Florida Emergency Physician and EMS leader dies suddenly at 56

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Fire-medic

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This guy is going to be missed, because of his dedication to helping prehospital EMS be the best it can be. A game-changer kinda guy. From EMS services provision to EMS education, Dr. 'Sal' Silvestri made a huge difference.

A few years ago, a program he was doing showed after a research of the State of Florida EMS reports, that less than 50% of the paramedics using advanced airways on critical patients made use of capnography, which allows a healthcare provider to confirm the advanced airway is where it's supposed to be. If the airway isn't in the trachea (the patient's windpipe) then the paramedic is causing a very serious error, which essentially is not giving the patient's lungs oxygen. You can imagine the outcome to the patient of such an error.

Now the paramedics have to use capnography, which is a very simple device to measure the CO2 levels to patient exhales, and which provides proof of the correct advanced airway in the patient. The monitoring system is already built-into the portable EKG machine the paramedics carry, all they have to do is connect a sampling tube to the patient, and they immediately know if the advanced airway is where it's supposed to be. Simply-put, this saves lives, and it helps the paramedics to not make errors in advanced airway placement, with very minimal cost or additional equipment.

This is just one of the things Dr. Silvestri did for the world-wide EMS community. As the article says, he instituted best practices using results-based research to make healthcare practitioners more-successful in the treatment of their patients. Where I teach EMT and paramedic students, part of the State of Florida college system, we use Dr. Silvestri's research as a basis for student instruction daily.

Godspeed, Dr. Silvestri.

The State of Florida was just recognized by US News & World Report for the excellence of its system of college and university education, rated #1 in the nation. https://www.yahoo.com/news/m/28d68cea-9fb8-335e-939a-9bcfd6cf301b/ss_florida-is-no.-1-in-nation.html

Because of dedicated people like Dr. Silvestri, our higher education system excells. I am proud to be a part of it.

http://touch.orlandosentinel.com/#section/-1/article/p2p-92703254/?related=true

Dr. Salvatore Silvestri, a central figure in Orange County’s emergency medicine and public safety who made all emergency medical service practices based on evidence-based protocols and implemented programs that have become national standards, and a man who mentored hundreds of residents and emergency physicians, died unexpectedly on Sunday. He was 56.
 
Ah.. that is a shame.. he died so young.

As for your comment about Capnography, we've recently been required to use it on most elderly/altered/general medical/recent surgeries patients and anytime you feel its necessary due to the high rates of sepsis being missed.

We've only adapted this policy since the beginning of the year.

They were finding that since ALS/BLS providers were missing septic patients, and claiming the patient had flu-like symptoms causing them to be triaged to the waiting room, or lower priority. In the end it killed enough people that we've started sepsis alerts this year.
 

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