The Prehospitalist

The Prehospitalist Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from The Prehospitalist, Medical and health, Williamsburg, VA.
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🚁 Critical care flight paramedic & prehospital educator (MS, FP-C)
🚑 Prehospital pearls & tidbits
⚠️ Not a replacement for protocols, formal education
🗣️ Conversations primarily monitored on IG .prehospitalist

Sometimes the best lessons are learned in the hardest ways: the mistakes - or simply wrong decisions - that result in pa...
09/19/2026

Sometimes the best lessons are learned in the hardest ways: the mistakes - or simply wrong decisions - that result in patient harm or death.

It’s a tragic reality in the practice of medicine. Mistakes happen. Misjudgments happen. Some of my biggest regrets in patient care have turned into the biggest wins for the patients who came after. “I will never let that happen again.”

Learning from what we could’ve done better to help those who come after is one of the most impactful moves we can make.

How do you use bicarb?👇🏻• • • • •📚: EMCrit.org, “Sodium Channel Blocker Toxicity (including tricyclic antidepressants)” ...
09/18/2026

How do you use bicarb?👇🏻

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📚: EMCrit.org, “Sodium Channel Blocker Toxicity (including tricyclic antidepressants)” by Josh Farkas, 2025

📚: EMCrit.org, “Management of severe hyperkalemia in the post-Kayexalate era,” by Josh Farkas, 2015

📚: Bourdeaux C, Brown J. Sodium bicarbonate lowers intracranial pressure after traumatic brain injury. Neurocrit Care. 2010 Aug;13(1):24-8. doi: 10.1007/s12028-010-9368-8. PMID: 20422466.

📚: Bourdeaux CP, Brown JM. Randomized controlled trial comparing the effect of 8.4% sodium bicarbonate and 5% sodium chloride on raised intracranial pressure after traumatic brain injury. Neurocrit Care. 2011 Aug;15(1):42-5. doi: 10.1007/s12028-011-9512-0. PMID: 21298358.

Yesterday I came across two interesting posts: the first from Dr. Konstantinos Kyriakopoulos regarding endometriosis in ...
09/13/2026

Yesterday I came across two interesting posts: the first from Dr. Konstantinos Kyriakopoulos regarding endometriosis in a finger, and the second from Siddartha Simha, MD regarding endo in a male patient. Alas, I ended up down a rabbit hole.

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As-Sanie S, Mackenzie SC, Morrison L, Schrepf A, Zondervan KT, Horne AW, Missmer SA. Endometriosis: A Review. JAMA. 2025 Jul 1;334(1):64-78. PMID: 40323608

Al Shenawi H, Al Buhmaid S, Al Shenawi F, AlRumaihi M, Alhamar N. Umbilical Endometriosis: A Case Report. Cureus. 2025 Nov 24 PMID: 41450365

Elefante C, Brancati GE, Oragvelidze E, Lattanzi L, Maremmani I, Perugi G. Psychiatric Symptoms in Patients with Cerebral Endometriosis: A Case Report and Literature Review. J Clin Med. 2022 Dec 4 PMID: 36498786

Ye H, Shen C, Quan Q, Xi M, Li L. Endometriosis of the skeletal muscular system (ESMS): a systematic review. BMC Womens Health. 2023 Jan 26;23(1):37. PMID: 36703173

Bindra V, Nori M, Reddy R, Reddy R, Satpathy G, Reddy CA. Sciatic nerve endometriosis - The correct approach matters: A case report. Case Rep Womens Health. 2023 May 19;38:e00515. PMID: 37275569

Rahman S, Youssef Y, Maroun G, Inaty D, Kheil MH, Moawad G. Eyes, menstruation and endometriosis. Facts Views Vis Obgyn. 2023 Jun;15(2):107-113. PMID: 37436046

Nguyen K, Nudelman BG, Quiros J, Cortes M, Savu C. Catamenial Pneumothorax: A Rare Diagnosis Among Menstruating Women. Cureus. 2023 Sep 22;15(9):e45769. PMID: 37872905

Jena SK, Mishra L, Behera S, Samal S. Spontaneous Fingertip Endometriosis: A Rare Case Report. J Clin Diagn Res. 2015 May;9(5):QL01. PMID: 26155522

Rei C, Williams T, Feloney M. Endometriosis in a Man as a Rare Source of Abdominal Pain: A Case Report and Review of the Literature. Case Rep Obstet Gynecol. 2018 Jan 31;2018:2083121. PMID: 29670782

Nawaz MM, Masood Y, Usmani AS, Basheer MI, Sheikh UN, Mir K. Renal endometriosis: A benign disease with malignant presentation. Urol Case Rep. 2022 May 7;43:102110. PMID: 35586402

Aliyeva A, Safarova V. Perimenstrual Epistaxis Caused by Nasal Septal Endometriosis: Very Rare Case Report. J Rhinol. 2022 Nov;29(3):182-184. PMID: 39664306

📷: https://www.nature.com/articles/nrendo.2013.255

It’s less of a surprise if you’re ready for it 💁🏻‍♀️
09/12/2026

It’s less of a surprise if you’re ready for it 💁🏻‍♀️

09/09/2026

Commotio cordis occurs when a sudden, blunt blow to the chest strikes during the heart’s relative refractory period (a vulnerable period when the heart is partially reset), triggering ventricular fibrillation. In this case, we can see the athlete taking a blow to the chest, presumably entering vfib immediately, and staying upright for a few seconds until perfusion dissipates.

Commotio cordis is a traumatic cause of a medical cardiac arrest. These patients need immediate CPR and defibrillation as soon as possible.

Outcome unknown for this patient.

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🎥: SureFireCPR on YouTube, “Sudden Cardiac Arrest at a Martial Arts Tournament - Commotio Cordis,” (2011)

It’s research presentation week in medic class, my favorite 🤓 Love love learning from students. Shoutout to Emily Renee ...
09/08/2026

It’s research presentation week in medic class, my favorite 🤓 Love love learning from students. Shoutout to Emily Renee for teaching me this one today!

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📚: PMIDs: 40503820, 32589580, 35518795, 26757615, 36336673, 35190246

09/07/2026

Someone requested this the other day so here it is. Don’t hate on the videography, it’s a no-budget show around here.

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