The nightclub was packed when you pulled up front. The bouncers were waving frantically from just beyond the entrance as they stood over an unconscious male who was sprawled on the sidewalk. You and your partner grab the usual equipment: the airway bag, monitor, drug box, and portable suction unit. And it’s a good thing you included the suction. When you approach the patient, he’s unresponsive, frothing at the mouth, and barely moving any air.

The patient was practically comatose by the time you arrived on scene. A gastric cancer patient, he had lost his ability to effectively swallow and had regurgitated once he arrived home from his chemotherapy treatment. As your partner flips open the airway bag, you attach the monitor and note a bradycardic rate of fifty-four. You set up for an IV while your partner cranks on the O2, only to realize the tank is empty. He dashes out to the truck for a replacement while you attempt the IV. Valuable seconds tick by. The patient is breathing on his own, yet gasping, and you fail to notice the remnants of vomit and bile rimming his mouth. With each passing minute, he inhales more of the acidic stomach contents lodged in his airway. His prognosis is quickly devolving.

Depending upon where you work as an EMS professional, chances are you’ll respond to a natural disaster at some point in your career. In Florida, it could be a Category Five hurricane. North Dakota, perhaps a record-setting blizzard. California medics could face “the big one” – that catastrophic earthquake many experts say is long overdue. Or if you work in Kansas, where tornadoes are as much a part of summer as hotdogs and fireworks, that F3 could be just on the horizon.

When was the last time you intubated a patient? If you work in a busy metropolitan area, with high trauma rates or a large elderly population, intubations may be a regular occurrence. But for many emergency personnel, especially those assigned to slower stations, intubations are few and far between. Which makes it all the more critical to stay on top of your skills. And if you aren’t getting tubes in the field, the only other place to hone your technique is through training.

It was her second stroke in a year, and her daughter was doing the best she could, caring for her aging mother at home. The elderly woman had significant neural impairment, could barely speak, and had a stoma in place, which seemed to be doing little to ease her difficulty breathing. She had copious secretions bubbling up into her mouth and a rattling cough that wracked her slight frame. As the first responder, you automatically crank on your portable suction unit to try to ease her distress.

Your hospital has addressed natural disasters within its Emergency Operations Plan. Taking into account such things as your hospital’s location and weather-related risks, the types of disasters that are most likely to occur have been identified through your hospital’s Hazard Vulnerability Analysis. Action plans have been created and communicated to the entire staff.

Your shift is just beginning and you’re busy checking out your truck, when the paramedic student arrives, eager for a chance to exercise his new-found knowledge. You guide him through the equipment check and as you’re taking him through the drug box, he begins peppering you with questions about the proper pediatric doses for an array of cardiac meds. Suddenly, you realize it’s been awhile since you reviewed your protocols. As you stumble over your responses while quickly reaching for the Broselow Tape, you realize you could use a refresher. And if you are rusty, it’s a good bet your entire crew could benefit from some continuing education.

Paramedics rely on a multitude of tools. Imagine treating the range of patients you encounter in the field – from cardiacs, to trauma, to pediatrics – without a wide assortment of tools from which to choose. Impossible, right? And although some of these tools are essential to the job, and dictated by local and national standards, each tool contains various components that make it ideal for the system within which you work.

The child was pulled from the deep end pulseless and apneic. CPR was initiated immediately, and by the time you and your crew arrive on scene, a faint pulse is detectable. Your partner begins ventilating the patient, when suddenly the child vomits. Your potential save is once again in peril; this time from choking and aspiration. You reach for your portable suction unit and realize you left it on the truck. A crew member races back to the rescue to retrieve it as you log-roll the child onto his side, all the while struggling to ventilate, maintain c-spine, and continue resuscitative efforts. Not a good scenario.

The Zika virus has been getting a lot of coverage in the media. Primarily transmitted by infected mosquitoes, those who acquire the disease will experience symptoms such as fever, rash, and joint pain. Though the disease symptoms are relatively mild, concerns exist for pregnant women who contract the virus because it can lead to serious birth defects.