February ushered in another mass shooting at another school, this time with 17 people killed. Much has been debated about the response of law enforcement—their lack of a timely entry, their failure to engage the shooter. As emergency responders, we should reserve judgment on our partners in law enforcement, and instead, focus on how we can all work together to reduce mortalities when these horrific incidents take place.

We've all been there: You're working a code in a crowded restaurant—a patron who has just finished a gargantuan meal—and as you set up your intubation equipment, the patient begins to vomit. Luckily, you have your portable suction unit ready, so your partner begins to suction as you prep your tube. But as you position yourself at the head, the patient continues to spew. What should you do? How are you supposed to intubate a patient who is actively vomiting? Impossible, right? No. There is now a technique that enables you to intubate, even in the most difficult conditions.

Anyone who has seen the news lately can attest to the fact that we are in the throes of a serious flu season. Not only has there been widespread infection across the country, but there are numerous strains out there that fall outside of this year’s immunization. That’s not to say that the flu shot is useless. On the contrary, seasonal flu shots are a great way to protect yourself, especially if you are very young, elderly, or immunocompromised. The flu shot may lessen the symptoms and shorten the infection, even if you acquire a different strain. And if you’re a health care provider, you need all the protection you can get.

Thanks to modern medicine and advances in genomics, cancer treatment, and longevity research, the aging population across the United States continues to grow. As it grows, the frequency of EMS providers responding to geriatric patients will only increase.

The victim was another in a long line—that same dark, narrow stretch of roadway that seems to breed head-on collisions. He was unresponsive, pinned beneath the wreckage of the steering wheel, and bleeding profusely from the mouth. As the crews wrestled the extrication tools, working to pop the door, you cranked on your portable suction unit to clear the airway.

Responding to pediatric medical emergencies is never easy, especially since most such emergencies involve some form of trauma. Emergencies involving traumatic injuries to a child can be highly stressful events not only for the patient and their family, but for you, the responder, as well. Motor vehicle accidents, falls, and bicycle crashes are just a few of the scenarios that can result in serious, even life-threatening injuries for children; between infancy and adulthood, traumatic injuries make up the most common cause of death, according to the American Academy of Pediatrics (AAP).¹

Respiratory emergencies are some of the most critical calls to which you will respond. If the airway is impeded or the patient is unable to exchange oxygen, you could be heading straight toward respiratory arrest. Your job is to prevent the arrest and ensure a patent airway with good air exchange—which is why a thorough understanding of thoracic anatomy is fundamental to correcting respiratory insufficiency.

On October 2, 2017, we woke up to the grim news of another mass shooting. The night before, a man in Las Vegas had opened fire on a crowd of concert fans, discharging high-powered weapons from the 32nd floor of the Mandalay Bay hotel, killing 58 people and injuring over 800. Police stormed the hotel but found the gunman had already committed suicide, thus ending the siege after leaving a morbid path in his wake.

As we kick off the new year, and make plans for emergency preparedness, it behooves us to take a glimpse in the rearview. The prior year, 2017, was not pretty; we saw a plethora of natural disasters, from earthquakes in Mexico, to flooding in Bangladesh, to a hurricane leaving thousands without power on Puerto Rico, months after the rains have moved on.

Ask any paramedic and they’ll tell you one of the most critical pieces of equipment in their EMS arsenal is their portable suction unit. Nothing takes the place of a suction unit. There is no other means of removing blood, vomit, or secretions from an airway, except through immediate, aggressive suction. This is why the maintenance of your unit is vital to airway management.