Author Archives: Tom Bouthillet

Electrocardiographically Silent High Lateral STEMI Equivalent

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A 60s male woke up with chest pain and contacted 9-1-1 after self-administered nitro did not help. Past medical history: hypertension, chronic back pain, stents “10 years ago” Medications: hydrocodone, nitroglycerin O: 15 minutes prior to 9-1-1 activation P: Nothing makes the pain better or worse Q: Dull and heavy “same as 10 years ago” […]

What are the Essential Elements of High Performance CPR?

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Adult High Performance CPR (HP-CPR) Demo at the South Carolina Resuscitation Academy! Hilton Head Island Fire Rescue: Tim Santini, Jon Ceiply, Shane Marstiller, Sean Kavlick What is High Performance CPR? High Performance CPR typically consists of expertly performed BLS with strict attention to: Minimally interrupted chest compressions Ensuring optimal rate (100-120) Ensuring adequate depth (2 […]

RCP de Alto Desempaño – ¡Rendimiento sobre Protocolo!

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Posición 1: Monitor Posición 2: RCP Posición 3: Vía Aérea Posición 4: Asistente Esta entrada es un complemento a Pit-Crew CPR en Adultos y Pit-Crew CPR Pediátrica. En concreto, esta es la forma en la que hemos modificado nuestro proceso de formación tras asistir a la Resuscitation Academy en Seattle / King County. Durante el […]

High Performance CPR – Performance Not Protocol!

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[Español] This is a supplement to Adult Pit Crew CPR and Pediatric Pit Crew CPR. Specifically, this is how we have modified our training process since attending the Resuscitation Academy in Seattle / King County. Each rescuer should experience each position at least twice. In other words, you run the drill, stop and switch, run the drill, […]

Pit Crew / High Performance CPR on the EMS Nation Podcast

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Editor-in-Chief Tom Bouthillet (@tbouthillet) was on the EMS Nation podcast (@EMS_Nation) for EMS Week. The topic was Pit Crew / High Performance CPR and Systems of Care. Click HERE to open in iTunes. Click HERE to open in Libsyn (with built-in media player). Referenced in this podcast Adult Pit Crew CPR – The Explicit Details […]

Continuous Chest Compressions vs. 30:2. Does It Matter? Depends On the Quality!

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Seattle Fire Department Engine 2. The rescuer on the left has just placed a metronome on the ground. I will eventually get around to composing a more thoughtful blog post about my experiences at the Resuscitation Academy but in the interim I wanted to share something about the ventilation strategy in King County, Washington. There […]

“Seizures” prove to be recurrent arrhythmias with multiple ICD shocks

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EMS is called to the residence of a 71 year old male for “seizures.” On arrival the patient’s spouse meets the ambulance outside and hurries the paramedics along saying “Come quickly! Please help him!” The paramedics arrive at the patient’s side just in time to see him receive an ICD shock. They ask how long […]

Elderly female with abdominal pain and wide complex tachycardia

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EMS is called to the residence of a 90 year old female who awoke to an “uncontrolled bowel movement” that corresponded with sudden onset abdominal pain. On EMS arrival, the patient is alert and oriented to person, place, time, and event. She has a grimace on her face and appears acutely ill. When asked the […]

30 Day Challenge

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Today is July 11 and I have not had a drink in 30 days. Some of you may know that my mother suffers from advanced dementia and requires round-the-clock care. She is on hospice and I have been out on FMLA leave helping with her care (which is why I missed SMACC in Chicago). This time […]

How to be successful at IV therapy – some advice for paramedic students

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Image credit: Wikimedia Commons In a recent thread at EMT Life a paramedic student wrote: Just entering my 2nd semester of paramedic school. So far I’ve found the coursework to be the easiest part. Instead of being stressed over tests I’m stressed over IV’s. 170 sticks in overall my % sucks. Granted most of those […]

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