Learn by Category
185 lessons in five subjects. Each lesson states one objective, takes 15 minutes or less, and ends with a self-check drawn only from that lesson. Sources are named on the lesson. Doses, energy, and procedures stay on local protocol.
Five subjects
Thirty-seven lessons in each subject. Open a category for the full list, or use the catalog below.
Airway & Breathing
Airway assessment, oxygenation, and ventilation. Lessons cover bag-mask technique, adjuncts, waveform capnography, difficult-airway planning, and confirmation after an advanced airway.
37 lessons
Cardiac & ECG
Cardiac arrest, acute coronary syndromes, and ECG interpretation for field use. Lessons cover CPR quality, 12-lead timing, pacing, cardioversion, and rhythms that change the next action.
37 lessons
Medical
Medical emergencies before the hospital: shock, sepsis, stroke, glucose emergencies, toxicology, and environmental illness. Lessons separate field recognition from hospital treatment.
37 lessons
Meds & Pharma
Medication safety for prehospital use: closed-loop checks, concentration errors, and weight-based calculations. This is not a formulary. Doses stay on local protocol.
37 lessons
Trauma
Hemorrhage, shock, traumatic brain injury, spinal motion restriction, and trauma destination. Lessons follow a priority order and name the guideline they use.
37 lessonsAll Lessons
All 185 lessons, thirty-seven in each category. Jump to a category, or scan the full library.
Airway & Breathing
Open category →Airway assessment, oxygenation, and ventilation. Lessons cover bag-mask technique, adjuncts, waveform capnography, difficult-airway planning, and confirmation after an advanced airway.
Effective BVM Ventilation
10 min
Two-person bag-mask ventilation: positioning, adjuncts, mask seal, modest tidal volume, and troubleshooting when saturation does not improve.
Start lesson →Waveform Capnography: The Gold Standard
12 min
Continuous waveform capnography for tube confirmation, CPR quality, ROSC clues, and displacement after movement — not a single color-change check.
Start lesson →Failed Oxygenation: DOPE-S
10 min
A structured DOPE-S check when oxygenation fails after an advanced airway: displacement, obstruction, pneumothorax, equipment, stacked breaths, then a different plan.
Start lesson →Difficult Airway Anticipation
12 min
Anticipating a difficult airway before the first attempt: external clues, Plan A/B/C including oxygenation rescue, and why repeating the same failed look is not a plan.
Start lesson →Asthma & COPD Crisis Ventilation
12 min
Ventilation in obstructive lung disease: prolonged exhalation, modest volumes, auto-PEEP, shark-fin capnography, and a silent chest as a critical finding.
Start lesson →Supraglottic Airways in the Field
10 min
Supraglottic airways as primary or rescue devices: sizing, waveform confirmation, and reassessment after every patient move.
Start lesson →Post-Intubation Care
12 min
Care after a successful intubation: waveform confirmation, securing depth, ventilation rate, blood pressure, and rechecking after packaging.
Start lesson →Oxygen Titration
10 min
Oxygen as a drug: who needs high-flow immediately, COPD without the hypoxic-drive myth, and disease-specific saturation targets for ACS, stroke, ROSC, and TBI.
Start lesson →CPAP & Noninvasive Ventilation
12 min
When CPAP or NIV helps pulmonary edema or COPD work of breathing, who should not receive a mask, and how to recognize failure.
Start lesson →Preoxygenation & Apneic Oxygenation
10 min
Preoxygenation before RSI or laryngoscopy: positioning, a two-person mask seal, apneic oxygenation as an adjunct, and stopping when saturation falls.
Start lesson →OPA & NPA Adjuncts
10 min
Selecting, sizing, and seating OPAs and NPAs so bag-mask ventilation works, including gag, midface trauma, and when an adjunct is the wrong tool.
Start lesson →Foreign-Body Airway Obstruction
10 min
Mild versus severe choking, the 2025 back-blow then thrust cycle, infant and pregnancy variants, and switching to CPR if the patient becomes unresponsive.
Start lesson →Pediatric Airway Differences
12 min
Pediatric airway anatomy and time: occiput, obligatory nose breathing, gentle bagging, and why respiratory failure precedes most pediatric arrests.
Start lesson →Tracheostomy Emergencies
12 min
A failing tracheostomy: oxygenate the stoma, suction or change the tube, and do not treat a plugged cannula as simple COPD.
Start lesson →Front-of-Neck Access
12 min
Cannot-intubate-cannot-oxygenate: state CICO explicitly, last-resort front-of-neck access only if trained and authorized, and waveform confirmation of whatever is in the neck.
Start lesson →Airway Suction
10 min
Large-bore suction that is ready before laryngoscopy: vomit, blood, and when suction itself delays oxygenation.
Start lesson →Ear-to-Sternal-Notch Positioning
10 min
Ear-to-sternal-notch positioning with blankets, ramps, and the stretcher so bag-mask and laryngoscopy can succeed in obese, pregnant, or barrel-chest patients.
Start lesson →Video Laryngoscopy in the Field
10 min
Video laryngoscopy as Plan A when trained: screen discipline, bougie, attempt limits, and returning to bag-mask or an SGA instead of identical failed looks.
Start lesson →Bougie Use in the Field
10 min
The bougie as a change of plan: tracheal clicks, hold-up, railroading the tube, and stopping if the introducer advances into a quiet esophagus.
Start lesson →Drowning: Airway & Ventilation First
10 min
Drowning as hypoxic arrest: scene safety, suction, rescue breaths with CPR (not compression-only), and not using Heimlich as a lung-drain ritual.
Start lesson →Smoke Inhalation and the Airway
10 min
Inhalation injury timing: soot, voice change, burns around the mouth, high-flow oxygen, and a destination that can manage a swelling airway.
Start lesson →Stridor: Croup vs Epiglottitis vs FBAO
10 min
Sorting stridor into croup-like, epiglottitis-like, and foreign-body obstruction: calm positioning, what not to place in the throat, and destination.
Start lesson →Delayed Sequence Intubation Framing
10 min
Delayed sequence intubation as dissociation to allow preoxygenation — only if protocol names it — not a ketamine shortcut around an airway exam or RSI.
Start lesson →Respiratory Arrest With a Pulse
10 min
Pulse without breathing: bag at about 10 breaths per minute, watch for loss of pulse, and do not treat it first as cardiac arrest.
Start lesson →Mainstem Intubation Recognition
10 min
Recognizing a right-mainstem intubation: depth at the teeth, unilateral chest rise, and withdrawing the tube without calling it a pneumothorax.
Start lesson →Airway Attempt Limits
11 min
Counting laryngoscopy attempts, oxygenating between them, changing one variable, and stopping when the same blade is failing.
Start lesson →Angioedema and the Airway
12 min
Progressive lip, tongue, or floor-of-mouth swelling as a time-critical airway: oxygenate, limit attempts, and go to a facility that can perform a surgical airway.
Start lesson →Ramping the Obese Airway
11 min
Ramping a high-BMI patient so ear, sternal notch, and glottis align instead of attempting laryngoscopy on a flat mattress.
Start lesson →Cricoid Pressure & Gastric Distention
10 min
Why routine cricoid pressure is no longer recommended, how rapid bagging distends the stomach, BURP versus Sellick, and decompressing gastric distention.
Start lesson →Pediatric Work of Breathing
12 min
The pediatric assessment triangle: appearance, work of breathing, and circulation — tiring as an emergency, and supporting ventilation before a precise label.
Start lesson →Soiled Airway and Aspiration
11 min
Blood and vomit in the pharynx: positioning, large-bore suction, and oxygenation as the priority — not passing a tube through a soiled airway.
Start lesson →Unrecognized Esophageal Intubation
12 min
No sustained EtCO₂ means the tube is not in the trachea: condensation and breath sounds can mislead; remove the tube and reconfirm after every move.
Start lesson →The Physiologically Difficult Airway
12 min
The physiology behind a difficult intubation: hypoxia, hypotension, acidosis, and right-heart failure — treat those before RSI so induction does not cause arrest.
Start lesson →Home Ventilator Failure
11 min
Alarming home ventilator: oxygenate through the trach, separate leak from obstruction, and do not change modes you were not trained to use.
Start lesson →Laryngectomy vs Tracheostomy
10 min
Laryngectomy versus tracheostomy: the mouth may not connect to the lungs. Oxygenate the neck stoma until you know which airway you have.
Start lesson →The Airway in Pregnancy
11 min
Pregnancy airway: faster desaturation, aspiration risk, ear-to-sternal-notch position, and left uterine displacement after about 20 weeks.
Start lesson →Reading Capnography Waveforms
12 min
Waveform shapes: a square wave, a shark fin, a rising baseline, and a sudden flat line. Each shape changes what you do next.
Start lesson →Cardiac & ECG
Open category →Cardiac arrest, acute coronary syndromes, and ECG interpretation for field use. Lessons cover CPR quality, 12-lead timing, pacing, cardioversion, and rhythms that change the next action.
Systematic ECG Approach
10 min
A six-step ECG method under time pressure: rate, regularity, P waves, PR, QRS, then an action for the crew — not a contest to name the rhythm.
Start lesson →AV Blocks: Three-Question Path
12 min
Distinguishing first-degree, Mobitz I, Mobitz II, and complete heart block with a three-question path, with pacing-ready thinking for high-grade block.
Start lesson →Stable vs Unstable Tachycardia
12 min
Perfusion, not the number on the monitor: when tachycardia means shock, altered mentation, or ischemic pain versus a stable rate-control or vagal/adenosine path.
Start lesson →Wide-Complex Tachycardia: VT vs Mimics
12 min
Regular wide-complex tachycardia treated as VT until proven otherwise, plus hyperkalemia, paced, and pre-excited AF traps — and when adenosine is not appropriate.
Start lesson →PEA: Without a Pulse
10 min
Organized complexes without a pulse: name PEA, continue high-quality CPR, and search for reversible causes that can be treated prehospital.
Start lesson →Asystole vs Fine VF
10 min
Confirming true asystole versus fine VF: gain, a second lead, pads seated, and not calling death on a technical problem.
Start lesson →ROSC & Post-Arrest Care
12 min
After return of pulses: airway and EtCO₂, oxygen and blood-pressure targets, 12-lead, temperature, and a destination that can complete post-arrest care.
Start lesson →12-Lead STEMI Recognition
12 min
When ACS is suspected: a 12-lead within about 10 minutes of first medical contact, territorial STEMI thinking, transmission language, and PCI destination.
Start lesson →Symptomatic Bradycardia
10 min
Bradycardia with poor perfusion: airway and breathing, pads applied, atropine versus pacing, and not delaying care for a rhythm argument.
Start lesson →Shockable Arrest: VF & pVT
10 min
VF and pulseless VT: early defibrillation, immediate CPR, minimizing pauses, and the two-minute cycle.
Start lesson →High-Quality CPR
10 min
Measurable CPR: 100–120 compressions per minute, depth, recoil, short pauses, 30:2 versus about 10 breaths/min with an advanced airway, and why mechanical devices are not routine.
Start lesson →SVT & Adenosine Framing
12 min
Regular narrow-complex SVT: vagal maneuvers, adenosine if stable, synchronized cardioversion if unstable — and why this is not atrial fibrillation.
Start lesson →Atrial Fibrillation with RVR
12 min
Irregularly irregular AF with a rapid rate: cardioversion if unstable, rate control if stable and protocol allows, and never treating AF with adenosine.
Start lesson →Hyperkalemia ECG Recognition
12 min
The hyperkalemia ECG: peaked T waves, wide QRS, sine wave, calcium for membrane toxicity, shifting agents per protocol, and a dialysis-capable destination.
Start lesson →Right-Sided & Posterior MI
12 min
Inferior MI plus V4R for right-ventricular involvement, V7–V9 for posterior occlusion, and nitroglycerin caution when the right ventricle is the pump.
Start lesson →Pit-Crew CPR
10 min
Assigning roles, switching compressors about every two minutes, applying pads while compressing, and keeping pulse checks short.
Start lesson →Transcutaneous Pacing in the Field
10 min
Unstable bradycardia and transcutaneous pacing: pads, rate then output, mechanical capture as a pulse with each paced beat, and sedation only if protocol allows.
Start lesson →Synchronized Cardioversion in the Field
10 min
Unstable SVT, AF, or VT with a pulse: confirm synchronization, energy per protocol, and not defibrillating asystole or PEA.
Start lesson →Double Sequential Defibrillation Framing
10 min
Refractory VF after standard shocks: AHA 2025 does not establish DSED or vector-change as routine — only if protocol includes it, never instead of CPR and the first shock.
Start lesson →Termination of Resuscitation
10 min
When to stop resuscitation: BLS/ALS/universal TOR rules, medical control, hypothermia and toxin exceptions, and documenting times and family communication.
Start lesson →Hypothermic Cardiac Arrest
10 min
Severe hypothermic arrest: gentle handling, delayed medications and shocks as protocol writes, and a rewarming destination — not scene TOR in the driveway.
Start lesson →Cardiac Arrest in Pregnancy
10 min
Maternal arrest: left uterine displacement, high-quality CPR, standard defibrillation, and that resuscitative delivery is a hospital and system skill.
Start lesson →Opioid-Associated Cardiac Arrest
10 min
Pulseless suspected opioid overdose: CPR first; naloxone only if it does not interrupt compressions. Pulse plus apnea is a ventilation problem.
Start lesson →Cardiogenic Shock in the Field
10 min
Pump-failure shock: pulmonary edema, hypotension, ACS as a trigger, no trauma-style fluid loading, and a PCI-capable destination.
Start lesson →Aortic Dissection: Field Suspicion
10 min
Sudden tearing pain, pulse deficit, or neurologic findings: pause the ACS reflex (nitroglycerin and preload-dropping fluids) and go to a center that can repair an aorta.
Start lesson →STEMI Equivalents
12 min
Patterns that should still activate: hyperacute T waves, de Winter, Wellens, isolated posterior, and uncertain LBBB or paced rhythms — transmit and treat as STEMI until proven otherwise.
Start lesson →Pre-Excited AF (WPW)
12 min
Irregular and very wide QRS: possible pre-excited AF. No AV-nodal blockers. Unstable means synchronized cardioversion; protocol owns any stable medication.
Start lesson →LVAD Emergencies
12 min
LVAD on scene: listen for the hum, assess MAP and mentation, restart the controller, and start CPR only if the patient is truly lifeless per AHA LVAD framing.
Start lesson →Defibrillation Pads & Vector Change
11 min
Anterolateral pads with a true cardiac vector, clear of breast tissue, and anterior-posterior vector change only after failed shocks if the system allows it.
Start lesson →ACS Without Chest Pain
12 min
Anginal equivalents — dyspnea, fatigue, nausea, epigastric pain — especially in women, older adults, and diabetes. Obtain a 12-lead within 10 minutes of first medical contact.
Start lesson →Serial 12-Leads in ACS
10 min
A nondiagnostic first tracing plus an ongoing ACS story: serial 12-leads, transmit both, and do not close the case on a single ECG.
Start lesson →STEMI Mimics in the Field
12 min
Early repolarization, LVH strain, pericarditis, LBBB, and paced rhythms versus true occlusion. Reciprocal depression is not a mimic. If uncertain, transmit.
Start lesson →Pediatric SVT vs Sinus Tachycardia
11 min
Infant rates often ≥220 in SVT versus sinus tachycardia with P waves and variability. Unstable patients receive electricity per protocol, not a prolonged sinus lecture.
Start lesson →Lead Misplacement and Artifact
11 min
Limb-lead reversal and artifact can fake infarction or VF. Check the cables and the pulse before a shock or a STEMI decision.
Start lesson →Sodium-Channel Blocker Toxicity
12 min
Wide QRS, tall R in aVR, and a sodium-channel blocker on the med list. Support the airway and the pressure. Bicarbonate only per protocol.
Start lesson →PE and Right-Heart Strain on ECG
11 min
Right-heart strain on the ECG supports possible PE. It does not prove a clot and it does not clear one. Oxygen, a 12-lead, and destination still matter.
Start lesson →Pacemaker and ICD Emergencies
12 min
Pacemaker spikes without a pulse, or an ICD that keeps shocking: treat the rhythm you see. Keep pads off the generator. Magnet use is protocol-specific.
Start lesson →Medical
Open category →Medical emergencies before the hospital: shock, sepsis, stroke, glucose emergencies, toxicology, and environmental illness. Lessons separate field recognition from hospital treatment.
Shock Categories
12 min
Volume, distributive, cardiogenic, or obstructive shock — matching fluids and destination to the category instead of treating every low blood pressure the same.
Start lesson →Sepsis Recognition in the Field
12 min
Infection plus new organ dysfunction or hypoperfusion: screen, pre-notify, fluids per protocol (30 mL/kg is a hospital three-hour target), and qSOFA is not a rule-out.
Start lesson →Stroke Recognition & Last Known Well
12 min
Last known well as last seen normal, a brief stroke screen, glucose, NPO, scene-time discipline, and destination per local endovascular and transfer rules.
Start lesson →Altered Mental Status Framework
12 min
A field AMS framework: glucose, stroke, seizure, toxin, trauma, and infection — treat life threats, then the cause that can be found.
Start lesson →Anaphylaxis Recognition
10 min
Anaphylaxis without waiting for hives: intramuscular epinephrine in the mid-anterolateral thigh, airway and fluids, and why diphenhydramine is not the priority drug.
Start lesson →Diabetic Emergencies: Hypo & Hyper
12 min
Hypoglycemia, DKA, and HHS in the field: check glucose early, D10 versus oral versus glucagon framing, and when “intoxication” is a glucose problem.
Start lesson →Overdose and Toxidromes
12 min
Opioid, sympathomimetic, anticholinergic, cholinergic, and sedative patterns — airway first, antidotes only as authorized, and bringing the containers.
Start lesson →Seizure & Status Epilepticus
12 min
Protect the head, nothing in the mouth, glucose, the five-minute status threshold, IM or IN benzodiazepine if no IV, and Todd’s paralysis as a stroke mimic.
Start lesson →CHF & Pulmonary Edema
12 min
Hypertensive flash pulmonary edema versus COPD: sit the patient up, CPAP if the airway is protected, nitroglycerin if authorized, and no trauma-style fluid boluses.
Start lesson →Syncope in the Field
10 min
A high-risk syncope screen: 12-lead, glucose, cardiac, hemorrhage, and neurologic clues, and why hospital scores do not clear a patient on scene.
Start lesson →Pulmonary Embolism: Field Suspicion
12 min
Sudden dyspnea, hypoxia, or syncope with PE risk: supportive care, 12-lead, and not treating it as simple anxiety or pneumonia. Diagnosis is hospital-based.
Start lesson →Hypertensive Emergency vs High BP
10 min
A high cuff reading versus a failing organ: do not lower asymptomatic hypertension on scene; stroke, ACS, heart failure, and pregnancy own the path.
Start lesson →Heat Stroke vs Heat Exhaustion
12 min
Heat stroke as CNS dysfunction plus hyperthermia: cool immediately, sweat does not rule it out, ice-water immersion when available; antipyretics do not treat it.
Start lesson →Eclampsia & Preeclampsia
12 min
Seizure in pregnancy or up to six weeks postpartum: magnesium first, left lateral or uterine displacement, glucose, and an OB-capable hospital.
Start lesson →GI Bleed in the Field
10 min
Upper versus lower GI bleed clues, shock recognition, airway if the patient vomits blood, TXA only if protocol, and a destination that can endoscope or operate.
Start lesson →Carbon Monoxide in the Field
10 min
Multiple patients, generators, and unreliable pulse oximetry: high-flow oxygen, remove from the source, and pregnant patients as a destination priority.
Start lesson →Accidental Hypothermia (Not Arrest)
10 min
Accidental hypothermia with a pulse: gentle handling, insulation, and not declaring death on a cold patient your protocol says to rewarm.
Start lesson →Dialysis Emergencies
10 min
Missed dialysis: hyperkalemia, volume overload, access-site bleeding, and a destination that can dialyze.
Start lesson →Abdominal Pain Red Flags
10 min
Field red flags in abdominal pain: shock, peritonitis, AAA, ectopic pregnancy, and why gastroenteritis is a dangerous first label.
Start lesson →Severe Agitation in the Field
10 min
De-escalation, glucose and hypoxia, no prone restraint or hobble, and monitoring after sedation — describing severe agitation without “excited delirium” as a diagnosis.
Start lesson →Alcohol Withdrawal in the Field
10 min
Withdrawal versus intoxication: seizures, delirium tremens, glucose, benzodiazepines per protocol, and not leaving a withdrawing patient to sleep it off.
Start lesson →Vaginal Bleeding in the Field
10 min
Pregnant and non-pregnant vaginal bleeding: shock, ectopic and miscarriage thinking, pads in place, and not packing the vagina.
Start lesson →Meningitis & Fever With Stiff Neck
10 min
Fever, stiff neck, photophobia, or petechiae: isolation thinking, sepsis support, and not waiting for a hospital lumbar puncture to treat the patient as sick.
Start lesson →Sickle Cell Crisis in the Field
10 min
Vaso-occlusive pain, acute chest syndrome, and stroke in sickle cell disease: oxygen, analgesia per protocol, and taking pain seriously.
Start lesson →Hypoglycemia Refusal & Capacity
10 min
After correcting hypoglycemia: capacity, a real meal, why the glucose fell, and when a refusal requires medical control.
Start lesson →Pediatric Septic Shock in the Field
12 min
Compensated pediatric shock: tachycardia, cap refill, and mentation before hypotension. Bolus, reassess the lungs, pediatric-capable emergency department.
Start lesson →Stroke Mimics
11 min
Hypoglycemia, post-ictal Todd’s paralysis, migraine, and functional presentations as stroke mimics — still run the stroke path when criteria are met.
Start lesson →Adrenal Crisis in the Field
11 min
Adrenal crisis from the steroid list and shock picture: glucose, fluids, and steroid if protocol allows — not unexplained hypotension.
Start lesson →Thunderclap Headache & SAH
11 min
Thunderclap or worst-headache-of-life presentations and subarachnoid hemorrhage thinking: ABCs, glucose, no improvised blood-pressure drop, and a hospital that can image.
Start lesson →Field Death Notification
12 min
After termination of resuscitation: one speaker, the word died, a pause, and a short script — not euphemism and not leaving the family without a statement.
Start lesson →Imminent Childbirth
12 min
Crowning on scene: stay, control the head, nuchal cord, dry, stimulate, and warm the newborn, delayed cord clamping if the infant is well, and two patients on the radio.
Start lesson →Weakness and Dizziness in Older Adults
12 min
Weakness and dizziness in older adults: ACS, stroke, hemorrhage, infection, and medications — a high-risk screen instead of a dismissive label.
Start lesson →Cognitive Bias in Field Decisions
10 min
Anchoring on dispatch, confirmation bias, and premature closure: treat the first story as a hypothesis and reassess after the first intervention.
Start lesson →Serotonin Syndrome vs NMS
12 min
Clonus and serotonergic drugs versus rigid muscles and an antipsychotic. Cool, support the airway, benzodiazepines per protocol, and bring the medication list.
Start lesson →Thyroid Storm and Myxedema
11 min
Thyroid storm: hot, fast, altered — cool and support, and do not use aspirin for the fever. Myxedema: cold, slow, altered — airway, glucose, gentle warming.
Start lesson →BRUE: The Resolved Infant Event
10 min
The infant looks fine now after a color, breathing, or tone change. That is not a field clearance. BRUE low-risk rules belong to the clinician after a full exam.
Start lesson →Refractory Anaphylaxis
12 min
Anaphylaxis that persists: repeat IM epinephrine per protocol, airway early, supine if hypotensive. Never IV-push the IM concentration. Glucagon does not replace epinephrine.
Start lesson →Meds & Pharma
Open category →Medication safety for prehospital use: closed-loop checks, concentration errors, and weight-based calculations. This is not a formulary. Doses stay on local protocol.
Medication Rights & Safety Culture
10 min
Closed-loop medication rights: right patient, drug, dose, route, and time — and a culture that thanks the partner who stops an error.
Start lesson →Weight-Based Dosing Safety
10 min
Kilograms not pounds, mg/kg, concentration, volume, and a second check — stopping when the milliliters look wrong. Protocol owns the milligrams.
Start lesson →Fentanyl for Pain Management
10 min
Opioid analgesia for severe pain: assess, treat, reassess, and why a short transport time is not a reason to skip protocol pain care.
Start lesson →Epinephrine: Anaphylaxis & Arrest
12 min
Intramuscular thigh epinephrine for anaphylaxis versus intravenous or IO arrest concentrations — reading the vial every time so the indication matches the ampule.
Start lesson →Naloxone Use
10 min
Naloxone to restore breathing, not full wakefulness: airway first, titration if protocol allows, and capacity after the patient wakes.
Start lesson →Ketamine in the Field
10 min
Ketamine’s three uses — analgesia, severe agitation, and induction — airway vigilance, and not mixing dose ranges from memory. Protocol owns the milligrams.
Start lesson →Push-Dose Pressors
12 min
A temporary blood-pressure bridge when authorized: exact dilution, labeling, verbalizing concentration, and treating the cause (hemorrhage, tension, rhythm).
Start lesson →Aspirin in ACS
10 min
Early aspirin in suspected ACS when protocol allows — chew, document, and do not wait for the catheterization lab to start antiplatelet therapy.
Start lesson →Nitroglycerin Cautions
10 min
Nitroglycerin drops preload: when it helps ACS or wet lungs, and when it harms right-ventricular infarct, PDE5 use, or anyone already hypotensive.
Start lesson →Benzodiazepines in the Field
10 min
Benzodiazepines for seizure, agitation, and sympathomimetic toxicity: airway, glucose, and not using them as first-line therapy for eclampsia.
Start lesson →Albuterol & Bronchodilators
10 min
Nebulized bronchodilators for bronchospasm, when wheeze is actually heart failure, lactic acidosis with frequent SABA, and ipratropium as a partner drug per protocol.
Start lesson →Dextrose: D10 Framing
10 min
D10 titrated to effect versus D50 extravasation and overshoot — confirm hypoglycemia, recheck mentation, and protocol owns the bag.
Start lesson →Magnesium: Three Field Uses
12 min
Three magnesium indications: eclampsia, torsades, and severe asthma — mixing, respiratory depression, and not treating it as a benign mineral.
Start lesson →Tranexamic Acid in Trauma
10 min
TXA after life-saving hemorrhage control, only with clinical shock, only inside three hours — never a substitute for a tourniquet or an operating room. Pediatric use is not well studied.
Start lesson →Amiodarone & Lidocaine in Arrest
10 min
Antiarrhythmics in shockable arrest after defibrillation: protocol timing, IO flush, and not using them as a PEA reflex.
Start lesson →Atropine in the Field
10 min
Atropine for vagal or AV-nodal bradycardia versus pacing-ready high-grade block, and a completely different cholinergic-poisoning indication.
Start lesson →Calcium for HyperK ECG Toxicity
10 min
Calcium for ECG toxicity in hyperkalemia — membrane stabilization, not a potassium eraser — and protocol routes that reduce vein injury.
Start lesson →Sodium Bicarbonate Framing
10 min
Bicarbonate is not an arrest reflex: sodium-channel poison and selected hyperkalemia cards only, as protocol names them.
Start lesson →Glucagon Without IV Access
10 min
Intramuscular or intranasal glucagon when there is no IV: vomiting, the need for carbohydrate after they wake, and patients without glycogen stores.
Start lesson →Ipratropium With Albuterol
10 min
Adding ipratropium in obstructive crisis: who it helps, that it is not a standalone rescue, and protocol timing with albuterol.
Start lesson →Ondansetron in the Field
10 min
Ondansetron after considering ACS, head injury, and QT interval — comfort and aspiration prevention, not a substitute for turning the patient.
Start lesson →Oral Analgesics in the Field
10 min
Oral acetaminophen and NSAIDs as real analgesia for the right patient, and when the oral route is the wrong route.
Start lesson →Activated Charcoal Framing
10 min
When charcoal is even on the table: intact airway, recent ingestion, medical control, and why it is not a universal overdose intervention.
Start lesson →Oxytocin in Postpartum Hemorrhage
10 min
Oxytocin only after the infant is delivered, for uterine atony, with fundal massage — never for bleeding in an undelivered pregnancy.
Start lesson →Diphenhydramine Cautions
10 min
Diphenhydramine as an adjunct, not anaphylaxis care, and anticholinergic and sedation cautions in older adults.
Start lesson →Hydroxocobalamin for Smoke Cyanide
11 min
Closed-space smoke plus unexplained shock or arrest: cyanide suspicion, hydroxocobalamin if carried, without delaying airway and destination.
Start lesson →Dexamethasone & Field Steroids
10 min
Field steroids by indication — croup, bronchospasm, adrenal crisis, anaphylaxis adjunct — without delaying epinephrine or a bronchodilator for a steroid draw.
Start lesson →Diltiazem in AF with RVR
12 min
Diltiazem only for stable irregular narrow-complex AF your protocol names: watch the blood pressure, and never on an irregular wide-complex rhythm.
Start lesson →Droperidol & Haloperidol in the Field
11 min
Droperidol or haloperidol for agitation your protocol names: QT interval and medical mimics, monitoring, and not stacking blindly with other sedatives.
Start lesson →Undertreated Pain
11 min
Undertreating pain: score it, treat per protocol regardless of short ETA, reassess, and intranasal fentanyl in children if the protocol includes it.
Start lesson →Pediatric 10-Fold Med Errors
11 min
Kilograms not pounds, length-based tape, adult maximum as a ceiling, saying milligrams out loud — the classic ten-fold pediatric error.
Start lesson →Look-Alike Med Errors
11 min
Look-alike medications: read the name and concentration, closed-loop communication, and epinephrine 1 mg/mL versus 0.1 mg/mL as a grab error.
Start lesson →IO Medication Flush
11 min
IO access when IV is delayed: same dose as IV, a rapid flush, pressure for fluids, and not leaving the drug in the marrow.
Start lesson →Beta-Blocker and Calcium-Channel Overdose
12 min
Bradycardia and shock from a beta blocker or calcium-channel blocker. Atropine and pacing may fail. High-dose treatments belong to protocol and the poison center.
Start lesson →Intranasal Medication Delivery
10 min
Atomizer, both nostrils, and the formulation on your protocol. Large volumes run out of the nose. Arrest epinephrine is not an intranasal drug.
Start lesson →Cholinergic Crisis and Nerve Agents
12 min
Cholinergic crisis: small pupils, wet lungs, slow heart, seizures. Scene safety and decontamination first. Atropine and pralidoxime only from the authorized kit.
Start lesson →Sedation After an Advanced Airway
11 min
After a paralytic, sedation and analgesia are part of the airway. Protocol owns the drugs. Watch the pressure, and keep the waveform on.
Start lesson →Trauma
Open category →Hemorrhage, shock, traumatic brain injury, spinal motion restriction, and trauma destination. Lessons follow a priority order and name the guideline they use.
Massive Hemorrhage First
10 min
Catastrophic external bleeding before the airway: MARCH order, tourniquets, packing, hypothermia prevention, and a short scene for hemorrhage that cannot be packed.
Start lesson →Tension Pneumothorax Recognition
10 min
Tension as obstructive shock — not tracheal deviation. Needle decompression only for tension physiology, not a simple pneumothorax, then reassess ventilation and blood pressure.
Start lesson →Spinal Motion Restriction Decisions
10 min
Airway, oxygen, and blood pressure first. Boards for extrication then off the board. Collar only if protocol still names one. Hypoperfusion injures the cord more than a careful move.
Start lesson →Traumatic Brain Injury
12 min
Preventing secondary brain injury: hypoxia, hypotension (adult SBP teaching about 110 mm Hg), EtCO₂ about 35–45 mm Hg, and brief hyperventilation only for herniation.
Start lesson →Pelvic Injury & Binder Thinking
10 min
Do not rock the pelvis. Shock is often not the pelvic ring. If protocol still uses a binder: greater trochanters, legs internally rotated, trauma center.
Start lesson →Burn Assessment
12 min
Airway risk, honest TBSA, hypothermia prevention, fluid themes, and ABA-style burn-center referral — not a wet-sheet delay.
Start lesson →Trauma Triage & Destination
10 min
ACS 2021 field triage: physiology, anatomy, mechanism, and special considerations (age, anticoagulation, pregnancy). The closest hospital is not always the right hospital.
Start lesson →Open Chest Wounds & Seals
10 min
Open chest wounds: a vented seal if the patient is breathing spontaneously; do not default to sealing a bagged or intubated chest. Watch for tension. Do not pack the thorax.
Start lesson →Traumatic Cardiac Arrest
12 min
Life-saving interventions first in traumatic arrest: hemorrhage, least-invasive airway, tension if suspected. Compressions are secondary. TOR only per written rule.
Start lesson →Trauma in Pregnancy
12 min
Mother first: left uterine displacement from about 20 weeks, MARCH still applies, shock can hide, and a trauma center with obstetric capability.
Start lesson →Tourniquet Application
10 min
A tourniquet that stops arterial bleeding: high and tight then deliberate placement 2–3 inches on skin, a second tourniquet if bleeding continues, and the time documented.
Start lesson →Wound Packing & Junctional Bleed
12 min
Junctional and deep wounds: pack to the source, sustained pressure, hemostatic versus plain gauze, and chest seals for open chest wounds — not packing the thorax.
Start lesson →Damage-Control Resuscitation
12 min
Stop the bleed, restrict crystalloid, blood if carried, keep the patient warm, TXA after life-saving interventions if protocol, and do not restrict volume in TBI.
Start lesson →Crush Syndrome
12 min
Prolonged entrapment: saline before the lift when possible, no potassium in the bag, hyperkalemia after release, and calcium when the QRS widens.
Start lesson →Geriatric Trauma
12 min
Older trauma patients: SBP under 110 mm Hg may already be shock, anticoagulants, falls, frailty, and the highest-level trauma center when criteria are met.
Start lesson →Pediatric Trauma in the Field
10 min
Children hide shock: length-based tape, warmth, glucose, a quiet child as a red flag, and not undertriaging because they appear well.
Start lesson →Blast Injury in the Field
10 min
Scene safety, MARCH, occult blast lung, tympanic rupture as a clue, and combined burns and trauma in one patient.
Start lesson →Traumatic Amputation
10 min
Stump hemorrhage first, the amputated part dry-bagged and cooled, and not delaying the living patient for an endless search.
Start lesson →Impaled Objects
10 min
Leave the object in place and stabilize it unless it obstructs the airway or prevents compressions — then be ready for hemorrhage.
Start lesson →Abdominal Evisceration
10 min
Moist sterile cover, no reducing bowel, warmth, and a surgical destination — without ignoring hemorrhage and airway.
Start lesson →Facial Trauma and the Airway
10 min
Blood as the obstruction: suction, sitting up if protocol allows, NPA caution through a smashed midface, and SGA or ETT per training.
Start lesson →Helmet Removal for Airway
10 min
When the helmet blocks bag-mask or laryngoscopy it comes off — two people, in-line, and a plan for shoulder pads so the neck does not extend.
Start lesson →Electrical & Lightning Injury
10 min
Power off first, reverse-triage lightning victims who appear dead, CPR and defibrillation, then burn and trauma care.
Start lesson →Chemical Eye Injury
10 min
Irrigate immediately, remove contacts if they come easily, alkali worse than acid, and bring the container if it is safe.
Start lesson →Flail Chest & Pulmonary Contusion
10 min
Flail as a marker for pulmonary contusion: oxygen, analgesia so the patient can breathe, CPAP if protocol allows, and not strapping the segment down.
Start lesson →Penetrating Neck Trauma
11 min
Penetrating neck trauma: airway, direct pressure, no probing, expanding hematoma left in place, and a trauma center with a CICO plan.
Start lesson →Anticoagulated Trauma
11 min
Anticoagulant plus mechanism: assume occult hemorrhage even if the patient looks well, short scene, CT-capable trauma or stroke hospital, bring the medication bottle.
Start lesson →Prehospital Blood Transfusion
12 min
If the service carries blood: stop compressible hemorrhage first, then product for traumatic shock — not pressors, not a liter of saline.
Start lesson →Compartment Syndrome in the Field
10 min
Pain out of proportion and a tight compartment: splint, do not ice hard, do not wait for pulselessness, surgeon-capable emergency department.
Start lesson →Hidden Hemorrhagic Shock
12 min
Compensated hemorrhage: tachycardic, cool, anxious, with a “normal” blood pressure. Expose, MARCH, and a destination that can operate.
Start lesson →Trauma Bay Handoff
10 min
A 30-second trauma-bay handoff: MIST or IMIST-AMBO, one speaker, the remaining life threat, times, then listen.
Start lesson →Needle Decompression Technique
12 min
Needle decompression of true tension: protocol site, over the rib, not too medial, catheter long enough, and reassess — technique, not indication.
Start lesson →Neurogenic vs Hemorrhagic Shock
11 min
Warm, slow, and hypotensive after a high cord injury versus cool and fast from bleeding — look for bleeding in either case, and do not skip tourniquets.
Start lesson →Tourniquet Conversion
11 min
Do not loosen a tourniquet on a crashing patient. Conversion is a protocol step for a patient who is not in shock, with a visible wound you can re-bleed.
Start lesson →SALT Mass-Casualty Triage
12 min
SALT triage: global sorting, individual assessment, a few lifesaving interventions, then treatment and transport. Your MCI plan still owns the details.
Start lesson →Suspension Syndrome
10 min
Get a suspended person down. If they are peri-arrest, lay them flat and start standard care. The old advice to keep them sitting for 30 minutes is not supported.
Start lesson →Circumferential Burns
11 min
Circumferential burns: chest eschar can block ventilation, limb eschar can threaten the limb. Cool briefly, then prevent hypothermia. Do not cut an escharotomy in the field.
Start lesson →