Episode 12: Flight medicine with Tyler Christifulli and Sam Ireland (part 2)

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Part two of our interfacility transfer from Hell. Tyler Christifulli, FP-C, EMT-P (@christifulli88) and Sam Ireland FP-C, EMT-P (@ireland_sam1) show us how they handle GI bleeding, arrhythmias, shock, cardiac arrest, and more, all from the confines of a helicopter. Listen to Part 1 here.

Check out the great educational content from Tyler and Sam over at FOAMfrat, including blogs, podcasts, and online EMS continuing education.

Takeaway lessons

1. When faced with an unstable patient in a wide complex tachycardia, stop thinking and just shock it.
2. As the nature of the transport (and the patient) changes, change your focus with it. The initial diagnosis is a starting point, not a headline.
3. Consider esmolol as an easily-titratable means of rate control in unstable patients.
4. Communicate ahead with the receiving hospital if urgent interventions will be needed upon your arrival.
5. Non-invasive positive pressure ventilation offers a preview of the hemodynamic response to intubation.