Mike McEvoy
Hudson, New York
author, speaker, nurse, paramedic, firefighter, adventurer
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Articles by Mike McEvoy
The critical role of capnography
In the life and death business of EMS, you need tools that you can rely upon. Capnography is the non-invasive measurement of exhaled carbon dioxide (CO2) displayed as a CO2 waveform concentration over time. During the 1980s, capnography became a standard for anesthesia care in the U.S. [1] and is now a standard of care in EMS, the emergency department and the ICU. While pulse oximetry mirrors oxygenation status, capnography reflects ventilation, perfusion, and metabolism.
MCIs are changing: Are you ready?
The escalating level of violence in society, increased incidence of domestic and international terrorism, coupled with the rise of social media use and the realities of generational differences in the population have drastically altered the effectiveness of conventional mass casualty incident (MCI) response paradigms. In more recent MCIs, conventional management strategies and long-taught practices have gone out the window.
Training Tips for CPAP and BiPAP
Jul 12, 2021 | Articles, Featured Articles | In earlier columns, use of CPAP and/or BiPAP to treat respiratory distress was described as both an art and a science. The art of using non-invasive ventilation (NIV) involves recognizing the need, selling NIV to your patient, and knowing when to quit. NIV science describes the ability to size a mask, select initial settings and titrate pressures.
Choosing the Best Non-Invasive Ventilation Device
Paramedics with Southside EMS prep the ambulance after transporting a patient to Memorial Hospital in Savannah, Georgia May 3, 2017. (US Army photo by Staff Sgt. Kellen Stuart, 3rd CAB Public Affairs) In previous columns, we’ve reviewed various non-invasive ventilation (NIV) modalities: CPAP, BiPAP and High-Flow Nasal Cannula. While there are similarities, each has a unique niche in management of respiratory distress.
Introduction to the High-Flow Nasal Cannula
While not yet ready for field application, the high-flow nasal cannula is widely used in clinical settings to treat patients with hypoxemic respiratory failure. (Photo courtesy of Hamilton Medical) The COVID pandemic has focused new attention on the value of the high-flow nasal cannula (HFNC).
Essentials of BiPAP
CPAP of 10 CWP compared to BiPAP of 10/5. Since 2001, continuous positive airway pressure (CPAP) has played an increasingly important role in EMS care for patients who are acutely short of breath, regardless of the cause. CPAP is included in the current EMT, AEMT and paramedic scopes of practice. The introduction of disposable, single-use devices several years ago made CPAP inexpensive and more widely available.
Transitioning Care with CPAP
High-risk, low-frequency procedures such as CPAP leave little room for error. (Photo/Rick McClure) Preventable injuries resulting from medical errors are a leading cause of death among Americans.
PEEP: A Tool for Any EMS Provider
Positive End Expiratory Pressure, or PEEP, is getting a lot of attention lately. First described in 1938 as an addition to mechanical ventilation that improved oxygenation1 in acute pulmonary edema, asphyxia and sepsis, the hemodynamic effects of PEEP prevented its widespread use until the 1960s.
Why PEEP? - EMS Airway
Positive End Expiratory Pressure, or PEEP, is getting a lot of attention lately. First described in 1938 as an addition to mechanical ventilation that improved oxygenation1 in acute pulmonary edema, asphyxia and sepsis, the hemodynamic effects of PEEP prevented its widespread use until the 1960s.
Managing COVID-related Respiratory Distress
A novel coronavirus virus was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. (Illustration/Alissa Eckert, MS; Dan Higgins, MAM) The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third novel coronavirus known to infect humans.
The Evidence for Prehospital CPAP
Prehospital CPAP belongs in every EMS toolbox. (Photo/Adam Mason) CPAP (Continuous Positive Airway Pressure) ranks as one of the most effective interventions in the EMS toolbox for improving patient outcomes.
How to Use Capnography to Titrate CPAP
The image shows a significantly widened alpha angle, also referred to as “shark fin” capnography waves. (Photo courtesy iSimulate.com) CPAP (Continuous Positive Airway Pressure) is a valuable tool for a wide variety of patients with acute shortness of breath. There are very few reasons why any acutely dyspneic patient should not have at least a trial of CPAP. In some situations, such as acute pulmonary edema, the beneficial effects of CPAP become apparent within seconds to minutes.
Using Capnography to Titrate CPAP
The image shows a significantly widened alpha angle, also referred to as “shark fin” capnography waves. (Photo courtesy iSimulate.com) CPAP (Continuous Positive Airway Pressure) is a valuable tool for a wide variety of patients with acute shortness of breath. There are very few reasons why any acutely dyspneic patient should not have at least a trial of CPAP. In some situations, such as acute pulmonary edema, the beneficial effects of CPAP become apparent within seconds to minutes.
Editorial: The Future of EMS Today
JEMS Executive Editor Mike McEvoy In March 2013, a conference in Sydney, Australia, changed the landscape of medical conferences worldwide.1 The first annual Social Media and Critical Care (SMACC) was purposefully redesigned, opening with a typical, boring presenter who was promptly tossed from the stage by a hulking wrestler.
5 errors that are giving you incorrect blood pressure readings
Nurses and physicians often argue over differences between arterial line and non-invasive blood pressure (NIBP) cuff readings. Revised guidelines for management of high blood pressure increased thresholds for diagnosing and treating hypertension, causing further debate and controvery [1]. To make the best use of blood pressure monitoring equipment, it is helpful to have an insight into how the equipment works and the likely sources of error that can affect readings.
Tips for Using a Small-Volume Nebulizer
Oct 25, 2019 | Featured Articles, Videos | Mike McEvoy shares some tips on delivering medicine to a patient for using a small-volume nebulizer. About the Author(s) About the Author Mike McEvoy, PhD, NRP, RN, CCRN is the EMS Coordinator for Saratoga County, New York and a Paramedic Supervisor for Clifton Park & Halfmoon Ambulance. He is a nurse clinician in the adult and pediatric cardiac surgery ICUs at Albany Medical Center where he also teaches critical care medicine.
Successfully Selling CPAP
Photo by Rick McClure Once you turn the CPAP device on, it becomes time to make your sales pitch. Severe difficulty breathing, regardless of the cause, is an incredibly frightening experience for a patient. Your ability to quickly gain their confidence and reduce their fear is crucial to improving their respiratory status.
The Miracle of CPAP
In this illustration, a transpulmonary pressure of -8 is added to the 150 systolic blood pressure. The total (158) is reduced by CPAP of 12 CWP, resulting in a significant reduction in both transpulmonary pressure and cardiac afterload. EMS protocols suggest continuous positive airway pressure (CPAP) for a wide range of conditions associated with acute shortness of breath (SOB). The mechanisms by which CPAP provides relief are complex and require an understanding of pulmonary physiology.
ECG Consult: 55yo Firefighter with Acute Chest Pain
Tue, Jul 23, 2019 John Hayden, MD, EdD, FACEP , Jonathan Barney, BA, EMT, MS4 , Troy Kennedy, MS, MPH, EMT-P In this month's ECG consult video, we encounter a 55-year-old firefighter complaining of acute chest pain after unloading a fire hose. View details in the player below. MORE ECG Consult: 63yo Male Experiencing Chest Pain ECG Consult: 63yo Female, Onset of Weakness while Cleaning ECG Educational Standards for Prehospital Providers By J.
Video: Spinal Motion Restriction
Subscribe to Newsletters Published by JEMS and EMS Today The Journal of Emergency Medical Services (JEMS) and EMS Today provide you real-world insight to topics that matter to you , from patient care to operations and management. We're here to help you do your job more effectively, with content from writers who are professionals in prehospital patient management. You can always rely on us to be an informative, practical and an outstanding educational resource.
Paramedics in the Face of Tear Gas
Subscribe to Newsletters Published by JEMS and EMS Today The Journal of Emergency Medical Services (JEMS) and EMS Today provide you real-world insight to topics that matter to you , from patient care to operations and management. We're here to help you do your job more effectively, with content from writers who are professionals in prehospital patient management. You can always rely on us to be an informative, practical and an outstanding educational resource.
Podcast: The National Registry of EMTs: Past, Present, and Future
Mon, Jul 8, 2019 The National Registry of EMTs will celebrate its 50th year as the nation's EMS Certification Organization, protecting the public and advancing the EMS profession.
AED On The Fly
Drone service partners with paramedics in Canada Tue, Jul 2, 2019 Drone Delivery Canada Drone Delivery Canada - Drone Delivery Canada has partnered with Peel Region Paramedics to pilot its proprietary drone delivery platform to enable rapid first responder technology via drone with the goal to reduce response time and potentially save lives. [Native Advertisement] By Sponsored Content is made possible by our sponsor; it does not necessarily reflect the views of our editorial staff.
Two More Deputies Fired After Shooting at Florida School
By CURT ANDERSON Associated Press MIAMI (AP) — Two additional deputies have been fired as a result of an internal affairs investigation into the agency's response to the shooting at Marjory Stoneman Douglas High School in Parkland that killed 17 people, the Broward County sheriff said Wednesday. At a brief news conference, Sheriff Gregory Tony said deputies Edward Eason and Josh Stambaugh were fired Tuesday for their inaction following the Feb. 14, 2018, shooting.
Training Minutes: CPAP Applications
Subscribe to Newsletters Published by JEMS and EMS Today The Journal of Emergency Medical Services (JEMS) and EMS Today provide you real-world insight to topics that matter to you , from patient care to operations and management. We're here to help you do your job more effectively, with content from writers who are professionals in prehospital patient management. You can always rely on us to be an informative, practical and an outstanding educational resource.
ECG Consult: 63yo Male Experiencing Chest Pain
Tue, Jun 25, 2019 John Hayden, MD, EdD, FACEP , Jonathan Barney, BA, EMT, MS4 In this month's ECG Consult, we encounter a 63-year-old male with a history of hyperlipidemia, hyperension, and rheumatoid arthritis who presents with chest pain. MORE ECG Consult: 63yo Female, Onset of Weakness while Cleaning ECG Educational Standards for Prehospital Providers By J.
UN Health Agency to Remove Controversial Opioid Guidelines
By CLAIRE GALOFARO Associated Press The World Health Organization notified U.S. lawmakers last Wednesday that it will discontinue two publications on prescribing opioid painkillers in response to allegations that the pharmaceutical industry influenced the reports. The pledge to remove the guidelines comes a month after U.S. Reps. Katherine Clark and Hal Rogers accused the WHO of being influenced by Purdue Pharma, the American manufacturer of the potent painkiller OxyContin.
Stars of Life 2019: Mary Anselmo
Tue, Jun 25, 2019 JEMS Executive Editor Mike McEvoy talks to some of the American Ambulance Association's Stars of Life award recipients, including Mary Anselmo of Cataldo Ambulance Service in Somerville, Mass. Watch in the player above, and learn more about the Stars of Life program HERE. By Sponsored Content is made possible by our sponsor; it does not necessarily reflect the views of our editorial staff.
Stars of Life 2019: John Sossei
Tue, Jun 25, 2019 JEMS Executive Editor Mike McEvoy talks to some of the American Ambulance Association's Stars of Life award recipients, including John Sossei. John is a veteran of the U.S. Air Force and is now with Armstrong Ambulance Service, which provides paramedic services to multiple 911 service areas and entities in the Metro-Boston region Watch in the player above, and learn more about the Stars of Life program HERE.
Podcast: Cardiac Arrest Protocol for Excellence in Lawrence, Kansas
Fri, Jun 21, 2019 Lawrence-Douglas County (Kan.) Fire Medical instituted Cardiac Arrest Protocol for Excellence (CAPE), which resulted in a significant improvement in their cardiac arrest patient care processes and better outcomes. In the June 2019 edition of the "Firemedically Speaking" podcast, JEMS Executive Editor Mike McEvoy talks with Division Chief Kevin Joles and Medical Director Caleb Trent about the CAPE program, its design, implementation and results. Listen in the player above.
Assessing Acute Shortness of Breath
By Mike McEvoy, PhD, NRP, RN, CCRN Shortness of breath, or dyspnea, results from air hunger, a sensation that you’re not getting enough air. Healthcare providers often incorrectly associate dyspnea with hypoxia (i.e., lack of oxygen). In fact, healthy patients who become hypoxic don’t experience shortness of breath.
A Look at EMS Today 2019
More than 4,600 EMS providers, educators, and vendors will gather at the Gaylord Resort and Convention Center in National Harbor, Maryland February 20 – 22, 2019 for EMS Today, a premier EMS conference for more than 36 years. Opportunities abound for networking, education, interaction with exhibitors, hands-on experiences, and socializing.
EMS Today 2019: Non-Invasive Ventilation
Mike McEvoy, PhD, NRP, RN, CCRN EMS Coordinator Saratoga County, New York; EMS Technical Editor, Fire Engineering Room: National Harbor 13 Friday, February 22, 2019: 9:00 AM - 10:00 AM REGISTER NOWcswvxeqayftrvwfavuxybwwwabxwatfryrtytf CPAP, BiPAP and High Flow Nasal Cannula (HFNC) are all Non-Invasive Ventilation (NIV) tools that save lives.
Methyl Fentanyl Bad Stuff
It is dangerous out there, no doubt about it. We have a responsibility to protect ourselves, our brothers and sisters and our patients from harm. The latest danger seems to me not to be carfentanil but paranoia. That's right, I'll call it "fentanyl analog paranoia." It's bad enough that widespread misinformation has made prehospital providers the poster children for misuse of nitrile gloves.
Top 3 products you can't get in the US - yet
Three interesting products were demonstrated at the European Resuscitation Council 2012 Congress in Vienna, Austria, last week. They are all so brand-new that they're not even available in the U.S. yet. Physio-Control based out of Redmond, Wash., unveiled its newest product, TrueCPR, a standalone CPR feedback device designed to provide rescuers with real-time feedback on chest compression depth, rate and quality.
7 Reasons To Create High Quality Website Content
Do you know what the most important component of your website is? CONTENT. In the age of DIY website creation, small business owners are able to quickly publish a business website with any number of platform products. While the convenience is unprecedented and the ease of use is unparalleled, a pretty website is not the same as a high quality website. Your audience is visiting your website with specific intentions or goals in mind.
Hydrocodone/APAP: Drug Whys
Learn about Hydrocodone's drug profile, proper doses, potential side effects and how it affects your patients. Updated October 17, 2016 Generic name: Hydrocodone/APAP (multiple manufacturers) Common U.S. brand names: Lortab (UCB Pharma), Vicodin (Abbott Laboratories) Popularity: First most commonly prescribed drug between 2002-2007 (U.S.). In 2014 it was the second most commonly prescribed drug. Class: Analgesic combination, narcotic Treatment Uses — Relief of moderate to moderately-severe pain.
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