The World’s Okayest Medic Podcast

Janz D, Casey J, Semler M, et al. Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial. Lancet Respir Med. October 2019. https://www.ncbi.nlm.nih.gov/pubmed/31585796.

Random rantings and thoughts: Reels and listener questions SWAT medic stuff "Worthless" trainings ASV Paramedic school sans EMT experience Just can't hack it... Tempus Pro updates

References: AIDS and TB: PMID 7629858 Owens, William. (2021). The Ventilator Book.

References: Low-Fi Sim > HiFi: PMID 33872104 HiFi not necessarily better: PMID 27215280 Clincial outcomes and sims: PMID 19642147

References: Collins, Jim. Good to Great. Attrition Rates: PMID 37034493 Accreditation: PMID 16531381 Flipped Programs: PMID 33328795

Wesley Nelson comes back onto the podcast to talk about mentorship and precepting.

Thanks to Rob Friedman for coming on the podcast and shooting the breeze about life and issues working EMS in the big city...

Cabrera, Daniel. (Nov 2, 2014). A Basic Approach to the LVAD Patient in the Emergency Department. Available: https://emblog.mayo.edu/2014/11/02/a-basic-approach-to-the-lvad-patient-in-the-emergency-department/ Tchantchaleishvili V, Sagebin F, Ross RE, Hallinan W, Schwarz KQ, Massey HT. Evaluation and treatment of pump thrombosis and hemolysis. Ann Cardiothorac Surg. 2014 Sep;3(5):490-5. doi: 10.3978/j.issn.2225-319X.2014.09.01. PMID: 25452909; PMCID: PMC4229473.

20+ year paramedic and retired fire captain Steve came on to talk about his 10 Rules for BLS Providers!

References: Miles MVP, Beasley JR, Reed HE, Miles DT, Haiflich A, Beckett AR, Lee YL, Bowden SE, Panacek EA, Ding L, Brevard SB, Simmons JD, Butts CC. Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure. J Surg Res. 2022 May;273:211-217. doi: 10.1016/j.jss.2021.12.038. Epub 2022 Jan 29. PMID: 35093837. Roman J, Shank W, Demirjian J, Tang A, Vercruysse GA. Overutilization of Helicopter Transport in the Minimally Burned-A Healthcare System Problem That Should Be Corrected. J Burn Care Res. 2020 Jan 30;41(1):15-22. doi: 10.1093/jbcr/irz143. PMID: 31504602. Adcock AK, Minardi J, Findley S, Daniels D, Large M, Power M. Value Utilization of Emergency Medical Services Air Transport in Acute Ischemic Stroke. J Emerg Med. 2020 Nov;59(5):687-692. doi: 10.1016/j.jemermed.2020.08.005. Epub 2020 Oct 1. PMID: 33011044; PMCID: PMC8006070. Chen X, Gestring ML, Rosengart MR, Peitzman AB, Billiar TR, Sperry JL, Brown JB. Logistics of air medical transport: When and where does helicopter transport reduce prehospital time for trauma? J Trauma Acute Care Surg. 2018 Jul;85(1):174-181. doi: 10.1097/TA.0000000000001935. PMID: 29787553. Chen X, Gestring ML, Rosengart MR, Billiar TR, Peitzman AB, Sperry JL, Brown JB. Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport. J Trauma Acute Care Surg. 2018 Apr;84(4):549-557. doi: 10.1097/TA.0000000000001769. PMID: 29251708.

Topics: Tempus Pro, clinical competencies, bureaucratic comeuppance, IV acetaminophen

Gwenny and Ashley came on the podcast to talk about dealing with sick pediatric patients. References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/. Lucking, S. Maffei, F., Tamburro, R., & Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide. Nagler, Joshua. Cheifetz, Ira. (2021). Initiating Mechanical Ventilation in Children. Up-to-Date.

Bartos JA, Clare Agdamag A, Kalra R, Nutting L, Frascone RJ, Burnett A, Vuljaj N, Lick C, Tanghe P, Quinn R, Simpson N, Peterson B, Haley K, Sipprell K, Yannopoulos D. Supraglottic Airway Devices are Associated with Asphyxial Physiology After Prolonged CPR in Patients with Refractory Out-of-Hospital Cardiac Arrest Presenting for Extracorporeal Cardiopulmonary Resuscitation. Resuscitation. 2023 Mar 16:109769. doi: 10.1016/j.resuscitation.2023.109769. Epub ahead of print. PMID: 36933882.

REFERENCES: Nick Costain. (2018). Management Controversies in Traumatic Cardiac Arrest. EM Ottawa Blog. Available at https://emottawablog.com/2018/04/management-controversies-in-traumatic-cardiac-arrest/epi Royal Melbourne Hospital. (2018). Traumatic Cardiac Arrest Guideline. https://www.thermh.org.au/sites/default/files/media/documents/clinical/TRM%2008.12%20Traumatic%20Arrest%20Guideline%20V1.0_08.17.pdf Watts S, Smith JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhage-induced traumatic cardiac arrest. Resuscitation. May 2019. doi:10.1016/j.resuscitation.2019.04.048 Wongtanasarasin W, Thepchinda T, Kasirawat C, Saetiao S, Leungvorawat J, Kittivorakanchai N. Treatment Outcomes of Epinephrine for Traumatic Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis. J Emerg Trauma Shock. 2021 Oct-Dec;14(4):195-200. doi: 10.4103/JETS.JETS_35_21. Epub 2021 Nov 23. PMID: 35125783; PMCID: PMC8780637. Yamamoto, R., Suzuki, M., Hayashida, K. et al. Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study. Scand J Trauma Resusc Emerg Med 27, 74 (2019). https://doi.org/10.1186/s13049-019-0657-8

References: PMID 26557486 Wood, Owen. (2017). https://www.ditchdocem.com/2017/04/17/racemic-epinephrine/

REFERENCES: Bhardwaj H, Bhardwaj B, Awab A. Revisiting opioid overdose induced acute respiratory distress syndrome. Indian J Crit Care Med. 2014 Feb;18(2):119-20. doi: 10.4103/0972-5229.126095. PMID: 24678160; PMCID: PMC3943122. Elkattawy S, Alyacoub R, Ejikeme C, Noori MAM, Remolina C. Naloxone induced pulmonary edema. J Community Hosp Intern Med Perspect. 2021 Jan 26;11(1):139-142. doi: 10.1080/20009666.2020.1854417. PMID: 33552437; PMCID: PMC7850343. Kummer RL, Kempainen RR, Olives TD, Leatherman JW, Prekker ME. Naloxone-associated pulmonary edema following recreational opioid overdose. Am J Emerg Med. 2022 Mar;53:41-43. doi: 10.1016/j.ajem.2021.12.030. Epub 2021 Dec 17. PMID: 34973491. Saybolt MD, Alter SM, Dos Santos F, Calello DP, Rynn KO, Nelson DA, Merlin MA. Naloxone in cardiac arrest with suspected opioid overdoses. Resuscitation. 2010 Jan;81(1):42-6. doi: 10.1016/j.resuscitation.2009.09.016. Epub 2009 Nov 13. PMID: 19913979. Ventura AL, White CC 4th, Braude D. Letter to the Editor in Response to "Naloxone Cardiac Arrest Decision Instruments (NACARDI) for targeted antidotal therapy in occult opioid overdose precipitated cardiac arrest". Resuscitation. 2021 Jul;164:157-158. doi: 10.1016/j.resuscitation.2021.02.044. Epub 2021 May 9. PMID: 33979667.

REFERENCE: Meyers, P., Weingart, S., Smith, S. (2018). The OMI Manifesto. Available: http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html

REFERENCES: August, P., Siabi, B. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date. Judy AE, McCain CL, Lawton ES, Morton CH, Main EK, Druzin ML. Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California. Obstet Gynecol. 2019 Jun;133(6):1151-1159. doi: 10.1097/AOG.0000000000003290. PMID: 31135728.

Helman, A. (2022). Pericarditis and Cardiac Tamponade. Emergency Medicine Cases. Available at: https://emergencymedicinecases.com/pericarditis-cardiac-tamponade/ Imazio, M. (2022). Acute Pericarditis: Clinical Presentation and Diagnosis. Up-to-Date. Imazio M, Cecchi E, Demichelis B, Ierna S, Demarie D, Ghisio A, Pomari F, Coda L, Belli R, Trinchero R. Indicators of poor prognosis of acute pericarditis. Circulation. 2007 May 29;115(21):2739-44. doi: 10.1161/CIRCULATIONAHA.106.662114. Epub 2007 May 14. PMID: 17502574. Swaminathan, A. (2016). Pericarditis. Core EM Blog. Available at https://coreem.net/core/pericarditis/

EPISODE WARNING: SENSITIVE TOPICS, FOUL LANGUAGE

Simply a commentary episode.

Mike, Sarah, Alaina, and Wes discuss various topics and go down rabbitholes.

References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/. Nishimura, Masaji. (2016). High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respiratory Care, 61(4), 529-41. Sharma S, Danckers M, Sanghavi D, et al. High Flow Nasal Cannula. [Updated 2022 Sep 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526071/

August, Phyllis. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date. Euser, A. & Cipolla, M. (2009). Magnesium sulfate for the treatment of eclampsia. Stroke, 40. Nelson, K. (2019). Determining FHR during air transport. Available: http://survivalflighteducationblog.com/determining-fetal-heart-rate-during-air-transport/lit NHS. The Obs Podcast. Episode: FHT - Part One. Simhan, H. Caritis, S. (2022). Inhibition of Acute Preterm Labor. Up-to-Date.

Listner questions and my (rambling) answers. REFERENCES Baize, Kohman, Stoffel, Weigartz. (2021). Albuterol versus terbutaline in emergency department management of asthma or COPD exacerbation. Critical Care Medicine 49(1 suppl 1): 410. Busti. (2015). Nitroglycerin Use in the Initial Management of Ischemic Pain from Acute Myocardial Infarction (NSTEMI, STEMI). Available: https://www.ebmconsult.com/articles/nitroglycerin-use-in-initial-management-ischemic-pain-acute-myocardial-infarction-nstemi-stemi Mike Sarraille, George Randle, Josh Cotton. The Talent War: How Special Operations and Great Organizations Win on Talent. Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

References: PMID 30167699, 22664746, 22504150, 220474079, 25461079, 22664746, 35001830

References: Burton LV, Beier K. Papillary Muscle Rupture. [Updated 2022 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499976/ Jung J, Rice J, Bord S. Rethinking the role of epinephrine in cardiac arrest: the PARAMEDIC2 trial. Ann Transl Med. 2018 Dec;6(Suppl 2):S129. doi: 10.21037/atm.2018.12.31. PMID: 30740450; PMCID: PMC6330609. Thiele, Holger. Abbott, J Dawn. (2022). Acute Myocardial Infarction: Mechanical Complications. Up-to-Date.