As you first approach your patient, you hear him snoring and notice the familiar sound of gurgling coming from his mouth. You immediately know you will be working to manage his airway—all within seconds of looking at, listening to, speaking with, and touching the patient. In fact, the first few seconds when you approach your patient will likely give you the most clinical information about your patient’s condition. You are bombarded with your patient’s information rapidly, sometimes instantaneously.

The EMS industry seems to have different trends constantly—new technologies and improved techniques bombard you on what seems like a daily basis. In 2019, these trends appear to have a deeper focus on the EMS system as a whole and the ultimate goal of improving the system and focusing on the patient. Let’s look at a few EMS trends to watch in 2019 and how they can impact you and your practice.

In the last 8 years, rural America has seen 83 hospitals close their doors¹, putting added strain on already limited resources and leaving communities without access to emergency healthcare. The remaining hospitals are responsible for a wider radius of territory which has led to increased patient transport time. As a result, first response care has become even more crucial in rural communities when an emergency situation arises and every second counts.

Airway suctioning is a routine part of a first responder’s job. From preventing aspiration pneumonia to clearing the airway of a drowning victim, the right suction machine is an integral part of your EMS toolkit. Yet many paramedics, EMTs, and other first responders avoid suctioning the airway unless they absolutely have to.

Each change of season brings special challenges for EMS professionals. Depending on where you live, and the climate in which you respond, temperature extremes can dictate specific precautions when it comes to equipment maintenance. In the extreme north, where heavy snowfall impedes response, specialized gear such as tires and protective clothing may need to be employed.

We tend to think of prehospital suctioning as a simple, straightforward treatment. You assemble your equipment, prep the patient, turn on the unit, and get to work clearing the airway. Easy, right?

Anyone who has worked in the field of EMS has worked their fair share of codes. You arrive on scene to find a patient in full arrest, so you initiate CPR, begin bagging, and break out your ALS equipment. Everything is running smoothly—that is, until the patient vomits. You reach for your portable suction unit, only to realize you left it on the truck. Big mistake!

Mass-casualty incidents (MCIs) are a growing concern in EMS. It seems we can't go a week without a mass shooting—a frightening reality in today's society. But MCIs also take other forms: multi-car pileups on the interstate, natural disasters that strike without warning, and the threat of bioterrorism from enemies abroad. As EMS professionals, we must be ready for anything.

Although the placement of chest tubes usually falls to physicians, many healthcare workers—be they paramedics or nurses—have had to take care of patients with chest tubes in place, either in a hospital setting or during transport. Chest tubes are a critical factor in certain respiratory emergencies, so let’s review the indications for placement and some of the dangerous complications you can avoid when caring for such patients.

As a medical professional, you know the critical role suctioning plays in airway management. Whether you are a medic on a rescue, a flight nurse on a helicopter, or part of an emergency room staff, you’ve seen how effective suctioning can be for a patient in respiratory distress.