In this episode, Tyler sits down with Hanna Thompson to discuss a critical yet often overlooked topic in EMS—eating disorders. Drawing from personal experience and clinical insight, they explore how these conditions present both medically and behaviorally, especially in prehospital and interfacility transport settings.
They break down the subtle physical signs that EMS providers can look for—such as Russell's sign, lanugo, unexplained bradycardia, and electrolyte disturbances—and emphasize the importance of sensitive history taking. The conversation also dives into the dangers of refeeding syndrome, slow correction strategies, fluid choice, and the clinical significance of thiamine, magnesium, and phosphate replacement.
What You'll Learn:
How eating disorders can manifest in EMS calls
Why you may be treating the consequences, not the disorder itself
Red flags like bradycardia, lanugo, and Russell's sign
How to handle refeeding syndrome safely
Why dextrose, fluids, and electrolyte replacement should be approached cautiously
The connection between electrolyte shifts and seizures or arrhythmias
Key Takeaway:
Patients with eating disorders are medically and psychologically fragile. In EMS, we often encounter them through the effects of the disorder—not the diagnosis itself. Recognizing subtle clues and avoiding aggressive interventions could save a life.
Resources Mentioned:
Hannah's blog on EMS considerations in eating disorders
Data on post-COVID spikes in eating disorder incidence
Guidelines for electrolyte correction and refeeding syndrome
Disclaimer:
This podcast is for educational purposes only and not a substitute for clinical protocols or medical direction. Always consult your agency's guidelines and medical control.
