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Media and Public Relations

Questions and Answers 1 What is the role of a public information officer (PIO)? PIOs are the relay between the organization/department and the public They serve as the spokespersons providing information as necessary to the media. Having a designated spokesperson for your department who works with the marketing/public relations team before and when addressing the media will ensure that there is only one message being communicated.…

Emergency Vehicle Operation, EMS System Design, and Prehospital Communications

Questions And Answers 1 What types of vehicles are used by emergency medical services (EMS) systems? There are multiple types of vehicles employed in emergency services response, with the most common being an ambulance. Other vehicle types like helicopters, airplanes, four-wheel all-terrain vehicles, snowmobiles, and boats or nontransport vehicles like bicycles and fire engines may also be utilized. Vehicle choice is dependent on multiple factors including,…

Destination Guidelines and Hospital Designation

Questions and Answers 1 Are there other important determinants of patient outcome besides assessment and treatment of a patient? While prehospital assessment and interventions are important to patient care, the determination of where to transport is also critical. If there is only one available hospital, the choice is easy. However, if there are multiple potential facilities, the decision must be based on the patient’s medical needs.…

History of Emergency Medical Services

Questions and Answers 1 When did emergency medical services originate? There are reports from biblical times where care was performed outside of places for healing. The Edwin Smith Papyrus and Babylonian Code of Hammurabi detailed early treatment and transport protocols. The Good Samaritan parable tells the story of a man who remedied travelers’ wounds with oil and wine on the roadways. The man also helped care…

Frog in your throat: Supraglottic infections and bacterial tracheitis

Case presentation A 10-year-old female presents with 2–3 weeks of progressively worsening throat pain and dysphagia. She was diagnosed 2 weeks ago with Streptococcal pharyngitis by her primary care provider. She was treated with a 10-day course of amoxicillin and had mild improvement, but her symptoms returned. She was evaluated by her physician again and told she had a viral infection, since her rapid strep test…

All that drools: Retropharyngeal and peritonsillar abscess

Case presentation A 4-year-old child is referred from her primary care provider’s office over concerns for meningitis. The patient has had fever and decreased oral intake and has not wanted to move her neck or head for the past 3 days. She has had rhinorrhea and mild cough for the past 3 days. She was seen by her primary care physician initially, who diagnosed an upper…

Who let the dogs out? Croup

Case presentation A 14-month-old, previously healthy child presents to the Emergency Department in the middle of the night with respiratory distress, hoarseness, and a barky cough. He has had mild congestion and a low-grade fever for a day. On physical examination, the child is in moderate respiratory distress and is anxious appearing while struggling to inhale each breath. His respiratory rate is 58 breaths per minute,…

What is this? Bone cyst

Case presentation A 5-year-old male presents with left arm pain after a fall. He was playing soccer when he fell and landed on his left shoulder. He immediately complained of upper arm pain. His examination is significant for focal tenderness to the proximal left humerus with decreased range of motion when he attempts to raise the arm. There is mild edema. He is grossly neurovascularly intact.…

Not those Ewings: Ewing sarcoma

Case presentation A 9-year-old male presents with a 4-month history of right upper arm pain. Over the past 2 months, he and his parents have noted the development of swelling to the arm as well. The patient is active in sports, particularly baseball, and the pain started after he pitched a game. He was given ibuprofen with some relief of the pain, but over the past…

My knee won’t stop swelling! Osteosarcoma

Case presentation A 6-year-old female presents with persistent, worsening right knee swelling for the past 2 months. The area has become painful over the past few weeks, especially at night. There has been no fever, erythema, or swelling of the other extremities or joints. There is no report of trauma, but prior to the development of symptoms, the child was quite physically active and it is…

Hurtn’ to stand: Discitis

Case presentation An 18-month-old female presents with 1 to 2 weeks of fussiness and not wanting to ambulate. She has not had any fevers, vomiting, or diarrhea. There is no report of trauma. About 2 weeks prior, she had a cough, congestion, and low-grade fever (100.4 degrees Fahrenheit) that resolved after a few days. She has been healthy since then. Her primary care physician evaluated the…

More than an achy back: Spinal epidural abscess

Case presentation A 4-year-old female presents with 1 week of left-sided abdominal and hip pain. She was evaluated at an outside facility 5 days ago, had plain abdominal radiography, and was diagnosed with constipation. She then returned 2 days later with continued fever but was noted to have difficulty ambulating and reported generalized back pain. She had a urinalysis done that was reportedly concerning for a…

I feel it in my bones: Osteomyelitis

Case presentation A 13-year-old male is referred to the Emergency Department by his primary care provider. The patient has had left hip pain for the past week, which has progressively interfered with his daily activities, such as sports, and now has made ambulation difficult. He has had subjective fever but no recent illness and denies any trauma. There has been no back pain, abdominal pain, incontinence,…

Who’s Brodie? Brodie abscess

Case presentation A 14-month-old previously healthy male presents with limping for the past 5 days. Prior to this symptom, he had cough, congestion, and subjective fever, which his primary care provider had diagnosed as a viral upper respiratory infection. He appeared to be improving when he developed a left-sided limp, which appeared at times to be painful, although over-the-counter ibuprofen seemed to help with pain. On…

‘Lil stuffy noses: Sinusitis

Case presentation A 15-year-old male presents to the Emergency Department with a complaint of “severe headaches” for the past week. He states he has had cough, which is worse at night, and congestion for the past 2 weeks. He has had minimal rhinorrhea that was initially clear, then green, and is now clear again. He initially had a temperature of 101 degrees Fahrenheit, but this resolved…

Achy muscles: Pyomyositis/myositis

Case presentation A previously healthy 14-year-old male presents with left lower quadrant pain, difficulty bearing weight, and fever. He awoke 6 days ago with sharp left lower quadrant pain. At that time, he was seen at an Emergency Department where abdominal computed tomography (CT) and bloodwork were obtained, which were reported to be normal. He was diagnosed with abdominal wall strain and was discharged home with…

My achin’ back! Spondylolysis/spondylolisthesis

Case presentation A 15-year-female presents with low back pain for 2 months. She had no trauma preceding the pain but is very active and plays soccer. The pain increases with activity. She has tried ibuprofen multiple times, with some relief. Her mother took her to her primary care provider last week where a urine test was performed, which was unremarkable. She has not had fever, vomiting,…