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Articles by Casey Patrick
Safety of Prehospital Intravenous Bolus Dose Nitroglycerin in Patients With Acute Pulmonary Edema: A 4-Year Review
Journal of the American College of Emergency Physicians Open Post-print yes acute pulmonary edema, congestive heart failure, emergency medical services, nitroglycerin, prehospital Patrick, Casey; Fornage, Louis; Ward, Brad; et al., "Safety of Prehospital Intravenous Bolus Dose Nitroglycerin in Patients With Acute Pulmonary Edema: A 4-Year Review" (2023). Faculty and Staff Publications. 3897. https://digitalcommons.library.tmc.edu/baylor_docs/3897
Safety of Prehospital Intravenous Bolus Dose Nitroglycerin in Patients With Acute Pulmonary Edema: A 4-Year Review
BACKGROUND: Intravenous nitrates are a primary therapy for hypertensive congestive heart failure (CHF) with acute pulmonary edema (APE) in the hospital setting. Historically, sublingual nitrates are the mainstay of emergency medical services (EMS) pharmacologic therapy for these patients. We aimed to evaluate the safety of prehospital bolus dose intravenous nitroglycerin in patients with APE.
Functional differences in the mu opioid receptor SNP 118A>G are dependent on receptor splice‐variant and agonist‐specific recruitment of β‐arrestin
WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC? The OPRM1 118A>G SNP has been associated with variable clinical response to opioids. WHAT QUESTION DID THIS STUDY ADDRESS? What is the mechanism of variable clinical response to this SNP? WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE? We have performed a series of triangulated experiments to determine the mechanism that contributes to variable clinical effects in patients with the OPRM1 118A>G SNP.
Threads of Gold - DePauw University
Being in a sorority or fraternity means you are inherently part of a larger community that spans many generations, but Greek life is only a sliver of what defines the DePauw experience. McKiernan says that a fierce sense of curiosity is also key. “We know that we are unfinished – and never finished – and somehow curiosity and being open to courses and people will further shape us on our journey,” she says.
ESD11 clinical spotlight: Airway quality initiatives
By Casey Patrick, MD, FAEMS; Jordan Anderson, Dustin Yates, Pandora Peckne, Dana Hogue and Brandi Richardson Paralytic-assisted airway management is a high-risk prehospital procedure. Increasing emergency department data suggests that video laryngoscopy should be first line for emergent airway management.
MCHD's novel use of carotid ultrasound
By Ryan Richardson, MD; Casey Patrick, MD; James Seek, LP; Nick Smith, LP; Kevin Crocker, LP; Himanshu Gupta, MD; Joshua Rasco; Robert Dickson, MD Staffed by about 300 paramedics and supported by 12 regional first-responder organizations, Montgomery County Hospital District (MCHD) EMS is a publicly funded 911 provider for Montgomery County, Texas, covering 1,100 square miles just north of Houston. MCHD answers more than 90,000 calls a year.
Revolutionizing OHCA response: MCHD's novel use of carotid ultrasound Original
By Ryan Richardson, MD; Casey Patrick, MD; James Seek, LP; Nick Smith, LP; Kevin Crocker, LP; Himanshu Gupta, MD; Joshua Rasco; Robert Dickson, MD Staffed by about 300 paramedics and supported by 12 regional first-responder organizations, Montgomery County Hospital District (MCHD) EMS is a publicly funded 911 provider for Montgomery County, Texas, covering 1,100 square miles just north of Houston. MCHD answers more than 90,000 calls a year.
Traumatic brain injuries: Keep it simple!
The MCHD Paramedic Podcast By Devin Shumway, MD; Casey Patrick, MD; and Robert Dickson, MD Traumatic brain injuries (TBIs) are a common injury pattern and can result in significant morbidity and mortality. Injury to the brain tissue can affect the functionality of the brain and can have a prolonged effect on both mortality and quality of life [1].
Traumatic brain injuries: Keep it simple!
The MCHD Paramedic Podcast was launched in early 2018 in an effort to provide easily consumable core-content EMS education and insights from prehospital care thought leaders. The Clinical Services Department of The Montgomery County Hospital District EMS service developed the podcast as a tool to better engage and disseminate continuing education to our MCHD medics as well as first responders and EMS professionals nationwide.
Prehospital treatment options for hyperkalemic emergencies
By Konner Cue, MD; Casey Patrick, MD; Brad Ward, EMT-P; and Robert Dickson, MD Let’s review hyperkalemia to: Know the red flag historical features suggestive of hyperkalemia Recognize EKG features suggestive of severe hyperkalemia and patients at high risk of cardiac arrest Understand prehospital treatment options for hyperkalemic emergencies, including IV calcium carbonate, nebulized albuterol and sodium bicarbonate therapy Hyperkalemia is one of the most dangerous electrolyte emergencies,...
EMS treatment of hemorrhagic trauma
By Darien LaGoy; Jordan Anderson; Casey Patrick, MD, FAEMS; Xavier De La Rosa, BS, LP, NRP, FP-C Trauma is consistently a leading cause of death in the U.S. and is the No. 1 cause of death for people under 45 years of age [1]. Preventable traumatic deaths are often hemorrhagic in nature and a majority occur in the prehospital setting [2].
Association between sleep characteristics, ideal cardiovascular health, and systemic inflammation, NHANES 2017-2018
RESEARCH ARTICLE Rebecca E. Cash, Corresponding Author rcash@mgh.harvard.edu orcid.org/0000-0002-0355-1014 Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA Correspondence Rebecca E. Cash, Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua Street, Suite 920, Boston, MA 02114, USA. Email: rcash@mgh.harvard.edu Search for more papers by this author Remle P. Crowe, Scott A.
Medical direction: Stepping up the ladder
Communication applications, tech allow real-time feedback on critically ill patients; enable error-insulated hospital reporting At Montgomery County Hospital District EMS service in Greater Houston, we looked for a streamlined way to step critically ill patient prehospital care up the ladder to medical direction.
Diagnostic dilemma: Syncope vs. seizure
I’ve been thinking and teaching lately about the diagnostic dilemma posed between syncope and seizure. These two presentations can be impossible to sort in the prehospital setting. As for syncope, my feeling is that emergency providers often pigeonhole all young folks who pass out very conveniently into the “vasovagal” diagnostic category. Here, I’ll share some resources that are not directed toward standard textbook teaching. Are you guilty?
Article Bites: 12-leads after ROSC: It's all in the timing
Should we overhaul our protocols? What we’ve learned about STEMI, OHCA ROSC from the PEEACE study By Casey Patrick, MD; and Brad Ward, EMT-P Article reviewed: Baldi E, Schnaubelt S, et al. Post-ROSC electrocardiogram timing in the management of out-of-hospital cardiac arrest: results of an international multicentric study (PEACE study). European Heart Journal, Volume 41, November 2020 Background.
Debbie Turner earns 'Tulip Tree Salute'
PAOLI — Debbie Turner never intended to stay put in Orange County, but she and her husband, Bob, fell in love with the place 23 years ago. They bought a house in the country outside of Hoosier National Forest, made friends with local musicians and picked up kayaking on the backwaters of Patoka Lake. And just as their neighbors have embraced them, Turner has rolled up her sleeves to return the favor to this southern Indiana county.
Living Richly and Buying Locally in Paoli | Indiana Environmental Reporter
All across Indiana, people are taking care of the communities they love through environmental actions big and small. IER's “Tulip Tree Salute” celebrates these individuals and their spirit, creativity and energy. Nominate someone making a difference for the environment in your town or city. Go to the nomination form. Debbie Turner never intended to stay put in Orange County, but she and her husband, Bob, fell in love with the place 23 years ago.
Article bites: Is eCPR the future of refractory vfib management?
Coordinating care across EMS, the ED, cath lab, ICU and even rehabilitation can improve outcomes with ECMO By Casey Patrick, MD (@cpatrick_89) Article: Yannopoulos D, Bartos J, Raveendran G, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomized controlled trial. Lancet 2020; Nov 13 ECMO and CPR (eCPR) Background.
COVID-19 reinfection FAQs
How to approach high-risk exposures in paramedics previously infected with SARS-CoV-2 By Casey Patrick, MD, FAEMS; and Robert Dickson, MD, FAEMS As the first anniversary of the COVID-19 pandemic approaches, more questions have developed around the area of potential SARS-CoV-2 reinfection. It is currently unknown how long immunity lasts following infection, but past coronavirus literature suggests that prolonged protection is far from guaranteed.
Article bites: Compassion first: Mortality risk of patients with psychogenic nonepileptic seizures
There is nothing fake or pseudo about the mortality rate of patients with PNES By Casey Patrick, MD (@cpatrick_89) Article: Nightscales, R et al. “Mortality in Patients with Psychogenic Nonepileptic Seizures.” Neurology 95.6 (2020): e643–e652. Neurology. Background. Caring for psychogenic non-epileptic seizure (PNES) patients (the condition formerly known as “pseudoseizures”) in the emergency setting can be exceedingly difficult and frustrating.
The pediatric general assessment triangle
Caring for and assessing critically ill pediatric patients brings added stress and anxiety to all emergency providers. In recent years, we have had the added burden of the combination of COVID-19 and associated multi-system inflammatory disease of children (MIS-C) on top of the usual winter season that includes croup, respiratory syncytial virus (RSV), influenza and other various viral respiratory pathogens.
How to protect EMS and patients from COVID-19 during airway management
Prehospital caveats for non-invasive and invasive airway management as we learn more about the pathophysiology of COVID-19 When approaching airway management in the era of COVID-19, several overarching themes emerge that differ significantly from classic teaching. First of all, every patient care encounter begins with the initial objective of keeping providers protected first and foremost. PPE is essential and should be fully in place before the initiation of patient contact.
Preparation, Response and Lessons Learned from Hurricane Harvey
Houston-area EMS agencies put to the test responding to Hurricane Harvey’s epic flooding Rescue boats fill Tidwell Road as they help flood victims evacuate as floodwaters from Tropical Storm Harvey rise Monday, Aug. 28, in Houston. AP Photo/David J. Phillip Hurricane Harvey made landfall on Friday, August 25, at 11p.m., between Port Aransas and Port O’Connor, Texas. A Category 4 hurricane, it was the strongest to hit Texas since 1961.
Evidence-Based Prehospital Lung Protective Ventilation Protocol Reduces Lung Injury
Lowering tidal volumes in an effort to reduce lung injury following initiation of mechanical ventilation is far from a new idea, the original ARDSNet data are nearly 20 years old.
Evidence-Based Prehospital Lung Protective Ventilation Protocol Reduces Lung Injury
Protective mechanical ventilation strategies in the prehospital setting Montgomery County Hospital District EMS developed an evidence-based paramedic-initiated lung protective ventilation bundle to reduce ventilator-induced lung injury. Photo courtesy Montgomery County Hospital District Lowering tidal volumes in an effort to reduce lung injury following initiation of mechanical ventilation is far from a new idea, the original ARDSNet data are nearly 20 years old.
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