Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Explore anaphylaxis care from the basics to the critical approach to managing severe anaphylaxis with Bruce Hoffman, FlightBridge ED senior educator. Find out what it means to be aggressive with anaphylaxis care explained through the AMAX4 framework. Learn how the framework can help reverse anaphylactic shock and prevent catastrophic outcomes. Hear the impactful story behind the framework and gain insight into the most effective practices for treating unresponsive anaphylactic and asthmatic patients. Special thanks to the McKenzie family for their mission-driven educational work. Resource links Episode Blog Post / Show Notes AMAX4 website Anaphylaxis deep dive Updated Anaphylaxis Definition EMScast15 - code for 15% off an awesome pair of sunglasses Help us learn how to make this show better for you Medic Box - awesome medical gear shipped directly to your door Guest/Cast/Crew information- Guest- Bruce Hoffman- Goodwin University Program Director and Assistant Professor, FlightBridgeED senior educator, Bay State Health Critical Care RN and Paramedic Host- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

The Power of Embracing Mistakes- Special guest Geoff Murphy, founder of Master Your Medics, shares how acknowledging and learning from mistakes can save lives in the field of prehospital medicine. Recorded at the Fast 24 conference, this episode emphasizes the importance of cultivating a culture of safety, vulnerability, and continuous learning within EMS teams. Discover actionable strategies to foster a psychologically safe environment where mistakes are openly discussed and used as invaluable learning tools to enhance professional development and patient care. This insightful discussion is a must-watch for anyone looking to elevate their skills and create a high-performing EMS team. EMScast15 - code for 15% off an awesome pair of sunglasses Enter to Win a FREE Pair of Frontline Optics Sunglasses Medic Box - awesome medical gear shipped directly to your door Guest/Cast/Crew information- Guest- Geoff Murphy, founder of Master Your Medics Host- Ross Orpet, Will Berry Resources Ep. 31 You Were Taught Wrong, Traumas Not Algorithmic MasterYourMedics.com Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com 00:00 Introduction: The Power of Discussing Mistakes 00:38 Welcome to EMS Cast 00:52 Today's Topic: How Mistakes Can Save Lives 01:16 Embracing Failure: Insights from Jeff Murphy 01:37 Creating a Culture of Safety and Vulnerability 06:29 The Fearless Organization: High vs. Low Performing Teams 11:49 Personal Stories: Learning from Mistakes 19:15 Master Your Medics: The Journey and Vision 23:43 Conclusion: The Path to Mastery Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Think you only need to worry about toxicities that exist in the sea if you live by an ocean? Think again. No matter where you are fish may be on the menu, or there may be a zoo nearby, or a marine enthusiast with an elaborate home aquarium. These toxicities can be seen in Colorado. They can be in Australia or in the US. No matter where you are you have the potential to see one or many of these. From scombroid poisoning to puffer fish, irukandji syndrome, jellyfish, and sea snakes- tune in to this week's episode to learn all about the various poisons that come from the sea with toxicologist Nik Matsler. Website show notes link EMScast15 - code for 15% off an awesome pair of sunglasses Enter to Win a FREE Pair of Frontline Optics Sunglasses Medic Box - awesome medical gear shipped directly to your door Guest/Cast/Crew information- Guest- Dr. Nik Matsler Host- Dr. Ross Orpet and Critical Care Paramedic Will Berry Resources Other episodes you might like Episode 26: Snake Bites Episode 25: Cocaine Overdose Third-party websites where you can learn more Marine Envenomations Journal Article 5 Step Approach to Marine Envenomations Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Whitney Barrett, the Medical Director of the Highlonsome 100 mile ultra endurance race, discusses the critical considerations for EMS providers when encountering sick runners during endurance events. Insights on managing ultra-endurance athletes, focusing on conditions such as hyponatremia, dehydration, electrolyte imbalances, and the unique challenges presented by high-altitude races. Learn about effective rehydration and cooling strategies, and the critical role of context in diagnosing and treating affected runners. EMScast15 for 15% Off Frontline Optics Sunglasses Enter to Win a FREE Pair of Frontline Optics Sunglasses Blog Post and Critical Runner Algorithm- The Critical Care of the Sick Runner 00:00 Introduction and Hosts 00:39 Conference Recap 01:03 Guest Introduction: Dr. Whitney Barrett 01:29 Understanding the Sick Runner 02:29 Medical Considerations for Ultra Marathons 08:15 Common Issues in Ultra Runners 12:45 Responding to Sick Runners 19:42 Fluid Management and Hyponatremia 35:10 Handling Hyperthermia and Hypothermia 44:05 Dealing with Collapsed Runners 53:36 Final Thoughts and Takeaways Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

EMCRIT's Scott Weingart discusses the concept of being a true resuscitationist. The mindset necessary for providing aggressive, excellent care outside hospital boundaries and the emphasis on the importance of preparation, critical thinking, and meticulous attention to detail in emergency medical situations. Dr. Weingart shares insights on mental simulation, embracing challenges, handling crises efficiently, and continuous self-improvement. We conclude our discussion by exploring the philosophy 'Amor Fati' and underscore the broader impact EMS professionals can have beyond simply saving lives. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- How to Master the Resuscitation Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Will and I recently attended FAST24, an educational conference hosted by FlightBridgeED in Wilmington, North Carolina. We had a fantastic time meeting industry top speakers, including Eric Bauer, one of the original founders of FlightBridgeED. In today's episode, we delve into Eric's journey in EMS education, how FlightBridgeED was conceived, and the importance of continuous learning. We also discuss the challenges of becoming an expert in the field and tips on improving your skills incrementally. Join us as we explore these valuable insights and look forward to upcoming episodes featuring more stellar guests from FAST24! Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- Building Better Providers Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In this episode, we delve into the fascinating and often perilous world of mushrooms. Join us as we explore with Dr. Nik Matsler how these fungi can be a culinary delight, a source of psychedelic experiences, or a deadly hazard. We discuss the challenges of identifying mushrooms, even for experts, and why toxicologists rely on mycologists for accurate identification. We'll break down the different types of mushrooms—non-toxic edible varieties, toxic species, and psilocybin-containing "magic mushrooms." Learn the practical tips for EMS professionals on managing mushroom poisoning, including supportive care strategies and specific interventions for severe cases. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Episode Blog Post- https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Derek Miller, outreach coordinator for the UNC JC Burn Center, joins us again to explore electrical injuries and lightning strikes. We discuss the various types of electrical injuries, the mechanisms behind these injuries, and the essential steps EMS providers must take to ensure their safety and provide effective patient care. Through real-life case studies and expert insights, this episode delves into the complexities of managing electrical burn patients, the importance of immediate interventions, and the potential long-term sequelae of such injuries. Tune in for practical advice and essential knowledge to enhance your skills in handling electrical emergencies. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- Electrical Injuries and Lightning Strikes Here are some additional resources: Electrical Injuries Overview- Nice overview, though not limited to EMS specifically. The references list at end is also a good jumping off spot for those wanting more. Photo examples- Variety of pictures As mentioned at the end, fireworks safety- https://www.safefireworksnc.com/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Explore the nuances of stroke assessments, the challenges EMS professionals face in the field, and the impact of prehospital interventions on patient outcomes. Coco Wham, a former paramedic who's transitioned to a physician, and Dr. Layne Dylla, an associate professor of emergency medicine join us to dive into their ongoing research efforts aimed at defining what matters in prehospital stroke care and refining stroke response protocols. Hear firsthand how evidence-based practices are developed from the ground up in EMS settings. This episode is packed with valuable information to enhance your practice and understanding of stroke care in prehospital environments. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- Stroke Care on the Streets Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

This is Part 2. Derek, an experienced clinician in burn care, joins us to delve into the intricacies and challenges of treating burn patients. This discussion provides valuable insights into the unique aspects of burn injuries, the importance of a comprehensive assessment, and the latest trends in burn treatment. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae Blog post- The Critically Burned Patient Key Topics Covered Complexity of Burn Injuries: Derek begins by explaining why burn patients require a unique approach compared to other trauma patients. He highlights the potential for burns to mask other critical injuries, underscoring the necessity of a thorough and trauma-informed initial assessment. The 'Big Three' Considerations: The conversation shifts to what Derek refers to as the "big three" — polytrauma, airway loss, and inhalation injuries — which are crucial early considerations in burn care. He stresses the importance of recognizing these potentially life-threatening conditions alongside the burn injury itself. Fluid Resuscitation: A significant portion of the discussion is dedicated to fluid resuscitation, a critical aspect of burn care. Derek talks about the Parkland formula for calculating fluid needs based on the total body surface area affected by burns but a better simpler method is- 500 ml/hr for an adult (<13 yo) 250 ml/hr for a young kid (6-13 yo) 125 ml/hr for a child (<5 yo) Pain Management and Ethical Concerns: Derek addresses the ethical and practical aspects of pain management in burn victims. Effective pain control not only improves patient comfort but also aids in overall patient management and long term healing, making it a critical component of the initial response. Assessment Tools and Techniques: Various assessment tools such as the Rule of Nines and the Palmer Method are discussed. Derek explains their applications and limitations, emphasizing that while these tools are helpful for initial assessments, more detailed evaluations are typically conducted at specialized burn centers. A link from ABA that may be helpful: https://ameriburn.org/resources/burnreferral/ Includes brief overview of severity/depth (with diagrams, not pictures), Rule of Nines & Palmar Method, plus a link for ABA referral criteria. Here is another great article for a deeper dive into pros & cons of different methods of estimating TBSA, although not exhaustive, per se. Gretchen C., Burn size estimation: A remarkable history with clinical practice implications,Burns Open, Volume 8, Issue 2, 2024, Pages 47-52, ISSN 2468-9122 Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations, The Journal of Emergency Medicine, Volume 65, Issue 4, 2023, Pages e320-e327. Burn depth estimates: There are free diagrams out there, but for actual real wound pictures, very little is open-license. UpToDate has a decent starting place, with four pictures embedded, and likely accessible for most. https://www.uptodate.com/contents/assessment-and-classification-of-burn-injury?search=burn%20depth&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1 Other Scientific papers mentioned- Burn resuscitation First article is an overview of evolution of burn fluid resuscitation formulas & philosophy – although again, not exhaustive, per se. Bacomo, F. K., & Chung, K. K. (2011). A primer on burn resuscitation. Journal of emergencies, trauma, and shock, 4(1), 109–113. Next article underscores the risks of fluid creep. Starting too high, being reluctant to titrate down, and the fact that giving too much fluid can actually CAUSE an increased need for fluids (vicious cycle). Chung KK, Wolf SE, Cancio LC, Alvarado R, Jones JA, McCorcle J, King BT, Barillo DJ, Renz EM, Blackbourne LH. Resuscitation of severely burned military casualties: fluid begets more fluid. J Trauma. 2009 Aug;67(2):231-7; discussion 237. doi: 10.1097/TA.0b013e3181ac68cf. PMID: 19667873.

Derek, an experienced clinician in burn care, joins us to delve into the intricacies and challenges of treating burn patients. This discussion provides valuable insights into the unique aspects of burn injuries, the importance of a comprehensive assessment, and the latest trends in burn treatment. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae **CORRECTION** In the summary at the end of the episode, the rule of 5's was inappropriately attributed to the pediatric population. Rule of Fives is meant for morbidly obese adults, not for kids. Lund-Browder is great tool for peds of different age ranges, though still doesn’t address body morphology (obese kids). Resource- Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations, The Journal of Emergency Medicine, Volume 65, Issue 4, 2023, Pages e320-e327. Blog post- The Critically Burned Patient Key Topics Covered Complexity of Burn Injuries: Derek begins by explaining why burn patients require a unique approach compared to other trauma patients. He highlights the potential for burns to mask other critical injuries, underscoring the necessity of a thorough and trauma-informed initial assessment. The 'Big Three' Considerations: The conversation shifts to what Derek refers to as the "big three" — polytrauma, airway loss, and inhalation injuries — which are crucial early considerations in burn care. He stresses the importance of recognizing these potentially life-threatening conditions alongside the burn injury itself. Fluid Resuscitation: A significant portion of the discussion is dedicated to fluid resuscitation, a critical aspect of burn care. Derek talks about the Parkland formula for calculating fluid needs based on the total body surface area affected by burns but notes that real-time adjustments are often necessary to avoid complications like over-resuscitation. Pain Management and Ethical Concerns: Derek addresses the ethical and practical aspects of pain management in burn victims. Effective pain control not only improves patient comfort but also aids in overall patient management and long term healing, making it a critical component of the initial response. Assessment Tools and Techniques: Various assessment tools such as the Rule of Nines and the Palmer Method are discussed. Derek explains their applications and limitations, emphasizing that while these tools are helpful for initial assessments, more detailed evaluations are typically conducted at specialized burn centers. A link from ABA that may be helpful: https://ameriburn.org/resources/burnreferral/ Includes brief overview of severity/depth (with diagrams, not pictures), Rule of Nines & Palmar Method, plus a link for ABA referral criteria. Here is another great article for a deeper dive into pros & cons of different methods of estimating TBSA, although not exhaustive, per se. Gretchen C., Burn size estimation: A remarkable history with clinical practice implications,Burns Open, Volume 8, Issue 2, 2024, Pages 47-52, ISSN 2468-9122 Burn depth estimates: Unfortunately, all of my favorite wound pictures for discussing 1st/2nd/3rd degree (superficial; both superficial & deep varieties of partial-thickness; full-thickness) are copyrighted, etc. There are free diagrams out there, but for actual real wound pictures, very little is open-license. UpToDate has a decent starting place, with four pictures embedded, and likely accessible for most. https://www.uptodate.com/contents/assessment-and-classification-of-burn-injury?search=burn%20depth&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1 Part 2: This is just part 1. Part 2 will be coming May 1st. We will simplify our approach to fluid resuscitation and dive into some nuances of burns and burn care. Other Scientific papers mentioned- Burn resuscitation First article is an overview of evolution of burn fluid resuscitation formulas & philosophy – although again, not exhaustive, per se. Bacomo, F. K., & Chung, K. K. (2011). A primer on burn resuscitation. Journal of emergencies, trauma, and shock, 4(1), 109–113. Next article underscores the risks of fluid creep. Starting too high, being reluctant to titrate down, and the fact that giving too much fluid can actually CAUSE an increased need for fluids (vicious cycle). Chung KK, Wolf SE, Cancio LC, Alvarado R, Jones JA, McCorcle J

Which comes first epinephrine or airway? Out of hospital cardiac arrests involve critical and often complex decisions with sequence and timing of various procedure. What should you prioritize? We examine the nuances of advanced interventions, such as epinephrine and advanced airway placement, through the lens of recent studies, including a notable piece of research published recently in JAMA Network Open. Take a deep dive into the practicalities and philosophies that underpin prehospital cardiac arrest management, emphasizing the significance of basic life support skills and the role of advanced techniques in the pre-hospital setting. This episode engages, educates, and challenges EMS providers on the best practices that could potentially save lives during those critical first minutes of a cardiac emergency. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Articles- Sequence of Epinephrine and Advanced Airway Placement After Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2024 Feb 5;7(2):e2356863. doi: 10.1001/jamanetworkopen.2023.56863. Association of timing of epinephrine administration with outcomes in adults with out-of-hospital cardiac arrest. JAMA Netw Open. 2021;4(8):e2120176. doi:10.1001/jamanetworkopen.2021.20176 Epinephrine in Out of Hospital Cardiac Arrest: A Network Meta-analysis and Subgroup Analyses of Shockable and Nonshockable Rhythms. Chest. 2023 Aug;164(2):381-393. DOI: 10.1016/j.chest.2023.01.033 A Randomized Trial of Epinephrine in Out of Hospital Cardiac Arrest. (PARAMEDIC2) New Eng J Med. DOI: 10.1056/NEJMoa1806842 The influence of time to adrenaline administration in the Paramedic 2 randomised controlled trial. Intensive Care Med. 2020;46(3):426-436. doi:10.1007/s00134-019-05836-2 Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Toxicologist Dr. Nik Matsler teaches us the critical topic of toxic alcohol poisoning. The discussion sheds light on the dangers lurking in everyday household and industrial products that contain methanol, ethylene glycol, and isopropyl alcohol—substances not far removed from the alcohol found in beverages yet capable of causing severe, sometimes fatal, health issues. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- Toxic Alcohols Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In the high-stakes environment of prehospital medicine, the ability to perform a successful intubation on the first attempt is critical. The complexity of prehospital airway management cannot be understated, given the challenging conditions and the acuity of patients encountered. This episode delves into the strategies and techniques that can significantly improve the success rates of prehospital intubations, focusing on preparation, positioning, and the SALAD (Suction-Assisted Laryngoscopy and Airway Decontamination) method. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog post- Art of Laryngoscopy- The SALAD technique Additional Podcast Episode- Mac 3 vs 4 podcast episode Additional Resources- Youtube SALAD demonstration Published Article on the SALAD Technique YouTube video of the hypoepiglottic ligament in action Airway Jedi blog post Additional SALAD Resources Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Despite the allure of consistent compressions and reduced provider fatigue, does the data actually show that mechanical CPR devices improve outcomes? Tune in for a nuanced exploration of evidence-based practice in emergency medical services. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog Post- https://emspodcast.com/the-truth-about-mechanical-cpr-devices-what-the-data-really-says/ Original Article- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328162/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Overcoming Fear in Neonatal Resuscitation: A Step-by-Step Guide Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog post: Neonatal Resuscitation Introduction: Welcome to another episode of EMScast, where high-level education meets real-world emergency medical scenarios. Today, we have Dr. Avery MacKenzie, an ER physician from Southwest Colorado, joining us to discuss a topic that often induces stress – neonatal resuscitation. Dr. MacKenzie shares her experiences and insights into handling neonatal emergencies in rural settings. Summary: Dr. MacKenzie opens the episode by acknowledging the inherent fear associated with neonatal resuscitation, especially in rural emergency departments where one might be the sole provider. She emphasizes that despite the fear, the process is not hard, and providers already possess the necessary skills. Key Takeaways: 1. **Facing the Fear:** - Dr. MacKenzie encourages listeners to remember that while neonatal resuscitation may seem intimidating, the skills required are well within their expertise. 2. **Algorithm Overview:** - The neonatal resuscitation algorithm is simplified into manageable steps, beginning with stimulating, warming, and drying the baby for the first 30 seconds. - The next 30 seconds involve providing positive pressure ventilation to initiate breathing. - Monitoring the heart rate is crucial, and if it remains below 100, providers should focus on correcting ventilation strategies. 3. **Initial Assessment:** - Dr. MacKenzie introduces a simple three-question assessment for determining the need for resuscitation: term gestation, good muscle tone, and respiratory effort. 4. **Positive Pressure Ventilation:** - The trigger for initiating positive pressure ventilation is if the heart rate is less than 100 or the baby is apneic or gasping. - The emphasis is on adequate ventilation, and adjustments, such as using the MR. SOPA mnemonic, can be made to improve ventilation. 5. **Advanced Airway Considerations:** - While advanced airways, such as intubation, are possible, Dr. MacKenzie highlights that pre-hospital protocols may favor supraglottic airways due to the challenging nature of neonatal intubation and the need to limit pauses in oxygenation and respiratory support. 6. **Continued Support:** - The algorithm emphasizes a continuous loop of assessment, correction, and reassessment, with the goal of maintaining the baby's heart rate above 100. Conclusion: Dr. MacKenzie wraps up the episode by reassuring providers that familiarity with the neonatal resuscitation algorithm and periodic mental reviews can alleviate the fear associated with these critical situations. The key is to focus on what providers already know and apply those skills with confidence. Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Nik Matsler is back to discuss the treatment of patients with crush injuries and crush syndrome. Dr. Matsler's insight as an emergency physician and a toxicologist are put to work helping us understand the pathophysiology of crush related injuries. We also try to discuss very practical approaches to these situations which are complex. No two crush injuries will present the same. Many variables contribute to the presentation of these patients. Duration of crush, amount of force applied, the size of the body part crushed, all play a role. There is much EMS folklore about treating these patients prophylactically in order to stave off deadly arrhythmia. Does this work? What treatments matter for these patients? Paramedics and EMS are the first line of care for these patients. How can you give them the best chance of survival? This episode topic was submitted by a listener! Thank you, and please keep the ideas coming. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Jim Barrick has more than 37 years of experience in Emergency Medical Services and Helicopter Emergency Medical Services (EMS and HEMS). His humble approach makes him a wealth of wisdom for anyone in this career field. As kickoff for 2024 we depart from our normal format of short education topics to long term reflection. If you work in and around EMS and Critical Care Transport, learn from Jim. Take time to listen to those in your world that have years of experience and expertise. Take time to be humble and learn the lessons they pass forward. Many of them have been paid for with hardship. Take time to reflect on your goals as a provider and how you want to better yourself in 2024! We sat down with Jim in the kitchen of his North Carolina home to learn about his experience with Orange County, North Carolina and Carolina Air Care. Jim was in a group of 5, that were the first Flight Paramedics in the state of North Carolina. They helped pioneer a program that is now a staple of EMS in the State of North Carolina. Carolina Air Care is a division of UNC Health, a part of the University of North Carolina system. They currently provide critical care transport to the entire state of North Carolina. They are affiliated with a level I Trauma Center, Burn Center, and a large multi-specialty educational institution. If it can happen, Jim has seen it. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

We delve into the high-stakes world of postpartum hemorrhage management with the esteemed Dr. Maria Moreira. Joins us to demystify the management of postpartum hemorrhage in the pre-hospital setting. Dr. Moreira presents a systematic approach to intervention. Learn about the four T's of postpartum hemorrhage and on-field strategies like tranexamic acid and uterotonic administration. Dr. Moreira guides us through a concise roadmap for effective pre-hospital care. Tune in for critical insights and be prepared for any obstetric emergency! Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Episode Summary: Understanding Postpartum Hemorrhage: Postpartum hemorrhage, or excessive bleeding after childbirth, is a significant concern, occurring in approximately 1-5% of deliveries. The mortality rate associated with postpartum hemorrhage is around 2%, but this can vary globally. Some countries experience mortality rates as high as 20%. Additionally, there's a 10-15% risk of recurrence in subsequent pregnancies, emphasizing the importance of understanding and addressing this issue. Physiological Changes and Risks: Pregnancy induces significant physiological changes, resulting in a high-volume, low-resistance state. The uterus receives ten times the normal blood flow during pregnancy, making postpartum hemorrhage a critical concern. Notably, vital signs might not immediately reflect bleeding, making early detection challenging. Pregnant patients can lose up to two liters of blood without immediate changes in vital signs. Recognizing Post-Delivery Physiological Changes: Understanding the physiological changes in vital signs during and after pregnancy is crucial for pre-hospital providers. Pregnancy induces peripheral vasodilation, causing a slight drop in blood pressure. The heart rate increases by 10-15 points, and the respiratory system undergoes changes, requiring increased oxygen. Although the heart rate goes up in a pregnancy and the blood pressure goes down normaly, it is important that any abnormal vital signs such as a heart rate above 100 and a blood pressure below 100 systolic be treated as abnormal until proven otherwise. Four T's: Causes of Postpartum Hemorrhage: Tone: Involving inadequate uterine contraction, the most common cause. Trauma: Typically lacerations that result during delivery and can lead to significant bleeding. Tissue: Relates to retained placental tissue. Thrombin: Referring to coagulopathy or difficulty in clotting. Approach to Postpartum Hemorrhage in the Field: In a pre-hospital setting, managing postpartum hemorrhage involves a systematic approach. Key steps include: Administration of TXA: Tranexamic acid, if available, can help reduce bleeding. Uterotonic Administration: Oxytocin induces uterine contractions. If not available, can have baby latch which will stimulate the production of moms natural occurring oxytocin. Fundal Massage: Applying firm pressure to the uterus to encourage contraction. Addressing Lacerations: Check for lacerations and apply direct pressure to bleeding points if lacerations are visible. Transport to Hospital: Prioritize getting the patient to the hospital immediately for further evaluation and intervention. Secondary Postpartum Hemorrhage: In some cases, bleeding may occur after the initial 24 hours post-delivery, indicating secondary postpartum hemorrhage. Possible causes include retained products, subinvolution of the placental bed, or infection. In such cases, prompt resuscitation aimed at supportive care of abnormal vitals and transport to the hospital are critical. Summary and Takeaways: Dr. Moreira emphasizes the importance of considering postpartum hemorrhage in every pregnant patient. Pre-hospital providers should be prepared to manage complications by following a systematic algorithm. Early recognition, administration of appropriate medications, fundal message, direct pressure and prompt transportation to the hospital are key components of effective intervention. In conclusion, being proactive and vigilant in managing postpartum hemorrhage in the field is crucial for ensuring the well-being of both mother and child. Regular training, awareness, and a systematic approach are vital for pre-hospital providers to navigate these critical situations successfully. Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In this episode Dr. Maria Moreira joins us to talk us through prehospital pregnancy difficult deliveries. We'll discuss how to handle nuchal cords, cord prolapse, breech presentations, and shoulder dystocias. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Videos of each technique- https://emspodcast.com/difficult-deliveries/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In this episode we look at a recent observational study out of the journal of neurology looking at the effectiveness of midazolam when comparing the IV vs IM vs IN routes. We'll discuss the study as well as other studies involving status epilepticus to tease out best practices for your next shift. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae This Episodes Journal article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930617/ RAMPART trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211107/ American Epilepsy Society Algorithm: https://www.aesnet.org/clinical-care/clinical-guidance/guideline-prolonged-seizures?_gl=1*1lmlmse*_ga*MTIzMDc0MjA2NC4xNzAwMDM0ODUx*_ga_GV192D9FPY*MTcwMDAzNDg1MS4xLjAuMTcwMDAzNDg1MS42MC4wLjA. Blog post:

There are few treatments in our tool box that can have more of a positive impact than non-invasive ventilation. This episode is designed to help you better understand the physiology of how it works and how to use it more effectively. Dr. Bo Burns, the Chair of Emergency Medicine at the University of Oklahoma School of Community Medicine, joins us again for another great discussion. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae Blog post- https://emspodcast.com/non-invasive-ventilation-understanding-the-physiology/ Intubation checklist mentioned at the end of the episode- https://emspodcast.com/ou-em-intubation-checklist/

Coco Wham is a paramedic at the Denver Health Paramedic Division. She is also a 4th year medical student and has a masters in integrated sciences. She is an author on a recent study in the American Journal of Surgery with our previous guest, Dr. Eric Campion. Their latest study looked at prehospital ETCO2 values and if they were predictive of death and need for massive transfusion as compared to commonly accepted measurements, such as systolic blood pressure and shock index. The new study is titled, "Prehospital ETCO2 is predictive of death in intubated and non-intubated patients." We discuss this study with her and what's next for this research. We also touch on why prehospital providers should get involved with research. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Eric Campion is an attending trauma surgeon at Denver Health Medical Center in Denver, Colorado. He has several studies published on the utilization of End Tidal CO2 (ETCO2) in critically injured hemorrhagic shock patients. As a former paramedic, Dr. Campion has also been studying this data's application to the prehospital setting. In this episode we discuss the results of two specific studies which lead to his most recent study with Paramedic Courtney "Coco" Wham. There will be a companion episode released later this month! Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Spencer Tomberg, a physician in the Department of Emergency Medicine and Orthopedics at Denver Health, discusses pain management and the complex nature of pain perception, highlighting the physical and emotional components. He describes how individuals may have different perceptions of pain due to variations in the action potential and synaptic regions. He dives into the etiology and routes of pain signals from the visceral system and how that contributes to referred pain. He also discusses the differences in treatment when approaching acute, subacute, and chronic pain. Ultimately, it's important to consider the individuality of pain experiences when treating patients and not take a one size fits all approach. Check out another great lecture from the Rocky Mountain Trauma and Emergency Medicine Conference. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses See more from the blog post on our website at: https://emspodcast.com/pain-perception-is-complex/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In the high-stakes world of emergency medicine, innovations continually push the boundaries of what's possible. One such groundbreaking procedure is Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Dr. Ernest E Moore, who has literally written the book on trauma surgery, teaches us what REBOA is and how it is being used to save lives in critical situations. Another episode from the Rocky Mountain Trauma and Emergency Medicine Conference. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses See more on this topic from the blog post on our website: https://emspodcast.com/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Stacy Trent, an Associate Professor of Emergency Medicine at the Denver Health Emergency Department, discusses the importance of proper airway management in the emergency setting and introduces the mnemonic SOAPME (suction, oxygen, airway assessment, pharmacy and plan, monitor and equipment) for intubations. Dr. Trent brings with her the most up to date literature about optimizing success and decreasing adverse events during intubation. In this episode we delve deep into the often overlooked aspects of pre-oxygenation and airway assessment, emphasizing the need for thorough preparation and the potential consequences of neglecting these steps. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses More on our website at: https://emspodcast.com/are-you-prepared-for-your-next-intubation/ Plus check out this new trail on DL vs VL for intubation that Dr. Trent eludes to at the end of this episode: https://www.nejm.org/doi/pdf/10.1056/NEJMoa2301601 Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Is your EMS agency prepared for a pediatric disaster? In this episode of EMS CAST, Dr. Jeffrey Upperman joins the hosts live at the Rocky Mountain Trauma and Emergency Medicine Conference. Dr. Upperman gave an entertaining and engaging lecture on what you need to start thinking about to be prepared for a pediatric disaster in your area. After his lecture he joined our podcast to discuss his passion for pediatric disaster preparedness and the journey he has taken over the past 15 years to develop educational platforms in this area. There are some easy steps you can take to make sure that you and your crew are prepared should a disaster strike. Tune in to learn more about Dr. Upperman's work and the importance of being prepared for emergencies involving children. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses EMS Cast Blog Post: https://emspodcast.com/pediatric-disaster-preparedness/ Video of the Childrens Hospital Los Angeles disaster Olympix- https://www.youtube.com/watch?v=sZVgdRj-bCc And check out some more great resources here - https://www.chla.org/trauma-program/pediatric-disaster-resource-and-training-center Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Stop blowing off back pain patients! There may be a true emergency lurking underneath. Dr. Bo Burns teaches us why we should take atraumatic back pain so seriously. We're back with another episode from the RMTEMC. We dive deep into the topic of epidural abscesses and cauda equina. These are true spinal emergencies, so we should understand them. Our expert guest, Dr. Bo Burns shares valuable insights on how to recognize and diagnose, emphasizing the importance of a high index of suspicion. We also explore the role of pre-hospital providers in identifying at-risk patients and providing crucial information to the emergency department. Join us as we unravel the complexities of spinal emergencies and learn about the latest clinical decision tools and treatment options. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Blog post- https://emspodcast.com/spinal-emergencies-a-closer-look-at-back-pain/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

In this episode of EMSCast, hosts Ross Orpet and Will Berry discuss a lecture given by Dr. David Bliss on taking care of pediatric trauma patients. Dr. Bliss emphasizes the importance of supporting the psychosocial needs of pediatric patients, as they may not have the same coping skills as adults. He also discusses the unique challenges of treating pediatric trauma patients, including the need for specialized equipment, medication errors, and issues with diagnosis and communication. Listeners are encouraged to follow EMSCast on Instagram and visit their website emspodcast.com for more educational content. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses https://emspodcast.com/taking-care-of-pediatric-trauma-patients-with-dr-david-bliss/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Earlier this month Ross and Will visited the Rocky Mountain Trauma and Emergency Medicine Conference. In addition to trauma games and sim wars, there were so many great lectures and EMS Cast was lucky enough to get to interview some of the speakers about their talks. We are excited to get to bring some of this great content to our listeners. Dr. Maria Moreira tells us about the conference and then Ross and Will sit down with Trauma Critical Care Fellow Dr. Chelsea Horwood to learn all the ins and outs of ECMO in the trauma patient. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses To see a list of this years lectures and events- https://web.cvent.com/event/591e0026-80af-42cb-a801-ae94dd363ed6/summary https://www.denverhealth.org/for-professionals/clinical-specialties/trauma/trauma-emergency-medicine-conference To learn more about ECMO- https://www.elso.org/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

American College of Surgeons just updated their prehospital trauma triage recommendations. Learn about what the updates mean for paramedics and EMTs and how you can practice this on everyday EMS calls. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Link to Blog Post- https://emspodcast.com/trauma-triage-guidelines-update/ Link to ACS Trauma Triage Guidelines- https://www.facs.org/quality-programs/trauma/systems/field-triage-guidelines/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Pharmacist, Kevin Kaucher, joins us to discuss the ins and outs of nitro in acute coronary syndrome. Does it work? Is sublingual better than paste? Can it be dangerous? Come learn the latest on nitroglycerin. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses For more info and to see the EKGs from the case: https://emspodcast.com/the-truth-about-nitro-separating-fact-from-fiction/ Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Toxicology Fellow Nik Matsler joins us again to discuss more gas poisonings. Do you know how to properly protect yourself from hydrogen sulfide in the prehospital setting? EMS providers- come learn how to recognize these patients and where you might find them and most importantly how to keep yourself safe. We'll also discuss nerve agents and how to recognize and treat these as well. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Toxicology fellow Dr. Nik Matsler teaches us about the pathophysiology of cyanide toxicity and it's various antidotes. Learn how to recognize, learn when to treat, and learn some historical trivia while we're at it. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Whitney Barrett shares why the Glasgow Coma Score is a useless number and what we should use instead. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

This is a Q&A follow up to last weeks episode on serotonin syndrome. This week paramedic Will Barry asks toxicology fellow Dr. Nik Matsler the questions that came up for him after listening to last weeks case. And at the end we kept in an impromptu conversation on end tidal CO2 in the pre-hospital setting. Enjoy. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Toxicology fellow Dr. Nik Matsler helps us dissect a case that Matt saw working an EDM concert. As I interview Matt about the case, Nik gives us the dos and don'ts when it comes to serotonin syndrome. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

This is a tough job and we all have scars from it. It's time to quit sweeping them under the rug and start openly discussing them. This episode was inspired by an upcoming documentary- "Into the Unknown, the Paramedics Journey". You can check out the trailer and more about the movie here - https://intotheunknowndoc.com/watchtrailer/ Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Emergency pharmacist Lance Ray helps us breakdown the latest literature with regards to steroids in cardiac arrest. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Andersen LW, Isbye D, et al. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2021 Oct 26;326(16):1586-1594. doi: 10.1001/jama.2021.16628. PMID: 34587236; PMCID: PMC8482303. https://pubmed.ncbi.nlm.nih.gov/34587236/ Resouces: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dangers of lights and sirens. Who is EMS? Dispatcher assisted CPR. Intubation video review. And more! Last week was the annual conference for the National Association of EMS Physicians. For 2 1/2 days experts in the field of EMS medical direction gave insights to a whole range of topics. I had the pleasure of getting to see some of them. Check out this recap to learn more. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Emergency Pharmacist Lance Ray joins us to educate us on all the various new classes of diabetic medications. Learn which ones cause hypoglycemia, which ones don't, and a couple which cause some rare life threatening conditions. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Which blade do you prefer when you intubate? Mac 3 or Mac 4? Is there any data to guide our choice? Matt and I review a recent study from Intensive Care Medicine Journal that attempted to answer the question of which is better. You can find the full article here. https://link.springer.com/article/10.1007/s00134-022-06832-9?mc_cid=93f14f4c87&mc_eid=65c52bf2df Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Are you running your traumas as efficiently as you should? Dave Edwards shares with us the ideal approach/philosophy/teaching tool to how theses calls should ideally go. This document is years in the making with input from Trauma Surgeons, Emergency Physicians, and Paramedics to help clearly delineate our priorities in trauma. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses To view the whole document visit our website: The Ideal Trauma Call Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

The sick asthmatic is one of the scariest calls you may run. You need to understand this is different from other respiratory distress. Your treatments can have a profoundly negative impact on the patient if you don't understand the physiology. But if you do understand what is going on, you can make a real difference and save a life. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

It seems like there are new drugs hitting the streets every month. That's because there are and there's a reason for that! Come learn why and what we need to look out for and be aware of on the streets. Welcome back Dr. Nik Matsler who's going to take us through how novel drugs escape our legal system and what the dangers are. And a new update on good ol' meth too! Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Full show notes at: EMSpodcast.com Papers mentioned in the show: 2019 Review Article of papers looking at antipsychotics in the treatment of sympathomimetics Chemical restraint for the agitated patient in the emergency department: lorazepam versus droperidol Midazolam-Droperidol compared to droperidol alone Benzodiazepines and antipsychotic medications for treatment of acute cocaine toxicity in animal models--a systematic review and meta-analysis Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Will Berry's back on the show to chat with us about a commonly overlooked part of our care. He can't stress enough how important a good detailed physical exam can be. Are you dedicating enough attention to your physical exams? Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Join us for part four of our four part series looking at the physiologically difficult airway. Matt takes us through the approach to RV failure why these patients are so dangerous to intubate. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses

Summer's not over yet which means the snakes they are a still slithering. Come learn everything you need to know about treating North American snake bites in the field and dispel some myths along the way. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

Dr. Lesley Pepin joins us to talk about the nuances of cocaine overdose and it's various managements. There's more than you think. And the more you know could make a difference and save a life. Enter to Win a FREE Pair of Frontline Optics Sunglasses EMScast15 for 15% Off Frontline Optics Sunglasses Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae