In the field of EMS, maintenance is critical. Our trucks must be kept in good working order, our drugs must be up to date, and even our knowledge base must be tweaked regularly to ensure we keep up with new trends in the field and keep our skills sharp.

We all know the key to a thorough patient assessment is to approach it systematically so that we don’t become distracted (by that bleeding scalp wound) or skip steps that may yield valuable information (like listening to breath sounds). There’s a reason we are all taught “head-to-toe” surveys: so that we work our way through essential assessment points, avoiding a haphazard exam where key signs are missed.

You are called to the nursing home to treat a “patient choking.” Upon arrival, you are rushed to the room of an elderly man who has suffered three previous strokes, resulting in limited mobility and significant speech impairment. Fortunately, the patient is no longer choking. Swift action on the part of the staff prevented an airway obstruction, and the patient is now resting comfortably. But is he truly out of danger? 

EMTs deal with emergencies every day, so it’s easy to feel like emergency preparedness is baked into the job – and that can lead to complacency.

Foreseeable disasters can come in all shapes and sizes, from a power failure that affects only your facility to an earthquake that sends hundreds of casualties to your emergency department.

A growing group of people are passionate about airway management and minimizing the risks of aspiration and its subsequent effects. Dr. James DuCanto identified an improved technique called suction-assisted laryngoscopy and airway decontamination (SALAD).

Training is an essential part of your job. With the demands of your work schedule, spending time with your family, and your daily obligations, you may find yourself struggling to find the motivation to put in extra time for training. But even the most skilled practitioners need to train—and train often—to best serve their patients when airway emergencies occur.

Tracheostomies are increasingly common, particularly in long-term skilled nursing facilities and intensive care units, which means all medical providers must master tracheostomy secretion management. Tracheostomy reduces cough strength, lowers subglottic pressure, and weakens sensations in the pharynx and larynx.

It’s a dramatic plot twist in movies, medical dramas, and even the occasional sitcom (think MacGyver): A character is choking or in respiratory distress and standard interventions like the Heimlich maneuver just aren’t cutting it. So a heroic bystander takes things into their own hands and jams a pen into the victim’s throat, much to everyone’s horror. But then, to everyone’s shock and relief, doing so clears the airway, allowing the survivor to breathe until help arrives. But can you really do this?