Centre for Paramedic Education and Research
@cper-hhs.bsky.social
🚑 The Centre for Paramedic Education and Research (CPER) provides medical delegation, certification, education, and quality assurance for paramedics in the West Region of Ontario. 🏥 https://cper.myobh.ca/
On the latest AskMED: CPAP in palliative lung Ca dyspnea • suction & iGels • amio for VT • DNRs vs reversibility • and what ALS-PCS 5.4 does (and doesn’t) say on opioid switching in the analgesia directive.
www.youtube.com/live/P1vh8fF...
www.youtube.com/live/P1vh8fF...
AskMED August 19, 2025
YouTube video by Centre for Paramedic Education and Research
www.youtube.com
August 21, 2025 at 10:47 AM
On the latest AskMED: CPAP in palliative lung Ca dyspnea • suction & iGels • amio for VT • DNRs vs reversibility • and what ALS-PCS 5.4 does (and doesn’t) say on opioid switching in the analgesia directive.
www.youtube.com/live/P1vh8fF...
www.youtube.com/live/P1vh8fF...
Tune in to AskMED on the CPER YouTube Channel. Streaming live on Tuesday, August 19th at 3:30pm.
You've sent us your questions; we'll come up with some answers!
youtube.com/@CPER_HHS
You've sent us your questions; we'll come up with some answers!
youtube.com/@CPER_HHS
August 14, 2025 at 9:30 PM
Tune in to AskMED on the CPER YouTube Channel. Streaming live on Tuesday, August 19th at 3:30pm.
You've sent us your questions; we'll come up with some answers!
youtube.com/@CPER_HHS
You've sent us your questions; we'll come up with some answers!
youtube.com/@CPER_HHS
That wraps it up for #MedTalk2024 from CPER. Thanks for following along online. We look forward to your thoughts on the subjects covered today.
Got questions for AskMED? Hit us up at askmed@cper.ca
Got questions for AskMED? Hit us up at askmed@cper.ca
November 13, 2024 at 9:07 PM
That wraps it up for #MedTalk2024 from CPER. Thanks for following along online. We look forward to your thoughts on the subjects covered today.
Got questions for AskMED? Hit us up at askmed@cper.ca
Got questions for AskMED? Hit us up at askmed@cper.ca
The 2024 Western Trauma Association indications for resuscitative thoracotomy:
- Penetrating Thoracic Trauma: prehospital CPR for <15 min
- Blunt Trauma: signs of life upon initial eval, prehospital CPR <10 min
- Penetrating Neck or Extremity Injury: prehospital CPR <5 minutes.
- Penetrating Thoracic Trauma: prehospital CPR for <15 min
- Blunt Trauma: signs of life upon initial eval, prehospital CPR <10 min
- Penetrating Neck or Extremity Injury: prehospital CPR <5 minutes.
November 13, 2024 at 8:57 PM
The 2024 Western Trauma Association indications for resuscitative thoracotomy:
- Penetrating Thoracic Trauma: prehospital CPR for <15 min
- Blunt Trauma: signs of life upon initial eval, prehospital CPR <10 min
- Penetrating Neck or Extremity Injury: prehospital CPR <5 minutes.
- Penetrating Thoracic Trauma: prehospital CPR for <15 min
- Blunt Trauma: signs of life upon initial eval, prehospital CPR <10 min
- Penetrating Neck or Extremity Injury: prehospital CPR <5 minutes.
Pericardial tamponade -> Thoracotomy/needle pericardiocentesis
Tension pneumothorax -> Thoracostomy
Thoracic hemorrhage -> Thoracotomy
Abdominal hemorrhage -> Thoracotomy/REBOA
Extremity hemorrhage -> Tourniquet Application
Hypoxia -> Definitive airway management
#MedTalk2024
Tension pneumothorax -> Thoracostomy
Thoracic hemorrhage -> Thoracotomy
Abdominal hemorrhage -> Thoracotomy/REBOA
Extremity hemorrhage -> Tourniquet Application
Hypoxia -> Definitive airway management
#MedTalk2024
November 13, 2024 at 8:40 PM
Pericardial tamponade -> Thoracotomy/needle pericardiocentesis
Tension pneumothorax -> Thoracostomy
Thoracic hemorrhage -> Thoracotomy
Abdominal hemorrhage -> Thoracotomy/REBOA
Extremity hemorrhage -> Tourniquet Application
Hypoxia -> Definitive airway management
#MedTalk2024
Tension pneumothorax -> Thoracostomy
Thoracic hemorrhage -> Thoracotomy
Abdominal hemorrhage -> Thoracotomy/REBOA
Extremity hemorrhage -> Tourniquet Application
Hypoxia -> Definitive airway management
#MedTalk2024
Why do trauma patients arrest?
- Exsanguination.
- Brain Injury
- Tension/pressure conditions of the chest.
- High-spinal cord injury.
#MedTalk2024
- Exsanguination.
- Brain Injury
- Tension/pressure conditions of the chest.
- High-spinal cord injury.
#MedTalk2024
November 13, 2024 at 8:32 PM
Why do trauma patients arrest?
- Exsanguination.
- Brain Injury
- Tension/pressure conditions of the chest.
- High-spinal cord injury.
#MedTalk2024
- Exsanguination.
- Brain Injury
- Tension/pressure conditions of the chest.
- High-spinal cord injury.
#MedTalk2024
"Witnessed prehospital traumatic arrest: predictors of survival to hospital discharge."
For EMS witnessed arrests, 10% survived to hospital discharge, 22% with ROSC but did not leave hospital, 68% pronounced deceased on arrival or within the ED. #MedTalk
https://buff.ly/3Z3JuUr
For EMS witnessed arrests, 10% survived to hospital discharge, 22% with ROSC but did not leave hospital, 68% pronounced deceased on arrival or within the ED. #MedTalk
https://buff.ly/3Z3JuUr
November 13, 2024 at 8:28 PM
"Witnessed prehospital traumatic arrest: predictors of survival to hospital discharge."
For EMS witnessed arrests, 10% survived to hospital discharge, 22% with ROSC but did not leave hospital, 68% pronounced deceased on arrival or within the ED. #MedTalk
https://buff.ly/3Z3JuUr
For EMS witnessed arrests, 10% survived to hospital discharge, 22% with ROSC but did not leave hospital, 68% pronounced deceased on arrival or within the ED. #MedTalk
https://buff.ly/3Z3JuUr
"Trauma is the ultimate team sport." #MedTalk2024
November 13, 2024 at 8:25 PM
"Trauma is the ultimate team sport." #MedTalk2024
Next a talk from Dr. Paul Engels, from the Trauma Program at Hamilton Health Sciences. "Traumatic Cardiac Arrest" #MedTalk2024
November 13, 2024 at 8:23 PM
Next a talk from Dr. Paul Engels, from the Trauma Program at Hamilton Health Sciences. "Traumatic Cardiac Arrest" #MedTalk2024
In pediatric resuscitation, what do paramedics do well? A smattering of feedback from some other medical professionals.
Be comfortable that paramedics are good at this stuff. You have the skills you need.
#MedTalk2024
Be comfortable that paramedics are good at this stuff. You have the skills you need.
#MedTalk2024
November 13, 2024 at 7:54 PM
In pediatric resuscitation, what do paramedics do well? A smattering of feedback from some other medical professionals.
Be comfortable that paramedics are good at this stuff. You have the skills you need.
#MedTalk2024
Be comfortable that paramedics are good at this stuff. You have the skills you need.
#MedTalk2024
The PRIME Study is looking at whether IM epinephrine added to the standard of care will improve outcomes in pediatric cardiac arrest patients. Some of our CPER services are participants in this important research study. #MedTalk2024
https://buff.ly/3UPzpIq
https://buff.ly/3UPzpIq
November 13, 2024 at 7:49 PM
The PRIME Study is looking at whether IM epinephrine added to the standard of care will improve outcomes in pediatric cardiac arrest patients. Some of our CPER services are participants in this important research study. #MedTalk2024
https://buff.ly/3UPzpIq
https://buff.ly/3UPzpIq
Don't cut your care to expedite transport. #MedTalk2024
'
"Survival After Intra-Arrest Transport vs On-Scene Cardiopulmonary Resuscitation in Children"
Paper: https://buff.ly/48QQgjx
'
"Survival After Intra-Arrest Transport vs On-Scene Cardiopulmonary Resuscitation in Children"
Paper: https://buff.ly/48QQgjx
November 13, 2024 at 7:46 PM
Don't cut your care to expedite transport. #MedTalk2024
'
"Survival After Intra-Arrest Transport vs On-Scene Cardiopulmonary Resuscitation in Children"
Paper: https://buff.ly/48QQgjx
'
"Survival After Intra-Arrest Transport vs On-Scene Cardiopulmonary Resuscitation in Children"
Paper: https://buff.ly/48QQgjx
"Early On-Scene Management of Pediatric Out-of-Hospital Cardiac Arrest Can Result in Improved Likelihood for Neurologically-Intact Survival."
Don't forget. As paramedics, you have what these kids need. #MedTalk2024
Don't forget. As paramedics, you have what these kids need. #MedTalk2024
Redirecting
buff.ly
November 13, 2024 at 7:38 PM
"Early On-Scene Management of Pediatric Out-of-Hospital Cardiac Arrest Can Result in Improved Likelihood for Neurologically-Intact Survival."
Don't forget. As paramedics, you have what these kids need. #MedTalk2024
Don't forget. As paramedics, you have what these kids need. #MedTalk2024
"Advanced airway management for pediatric out-of-hospital cardiac arrest: A systematic review and network meta-analysis." #MedTalk2024
buff.ly
November 13, 2024 at 7:35 PM
"Advanced airway management for pediatric out-of-hospital cardiac arrest: A systematic review and network meta-analysis." #MedTalk2024
Remember that intubation is PART of airway management. It is not the same as airway management. - Johnathan Lee, #MedTalk2024
November 13, 2024 at 7:35 PM
Remember that intubation is PART of airway management. It is not the same as airway management. - Johnathan Lee, #MedTalk2024
High quality CPR is one of the few things we do in resuscitation that has really good evidence to support that it makes a difference.
Don't forget the basics.
#MedTalk2024
Don't forget the basics.
#MedTalk2024
November 13, 2024 at 7:34 PM
High quality CPR is one of the few things we do in resuscitation that has really good evidence to support that it makes a difference.
Don't forget the basics.
#MedTalk2024
Don't forget the basics.
#MedTalk2024
Thanks, Jeff. Next up is the incomparable Jonathan Lee with his talk on' "Everything You Wanted To Know About Pediatric Arrest But Were Too Afraid To Ask" #MedTalk2024
November 13, 2024 at 7:34 PM
Thanks, Jeff. Next up is the incomparable Jonathan Lee with his talk on' "Everything You Wanted To Know About Pediatric Arrest But Were Too Afraid To Ask" #MedTalk2024
Work with law enforcement on as minimal restraint as possible, remember this is YOUR patient. Consider moving to chemical sedation rapidly, and monitor, monitor, monitor.#MedTalk2024
November 13, 2024 at 7:34 PM
Work with law enforcement on as minimal restraint as possible, remember this is YOUR patient. Consider moving to chemical sedation rapidly, and monitor, monitor, monitor.#MedTalk2024
Chemical sedation doesn't come /after/ physical restraint. It's not sequential. Consider them concurrently, and with just enough physical restraint to get chemical sedation on board and expedite your patient to the definitive medical care they need. #MedTalk2024
November 13, 2024 at 7:11 PM
Chemical sedation doesn't come /after/ physical restraint. It's not sequential. Consider them concurrently, and with just enough physical restraint to get chemical sedation on board and expedite your patient to the definitive medical care they need. #MedTalk2024
(Strömmer 2022) - Literature review of all studies on "excited delirium" or "agitated delirium" up to April 2020. The restraint rate in those with a fatal outcome was 90%, with "forceful restraint" markedly increasing the rate. #MedTalk2024
The role of restraint in fatal excited delirium: a research synthesis and pooled analysis - PubMed
The purpose of the present study was to perform a comprehensive scientific literature review and pooled data risk factor analysis of excited delirium syndrome (ExDS) and agitated delirium (AgDS). All…
buff.ly
November 13, 2024 at 7:01 PM
(Strömmer 2022) - Literature review of all studies on "excited delirium" or "agitated delirium" up to April 2020. The restraint rate in those with a fatal outcome was 90%, with "forceful restraint" markedly increasing the rate. #MedTalk2024
A very difficult look at what went wrong in the 2022 in-custody death of Ladamonyon “DeeDee” Hall. #MedTalk2024
November 13, 2024 at 6:56 PM
A very difficult look at what went wrong in the 2022 in-custody death of Ladamonyon “DeeDee” Hall. #MedTalk2024
This is the Physicians for Human Rights report (PDF) mentioned by Jeff Bilyk
in the current talk. Physical restraint plays the major role in in-custody deaths. #MedTalk2024
https://buff.ly/4fMC5ye
in the current talk. Physical restraint plays the major role in in-custody deaths. #MedTalk2024
https://buff.ly/4fMC5ye
November 13, 2024 at 6:45 PM
This is the Physicians for Human Rights report (PDF) mentioned by Jeff Bilyk
in the current talk. Physical restraint plays the major role in in-custody deaths. #MedTalk2024
https://buff.ly/4fMC5ye
in the current talk. Physical restraint plays the major role in in-custody deaths. #MedTalk2024
https://buff.ly/4fMC5ye
Hyperactive delirium is a syndrome of severe agitation. It is not a diagnosis. Make sure to assess for underlying causes: CNS/neuro, tox, psychiatric and mental health crisis, traumatic, metabolic, etc. #MedTalk2024
November 13, 2024 at 6:41 PM
Hyperactive delirium is a syndrome of severe agitation. It is not a diagnosis. Make sure to assess for underlying causes: CNS/neuro, tox, psychiatric and mental health crisis, traumatic, metabolic, etc. #MedTalk2024
Defining "Hyperactive Delirium." See also the recent statement from ACEP that provides their definition. #MedTalk2024
November 13, 2024 at 6:38 PM
Defining "Hyperactive Delirium." See also the recent statement from ACEP that provides their definition. #MedTalk2024