Author Archives: Tom Bouthillet

Mark your calendars: EMS Today is back in Baltimore!

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Those of you who miss the Pratt Street Ale House, Slider’s Bar and Grill, Pickles Pub, “Natty Boh”, Maryland crabcakes, the Inner Harbor, and Fell’s Point will be glad to know that EMS Today is back in Baltimore Feb 25-28, 2015! I like the Smithsonian as much as the next guy (all right, probably more […]

100 yof CC: Rib pain and intermittent spasms

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Here’s an interesting set of ECGs sent to us by Frank Intessimoni of Atlanticare EMS. You can follow Frank on Twitter: @njmedic3228. EMS is called to a local nursing home for a 100 year old female patient who had been complaining of rib pain and intermittent spasms for 3 days. Vital signs were assessed. RR: […]

Pediatric Pit Crew CPR

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A reader asks, “Does your Pit Crew CPR process work for pediatrics?” The answer is yes (with some minor modifications). Some things to keep in mind: Pediatric cardiac arrest is more likely to be respiratory or asphyxial so there is less emphasis on “patient’s side to first shock” as the arrest rhythm is more likely […]

The most awesome STEMI test on the internet!

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Senior Editor Christopher Watford created an online STEMI test based on McCabe JM, et al. Physician Accuracy in Interpreting Potential ST-Segment Elevation Myocardial Infarction Electrocardiograms. J Am Heart Assoc. 2013; 2:e000268. It was in beta testing for a while (see this thread at but apparently it is now ready for prime time! I say that […]

Adult Pit Crew CPR – The Explicit Details

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I’ve given an overview of my department’s Pit Crew CPR process many times at, our Facebook page, the Resuscitation group, and various conferences around the country. (See also: Why do we send so many people to a cardiac arrest?) Even so, I’m frequently asked for specific details. People want to know exactly how we do it. […]

Why do we send so many people to a cardiac arrest?

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I did a fair amount of traveling and teaching in 2013 and I’ve been struck by the number of people who have been gobsmacked by the number of rescuers my fire department sends to a sudden cardiac arrest (1 ambulance, 2 engines, and a battalion chief). I think there are several reasons for this. In […]

STEMI Mimics and STEMI Equivalents

Here’s my presentation from the VA EMS Symposium on 11/08/2013. STEMI Equivalents and STEMI Mimics from Tom Bouthillet

Survivor gives us a lens into regional systems of care for acute ischemic stroke in North Dakota

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I just got back from the North Dakota Mission: Lifeline STEMI and Acute Stroke Conference in Bismark, ND. I had a great time and I learned a lot. I often get asked to speak in various venues about acute STEMI and 12-lead ECG interpretation, but for this conference they wanted me to talk mostly about […]

Episode #11 – Are we harming patients with oxygen?

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EMS 12-Lead Podcast – Episode 11 – Are We Harming Patients With Oxygen? In this episode of the EMS 12-Lead podcast we’re joined by Kelly Arashin, ACNP, CCNS and Mike McEvoy, PhD, RN, CCRN, REMT-P at EMS Today 2013 in Washington D.C. We discuss the benefits and dangers of oxygen administration. Kelly is a dual […]

Code STEMI – London Ambulance Service

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Ivan Rokos, M.D. has referred to primary PCI for acute STEMI as “the most complex, multi-disciplinary, and time-sensitive therapeutic intervention in the world of medicine.” The emphasis on door-to-balloon times, and more recently, first medical contact or EMS-to-balloon times has transformed how acutely ill patients suffering heart attacks receive timely reperfusion in many communities, because […]

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