Birth of APRV APRV is not new. It traces back to the work of Dr. John Downs, a University of Florida anesthesiologist, in the mid to late 1980s. Downs was intensely focused on respiratory physiology and had already influenced prehospital care through the development of early CPAP systems, such as the Downs Flow Generator. APRV evolved naturally from that same CPAP mindset. At its core, APRV was designed as an alternative to inverse-ratio pressure-control ventilation for patie

The Airway Assistant If intubation is not part of your scope of practice, the whole procedure may feel foreign. This is especially true if you work in a crew configuration that does not include a paramedic. Perhaps you’ve experienced a situation like this: you call for an ALS intercept, the crew arrives, performs what seems like a thousand tasks quickly, intubates the patient, and then they’re gone. These situations might leave you with at least a few questions:   •  How do t

In this episode of the FOAMfrat Podcast, Dr. Harrison Brookeman (@hbrookeman) joins the discussion to examine methemoglobinemia and the emerging prehospital threat of sodium nitrite ingestion. Often viewed as a rare toxicology concept, this condition is appearing more frequently and can progress rapidly with devastating consequences if it is not recognized early. The episode focuses on what matters most to EMS clinicians in the field: the physiology of methemoglobinemia, why