Mitch Page

Paramedic, nerd, aspiring resuscitationist. Obsessed with taking critical care to patients, wilderness medicine, tech rescue. #FOAMed

[Mitch Page @mitchpage3]

@doctimcook I would buy it

[Mitch Page @mitchpage3]

@doctimcook @IM_Crit_ To be clear it is absolutely uniformly present in the prehospital space. Non OR hospital environments its quite variable.

[Mitch Page @mitchpage3]

@nickmmark Also despite the hype
I think humeral head IOs are a relatively niche procedure
High success, less dislodgment, logistic superiority of tibial beats the hell out of the theoretical advantages of humeral. Except maybe for rapid volume which is not an ideal use of IO anyway.

[Mitch Page @mitchpage3]

@EMNerd_ I have this idea that if we changed the “anion gap” to “Unmeasured anions” maybe people would understand.

[Mitch Page @mitchpage3]

@PulmCrit @akatzzzzz 4. Sure, who cares? Could happen with any drug we give, and we are aggressively prepared

5. This is a reasonable and the best criticism in my mind.

The hypotensive, septic patient a long way from the hospital is in a lot of danger. Seems sensible to give them the best chance.

[Mitch Page @mitchpage3]

@PulmCrit @akatzzzzz 2. Can draw cultures, the program I’ve been involved in required this

3. The mortality for prehospital Id’d septic shock is very high seems like not the population to save one dose of broad spectrum abx?

[Mitch Page @mitchpage3]

@Aidan_Baron @joshkimbre I’d love to see it
I have been using femoral/carotid ultrasound +/- peak systolic velocity to adjust compression point and anecdotally have found it quite helpful. Requires much more basic skill set and equipment.

[Mitch Page @mitchpage3]

@ross_prager More and more I just put in an immediate LMA, unless planing for very early intubation.
LMA is far more reliable compared to face mask even in skilled hands and is just as quick as oral and nasal airway.

[Mitch Page @mitchpage3]

@harryfisherEMTP To be clear you’re nothing but a fraud who is attempting to gain popularity and perhaps money from peddling dangerous lies.

In the event you ever were a paramedic you’re an embarrassment to our profession.

[Rob Major @phemDM]

Prehospital publication alert!!

Hugely proud to have delivered this publication on the morbidity and mortality associated with post intubation hypotension.

This redefines the blood pressure targets for intubation in TBI, associated with outcomes.

https://t.co/G8zMiYJ7ij

[Mitch Page @mitchpage3]

@nickmmark I have no idea in this case
But it is very, very common for paramedics to remove AED pads placed prior to our arrival because they are incompatible with our monitor/defib and/or they are less than optimally placed.

[Aditya C. Shekhar @dj_deets]

We compared out-of-hospital cardiac arrest at US airports versus other public (non-residential settings) and found significant differences between locations. @joshkimbre @JacobStebel

Out now in JAMA Network Open: https://t.co/4EFPD9aAal

[EMSC Innovation & Improvement Center @EMSCImprovement]

Nina Friedman, MS, CCLS, a Child Life Specialist and member of the inaugural EMSC Scholars cohort, led a newly published study on quality of life for children experiencing mental and behavioral health emergencies in the ED. https://t.co/5ItiFhYB5U

#EMSC #PediatricReadiness

[Mitch Page @mitchpage3]

@jab_doc We send everyone, which can be quite a large response in remote areas. Not sure what else to do though.

[Mitch Page @mitchpage3]

@MDtheDO It’s also quite common to need both for refractory hypotension in my experience, though this depends a bit on local practice around max doses of norepi.

[Mitch Page @mitchpage3]

@MDtheDO It’s interesting, typically i like norepi and frequently have the drip ready to go attached to a line, even before ROSC
Will use push dose epi if drips aren’t ready or if the patient seems about to arrest. Add epi drip for bradycardia, or if i think they need more inotropy.

[Mitch Page @mitchpage3]

@jab_doc It’s a really outstanding course. Even if you’re not fire based you can still go and i would recommend it to everyone.

[Jesse McLaren @ECGcases]

Great talk by @amalmattu at @EM_Update on cardiac emergencies, including @AslangerE pattern #EMU2025

[Mitch Page @mitchpage3]

@michaelbmarlin We usually give it for moderate pain (when we would have probably given nothing before) or as part of a multi modal strategy for severe pain or sometimes for a patient who adamantly refuses opioids.
A toolbox of analgesics if better than just opioids