Avoiding Common Prehospital Errors

Section I Airway Management
1 Don’t Have a Failed Airway Because You Failed to Prepare
Marianne Gausche-Hill

2 Don’t Forget to Properly Position the Patient Prior to Attempting Intubation!
Christopher Touzeau and Benjamin Kaufman

3 Which Patients Should Undergo RSI? It’s Not Just About the Clenched Jaw!
Benjamin Kaufman and Christopher Touzeau

4 If a Non-rebreather Is Not Cutting It, Slap on the PAP. Use Noninvasive Positive Pressure in Patients in Moderate to Severe Respiratory Distress
Steven Barmach

5 Cannulas Aren’t Just for Supplemental Oxygen Anymore: Use EtCO2 for Differentiating Causes of Respiratory Distress
Jonathan Wendell

6 Errors in Difficult Airway Assessment: Always Assess the Anatomy First
Jonathan Wenk

7 Problems Encountered with Movement and Airway Management: Confirm and Reconfirm Endotracheal Intubation
Scott H. Wheatley

8 High Pressure Airway? Lay Off the Cricoid!
Benjamin Lawner

9 Don’t Be So Quick to Throw Your Battery-Operated Laryngoscope Away!
Benjamin Lawner

10 Drop That Tube!
Stephen C. Andrews

11 It’s Not All About Intubation: New Perspectives on Prehospital Airway Management
Kevin G. Seaman

12 GCS Less Than 8? Don’t Automatically Intubate!
Benjamin Lawner

13 I Can’t See Cords! What to Do When You’re Already in Too Deep
Benjamin Lawner

14 Pediatric Airway Management: Don’t Underestimate the Value of a Stepwise Approach
Spencer C. Smith

15 Practice Makes Perfect: There’s Never Enough Practice
Jessica Manka and Cynthia Shen

16 RSI Without Paralytics? Just Don’t Do It
Benjamin Lawner

17 Tantalizingly Tangible Techniques for Telegraphing the Tough Tube
P. Marc Fischer and Kevin G. Seaman

Section II Respiratory Emergencies
18 Avoid Becoming a Patient When Transporting One
Jeremy Brywczynski and Jared McKinney

19 Avoid Hyperventilation and Know the Downfalls of Positive Pressure in the Intubated Patient
Jeffrey M. Goodloe

20 Be Careful of Just a Little Blood!
Benjamin W. Webster

21 Fear the Tracheostomy Patient!
Christopher B. Colwell

22 Common Pitfalls in the Use of Pulse Oximetry
Karen Wanger

23 Beware the Intubated Patient!
Jared McKinney and Jeremy Brywczynski

24 Don’t Underestimate Waveform Capnography in the Intubated Patient
Jeffrey M. Goodloe

25 The Dos and Don’ts of Nitroglycerin in Acute Respiratory Distress
James V. Dunford

26 Fear the Elderly Patient With New Onset Wheezing
Marc Eckstein

27 The Perils and Pitfalls of Needle Decompression
Jullette M. Saussy

28 Don’t Forget CPAP in Prehospital Respiratory Distress
Kathleen Schrank

29 Use Caution With Morphine in Treatment of Acute Cardiogenic Pulmonary Edema
Neal Richmond and Jesse Yarbrough

30 To PE or Not to PE? Don’t Forget Embolism in the Patient With Shortness of Breath!
Neal Richmond and Jesse Yarbrough

31 Avoid Inappropriate Administration of Furosemide
Jullette M. Saussy

32 Shortness of Breath: It’s Not Always the Lungs
Corey M. Slovis

33 Adults Get Stridor Too
Jeff Beeson

34 The Perils of Treating a Patient in Status Asthmaticus
John P. Freese

35 Toxic Inhalation Pitfalls
J. Brent Meyers

36 Don’t Administer Too Much or Too Little Oxygen to the COPD Patient
Terence Valenzuela and Jarrod Mosier

Section III Cardiac Emergencies and ECG
37 Don’t Fail to Interpret Tachycardia
Sean Covant and Ray Fowler

38 Don’t Fail to Interpret Bradycardia
Sean Covant and Ray Fowler

39 Don’t Be Fooled by These ECG Mimics
Sean Covant

40 Don’t Forget That There Are Many Causes of Chest Pain
David Lehrfeld

41 Don’t Forget to Analyze Wide Complex Tachycardias
David Lehrfeld

42 Don’t Miss the Subtle ECG Findings of STEMI
A. J. Kirk

Section IV Management of Cardiac Arrest
43 Don’t Overlook the Role of Hands-Only CPR in Community-Based Strategies for Survival
Jennifer Triaca
44 Don’t Overlook the Uses of Capnography in Cardiac Arrest
Max Patterson and Jonathan C. Wendell
45 Do Not Interrupt CPR for More Than 10 Seconds: It Can Be the Difference Between Staying Alive and Biting the Dust
Jonathan Wenk
46 Pay Close Attention to BLS Intervention!
Joel Higuchi
47 Refer Your Patients With ROSC to the Most Appropriate Facility
Bruce G. VanHoy
48 It’s a Cold Day on the Horizon: Chill Your ROSC Patients Out!
Rick Leonard and Kevin G. Seaman
49 Chest Compressions Are Your Most “Advanced” BLS Technique
Gregory R. Valcourt and Kevin G. Seaman
50 CPR Devices: Don’t Believe Everything You Hear
Sam Matta
51 Confirmation Is About More Than Direct Visualization, Especially in Cardiac Arrest
Scott H. Wheatley and Elizabeth Moye
52 Know When to Say “When!”: Termination of Resuscitation Efforts in Cardiac Arrest
Thomas G. Chiccone
53 Noninvasive Airway Management in Cardiac Arrest: Think Beyond Intubation
Alexander J. Perricone
54 Do Not Fail to Ensure Quality Chest Compressions!
Cerisa C. Speight and Dale E. Becker
55 Involve Your Community in Cardiac Arrest: Together You Can Make a Difference
Cassandra M. Chiras and Kevin G. Seaman
56 Teamwork in Cardiac Arrest: No One Codes Alone
Elizabeth L. Seaman and Kevin G. Seaman
57 Think About Where to Begin Your Resuscitation!
Gregory R. Valcourt and Kevin G. Seaman

Section V Trauma Emergencies
58 Neglecting to Take a Thorough Patient History
Patrick Brady
59 Failure to Fully Assess the Patient
Patrick Brady
60 Pitfalls in Confirming Death at Scene
Patrick Brady
61 Failure to Document
Patrick Brady
62 Transporting a Patient to an Inappropriate Facility
Patrick Brady
63 Pitfalls in Spinal Immobilization for Trauma Patients
Patrick Brady
64 Don’t Forget to Look for a “Cardiac Cause” of an Accident
Stephen Bock
65 Don’t Underestimate Hemorrhage From Pelvic and Long Bone Fractures
Stephen Bock
66 Pitfalls in Vascular Access in the Trauma Patient
Stephen Bock
67 Failure to Adequately Manage the Patient’s Airway
A. J. Kirk
68 Don’t Fail to Control Hemorrhage If Possible
A. J. Kirk
69 Don’t Forget to Treat Pain
A. J. Kirk
70 Failure to Recognize Penetrating Trauma
A. J. Kirk

Section VI Pediatric Emergencies
71 Don’t Wait for Hypotension to Diagnose Shock
Brian S. Bassham
72 Kids With Altered Mental Status Need a Glucose Check
Timothy E. Brenkert
73 Refusing Pediatric Refusals: Beneath the Surface of the Iceberg
Eric Clauss and Lee Blair
74 Don’t Intubate That Child!
Patrick Drayna
75 Weight-Based Care Is Essential in the Care of Children
Cristina Estrada
76 Think Intraosseous, Not Intravenous
Laurie MacPherson Lawrence
77 Pain Management Is Not Just for Adults
Matthew R. Locklair
78 If You Are Missing the Vital Signs, You Are Missing the Point!
Julie Phillips
79 Not Are Pediatric Seizures Are Status
Valerie N. Whatley
80 All That Wheezes Is Not Asthma
Abby M. Williams

Section VII Aeromedical/Critical Care Considerations
81 Trauma Transport: Don’t Forget You Can Drive!
Chris Touzeau and Ben Kaufman
82 Don’t Be Afraid to Use Existing Central Venous Catheters!
Chris Touzeau and Ben Kaufman
83 The Dynamic Environment of a Helicopter Landing Zone: Always Remain Aware!
Matt Messinger
84 Know Your HEMS Providers: They’re Not All Alike!
Kevin High
85 Requesting a Helicopter Is a Medical Decision: Choose the Right Patient for Aviation Utilization
Roger M. Stone
86 Don’t Wait for the Helicopter! Pitfalls in Aviation Selection
Roger M. Stone
87 Pearls and Pitfalls of Interhospital Transport: It’s About Much More Than Paperwork!
Robert Dice and Kevin G. Seaman
88 Sedation During Transport: Think Beyond Paralysis!
Jill D. Smith and Cynthia S. Shen
89 Understand the Spectrum of Sepsis: How to Identify, Monitor, and Treat!
Jill D. Smith and Cynthia S. Shen
90 Don’t Fear the Pressor!
Sam Matta

Section VIII Incident Command/Disaster
91 Avoid Being the Modern Day Canary: Ensure Scene Safety When Responding to a Mass Casualty Event
Frederick W. Smith
92 Prepare, Prepackage, and Pre-plan the Disaster Pack You Need
Brian Froelke
93 Don’t Forget the Special Populations That Require Special Response
Brian Froelke and Hawnwan Philip Moy
94 From the Hot Zone to Hospitals: Transport Your Patients Safely and Efficiently
Frederick W. Smith
95 Understand How Your PPE Works Before the Big Day
Michael T. Lohmeier
96 Know the Value of Stakeholder Communications
Mark D. Levine and Jacob B. Keeperman
97 Know the Principles of Disaster Management Before an Event Occurs
Mario Luis Ramirez
98 Know How to Interact With the Media
Greg Taggard
99 Ensure Optimal Communication Between All Parties
Jacob B. Keeperman
100 Use an Appropriate Triage System to Guide Decision Making in the Mass Casualty Setting
Michael T. Lohmeier

Section IX Customer Service/Medicolegal
101 Never Forget: EMS Is Mostly About Great Customer Service!
Kevin G. Seaman
102 Don’t Forget to Keep an Open Mind With Each New Call
Roger M. Stone
103 Don’t Fail to Manage the Difficult But Still Manageable Consumer
Roger M. Stone
104 The Buck Has to Stop at Quality Assurance/Leadership Offices
Roger M. Stone
105 Don’t Leave High-Risk Chief Complaints on the Scene!
Roger M. Stone
106 Don’t Drop the Ball in the Dispatch Center
Roger M. Stone
107 Avoid Engaging in Conflict When Responding to Health Care Facilities
Roger M. Stone
108 Don’t Fail to Consider the Family
Jeff Beeson
109 Don’t Post Patient or Family Info on Social Media
Jeff Beeson
110 Consent and Confidentiality in EMS
R. Jack Ayres, Chris Ayres, and Wendy Ruggeri
111 Don’t Be Guilty of Showing Negligence
R. Jack Ayres, Chris Ayres, and Wendy Ruggeri
112 Don’t Confuse Roles in the EMS
R. Jack Ayres, Chris Ayres, and Wendy Ruggeri
113 Don’t Make These Common Errors in Managing Medications and Maintaining a Clear Patient Care Environment
Brad London

Section X Behavioral/Psychiatric
114 Know the Pros and Cons of Chemical Restraint
C. Crawford Mechem
115 Consider Physical Restraint as a Last Resort Option for the Combative Patient
Sabina Braithwaite and Jon E. Friesen
116 Do Not Overdose Anxiety
David Persse
117 Don’t Assume the Intoxicated Patient Is Just Drunk
Corey M. Slovis
118 Consider Neuroleptic Malignant Syndrome and Serotonin Syndrome in Psychiatric Patients
Elizabeth M. LiCalzi and Amanda G. Wilson
119 Don’t Miss the Diagnosis of Excited Delirium
Joseph Eugene Holley, Jr.
120 Keep Yourself Safe on the Scene
Amanda G. Wilson
121 Recognize the Malingerer!
Amanda G. Wilson
122 Be Wary of the Suicidal Patient!
Amanda G. Wilson

Section XI OB/GYN Emergencies
123 Don’t Miss Pulmonary Embolism in the Pregnant Patient!
Anders Apgar
124 Don’t Get Tangled Up in a Cord Emergency
Morgan M. Walker
125 Don’t Throw Your Hands Up Just Yet: What You Need to Know About Hyperemesis
Morgan M. Walker and Benjamin Lawner
126 Don’t Dismiss Headaches in the Postpartum Patient
Anders Apgar
127 It Can Still Be a Surprise, Even After Nine Months! Do Not Fail to Prepare for the Emergent Delivery
Theresa Gallo and Kevin G. Seaman
128 Don’t Be Shocked When It’s Occult Birth!
Azher Merchant

Section XII Neurologic Emergencies
129 Failure to Consider Child Abuse in Pediatric AMS
Gilberto Salazar
130 Failure to Consider Drugs, Toxins, and Meds in AMS
Gilberto Salazar
131 Failure to Consider Excited Delirium
Gilberto Salazar
132 Failure to Consider Hypoglycemia
Gilberto Salazar
133 Failure to Consider Hypoxia Causing AMS
Gilberto Salazar
134 Failure to Diagnose or to Transfer to a Stroke Center
Gilberto Salazar
135 Failure to Evaluate Headache
Gilberto Salazar
136 Failure to Immobilize CNS Injuries
Gilberto Salazar
137 Failure to Suspect a Cord Problem in Back Pain
Gilberto Salazar
138 Failure to Suspect Increased ICP and Manage Airway
Gilberto Salazar
Index

• Concise descriptions of each error are followed by insightful analysis of the “hows” and “whys” underlying the mistake, and clear descriptions of ways to avoid such errors in the future.
• “Pearls” highlighted in the text offer quick vital tips on error avoidance based on years of clinical and field experience.
• Focused content emphasizes "high impact" areas of prehospital medicine, including airway management, cardiac arrest, and respiratory and traumatic emergencies.