Clinical Updates: February 2025

James and Ben cover the latest clinical news from across Ambulance Victoria, including:Intranasal Fentanyl Update – Using IV preparation for intranasal use.Other guidelines updates: Extrication monitoring, shoulder reduction, wilderness pain relief.Blood Administration – New pre-hospital blood transfusion training coming.Rocuronium Storage – Heat-related potency issues; rotate every 30 days.Communication Book – New tool for patients with communication disabilities.MICA targeted Dispatch – 8-week trial, enter any patient safety concerns in Riskman or ROAM appPaper of the Month – ALS paramedics safely managing post-thrombolysis STEMI.Equipment Update – Check serial numbers when reporting medical device issues.Professional Development – Advanced mechanical ventilation workshop available.Chapters00:00 Introduction and Overview of ClinicalUpdates01:21 Rapid summary02:50 Updates on Intranasal Fentanyl 5:40 Other CPG updates: Extrication monitoring, shoulder reduction, wilderness pain relief. 07:50 Blood Product Administration andSafety10:00 Rocuronium storage and efficacy concerns11:18  Emergency Healthcare Communication Book12:11 Medical Advisor on Call and PatientSafety12:50 MICA targeted Dispatch and PatientSafety Reporting14:12 Extrication related adverse events15:30 Case reports16:01 Paper of the Month: STEMI CareInsights17:30 Equipment updates18:31 External Professional DevelopmentOpportunities19:25 Small Steps to Transform YourPractice Further resourcesAdverse events and paramedic interventionsduring extended ground transport in a rural pharmaco-invasive STEMI program https://onlinelibrary.wiley.com/doi/full/10.1111/1742-6723.70005?saml_referrer=Ventilator workshop: https://www.alfredicu.org.au/files/general/Documents/2025_EVENT_FLYER_CURRENT.pdfMedication stability in hot environments: https://www.sciencedirect.com/science/article/pii/S2211419X23000630 Get in touchX / TwitterJames: ⁠⁠⁠@JamesOz1⁠⁠Ben: ⁠@ben_meadley⁠LinkedinJamesBenBluesky SocialJames: ⁠⁠@jamesoz1.bsky.social

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