Will Johnston

Fantastic listen with many take aways! Thanks @ClairePark01! “Act when you have 40-70% of the information. Waiting for more certainty risks losing critical time”

Our data suggest that prioritization of prehospital transfusion improves survivability in patients with severe hemorrhage despite a modest increase in transport time. @Tulane_Surgery @MarkPiehl @JakeBroome journals.lww.com/jtrauma/abstra…

Happening today at 2pm EST. SESSION TITLE: Blues run the game – The bio-psycho-medico model and the promise of medical sociology in paramedicine REGISTRATION: Registration is free. Register here: lnkd.in/eWMFnyGv

#Paramedics Are you languishing or flourishing at work? @PaigeMason2 speaking about #MentalHealth and #WorkplaceWellbeing Fantastic insights on the importance of role identity, systems thinking and sense of connection #PHECC24

A panel of trauma experts calls for the urgent need to make EMS access to blood products available to all trauma patients ems1.com/bringing-blood…

@jawmedic Hi Jay! We had this discussion recently as well. I think TST, temporize, and extricate to definitive care. But if we’re stuck for location/resources allowing clinicians to use their judgement seems a good system. I think most do that and retroactively “use” a tool anyway…

I'm going down the rabbit hole of comparing triage tools. START vs. 10-second vs. SALT while doing a update of the all-hazards plan. Lots of pros and cons to weigh.. I'm wondering, is there a combination that works? or... I'm thinking 10-second triage as a first pass process, then move to a developed a CCP, and allowing the clinician at the CCP to use clinical judgment and CTAS to determine transport order and destination decisions. SALT and START seem good for inexperienced clinicians or first-aiders, but perhaps not a great tool for paramedics? What are your thoughts?

It's time once again to remind everyone that emergency department (ED) crowding is not due to low acuity visits. ED crowding is due to hospital crowding and the inability to move admitted patients to the floors. Emergency Physicians can handle busy. It's crowding that kills.

“Importantly, we observed significant differences in patient characteristics, such as higher rates of bystander CPR and overall improved survival, in the TTM-2 trial when compared to others.”

In this prespecified subanalysis of the Prehospital TXA for TBI trial, an association between a 2g prehospital TXA bolus and decreased mortality in patients with intracranial hemorrhage was identified #TBI #TXA @SusanRowellMD journals.lww.com/jtrauma/abstra…

@SeanHarris999 Yes absolutely I think incorporating it into our system outside of specialist roles is an important step to take

@SeeWillyJ However! I strongly believe that such capabilities should form part of a high threat or major incident response & should be available following TST for those who need it. Important to bare in mind that TST may not be completed by responders who are equipped or trained for either

@SeanHarris999 really appreciate the tweetorial on TST! Interested how it would fit in our system! Do you see a place for either chest seals or needle thoracostomy during the chest assessment? Do you save that for the transition to MITT and CCPs?

@SeanHarris999 Ideally we assess -> temporize -> extricate but can be in situations where there is less access to patients so more care can be done. Always discussing the balance of speed, life saving intervention, and rapid transport. But always looking to improve our system too

@SeanHarris999 Awesome thanks for the clarification. Came up as part of a discussion around our hostile event/active attacker responses. Patients in exclusion zones where access is by non-specialty responders is unsafe.

@NoobieMatt Massive Hemorrhage, Airway, Respirations, Howitzer/Hypothermia….

I can’t wait to go to a TEMS vendor fair and see a mobile howitzer.

Thanks @SeanHarris999 for the highlight reel from @TacTrauma Looking like this is a must attend conference in the future for me!

American Heart Association proposes to omit the following terminologies in it's latest scientific statement (May 2024) ❌️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙪𝙧𝙜𝙚𝙣𝙘𝙮 ❌️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙘𝙧𝙞𝙨𝙞𝙨 Use of subjective emotive language such as 𝙘𝙧𝙞𝙨𝙞𝙨 and 𝙪𝙧𝙜𝙚𝙣𝙘𝙮 fail to acknowledge the nuances of treatment decisions and may encourage unnecessary antihypertensive treatment. Therefore in a statement paper from AHA in May 2024, it is proposed the following objective terminology: ✅️ 𝙃𝙮𝙥𝙚𝙧𝙩𝙚𝙣𝙨𝙞𝙫𝙚 𝙚𝙢𝙚𝙧𝙜𝙚𝙣𝙘𝙮 🔸️SBP/DBP >180/110–120 mm Hg with evidence of new or worsening target-organ damage ✅️ 𝘼𝙨𝙮𝙢𝙥𝙩𝙤𝙢𝙖𝙩𝙞𝙘 𝙢𝙖𝙧𝙠𝙚𝙙𝙡𝙮 𝙚𝙡𝙚𝙫𝙖𝙩𝙚𝙙 𝙞𝙣𝙥𝙖𝙩𝙞𝙚𝙣𝙩 𝘽𝙋 🔸️SBP/ DBP >180/110–120 mm Hg without evidence of new or worsening target-organ damage ✅️ 𝘼𝙨𝙮𝙢𝙥𝙩𝙤𝙢𝙖𝙩𝙞𝙘 𝙚𝙡𝙚𝙫𝙖𝙩𝙚𝙙 𝙞𝙣𝙥𝙖𝙩𝙞𝙚𝙣𝙩 𝘽𝙋 🔸️SBP/DBP ≥130/80 mm Hg without evidence of new or worsening target-organ damage.

Learning about tiny trauma with @ThatJonLee! Are kids just little adults? @cantacmed #CanTacMed

Successfully defended my Master’s thesis today! This thing was my Everest, so grateful to everyone that made it possible. Some paramedics are flourishing at work, it’s time to replicate their excellence for the future of Paramedicine. @RoyalRoads

Stop the Killing, Stop the Dying, Stop the Destruction. Join Matt Rushton and Geoff Berthiaume for a practical session on Ottawa's joint agency response to active killer events, the Rescue Task Force, no extra charge. Sign up on the website now. #rescuetaskforce #CANTACMED

Many problematic "solutions" emerge from a top-down process that @StevenShorrock calls work-as-imagined solutioneering A must read for healthcare leaders. Unintended consequences, solutions waiting for a problem, compromises... Some thoughts in a 🧵 humanisticsystems.com/2018/06/03/wor…