When assessing a patient in shock or with altered mental status, do not just look at the Systolic Blood Pressure (SBP). The Mean Arterial Pressure (MAP) is often a more accurate reflection of organ perfusion, particularly for the brain, kidneys, and heart. Pulse pressure (PP) is a vital sign that often tells a more compelling story about your patient’s hemodynamic status than the systolic blood pressure alone. In the prehospital environment, it serves as a "window" into stroke volume and systemic vascular resistance.

Hypothermia is a dangerous drop in core body temperature below 35°C, affecting the whole body, including the brain and organs, and can be fatal if untreated. Symptoms progress from shivering and confusion to loss of coordination, unconsciousness, and death, often caused by prolonged exposure to cold, wet, or windy conditions. 

Frostbite is the freezing of skin and underlying tissues, usually in extremities like fingers, toes, nose, or ears. It causes localized numbness, pale or gray skin, and a hard or waxy feel, with severe cases leading to blisters or tissue death. While frostbite can cause permanent damage or amputation, it does not kill by itself.

As we move into colder weather and more indoor-based activities there is typically a rise in respiratory illnesses. While these illnesses often appear mild or routine, they can lead to serious complications in vulnerable populations such as children, older adults, and those with chronic respiratory disease.

Diabetic emergencies are among the most common and potentially reversible causes of altered mental status encountered prehospitally. Rapid recognition is essential to preventing serious complications. Within the ALS-PCS and BLS-PCS, paramedics are empowered and expected to assess, manage and transport patients experiencing hypoglycemia or hyperglycemia safely and effectively.

Whether caring for a known diabetic or an undiagnosed patient with non-specific symptoms, a strong understanding of the pathophysiology, clinical presentation and treatment options can be the difference between deterioration and recovery.