Ejection Trauma: What First Responders Need to Know About High-Impact MVCs

Ejection Trauma: What First Responders Need to Know About High-Impact MVCs

Ejection trauma is one of the most catastrophic outcomes of a motor vehicle collision. For first responders, understanding how to assess, stabilize, and prioritize care for these high-impact patients is critical. Here’s how to stay calm, organized, and effective in the moments that matter most.

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Traumatic Cardiac Arrest: What Every Professional Responder Should Know

Traumatic Cardiac Arrest: What Every Professional Responder Should Know

Traumatic cardiac arrest is one of the most demanding situations a responder can face. This in-depth guide explains how to rapidly identify reversible causes, manage airway and bleeding, and provide effective field care to improve survival chances in severe trauma cases.

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Treating Gunshot Wounds: A Professional Responder’s Guide

Treating Gunshot Wounds: A Professional Responder’s Guide

Gunshot wounds are life-threatening emergencies that require quick, precise action. This guide for professional responders covers wound assessment, bleeding control, chest seal application for thoracic injuries, and key steps for safe transport to trauma centers.

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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.

Suspected Pelvic Fractures: A Guide for Advanced First Aiders

Suspected Pelvic Fractures: A Guide for Advanced First Aiders

Pelvic fractures are serious injuries that can lead to life-threatening internal bleeding. This guide for advanced first aiders covers common causes such as vehicle collisions and falls from height, how to recognize signs and symptoms in the field, and step-by-step instructions for proper pelvic immobilization, including correct binder placement over the iliac crests. Learn how to provide effective prehospital care while minimizing complications and preparing for rapid transport.

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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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Hypoxia 101: Symptoms, Causes, and First Aid Tips

Hypoxia 101: Symptoms, Causes, and First Aid Tips

Hypoxia can lead to irreversible brain damage within minutes. Rapid recognition, airway management, aggressive oxygenation, and swift treatment of the underlying cause—especially opioid-related respiratory depression—are essential to preserving neurological function and improving outcomes.

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Croup vs. Epiglottitis in Children: What First Responders and Parents Need to Know

Croup vs. Epiglottitis in Children: What First Responders and Parents Need to Know

Breathing problems in children can be terrifying, and knowing the difference between croup and epiglottitis could save a life. Parents need to know the warning signs, while first responders must act quickly and carefully. Here’s how to tell them apart and what steps to take in an emergency.

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Distracting Injuries: Pulling Focus and Masking Pain

Distracting Injuries: Pulling Focus and Masking Pain

In trauma care, some injuries grab all the attention—but they aren’t always the deadliest. Distracting injuries can mislead responders and mask life-threatening conditions. Here’s what every first responder needs to know about spotting them, staying systematic, and keeping patient safety the top priority.

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Becoming a Paramedic in Canada: How EMR Training Fits Into the Bigger Picture

Becoming a Paramedic in Canada: How EMR Training Fits Into the Bigger Picture

Thinking about becoming a paramedic in Canada? It starts with understanding the paramedicine pathway. This blog explains where EMR training fits into the journey and why it’s a key first step toward a rewarding career in emergency services.

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ETCO₂: What It Is and Why It Matters for First Responders

When you first hear the term ETCO₂, it might sound like complicated medical jargon. But in reality, it’s a simple concept that every professional responder should understand — and once you do, it can completely change the way you see your patients.

Let’s break it down step by step.

What Does ETCO₂ Mean?

ETCO₂ stands for End-Tidal Carbon Dioxide.

  • End-Tidal = the very end of an exhaled breath.

  • Carbon Dioxide (CO₂) = the waste gas your body produces when it uses oxygen for energy.

So, ETCO₂ is literally the measurement of how much CO₂ is in the air a patient breathes out at the very end of their breath.

This number tells us an incredible amount about what’s going on inside the body — with both the lungs and the heart.

How Do We Measure ETCO₂?

ETCO₂ is measured using a device called capnography.

  • In simple terms, it’s a little sensor attached to a mask, nasal cannula, or an airway device.

  • It continuously analyzes the breath coming out and gives two things:

    1. A number (usually measured in mmHg, with normal being about 35–45 mmHg).

    2. A waveform (a little graph showing how the CO₂ rises and falls with each breath).

Why Is ETCO₂ Important?

Here’s the key: ETCO₂ reflects how well a patient is ventilating (moving air), but it also gives clues about circulationand metabolism. That’s why responders call it the “vital sign of ventilation.”

Think of it as a window into three systems at once:

  1. Airway & Breathing

    • Low or absent ETCO₂ can mean the patient isn’t breathing well, has an obstructed airway, or isn’t ventilated properly with a bag-valve mask.

  2. Circulation (Blood Flow)

    • In cardiac arrest, ETCO₂ is a powerful indicator of CPR quality. Good chest compressions circulate blood, and ETCO₂ rises.

    • A sudden spike in ETCO₂ can even mean return of spontaneous circulation (ROSC) — the patient’s heart has started beating again.

  3. Metabolism

    • Conditions like sepsis, diabetic emergencies, or shock can alter CO₂ levels. ETCO₂ helps responders piece together the bigger clinical picture.

Real-World Examples for Responders

  • Cardiac Arrest: ETCO₂ below 10 mmHg during CPR often means compressions aren’t effective. When it jumps above 35 suddenly, it may mean you’ve got ROSC.

  • Airway Management: If you intubate a patient and see a nice ETCO₂ waveform, you know the tube is in the trachea (not the stomach).

  • Respiratory Emergencies: In asthma or COPD, ETCO₂ waveforms can show “shark fin” patterns, helping you confirm and monitor the severity.

  • Sedation & Monitoring: If a patient is given pain medication, ETCO₂ helps detect if their breathing slows down before oxygen levels drop.

Why Should EMRs and Fire Applicants Care?

As an Emergency Medical Responder (EMR) or a firefighter applicant, understanding ETCO₂ gives you an edge. It shows you’re not just memorizing steps, but actually thinking about what’s happening inside the body.

  • It ties together your knowledge of the respiratory system and cardiovascular system.

  • It reinforces the importance of ventilation, circulation, and metabolic function.

  • And most importantly, it helps you make better decisions in high-pressure situations.

The Bottom Line

ETCO₂ might sound technical, but at its core it’s simple: it’s how we measure how well a patient is breathing and circulating. For responders, it’s one of the most valuable tools you can use to guide patient care, especially in emergencies where seconds matter.

At Delta Emergency Support Training, we break down concepts like ETCO₂ in plain language and then show you how to apply them in real-world scenarios. Our courses are taught by active paramedics and firefighters, so you’ll learn not just the “what,” but the “why” and “how” behind every skill.

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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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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Your Mental Checklist for Altered Level of Consciousness Calls

Your Mental Checklist for Altered Level of Consciousness Calls

Altered level of consciousness (LOC) can signal everything from trauma to stroke, overdose, or diabetic emergencies. For EMRs and Advanced First Aiders, quick assessment using tools like AVPU and GCS is essential. Learn how to approach LOC calls with confidence and clinical clarity.

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From Oilfield to Firehall: Why Tradespeople Are Switching to Emergency Services

From Oilfield to Firehall: Why Tradespeople Are Switching to Emergency Services

Many tradespeople in Alberta’s oil and gas sector are transitioning to emergency services careers. At Delta Emergency Support Training in Calgary, our Advanced First Aid course provides the essential skills and certification needed to make that move with confidence.

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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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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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