Scenario A: Marty, of the local public swimming pool, is preparing for the upcoming season. He enters the maintenance shed, where 55 gallon drums of liquid chlorine are being stored. Scenario B: Tabitha did not use her backyard pool last year, as she did not want to deal with the headache of maintaining the water quality throughout the season. […]
About Michael Spigner MD
Michael Spigner is a resident physician in the Emergency Department at the University of Cincinnati (USA). He currently serves multiple prehospital roles, including Team Physician for Cincinnati Police Department SWAT, Flight Physician for UC AirCare, and Assistant Medical Director for Reading Fire Department and Evandale Fire Department. He is a former Ambulance Unit President of the Manhasset-Lakeville Fire Department (NY), where he served as a firefighter, EMT-Critical Care, and member of the Technical Rescue Team for seven years. He has also held national leadership positions with the Emergency Medicine Residents’ Association, including as the Chair of Prehospital and Disaster Medicine. He is a former Assistant Medical Director of the Colerain Township Fire Department (OH). He has a vested interest in promoting evidence-based medicine in the prehospital environment, and empowering prehospital providers to advance their field through critical thinking and personal accountability.
Paramedic Humphrey has just responded to the residence of a lovely 72-year old woman who fell in her home. As he engages her in conversation, he makes a point of asking whether she “tripped”, or whether she had any preceding symptoms that may have induced her fall. She responds, “I don’t think I had any symptoms.” Humphrey is […]
Resuscitation protocols almost ubiquitously state the need for two large-bore IVs for rapid fluid administration. The fact that more fluid flows through a larger tube shouldn’t surprise anyone. It’s the reason that straws at fast food restaurants are so much wider than normal straws — larger diameter means more gulp per suck. It’s also the same reason […]
Let’s talk gas. As you lean over your keyboard breathing right now, you are inhaling a mixture of atmospheric gasses consisting primarily of oxygen (21%), nitrogen (78%), and carbon dioxide (0.04%). The total weight of the atmosphere on you is exerting a particular pressure. When you rise in altitude, the amount of atmosphere above you […]
When New York rolled out a massive protocol update in 2014, our fire department was fortunate enough to be able to add a few more trays to our drug box. Among the newcomers was norepinephrine, which was not unreasonably placed next to our existing stores of dopamine. Prior to this point, we had relied on dopamine as […]
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 […]