Mike Bowen

Mike Bowen has worked at Fisdap since December 2009 as an item developer extraordinaire and test bank manager.  Mike received his paramedic certification from Inver Hills Community College, where he now occasionally steps in as a substitute instructor.  He works part-time for Lake City Ambulance Service and volunteers for the American Red Cross-Twin Cities chapter. Mike readily admits that the free Minnesota Wild hockey games are the best part of volunteering. Mike also enjoys an active lifestyle and traveling.

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Posts by Mike Bowen

Paramedic Readiness Exam 4 Now AvailableBy Mike Bowen

November 12, 2014

Comprehensive Exam shieldWe are very excited to announce the release of a brand new comprehensive exam for paramedic students: the Paramedic Readiness Exam 4 (PRE4).

The PRE4 is a multiple choice summative exam which is designed to prepare students for the challenges of a state or national certification examination.

Exam Development & Pilot

As is the case for all of our tests, we owe a debt of gratitude to so many EMS educators who participated in various phases of the exam development process: item writing, item selection, revision, and test item analysis.

Update from ECCU 2014: Road to the 2015 Resuscitation GuidelinesBy Mike Bowen

June 24, 2014

AHA Update 2015In early June I was fortunate enough to attend the ECCU 2014: Road to the 2015 Resuscitation Guidelines. The conference was exceedingly informational and presented by the people behind the research, mostly physicians. The intention of the conference was to present the new and emerging science that is the driving force behind the expected changes in 2015 resuscitation guidelines.  Although this was not an official release from the American Heart Association (AHA), it was a good insight into the ongoing research and outlines the of projected changes.

Throughout the three days several topics were reiterated. High-quality chest compressions are still essential. The researchers stated that they’ve found a “sweet spot” for chest compression rates: 100-120 per minute at depth of two inches or 50 mm. Anything slower and the myocardium (heart muscle) is not being perfused well; anything faster, and chest compressions become less effective. If chest compressions are performed too fast the provider may be in poor form and make errors such as leaning off the breast bone, inhibiting chest recoil, or shallow compression depth.

The researchers did not endorse any specific automated chest compression device but did reflect on how beneficial these products may be if applied with minimal interruption to CPR and at the appropriate time. The benefits of an automated device are consistent high-quality chest compressions and slightly negative upstroke with each compression that increases preload and decreases the duration of interruptions. They also discussed the importance of intrathoracic pressure and the increase of survival rates with the application of an impedance threshold device (ITD). This was a reversal of their initial recommendations because they did not originally look at compression depth.

"Improving Overtriage of Aeromedical Transport in Trauma"

March 14, 2014

A study published in Journal of Acute Care Surgery examined the implementation of a Trauma Advisory Committee (TAC) to perform outreach and education of emergency medical agencies in the use of Aeromedical Transportation (AMT). This study discovered that after implementation of a process improvement initiative (PI), there was a marked decrease (14%) in the percentage of AMT overtriage in counties with implementation of the PI when compared to counties without the PI.

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Paramedic Ability to Recognize STEMI on Prehospital ECGs

February 25, 2014

In this study, paramedics were given a survey of ECG print outs and asked to identify an ST segment elevation myocardial infarction (STEMI) out of 10 rhythm strips. Paramedics were able to correctly identify the inferior STEMI 96% of the time. They identified the lateral STEMI (51%) and the anterior STEMI (78%) at demonstrably lower frequencies. In this podcast, the speakers recognize the potential shortcomings of the study design: the ECG print outs utilized were markedly difficult to interpret, were borderline in terms of STEMI mimics, and were prone to under-evaluation due to lack of patient context. The conclusion drawn from this study states that “given the paramedics' low sensitivity and specificity, we cannot rely solely on their ECG interpretation to activate the cardiac catheterization laboratory,” but the speakers criticize this assertion given the study design and potential motivation.

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"Pediatric Anaphylaxis Management in the Prehospital Setting"

January 9, 2014

A recent retrospective study analyzing the management of pediatric anaphylaxis was performed by comparing discharge diagnoses with prehospital patient care reports. The study concluded that in the 218 cases of anaphylaxis analyzed, only 36% of patients received an intramuscular injection of epinephrine. Much of this discrepancy was likely due to the fact that these patients received epinephrine before EMS arrival. The protocols for the EMS agency responding to these calls were also such that epinephrine was the last line in interventions for the treatment of anaphylaxis. This study does, however, demonstrate the greater need for the differentiation of anaphylaxis from other respiratory ailments by EMS providers.

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Prehospital Point-of-Care Testing for Troponin: Are the Results Reliable?

January 2, 2014

A study conducted by J. Venturini, C. Stake, and M. Cichon demonstrated the viability of using prehospital troponin levels as a diagnostic tool for patient care and transport destination.  An i-STAT machine was used to assess patient troponin levels enroute and again at the ED to determine the correlation between the two results.  The study showed high correlation between the two sample tests, indicating the potential for this device to be used in the field.

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Psychometric Testing of the Jefferson Scale of Empathy with Paramedic Students

December 19, 2013

This study was performed to analyze the Jefferson Scale of Empathy Health Profession and its measurement of empathy in health care providers. A modified Jefferson Scale was given to paramedic students in a large Australian university to determine their level of empathy. The study showed a positive correlation between the students’ scores in “compassionate care” and “perspective taking,” confirming that the Jefferson Scale is a valid and reliable measure for empathy in paramedic students.

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Neurologically Favorable Survival After In-Hospital Cardiac Arrest

December 13, 2013

A recent article in the Journal of the American Medical Association entitled "Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest: a randomized clinical trial" describes a double blind, randomized study performed in Greece regarding cardiac arrest survival to hospital discharge. 

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Differences in Long Term Mortality after Acute Poisoning

November 27, 2013

This podcast features the discussion of a study conducted by Dr. Catherine Lund of Oslo, Norway. The study illustrated the differences in long term mortality of acute poisoning patients based on the care they were given in a prehospital, clinical or hospital setting.

Speakers: David Page, MS, NREMT-PAlexander Trembley, NREMT-PKeith Wesley, MD, FACEP, Chris Schultz, MHA, EMT-CP

Original article: "Five-year mortality after acute poisoning treated in ambulances, an Emergency outpatient clinic, and hospitals in Oslo," by Cathrine Lund, Mari A. Bjornaas, Leiv Sandvik, Oivind Ekeberg, Dag Jacobsen, and Knut E. Hovda.

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Resuscitation Fluids

November 20, 2013

A review article entitled "Resuscitation Fluids," written by John A. Myburgh, M.B., B.Ch., Ph.D. and Michael G. Mythen, M.D., M.B., B.S., was published this year in the New England Journal of Medicine. The article analyzed the use of fluid resuscitation in both the prehospital and hospital settings, examining both the physiological principles and clinical practices involved in selecting from the many types of fluid resuscitation available.  Normal saline was ultimately determined to have the broadest application in the prehospital and hospital settings, while other methodologies proved to have certain setbacks.  The article offers a good review of the intricacies of human pathophysiology and fluid resuscitation.  It reiterates the evidence that defining and correcting the etiology of the patient's hypovolemia is a more definitive treatment than fluid resuscitation.

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