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We're a couple buffs providing free, open-access content to encourage prehospital providers to think critically. Our opinions don't represent expert consensus.

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    Scoop and Run: The Multicenter Canadian Study of Prehospital Trauma Care

    Scoop and Run: The Multicenter Canadian Study of Prehospital Trauma Care

            Scoop-and-run or stay-and-play? The question has been asked countless times in the prehospital setting. While there is no disputing the fact that the hospital represents the ultimate destination for definitive care, there is always some question as to whether precious transport time should be compromised for prehospital interventions. In some instances, immediate therapy appears to be justified. In cases of trauma, however, a growing body of evidence supports the rapid transport of patients to a trauma-referral center. One...
    By Michael Spigner MD | January 3, 2016 |
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    Is lorazepam worth the effort to securely refrigerate?

    Is lorazepam worth the effort to securely refrigerate?

    In EMS systems in which benzodiazepines are in-protocol, there is often a discussion about whether lorazepam is worth having on the ambulance, especially since it requires secure, refrigerated storage. In comparison, diazepam and midazolam, which are other commonly carried benzodiazepines, do not require refrigeration. An argument for lorazepam's place on the ambulance can be made by a couple unique features. While midazolam can also be administered by this route, it is more short-acting that lorazepam, and thus is less suitable for...
    By Michael Spigner MD | December 29, 2015 |
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    Blood Pressure: What to know, and how to measure one properly.

    Blood Pressure: What to know, and how to measure one properly.

    Blood pressure is one of the four main vital signs, along with pulse, respirations, and temperature, which are aptly named to reflect their importance in the evaluation of a patient. Blood pressure is an especially important figure, as it is directly proportional to the perfusion pressure of various organs (the pressure needed to squeeze oxygen-carrying blood to vital organs). For example, if a patient's blood pressure is too low, blood may not be able to overcome the resistance of blood vessels...
    By Michael Spigner MD | December 17, 2015 |
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