The Epi Controversy in Pediatric Bradycardia: Evidence, Ethics, and the Reality of Guideline Development

For decades, pediatric resuscitation has taught us that when a child becomes bradycardic with poor perfusion and requires CPR, arrest-dose epinephrine is the natural next step. It’s a familiar reflex.…

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Amiodarone vs. Lidocaine in Refractory VF: Lessons from the ALPS Trial

Introduction Shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) remain among the most difficult cardiac arrest rhythms to manage. Even with rapid defibrillation and high-quality CPR, some patients simply…

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By-the-Book Deaths: When Following Medical Control Still Puts Your License at Risk

Disclaimer:This article is not a call for paramedics to ignore or override written protocols. Protocols are critical tools that guide safe, evidence-based care. Providers must always follow the clinical guidelines…

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Hemorrhagic Shock and Fluid Resuscitation in Trauma Patients: A Call to Action for Blood-Based Resuscitation

Introduction Hemorrhagic shock is a life-threatening condition that remains a leading cause of preventable deaths in trauma patients, particularly in the prehospital setting (1). Defined by a critical loss of…

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