Evans County EMS

12/26/2025

💉 Angles & Routes of Injections (ID → SC → IM → IV)|| Angeles & Routes of Injections 💉💉

🧴 Intradermal (ID)

➡️ Layer: Epidermis → Dermis (very superficial)
➡️ Angle: 📐 10–15°
➡️ Purpose: TB (Mantoux) test → Allergy testing
➡️ Volume: 💧 0.1 mL (standard)

➡️ Needle: 25–27 gauge → short → fine bevel
➡️ Technique:
→ Bevel up
→ Insert just under skin surface
→ ✔️ Small wheal/bleb should appear

➡️ Common sites:
→ Inner forearm
→ Upper back (scapular area)

➡️ Absorption: 🐢 Slow (minimal vascularity)

💛 Subcutaneous (SC)

➡️ Layer: Dermis → Subcutaneous fat
➡️ Angle: 📐 45° (thin patient) → 90° (adequate adipose tissue)
➡️ Purpose: Insulin → Heparin → Some vaccines/biologics

➡️ Volume:
→ 0.5–1 mL typical
→ ⚠️ Up to 2 mL in adults (site & policy dependent)

➡️ Needle: 25–30 gauge → short
➡️ Technique:
→ Skin may be pinched
→ Do not aspirate (insulin, heparin)

➡️ Common sites:
→ Abdomen (preferred for insulin)
→ Outer upper arm
→ Anterior thigh
→ Upper buttocks

➡️ Absorption: ⏳ Moderate
→ Slower than IM → Faster than ID

💪 Intramuscular (IM)

➡️ Layer: Subcutaneous tissue → Muscle
➡️ Angle: 📐 90°
➡️ Purpose: Vaccines → Antibiotics → Analgesics → Hormones

➡️ Volume (site-dependent):
→ Deltoid: ≤ 1 mL (occasionally up to 2 mL)
→ Ventrogluteal: 3–5 mL (preferred for large volumes)
→ Vastus lateralis:
→ Adults: 2–3 mL
→ Infants/children: ✔️ preferred site

➡️ Needle: 20–25 gauge → longer length
➡️ Technique:
→ Skin stretched taut
→ Insert quickly at 90°

➡️ Absorption: ⚡ Fast
→ Depends on muscle perfusion & activity

🔴 Intravenous (IV)

➡️ Layer: Directly into a vein
➡️ Angle: 📐 15–30° (≈ 25° as shown)
➡️ Purpose:
→ Rapid drug administration
→ Fluids → Blood products → Emergency meds

➡️ Volume:
→ Varies widely (bolus to continuous infusion)

➡️ Needle/Catheter:
→ IV cannula (18–24 gauge, site dependent)

➡️ Technique:
→ Bevel up
→ Advance until blood flashback
→ Lower angle → advance catheter → remove needle

➡️ Absorption: 🚀 Immediate (100% bioavailability)..See more...💉💉💉🩺🧑🏻‍⚕️

12/26/2025

A 58-year-old man presents to the emergency department with acute chest pain and shortness of breath. The following ECG is obtained ...
https://ecgweekly.com/weekly-workout/interesting-cases-from-ummc-part-ii-2/?utm_campaign=meetedgar&utm_medium=social&utm_source=meetedgar.com

12/26/2025

Get your blood pressure checked at least once a year and understand what the numbers mean. Severe high blood pressure combined with symptoms such as chest pain or trouble speaking may be a hypertensive emergency, and you should call 911 immediately.

12/25/2025

🎄🎅 Merry Christmas to the Bulloch Central 911 dispatch team! Y'all are the real MVPs, keeping everyone safe on Christmas Day 😊. And everyday of the year.

12/25/2025

"Wishing the heroes of Evans EMS a joyous Christmas! 🌟 With heartfelt thanks for all the hard work, both seen and unseen, that you do to keep our community safe. May this holiday season bring you joy, relaxation, and time with loved ones. Merry Christmas! 🎄"

12/20/2025

12/20/2025

“Heart failure doesn’t whisper—it floods, it swells, it suffocates. Right-sided HF swells the body… left-sided HF drowns the lungs. Know the signs. Save a life.”“Heart failure doesn’t whisper—it floods, it swells, it suffocates. Right-sided HF swells the body… left-sided HF drowns the lungs. Know the signs. Save a life.”

This visual turns heart failure into a story of two battles being fought inside one body—a powerful reminder that the heart, though small, carries the weight of an entire life with every beat.

On the left side of the graphic, we see Right-Sided Heart Failure, represented by the memory trick “Right = Rest of the Body.”
And truly, when the right heart fails, the aftermath spills into every corner outside the lungs—
the legs swell, the hands puff up, the abdomen stretches with ascites, and the jugular veins rise like warning signals.
The patient gains weight not from food, but from water they never asked for.
They feel heavy, tired, sluggish—
as if gravity suddenly doubled just for them.

The mnemonic SWELLING perfectly captures the tragedy:
fluid shifting, organs congesting, tissues drowning silently under pressure.
Right-sided HF is the story of a heart too exhausted to carry blood forward… so it flows backward, pooling where it shouldn’t, leaving the body swollen and weary.

On the right side of the graphic, the tone changes dramatically—
Left-Sided Heart Failure, where “Left → Lungs.”
If right-sided HF is swelling, left-sided HF is drowning.

The mnemonic DROWNING captures the terror beautifully.
Fluid fills the lungs like an uninvited storm.
Breathing becomes a desperate act—
dyspnea, crackles, orthopnea, gasping at night in sudden panic as fluid surges upward.

The cough becomes frothy, pink, blood-tinged—
a chilling sign that the lungs are no longer just congested…
they’re flooded.

Patients aren’t just tired—they’re air-hungry.
Each breath feels stolen.
The heart, unable to push blood forward, lets it swell backward into the lungs—
and the lungs pay the price.

This visual perfectly splits the battlefield:
Right-sided = the swollen body.
Left-sided = the drowning lungs.

Two halves of one failing pump…
two stories, one heartbreaking fight.

📌Disclaimer: Image Credit to the Rightful Owner.

12/20/2025

Lol we love yall Central

12/18/2025

Lung sounds are audible vibrations heard with a stethoscope during auscultation that provide important clues about airway patency, lung tissue condition, and the presence of fluid, inflammation, or obstruction. ✔️ https://bit.ly/4aQPXZ2

12/18/2025

Some cardiovascular causes of chest pain

❤️ Cardiac Tamponade

Mnemonic: “BECK + PRESSURE”

🔧 Mechanism
• Rapid pericardial fluid accumulation → ↓ ventricular filling → ↓ cardiac output

🧠 Key clues
• Beck triad: Hypotension, JVD, muffled heart sounds
• Pulsus paradoxus
• ECG: Electrical alternans
• Echo: Diastolic chamber collapse

🩸 Aortic Dissection

Mnemonic: “TEARING → BACK”

🔧 Mechanism
• Intimal tear → blood enters media → false lumen

🧠 Key clues
• Sudden tearing chest/back pain
• BP difference between arms
• New diastolic murmur (AR)
• CT: Intimal flap
• D-dimer ↑

💔 NSTEMI / Unstable Angina

Mnemonic: “PARTIAL BLOCK”

🔧 Mechanism
• Partial coronary artery occlusion → subendocardial ischemia

🧠 Key clues
• Pressure/squeezing chest pain
• Nausea, diaphoresis
• ECG: ST depression / T inversion
• Troponin: ↑ (NSTEMI), normal (UA)

❤️‍🔥 STEMI

Mnemonic: “TOTAL BLOCK”

🔧 Mechanism
• Complete coronary artery occlusion → transmural infarction

🧠 Key clues
• Severe persistent chest pain
• ECG: ST elevation, Q waves
• Troponin ↑↑
• Wall motion abnormality on echo

⚡ Needs immediate reperfusion

🫀 Thoracic Aortic Aneurysm

Mnemonic: “BIG AORTA PRESSES”

🔧 Mechanism
• Progressive aortic wall weakening → dilation ± rupture

🧠 Key clues
• Chest/back pressure
• Dysphagia, hoarseness (compression)
• CXR: Widened mediastinum
• CT: Dilated aorta

💓 Pericarditis

Mnemonic: “PLEURITIC + LEAN FORWARD”

🔧 Mechanism
• Inflammation of pericardium (viral, autoimmune, post-MI)

🧠 Key clues
• Sharp pleuritic chest pain
• Worse lying flat, better leaning forward
• ECG: Diffuse ST elevation + PR depression
• Pericardial friction rub

12/15/2025

A 35-year-old woman arrives at the emergency department after a witnessed seizure and brief cardiac arrest with ROSC. Her arrival ECG shows a very wide complex rhythm that the machine labels as ventricular tachycardia......https://ecgweekly.com/weekly-workout/the-post-arrest-wide-complex-rhythm-that-was-not-vt/?utm_campaign=meetedgar&utm_medium=social&utm_source=meetedgar.com