified specialist in poison information at the Philadelphia Poison Control Center. Contact him at bartlett@email.chop.edu.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

The Splitting Headache

The Splitting Headache: Prehospital Assessment & Treatment Of Acute Head Pain By Stephen Rinaldi, NREMT-P, & Kristen Bulmer, RPh This course meets the NREMT paramedic refresher requirements for: Medical Emergencies This course meets the NREMT paramedic refresher requirements for: Medical/Behavioral Lesson Abstract Approximately 45 million Americans suffer from chronic headaches, and an additional 28 million suffer from migraines annually. Although EMS responds to a large number of calls for headache or head pain each year, the underlying causes can be elusive. Therefore, prehospital providers must be competent in the provision of a comprehensive physical exam and review of symptoms to arrive at a working diagnosis in order to improve patient outcomes, reduce pain and anxiety, and aid in the delivery of definitive care for patients with acute headache.   Learning Objectives After taking this lesson, you should be able to: Identify the cranial nerves and their relationship to patient assessment Recognize signs and symptoms of acute head pain and the associated differential diagnosis. Choose the standard approach to taking the “headache history” Identify pharmacologic treatment options outside of typical standing orders About The Author Stephen Rinaldi, NREMT-P, is a paramedic with the Albany County (N.Y) Sheriffs Department EMS Unit and a continuing education lecturer on EMS. He previously served as paramedic and ALS Coordinator for the Delmar Fire Department in Delmar, New York and as paramedic for Windham Mountain Ski Patrol in Windham, New York. Kristen Bulmer, RPh, is a graduate of the Massachusetts College of Pharmacy, and is a registered pharmacist living and working in upstate New York. Currently specializing in patient care and consulting, Kristen has worked in all phases of inpatient, outpatient and retail pharmaceutical care. CECBEMS Statement This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers. As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices. This course is just $7 and is located in our Jems ALS and BLS provider curricula. Click here to access our CE catalog to take this course.

The New Hemophiliacs

The New Hemophiliacs Basic review of hemostasis By Ben Usatch, MD, FAAEM, NREMT-P,

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

Hemostasis, the body’s natural process to stop blood loss, is a very complex series of events. For maximum efficiency, the process relies on a precise balance of multiple chemicals and cell products. Various commonly prescribed patient medications may interfere with this process thereby allowing exaggerated blood loss with seemingly minor trauma. Patients taking these medications may be classified as pharmacologically-induced haemophiliacs and must be recognized promptly to allow alterations in normal patient care plans.

Lesson Objectives

At the completion of this CE activity, you will be able to

1. 1. Review the series of events that occur in the physiological process of blood clotting.
   2. Identify and discuss common medications that can inhibit blood-clot formation.
   3. Describe the risks associated with taking blood-thinning agents.
   4. Discuss and apply appropriate assessment and management of patients with either pathologically or pharmacologically induced bleeding disorders.

About the Author

Ben Usatch, MD, FAAEM, NREMT-P, has been involved in EMS for more than 25 years, first as a paramedic and now as an emergency medicine physician. He serves as the medical director for community- and hospital-based units in the Philadelphia area. He works as an attending physician and the EMS director at the Lankenau Hospital in Wynnewood.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

The Modern Diabetic

The Modern Diabetic Diabetes and the treatment of diabetic emergencies. By Connie Mattera, MS, RN, TNS, EMT-P

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

Diabetes is a major cause of morbidity and mortality in the United States. EMS professionals are increasingly being called to treat the consequences of this debilitating disease. Medical science continues to investigate new and innovative therapies for managing the effects of the disease. This CE module will provide the responder with some basic information necessary for keeping abreast of the current management trends.

Lesson Objectives

At the completion of this CE activity, you will be able to

1. Recognize symptoms and indications of diabetes mellitus and list its primary causes.
2. Compare and contrast the onset, common causes, risk factors, pathophysiology, signs and symptoms, and complications of Metabolic Syndrome, and type 1 and type 2 diabetes.
3. Identify medications and devices used in the treatment of hyperglycemia, including the insulin pump.

About the Author

Connie Mattera, MS, RN, TNS, EMT-P, is the EMS administrative director for the Northwest Community EMS System located in the northwest suburbs of Chicago. She has been an emergency nurse and paramedic for more than 30 years and has a passion for excellence in prehospital education and care.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Sorting Through Confusion

Sorting Through Confusion Prehospital Identification & Treatment Of Dementia & Delirium By Paul Phrampus, MD, & Laura Walker, DMc, NREMT-P This course meets the NREMT paramedic refresher requirements for: Medical Emergencies. This course meets the NREMT EMT refresher requirements for: Medical/Behavioral Lesson Abstract To overcome the challenging task of assessing a patient with altered mental status, the careful provider must be able to differentiate between delirium and dementia. Because chronic states of confusion and complications of underlying medical conditions can often have similar signs and symptoms, maintain a high index of suspicion for treatable causes while performing a detailed physical examination. This lesson focuses on recognizing signs and symptoms of each and discusses the identification of underlying treatable causes. Learning Objectives After taking this lesson, you should be able to: Differentiate dementia and delirium List treatable causes for delirium Identify the appropriate method to obtain history and physical assessment of the patient with altered mental status. Recognize the anatomy components of the brain and nervous system and the appropriate physiology of the same. About the Authors Paul Phrampus, MD, is an assistant professor in the Department of Emergency Medicine at the University of Pittsburgh. He’s a medical command physician at the University of Pittsburgh and the medical director of Fayette EMS in Connellsville, Pa. He’s also a former paramedic, member of the Street Medicine Society, and an EMS educator. Laura Walker, DMc, NREMT-P, is the regional field coordinator of the Tidewater Emergency Medical Service Council in Norfolk, Va. She is a prolific EMS educator and has been involved in EMS for more than 20 years.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Smallpox

Smallpox Understanding Smallpox & Its Implications For Prehospital Crews By Chad E. Brocato, EMT-P, & Geoffrey T. Miller, NREMT-P

This course meets NREMT paramedic refresher requirements for 1B Medical Emergencies.

This course meets NREMT EMT refresher requirements for Medical/Behavioral.

Lesson Abstract

After taking this lesson, the EMS provider will understand some of the common categories of nerve agents, their clinical effects and principles of management and treatment. This CE lesson is approved by the Continuing Education Coordinating Board for EMS (CECBEMS) for 1.5 hours of Continuing Education in the Advanced category.

Lesson Objectives

• Explain the routes of transmission for smallpox
• List the signs and symptoms of smallpox from exposure through final stages of the disease process
• Describe the EMS care of a patient with smallpox or when a smallpox exposure is suspected

About the Author

Chad Brocato, EMT-P, is an EMS educator at Miami-Dade Community College and a rescue supervisor with Deerfield Beach Fire-Rescue. He’s currently completing a master’s degree in medical sciences at Nova Southeastern University in south Florida.

Geoffrey T. Miller, NREMT-P, is educational programs coordinator for the medical training and simulation laboratory at the University of Miami School of Medicine, Center for Research in Medical Education.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Sickle Cell Disease

Sickle Cell Disease A painfull killer By Sandy L. Hunter, MAPh. D., NREMT-P

This course meets NREMT paramedic refresher requirements for: Medical Emergencies 

This course meets NREMT EMT refresher requirements for: Electives

 Lesson Abstract

With more than 70,000 sickle cell disease patients in the United States, many of whom experience episodes of sever pain and organ failure, it’s possible that a number of these patients will use EMS and ED services during crises or other health emergencies. Thus, it’s helpful for EMS providers to be able to recognize and properly manage patients suffering from the condition. Prehospital care personnel must recognize the real and significant nature of SCD pain and be willing and able to properly manage it.

Lesson Objectives

• Describe the basic pathophysiology, signs and symptoms of sickle cell disease
• Describe the prevalence of sickle cell disease
• Describe social and health-care system considerations for sickle cell patients
• Describe practical guidelines for prehospital management of sickle cell crises

About The Author

Sandy L. Hunter, MAPh. D., NREMT-P, is an associate professor in the paramedic program at Eastern Kentucky University. Dr. Hunter’s academic degrees include an undergraduate degree in emergency medical care from Western Carolina University; a masters degree in health education from Eastern Kentucky University and a doctorate in educational psychology from University of Kentucky. and an educational psychology doctoral student (ABD) at the University of Kentucky. The author would like to express appreciation for the assistance received in the review of this lesson by Dr. Neville Pohl, medical director for the Eastern Kentucky University Paramedic program, Dr. Rebecca Newsome for reviewing the information on genetic prevalence of sickle cell disease and Jenni Glenn.

CECBEMS Statement

This continuing education activity is approved by the Center for Emergency Medicine of Western Pennsylvania, Inc., an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Protect Yourself with “DOCTOR”

Protect Yourself with “DOCTOR”: from infectious diseases such as SARS and pandemic flu By Walter Eric Meyer IV, MPA-EM,NREMT-P; Shannon W. Stephens; Susan C Meyer,DSN,RN; Jan G Glarum, EMT-P & Jeffrey R Ryan, PhD

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Preparatory

Lesson Abstract

What can we do to better prepare medical personnel for the biological challenge posed by these threats? To start, we can draw on the lessons learned from the severe acute respiratory syndrome (SARS) outbreak of 2003 to make observations about EMS practitioners and other health-care workers faced with highly transmissible, deadly pathogens. Further, we must refresh ourselves on standard precautions and use a simple acronym, DOCTOR, to remind ourselves of when to take precautionary measures.

Learning Objectives:

1. Differentiate the modes of transmission for infectious respiratory agents.
2. Identify and analyze key patient history data to determine the possible presence of an infectious respiratory disease.
3. Identify appropriate personal protective equipment for prehospital personnel during care of patients with suspected respiratory infections.
4. Identify prehospital safety precautions and procedures that reduce transmission of infectious respiratory agents.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

This course is just $10 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Measuring and Interpreting Vital Signs

Measuring & Interpreting Vital Signs An in-depth discussion of the objective data points that lead to a presumptive diagnosis & treatment plan By Ian Greenwald, MD, & Jake O’Shea, MD

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Patient Assessment

 

Lesson Abstract

Vital signs are simply that-vital. They are crucial objective data points that, along with a constellation of symptoms and physical exam findings, allow an EMS professional to create a presumptive prehospital diagnosis. Vital sign abnormalities should instinctively heighten your level of concern and should never be ignored or dismissed. We will first discuss the four vital signs-pulse, respiratory rate, temperature and blood pressure-and how they are measured.

Lesson Objectives

• Define the qualities and characteristics of different heart rates and respiratory patterns
• Describe appropriate sizing of BP cuff and steps for auscultation of blood pressures
• Describe two limitations of standard pulse oximetry measurement
• Describe utility of orthostatic (positional) vital signs for volume-depleted patients

About The Author

Ian Greenwald, MD, is an assistant professor of emergency medicine at Emory University in the Section of Prehospital and Disaster Medicine. He was a former Fellow of EMS with the Fire Department of New York and is a Captain in the United States Army Medical Reserve Corps.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Infectious Disease Update

Infectious Disease Update How to protect yourself & your patients By Gerald Maloney, DO

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies.

 This course meets the NREMT EMT refresher requirements for: Medical/Behavioral.

Lesson Abstract

Despite advancements in both prevention and treatment of infectious diseases, they remain in the forefront of attention for both the media and the professional medical community. This lesson discusses the more important infectious diseases prehospital providers should be aware of, focusing on prehospital management and precautions.

Learning Objectives

After taking this lesson, you should be able to:

• Describe the concepts of virulence and resistance and their role in the spread of infectious disease.
• Describe the emergency airway interventions that may be necessary for patients with ENT diseases.
• List signs and symptoms of meningitis.
• List common CNS infections, skin infections and childhood diseases, and the emergency medical care for each.

About The Author

Dr. Gerald Maloney is an attending physician at the Department of Emergency Medicine, Cook County Hospital in Chicago. Prior to medical school, he worked as a paramedic for Cataldo Ambulance Service in the Boston area.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Infection Protection

Infection Protection: A Review of Post-Exposure Prophylaxis By Timothy Rupp, MD, FACEP, FAAEM, and Katherine Christensen, MD

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

Hepatitis B and C along with the human immunodeficiency virus represent the greatest threat to prehospital care providers. This module will review the characteristics and prevention strategies of each of the types of infections. Finally, the module will review techniques for minimizing the risk of infection when exposure to blood or body fluids occurs.

Learning Objectives

After completing this lesson, you will be able to:

1. Identify the strategy for preventing infections that may result from occupational exposure.
2. Recognize the infections to which EMS providers are most at risk.
3. Identify effective post-exposure prophylaxis procedures.

About the Authors

Timothy Rupp, MD, FACEP, FAAEM, is the former associate director of the emergency medicine residency training program at the University of Texas Southwestern Medical Center at Dallas. He’s a staff emergency physician at Methodist Health System in Dallas, Children’s Medical Center in Dallas and Centennial Medical Center in Frisco, Texas. Contact him at Timothy.Rupp@childrens.com.

Katherine Christensen, MD, attended medical school at Thomas Jefferson University in Philadelphia, Pa., and recently completed residency training in emergency medicine at the University of Texas Southwestern Medical Center at Dallas.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Exercise Restraint

Exercise Restraint Medical & legal issues you must understand to protect the patient & yourself By W. Ann Maggiore, JD, NREMT-P, & Robert B. Palmer, PhD, NREMT-P

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

You can hear your patient before you see them. They’re sometimes engaged with police; other times you’ve been called by a family member. Often, your patient is under the influence of alcohol or drugs, making your assessment more difficult. Sometimes your patient has physical injuries, and you try to determine which came first: the injury or the aggressive behavior. Either way, your patient is a volcano ready to erupt. Your job: to safely treat and transport this patient to the hospital for evaluation.

Lesson Objectives

• List medical, psychiatric and traumatic conditions that can commonly cause patients to become aggressive or combative
• Describe positional asphyxia
• Explain the guidelines EMS agencies should follow when physically restraining a patient
• Identify medications that may be useful for chemically restraining patients

About the Authors

W. Ann Maggiore, EMT-P, JD, is a medical negligence defense attorney with Butkus, Gay & Jahner, Albuquerque, N.M. Formerly a full-time paramedic, she also teaches legal issues to paramedics at the University of New Mexico School of Medicine.

Robert B. Palmer, NREMT-P, PhD, is a toxicology fellow with the Rocky Mountain Poison & Drug Center in Denver and former faculty at the University of New Mexico in the College of Pharmacy and School of Medicine. He continues to work part-time as a paramedic for Thompson Valley EMS in Loveland, Colo.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Evolving Assessment

Evolving Assessment A systematic approach to the not-so-elementary assessment of respiratory emergencies in infants & young children. By James F. Goss, EMT-P

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Patient Assessment

 

Lesson Abstract

Recognition of respiratory distress is the most important responsibility of health-care providers in preventing cardiac arrest in children. Knowledge and periodic review of the developing respiratory anatomy and physiology contributes to our understanding of the signs and symptoms exhibited by children in respiratory distress.

Lesson Objectives

• List anatomic differences between the respiratory systems of children and adults
• Describe the standard approach to assessing the respiratory status of a pediatric patient
• Identify the changes in the physiology of the pediatric respiratory system that lead to less efficient compensatory mechanisms for respiratory distress (compared with adults)

About the Author

James F. Goss, EMT-P James Goss is the regional training manager for American Medical Response in the Inland Empire of Southern California. He is also a member of the faculty at Loma Linda University and a flight medic for Mercy Air.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Escape Faulty Thinking

Escape Faulty Thinking: How to Minimize the Influence of Bias in Patient Assessment By Timothy Rupp, MD, FACEP, FAAEM and Katherine Christensen, MD

This course meets NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

Improper or faulty patient assessments are a significant source of liability for EMS providers and their agencies. In many cases, the EMS care giver unknowingly brings to the assessment an intuitive or learned bias that clouds judgement. In order to reduce patient assessment errors and protect future patients, EMS providers must recognize that biases exist and formulate a strategy to overcome their harmful effects.

Lesson Objectives

1. Recognize that most EMS errors occur during prehospital patient assessments.
2. Describe EMS patient assessment errors and the common cognitive dispositions to respond (CDRs) that contribute to them.
3. Identify cognitive strategies to reduce errors in EMS patient assessments.
4. Delineate common health conditions experienced in the elderly population

About the Authors

Timothy Rupp, MD, FACEP, FAAEM, is the former associate director of the emergency medicine residency training program at the University of Texas Southwestern Medical Center at Dallas. He’s a staff emergency physician at Methodist Health System in Dallas, Children’s Medical Center in Dallas and Centennial Medical Center in Frisco, Texas. Contact him at Timothy.Rupp@childrens.com.

Katherine Christensen, MD, attended medical school at Thomas Jefferson University in Philadelphia, Pa., and recently completed residency training in emergency medicine at the University of Texas Southwestern Medical Center at Dallas.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

DNP: 2,4-Dinitrophenol

DNP: 2,4-Dinitrophenol A deadly way to lose weight By James C. Suozzi, BA, NREMT-P, Christopher M. Rancont, MS, NREMT-P, and Robin B. McFee, DO, MPH

This course meets NREMT paramedic refresher requirements for: Medical Emergencies.

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Lesson Abstract

The use of chemical and herbal supplements is at an all-time high. One such supplement, 2,4-dinitrophenol (DNP), is being promoted as easy way to lose weight and is emerging as a public health threat. EMS providers and hospital personnel must be familiar with the presentation of hyperthermia, lethargy, tachypnea and diaphoresis with yellow-stained sweat as pathognomonic for DNP toxicity in order to aggressively and effectively manage these patients.

About the Authors

James C. Suozzi, BA, NREMT-P, has been involved in EMS for 14 years. He is currently an adjunct instructor at Nova Southeastern University’s Division of EMS Education and Training, and a fourth-year medical student at Nova Southeastern University College of Osteopathic Medicine in Ft. Lauderdale, Fla. Contact him via e-mail at JSuozzi120@aol.com.

Christopher Rancont, MS, EMT-P, has worked as a paramedic for 15 years and also trained paramedics in Southeastern Michigan as well as abroad. He is a fourth-year medical student at Kirksville College of Osteopathic Medicine.

Robin B. McFee, DO, MPH, is a toxicologist with the LI Regional Poison Control Center and the director of Threat Science, a bioterrorism and WMD consulting company. She has authored numerous articles and lectures nationally.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Dealing with Death

Dealing with Death & Dying in Prehospital Emergency Care 2nd edition copyright © By Seth C. Hawkins, MD, FACEP

This course meets the NREMT paramedic refresher requirements for: Medical Emergencies

This course meets the NREMT EMT refresher requirements for: Electives

Lesson Abstract

“The opposite of life is not death, it’s indifference.”
Elie Wiesel, 1986

The death of a patient is one of the most difficult experiences any healthcare provider faces. At times the emotional reactions of family members to a loved one’s terminal condition or death will be more difficult to deal with than the patient’s medical needs. This lesson discusses caring for the dying patient and their family members. It also discusses issues involving the death of a patient and addresses the psychological and professional stressors experienced following the death of a colleague.

Learning Objectives

After completing this lesson, you will be able to:

• Discuss appropriate methods to communicate with a family/friends when a loved one has died, including young children and co-workers
• Discuss the stages of death and dying with examples of each
• Describe managment of difficult issues in dealing with the dying patient such as patient refusals, do not resuscitate issues, field pronouncements and homocides/suicides

About the Author

Seth C. Hawkins, MD has more than a decade of experience in prehospital medical care. He has worked as an EMT in rural Colorado, a technical rescue provider in North Carolina, and a flight physician and EMS physician in urban Pennsylvania. He now works with Mountain Emergency Physicians at Blue Ridge HealthCare in Morganton, N.C., and serves as assistant medical director of the Burke EMS Special Operations Team.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

 

CNS Infections

CNS Infections Bugs and Brains Don’t Mix By Paul E. Phrampus, MD, FACEP

This course meets the NREMT paramedic refresher requirements for: Flexible Core Content-Medical Emergencies.

This course meets the NREMT EMT refresher requirements for: Medical/Behavioral.

Lesson Abstract

The disease presentation of CNS infections can range from mild to quite severe with a rapid course of deterioration and death. Because cases are infrequent but potentially fatal, it’s important that prehospital providers understand the signs and symptoms of patients presenting with a CNS infection and be able to provide initial treatment and stabilization.

Learning Objectives

• Describe the anatomy of the central nervous system.
• Describe mechanisms by which patients contract CNS infections.
• List the historical information necessary when treating a patient with a CNS infection.
• Prioritize treatment options for patients with CNS infections.

About The Author

Paul E. Phrampus, MD, FACEP, is the director of the Peter M. Winter Institute for Simulation, Education and Research (WISER), and an assistant professor in the Departments of Emergency Medicine and Anesthesiology at the University of Pittsburgh. He has been actively involved in EMS since 1981, and is the medical director for Fayette EMS in Connellsville, Pa. Dr Phrampus is a nationally recognized medical educator and author. He serves as a leader in the field of incorporating simulation into healthcare education. He is a member of the Street Medicine Society. Contact him via e-mail at p.phrampus@comcast.net.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Caring for the Aged

Caring for the Aged The pathophysiology of aging & its significant implications for prehospital care By Susan Caslow, MD and Thompson Kehrl, MD

This course meets NREMT paramedic refresher requirements for: Medical Emergencies

This course meets NREMT EMT refresher requirements for: Electives

 

Lesson Abstract

As EMS providers, we must recognize the differences and address some of the challenges inherent in caring for an older population. In this article, we review the physiologic changes that accompany the aging process, discuss the different disease pathologies common in the elderly and consider side effects and interactions of frequently used medications.

Lesson Objectives

• Understand the normal physiologic changes that accompany the aging process.
• Recognize adverse events associated with medications commonly used in the elderly population.
• Differentiate dementia from delirium.
• Delineate common health conditions experienced in the elderly population

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Bad Medicine

Bad Medicine Preventing Drug Errors in The Prehospital Setting By Anh Vu Nguyen, MD, FAAFP

Lesson Abstract

This course meets NREMT paramedic refresher requirements for: 1A Medical Emergencies or 1B Medical Emergencies.

This course meets NREMT EMT refresher requirements for: Preparatory

Every year, the Food and Drug Administration receives thousands of reports concerning medication errors. The Institute of Medicine reports a significant number or deaths each year result for these errors. Despite the fact that protocols and treatment guidelines are designed for the patient’s safety, EMTs and Paramedics often commit one of several types of medication administration errors. By adhering to the “Rights of Medication Administration,” EMS personnel can reduce the possibility of an error and insure safe drug administration for the patent.

Lesson Objectives

1. Identify the types of medication errors that can occur in the prehospital setting.
2. Identify techniques that minimize the risk of prehospital medication errors.
3. Regognize the patient populations that should be given special consideration for possible medication errors.

About the Author

AnhVu Nguyen, MD, FAAFP, is board certified in both emergency medicine and family medicine. He’s a full-time emergency physician and a physician with the Pinellas County (Fla.) Office of the Medical Director. He’s the author of three medical books. He can be contacted at Office of the Medical Director, 12490 Ulmerton Rd., Largo, Fla. 33774.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Antianxiety Medications

Antianxiety Medications A review of mechanisms & presentations of drug-related emergencies By Gerald Maloney, DO

Lesson Abstract

This course meets NREMT paramedic refresher requirements for: 1A Medical Emergencies or 1B Medical Emergencies.

This course meets NREMT EMT refresher requirements for: Medical/Behavioral

Antianxiety medications are among the most commonly prescribed medications in the United States, with more than 50 million prescriptions annually. These encompass not only traditional antianxiety medications, or anxiolytics, but also other classes of medications used to treat such conditions as depression. The most common class of anxiolytics are benzodiazepines. Given the frequency with which these medications are prescribed, EMS providers will likely encounter many clinical scenarios with these drugs during their careers.

Lesson Objectives

• List the classes of antianxiety medications.
• Review the mechanisms of action of antianxiety medications.
• Discuss the prehospital presentation and management of emergencies involving antianxiety medications.

About the Author

Gerald Maloney, DO, is an attending emergency physician and toxicologist at MetroHealth Medical Center in Cleveland, OH, a flight physician with Metro LifeFlight (also in Cleveland), and a Major in US Army Reserve. He holds an appointment as a senior instructor in emergency medicine at Case Western Reserve University. Before receiving his medical degree from the University of New England in Biddeford, ME, he was a paramedic at Cataldo Ambulance Service in Massachusetts.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Genitourinary Emergencies

Genitourinary Emergencies How to appropriately manage GU injuries & illnesses Krishnan Venkatesan, MD, & Richard A. Santucci, MD

Lesson Abstract

This course meets NREMT paramedic & EMT refresher requirements for: Trauma

Genitourinary (GU) emergencies can result from trauma, anatomic problems (e.g., kidney stones) or infections. Despite their less frequent occurrence than other medical emergencies commonly encountered in the field, understanding these injuries is an important part of the accurate evaluation of the injured or ill patient. GU injuries and pathologies range from minor conditions that can be easily treated to major conditions often requiring tertiary care resources or rapid transport decisions to save critical organs.

Lesson Objectives

• Understand the pathophysiology of genitourinary emergencies
• Identify conditions affecting the genitourinary tract that may present in the prehospital setting
• Describe prehospital treatment for common genitourinary conditions
• Describe assessment findings that would lead you to suspect a genitourinary illness

About The Author

Richard A. Santucci, MD, is chief of urology at the Detroit Receiving Hospital, an assistant professor at the Wayne State University School of Medicine, and a specialist in trauma and reconstructive urology. His training has included an NRSA/NIH research fellowship in burn and trauma research and a clinical fellowship in trauma and reconstructive urology at the University of California, San Francisco.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Concussion and Second Impact Syndrome

Concussion & Second Impact Syndrome How EMS Providers Should Treat and Protect Their Patients By Roy R. Danks, DO, & Chris Cannon, BS, MICT

Lesson Abstract

This course meets the NREMT paramedic refresher requirements for: Mandatory Core Content-Trauma.

Every 23 seconds in the United States, a person suffers a traumatic brain injury (TBI) from such common causes as motor vehicle crashes, falls and blunt trauma to the head sustained in contact sports. Because mild TBI is commonly seen in the prehospital setting, EMS providers must be aware of its common causes and the risk of second impact syndrome, the concussion grading schema and treatment guidelines.

Learning Objectives

• Describe the anatomy and function of the brainstem, diencephalon, cerebellum and cerebrum.
• Define mild traumatic brain injury and findings that would support this diagnosis.
• List findings associated with grade 1, 2 and 3 concussions.
• Identify conditions that would prevent an athlete from returning to play or an employee from returning to work following a mild traumatic brain injury.

About The Authors

Roy R. Danks, DO, is a general/trauma/burn surgeon and surgical intensivist at Kansas Surgical Consultants, Wichita, KS. He has been actively involved in EMS education for many years and was formerly a field paramedic. He’s also the Associate Medical Advisor for the Paramedic Program at Cowley College, Winfield.

Chris Cannon, BS, MICT, is a paramedic instructor with Cowley College, Winfield. He has extensive prehospital care experience as both an EMT and a paramedic.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Traumatic Hand Injuries

Traumatic Hand Injuries Getting a grip on prehospital hand trauma assessment & management By William Northington, MD, & Sanjay Premakumar, MD, MPH

Lesson Abstract

This course meets NREMT paramedic & EMT refresher requirements for: Trauma

The loss of hand use can be devastating, both personally and professionally. Because of their frequent use, hands are often placed in harm’s way. Hand injuries account for between 5 and 10% of overall emergency department (ED) visits, or approximately 11 million injuries in the United States each year. Many of these injuries occur at work, making hand trauma a significant etiology of chronic disability and lost time from employment. Proper prehospital identification and management of hand injuries help prevent the significant negative sequelae associated with even apparently minor injuries.

Objectives:

• Describe the anatomy of the hand related to bones, muscles, nerves and vascular supply.
• Explain the steps for assessing the sensory, motor and vascular functions of the hand.
• List common injuries of the hand and their prehospital treatment.

About The Authors:

William Northington, MD, completed his undergraduate work at Johns Hopkins University in 1998 before obtaining his MD from the University of North Carolina in 2002. He is currently a second-year emergency medicine resident at the University of Pittsburgh Affiliated Residency in Emergency Medicine.

Sanjay Premakumar, MD, MPH, completed his undergraduate degree at the University of North Carolina where he also received his MD and MPH in 2002. He is currently a second-year emergency medicine resident at the University of Pittsburgh Affiliated Residency in Emergency Medicine.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

Smoke Inhalation and Acute Cyanide Poisoning

Smoke Inhalation & Acute Cyanide Poisoning Hydrogen cyanide poisoning proves increasingly common in smoke-inhalation victims By Richard Alcorta, MD, FACEP

Lesson Abstract

This course meets NREMT paramedic and EMT refresher requirements for: Trauma

Smoke inhalation is an important but often overlooked cause of cyanide poisoning. A substantial body of evidence reveals that cyanide can be as great a threat as carbon monoxide in fire smoke.

This lesson will discuss:

• Why cyanide poisoning is a growing concern in the fire and EMS communities
• The role of cyanide in smoke inhalation-associated morbidity and mortality as evidenced by two prospective studies-a 2002 meta-analysis of fire victim studies and animal research on cyanide-related incapacitation
• The factors involved in the management of smoke inhalation-associated cyanide poisoning-its mechanism, manifestations, recognition and treatment

Lesson Objectives

• List reasons for the increased incidence of smoke inhalation-associated cyanide poisoning
• Determine the role of cyanide in smoke inhalation-associated morbidity and mortality
• Describe the management of smoke inhalation-associated cyanide poisonings

About the Author

Richard Louis Alcorta, MD, FACEP, is the state EMS director for the Maryland Institute for Emergency Medical Services Systems (MIEMSS). He is also the Maryland medical director of the Chemical Stockpile Emergency Preparedness Program and an emergency specialist/physician. A former paramedic liaison at the Suburban Hospital in Bethesda, Md., Alcorta is a fellow of the American College of Emergency Physicians and is board-certified in emergency medicine by the American Board of Emergency Medicine. He is also a certified Maryland state EMT-paramedic instructor, hospital hazardous material instructor and Advanced Trauma Life Support instructor. Alcorta is a member of many professional organizations, including the Alpha Omega Alpha Medical Honor Society, the American Medical Association, the American College of Emergency Physicians, the National Association of EMS Physicians and the National Association of State EMS Directors.

Special thanks to Jane Saiers, PhD, who completed the background literature research on cyanide presented in this lesson.

CECBEMS Statement

This continuing education activity is approved by the Center for Emergency Medicine of Western Pennsylvania, Inc., an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), for 1.5 hours credit for Basic and Advanced providers.

As with any continuing education, please check with your state EMS office for accreditation and certification requirements. Click here for a list of offices.

This course is just $7 and is located in our Jems ALS and BLS provider curricula.

Click here to access our CE catalog to take this course.

The Lost Art of Splinting

This course meets the NREMT paramedic & EMT refresher requirements for: Trauma

Lesson Abstract

Despite the availability of a variety of techniques, recent evidence suggests that EMS personnel do not adequately address the pain experienced by patients suffering an orthopaedic injury. Some techniques require advanced training and physician authorization but most may be implemented by providers at any level. This CE module will review several types of orthopaedic injuries, splinting techniques and basic pain control techniques.

Learning Objectives

After taking this lesson, participants should be able to:

• Review and differentiate assessment and management of extremity injuries.
• Identify splinting materials available to prehospital care providers
• Identify common complications of splinting

About The Author 

Jennifer Cuske works in the emergency department at Aurora Sinai Medical Center in Milwaukee, Wisconsin. She has previously worked as an EMT-P in both urban and rural settings. She continues to hold a paramedic license in addition to her nursing credentials, while providing EMS continuing educational lectures independently and for Aurora Healthcare System’s ambulance services. She can be reached at Jennifer.cuske@aurora.org.

CECBEMS Statement

This continuing education activity is approved by the University of Texas Southwestern Medical Center at Dallas, an organization accredited by the Continuing Education Board for Emergency Me