Topic Index

There are a few ways to find specific material on this site. One is to search — plug the things you’re looking for into the bar at the right-hand side of the navigation bar, and it’ll bring back all posts that mention those terms. You can also click on one of the categories listed in the column to the left of the page, which defines broad realms of posts — for instance, those discussing specific skills vs. those offering general education. Or you can browse chronologically. Finally, you can click one of the tags in the “cloud” in the column at the right of the page; these are more specific keywords, and clicking one will return all posts that touch upon that topic.

This index provides a more organized approach. Every single post on this site is indexed here, and it’s updated in a relatively timely fashion, so you can browse through to find whatever interests you.

In a few cases, relevant posts from Lit Whisperers, the EBM blog managed by our DRL staff, are listed here as well.

 

Featured Posts

How and Where? The Cornerstone of BLS

The Art of Driving Well

Helping

Good Partners

Patient Advocacy

Dialing it Down a Notch

Job Stability in EMS

The Laws of EMS

 

Drug Families

These discuss broad classes of drugs, in many cases grouping them into opposing types (such as stimulants vs. depressants). We discuss the physiological systems involved, how these drugs interact with them, give examples of the most common meds, and provide tips for recognizing them (such as standard suffixes). These posts feature some of the more in-depth discussions of physiology on this site.

Drug Families: Stimulants and Depressants – describes the sympathetic vs. parasympathetic systems, alpha and beta receptors, their most important effects, and the common drugs that interact with them.

Drug Families: Steroids and Antibiotics – goes through the basic concepts of inflammatory response and the role of steroids and antimicrobials (antibiotics, antivirals, and antifungals) in mitigating or supporting it.

Drug Families: ACE inhibitors and ARBs – outlines the renin-angiotensin-aldosterone system and discusses the role of drugs that inhibit it.

Drug Families: Anticoagulants and Antiplatelets – a combination text-and-video post walking through the entire coagulation cascade and the common drugs, including warfarin/Coumadin, unfractionated and low molecular weight heparin, dabigatran/Pradaxa, aspirin, glycoprotein IIB/IIIA inhibitors, and clopidogrel/Plavix.

 

What it Looks Like

Some of our most popular posts, these focus on important, often-discussed, but rarely-seen clinical phenomena — the sort of things you read about, but don’t really know “what it looks like” until you’ve developed some experience. We discuss the basic pathophysiology and significance of each phenomenon, then give examples of photos or video clips that illustrate it well.

What it Looks Like: Agonal Respirations

What it Looks Like: Seizure

What it Looks Like: Jugular Vein Distention

What it Looks Like: Cardiac Arrest and CPR

 

Live from Prospect St.

These are “interactive” stories, where we describe a clinical scenario and ask how you’d handle it. They unfold in two or three posts each, pausing at important decision points and letting you take each new development as it comes. They conclude with a discussion of the relevant findings, risk factors, assessment tips, and disease states.

Live from Prospect St: Dizzy at Hillcrest (part 1)

Live from Prospect St: Dizzy at Hillcrest (part 2)

Live from Prospect St: Dizzy at Hillcrest (conclusion) – neurological exams, intracranial bleeds, strokes, and dizziness

Live from Prospect St: The Reluctant Tumble (part 1)

Live from Prospect St: The Reluctant Tumble (part 2)

Live from Prospect St: The Reluctant Tumble (conclusion) – traumatic head injury, high-risk refusals, medical control, health care proxies, and the ethics and legality of compelling patient transport

Live from Prospect St: The Big Crunch (part 1)

Live from Prospect St: The Big Crunch (part 2)

Live from Prospect St: The Big Crunch (conclusion) – MVA scene management, mechanism of injury, triage, the Pediatric Assessment Triangle, trauma destinations, and documenting child neglect

 

Evidence-based Medicine

Quick-and-dirty tips on reading medical studies, for those who lack strong backgrounds in biomedicine or statistics but still want to practice evidence-based care. Contains some select posts from the Lit Whisperers blog, but for more EBM goodness, head that way.

Reading Research: Diagnostics – the commonly-calculated attributes of diagnostic tests. Sensitivity, specificity, false/true positives and negatives, gold standards, positive and negative predictive values, pre-test probability, and likelihood ratios.

Reading Research: Outcomes – understanding how the study endpoints affect you

OR, ARR, RRR, NNT, WTF? [at Lit Whisperers] — calculating and understanding odds ratios, absolute risk reduction, relative risk/relative risk reduction, and NNT

Determining Risk/benefit Using Test Thresholds [at Lit Whisperers] — illustrating the general method of weighing risk-vs-benefit using scientific evidence

Publication Bias [at Lit Whisperers] — publication bias in research and how to be aware of it

A Jaundiced Eye for Clinical Guidelines [at Lit Whisperers] – the problem of biased guideline committees

Outcomes (and why you don’t get to supersize them) [at Lit Whisperers] – why study endpoints should be few and must be specified beforehand

 

Understanding Shock

An extensive tutorial on the pathophysiology, recognition, and treatment of shock, with an emphasis on hemorrhagic shock secondary to penetrating trauma.

Understanding Shock I: Introduction

Understanding Shock II: What the What?

Understanding Shock III: Pathophysiology

Understanding Shock IV: Bleeding Control

Understanding Shock V: Blood Transfusion

Understanding Shock VI: Fluid Resuscitation

Understanding Shock VII: Negatives of Fluid Resuscitation

Understanding Shock VIII: Prehospital Course of Care

Understanding Shock IX: Assessment and Recognition

Understanding Shock X (supplement): Fluid Choices

 

Pulse Oximetry

In-depth information on the intelligent use of the pulse oximeter.

Respiration and Hemoglobin — the basics of pulmonary and cellular oxygen transport, oxyhemoglobin binding and delivery, and understanding the oxyhemoglobin dissociation curve

Pulse Oximetry: Basics — how the oximeter works

Pulse Oximetry: Application — using it in the field and interpreting the results

 

Glucometry

In-depth information on the intelligent use of the glucometer.

Glucometry: Introduction — background information on glucose metabolism, the basic pathophysiology of diabetes, and how hypoglycemia and hyperglycemia occur

Glucometry: How to Do it – basic use of the glucometer, accuracy, capillary vs. venous blood sources, calibration, and more

Glucometry: Clinical Interpretation – correlating glucometry results with clinical findings and recognizing sources of error

 

Mastering BLS Ventilation

Mastering BLS Ventilation: Introduction — challenges and goals of BLS ventilation and airway management

Mastering BLS Ventilation: Hardware — OPAs, NPAs, non-rebreathers, and apneic oxygenation using nasal cannulae

Mastering BLS Ventilation: Core Techniques – one- and two-hand BVM techniques, the sniffing position, and ramping

Mastering BLS Ventilation: Supplemental Methods – cricoid pressure, pocket masks, mouth-to-mouth, mandible grabs, risk factors, and creating PEEP with the BVM

Mastering BLS Ventilation: Algorithms – bringing it all together, and a proposed graphical algorithm

 

Assessment and Diagnosis

Some Things to Say — questions about general complaints and how to help

Some Things to Say (part 2) — questions about chest pain

Some Things to Say (part 3) — useful stock phrases for medical communication

Treat the Patient? — viewing assessment findings in context, occult killers, and “treat the patient” vs “treat the machine”

The Rapid Initial Assessment: Look, Talk, Feel – a basic, universal approach to forming your initial impression

Get Up, Stand Up: Orthostatics — taking and interpreting orthostatic vital signs

Vital Signs: Respirations — tips for counting respirations

Vital Signs: Pulse — tips for measuring pulses

Vital Signs: Blood Pressure — tips for obtaining blood pressures, as well as maintaining the BP cuff and using it as a tourniquet

The Rhythm Method — using rhythm to facilitate the taking of vital signs

Polypharmacy in the Elderly — the most common adverse drug complications in the elderly

Pediatric Airway Emergencies — recognition and treatment of croup and epiglottitis

The “Big Picture” Diagnosis — video piece on interpreting assessment findings in their overall context

Differentiating Syncope: A Few Pearls — tips for assessment of the syncope patient

Managing STEMI Mimics in the Prehospital Environment — PowerPoint on recognizing and treating LBBB, LVH, BER, etc. using the ECG

Managing STEMI Mimics in the Prehospital Environment: Video Lecture – a narrated video lecture of the above PowerPoint

Am I Normal? Finding the Baseline – tricks for differentiating new vs. chronic abnormal assessment findings

The Curious Incident of the Dog in the Diagnosis – lessons from Sherlock Holmes about the diagnostic arts

Staying in Place: Compensation and Endpoints – understanding how the body uses certain systems to compensate for others

 

Working in EMS

Acceptable Risk — understanding that flukes don’t mean the system is broken

Decision Fatigue and Good Habits — how decision fatigue can affect our work, and how to manage it

Job Stability in EMS – employment in private EMS and how to keep it

But it’s Just a Broken Nail! – when it’s “okay” for patients to refuse transport

Confidence vs. Competence — matching your demeanor to your abilities

The Laws of EMS — universal principles for the job

Clinical Judgment: How to Do Less – using experience and knowledge to titrate care

Podcast: EMS to ED Interface — an audio discussion with an ED nurse and Dr. Brooks Walsh about improving transfer of care

Preparation vs. Improvisation – the importance of preparation even when planning to roll with punches

The 10 Easiest Ways to Violate HIPAA – common and easy pitfalls that break the law

Child-rearing and You – advice for training new partners

A Saving People Thing – thoughts on the unique appeal of EMS, and parting comments as site updates take a back burner

Glass Houses: Suicide in Both Seats – remarks on the frequency and red flags for suicide attempts, and why EMS providers themselves are at risk

 

Patient Transfers

The Art of the Transfer (part 1) — practicing assessments on routine transfers

The Art of the Transfer (part 2) — the educational benefits of patient charts

The Art of the Transfer (part 3) – the human perks of meeting non-emergent patients

 

Tips, Tricks, Logistics, and Skills

Experience: Sweating the Small Stuff – comments inspired by Scott Weingart‘s remarks on mastering the small things in order to smoothly perform the large in difficult, dynamic circumstances

Check, Check, Check — Check it Out — optimizing your start-of-shift equipment check

Lifting Things Up and Putting Them Down — safe lifting and strength training for EMS

Cheat Sheets — creating personalized pocket references

Eight Tips on Ambulance Wrangling – some less-known tricks for using Type II and III Ford ambulances

Eight More Tips on Ambulance Wrangling — more tricks for the Ford ambulances

Spinning a Yarn: The Chronological Narrative — samples and ideas for writing long-form narratives

Hurry Up and Wait — minimizing transfer times for time-critical patients

Oldest Trick in the Book — wearing visible IDs

CPR for Dummies: How to Save a Life – fundamentals of post-2010 resuscitation

Ensuring Appropriate Triage – Bob Sullivan‘s suggestions for doing your part at the ED

What’s it Got in its Pockets? – tools to carry with you at all times

Dialing it Down a Notch – bringing order to chaos and managing anxious patients

Tiny Monsters – cross-contamination and proper handwashing

The Slow Ride — comfortably transporting extremely pain-sensitive patients

A Million and One Towelplications — the countless uses for towels and other linen

Cuff Links and Hijinks – zeroing out miscalibrated blood pressure cuffs, using them as tourniquets, and creating an airway pressure gauge

Advanced CPR Techniques for Basic Providers – BLS techniques for going the extra mile during resuscitation

Super Soakers: Building a BLS Irrigation Device – drilling a hole in sterile water bottles for easy irrigation

Child Rearing and You – concepts and suggestions for training and dealing with new partners

Toastmasters and Trauma Patients – using tone, pacing, cadence, and body language to bring clarity to verbal reports

 

Warm and Fuzzy Stuff: Palliative Care and Dealing with People

Glove Monsters — making kid-friendly balloon puppets from gloves

People Care — the most important book for any EMT, by our hero Thom Dick

All Nestled in Bed: Blanket Warmers — using warmed blankets

The Tough Ones — dealing with difficult patients

Unique, Just Like Everyone Else – lessons from Randy Pausch on treating people routinely but uniquely

Because it’s Cold Out There — advocating for people who have nobody else

Psychological First Aid — evidence-based methods for managing the acute aftermath of an emergency

Missing your Manners — the importance of the introduction

Your High Horse — the value of kneeling beside the patient

Somebody Should be Upset — reflections on the role of a provider’s grief reaction and one’s connection with their patients

 

Community

David Hiltz on Resuscitation — interview with Dave Hiltz of the AHA regarding HEARTSafe communities and current issues in out-of-hospital cardiac arrest

Russ Reina: Moments in the Death of a Flesh Mechanic – book review

Thoughts from WMEMS — lecture notes from the 2011 Western Massachusetts EMS Conference, with emphasis on talks by Kyle David Bates

Product Review: Shoes for Crews Maverick – review of some slip-resistant boots

 

Those who Save Lives

Telling the stories of notorious life-savers and rescuers worth emulating from the pages of history.

Those who Save Lives: The Royal Humane Society – historical life-saving from the early days of resuscitation in England

Those who Save Lives: Harry Watts – the story of the English sailor and diver who saved 36 lives

 

Miscellaneous Musings

A Few More Weeks

Copy, Roger Roger – regional lingo in EMS

The Way You Do the Things You Do — the EMS persona and why we adopt it

Happy New Year — the blog’s first year anniversary, with reflections and acknowledgements

Year Two — second anniversary post

Welcome to Scenarioville! — announcing the launch of the Scenarioville project

Cutting the Ribbon: The EMSB Digital Research Library – announcing the launch of the DRL

Surly Librarians and their Rants – announcing the launch of the Lit Whisperers blog

Love in the Time of Melena – thoughts on dating in EMS

 

Comments

  1. Wow! I recently found your site. I love the Scenarioville. I can’t wait to read more of the things you have on this site. Thanks for putting it all together.

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