The World’s Okayest Medic Podcast

Listener discretion is advised.

Listener discretion is advised. Thank you to Pulmonologist Nick Ghionni and host of the EmCrit Podcast, Dr. Scott Weingart for coming onto the podcast and talking about approaches to the assessment and management of the often vague and really sick patient with respiratory distress.

Listener discretion is advised.

Listener discretion is advised. DOSE VF Trial: PMID 36342151 PARAMEDIC: PMID 25467566 Heads Up CPR: PMID 39442790.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised. References: Christine Witten. Airway Jedi Blog. Available: https://airwayjedi.com/2019/01/24/etco2-valuable-vital-sign-perfusion/ Dubin A, Murias G, Estenssoro E, Canales H, Sottile P, Badie J, Barán M, Rossi S, Laporte M, Pálizas F, Giampieri J, Mediavilla D, Vacca E, Botta D. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care Med. 2000 Nov;26(11):1619-23. doi: 10.1007/s001340000669. PMID: 11193267. Öztürk Örmeci G, Yiğit Ö, Eray O. Utility of ETCO2 to predict hemorrhagic shock in multiple trauma patients. Turk J Med Sci. 2022 Feb;52(1):206-215. doi: 10.3906/sag-2103-206. Epub 2022 Feb 22. PMID: 36161601; PMCID: PMC10734833. Wahba RW, Tessler MJ, Béïque F, Kleiman SJ. Changes in PCO2 with acute changes in cardiac index. Can J Anaesth. 1996 Mar;43(3):243-5. doi: 10.1007/BF03011742. PMID: 8829863 Warner KJ, Cuschieri J, Garland B, Carlbom D, Baker D, Copass MK, Jurkovich GJ, Bulger EM. The utility of early end-tidal capnography in monitoring ventilation status after severe injury. J Trauma. 2009 Jan;66(1):26-3

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

@pulmtoilet Dr. Nick Ghionni comes onto dispel some of the thoughts on SCAPE and high-dose nitroglycerin. Listener discretion is advised.

Listener discretion is advised. Topics: Inappropriate OB Transfers Situational Awareness Organizational Standards and Lazy People

Listener discretion is advised. Dr. Steve Wood and Paramedic Ryan Mueller come on to debrief the New England Whole Blood Summit and talk about all things prehospital blood (and politics.....blood politics...not world politics)...

The audio is not studio-crisp beautiful. This was the first outdoor podcast I've ever recorded. Thanks to the crew for Heavy Lies the Helmet for coming onto the show and debriefing the Crash and Learn Conference. Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised. @medicmagill and @ordinaryopsmedic come on to the podcast and discuss a topic I know absolutely nothing about: community paramedicine.

Listener discretion is advised. Rambling about a range of topics: Nobody cares that you work in the big city Clipboards, tablets, charting in front of the patient Video laryngoscopy The vallecula Stupid supervisors Dealing with stupid supervisors Needle decompression

Listener discretion is advised.

LISTENER DISCRETION IS ADVISED. References: Buxton. Sustained Monomorphic VT: Clinical Manifestations, Diagnosis, and Evaluation. Up-to-Date. Farré J, Rubio JM, Sternick EB. Confounding factors leading to misdiagnosing ventricular tachycardia as supraventricular in the emergency room. Indian Pacing Electrophysiol J. 2023;23(1):1-13. doi:10.1016/j.ipej.2022.11.002 Kashou AH, Evenson CM, Noseworthy PA, et al. Differentiating wide complex tachycardias: A historical perspective. Indian Heart J. 2021;73(1):7-13. doi:10.1016/j.ihj.2020.09.006 Salim Rezaie, "SVT With Aberrancy Versus VT", REBEL EM blog, November 22, 2013. Available at: https://rebelem.com/svt-aberrancy-versus-vt/. Steinman RT, Herrera C, Schuger CD, Lehmann MH. Wide QRS tachycardia in the conscious adult. Ventricular tachycardia is the most frequent cause. JAMA. 1989 Feb 17;261(7):1013-6. PMID: 2915409. Vereckei A. Current algorithms for the diagnosis of wide QRS complex tachycardias. Curr Cardiol Rev. 2014 Aug;10(3):262-76. doi: 10.2174/1573403x10666140514103309. PMID: 24827795; PMCID: PMC4040878.

LISTENER DISCRETION IS ADVISED.

Listener discretion is advised.

Listener discretion is advised. References: Cook AM, Morgan Jones G, Hawryluk GWJ, Mailloux P, McLaughlin D, Papangelou A, Samuel S, Tokumaru S, Venkatasubramanian C, Zacko C, Zimmermann LL, Hirsch K, Shutter L. Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients. Neurocrit Care. 2020 Jun;32(3):647-666. doi: 10.1007/s12028-020-00959-7. PMID: 32227294; PMCID: PMC7272487. Desai A, Damani R. Hyperosmolar therapy: A century of treating cerebral edema. Clin Neurol Neurosurg. 2021 Jul;206:106704. doi: 10.1016/j.clineuro.2021.106704. Epub 2021 May 20. PMID: 34045110. Mount CA, Das JM. Cerebral Perfusion Pressure. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537271/ Susanto M, Riantri I. Optimal Dose and Concentration of Hypertonic Saline in Traumatic Brain Injury: A Systematic Review. Medeni Med J. 2022 Jun 23;37(2):203-211. doi: 10.4274/MMJ.galenos.2022.75725. PMID: 35735001; PMCID: PMC9234368.

Listener discretion is advised. Jake Potter from Scope Education and Josh Cooke from The Alert Medic One Podcast joined me for an agendaless discussion.

Listener discretion is advised. Thank you to Dr. Haney Mallemat and my partner Cameron for coming on to discuss a high-risk/low-frequency case.

Listener discretion is advised. Reference: Tsukube, T., Okita, Y. (2017). Cardiac tamponade due to aortic dissection: clinical picture and treatment with focus on pericardiocentesis. E-Journal of Cardiology Practice. European Society of Cardiology. Available: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Cardiac-tamponade-due-to-aortic-dissection-clinical-picture-and-treatment-with-focus-on-pericardiocentesis

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LISTENER DISCRETION IS ADVISED. More thoughts on OB Learning 12-leads Paralytic choices ALS for AMS Cash RE, Kaimal AJ, Samuels-Kalow ME, Boggs KM, Swanton MF, Camargo CA Jr. Epidemiology of Emergency Medical Services-Attended out-of-Hospital Deliveries and Complications in the United States. Prehosp Emerg Care. 2024;28(7):890-897. Dexter F, Epstein RH, Wachtel RE, Rosenberg H. Estimate of the relative risk of succinylcholine for triggering malignant hyperthermia. Anesth Analg. 2013 Jan;116(1):118-22. Nunnally ME, O'Connor MF, Kordylewski H, Westlake B, Dutton RP. The incidence and risk factors for perioperative cardiac arrest observed in the national anesthesia clinical outcomes registry. Anesth Analg. 2015 Feb;120(2):364-70.

Listener discretion is advised. We will address three topics on this episode: Burnout: "I hate my patients." Managers who don't handle a low performing employee "I don't feel accepted by my new team."

LISTENER DISCRETION IS ADVISED.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised!

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised. You all know him and love him: Mustafa Sidik from The Alert Medic One Podcast joined me for a discussion about...well, a lot of things.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

LISTENER DISCRETION IS ADVISED. Dr. Stephen Wood, host of the "Tac Medic Whiskey Podcast" joined us again! We talk about a wide-range of topics from politics (the EMS kind, not national), blood, airway, degrees, trauma...

Listener discretion is advised. References: Ball CG, Lord J, Laupland KB, Gmora S, Mulloy RH, Ng AK, Schieman C, Kirkpatrick AW. Chest tube complications: how well are we training our residents? Can J Surg. 2007 Dec;50(6):450-8. PMID: 18053373 Hannon L, St Clair T, Smith K, Fitzgerald M, Mitra B, Olaussen A, Moloney J, Braitberg G, Judson R, Teague W, Quinn N, Kim Y, Bernard S. Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service. Emerg Med Australas. 2020 Aug;32(4):650-656. Harrison J, Bhardwaj A, Houck O, Sather K, Sekiya A, Knack S, Saarunya Clarke G, Puskarich MA, Tignanelli C, Rogers L, Marmor S, Beilman G. Emergency medical services level of training is associated with mortality in trauma patients: A combined prehospital and in hospital database analysis. J Trauma Acute Care Surg. 2025 Mar 1;98(3):402-409. Life in the Fast Lane Article: https://litfl.com/finger-thoracostomy/ Patel, S., Green, A. Death by p-value: the overreliance on p-values in critical care research. Crit Care 29, 73 (2025). https://doi.org/10.1186/s13054-025-05307-9 Taming the SRU Blog Article: https://www.tamingthesru.com/blog/acmc/finger-thoracostomy UVA Needle Decompression Presentation: https://www.vdh.virginia.gov/content/uploads/sites/23/2022/09/EMS-Needle-Decompression-PI-Project.pdf

Listener discretion is advised.

LISTENER DISCRETION IS ADVISED.

Listener discretion is advised.

LISTENER DISCRETION IS ADVISED.