From Pulse to Perfusion: Cardiac Output in Prehospital Medicine

From Pulse to Perfusion: Cardiac Output in Prehospital Medicine

Cardiac output is the foundation of perfusion — the lifeline that keeps every organ functioning. In prehospital care, understanding how heart rate and stroke volume interact helps responders identify shock early, guide treatment, and protect vital organs. This blog breaks down cardiac output in clear, practical terms for EMRs, advanced first aiders, and anyone working in emergency response.

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Managing Intoxicated Patients in the Field: An EMR Guide

As an Emergency Medical Responder (EMR), you’re trained to provide care in unpredictable situations. One of the more challenging scenarios is responding to patients under the influence of alcohol or drugs. Intoxicated patients can present with unpredictable behavior, altered physiology, and a higher risk of injury—making careful assessment and management critical.

At Delta Emergency Support Training, we emphasize both safety and effective patient care. Here’s a detailed guide for EMRs on safely responding to intoxicated patients, aligned with Alberta Health Services (AHS) guidelines.

Understanding Intoxication

Intoxication can result from alcohol, prescription medications, or illicit drugs. Common effects include:

  • Altered level of consciousness

  • Slurred speech or impaired coordination

  • Agitation, aggression, or unpredictable behavior

  • Nausea, vomiting, or respiratory depression

  • Increased risk of trauma from falls, fights, or accidents

  • Masked pain: Alcohol can dull pain perception, making trauma patients unreliable reporters of injury severity

  • Mimics: Hyperglycemia or hypoglycemia can appear similar to intoxication, making blood glucose assessment crucial

Recognizing the signs early helps EMRs anticipate complications and prioritize patient and responder safety.

Safety First: Protecting Yourself and Others

Intoxicated patients can be unpredictable. Before providing care, ensure:

  • Scene safety: Survey for weapons, hazards, or bystanders that may interfere.

  • Backup: If the patient is aggressive, call law enforcement or additional responders.

  • Personal protective equipment (PPE): Gloves, eye protection, and masks may be necessary.

  • Distance and positioning: Maintain a safe stance and keep an exit route clear.

Never compromise your safety—intoxicated patients may act impulsively, and an aggressive patient can escalate quickly.

Patient Assessment

Assessment of an intoxicated patient may be complicated by their altered state. EMRs should focus on:

  1. Responsiveness: Determine if the patient is fully conscious, verbally responsive, physically responsive, or unresponsive.

  2. Airway, Breathing, Circulation (ABCs): Alcohol and drugs can depress breathing and circulation.

    • Be prepared to clear the airway using suction if the patient vomits.

    • Airway adjuncts (oropharyngeal or nasopharyngeal airway) may be required if the patient’s airway is compromised but spontaneous breathing is present.

  3. Vital signs: Monitor heart rate, blood pressure, respiratory rate, oxygen saturation, and blood glucose.

    • Hyperglycemia or hypoglycemia can mimic intoxication and significantly affect patient management.

  4. Secondary survey: Look for trauma, especially since alcohol can mask pain. A patient may not report broken bones, internal injuries, or head trauma. Monitor carefully for subtle signs.

Common Challenges and How to Manage Them

  • Aggression or agitation: Stay calm, use a non-confrontational tone, and avoid physical confrontation unless absolutely necessary.

  • Vomiting or aspiration risk: Use suction immediately if needed, and position the patient in the recovery positionif unconscious but breathing.

  • Altered decision-making: Intoxicated patients may refuse care. Document refusals and use implied consent in life-threatening situations.

  • Polysubstance use: Patients may have multiple substances in their system, complicating presentation. Monitor closely for unexpected symptoms.

  • Trauma considerations: Be extra vigilant for head injuries, internal bleeding, or fractures. Pain may be unreliable, so rely on vital signs, visual assessment, and mechanism of injury.

  • Glucose considerations: Rapidly check blood glucose in any altered patient; treating hypoglycemia or hyperglycemia may resolve the presentation entirely.

Communication Tips

  • Use simple, clear language.

  • Speak slowly and calmly to reduce confusion.

  • Avoid judgmental language—patients respond better when treated respectfully.

  • Keep bystanders informed, but focus on patient care.

Transport Considerations

  • Monitor continuously: Intoxicated patients can deteriorate rapidly.

  • Secure safely: If aggressive, use restraints only per local protocols and monitor the patient closely.

  • Communicate with receiving facility: Provide details on level of intoxication, suspected substances, vital signs, airway interventions (suction or adjuncts used), trauma concerns, and any interventions performed.

Red Flags: When to Call for Immediate Backup

  • Unresponsiveness or decreased level of consciousness

  • Difficulty breathing or abnormal airway sounds

  • Vomiting with risk of aspiration

  • Seizures or convulsions

  • Severe trauma, especially head or internal injuries

  • Aggressive or violent behavior that cannot be safely managed

  • Hypoglycemia or hyperglycemia causing altered mental status

Final Thoughts

Responding to intoxicated patients requires a balance of emergency care skills, safety awareness, and empathy. Alcohol or drug use can mask pain and complicate assessment, and abnormal blood glucose levels can mimic intoxication. With proper airway management, suction, airway adjuncts, and glucose monitoring, EMRs can provide effective care safely.

At Delta Emergency Support Training, our courses prepare responders to handle complex patient scenarios, including intoxicated and trauma patients so you can provide care with confidence, skill, and safety.

Understanding Basic, Intermediate, and Advanced Airway Adjuncts in Prehospital Care

Understanding Basic, Intermediate, and Advanced Airway Adjuncts in Prehospital Care

Airway management is the cornerstone of emergency care. From simple oropharyngeal and nasopharyngeal airways to supraglottic devices and endotracheal intubation, prehospital providers need to know when—and how—to use each tool. This guide explains the essential skills and decision-making strategies for basic, intermediate, and advanced airway adjuncts to help responders keep patients breathing and safe.

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Alberta Fire Applicants & EMRs: Master the Medical Portion with Paramedics and Firefighters

Alberta Fire Applicants & EMRs: Master the Medical Portion with Paramedics and Firefighters

Succeeding in the medical portion of a firefighter or EMR application in Alberta comes down to mastering the fundamentals under pressure. At Delta Emergency Support Training, active paramedics and firefighters teach you vital patient assessment skills, accurate vitals, effective communication, and safe medication administration.

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Weathering the Storm: Responding to Emergencies in Harsh Conditions

Weathering the Storm: Responding to Emergencies in Harsh Conditions

Bad weather doesn’t stop emergencies, and it shouldn’t stop responders from being ready. From icy roads to scorching heat, first responders face unique challenges that affect both their safety and their patients’ well-being. This guide explores how weather impacts patient care, what responders can do to prepare, and key strategies to ensure safety when working in rain, snow, heat, or storms.

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Pulmonary Embolism for EMR Students: Signs, Symptoms, and Action Steps

Pulmonary Embolism for EMR Students: Signs, Symptoms, and Action Steps

Pulmonary embolisms are among the most serious complications post-surgery—and often go unnoticed until it’s too late. For Emergency Medical Responders, especially those working in Alberta’s high-risk environments, knowing the subtle signs and acting fast can make all the difference. This blog breaks down what to look for, how to respond, and why early recognition matters.

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Planning to Apply to Edmonton or Calgary Fire? Why Advanced First Aid Recertification Matters

Planning to Apply to Edmonton or Calgary Fire? Why Advanced First Aid Recertification Matters

Planning to apply to Calgary or Edmonton Fire? Delta Emergency Support Training in Calgary offers Advanced First Aid recertification taught by paramedics and firefighters. Choose from weekday or weekend formats between September and November. Build your resume and keep your skills current with this Red Cross-certified course.

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Cultural Differences and Language Barriers: A First Responder’s Guide to Respectful, Effective Care

Cultural Differences and Language Barriers: A First Responder’s Guide to Respectful, Effective Care

Emergency calls often involve diverse cultures and languages. First responders face unique challenges in communication and cultural understanding that can impact patient care. This guide offers essential strategies to navigate language barriers respectfully, recognize cultural differences, and deliver compassionate, effective emergency care. Improve your skills and confidence with our practical tips.

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Advanced First Aid for Dog Bites: A Firefighter & EMS Responder’s Guide

Advanced First Aid for Dog Bites: A Firefighter & EMS Responder’s Guide

Dog bites demand swift, skilled care from first responders. Our Red Cross Advanced First Aid & EMR course trains firefighters and EMS personnel in critical skills—from scene safety to wound management and emotional support. Learn to confidently handle dog bite emergencies and more with hands-on training that prepares you for real-world situations.

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The Critical Role of BSI: Protecting Yourself First as a First Responder

The Critical Role of BSI: Protecting Yourself First as a First Responder

Body Substance Isolation (BSI) is more than just wearing gloves—it's a life-saving habit for every first responder. From bloodborne pathogens to airborne illnesses, BSI protects you from invisible threats on every call. At Delta Emergency Support Training, we emphasize BSI in every scenario because your safety comes first. Learn what PPE to wear, how to use it, and why BSI is essential in every emergency situation.

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From First Aid to Fireline: Your Path to Wildland Deployment

From First Aid to Fireline: Your Path to Wildland Deployment

Canada’s wildfire seasons are getting more intense—so is the demand for skilled wildland firefighters. Learn what the job involves, the certifications you need (like S-100, S-185, and EMR), and how Delta Emergency Support Training helps future responders build a solid foundation in Red Cross-certified Advanced First Aid and Emergency Medical Responder programs.

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Why Advanced First Aid Is a Must-Have for Future Firefighters: Prepare for Firefighter Recruitment with the Right Medical Training

Why Advanced First Aid Is a Must-Have for Future Firefighters: Prepare for Firefighter Recruitment with the Right Medical Training

Thinking of applying to a fire department? Start with Advanced First Aid. Learn how Red Cross-certified training builds your emergency response skills and prepares you for a first responder career.

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Scene Assessment for AFA & EMR: A Step-by-Step Guide

Scene Assessment for AFA & EMR: A Step-by-Step Guide

Discover how first responders assess scenes in seconds using real tools like HEMPPA, PWCATS, and SCORTS. We teach it in our EMR course — with real-world scenarios to make it stick.

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Understanding Blood Pressure: A Critical Guide for Advanced First Aiders & EMRs

Understanding Blood Pressure: A Critical Guide for Advanced First Aiders & EMRs

Blood pressure isn’t just a number—it’s a key clue to what’s happening inside your patient’s body. Whether it’s shock, stroke, or dehydration, knowing how to take and interpret blood pressure can guide better decisions and faster interventions. This guide walks AFA and EMR students through practical skills, critical signs, and scene-ready tips to sharpen your response.

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Can I be a First Responder? The Skills and Traits You Need

Can I be a First Responder? The Skills and Traits You Need

Being a first responder requires more than just medical knowledge—it’s about having the right qualities. From staying calm under pressure to having a deep desire to help others, discover the traits that make someone a good fit for this rewarding career.

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The Red Cross: Everything Aspiring First Responders Need to Know Introduction

The Red Cross: Everything Aspiring First Responders Need to Know  Introduction

Thinking about becoming a first responder? The Red Cross provides essential training, from Standard First Aid (SFA) with CPR/AED Level C to Advanced First Aid (AFA), Basic Life Support (BLS), and Emergency Medical Responder (EMR). At Delta Emergency Support Training, we offer all these courses, including bridge programs and recertifications, helping you stay certified and ready to respond. 🚑

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What It Means to Be a First Responder: A Lifelong Commitment to Service, Compassion, and Community

What It Means to Be a First Responder: A Lifelong Commitment to Service, Compassion, and Community

Being a first responder is a calling to serve your community during times of crisis. It's about earning the trust of the people you help, offering support during their worst days, and making life-saving decisions under pressure. In this blog, we explore the profound responsibility and emotional commitment that comes with being a first responder, and how these professionals are the heart of their communities.

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EMR Guide to Facial Trauma: Airway Management, Bleeding Control, and Injury Assessment

EMR Guide to Facial Trauma: Airway Management, Bleeding Control, and Injury Assessment

Facial trauma is a serious medical emergency that requires prompt attention. This guide for EMRs covers essential steps for managing facial injuries, including airway management, bleeding control, and fracture stabilization. Learn how to assess and treat patients with maxillofacial trauma to reduce the risk of permanent functional loss and disfigurement.

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Meningitis: What Every First Responder Needs to Know

Meningitis: What Every First Responder Needs to Know

Meningitis is a serious infection that can escalate rapidly. As a medical first responder, understanding the types and symptoms of meningitis is essential for effective care. At Delta Emergency, we provide advanced first aid training across Canada, particularly in Edmonton and Calgary, to equip fire fighters and emergency responders with life-saving knowledge.

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Common Gynecological Medical Emergencies Every First Responder Should Know

Common Gynecological Medical Emergencies Every First Responder Should Know

Gynecological emergencies, such as ovarian torsion, ectopic pregnancy, and toxic shock syndrome, require quick action and careful handling. For first responders, understanding the symptoms, knowing how to prioritize care, and maintaining patient comfort and dignity are essential. This blog explores common gynecological emergencies, providing essential information for responders to manage these situations with professionalism, especially when male responders are involved. Learn how to respond effectively and respectfully to ensure the best outcomes for your patients.

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