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We're back! Have you ever had a patient who suffered a seemingly minor injury and was complaining about weakness in their hands and odd sensations in their legs? This week we're discussing the most common spinal cord injury: Central Cord Syndrome. We'll also touch briefly on neurogenic and spinal shock.

During this episode I mention a technique for placing a C-collar that was a "game changer" in my practice and promised to include a link to the video in the show notes. When you're done listening, go ahead and check out the video below. The "sweeping motion" made a huge difference in helping the collar sit better on the patient's neck and has reduced the number of patients that seemingly "can't tolerate" the procedure. I hope you find it helpful!

C-collar video: https://www.youtube.com/watch?v=ydljBEN2RU8

This episode is sponsored by CPR Ready Los Angeles, an American Heart Association Training Site offering BLS, ACLS, and PALS classes as well as California EMT Skills Verification services. Book your class today at cprreadyla.com!

References:

Ameer, M. A., Tessler, J., Munakomi, S., et al. (2023). Central cord syndrome. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from https://www.ncbi.nlm.nih.gov/books/NBK441932/

Brooks, N. P. (2017). Central cord syndrome. Neurosurgery Clinics, 28(1), 41-47.

EMCrit (2023, February 12). Traumatic spinal cord injury (SCI). EMCrit Project. https://emcrit.org/ibcc/sci/

Fehlings, M. G., Tetreault, L. A., Wilson, J. R., Aarabi, B., Anderson, P., Arnold, P. M., ... & Harrop, J. S. (2017). A clinical practice guideline for the management of patients with acute spinal cord injury and central cord syndrome: Recommendations on the timing (≤ 24 hours versus > 24 hours) of decompressive surgery. Global Spine Journal, 7(3_suppl), 195S-202S.

Harrop, J. S., Sharan, A., & Ratliff, J. (2006). Central cord injury: Pathophysiology, management, and outcomes. The Spine Journal, 6(6), S198-S206.

Skrabal, R. (2019, October 28) Central cord syndrome. https://coreem.net/core/central-cord-syndrome.

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We've all been taught that the last thing you want to do to a sick child in respiratory distress is upset them by sticking an oxygen mask to their face. For many of us, "blow by" oxygen is our go-to in these situations. But is it actually the right choice? In this episode we'll take a closer look at the practice and the evidence. (Spoiler alert: it doesn't work).

References:

Barends, C. R. M., Yavuz, P., Molenbuur, B., & Absalom, A. R. (2018). Performance of blow-by methods in delivering oxygen to pediatric patients during transport: A laboratory study. Pediatric Anesthesia, 28(12), 1142-1147. https://doi.org/10.1111/pan.13515

Blake, D. F., Shih, E. M., Mateos, P., & Brown, L. H. (2014). The efficacy of oxygen wafting using different delivery devices, flow rates and device positioning. Australasian Emergency Nursing Journal, 17(3), 119-125. https://doi.org/10.1016/j.aenj.2014.05.002

Davies, P., Cheng, D., Fox, A., & Lee, L. (2002). The efficacy of noncontact oxygen delivery methods. Pediatrics, 110(5), 964-967. https://doi.org/10.1542/peds.110.5.964

Harris, M., Lyng, J. W., Mandt, M., Moore, B., Gross, T., Gausche-Hill, M., & Donofrio-Odmann, J. J. (2022). Prehospital Pediatric Respiratory Distress and Airway Management Interventions: An NAEMSP Position Statement and Resource Document. Prehospital Emergency Care, 26(sup1), 118-128. https://doi.org/10.1080/10903127.2021.1994675

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Alcohol and benzodiazepine withdrawal are life-threatening conditions that are often under-appreciated by EMS providers. In this episode, we discuss what makes these conditions so dangerous and how to improve your detection and care of these patients. There's even an obscure music lyrics reference hidden inside. Enjoy!

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Audio of Sepsis Detective EMS CE presented via Zoom on June 15, 2023.

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Whether you call it Excited Delirium, Agitated Delirium, or the newer Hyperactive Delirium with Severe Agitation, this controversial condition often leads to restraint-related sudden cardiac arrest. Listen to this episode before you restrain your next agitated patient!

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Given for Hatzolah EMS on March 10, 2022. Capnography for EMS Providers.

Watch the video version at https://youtu.be/MKgDG9KFMHE

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Patients with Sickle Cell Disease often present to EMS with acute pain. In this episode we'll discuss best practices in assessing and treating that pain and discuss when to provide IV fluids and supplemental oxygen.

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They may end in "LOL" but Beta blocker overdoses are no laughing matter! Join us this week as we discuss pearls and pitfalls for the EMS management of these dangerous overdose emergencies.

EPISODE NOTE: In the case presentation the patient is identified as hypoglycemic but this was not specifically addressed in the episode. If present, hypoglycemia should be addressed by administering IV dextrose.