Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers https://emspodcast.com
Loud & Clear: EMS Guiding Principles is an EMS Cast LLC production]]> Thu, 14 May 2026 06:36:53 -0600 https://podbean.com/?v=5.5 en Copyright 2020 All rights reserved. 657666 Education 1440 episodic Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters. Ross Orpet, Paramedic turned EMS Physician Ross Orpet, Paramedic turned EMS Physician No true https://feed.podbean.com/loudandclear/feed.xml https://pbcdn1.podbean.com/imglogo/image-logo/7298469/Cover_Compressed_3000px.png Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers https://emspodcast.com 144 144 How to Build Procedural Skills - That Actually Stick How to Build Procedural Skills - That Actually Stick https://loudandclear.podbean.com/e/how-to-build-procedural-skills-that-actually-stick/ https://loudandclear.podbean.com/e/how-to-build-procedural-skills-that-actually-stick/#comments Thu, 14 May 2026 06:36:53 -0600 loudandclear.podbean.com/30f9ee90-5665-336f-8a57-28de48f83926 Most EMS skills training creates an illusion of competence. You drill a procedure, check a box, and move on. But what does the research actually show about competency and retention?

Dr. Jason Hine (EM physician, SimKit founder) breaks down the actual science of procedural skill acquisition: S-curves, encoding and consolidation, retrieval practice, and why expensive simulation labs often underperform cheap, high-rep lo-fi tools.

Plus: a big announcement about SimKit and the Paramedic Confidence Builder.

Book a Free Coaching Call at emspodcast.com/free-coaching-call

Sign up for the weekly newsletter at emspodcast.com/newsletter

 

SimKit - https://simkit.co

Made to Stick - https://amzn.to/4d5B5qA

]]> Most EMS skills training creates an illusion of competence. You drill a procedure, check a box, and move on. But what does the research actually show about competency and retention?

Dr. Jason Hine (EM physician, SimKit founder) breaks down the actual science of procedural skill acquisition: S-curves, encoding and consolidation, retrieval practice, and why expensive simulation labs often underperform cheap, high-rep lo-fi tools.

Plus: a big announcement about SimKit and the Paramedic Confidence Builder.

Book a Free Coaching Call at emspodcast.com/free-coaching-call

Sign up for the weekly newsletter at emspodcast.com/newsletter

 

SimKit - https://simkit.co

Made to Stick - https://amzn.to/4d5B5qA

]]> Ross Orpet, Paramedic turned EMS Physician true No 5872 121 full How to Fail Better in EMS: A Framework for Growth How to Fail Better in EMS: A Framework for Growth https://loudandclear.podbean.com/e/how-to-fail-better-in-ems-a-framework-for-growth/ https://loudandclear.podbean.com/e/how-to-fail-better-in-ems-a-framework-for-growth/#comments Tue, 28 Apr 2026 08:00:00 -0600 loudandclear.podbean.com/b605eb5b-433c-3738-ae76-7517a24f5e69 Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it.

In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus is a warning, not a role model. Why the best clinicians you'll ever work with have made bigger mistakes than you have. Why high-functioning organizations report mistakes ten times more often than average ones. Why self-identified perfectionists only ever climb to "moderately successful." 

Book Your Free Coaching Call at emspodcast.com/free-coaching-call

Sign up for the weekly newsletter - emspodcast.com/newsletter 

]]> Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it.

In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus is a warning, not a role model. Why the best clinicians you'll ever work with have made bigger mistakes than you have. Why high-functioning organizations report mistakes ten times more often than average ones. Why self-identified perfectionists only ever climb to "moderately successful." 

Book Your Free Coaching Call at emspodcast.com/free-coaching-call

Sign up for the weekly newsletter - emspodcast.com/newsletter 

]]> Ross Orpet, Paramedic turned EMS Physician true No 978 117 full The Call Nobody Trained You For — Jim Schmidt on Domestic Violence Recognition The Call Nobody Trained You For — Jim Schmidt on Domestic Violence Recognition https://loudandclear.podbean.com/e/the-call-nobody-trained-you-for-%e2%80%94-jim-schmidt-on-domestic-violence-recognition/ https://loudandclear.podbean.com/e/the-call-nobody-trained-you-for-%e2%80%94-jim-schmidt-on-domestic-violence-recognition/#comments Wed, 22 Apr 2026 08:19:00 -0600 loudandclear.podbean.com/320ed16a-e3d5-3f6f-ab17-c91384fd2af6 Most medics walk onto a domestic violence scene armed with instinct and not much else. Jim Schmidt thought 20 years in the fire service had prepared him for anything — until he had to identify his stepdaughter Gabby Petito's body in 2021. In the months and years after he realized how little EMS is prepared to recognize and treat domestic violence victims. What he's learned since has rewritten what first responders should be doing on these calls. Jim walks us through the red flags, why strangulation may leave no external marks but signals a 750% jump in homicide risk, how to document, how to treat and talk to the patient, and what patterns we can recognize.

Resources

Want to go deeper?

Book a Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter: emspodcast.com/newsletter

 

]]> Most medics walk onto a domestic violence scene armed with instinct and not much else. Jim Schmidt thought 20 years in the fire service had prepared him for anything — until he had to identify his stepdaughter Gabby Petito's body in 2021. In the months and years after he realized how little EMS is prepared to recognize and treat domestic violence victims. What he's learned since has rewritten what first responders should be doing on these calls. Jim walks us through the red flags, why strangulation may leave no external marks but signals a 750% jump in homicide risk, how to document, how to treat and talk to the patient, and what patterns we can recognize.


Resources

Want to go deeper?

Book a Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter: emspodcast.com/newsletter

 

]]> Ross Orpet, Paramedic turned EMS Physician true No 4327 115 full Great Mentors Shape Better Clinicians Great Mentors Shape Better Clinicians https://loudandclear.podbean.com/e/great-mentors-shape-better-clinicians/ https://loudandclear.podbean.com/e/great-mentors-shape-better-clinicians/#comments Tue, 14 Apr 2026 07:05:36 -0600 loudandclear.podbean.com/0420162d-fab1-32fe-ab1c-fa8ab44c6b0a Don't Be A Field Training Officer Be A Field Training Mentor.

Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down with Ben Tacy onsite at FASTCAN to talk about the origins of field training and why Ben prefers the language of mentorship over “field training officer”.

If you care about leadership, education, workplace culture, or building better medics, this conversation is worth your time.

If you want deeper discussions on topics just like this subscribe to our weekly newsletter - emspodcast.com/newsletter 

Want some individualized mentorship? Book a free coaching call with us - emspodcast.com/free-coaching-call 

]]> Don't Be A Field Training Officer Be A Field Training Mentor.

Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down with Ben Tacy onsite at FASTCAN to talk about the origins of field training and why Ben prefers the language of mentorship over “field training officer”.

If you care about leadership, education, workplace culture, or building better medics, this conversation is worth your time.

If you want deeper discussions on topics just like this subscribe to our weekly newsletter - emspodcast.com/newsletter 

Want some individualized mentorship? Book a free coaching call with us - emspodcast.com/free-coaching-call 

]]> Ross Orpet, Paramedic turned EMS Physician true No 1173 114 full Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite https://loudandclear.podbean.com/e/frozen-fingers-time-is-tissue-the-prehospital-approach-to-frostbite/ https://loudandclear.podbean.com/e/frozen-fingers-time-is-tissue-the-prehospital-approach-to-frostbite/#comments Wed, 01 Apr 2026 11:47:18 -0600 loudandclear.podbean.com/1854930e-6a6a-351e-a097-9f0382577731 Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective.

Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and when to bypass your local ED for a tertiary care center.

Whether you’re running urban calls or wilderness rescues, you may see this and this episode will help inform how you approach cold injury.

 

Want more?

Subscribe to The Confidence Dispatch, our free weekly newsletter for paramedics who want to get 1% better every shift: →  https://loudandclear.kit.com/d45b012fae

 

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands.

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance. The stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute coaching call and we'll talk about whether it's the right fit. Even if it’s not we’ll give you actionable advice on the call so that you still walk away with something valuable: →  calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

]]> Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective.

Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and when to bypass your local ED for a tertiary care center.

Whether you’re running urban calls or wilderness rescues, you may see this and this episode will help inform how you approach cold injury.

 

Want more?

Subscribe to The Confidence Dispatch, our free weekly newsletter for paramedics who want to get 1% better every shift: →  https://loudandclear.kit.com/d45b012fae

 

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands.

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance. The stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute coaching call and we'll talk about whether it's the right fit. Even if it’s not we’ll give you actionable advice on the call so that you still walk away with something valuable: →  calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

]]> Ross Orpet, Paramedic turned EMS Physician true No 3606 113 full Suction First: Dr. DuCanto on the SALAD Technique for the Contaminated Airway and What Comes Next Suction First: Dr. DuCanto on the SALAD Technique for the Contaminated Airway and What Comes Next https://loudandclear.podbean.com/e/suction-first-dr-ducanto-on-the-salad-technique-for-the-contaminated-airway-and-what-comes-next/ https://loudandclear.podbean.com/e/suction-first-dr-ducanto-on-the-salad-technique-for-the-contaminated-airway-and-what-comes-next/#comments Mon, 09 Mar 2026 11:40:18 -0600 loudandclear.podbean.com/b844eb22-2a6e-35e6-8567-ca62ee61d9b0 The contaminated airway is one of the most unforgiving calls in prehospital medicine. Blood, vomit, debris — your laryngoscope goes in and you're blind. For decades, paramedics managed this with tools designed for a clean OR and training that never got close to the real thing.

Dr. Jim DuCanto decided that was unacceptable. He's the anesthesiologist who invented the DuCanto catheter and SALAD (Suction Assisted Laryngoscopy and Airway Decontamination). Will Berry sat down with Dr. DuCanto at the FASTCAN conference for a conversation.

In this episode we cover:

- The SALAD technique, step by step

- Why paramedic OR training should default to video laryngoscopy

- The downsides of SALAD that Dr. DuCanto himself will tell you about

- What a new portable suction device does differently

Guest: Dr. Jim DuCanto anesthesiologist, inventor of the DuCanto catheter and the SALAD technique

 

Want more?

Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

 

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for medics who want to close the gap between what school taught them and what the job actually demands. 

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

]]> The contaminated airway is one of the most unforgiving calls in prehospital medicine. Blood, vomit, debris — your laryngoscope goes in and you're blind. For decades, paramedics managed this with tools designed for a clean OR and training that never got close to the real thing.

Dr. Jim DuCanto decided that was unacceptable. He's the anesthesiologist who invented the DuCanto catheter and SALAD (Suction Assisted Laryngoscopy and Airway Decontamination). Will Berry sat down with Dr. DuCanto at the FASTCAN conference for a conversation.

In this episode we cover:

- The SALAD technique, step by step

- Why paramedic OR training should default to video laryngoscopy

- The downsides of SALAD that Dr. DuCanto himself will tell you about

- What a new portable suction device does differently

Guest: Dr. Jim DuCanto anesthesiologist, inventor of the DuCanto catheter and the SALAD technique

 

Want more?

Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

 

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for medics who want to close the gap between what school taught them and what the job actually demands. 

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

]]> Ross Orpet, Paramedic turned EMS Physician true No 1788 112 full Wired to Fail: The Science of Human Error in EMS Wired to Fail: The Science of Human Error in EMS https://loudandclear.podbean.com/e/wired-to-fail-the-science-of-human-error-in-ems/ https://loudandclear.podbean.com/e/wired-to-fail-the-science-of-human-error-in-ems/#comments Wed, 25 Feb 2026 10:05:54 -0700 loudandclear.podbean.com/f8710e3a-9ec1-3a07-bb66-a0eeead0cac4 What if the mistake wasn't your fault... but it's still your responsibility?

That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actually do about it.

WHAT YOU'LL LEARN:

Task Brackets — Your brain bundles repetitive actions into smooth automated sequences.

The First Habit Rule — The first habit is permanently ingrained. Old habits lurk underneath new ones and surface under stress. Get it right the first time.

Goal-Oriented Stimulus — Don't ask "Do I have everything?" Ask "Where are the things I need?" and physically point to them.

The Preceptor Problem — Most preceptors feel unprepared. The goal isn't to make "mini me", it's to create independent critical thinkers.

Shift Fatigue — Cognitive function degrades meaningfully at 16 hours.

Just Culture — Human error is inevitable. Punishment doesn't fix the system. The guilty already feel terrible. They need peer support and system redesign.

 

RESOURCES:

Join our Paramedic Confidence Builder 

 

CONNECT WITH US:

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com 

 

CONNECT WITH SHEA:

- TikTok: @flightnurseshay

- Instagram: @flightnurseshay

]]> What if the mistake wasn't your fault... but it's still your responsibility?

That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actually do about it.

WHAT YOU'LL LEARN:

Task Brackets — Your brain bundles repetitive actions into smooth automated sequences.

The First Habit Rule — The first habit is permanently ingrained. Old habits lurk underneath new ones and surface under stress. Get it right the first time.

Goal-Oriented Stimulus — Don't ask "Do I have everything?" Ask "Where are the things I need?" and physically point to them.

The Preceptor Problem — Most preceptors feel unprepared. The goal isn't to make "mini me", it's to create independent critical thinkers.

Shift Fatigue — Cognitive function degrades meaningfully at 16 hours.

Just Culture — Human error is inevitable. Punishment doesn't fix the system. The guilty already feel terrible. They need peer support and system redesign.

 

RESOURCES:

Join our Paramedic Confidence Builder 

 

CONNECT WITH US:

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com 

 

CONNECT WITH SHEA:

- TikTok: @flightnurseshay

- Instagram: @flightnurseshay

]]> Ross Orpet, Paramedic turned EMS Physician true No 677 111 full Dump Kits and Checklists: Why Expert Paramedics Still Crash Dump Kits and Checklists: Why Expert Paramedics Still Crash https://loudandclear.podbean.com/e/dump-kits-and-checklists-why-expert-paramedics-still-crash/ https://loudandclear.podbean.com/e/dump-kits-and-checklists-why-expert-paramedics-still-crash/#comments Mon, 09 Feb 2026 11:14:50 -0700 loudandclear.podbean.com/726e6324-7f4b-3899-b211-650514472f06 Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. You'll learn the challenge-response checklist protocol that speeds up your intubation time (not slows it down), the HEAVEN criteria's six specific warning signs that predict difficult airways before you attempt, and why dump kits create muscle memory that works in the dark. David shares the story that started his human factors obsession and proves that expertise doesn't protect you from error—systems do. This is operational excellence: building checklists that think for you when tunnel vision sets in.

 

Want more? Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Built by an ER doc who runs medical direction for 5 rural Colorado agencies and has talked with hundreds of paramedics about exactly where that gap shows up.

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

Resources  

Paramedic Confidence Builder - emspodcast.com/program 

To see the actual checklist - https://www.airmedandrescue.com/latest/long-read/medical-insight-latest-tools-ensure-successful-first-pass-intubation 

 

Guest/Cast/Crew information-

Guest- David Olvera

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com

 

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

 

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J

]]> Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. You'll learn the challenge-response checklist protocol that speeds up your intubation time (not slows it down), the HEAVEN criteria's six specific warning signs that predict difficult airways before you attempt, and why dump kits create muscle memory that works in the dark. David shares the story that started his human factors obsession and proves that expertise doesn't protect you from error—systems do. This is operational excellence: building checklists that think for you when tunnel vision sets in.

 

Want more? Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

Want to go even further?

The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Built by an ER doc who runs medical direction for 5 rural Colorado agencies and has talked with hundreds of paramedics about exactly where that gap shows up.

Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

Resources  

Paramedic Confidence Builder - emspodcast.com/program 

To see the actual checklist - https://www.airmedandrescue.com/latest/long-read/medical-insight-latest-tools-ensure-successful-first-pass-intubation 

 

Guest/Cast/Crew information-

Guest- David Olvera

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com

 

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

 

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J

]]> Ross Orpet, Paramedic turned EMS Physician true No 1094 110 full Feeling Behind the Curve? Understanding the EMS Power Curve Will Help You Stay Ahead Feeling Behind the Curve? Understanding the EMS Power Curve Will Help You Stay Ahead https://loudandclear.podbean.com/e/behind-the-curve-understanding-the-ems-power-curve-will-help/ https://loudandclear.podbean.com/e/behind-the-curve-understanding-the-ems-power-curve-will-help/#comments Mon, 26 Jan 2026 08:00:00 -0700 loudandclear.podbean.com/03c90cb6-1494-3c28-9316-54bad75bb537 Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This episode breaks down the exact framework to chunk calls into five critical phases. When you understand phases you understand what is needed during each point of the call and how to stay ahead. How to build if-then statements that eliminate decision fatigue. The psychological safety that lets you reset after screwing up in the apartment. And why 80% of medical errors tie back to the one phase—the hospital handoff. Stop reverting to chaos. Build the system that keeps you ahead.

Guest/Cast/Crew information-

Guest- Moose and Josh from Alert Medic 1 podcast

Host- Ross Orpet, Will Berry 

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear  

Website- www.emspodcast.com

 

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn   

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

 

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 bi-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

]]> Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This episode breaks down the exact framework to chunk calls into five critical phases. When you understand phases you understand what is needed during each point of the call and how to stay ahead. How to build if-then statements that eliminate decision fatigue. The psychological safety that lets you reset after screwing up in the apartment. And why 80% of medical errors tie back to the one phase—the hospital handoff. Stop reverting to chaos. Build the system that keeps you ahead.


Guest/Cast/Crew information-

Guest- Moose and Josh from Alert Medic 1 podcast

Host- Ross Orpet, Will Berry 

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear  

Website- www.emspodcast.com

 

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn   

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

 

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 bi-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

]]> Ross Orpet, Paramedic turned EMS Physician true No 4619 109 full Stupidity in EMS: The causes and remedies Stupidity in EMS: The causes and remedies https://loudandclear.podbean.com/e/stupidity-in-ems-the-causes-and-remedies/ https://loudandclear.podbean.com/e/stupidity-in-ems-the-causes-and-remedies/#comments Mon, 12 Jan 2026 21:19:27 -0700 loudandclear.podbean.com/1ab601ed-2eb6-3c82-bd75-0f10291a4c57 You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them.

Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science behind high-stakes decision-making in emergency medicine.  

Guest/Cast/Crew information-

Guest- Kris Kaull, FP-C

Host- Ross Orpet

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

 

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

]]> You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them.

Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science behind high-stakes decision-making in emergency medicine.  

Guest/Cast/Crew information-

Guest- Kris Kaull, FP-C

Host- Ross Orpet

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

Books we recommend

- The Dichotomy of Leadership - https://amzn.to/4fiCAjN

- Extreme Ownership - https://amzn.to/3O1FWfa

-  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

- Thinking Fast and Slow - https://amzn.to/4fiJG85

Gear We Like

- Good Stethoscope - https://amzn.to/3YJJrf2

- Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  

- Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

 

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

]]> Ross Orpet, Paramedic turned EMS Physician true No 1401 108 full Anaphylaxis + Asthma: When Standard Anaphylaxis Treatment May Not Be Enough (AMAX4 Explained) Anaphylaxis + Asthma: When Standard Anaphylaxis Treatment May Not Be Enough (AMAX4 Explained) https://loudandclear.podbean.com/e/anaphylaxis-asthma-when-standard-anaphylaxis-treatment-may-not-be-enough-amax4-explained/ https://loudandclear.podbean.com/e/anaphylaxis-asthma-when-standard-anaphylaxis-treatment-may-not-be-enough-amax4-explained/#comments Wed, 17 Dec 2025 07:00:44 -0700 loudandclear.podbean.com/c07ee6ff-1eea-3606-96bd-67c777a3e4b0 This episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine may not be enough, and why this is the time to be aggressive.

But this isn't simply about memorizing another algorithm. It's about developing the operational confidence to recognize when standard approaches may fail and override your impulse to "try the book answer one more time." You'll learn to identify time-critical scenarios, build red-flag combination awareness, and make high-stakes decisions without second-guessing yourself. 

Want to systematically build this decision-making confidence? Discover the Paramedic Confidence Builder at emspodcast.com/program —where we teach the operational skills your school didn't.

 

Guest/Cast/Crew information- Guest- Bruce Hoffman, Associate Professor, Critical Care RN and Paramedic Host- Ross Orpet, Will Berry  Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com

Books we recommend

Gear We Like

 

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 episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine may not be enough, and why this is the time to be aggressive.

But this isn't simply about memorizing another algorithm. It's about developing the operational confidence to recognize when standard approaches may fail and override your impulse to "try the book answer one more time." You'll learn to identify time-critical scenarios, build red-flag combination awareness, and make high-stakes decisions without second-guessing yourself. 

Want to systematically build this decision-making confidence? Discover the Paramedic Confidence Builder at emspodcast.com/program —where we teach the operational skills your school didn't.

 

Guest/Cast/Crew information-
Guest- Bruce Hoffman, Associate Professor, Critical Care RN and Paramedic
Host- Ross Orpet, Will Berry 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com

Books we recommend

Gear We Like

 

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

]]> Ross Orpet, Paramedic turned EMS Physician true No 1143 107 full The Habit Loop: How Master EMS Clinicians Build Unconscious Competence Through Habits The Habit Loop: How Master EMS Clinicians Build Unconscious Competence Through Habits https://loudandclear.podbean.com/e/the-habit-loop-how-master-ems-clinicians-build-unconscious-competence-through-habits/ https://loudandclear.podbean.com/e/the-habit-loop-how-master-ems-clinicians-build-unconscious-competence-through-habits/#comments Thu, 11 Dec 2025 17:21:14 -0700 loudandclear.podbean.com/992a25e4-49e7-3117-8500-40227b738db8 Struggling to remember every protocol in high-pressure medical situations? You're not alone—and memorizing everything isn't the answer.

 

Join us for this game-changing conversation with Jean Francois Couture, co-founder of Parys Medical, as we unpack the science of habit formation for EMS and healthcare providers. Recorded live at FAST 25, Jean breaks down the "habit loop" (cue, routine, reward) and introduces the concept of the "meta-habit"—a habit of habits that transforms how you access critical information during emergencies.

 

Learn why the best clinicians don't memorize everything but know exactly where to find what they need when seconds count. Discover practical strategies for mental simulation, protocol familiarization, and building muscle memory with your cheat sheets. Jean shares actionable steps including planning your clinical scenarios, scheduling regular practice sessions, and developing unconscious competence through repetition.

 

Whether you're new to EMS or a seasoned veteran, this episode provides a roadmap for achieving clinical excellence through deliberate practice and smart information management.

 

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

]]> Struggling to remember every protocol in high-pressure medical situations? You're not alone—and memorizing everything isn't the answer.

 

Join us for this game-changing conversation with Jean Francois Couture, co-founder of Parys Medical, as we unpack the science of habit formation for EMS and healthcare providers. Recorded live at FAST 25, Jean breaks down the "habit loop" (cue, routine, reward) and introduces the concept of the "meta-habit"—a habit of habits that transforms how you access critical information during emergencies.

 

Learn why the best clinicians don't memorize everything but know exactly where to find what they need when seconds count. Discover practical strategies for mental simulation, protocol familiarization, and building muscle memory with your cheat sheets. Jean shares actionable steps including planning your clinical scenarios, scheduling regular practice sessions, and developing unconscious competence through repetition.

 

Whether you're new to EMS or a seasoned veteran, this episode provides a roadmap for achieving clinical excellence through deliberate practice and smart information management.

 

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

]]> Ross Orpet, Paramedic turned EMS Physician true No 985 106 full Hypothermia Rescue: Cardiac Arrest in a Tree Well Hypothermia Rescue: Cardiac Arrest in a Tree Well https://loudandclear.podbean.com/e/hypothermia-rescue-cardiac-arrest-in-a-tree-well/ https://loudandclear.podbean.com/e/hypothermia-rescue-cardiac-arrest-in-a-tree-well/#comments Tue, 02 Dec 2025 19:02:12 -0700 loudandclear.podbean.com/fad12d70-6350-34c0-b927-7a693675d4b4 What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits.

This wasn't luck. Miles breaks down the critical decision to defy transport protocols and how they managed a failed field intubation when her torso sank into the snow during compressions. The case became a catalyst for building Teaam Aeromedical, a progressive nonprofit wilderness air ambulance saves time, lives, and healthcare dollars. Learn the physiology of hypothermic cardiac arrest, why less intervention is sometimes more, and how to package patients in snow to prevent further heat loss. Whether you work in wilderness medicine or urban EMS, the principles here apply: know the science, challenge protocols when they don't serve your patient, and get them to the right place at the right time.

Interested in our Paramedic Confidence Builder course? Check us out at - emspodcast.com

Guest/Cast/Crew information-

Guest- Miles Randell, Paramedic, Founder of TEAAM Aeromedical, for more go to teaam.ca 

Host- Ross Orpet

 

Catch up with us after the show

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- 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 bi-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

]]> What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits.

This wasn't luck. Miles breaks down the critical decision to defy transport protocols and how they managed a failed field intubation when her torso sank into the snow during compressions. The case became a catalyst for building Teaam Aeromedical, a progressive nonprofit wilderness air ambulance saves time, lives, and healthcare dollars. Learn the physiology of hypothermic cardiac arrest, why less intervention is sometimes more, and how to package patients in snow to prevent further heat loss. Whether you work in wilderness medicine or urban EMS, the principles here apply: know the science, challenge protocols when they don't serve your patient, and get them to the right place at the right time.

Interested in our Paramedic Confidence Builder course? Check us out at - emspodcast.com

Guest/Cast/Crew information-

Guest- Miles Randell, Paramedic, Founder of TEAAM Aeromedical, for more go to teaam.ca 

Host- Ross Orpet

 

Catch up with us after the show

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- 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 bi-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

]]> Ross Orpet, Paramedic turned EMS Physician true No 2399 105 full When The Anatomy Is Gone: Facial Trauma Airway Management When The Anatomy Is Gone: Facial Trauma Airway Management https://loudandclear.podbean.com/e/when-the-anatomy-is-gone-facial-trauma-airway-management/ https://loudandclear.podbean.com/e/when-the-anatomy-is-gone-facial-trauma-airway-management/#comments Mon, 17 Nov 2025 08:00:00 -0700 loudandclear.podbean.com/e5e1c4d8-8e98-35d5-b7c7-4bec3bda988f What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality.

Critical care transport legend Allen Wolfe joins us to dissect a real case, a conscious patient with a self-inflicted shotgun wound—no mandible, no nose, no midface—just open tissue and blood spraying everywhere.

This conversation covers the Lefort facial injury classification, why the cervical collar is often more harmful than helpful in penetrating trauma, delayed sequence intubation techniques, and intubating in atypical positions. Allen also explains cerebral perfusion pressure through the Monroe-Kelley hypothesis, and why hypotension can be devastating in traumatic brain injury.

But beyond the technical skills, this episode is about leadership under pressure, verbalizing your thought process to your team, and having backup plans A through Z before you need them. It's about deliberate practice and mental simulation so you don't freeze when chaos hits.

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

 

Guest/Cast/Crew information-

Guest- Allen Wolfe, CFRN

Host- Ross Orpet, MD

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality.

Critical care transport legend Allen Wolfe joins us to dissect a real case, a conscious patient with a self-inflicted shotgun wound—no mandible, no nose, no midface—just open tissue and blood spraying everywhere.

This conversation covers the Lefort facial injury classification, why the cervical collar is often more harmful than helpful in penetrating trauma, delayed sequence intubation techniques, and intubating in atypical positions. Allen also explains cerebral perfusion pressure through the Monroe-Kelley hypothesis, and why hypotension can be devastating in traumatic brain injury.

But beyond the technical skills, this episode is about leadership under pressure, verbalizing your thought process to your team, and having backup plans A through Z before you need them. It's about deliberate practice and mental simulation so you don't freeze when chaos hits.

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

 

Guest/Cast/Crew information-

Guest- Allen Wolfe, CFRN

Host- Ross Orpet, MD

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 1461 104 full Stop Building Resilience, Strengthen Your Resistance Stop Building Resilience, Strengthen Your Resistance https://loudandclear.podbean.com/e/stop-building-resilience-strengthen-your-resistance/ https://loudandclear.podbean.com/e/stop-building-resilience-strengthen-your-resistance/#comments Mon, 10 Nov 2025 08:00:00 -0700 loudandclear.podbean.com/e06855a6-0c18-34b2-aee3-110b32008978 Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever). 

 

Recorded on-site at Fast25, James Boomhower, founder of StayFit4Duty, breaks down why the EMS culture of "pushing through" is fundamentally flawed. Using the metaphor of muscle training, he explains that continuing to stress a system without recovery doesn't build strength—it causes injury. The recovery time from a torn mental health muscle is exponentially longer than if you'd simply rested appropriately. 

 

With over 20 years in New England EMS including training to become a licensed mental health counselor, James brings a perspective that's desperately needed in emergency medicine. He provides the missing manual for sustainable careers in emergency medicine. In this episode he discusses why the 5 pillars of resilience should really be the 5 pillars of resistance. He shares vulnerable stories from his own journey, including the colleague who grabbed him by the collar to stop him from burning out while helping others, and even some relationship strategies to prevent your worst shift from destroying your home life.

 

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

 

Resources

 

Guest/Cast/Crew information-

Guest- James Boomhower, LMHC-A, MS, FP-C, NR-P, C- NPT, CCISM

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever). 

 

Recorded on-site at Fast25, James Boomhower, founder of StayFit4Duty, breaks down why the EMS culture of "pushing through" is fundamentally flawed. Using the metaphor of muscle training, he explains that continuing to stress a system without recovery doesn't build strength—it causes injury. The recovery time from a torn mental health muscle is exponentially longer than if you'd simply rested appropriately. 

 

With over 20 years in New England EMS including training to become a licensed mental health counselor, James brings a perspective that's desperately needed in emergency medicine. He provides the missing manual for sustainable careers in emergency medicine. In this episode he discusses why the 5 pillars of resilience should really be the 5 pillars of resistance. He shares vulnerable stories from his own journey, including the colleague who grabbed him by the collar to stop him from burning out while helping others, and even some relationship strategies to prevent your worst shift from destroying your home life.

 

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

 

Resources

 

Guest/Cast/Crew information-

Guest- James Boomhower, LMHC-A, MS, FP-C, NR-P, C- NPT, CCISM

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 1514 103 full What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS https://loudandclear.podbean.com/e/what-if-they-find-out-im-a-fraud-imposter-syndrome-in-ems/ https://loudandclear.podbean.com/e/what-if-they-find-out-im-a-fraud-imposter-syndrome-in-ems/#comments Mon, 03 Nov 2025 08:00:00 -0700 loudandclear.podbean.com/94e042fe-df33-32e7-bd12-c5575c17e67c Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vulnerable stories about impostor syndrome, burnout, and finding your way as a new paramedic.

 

Sophie's path to EMS started in the most unexpected way—from a 39-day hospitalization that included being intubated over the holidays to signing up for EMT school from her hospital bed. But becoming a paramedic brought new challenges: crushing self-doubt, constant anxiety before shifts, and the fear that everyone would discover she was a "fraud." Sound familiar? You're not alone. This conversation dives deep into the psychological struggles that plague EMS providers, especially new medics who lose their support structure after paramedic school.

 

Learn the difference between destructive doubt and healthy doubt, discover cognitive reframing techniques to combat catastrophizing and black-and-white thinking, and understand why bravery means doing things scared. Sophie emphasizes one crucial truth: you cannot fight impostor syndrome alone. So hit play and let’s do this together. 

 

**If you're struggling with confidence as a new paramedic, our Paramedic Confidence Builder Course can help. To learn more, reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear**

 

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

 

 

Guest/Cast/Crew information-

Guest- Sophie Fuller, EMS, HEMS 

Host- Ross Orpet

 

Catch up with us after the show 

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear 

Website- www.emspodcast.com

]]> Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vulnerable stories about impostor syndrome, burnout, and finding your way as a new paramedic.

 

Sophie's path to EMS started in the most unexpected way—from a 39-day hospitalization that included being intubated over the holidays to signing up for EMT school from her hospital bed. But becoming a paramedic brought new challenges: crushing self-doubt, constant anxiety before shifts, and the fear that everyone would discover she was a "fraud." Sound familiar? You're not alone. This conversation dives deep into the psychological struggles that plague EMS providers, especially new medics who lose their support structure after paramedic school.

 

Learn the difference between destructive doubt and healthy doubt, discover cognitive reframing techniques to combat catastrophizing and black-and-white thinking, and understand why bravery means doing things scared. Sophie emphasizes one crucial truth: you cannot fight impostor syndrome alone. So hit play and let’s do this together. 

 

**If you're struggling with confidence as a new paramedic, our Paramedic Confidence Builder Course can help. To learn more, reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear**

 

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

 

 

Guest/Cast/Crew information-

Guest- Sophie Fuller, EMS, HEMS 

Host- Ross Orpet

 

Catch up with us after the show 

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear 

Website- www.emspodcast.com

]]> Ross Orpet, Paramedic turned EMS Physician true No 1382 102 full Why Those With Addiction Don't "Just Change" - Opioid Crisis Reality for EMS Why Those With Addiction Don't "Just Change" - Opioid Crisis Reality for EMS https://loudandclear.podbean.com/e/why-addicts-dont-just-change-opioid-crisis-reality-for-ems/ https://loudandclear.podbean.com/e/why-addicts-dont-just-change-opioid-crisis-reality-for-ems/#comments Mon, 27 Oct 2025 08:00:00 -0600 loudandclear.podbean.com/fdaaf647-8706-30b7-943f-ffcaf634894c Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment

 

"Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.

 

Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challenge how EMS providers think about opioid overdoses. The one-year mortality rate after an overdose requiring Narcan? A staggering 6-7%—worse than the one-year mortality after a STEMI. Yet we invest far less in these patients than cardiac emergencies.

 

This episode covers the evidence-based treatments that actually work (methadone and buprenorphine have incredibly low numbers-needed-to-treat to save a life), how EMS can initiate life-saving treatment in the field, and why "tough love" and waiting for patients to "hit rock bottom" is a dangerous myth. Learn how just an extra 6-minutes on scene could save lives, why patients on buprenorphine need MORE pain medication during trauma, and how breaking the stigma starts with you.

 

Ready to make a real difference? Discover how EMS providers are uniquely positioned to interrupt the deadly cycle of opioid use disorder.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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

 

Guest/Cast/Crew information-

Guest- Jason Hoppe, D.O.

 

Hosts - Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment

 

"Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.

 

Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challenge how EMS providers think about opioid overdoses. The one-year mortality rate after an overdose requiring Narcan? A staggering 6-7%—worse than the one-year mortality after a STEMI. Yet we invest far less in these patients than cardiac emergencies.

 

This episode covers the evidence-based treatments that actually work (methadone and buprenorphine have incredibly low numbers-needed-to-treat to save a life), how EMS can initiate life-saving treatment in the field, and why "tough love" and waiting for patients to "hit rock bottom" is a dangerous myth. Learn how just an extra 6-minutes on scene could save lives, why patients on buprenorphine need MORE pain medication during trauma, and how breaking the stigma starts with you.

 

Ready to make a real difference? Discover how EMS providers are uniquely positioned to interrupt the deadly cycle of opioid use disorder.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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

 

Guest/Cast/Crew information-

Guest- Jason Hoppe, D.O.

 

Hosts - Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 3599 100 full When to Act: Mastering Vasopressors in 2025 When to Act: Mastering Vasopressors in 2025 https://loudandclear.podbean.com/e/when-to-act-mastering-vasopressors-in-2025/ https://loudandclear.podbean.com/e/when-to-act-mastering-vasopressors-in-2025/#comments Mon, 20 Oct 2025 08:00:00 -0600 loudandclear.podbean.com/15089f83-d6a4-3fe1-a037-95a9b23ffc4d What do you do when the blood pressure monitor shows a number you don’t like? Most providers hit the button again—but what if it’s real? In this episode, we’re joined by critical care transport specialist James Boomhower from Boston MedFlight, recorded live at the FASTCAN conference in Calgary, to break down modern vasopressor management.

 

We explore how norepinephrine replaced dopamine as the first-line vasopressor, the evidence behind those changes, and what to do when your patient is on three drips and the pressure still won’t budge. James shares practical, real-world insights from the space between the ED and ICU, where seconds matter and protocols are stress-tested in real time.

 

Key takeaways include: when to trust your BP reading and act, how to choose and sequence pressors based on evidence and logistics, why norepinephrine reduces arrhythmias and improves outcomes, and when to add adjuncts like steroids, sodium bicarb, or methylene blue. We also explore hidden factors like ventilator settings and underlying causes that can sabotage even the best pharmacology.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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 bi-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

 

 

Guest/Cast/Crew information-

Guest- James Boomhower, LMHC-A, FP-C

https://www.stayfit4duty.org/ 

 

Host- Ross Orpet

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

]]> What do you do when the blood pressure monitor shows a number you don’t like? Most providers hit the button again—but what if it’s real? In this episode, we’re joined by critical care transport specialist James Boomhower from Boston MedFlight, recorded live at the FASTCAN conference in Calgary, to break down modern vasopressor management.

 

We explore how norepinephrine replaced dopamine as the first-line vasopressor, the evidence behind those changes, and what to do when your patient is on three drips and the pressure still won’t budge. James shares practical, real-world insights from the space between the ED and ICU, where seconds matter and protocols are stress-tested in real time.

 

Key takeaways include: when to trust your BP reading and act, how to choose and sequence pressors based on evidence and logistics, why norepinephrine reduces arrhythmias and improves outcomes, and when to add adjuncts like steroids, sodium bicarb, or methylene blue. We also explore hidden factors like ventilator settings and underlying causes that can sabotage even the best pharmacology.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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 bi-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

 

 

Guest/Cast/Crew information-

Guest- James Boomhower, LMHC-A, FP-C

https://www.stayfit4duty.org/ 

 

Host- Ross Orpet

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

]]> Ross Orpet, Paramedic turned EMS Physician true No 854 101 full The 5 Levels of EMS Mental Breakdown & How to Escape Them The 5 Levels of EMS Mental Breakdown & How to Escape Them https://loudandclear.podbean.com/e/the-5-levels-of-ems-mental-breakdown-how-to-escape-them/ https://loudandclear.podbean.com/e/the-5-levels-of-ems-mental-breakdown-how-to-escape-them/#comments Mon, 13 Oct 2025 08:00:00 -0600 loudandclear.podbean.com/ef50b5a9-5824-3788-b878-758de5cc01b9 Why do some paramedics stay unshakable under pressure while others crumble on the exact same call? The answer isn't about years of experience—it's about understanding the neuroscience of stress and having the right mental tools.

 

Cody Winterford delivers an incredible breakdown of the five psychological "circles of hell" that providers face in high-stress situations. Starting with the amygdala hijack that triggers your fight-or-flight response, through the crisis of confidence that makes you question everything you've trained for, to analysis paralysis where you're drowning in information but can't make a decision—each level has specific warning signs and proven techniques to overcome it.

 

We explore why mental simulation is so effective and why elite athletes and the blue angels rely on it to perform at their peak. We discuss tactical breathing techniques, the power of self-talk and focus phrases (even inappropriate ones!), and how to recognize when life distractions are creating "brain fog" that prevents you from accessing your clinical knowledge.

 

This isn't theory—it's practical, field-tested mental performance strategies adapted from military and elite athletic training, specifically applied to EMS providers. If you've ever felt overwhelmed on scene, doubted your abilities during a critical call, or watched a partner struggle mentally, this episode provides the framework to understand and overcome those challenges.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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

 

 

Episode Blog Post- The 5 Levels of EMS Mental Breakdown and How to Escape Them

 

Guest/Cast/Crew information-

Guest- Cody Winniford, EMT-P, CCP-P, FP-C

@ordinary_ops_medic

@alertmedic1

 

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Why do some paramedics stay unshakable under pressure while others crumble on the exact same call? The answer isn't about years of experience—it's about understanding the neuroscience of stress and having the right mental tools.

 

Cody Winterford delivers an incredible breakdown of the five psychological "circles of hell" that providers face in high-stress situations. Starting with the amygdala hijack that triggers your fight-or-flight response, through the crisis of confidence that makes you question everything you've trained for, to analysis paralysis where you're drowning in information but can't make a decision—each level has specific warning signs and proven techniques to overcome it.

 

We explore why mental simulation is so effective and why elite athletes and the blue angels rely on it to perform at their peak. We discuss tactical breathing techniques, the power of self-talk and focus phrases (even inappropriate ones!), and how to recognize when life distractions are creating "brain fog" that prevents you from accessing your clinical knowledge.

 

This isn't theory—it's practical, field-tested mental performance strategies adapted from military and elite athletic training, specifically applied to EMS providers. If you've ever felt overwhelmed on scene, doubted your abilities during a critical call, or watched a partner struggle mentally, this episode provides the framework to understand and overcome those challenges.

 

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear 

 

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

 

 

Episode Blog Post- The 5 Levels of EMS Mental Breakdown and How to Escape Them

 

Guest/Cast/Crew information-

Guest- Cody Winniford, EMT-P, CCP-P, FP-C

@ordinary_ops_medic

@alertmedic1

 

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 2243 99 full Following Evidence or Following the Crowd? The Truth About Evidence-Based Medicine with Dr. Eddy Lang Following Evidence or Following the Crowd? The Truth About Evidence-Based Medicine with Dr. Eddy Lang https://loudandclear.podbean.com/e/following-evidence-or-following-the-crowd-the-truth-about-evidence-based-medicine-with-dr-eddy-lang/ https://loudandclear.podbean.com/e/following-evidence-or-following-the-crowd-the-truth-about-evidence-based-medicine-with-dr-eddy-lang/#comments Mon, 06 Oct 2025 08:00:00 -0600 loudandclear.podbean.com/40bc9024-00a4-382e-8dfd-28398967898a What if the evidence hierarchy you learned in school is incomplete? Dr. Eddie Lang, who helped develop the GRADE system now used by WHO and major resuscitation councils, explains why clinical practice guidelines—not RCTs or meta-analyses—should guide your practice decisions.

 

Join us at FASTCAN 25 as Dr. Lang, who's helped shap guidelines for the World Health Oganization (WHO) and the International Liaison Committee on Resuscitation (ILCOR), dismantles common misconceptions about evidence-based medicine and explains how it has evolved over the years. It's no longer "whatever the study says"—it's now carefully evaluating research limitations, considering patient values, and assessing feasibility, acceptability, and equity. Clinical practice guidelines sometimes get a bad rap but Dr. Lang explains why they ultimately should sit atop the evidence hierarchy.

 

We also discuss game-changing AI applications in EMS: consolidated electronic health records enabling precision prehospital care, automated documentation, predictive analytics for patient destination, and an AI tool providing evidence synthesis with references in seconds. 

 

Whether you're a paramedic, nurse, or physician, this episode has the power to change how you evaluate and apply clinical evidence.

 

Subscribe for more evidence-based EMS content that cuts through the noise so that you never lose sight of the forest through the trees.

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

 

Guest/Cast/Crew information-

Guest- Eddy Lang, MD

Hosts- Ross Orpet, Will Berry 

 

Catch up with us after the show

Instagram- @emsloudandclear

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

]]> What if the evidence hierarchy you learned in school is incomplete? Dr. Eddie Lang, who helped develop the GRADE system now used by WHO and major resuscitation councils, explains why clinical practice guidelines—not RCTs or meta-analyses—should guide your practice decisions.

 

Join us at FASTCAN 25 as Dr. Lang, who's helped shap guidelines for the World Health Oganization (WHO) and the International Liaison Committee on Resuscitation (ILCOR), dismantles common misconceptions about evidence-based medicine and explains how it has evolved over the years. It's no longer "whatever the study says"—it's now carefully evaluating research limitations, considering patient values, and assessing feasibility, acceptability, and equity. Clinical practice guidelines sometimes get a bad rap but Dr. Lang explains why they ultimately should sit atop the evidence hierarchy.

 

We also discuss game-changing AI applications in EMS: consolidated electronic health records enabling precision prehospital care, automated documentation, predictive analytics for patient destination, and an AI tool providing evidence synthesis with references in seconds. 

 

Whether you're a paramedic, nurse, or physician, this episode has the power to change how you evaluate and apply clinical evidence.

 

Subscribe for more evidence-based EMS content that cuts through the noise so that you never lose sight of the forest through the trees.

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

 

Guest/Cast/Crew information-

Guest- Eddy Lang, MD

Hosts- Ross Orpet, Will Berry 

 

Catch up with us after the show

Instagram- @emsloudandclear

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

]]> Ross Orpet, Paramedic turned EMS Physician true No 938 98 full Toxidromes Demystified Toxidromes Demystified https://loudandclear.podbean.com/e/subtle-clues-can-you-spot-the-signs-toxidromes-demystified/ https://loudandclear.podbean.com/e/subtle-clues-can-you-spot-the-signs-toxidromes-demystified/#comments Mon, 29 Sep 2025 08:00:00 -0600 loudandclear.podbean.com/516afd26-bc34-3f24-81ba-0c60555c6744 Understanding the toxidromes provides you with vital diagnostic tools in high-stakes environments. In this episode, we break down the clinical patterns that define.

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 toxidromes- the clusters of signs and symptoms that point to poisoning or overdose. We explore the hallmark features of the most common toxidromes, highlight common pitfalls in recognition, and explain how early pattern recognition changes patient outcomes. But not all symptoms are what they seem. In this episode, we peel back the layers of toxidromes to show how overlapping signs can mislead even experienced providers. From pinpoint pupils to altered mental status, we examine which clues you can trust and which demand a deeper look. Packed with real-world relevance, this discussion will sharpen your clinical instincts and prepare you for the next toxicological mystery.

 

 

Guest/Cast/Crew information-

  • Hosts- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Understanding the toxidromes provides you with vital diagnostic tools in high-stakes environments. In this episode, we break down the clinical patterns that define.

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 toxidromes- the clusters of signs and symptoms that point to poisoning or overdose. We explore the hallmark features of the most common toxidromes, highlight common pitfalls in recognition, and explain how early pattern recognition changes patient outcomes. But not all symptoms are what they seem. In this episode, we peel back the layers of toxidromes to show how overlapping signs can mislead even experienced providers. From pinpoint pupils to altered mental status, we examine which clues you can trust and which demand a deeper look. Packed with real-world relevance, this discussion will sharpen your clinical instincts and prepare you for the next toxicological mystery.

 

 

Guest/Cast/Crew information-

  • Hosts- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 2173 97 full Rescue Breaths: Demystifying the Physiology of Safe and Effective BVM Ventilation Rescue Breaths: Demystifying the Physiology of Safe and Effective BVM Ventilation https://loudandclear.podbean.com/e/rescue-breaths-demystifying-the-physiology-of-safe-and-effective-patient-ventilation/ https://loudandclear.podbean.com/e/rescue-breaths-demystifying-the-physiology-of-safe-and-effective-patient-ventilation/#comments Mon, 22 Sep 2025 08:00:00 -0600 loudandclear.podbean.com/79cbeaaa-9967-312e-8a3e-f502571b8678 Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques. This episode highlights common mistakes like insufficient exhalation time, discusses driving pressure, and explains the importance of proper technique to avoid lung injury. We also explore the nuances of endotracheal tube size, laminar flow, and the transition from BVM to mechanical ventilation. From FASTCAN in Calgary this episode will enhance your understanding and skills in respiratory care.

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

 

Resources

Guest/Cast/Crew information-

Guest- Melody Bishop, RRT, CCAA

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques. This episode highlights common mistakes like insufficient exhalation time, discusses driving pressure, and explains the importance of proper technique to avoid lung injury. We also explore the nuances of endotracheal tube size, laminar flow, and the transition from BVM to mechanical ventilation. From FASTCAN in Calgary this episode will enhance your understanding and skills in respiratory care.

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

 

Resources

Guest/Cast/Crew information-

Guest- Melody Bishop, RRT, CCAA

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 1620 96 full Prehospital Blood, Trauma Arrest, Hypertension in Pregnancy, and Diltiazem in Afib with RVR Prehospital Blood, Trauma Arrest, Hypertension in Pregnancy, and Diltiazem in Afib with RVR https://loudandclear.podbean.com/e/emerging-guidelines-best-practices-on-prehospital-blood-trauma-arrest-hypertension-in-pregnancy-and-diltiazem-in-afib-with-rvr/ https://loudandclear.podbean.com/e/emerging-guidelines-best-practices-on-prehospital-blood-trauma-arrest-hypertension-in-pregnancy-and-diltiazem-in-afib-with-rvr/#comments Fri, 12 Sep 2025 17:56:44 -0600 loudandclear.podbean.com/813255d2-cea1-3b07-8147-dfc2c124ca0d Dr. Jeff Jarvis, EMS medical director and host of the EMS Lighthouse Project, delves into the latest emerging EMS literature and guidelines from the National Association of EMS Physicians. We explore best practices for blood use in trauma, up-to-date trauma arrest recommendations, postpartum hemorrhage, and severe hypertension in pregnancy. Additionally, we discuss recent studies on field intubation times, pre-hospital treatment of AFib with RVR, and pre-treating with calcium before diltiazem for patients in AFib. This episode is packed with crucial, evidence-based information for best practices in the prehospital setting. Don't miss out!

 

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

 

Resources

Guest/Cast/Crew information- Guest- Dr. Jeff Jarvis Host- Ross Orpet, Will Berry  Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com

Gear We Like

]]> Dr. Jeff Jarvis, EMS medical director and host of the EMS Lighthouse Project, delves into the latest emerging EMS literature and guidelines from the National Association of EMS Physicians. We explore best practices for blood use in trauma, up-to-date trauma arrest recommendations, postpartum hemorrhage, and severe hypertension in pregnancy. Additionally, we discuss recent studies on field intubation times, pre-hospital treatment of AFib with RVR, and pre-treating with calcium before diltiazem for patients in AFib. This episode is packed with crucial, evidence-based information for best practices in the prehospital setting. Don't miss out!

 

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

 

Resources

Guest/Cast/Crew information-
Guest- Dr. Jeff Jarvis
Host- Ross Orpet, Will Berry 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com

Gear We Like

]]> Ross Orpet, Paramedic turned EMS Physician true No 2978 95 full Unlocking the Hidden Keys to Calm Under Chaos: How Simple Tools Like A Checklist Can Elevate Your Care Unlocking the Hidden Keys to Calm Under Chaos: How Simple Tools Like A Checklist Can Elevate Your Care https://loudandclear.podbean.com/e/unlocking-the-hidden-keys-to-calm-under-chaos-how-simple-tools-like-a-checklist-can-elevate-your-care/ https://loudandclear.podbean.com/e/unlocking-the-hidden-keys-to-calm-under-chaos-how-simple-tools-like-a-checklist-can-elevate-your-care/#comments Sat, 16 Aug 2025 07:18:34 -0600 loudandclear.podbean.com/42517b12-86c4-31b1-8911-6e6f5b3383a1 What's the real difference between paramedics who stay calm under pressure and those who panic when everything goes wrong? It's the ability to already know what comes next. In this episode we explore the power of consistency and how one simple tool, often dismissed, can improve patient care and outcomes. Geoff Murphy, founder of Master Medics, sat down with us onsite at FAST25 to discuss how checklists can not only save lives but allow you to remain confident in knowing what is next on scene. Not to mention they're a great training tool as well.

Resources

Gear We Like

Guest/Cast/Crew information- Guest- Geoff Murphy Host- Ross Orpet, Will Berry  Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • 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

 

]]> What's the real difference between paramedics who stay calm under pressure and those who panic when everything goes wrong? It's the ability to already know what comes next. In this episode we explore the power of consistency and how one simple tool, often dismissed, can improve patient care and outcomes. Geoff Murphy, founder of Master Medics, sat down with us onsite at FAST25 to discuss how checklists can not only save lives but allow you to remain confident in knowing what is next on scene. Not to mention they're a great training tool as well.


Resources

Gear We Like

Guest/Cast/Crew information-
Guest- Geoff Murphy
Host- Ross Orpet, Will Berry 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • 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

 

]]> Ross Orpet, Paramedic turned EMS Physician true No 1278 94 full EXCITING NEWS! FIND OUT WHAT WE'VE BEEN WORKING ON. EXCITING NEWS! FIND OUT WHAT WE'VE BEEN WORKING ON. https://loudandclear.podbean.com/e/exciting-news-find-out-what-weve-been-working-on/ https://loudandclear.podbean.com/e/exciting-news-find-out-what-weve-been-working-on/#comments Sat, 09 Aug 2025 08:39:31 -0600 loudandclear.podbean.com/feb146e4-4fa1-3f45-a7ac-2e6769c08d24 Were have we been? Well, the truth is, we've been incredibly busy working on some really exciting projects.

If you're interested in joining the founding members cohort of  the Paramedic Confidence Builder Course reach out to me at ross@emspodcast.com before August 15th.

Project #1: Understanding New Paramedic Challenges

We launched a research project diving deep into understanding exactly what newer paramedics struggle with as they make that transition from school into the real world of EMS.

We all remember that feeling - you graduate paramedic school, you pass your registry, you get your first job, and then... reality hits. The textbook scenarios suddenly become real patients with real families, real emergencies, and real consequences and it turns out none of those patients read the textbook. There's this gap between what you learned in class and what you need to know to be truly confident and effective on the streets.

We've been talking to new paramedics, experienced providers, educators, and EMS leaders to really understand where those gaps are. What are the specific challenges? What makes the difference between a new paramedic who struggles and one who thrives? This research has been fascinating, and it's going to inform not just the educational episodes we create going forward, but it's also led us to our next project.

Project #2: The Paramedic Confidence Builder Course

This is what we're most excited about - we've developed what we're calling right now the Paramedic Confidence Builder Course.

This isn't just another continuing education program. This isn’t just a set of pre-recorded lectures. This is about taking everything we've learned from our research and creating a comprehensive program to help bridge that gap between school and street confidence.

I'm talking about mentorship, coaching, practical scenarios, decision-making frameworks, and most importantly - building the kind of unshakeable confidence that lets you walk into any call knowing you've got the tools and mindset to handle whatever comes your way.

We've got a fantastic group of paramedics signed up for our founding members cohort, and we're about to launch in one week. If this sounds like something that might be a good fit for you, we do have a very short window left and only a few spots remaining in this founding cohort, but f you're interested, send me an email before August 15th at ross@emspodcast.com and we can chat about whether the course might be right for you.

Project #3: Continuing Education Credits

The third project we've been working on is the ability to get continuing education credits for listening to our episodes.

We're currently beta testing this system, and I'm optimistic that we'll have it ready to launch by the end of the year. 

Looking Ahead

So that's what we've been up to. 

The good news is we're back on track. We hope to have our next regular episode released next week, so tune in for some more of that high-level continuing education you've come to expect from us here at Loud and Clear.

Thank you again for being such an incredible community. Your support, your feedback, your engagement - it all matters. It's what drives us to keep pushing forward and finding new ways to serve you better.

Until next time, stay safe out there, keep learning, and remember - every call, no matter how big or small, is an opportunity to make a difference.

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

]]> Were have we been? Well, the truth is, we've been incredibly busy working on some really exciting projects.

If you're interested in joining the founding members cohort of  the Paramedic Confidence Builder Course reach out to me at ross@emspodcast.com before August 15th.

Project #1: Understanding New Paramedic Challenges

We launched a research project diving deep into understanding exactly what newer paramedics struggle with as they make that transition from school into the real world of EMS.

We all remember that feeling - you graduate paramedic school, you pass your registry, you get your first job, and then... reality hits. The textbook scenarios suddenly become real patients with real families, real emergencies, and real consequences and it turns out none of those patients read the textbook. There's this gap between what you learned in class and what you need to know to be truly confident and effective on the streets.

We've been talking to new paramedics, experienced providers, educators, and EMS leaders to really understand where those gaps are. What are the specific challenges? What makes the difference between a new paramedic who struggles and one who thrives? This research has been fascinating, and it's going to inform not just the educational episodes we create going forward, but it's also led us to our next project.

Project #2: The Paramedic Confidence Builder Course

This is what we're most excited about - we've developed what we're calling right now the Paramedic Confidence Builder Course.

This isn't just another continuing education program. This isn’t just a set of pre-recorded lectures. This is about taking everything we've learned from our research and creating a comprehensive program to help bridge that gap between school and street confidence.

I'm talking about mentorship, coaching, practical scenarios, decision-making frameworks, and most importantly - building the kind of unshakeable confidence that lets you walk into any call knowing you've got the tools and mindset to handle whatever comes your way.

We've got a fantastic group of paramedics signed up for our founding members cohort, and we're about to launch in one week. If this sounds like something that might be a good fit for you, we do have a very short window left and only a few spots remaining in this founding cohort, but f you're interested, send me an email before August 15th at ross@emspodcast.com and we can chat about whether the course might be right for you.

Project #3: Continuing Education Credits

The third project we've been working on is the ability to get continuing education credits for listening to our episodes.

We're currently beta testing this system, and I'm optimistic that we'll have it ready to launch by the end of the year. 

Looking Ahead

So that's what we've been up to. 

The good news is we're back on track. We hope to have our next regular episode released next week, so tune in for some more of that high-level continuing education you've come to expect from us here at Loud and Clear.

Thank you again for being such an incredible community. Your support, your feedback, your engagement - it all matters. It's what drives us to keep pushing forward and finding new ways to serve you better.

Until next time, stay safe out there, keep learning, and remember - every call, no matter how big or small, is an opportunity to make a difference.

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

]]> Ross Orpet, Paramedic turned EMS Physician true No 416 93 bonus Engineering Simplicity in Crisis: Mastering Airway Management Through Systematic Approaches With Dr. Rich Levitan Engineering Simplicity in Crisis: Mastering Airway Management Through Systematic Approaches With Dr. Rich Levitan https://loudandclear.podbean.com/e/unlocking-the-airway-stress-vs-success-dr-rich-levitans-approach-to-engineering-success-in-high-stakes-medical-procedures/ https://loudandclear.podbean.com/e/unlocking-the-airway-stress-vs-success-dr-rich-levitans-approach-to-engineering-success-in-high-stakes-medical-procedures/#comments Mon, 30 Jun 2025 19:56:13 -0600 loudandclear.podbean.com/44f9bf12-805b-3250-8798-7b64b7891e22 Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance.

Resources

  • YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw
  • The Resus Tailor - https://www.theresustailor.com/

Gear We Like

Guest/Cast/Crew information- Guest- Dr. Rich Levitan Host- Ross Orpet, Will Berry  Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance.


Resources

  • YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw
  • The Resus Tailor - https://www.theresustailor.com/

Gear We Like

Guest/Cast/Crew information-
Guest- Dr. Rich Levitan
Host- Ross Orpet, Will Berry 

Catch up with us after the show

  • Instagram- @emsloudandclear
  • YouTube- https://www.youtube.com/@EMSLoudandClear
  • Website- www.emspodcast.com
]]> Ross Orpet, Paramedic turned EMS Physician true No 4180 92 full The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use https://loudandclear.podbean.com/e/the-cost-of-saving-lives-complications-arising-from-pre-hospital-tourniquet-use/ https://loudandclear.podbean.com/e/the-cost-of-saving-lives-complications-arising-from-pre-hospital-tourniquet-use/#comments Wed, 18 Jun 2025 11:30:13 -0600 loudandclear.podbean.com/0280ef58-f7ee-37ab-ab8a-17bca18dcf2b
  • The Resus Tailor - https://www.theresustailor.com/ 
  • Critical Appraisal Checklists- https://casp-uk.net/casp-tools-checklists/ 

    •  

    Gear We Like

    Books We Recommend

    Guest/Cast/Crew information- Guest- Dr. Ben Li Host- Ross Orpet, Will Berry  Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.co
    ]]>     Resources

     

    Gear We Like

    Books We Recommend

    Guest/Cast/Crew information-
    Guest- Dr. Ben Li
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.co
    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3086 91 full     Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It https://loudandclear.podbean.com/e/why-two-paramedics-watched-their-trainer-nearly-kill-a-patient-and-said-nothing-how-lessons-from-the-aviation-industry-could-have-prevented-it/ https://loudandclear.podbean.com/e/why-two-paramedics-watched-their-trainer-nearly-kill-a-patient-and-said-nothing-how-lessons-from-the-aviation-industry-could-have-prevented-it/#comments Sat, 31 May 2025 18:38:09 -0600 loudandclear.podbean.com/e3847b53-0766-3a73-a144-a8b76ccdc0d8 A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar?

    In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift.

    Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence.

    Key Concepts Covered:

    • Crew Resource Management (CRM)
    • Just Culture principles
    • Aviation Safety Action Program (ASAP)
    • Power distance in medical teams
    • Human factors in emergency medicine
    • Error prevention strategies

    Books Mentioned by Glen:

    Other Resources:

    Gear We Like:

    Other books we recommend:

    Guest/Cast/Crew information- Guest- Glen Host- Ross Orpet, Will Berry  Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>     A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar?

    In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift.

    Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence.

    Key Concepts Covered:

    • Crew Resource Management (CRM)
    • Just Culture principles
    • Aviation Safety Action Program (ASAP)
    • Power distance in medical teams
    • Human factors in emergency medicine
    • Error prevention strategies

    Books Mentioned by Glen:

    Other Resources:

    Gear We Like:

    Other books we recommend:

    Guest/Cast/Crew information-
    Guest- Glen
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 4477 90 full     The Art of Managing Agitated Patients The Art of Managing Agitated Patients https://loudandclear.podbean.com/e/navigating-crisis-the-art-of-managing-agitated-patients/ https://loudandclear.podbean.com/e/navigating-crisis-the-art-of-managing-agitated-patients/#comments Sun, 25 May 2025 14:57:58 -0600 loudandclear.podbean.com/4e68dace-7f88-38d3-9622-f103eac65140
  • The Resus Tailor - https://www.theresustailor.com/
  • The Art of Managing Agitated Patients Supplemental Blog Post - https://emspodcast.com/the-art-of-managing-agitated-patients/
    • Gear We Like Guest/Cast/Crew information- Guest- Patrick Hendley Host- Ross Orpet, Will Berry  Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>     Resources Gear We Like Guest/Cast/Crew information-
    Guest- Patrick Hendley
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 4764 89 full     Upper GI Bleed: Rescue Strategies From Recognition to Stabilization Upper GI Bleed: Rescue Strategies From Recognition to Stabilization https://loudandclear.podbean.com/e/upper-gi-bleed-rescue-strategies-from-recognition-to-stabilization/ https://loudandclear.podbean.com/e/upper-gi-bleed-rescue-strategies-from-recognition-to-stabilization/#comments Wed, 30 Apr 2025 06:00:00 -0600 loudandclear.podbean.com/a72908d4-a866-3a2c-9b8e-e08a59ce35b4 Resources

    Gear We Like

    Guest/Cast/Crew information- Guest-  Host- Ross Orpet, Will Berry  Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>
    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- 
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1477 88 full     These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS https://loudandclear.podbean.com/e/these-conversations-arent-black-and-white-dnr-advanced-directives-and-the-intersection-with-ems/ https://loudandclear.podbean.com/e/these-conversations-arent-black-and-white-dnr-advanced-directives-and-the-intersection-with-ems/#comments Mon, 14 Apr 2025 08:56:24 -0600 loudandclear.podbean.com/59ebfbc0-ebec-3db0-9f23-6aa4aaac1459
  • Get 10% off FAST25 with promo code- loud&clear
  • The Resus Tailor
  • Todays Episode Show Notes
  • Survey- Help us learn what content you want
    • Gear We Like Guest/Cast/Crew information- Guest- Daniel Markwalter, MD Host- Ross Orpet, Will Berry  Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
      ]]>     Resources Gear We Like Guest/Cast/Crew information-
    Guest- Daniel Markwalter, MD
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
      ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3363 87 full     BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There. BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There. https://loudandclear.podbean.com/e/wise-guys-from-fast24-where-we-were-where-were-going-and-how-we-get-there/ https://loudandclear.podbean.com/e/wise-guys-from-fast24-where-we-were-where-were-going-and-how-we-get-there/#comments Fri, 28 Mar 2025 10:12:11 -0600 loudandclear.podbean.com/26969256-a2f0-3a84-9360-0f512e796729 Resources

    Gear We Like

    Guest/Cast/Crew information- Guest- Allen Wolfe, Michael Frakes Host- Ross Orpet, Will Berry  Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com

     

    ]]>
    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- Allen Wolfe, Michael Frakes
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com

     

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1886 bonus     Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature https://loudandclear.podbean.com/e/unlocking-practice-changing-insights-a-paramedics-guide-to-reviewing-the-medical-literature/ https://loudandclear.podbean.com/e/unlocking-practice-changing-insights-a-paramedics-guide-to-reviewing-the-medical-literature/#comments Wed, 12 Mar 2025 20:12:53 -0600 loudandclear.podbean.com/5f286cdb-a3dc-3165-8c88-ac1eb71a4cfa Enter to win Airpods, Cric-a-lot, and a belt buckle! Resources that can help

    Critical appraisal guides:

    https://casp-uk.net/casp-tools-checklists/ (my personal favorite)

    https://jbi.global/critical-appraisal-tools

    Reporting guidelines (similar to appraisal guides, but more are standards for the investigators to use and follow):

    https://www.equator-network.org/reporting-guidelines

      00:00 Introduction and Priorities 00:34 Show Restructure Announcement 01:42 The Evolution of EMS Practices 03:57 Understanding Evidence-Based Medicine 05:23 Interview with Dr. Ben Lee 07:20 Approaching and Appraising Medical Studies 08:14 Challenges in EMS Research 13:47 Study Design and Hierarchy 31:33 Applying Research to Practice 39:26 Final Thoughts and Takeaways   Resources Gear We Like Guest/Cast/Crew information- Guest-  Host- Ross Orpet, Will Berry  Catch up with us after the show
    • Instagram- @emscast
    • Twitter- @ems_cast
    • Website- www.emspodcast.com
      ]]>     Enter to win Airpods, Cric-a-lot, and a belt buckle! Resources that can help

    Critical appraisal guides:

    https://casp-uk.net/casp-tools-checklists/ (my personal favorite)

    https://jbi.global/critical-appraisal-tools

    Reporting guidelines (similar to appraisal guides, but more are standards for the investigators to use and follow):

    https://www.equator-network.org/reporting-guidelines

      00:00 Introduction and Priorities 00:34 Show Restructure Announcement 01:42 The Evolution of EMS Practices 03:57 Understanding Evidence-Based Medicine 05:23 Interview with Dr. Ben Lee 07:20 Approaching and Appraising Medical Studies 08:14 Challenges in EMS Research 13:47 Study Design and Hierarchy 31:33 Applying Research to Practice 39:26 Final Thoughts and Takeaways   Resources Gear We Like Guest/Cast/Crew information-
    Guest- 
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show
    • Instagram- @emscast
    • Twitter- @ems_cast
    • Website- www.emspodcast.com
      ]]>     Ross Orpet, Paramedic turned EMS Physician true No 2462 86 full     How Equipment Design Can Save Lives: Why Your Bag Organization Matters More Than You Think How Equipment Design Can Save Lives: Why Your Bag Organization Matters More Than You Think https://loudandclear.podbean.com/e/why-your-ems-bag-could-be-failing-you-essential-design-tips-you-need/ https://loudandclear.podbean.com/e/why-your-ems-bag-could-be-failing-you-essential-design-tips-you-need/#comments Fri, 28 Feb 2025 06:34:00 -0700 loudandclear.podbean.com/d9e0f4b5-33a5-31a1-b923-8d6f22e26e72 SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle   00:00 Introduction to Bag Design Challenges 00:44 Real-Life Emergency Scenario 02:33 The Importance of Equipment Layout 03:15 Exciting Announcements and Rebranding 04:00 Meet the Hosts and Today's Guest 05:27 Adam LaChapelle's Journey and Passion 11:32 The SCRAM Bag and Its Impact 16:20 Principles of Effective Design 21:42 Innovative Bag Design for Quality Care 22:19 The Importance of Iteration in EMS Gear 23:49 Key Considerations for Bag Design 28:05 Reducing Friction in Emergency Response 30:46 Challenges and Solutions in EMS Bag Design 35:33 Customizing Bags for Specific Needs 36:54 Practical Tips for EMS Providers 39:40 Partnering with Recess Tailor for Custom Solutions 42:45 Exciting Giveaway Announcement 44:03 Summary and Key Takeaways

     

    Resources

    Gear We Like

    Guest/Cast/Crew information- Guest- Adam LaChapelle, Founder and CEO of The Resus Tailor Host- Ross Orpet, Will Berry  Catch up with us after the show

     

    Creative Commons - Attribution 3.0 Unported - CC BY 3.0 Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic]]>     SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle   00:00 Introduction to Bag Design Challenges 00:44 Real-Life Emergency Scenario 02:33 The Importance of Equipment Layout 03:15 Exciting Announcements and Rebranding 04:00 Meet the Hosts and Today's Guest 05:27 Adam LaChapelle's Journey and Passion 11:32 The SCRAM Bag and Its Impact 16:20 Principles of Effective Design 21:42 Innovative Bag Design for Quality Care 22:19 The Importance of Iteration in EMS Gear 23:49 Key Considerations for Bag Design 28:05 Reducing Friction in Emergency Response 30:46 Challenges and Solutions in EMS Bag Design 35:33 Customizing Bags for Specific Needs 36:54 Practical Tips for EMS Providers 39:40 Partnering with Recess Tailor for Custom Solutions 42:45 Exciting Giveaway Announcement 44:03 Summary and Key Takeaways

     


    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- Adam LaChapelle, Founder and CEO of The Resus Tailor
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

     

    Creative Commons - Attribution 3.0 Unported - CC BY 3.0
    Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo
    Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic]]>     Ross Orpet, Paramedic turned EMS Physician true No 2741 85 full     NEW NAME! The podcast gets a new name, find out what and why... NEW NAME! The podcast gets a new name, find out what and why... https://loudandclear.podbean.com/e/new-name-the-podcast-gets-a-new-name-find-out-what-and-why/ https://loudandclear.podbean.com/e/new-name-the-podcast-gets-a-new-name-find-out-what-and-why/#comments Thu, 20 Feb 2025 17:04:00 -0700 emscast.podbean.com/3c919be4-21ff-3531-a0bc-814a55363d1f Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey.

    Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our podcast, originally named EMS Cast. Each year we have become more and more dedicated to our mission. However, as time passed, it became clear that our name didn't quite capture the essence of what we stand for—our mission or our identity as educators in the EMS field.

    Will and I devoted significant effort into clarifying our mission this last year. Determining how we could create a framework to help you navigate the inevitable uncertainties in EMS, to put an emphasis on what truly and what principles will guide you through the uncertainty. This framework is going to allow us  to bring you even better content with clearer messaging. We wanted a name that resonates with our commitment to provide in-depth discussions that extend beyond paramedic school learning but yet never loses sight of the fundamentals and guiding principles that actually matter. After months of brainstorming and reflection, Loud & Clear: EMS Guiding Principles felt like the perfect match—an embodiment of our dedication to make every lesson resonate strongly and clearly with you, the listener.

    In the world of EMS, ‘loud and clear’ is a phrase many of us know very well, whether you’re checking in with dispatch over the radio at the start of your shift or confirming the receiving hospital can clearly understand you. It signifies that there is clarity and understanding in the message that is received. We aim to bring this clarity  to every topic we discuss. Reinforcing our commitment to delivering information that is easy to comprehend and apply in real-life EMS situations, even when uncertainty abounds.

    While our name may have changed and our episode framework has evolved, our mission has not. We will continue to provide high level education, seeking to teach you principles that enrich your knowledge beyond the textbooks you read in paramedic school, preparing you for the unexpected scenarios you’ll face in the field. You won’t find cookie-cutter approaches here—we’re dedicated to helping you understand and fall back on an understanding of fundamental principles that allow you to navigate the uncertainty and chaos with confidence.

    Each episode of Loud & Clear will present high-level discussions about pathophysiology and treatment options. But more than that, every episode will guide you back to those time-tested EMS principles crucial for effective decision-making. This year promises ever more engaging content rich episodes, with an updated name, cover art, social media presence, and more as we embrace this exciting transition.

    We can't wait to embark on this new journey with you, our dedicated listeners. Thank you for your support and enthusiasm. Remember—we’re here to ensure your learning experience is loud and clear.

     

    Resources:

    ]]>     Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey.

    Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our podcast, originally named EMS Cast. Each year we have become more and more dedicated to our mission. However, as time passed, it became clear that our name didn't quite capture the essence of what we stand for—our mission or our identity as educators in the EMS field.

    Will and I devoted significant effort into clarifying our mission this last year. Determining how we could create a framework to help you navigate the inevitable uncertainties in EMS, to put an emphasis on what truly and what principles will guide you through the uncertainty. This framework is going to allow us  to bring you even better content with clearer messaging. We wanted a name that resonates with our commitment to provide in-depth discussions that extend beyond paramedic school learning but yet never loses sight of the fundamentals and guiding principles that actually matter. After months of brainstorming and reflection, Loud & Clear: EMS Guiding Principles felt like the perfect match—an embodiment of our dedication to make every lesson resonate strongly and clearly with you, the listener.

    In the world of EMS, ‘loud and clear’ is a phrase many of us know very well, whether you’re checking in with dispatch over the radio at the start of your shift or confirming the receiving hospital can clearly understand you. It signifies that there is clarity and understanding in the message that is received. We aim to bring this clarity  to every topic we discuss. Reinforcing our commitment to delivering information that is easy to comprehend and apply in real-life EMS situations, even when uncertainty abounds.

    While our name may have changed and our episode framework has evolved, our mission has not. We will continue to provide high level education, seeking to teach you principles that enrich your knowledge beyond the textbooks you read in paramedic school, preparing you for the unexpected scenarios you’ll face in the field. You won’t find cookie-cutter approaches here—we’re dedicated to helping you understand and fall back on an understanding of fundamental principles that allow you to navigate the uncertainty and chaos with confidence.

    Each episode of Loud & Clear will present high-level discussions about pathophysiology and treatment options. But more than that, every episode will guide you back to those time-tested EMS principles crucial for effective decision-making. This year promises ever more engaging content rich episodes, with an updated name, cover art, social media presence, and more as we embrace this exciting transition.

    We can't wait to embark on this new journey with you, our dedicated listeners. Thank you for your support and enthusiasm. Remember—we’re here to ensure your learning experience is loud and clear.

     

    Resources:

    ]]>     Ross Orpet, Paramedic turned EMS Physician false No 228 84 bonus     Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes https://loudandclear.podbean.com/e/unlocking-syncope-a-harbinger-of-hidden-perils-differentiating-benign-from-life-threatening-causes/ https://loudandclear.podbean.com/e/unlocking-syncope-a-harbinger-of-hidden-perils-differentiating-benign-from-life-threatening-causes/#comments Tue, 11 Feb 2025 11:44:38 -0700 emscast.podbean.com/22ac947b-a244-32d5-9f76-47f3a6813252
  • The Resus Tailor
  • EMS Cast Syncope Blog Post
  • Other episodes you might like: Wide Complex Tachycardia
  • Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES
  • Survey- Help us learn what content you want
    • Gear We Like Guest/Cast/Crew information- Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-Host Hosts- Ross Orpet, Will Berry  Catch up with us after the show Creative Commons - Attribution 3.0 Unported - CC BY 3.0 Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic ]]>     Resources Gear We Like Guest/Cast/Crew information-
    Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-Host
    Hosts- Ross Orpet, Will Berry 

    Catch up with us after the show Creative Commons - Attribution 3.0 Unported - CC BY 3.0
    Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo
    Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic
    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3541 83 full     Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS https://loudandclear.podbean.com/e/invisible-scars-the-battle-for-mental-health-in-ems-path4ems/ https://loudandclear.podbean.com/e/invisible-scars-the-battle-for-mental-health-in-ems-path4ems/#comments Fri, 31 Jan 2025 06:48:00 -0700 emscast.podbean.com/90232dc1-8ce2-344d-bc13-9ac4131227af Resources

    Gear We Like

    Guest/Cast/Crew information- Guest- Jessica Nelson, PATH4EMS coordinator Host- Ross Orpet, Will Berry  Catch up with us after the show

     

    ]]>
    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- Jessica Nelson, PATH4EMS coordinator
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

     

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 2224 82 full     Wide Complex Tachycardia: Get Comfortable With Uncertainty Wide Complex Tachycardia: Get Comfortable With Uncertainty https://loudandclear.podbean.com/e/wide-complex-tachycardia-get-comfortable-with-uncertainty/ https://loudandclear.podbean.com/e/wide-complex-tachycardia-get-comfortable-with-uncertainty/#comments Tue, 14 Jan 2025 15:02:20 -0700 emscast.podbean.com/fea95337-74e2-3610-b830-780d37ecd14e Resources

    Gear We Like

    Guest/Cast/Crew information- Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculum Host- Ross Orpet, Will Berry  Catch up with us after the show

     

    ]]>
    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculum
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

     

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3602 81 full     Trailer - Loud & Clear: EMS Guiding Principles Trailer - Loud & Clear: EMS Guiding Principles https://loudandclear.podbean.com/e/trailer-ems-cast/ https://loudandclear.podbean.com/e/trailer-ems-cast/#comments Sat, 28 Dec 2024 10:37:36 -0700 emscast.podbean.com/71f7e4b0-3440-3ab1-aad4-bfddc0214ccb You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there for someone on the worst day of their life. To change an outcome that would have otherwise been catastrophic if you weren’t there.

    There’s no resource for the practicing paramedic to plug the holes that were left behind by paramedic school. Everything seems stuck in basic algorithms of “A” then “do B” but what do you do when "A” wasn’t in the book. We need to get away from the algorithmic thinking and instead shift to understanding the principles behind WHY if A then B.

    The truth is, you can’t learn it all. Emergency Medicine includes too many pathologies and 911 calls are too unique and chaotic to know the answer to every situation. Instead of trying to learn every answer to every call, you need guiding principles for your knowledge to stand on. If you build these principles they become the foundation for every call no matter the complaint, for every situation, no matter the chaos surrounding you.

    If you have the foundation you can be stable when the storm comes. You can know when to push forward or when to change course. And then each additional piece of advanced content that you learn can be added to that foundation to build on, because mastery is not a destination, it’s a journey and the journey never ends.

    We are your hosts, Ross Orpet & Will Berry and this is EMS Cast.

    Come on this journey with us to mastering emergency medicine. We will cover topics in more depth than you learned in paramedic school, we will teach one step further and talk about what will happen to that patient in the Emergency Department after you drop them off. And we will connect all of this back to the principles that will guide you not just on this call but on all the calls. These principles will allow you to answer the question, at the end of the day, what’s really important to me, the paramedic, in the field, in that moment. You may not feel ready, you may not feel like you know enough, but you can understand the principles and that will make all the difference. Because what you do matters.   Resources: ]]>     You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there for someone on the worst day of their life. To change an outcome that would have otherwise been catastrophic if you weren’t there.

    There’s no resource for the practicing paramedic to plug the holes that were left behind by paramedic school. Everything seems stuck in basic algorithms of “A” then “do B” but what do you do when "A” wasn’t in the book. We need to get away from the algorithmic thinking and instead shift to understanding the principles behind WHY if A then B.

    The truth is, you can’t learn it all. Emergency Medicine includes too many pathologies and 911 calls are too unique and chaotic to know the answer to every situation. Instead of trying to learn every answer to every call, you need guiding principles for your knowledge to stand on. If you build these principles they become the foundation for every call no matter the complaint, for every situation, no matter the chaos surrounding you.

    If you have the foundation you can be stable when the storm comes. You can know when to push forward or when to change course. And then each additional piece of advanced content that you learn can be added to that foundation to build on, because mastery is not a destination, it’s a journey and the journey never ends.

    We are your hosts, Ross Orpet & Will Berry and this is EMS Cast.

    Come on this journey with us to mastering emergency medicine. We will cover topics in more depth than you learned in paramedic school, we will teach one step further and talk about what will happen to that patient in the Emergency Department after you drop them off. And we will connect all of this back to the principles that will guide you not just on this call but on all the calls. These principles will allow you to answer the question, at the end of the day, what’s really important to me, the paramedic, in the field, in that moment. You may not feel ready, you may not feel like you know enough, but you can understand the principles and that will make all the difference. Because what you do matters.   Resources: ]]>     Ross Orpet, Paramedic turned EMS Physician false No 164 trailer     From Novice to Navigator: Mastering the Art of EMS Field Training From Novice to Navigator: Mastering the Art of EMS Field Training https://loudandclear.podbean.com/e/from-novice-to-navigator-mastering-the-art-of-ems-field-training/ https://loudandclear.podbean.com/e/from-novice-to-navigator-mastering-the-art-of-ems-field-training/#comments Mon, 23 Dec 2024 05:00:00 -0700 emscast.podbean.com/22026df5-6b1d-36c7-8d6c-0259c0cf1ecd
  • Contact The Resus Tailor
  • Watch this episode on YouTube
  • Read the blog post for this episode
  • Other episodes you might like:
  • Podcast announcements- Big news coming in 2025! Stay Tuned!
  • Survey- Help us learn what content you want
    • Gear We Like Guest/Cast/Crew information- Guest- Josh, Cody, Moose Host- Ross Orpet, Will Berry  Catch up with us after the show
    • Instagram- @emscast
    • Twitter- @ems_cast
    • Website- www.emspodcast.com
        ]]>     Resources Gear We Like Guest/Cast/Crew information-
    Guest- Josh, Cody, Moose
    Host- Ross Orpet, Will Berry 

    Catch up with us after the show
    • Instagram- @emscast
    • Twitter- @ems_cast
    • Website- www.emspodcast.com

        ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3994 80 full     The Difference Between Equal and Equitable Care The Difference Between Equal and Equitable Care https://loudandclear.podbean.com/e/the-difference-between-equal-and-equitable-care/ https://loudandclear.podbean.com/e/the-difference-between-equal-and-equitable-care/#comments Thu, 05 Dec 2024 22:19:24 -0700 emscast.podbean.com/d0b2981c-735f-35f6-bfef-465429d9f02a
  • Good Stethoscope - https://amzn.to/3YJJrf2
  • Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
  • Notepad for taking notes on calls - https://amzn.to/3Z1X21J
  • Sunglasses - https://frontline-optics.com/discount/EMSCAST15
  • Books we recommend - 
    • Guest/Cast/Crew information- Guest- Ritu Sani, MD and Co-host of The EMS Show podcast Host- Ross Orpet, Chris Pfingsten from EMS 20/20 Catch up with us after the show ]]>
  • Good Stethoscope - https://amzn.to/3YJJrf2
  • Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
  • Notepad for taking notes on calls - https://amzn.to/3Z1X21J
  • Sunglasses - https://frontline-optics.com/discount/EMSCAST15
  • Books we recommend - 
    • Guest/Cast/Crew information-
    Guest- Ritu Sani, MD and Co-host of The EMS Show podcast
    Host- Ross Orpet, Chris Pfingsten from EMS 20/20

    Catch up with us after the show ]]>     Ross Orpet, Paramedic turned EMS Physician true No 972 79 full     Life Over Limb: Field Amputation, Preparing for the Unthinkable Life Over Limb: Field Amputation, Preparing for the Unthinkable https://loudandclear.podbean.com/e/life-over-limb-field-amputation-preparing-for-the-unthinkable/ https://loudandclear.podbean.com/e/life-over-limb-field-amputation-preparing-for-the-unthinkable/#comments Wed, 20 Nov 2024 08:06:03 -0700 emscast.podbean.com/e45e68b2-e514-3fdd-9bc9-b8761f7dbb24 Dr. Avery McKenzie interviews Dr. Eric Adler, regional medical director for Flight for Life, about the challenging and rare procedure of field amputations. They discuss the importance of being prepared for the unexpected, the steps involved in developing a protocol for such emergencies, and the logistical challenges faced during the process. Dr. Adler shares insights from real-life cases and emphasizes the critical need for planning and knowing the resources available in urgent scenarios.

      00:00 Emergency Field Amputation: A Real-Life Scenario 00:25 The Reality of Unlikely Medical Emergencies 02:04 Introducing Today's Episode and Guest 04:26 Dr. Eric Adler's Experience and Protocol Development 05:46 Indications and Procedures for Field Amputation 10:50 Challenges in Creating a Field Amputation Protocol 14:23 Final Thoughts and Preparedness  

    Resources

    Gear We Like

    Guest/Cast/Crew information- Guest- Erik Adler Host- Ross Orpet, Avery Mackenzie Catch up with us after the show

    • Instagram- @emscast
    • Website- www.emspodcast.com

     

    ]]>     Dr. Avery McKenzie interviews Dr. Eric Adler, regional medical director for Flight for Life, about the challenging and rare procedure of field amputations. They discuss the importance of being prepared for the unexpected, the steps involved in developing a protocol for such emergencies, and the logistical challenges faced during the process. Dr. Adler shares insights from real-life cases and emphasizes the critical need for planning and knowing the resources available in urgent scenarios.

      00:00 Emergency Field Amputation: A Real-Life Scenario 00:25 The Reality of Unlikely Medical Emergencies 02:04 Introducing Today's Episode and Guest 04:26 Dr. Eric Adler's Experience and Protocol Development 05:46 Indications and Procedures for Field Amputation 10:50 Challenges in Creating a Field Amputation Protocol 14:23 Final Thoughts and Preparedness  

    Resources

    Gear We Like

    Guest/Cast/Crew information-
    Guest- Erik Adler
    Host- Ross Orpet, Avery Mackenzie

    Catch up with us after the show

    • Instagram- @emscast
    • Website- www.emspodcast.com

     

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 926 78 full     The Untold Impact of EMS on Organ Donation: Transforming Tragedy into Hope The Untold Impact of EMS on Organ Donation: Transforming Tragedy into Hope https://loudandclear.podbean.com/e/the-untold-impact-of-ems-on-organ-donation-transforming-tragedy-into-hope/ https://loudandclear.podbean.com/e/the-untold-impact-of-ems-on-organ-donation-transforming-tragedy-into-hope/#comments Mon, 04 Nov 2024 14:10:28 -0700 emscast.podbean.com/863c78ff-ce38-3141-884b-34f92328f015  

    Guest/Cast/Crew information-

    Guest- Chris Meeks, Critical Care Flight Paramedic, Organ Recovery Coordinator

    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

    ]]>      

    Guest/Cast/Crew information-

    Guest- Chris Meeks, Critical Care Flight Paramedic, Organ Recovery Coordinator

    Host- Ross Orpet, Will Berry 

    Catch up with us after the show

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 991 77 full     Values-Driven Leadership Within A Just Culture- Chris Pfingsten from EMS 20/20 Values-Driven Leadership Within A Just Culture- Chris Pfingsten from EMS 20/20 https://loudandclear.podbean.com/e/values-driven-leadership-within-a-just-culture-chris-pfingsten-from-ems-2020/ https://loudandclear.podbean.com/e/values-driven-leadership-within-a-just-culture-chris-pfingsten-from-ems-2020/#comments Mon, 21 Oct 2024 06:00:00 -0600 emscast.podbean.com/b9b93198-d294-3a96-b35a-3ae0627cc35e Creating lasting behavioral changes in the workplace by moving beyond consequence-based policies. Chris discusses the importance of aligning personal and company values, highlighting 'just culture' in EMS and its role in understanding motivations and systemic issues. The conversation covers leadership in EMS, focusing on the significance of fostering supportive relationships with staff and avoiding fear-based management. Additionally, Chris shares his journey from paramedic to Field Training Officer, offering advice on effective training and mutual support. This episode is packed with valuable insights for anyone in the EMS field aiming to enhance performance, commitment, and team dynamics. Don't forget to check below for further resources on just culture and motivational learning.

     

    Guest/Cast/Crew information-

    Guest- Chris Pfingsten, Co-host of EMS 20/20

    Host- Ross Orpet, Will Berry 

     

    Resources

     

    Catch up with us after the show

    ]]>     Creating lasting behavioral changes in the workplace by moving beyond consequence-based policies. Chris discusses the importance of aligning personal and company values, highlighting 'just culture' in EMS and its role in understanding motivations and systemic issues. The conversation covers leadership in EMS, focusing on the significance of fostering supportive relationships with staff and avoiding fear-based management. Additionally, Chris shares his journey from paramedic to Field Training Officer, offering advice on effective training and mutual support. This episode is packed with valuable insights for anyone in the EMS field aiming to enhance performance, commitment, and team dynamics. Don't forget to check below for further resources on just culture and motivational learning.

     

    Guest/Cast/Crew information-

    Guest- Chris Pfingsten, Co-host of EMS 20/20

    Host- Ross Orpet, Will Berry 

     

    Resources

     

    Catch up with us after the show

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1056 76 full     Are They Choking? Esophageal Foreign Body Are They Choking? Esophageal Foreign Body https://loudandclear.podbean.com/e/are-they-choking-esophageal-foreign-body/ https://loudandclear.podbean.com/e/are-they-choking-esophageal-foreign-body/#comments Mon, 07 Oct 2024 06:10:00 -0600 emscast.podbean.com/6e9b65b8-6276-3cbc-89f5-017625161c5f
  • Resources and links

    •  

     

    Guest/Cast/Crew information-

    Host- Ross Orpet, Will Berry 

     

    Catch up with us after the show

      00:00 Introduction to Esophageal Foreign Bodies 00:43 Audience Survey and Sunglasses Giveaway 01:46 Interview with Contest Winner 06:11 A Choking Incident at Mile High Stadium 09:02 Discussion on Esophageal Obstructions 11:46 Life-Saving Story at Denver International Airport 13:28 A Life-Saving Outcome 14:11 The Choking Incident at the Tavern 14:57 Assessing the Patient's Condition 19:38 Understanding Esophageal Food Impaction 21:49 Treatment Options and Challenges 29:01 The Role of Endoscopy 37:45 Managing Esophageal Impactions in the Field 39:32 Final Thoughts ]]>
  • Resources and links

    •  

     

    Guest/Cast/Crew information-

    Host- Ross Orpet, Will Berry 

     

    Catch up with us after the show

      00:00 Introduction to Esophageal Foreign Bodies 00:43 Audience Survey and Sunglasses Giveaway 01:46 Interview with Contest Winner 06:11 A Choking Incident at Mile High Stadium 09:02 Discussion on Esophageal Obstructions 11:46 Life-Saving Story at Denver International Airport 13:28 A Life-Saving Outcome 14:11 The Choking Incident at the Tavern 14:57 Assessing the Patient's Condition 19:38 Understanding Esophageal Food Impaction 21:49 Treatment Options and Challenges 29:01 The Role of Endoscopy 37:45 Managing Esophageal Impactions in the Field 39:32 Final Thoughts ]]>     Ross Orpet, Paramedic turned EMS Physician true No 2384 75 full     10 Lessons From A Real Austere Rescue That Apply To You, No Matter Where You Work 10 Lessons From A Real Austere Rescue That Apply To You, No Matter Where You Work https://loudandclear.podbean.com/e/10-lessons-from-a-real-austere-rescue-that-apply-to-you-no-matter-where-you-work/ https://loudandclear.podbean.com/e/10-lessons-from-a-real-austere-rescue-that-apply-to-you-no-matter-where-you-work/#comments Mon, 23 Sep 2024 05:58:00 -0600 emscast.podbean.com/e3514093-32f6-3499-889b-c34359b106c7 Delve into a real-life rescue mission conducted by the U.S. Air Force Pararescue Jumpers (PJs) in the North Atlantic Ocean and learn ten crucial lessons for enhancing EMS practice. Dr. Michael Lauria shares these ten critical lessons from this challenging scenario that are essential for medical professionals working in any prehospital environment. From the importance of preparation and the power of a small team, to the significance of continuous learning and the dynamic nature of safety, these insights are invaluable for enhancing clinical practice. Tune in to learn how these lessons can be applied to improve how you approach the job.

    Guest/Cast/Crew information-

    Guest- Dr. Mike Lauria

    Host- Ross Orpet, Will Berry 

    Resources

    • Other episodes you might like
    • Third-party websites where you can learn more
    • Podcast announcements

    Catch up with us after the show

    ]]>     Delve into a real-life rescue mission conducted by the U.S. Air Force Pararescue Jumpers (PJs) in the North Atlantic Ocean and learn ten crucial lessons for enhancing EMS practice. Dr. Michael Lauria shares these ten critical lessons from this challenging scenario that are essential for medical professionals working in any prehospital environment. From the importance of preparation and the power of a small team, to the significance of continuous learning and the dynamic nature of safety, these insights are invaluable for enhancing clinical practice. Tune in to learn how these lessons can be applied to improve how you approach the job.

    Guest/Cast/Crew information-

    Guest- Dr. Mike Lauria

    Host- Ross Orpet, Will Berry 

    Resources

    • Other episodes you might like
    • Third-party websites where you can learn more
    • Podcast announcements

    Catch up with us after the show

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1969 74 full     Bonus: A Better BVM? How I Built This EMS Cast Style- A Crazy Story About an Emergency Nurses Invention and Battle to Save Lives and Prevent Harm. Bonus: A Better BVM? How I Built This EMS Cast Style- A Crazy Story About an Emergency Nurses Invention and Battle to Save Lives and Prevent Harm. https://loudandclear.podbean.com/e/bonus-a-better-bvm-how-i-built-this-ems-cast-style-a-crazy-story-about-an-emergency-nurses-invention-and-battle-to-save-lives-and-prevent-harm/ https://loudandclear.podbean.com/e/bonus-a-better-bvm-how-i-built-this-ems-cast-style-a-crazy-story-about-an-emergency-nurses-invention-and-battle-to-save-lives-and-prevent-harm/#comments Mon, 16 Sep 2024 06:00:00 -0600 emscast.podbean.com/61b7b754-f875-319a-8d19-b4c7624784fe VT Select Bag Valve Mask A Review of Ventilation in OHCA

    Pediatric BVM Delivers More Ideal Volumes in Mannequins

    Small BVMs Lead to Decreased Survival in a Small Real World Study 

    00:00 The Problem with Overventilation 00:53 Introduction to the VT Select Device 02:01 Meet the Inventor: Bobby Sue McCollum 05:06 The Journey of Invention 12:10 How the VT Select Works 14:04 Challenges and Triumphs 27:37 Advice for Aspiring Inventors 31:15 Conclusion and Final Thoughts   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]]>     VT Select Bag Valve Mask A Review of Ventilation in OHCA

    Pediatric BVM Delivers More Ideal Volumes in Mannequins

    Small BVMs Lead to Decreased Survival in a Small Real World Study 

    00:00 The Problem with Overventilation 00:53 Introduction to the VT Select Device 02:01 Meet the Inventor: Bobby Sue McCollum 05:06 The Journey of Invention 12:10 How the VT Select Works 14:04 Challenges and Triumphs 27:37 Advice for Aspiring Inventors 31:15 Conclusion and Final Thoughts   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]]>     Ross Orpet, Paramedic turned EMS Physician true No 1926 bonus     The Critical Four Minutes: AMAX4 framework for Anaphylaxis The Critical Four Minutes: AMAX4 framework for Anaphylaxis https://loudandclear.podbean.com/e/the-critical-four-minutes-amax4-framework-for-anaphylaxis/ https://loudandclear.podbean.com/e/the-critical-four-minutes-amax4-framework-for-anaphylaxis/#comments Mon, 09 Sep 2024 06:00:00 -0600 emscast.podbean.com/e4c24f7e-1d43-3d2f-b202-6a37c8bc1841 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. 

    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

    ]]>     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. 

    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

    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1827 73 full     From Errors to Excellence: Master Your Medics Geoff Murphy on the role of mistakes in EMS education From Errors to Excellence: Master Your Medics Geoff Murphy on the role of mistakes in EMS education https://loudandclear.podbean.com/e/from-error-to-excellence-master-your-medics-geoff-murphy-on-the-role-of-mistakes-in-ems-education/ https://loudandclear.podbean.com/e/from-error-to-excellence-master-your-medics-geoff-murphy-on-the-role-of-mistakes-in-ems-education/#comments Mon, 26 Aug 2024 07:00:00 -0600 emscast.podbean.com/c4a73186-ad8a-329a-b5b7-e2e6d7a3647f 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.

    Guest/Cast/Crew information-

    Guest- Geoff Murphy, founder of Master Your Medics

    Host- Ross Orpet, Will Berry 

     

    Resources

    Catch up with us after the show

    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

    ]]>     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.

    Guest/Cast/Crew information-

    Guest- Geoff Murphy, founder of Master Your Medics

    Host- Ross Orpet, Will Berry 

     

    Resources

    Catch up with us after the show

    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



    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 1506 72 full     Poisons of the Sea: Not Just a Coastal Problem Poisons of the Sea: Not Just a Coastal Problem https://loudandclear.podbean.com/e/ep-71-poisons-of-the-sea-not-just-a-coastal-problem/ https://loudandclear.podbean.com/e/ep-71-poisons-of-the-sea-not-just-a-coastal-problem/#comments Mon, 12 Aug 2024 05:00:00 -0600 emscast.podbean.com/32b04c34-59e7-3b7c-8737-532e9104b199 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.

    Guest/Cast/Crew information-

    Guest- Dr. Nik Matsler

    Host- Dr. Ross Orpet and Critical Care Paramedic Will Berry 

    Resources

    Catch up with us after the show

    ]]>     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.

    Guest/Cast/Crew information-

    Guest- Dr. Nik Matsler

    Host- Dr. Ross Orpet and Critical Care Paramedic Will Berry 

    Resources

    Catch up with us after the show



    ]]>     Ross Orpet, Paramedic turned EMS Physician true No 3859 71 full     The Critically Sick Runner: Unraveling the Mystery at an Ultra-endurance Event with Dr. Whitney Barrett The Critically Sick Runner: Unraveling the Mystery at an Ultra-endurance Event with Dr. Whitney Barrett https://loudandclear.podbean.com/e/ep-70-the-sick-runner-unraveling-the-mystery-of-the-critical-runner-at-an-ultra-endurance-event-with-dr-whitney-barrett/ https://loudandclear.podbean.com/e/ep-70-the-sick-runner-unraveling-the-mystery-of-the-critical-runner-at-an-ultra-endurance-event-with-dr-whitney-barrett/#comments Mon, 29 Jul 2024 06:00:00 -0600 emscast.podbean.com/ac32ce1a-8bc0-3e97-8c04-721bf34c881e 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]]>     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]]>     Ross Orpet, Paramedic turned EMS Physician true No 3265 70 full     EMCRITs Scott Weingart on How to Master the Resuscitation EMCRITs Scott Weingart on How to Master the Resuscitation https://loudandclear.podbean.com/e/ep-69-scott-weingart-how-to-master-the-resuscitation/ https://loudandclear.podbean.com/e/ep-69-scott-weingart-how-to-master-the-resuscitation/#comments Mon, 15 Jul 2024 06:42:00 -0600 emscast.podbean.com/a60822d4-36b7-3656-bec0-161a8a31c50b 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

    ]]>     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

    ]]>     emscast true No 1338 69 full     Building Better Providers: Eric Bauer, Lessons from FlightBridgeED Building Better Providers: Eric Bauer, Lessons from FlightBridgeED https://loudandclear.podbean.com/e/ep-68-building-better-providers-eric-bauer-lessons-from-flightbridgeed/ https://loudandclear.podbean.com/e/ep-68-building-better-providers-eric-bauer-lessons-from-flightbridgeed/#comments Mon, 01 Jul 2024 05:53:00 -0600 emscast.podbean.com/2f0e30a0-821c-3f66-a8e1-e7946ff4ea79 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

    ]]>     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

    ]]>     emscast true No 1681 68 full     Mushrooms: The Perils and Pleasures with Toxicologist Dr. Nik Matsler Mushrooms: The Perils and Pleasures with Toxicologist Dr. Nik Matsler https://loudandclear.podbean.com/e/the-perils-and-pleasures-of-mushrooms-with-toxicologist-dr-nik-matsler/ https://loudandclear.podbean.com/e/the-perils-and-pleasures-of-mushrooms-with-toxicologist-dr-nik-matsler/#comments Sat, 15 Jun 2024 05:32:00 -0600 emscast.podbean.com/9754fa74-7a52-32ba-854a-c44f4d2d648d 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

    ]]>     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

    ]]>     emscast true No 2860 67 full     Electrical Injuries and Lightning strikes Electrical Injuries and Lightning strikes https://loudandclear.podbean.com/e/electrical-injuries-and-lightning-strikes/ https://loudandclear.podbean.com/e/electrical-injuries-and-lightning-strikes/#comments Fri, 31 May 2024 20:28:00 -0600 emscast.podbean.com/57a84ebe-9875-373e-92d2-6c4578776214 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.

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    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

    ]]>     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

    ]]>     emscast true No 3927 66 full     Stroke Care on the Streets, What Actually Matters? Bridging Research and Real-World EMS Stroke Care on the Streets, What Actually Matters? Bridging Research and Real-World EMS https://loudandclear.podbean.com/e/ep-65-stroke-care-on-the-streets-bridging-research-and-real-world-ems/ https://loudandclear.podbean.com/e/ep-65-stroke-care-on-the-streets-bridging-research-and-real-world-ems/#comments Wed, 15 May 2024 05:00:00 -0600 emscast.podbean.com/347ab3e9-ab47-3cf0-a61e-ff56c6e80fe5 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

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    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

     

    ]]>     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

     

    ]]>     emscast true No 3586 65 full     The Critically Burned Patient Part 2- What You learned About Fluids Was Wrong, A Simpler Approach The Critically Burned Patient Part 2- What You learned About Fluids Was Wrong, A Simpler Approach https://loudandclear.podbean.com/e/ep-64-the-critically-burned-patient-part-2/ https://loudandclear.podbean.com/e/ep-64-the-critically-burned-patient-part-2/#comments Wed, 01 May 2024 05:00:00 -0600 emscast.podbean.com/45eda49a-a21d-3c3a-b76a-60dfa5e44de6 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.

    ]]>     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.

    ]]>     emscast true No 3303 64 full     The Critically Burned Patient - Part 1 The Critically Burned Patient - Part 1 https://loudandclear.podbean.com/e/ep-63the-critically-burned-patient/ https://loudandclear.podbean.com/e/ep-63the-critically-burned-patient/#comments Mon, 15 Apr 2024 05:00:00 -0600 emscast.podbean.com/9e819e29-25b9-302f-8e1b-a7bb95bec027 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).

    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, 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).

    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, 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.

    ]]>     emscast true No 4313 63 full     Rethinking Priorities in Out-of-Hospital Cardiac Arrest - Which Comes First Epi or Airway? Rethinking Priorities in Out-of-Hospital Cardiac Arrest - Which Comes First Epi or Airway? https://loudandclear.podbean.com/e/rethinking-priorities-in-out-of-hospital-cardiac-arrest-which-comes-first-epi-or-airway/ https://loudandclear.podbean.com/e/rethinking-priorities-in-out-of-hospital-cardiac-arrest-which-comes-first-epi-or-airway/#comments Tue, 02 Apr 2024 15:56:57 -0600 emscast.podbean.com/af39580d-4016-3387-afda-0c30d515a33a 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

    ]]>     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

    ]]>     emscast true No 2311 62 full     Toxic Alcohols: Hidden Danger in Everyday Products and an Everyday Call Toxic Alcohols: Hidden Danger in Everyday Products and an Everyday Call https://loudandclear.podbean.com/e/ep-61-toxic-alcohols-a-hidden-danger-in-everyday-products-and-an-everyday-call/ https://loudandclear.podbean.com/e/ep-61-toxic-alcohols-a-hidden-danger-in-everyday-products-and-an-everyday-call/#comments Fri, 15 Mar 2024 05:00:00 -0600 emscast.podbean.com/cbc0cd5a-c5f4-3562-9ebf-d049064fe068 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.

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    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

    ]]>     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

    ]]>     emscast true No 3136 61 full     Art of Laryngoscopy- The SALAD technique (Suction-Assisted Laryngoscopy and Airway Decontamination) Art of Laryngoscopy- The SALAD technique (Suction-Assisted Laryngoscopy and Airway Decontamination) https://loudandclear.podbean.com/e/ep-60-art-of-laryngoscopy-the-salad-technique-suction-assisted-laryngoscopy-and-airway-decontamination/ https://loudandclear.podbean.com/e/ep-60-art-of-laryngoscopy-the-salad-technique-suction-assisted-laryngoscopy-and-airway-decontamination/#comments Fri, 01 Mar 2024 05:10:00 -0700 emscast.podbean.com/d42faf40-7c12-36f5-bfc2-4cdaae3f1456 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

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    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

    ]]>     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

    ]]>     emscast true No 2840 60 full     The Truth about Mechanical CPR Devices: What the Data Really Says The Truth about Mechanical CPR Devices: What the Data Really Says https://loudandclear.podbean.com/e/the-truth-about-mechanical-cpr-devices-what-the-data-really-says/ https://loudandclear.podbean.com/e/the-truth-about-mechanical-cpr-devices-what-the-data-really-says/#comments Thu, 15 Feb 2024 05:00:00 -0700 emscast.podbean.com/a02a49f5-a392-325d-b028-b4f130512f9a 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

    ]]>     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

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    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

    ]]>     emscast true No 1061 59 full     Neonatal Resuscitation: Conquering the Fear, Step By Step Guide For Emergency Providers Neonatal Resuscitation: Conquering the Fear, Step By Step Guide For Emergency Providers https://loudandclear.podbean.com/e/ep-58-neonatal-resuscitation-conquering-the-fear-a-step-by-step-guide-for-emergency-providers/ https://loudandclear.podbean.com/e/ep-58-neonatal-resuscitation-conquering-the-fear-a-step-by-step-guide-for-emergency-providers/#comments Thu, 01 Feb 2024 05:00:00 -0700 emscast.podbean.com/8eda23c5-b23e-30ee-bdda-7ae4316b94c9 Overcoming Fear in Neonatal Resuscitation: A Step-by-Step Guide

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    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

    ]]>     Overcoming Fear in Neonatal Resuscitation: A Step-by-Step Guide

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    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

    ]]>     emscast true No 2927 58 full     Crush Injury and Crush Syndrome- Is What You Learned Folklore? Crush Injury and Crush Syndrome- Is What You Learned Folklore? https://loudandclear.podbean.com/e/ep-57-crush-injury-and-crush-syndrome/ https://loudandclear.podbean.com/e/ep-57-crush-injury-and-crush-syndrome/#comments Mon, 15 Jan 2024 01:29:00 -0700 emscast.podbean.com/01a99714-348d-36d6-9571-f0162569b6e9 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.

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    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. 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

    ]]>     emscast true No 4029 57 full     Lessons From a Sage: Interview with Jim Barrick Lessons From a Sage: Interview with Jim Barrick https://loudandclear.podbean.com/e/ep-56-interview-with-jim-barrick-retired-flight-paramedic/ https://loudandclear.podbean.com/e/ep-56-interview-with-jim-barrick-retired-flight-paramedic/#comments Mon, 01 Jan 2024 01:07:00 -0700 emscast.podbean.com/4321b227-1755-39a1-b8cd-26d04783e21a 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

    ]]>     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

    ]]>     emscast true No 6161 56 full     Postpartum Hemorrhage- What To Do When the Bleeding Won't Stop Postpartum Hemorrhage- What To Do When the Bleeding Won't Stop https://loudandclear.podbean.com/e/ep-55-managing-postpartum-hemorrhage-in-the-field/ https://loudandclear.podbean.com/e/ep-55-managing-postpartum-hemorrhage-in-the-field/#comments Fri, 15 Dec 2023 08:33:51 -0700 emscast.podbean.com/508c810a-d901-331b-8ece-373418fbbacc 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:

    1. Tone: Involving inadequate uterine contraction, the most common cause.
    2. Trauma: Typically lacerations that result during delivery and can lead to significant bleeding.
    3. Tissue: Relates to retained placental tissue.
    4. 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

    ]]>     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:

    1. Tone: Involving inadequate uterine contraction, the most common cause.
    2. Trauma: Typically lacerations that result during delivery and can lead to significant bleeding.
    3. Tissue: Relates to retained placental tissue.
    4. 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

    ]]>     emscast true No 1321 55 full     Delivering Nuchal Cords, Breech Presentations, Shoulder Dystocias- Field Obstetrics, What To Do When Things Go Sideways Delivering Nuchal Cords, Breech Presentations, Shoulder Dystocias- Field Obstetrics, What To Do When Things Go Sideways https://loudandclear.podbean.com/e/ep-54-it-s-a-boy-difficult-deliveries-prehospital-obstetrics/ https://loudandclear.podbean.com/e/ep-54-it-s-a-boy-difficult-deliveries-prehospital-obstetrics/#comments Thu, 30 Nov 2023 01:20:00 -0700 emscast.podbean.com/cc17d3bb-643b-33aa-8e71-bac95ef940b1 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.

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    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 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

    ]]>     emscast true No 2855 54 full     Which is Better, Midazolam IV, IM or IN? Which is Better, Midazolam IV, IM or IN? https://loudandclear.podbean.com/e/ep53-midazolam-iv-vs-im-vs-in-a-real-world-study/ https://loudandclear.podbean.com/e/ep53-midazolam-iv-vs-im-vs-in-a-real-world-study/#comments Wed, 15 Nov 2023 05:50:00 -0700 emscast.podbean.com/b205ea93-f986-3241-aa0f-63eee7449799 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: 

    ]]>     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: 

    ]]>     emscast true No 2239 53 full     Non-Invasive Ventilation - Do You Understand the Physiology? Non-Invasive Ventilation - Do You Understand the Physiology? https://loudandclear.podbean.com/e/ep-52-noninvasive-positive-pressure-ventilation/ https://loudandclear.podbean.com/e/ep-52-noninvasive-positive-pressure-ventilation/#comments Wed, 01 Nov 2023 05:53:00 -0600 emscast.podbean.com/18da976f-36a6-3334-b75f-8a4db56ff825 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. 

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    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/

    ]]>     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/

    ]]>     emscast true No 2054 52 full     Can End Tidal CO2 Predict Mortality in Hemorrhagic Shock? Part 2 with Paramedic Courtney ”Coco” Wham Can End Tidal CO2 Predict Mortality in Hemorrhagic Shock? Part 2 with Paramedic Courtney ”Coco” Wham https://loudandclear.podbean.com/e/ep-51-end-tidal-co2-etco2as-apredictorof-mortalitymorbidityandneedfor-massive-transfusion-in-hemorrhagic-shockwithparamediccourtneycocowham/ https://loudandclear.podbean.com/e/ep-51-end-tidal-co2-etco2as-apredictorof-mortalitymorbidityandneedfor-massive-transfusion-in-hemorrhagic-shockwithparamediccourtneycocowham/#comments Sun, 15 Oct 2023 01:34:00 -0600 emscast.podbean.com/c45e1c64-3abe-3e31-a4ea-b2e6d6b20f54 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.

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    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

    ]]>     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.

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    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

    ]]>     emscast true No 1655 51 full     What Can End Tidal CO2 Tell Us About Hemorrhagic Shock? Part 1 with Trauma Surgeon Dr. Eric Campion What Can End Tidal CO2 Tell Us About Hemorrhagic Shock? Part 1 with Trauma Surgeon Dr. Eric Campion https://loudandclear.podbean.com/e/ep-50-end-tidal-co2-in-the-setting-of-hemorrhagic-shock-with-trauma-surgeon-dr-eric-campion/ https://loudandclear.podbean.com/e/ep-50-end-tidal-co2-in-the-setting-of-hemorrhagic-shock-with-trauma-surgeon-dr-eric-campion/#comments Sun, 01 Oct 2023 01:58:00 -0600 emscast.podbean.com/4babe02e-5f06-3c15-a06b-4e2981782dd4 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!

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    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!

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    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

    ]]>     emscast true No 1069 50 full     Recognizing Individual Differences: Personalized Approaches to Pain Management Recognizing Individual Differences: Personalized Approaches to Pain Management https://loudandclear.podbean.com/e/ep-49-personalized-approaches-to-pain-management-recognizing-individual-differences/ https://loudandclear.podbean.com/e/ep-49-personalized-approaches-to-pain-management-recognizing-individual-differences/#comments Fri, 15 Sep 2023 05:04:00 -0600 emscast.podbean.com/bdf7ca98-a1cf-3e0c-9992-7e73ba2c32e7 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.

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    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

    ]]>     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

    ]]>     emscast true No 1056 49 full     Legendary Trauma Surgeon Dr. Gene Moore - how REBOA is changing trauma resuscitative care Legendary Trauma Surgeon Dr. Gene Moore - how REBOA is changing trauma resuscitative care https://loudandclear.podbean.com/e/ep-48-resuscitative-endobascularballoon-occlusion-oftheaortareboalegendarytrauma-surgeondrgenemooreteaches-us-howthisis-changing-traumaresuscitative-c/ https://loudandclear.podbean.com/e/ep-48-resuscitative-endobascularballoon-occlusion-oftheaortareboalegendarytrauma-surgeondrgenemooreteaches-us-howthisis-changing-traumaresuscitative-c/#comments Fri, 01 Sep 2023 05:29:00 -0600 emscast.podbean.com/da641420-75a6-3cd5-a10b-1e03f43749ac 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. 

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    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

     

    ]]>     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

     

    ]]>     emscast true No 987 48 full     Are you sure you're prepared for your next intubation? Dr. Stacey Trent Reviews the most up-to-date literature for intubation best practices. Are you sure you're prepared for your next intubation? Dr. Stacey Trent Reviews the most up-to-date literature for intubation best practices. https://loudandclear.podbean.com/e/ep-47-are-you-prepared-for-your-next-intubation-dr-stacey-trent-reviews-the-most-up-to-date-literature-for-intubation-best-practices/ https://loudandclear.podbean.com/e/ep-47-are-you-prepared-for-your-next-intubation-dr-stacey-trent-reviews-the-most-up-to-date-literature-for-intubation-best-practices/#comments Tue, 15 Aug 2023 05:48:00 -0600 emscast.podbean.com/9755890e-3b91-3232-ba2e-9f0286858b58 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.

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    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

    ]]>     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.

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    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

    ]]>     emscast true No 1566 47 full     Disasters Don't Just Involve Adults. Are You Prepared For a Pediatric Disaster? Get Prepared with Dr. Jeffery Upperman Disasters Don't Just Involve Adults. Are You Prepared For a Pediatric Disaster? Get Prepared with Dr. Jeffery Upperman https://loudandclear.podbean.com/e/pediatric-disaster-preparedness-with-dr-jeffery-upperman/ https://loudandclear.podbean.com/e/pediatric-disaster-preparedness-with-dr-jeffery-upperman/#comments Tue, 01 Aug 2023 05:28:00 -0600 emscast.podbean.com/94513277-e1ce-342f-a59c-95561a1eb247 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.

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    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

    ]]>     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

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    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

    ]]>     emscast true No 1098 46 full     It's Not Just Back Pain. Spinal Emergencies with Dr. Bo Burns. It's Not Just Back Pain. Spinal Emergencies with Dr. Bo Burns. https://loudandclear.podbean.com/e/spinal-emergencies-with-dr-bo-burns/ https://loudandclear.podbean.com/e/spinal-emergencies-with-dr-bo-burns/#comments Sat, 15 Jul 2023 05:23:00 -0600 emscast.podbean.com/e64bcfc2-0468-37a5-aca7-6adb682c4883 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. 

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    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

    ]]>     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. 

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    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

    ]]>     emscast true No 1410 45 full     Errors, Needs, and Communication in The Pediatric Trauma Call with Pediatric Surgeon Dr. David Bliss Errors, Needs, and Communication in The Pediatric Trauma Call with Pediatric Surgeon Dr. David Bliss https://loudandclear.podbean.com/e/ep-44-taking-care-of-pediatric-trauma-patients-with-dr-david-bliss/ https://loudandclear.podbean.com/e/ep-44-taking-care-of-pediatric-trauma-patients-with-dr-david-bliss/#comments Sat, 01 Jul 2023 05:00:00 -0600 emscast.podbean.com/e5cb819d-4edd-306d-b049-f59a321d57d1 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.

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    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

     

    ]]>     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

     

    ]]>     emscast true No 1766 44 full     Why ECMO in the Trauma patient? Why ECMO in the Trauma patient? https://loudandclear.podbean.com/e/ecmo-in-the-trauma-patient-onsite-at-the-rocky-mountain-trauma-conference/ https://loudandclear.podbean.com/e/ecmo-in-the-trauma-patient-onsite-at-the-rocky-mountain-trauma-conference/#comments Sat, 17 Jun 2023 07:57:00 -0600 emscast.podbean.com/3b97c0d7-599e-3626-9cc1-fa7c1ce356c0 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. 

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    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

    ]]>     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

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    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

    ]]>     emscast true No 1245 43 full     A Better Way to Triage? New Trauma Guidelines from the American College of Surgeons A Better Way to Triage? New Trauma Guidelines from the American College of Surgeons https://loudandclear.podbean.com/e/trauma-triage-update-new-american-college-of-surgeons-guideline-updates/ https://loudandclear.podbean.com/e/trauma-triage-update-new-american-college-of-surgeons-guideline-updates/#comments Thu, 01 Jun 2023 05:29:00 -0600 emscast.podbean.com/67652a9d-e444-3aaf-b5ac-68161de9a832 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.

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    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

     

    ]]>     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.

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    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

     

    ]]>     emscast true No 3389 42 full     Is nitroglycerin dangerous in inferior STEMIs or were we mislead? Separating fact from fiction. Is nitroglycerin dangerous in inferior STEMIs or were we mislead? Separating fact from fiction. https://loudandclear.podbean.com/e/is-nitroglycerin-dangerous-in-inferior-stemis/ https://loudandclear.podbean.com/e/is-nitroglycerin-dangerous-in-inferior-stemis/#comments Mon, 15 May 2023 05:34:00 -0600 emscast.podbean.com/bab7f647-2c69-380e-9505-5e034da6b45b 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. 

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    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

     

    ]]>     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. 

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    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

     

    ]]>     emscast true No 3001 41 full     Do You Smell Something? Deadly Gases - Hydrogen Sulfide and Nerve Agent Poisonings Do You Smell Something? Deadly Gases - Hydrogen Sulfide and Nerve Agent Poisonings https://loudandclear.podbean.com/e/hydrogen-sulfide-and-nerve-agent-poisonings/ https://loudandclear.podbean.com/e/hydrogen-sulfide-and-nerve-agent-poisonings/#comments Mon, 01 May 2023 05:51:00 -0600 emscast.podbean.com/00437a91-fae5-301c-b9f5-80619e1d84a9 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.

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    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

    ]]>     emscast true No 3103 40 full     Cyanide Toxicity Cyanide Toxicity https://loudandclear.podbean.com/e/cyanide-toxicity/ https://loudandclear.podbean.com/e/cyanide-toxicity/#comments Sat, 15 Apr 2023 05:33:00 -0600 emscast.podbean.com/bdc4706b-05d7-3018-91d3-d0262a83b71b 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.

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    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

    ]]>     emscast true No 2745 39 full     The GCS Sucks! Why it’s a useless number and what we should use instead. The GCS Sucks! Why it’s a useless number and what we should use instead. https://loudandclear.podbean.com/e/the-gcs-sucks-why-it-s-a-useless-number-and-what-we-should-use-instead/ https://loudandclear.podbean.com/e/the-gcs-sucks-why-it-s-a-useless-number-and-what-we-should-use-instead/#comments Sat, 01 Apr 2023 06:25:00 -0600 emscast.podbean.com/988f49d1-4eed-39e8-9d0f-792b08e01f8f Dr. Whitney Barrett shares why the Glasgow Coma Score is a useless number and what we should use instead. 

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    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. 

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    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

    ]]>     emscast true No 2133 38 full     Bonus Episode: Serotonin Syndrome Q&A - how to recognize and treat serotonin syndrome Q&A with paramedic Will Barry and tox fellow Nik Matsler Bonus Episode: Serotonin Syndrome Q&A - how to recognize and treat serotonin syndrome Q&A with paramedic Will Barry and tox fellow Nik Matsler https://loudandclear.podbean.com/e/bonus-episode-serotonin-syndrome-qa-how-to-recognize-and-treat-serotonin-syndrome-qa-with-paramedic-will-barry-and-tox-fellow-nik-matsler/ https://loudandclear.podbean.com/e/bonus-episode-serotonin-syndrome-qa-how-to-recognize-and-treat-serotonin-syndrome-qa-with-paramedic-will-barry-and-tox-fellow-nik-matsler/#comments Wed, 22 Mar 2023 07:01:00 -0600 emscast.podbean.com/42efe9a6-f342-3a56-a490-2a0b9a1dba22 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. 

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    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. 

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    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

    ]]>     emscast true No 1529 bonus     Serotonin Syndrome - Dos and Don'ts, Toxicologist Dr. Nik Matsler dissects an actual case Serotonin Syndrome - Dos and Don'ts, Toxicologist Dr. Nik Matsler dissects an actual case https://loudandclear.podbean.com/e/ep-34-serotonin-syndrome-how-to-recognize-and-treat-with-toxicology-fellow-dr-nik-matsler/ https://loudandclear.podbean.com/e/ep-34-serotonin-syndrome-how-to-recognize-and-treat-with-toxicology-fellow-dr-nik-matsler/#comments Wed, 15 Mar 2023 07:03:00 -0600 emscast.podbean.com/429d0483-8e96-367e-896f-26fae1f9abb6 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. 

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    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. 

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    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

    ]]>     emscast true No 4036 37 full     Your Mental Health Matters - Let’s talk about it. Your Mental Health Matters - Let’s talk about it. https://loudandclear.podbean.com/e/ep-36-your-mental-health-matters-let-s-talk-about-it/ https://loudandclear.podbean.com/e/ep-36-your-mental-health-matters-let-s-talk-about-it/#comments Wed, 01 Mar 2023 06:34:00 -0700 emscast.podbean.com/458a1f45-9535-3725-a370-d971b648b0d3 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/

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    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/

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    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

    ]]>     emscast true No 1195 36 full     Should we be giving steroids in cardiac arrest? With pharmacist Lance Ray. Should we be giving steroids in cardiac arrest? With pharmacist Lance Ray. https://loudandclear.podbean.com/e/ep-35-should-we-be-giving-steroid-in-cardiac-arrest/ https://loudandclear.podbean.com/e/ep-35-should-we-be-giving-steroid-in-cardiac-arrest/#comments Wed, 15 Feb 2023 06:15:00 -0700 emscast.podbean.com/265e5c7e-4b78-37d2-a704-31203783a538 Emergency pharmacist Lance Ray helps us breakdown the latest literature with regards to steroids in cardiac arrest. 

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    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

     

    ]]>     Emergency pharmacist Lance Ray helps us breakdown the latest literature with regards to steroids in cardiac arrest. 

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    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

     

    ]]>     emscast true No 1037 35 full     Dangers of Lights and Sirens plus more. 2023 NAEMSP recap. Dangers of Lights and Sirens plus more. 2023 NAEMSP recap. https://loudandclear.podbean.com/e/naemsp-conference-recap-part-1/ https://loudandclear.podbean.com/e/naemsp-conference-recap-part-1/#comments Wed, 01 Feb 2023 07:19:00 -0700 emscast.podbean.com/821e3012-b1e6-3576-b36d-60d6a208d9a6 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. 

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    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

    ]]>     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

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    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

    ]]>     emscast true No 1978 34 full     The Harmful Side of Diabetic Medications, Do You Know What You're Looking For? - with emergency pharmacist Lance Ray The Harmful Side of Diabetic Medications, Do You Know What You're Looking For? - with emergency pharmacist Lance Ray https://loudandclear.podbean.com/e/ep-33-do-you-know-all-the-new-diabetic-medications-with-emergency-pharmacist-lance-ray/ https://loudandclear.podbean.com/e/ep-33-do-you-know-all-the-new-diabetic-medications-with-emergency-pharmacist-lance-ray/#comments Sun, 15 Jan 2023 06:00:00 -0700 emscast.podbean.com/97bd0a38-90a8-33cb-93d3-1889c6fe58f2 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. 

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    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. 

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    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

    ]]>     emscast true No 1112 33 full     Mac 3 vs Mac 4 - Which blade should you use? Mac 3 vs Mac 4 - Which blade should you use? https://loudandclear.podbean.com/e/ep-32-mac-3-vs-mac-4-is-there-one-bade-to-rule-them-all/ https://loudandclear.podbean.com/e/ep-32-mac-3-vs-mac-4-is-there-one-bade-to-rule-them-all/#comments Sat, 31 Dec 2022 07:59:26 -0700 emscast.podbean.com/c3230acb-9bdb-3508-8ac5-49c273b7ddb8 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

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    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

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    📰 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

    ]]>     emscast true No 1149 32 full     The Ideal Trauma Call: You Were Taught Wrong, Traumas Not Algorithmic. The Ideal Trauma Call: You Were Taught Wrong, Traumas Not Algorithmic. https://loudandclear.podbean.com/e/ep-31-the-ideal-trauma-call/ https://loudandclear.podbean.com/e/ep-31-the-ideal-trauma-call/#comments Thu, 15 Dec 2022 06:00:00 -0700 emscast.podbean.com/66b671e1-0090-3dd0-a614-90e368877aa0 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. 

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    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

    ]]>     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. 

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    To view the whole document visit our website:

    The Ideal Trauma Call

     

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    📰 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

    ]]>     emscast true No 3742 31 full     The Sick Asthmatic- You're thinking about it wrong, this is so different from other causes of respiratory distress The Sick Asthmatic- You're thinking about it wrong, this is so different from other causes of respiratory distress https://loudandclear.podbean.com/e/ep-30-the-sick-asthmatic-why-this-is-so-different-from-other-causes-of-respiratory-distress/ https://loudandclear.podbean.com/e/ep-30-the-sick-asthmatic-why-this-is-so-different-from-other-causes-of-respiratory-distress/#comments Wed, 30 Nov 2022 06:44:00 -0700 emscast.podbean.com/d2985402-3155-3e7a-a254-3d0d350a8330 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. 

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    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. 

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    ]]>     emscast true No 1370 30 full     What did you just take? Novel Drugs of Abuse with Dr. Matsler What did you just take? Novel Drugs of Abuse with Dr. Matsler https://loudandclear.podbean.com/e/ep29-novel-drugs-of-abuse/ https://loudandclear.podbean.com/e/ep29-novel-drugs-of-abuse/#comments Mon, 31 Oct 2022 08:00:00 -0600 emscast.podbean.com/b0233b58-090e-31ce-8aaa-925912c8a7a5 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!

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    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

    ]]>     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

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    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

    ]]>     emscast true No 2689 29 full     Don't Miss Something Important, Your Physical Exam Matters Don't Miss Something Important, Your Physical Exam Matters https://loudandclear.podbean.com/e/ep-28-the-importance-of-the-physical-exam/ https://loudandclear.podbean.com/e/ep-28-the-importance-of-the-physical-exam/#comments Fri, 30 Sep 2022 08:00:00 -0600 emscast.podbean.com/e9cb1225-ba0b-3033-8417-12d09c4a81fa 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?

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    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

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    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

    ]]>     emscast true No 1579 28 full     The Physiologically Difficulty Airway - Part 4: Right Ventricular Failure, This Ones Scary The Physiologically Difficulty Airway - Part 4: Right Ventricular Failure, This Ones Scary https://loudandclear.podbean.com/e/right-ventricular-failure/ https://loudandclear.podbean.com/e/right-ventricular-failure/#comments Wed, 31 Aug 2022 04:00:00 -0600 emscast.podbean.com/4e5e2239-e1ab-304a-9e5c-bbb00c678c04 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.

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    ]]>     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.

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    ]]>     emscast true No 1001 27 full     Snake Bites Snake Bites https://loudandclear.podbean.com/e/ep-26-snake-bites/ https://loudandclear.podbean.com/e/ep-26-snake-bites/#comments Wed, 17 Aug 2022 15:02:55 -0600 emscast.podbean.com/29bef92c-f519-3442-8e97-8f6fb9444eb0 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. 

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    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

    ]]>     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. 

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    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

    ]]>     emscast true No 2226 29 full     Deadly Cocaine Overdose, Do You Know The Antidote? They Didn't Teach Me This In Paramedic School. Deadly Cocaine Overdose, Do You Know The Antidote? They Didn't Teach Me This In Paramedic School. https://loudandclear.podbean.com/e/ep-25-cocaine-overdose/ https://loudandclear.podbean.com/e/ep-25-cocaine-overdose/#comments Tue, 31 May 2022 06:00:00 -0600 emscast.podbean.com/65b87186-21a8-3017-a91e-93132574c640 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. 

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    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. 

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    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

    ]]>     emscast true No 1654 25 full     The Physiologically Difficulty Airway - Part 3: Severe Metabolic Acidosis The Physiologically Difficulty Airway - Part 3: Severe Metabolic Acidosis https://loudandclear.podbean.com/e/physiological/ https://loudandclear.podbean.com/e/physiological/#comments Sun, 01 May 2022 21:02:20 -0600 emscast.podbean.com/06574a22-32f0-35c3-adc2-04cc02183241 Join us for part three of our four part series looking at the physiologically difficult airway. Matt takes us through the approach to severe metabolic acidosis and why these patients are so dangerous to intubate.

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    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 three of our four part series looking at the physiologically difficult airway. Matt takes us through the approach to severe metabolic acidosis and why these patients are so dangerous to intubate.

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    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

    ]]>     emscast true No 1059 24 full     The Physiologically Difficulty Airway - Part 2: Hypotension The Physiologically Difficulty Airway - Part 2: Hypotension https://loudandclear.podbean.com/e/ep-23-physiologically-difficulty-airway-part-2-hypotension/ https://loudandclear.podbean.com/e/ep-23-physiologically-difficulty-airway-part-2-hypotension/#comments Thu, 31 Mar 2022 14:20:55 -0600 emscast.podbean.com/82a35b3a-9874-3b44-84e8-46c883efa984 Join us for part two of our four part series looking at the physiologically difficult airway. Matt takes us through the different causes of hypotension, why these patients are so dangerous to intubate, and how to resuscitate before you intubate. 

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    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 two of our four part series looking at the physiologically difficult airway. Matt takes us through the different causes of hypotension, why these patients are so dangerous to intubate, and how to resuscitate before you intubate. 

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    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

    ]]>     emscast true No 1046 23 full     Narrow Pulse Pressure as a Predictor of ED Thoracotomy in Trauma? Narrow Pulse Pressure as a Predictor of ED Thoracotomy in Trauma? https://loudandclear.podbean.com/e/ep-22-narrow-pulse-pressure-as-a-predictor-of-ed-thoracotomy-in-trauma/ https://loudandclear.podbean.com/e/ep-22-narrow-pulse-pressure-as-a-predictor-of-ed-thoracotomy-in-trauma/#comments Mon, 28 Feb 2022 05:00:00 -0700 emscast.podbean.com/f8af7e4f-0e54-3e13-8d62-27087109cf0e Enter to Win a FREE Pair of 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

    EMScast15 for 15% Off Frontline Optics Sunglasses

    ]]>     Enter to Win a FREE Pair of 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

    EMScast15 for 15% Off Frontline Optics Sunglasses

    ]]>     emscast true No 841 22 full     The Physiologically Difficult Airway - Part 1: Hypoxia The Physiologically Difficult Airway - Part 1: Hypoxia https://loudandclear.podbean.com/e/ep-21-the-physiologically-difficult-airway-part-1-hypoxia/ https://loudandclear.podbean.com/e/ep-21-the-physiologically-difficult-airway-part-1-hypoxia/#comments Mon, 31 Jan 2022 19:12:07 -0700 emscast.podbean.com/948683c6-9abc-355e-8a90-b76a0b635798 Ross and Matt discuss the importance of preoxygenating hypoxic patients prior to intubating them. This is the first of a 4 part series on the physiologically difficult airways. Link to the makeshift CPAP: https://www.youtube.com/watch?v=yHGMIQBak6A

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    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

    ]]>     Ross and Matt discuss the importance of preoxygenating hypoxic patients prior to intubating them. This is the first of a 4 part series on the physiologically difficult airways. Link to the makeshift CPAP:
    https://www.youtube.com/watch?v=yHGMIQBak6A

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    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

    ]]>     emscast true No 884 21 full     Does your radio work? In the middle of an MCI is too late to find out. Does your radio work? In the middle of an MCI is too late to find out. https://loudandclear.podbean.com/e/ep-20-mci-series-does-your-radio-work/ https://loudandclear.podbean.com/e/ep-20-mci-series-does-your-radio-work/#comments Fri, 31 Dec 2021 13:11:37 -0700 emscast.podbean.com/32ce8085-e0f2-36f3-98b6-11d6732f06e9 Will Berry and Ben Fisher join the show again to teach us about the handheld device on your hip. Do you really know how to use your radio? What do you do if it fails? It's important to talk and think about these things before they happen. 

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    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 and Ben Fisher join the show again to teach us about the handheld device on your hip. Do you really know how to use your radio? What do you do if it fails? It's important to talk and think about these things before they happen. 

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    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

    ]]>     emscast true No 2654 20 full     Don't Miss Carbon Monoxide Poisoning Don't Miss Carbon Monoxide Poisoning https://loudandclear.podbean.com/e/ep-19-carbon-monoxide/ https://loudandclear.podbean.com/e/ep-19-carbon-monoxide/#comments Tue, 02 Nov 2021 10:19:38 -0600 emscast.podbean.com/e88783c9-7eac-3f47-b52a-c5790447d2de Paramedic Will Berry sits down with toxicologist John Rague to talk about all things carbon monoxide including why snorkels aren't helpful.

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    ]]>     Paramedic Will Berry sits down with toxicologist John Rague to talk about all things carbon monoxide including why snorkels aren't helpful.

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    ]]>     emscast true No 3081 19 full     Your Run Report Matters More Than You Think Your Run Report Matters More Than You Think https://loudandclear.podbean.com/e/ep-18-your-run-report-matters-more-than-you-think/ https://loudandclear.podbean.com/e/ep-18-your-run-report-matters-more-than-you-think/#comments Thu, 30 Sep 2021 00:00:00 -0600 emscast.podbean.com/8fef0d00-9727-3c71-b840-5b7d5a7c0be7 Ben Fisher, paramedic and NEMSIS guru, joins us to talk about what NEMSIS is and it's importance to the career field.

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    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

    ]]>     Ben Fisher, paramedic and NEMSIS guru, joins us to talk about what NEMSIS is and it's importance to the career field.

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    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

    ]]>     emscast true No 1472 18 full     When the provider becomes the patient When the provider becomes the patient https://loudandclear.podbean.com/e/ep-17-when-the-provider-becomes-the-patient/ https://loudandclear.podbean.com/e/ep-17-when-the-provider-becomes-the-patient/#comments Tue, 31 Aug 2021 06:03:00 -0600 emscast.podbean.com/a462cb6a-2d1b-3c2f-8d84-c41eea21b6b8 Glen Andrews has 28 years of experience in medicine but on July 21st, he had to put all of his experience behind and surrender his fate to the care of others. Join us to hear how this event changed him and the insights he has gained from now being on both sides of the gurney. 

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    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

    ]]>     Glen Andrews has 28 years of experience in medicine but on July 21st, he had to put all of his experience behind and surrender his fate to the care of others. Join us to hear how this event changed him and the insights he has gained from now being on both sides of the gurney. 

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

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    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

    ]]>     emscast true No 1861 17 full     You're Not Treating Seizures Correctly. Pharmacist Lance Ray on Why Dosing is so Important. You're Not Treating Seizures Correctly. Pharmacist Lance Ray on Why Dosing is so Important. https://loudandclear.podbean.com/e/ep16-treating-seizures-correctly-with-lance-ray/ https://loudandclear.podbean.com/e/ep16-treating-seizures-correctly-with-lance-ray/#comments Mon, 26 Jul 2021 17:57:15 -0600 emscast.podbean.com/890275cd-f18d-357b-85b4-45d23ec99a39 Lance Ray joins us to emphasize the importance of correct seizure treatment.

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    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

    ]]>     Lance Ray joins us to emphasize the importance of correct seizure treatment.

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    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

    ]]>     emscast true No 2193 16 full     Dirty Epi drip - We Don't Call it Dirty For Nothin' Dirty Epi drip - We Don't Call it Dirty For Nothin' https://loudandclear.podbean.com/e/ep-15-dirty-epi-with-lance-ray-we-dont-call-it-dirty-for-nothin/ https://loudandclear.podbean.com/e/ep-15-dirty-epi-with-lance-ray-we-dont-call-it-dirty-for-nothin/#comments Sun, 30 May 2021 23:59:00 -0600 emscast.podbean.com/29d96ccd-372f-3236-a901-f23f1061db19 We sit down with pharmacist Lance Ray about dirty epi drips. These are probably our best prehospital option but they aren't silver bullets and they come with downsides. In other words, "we don't call em dirty for nothin."

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    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 sit down with pharmacist Lance Ray about dirty epi drips. These are probably our best prehospital option but they aren't silver bullets and they come with downsides. In other words, "we don't call em dirty for nothin."

    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

    ]]>     emscast true No 1532 15 full     Digoxin Toxicity and Other Cardiac Glycosides with Dr. Rague Digoxin Toxicity and Other Cardiac Glycosides with Dr. Rague https://loudandclear.podbean.com/e/ep-14-digoxin-toxicity-and-other-cardiac-glycosides/ https://loudandclear.podbean.com/e/ep-14-digoxin-toxicity-and-other-cardiac-glycosides/#comments Fri, 30 Apr 2021 13:02:14 -0600 emscast.podbean.com/be0427cc-b537-3166-ab29-3f229b764539 Emergency Physician and Toxicology Fellow John Rague joins us to discuss the presentation and management of digoxin toxicity in addition to other cardiac glycosides. Digoxin is not as commonly prescribed anymore thus our teaching on this topic has become less common. But digoxin and other cardiac glycosides are still available and used today so it's still important to understand the recognition and treatment of this toxicity. 

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    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 Physician and Toxicology Fellow John Rague joins us to discuss the presentation and management of digoxin toxicity in addition to other cardiac glycosides. Digoxin is not as commonly prescribed anymore thus our teaching on this topic has become less common. But digoxin and other cardiac glycosides are still available and used today so it's still important to understand the recognition and treatment of this toxicity. 

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    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

    ]]>     emscast true No 1091 14 full     MCI - Don't Be Unprepared for the Unexpected MCI - Don't Be Unprepared for the Unexpected https://loudandclear.podbean.com/e/ep-13-mcis/ https://loudandclear.podbean.com/e/ep-13-mcis/#comments Thu, 01 Apr 2021 12:51:13 -0600 emscast.podbean.com/18115002-629e-3732-86d5-99ed795ec365 A deep dive on MCI with Will Berry. You have to practice. 

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    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

    ]]>     A deep dive on MCI with Will Berry. You have to practice. 

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    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

    ]]>     emscast true No 3840 13 full     One of the Sickest Patients- Calcium Channel and Beta Blocker Overdose with Dr. Camarena-Michel. One of the Sickest Patients- Calcium Channel and Beta Blocker Overdose with Dr. Camarena-Michel. https://loudandclear.podbean.com/e/ep-12-calcium-channel-and-beta-blocker-overdose/ https://loudandclear.podbean.com/e/ep-12-calcium-channel-and-beta-blocker-overdose/#comments Sun, 28 Feb 2021 17:17:08 -0700 emscast.podbean.com/b24a0559-111b-3719-ac97-797d3ddbd3d2 Toxicology fellow extraordinaire Alexa Camarena-Michel, MD joins us again to talk about one of sickest overdose patients you may see. Calcium channel blocker and beta blocker overdose patients can be really sick and are often refractory to our standard therapies. Learn how to better manage these patients. 

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    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 extraordinaire Alexa Camarena-Michel, MD joins us again to talk about one of sickest overdose patients you may see. Calcium channel blocker and beta blocker overdose patients can be really sick and are often refractory to our standard therapies. Learn how to better manage these patients. 

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    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

    ]]>     emscast true No 1415 12 full     Stuck Outside- Hypothermia with Dr. Martin Musi Stuck Outside- Hypothermia with Dr. Martin Musi https://loudandclear.podbean.com/e/ep-11-hypothermia-with-martin-musi/ https://loudandclear.podbean.com/e/ep-11-hypothermia-with-martin-musi/#comments Sat, 30 Jan 2021 21:12:39 -0700 emscast.podbean.com/1b4d6deb-2a12-3499-9e2f-cae21a9ce1a7 A longer one than usual. We take a deep dive into hypothermia with wilderness medicine physician and expert Martin Musi.

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    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

    ]]>     A longer one than usual. We take a deep dive into hypothermia with wilderness medicine physician and expert Martin Musi.

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    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

    ]]>     emscast true No 3599 11 full     Simple Approach to Caustic Ingestions Simple Approach to Caustic Ingestions https://loudandclear.podbean.com/e/ep-10-caustic-ingestions/ https://loudandclear.podbean.com/e/ep-10-caustic-ingestions/#comments Thu, 31 Dec 2020 12:23:34 -0700 emscast.podbean.com/b2899cc3-5f9b-39ed-a99d-5e29ec107f7d Alexa Camarena-Michel teaches us a simple approach to caustic ingestions and more.

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    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

    ]]>     Alexa Camarena-Michel teaches us a simple approach to caustic ingestions and more.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

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    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

    ]]>     emscast true No 1046 10 full     Why You Can't Oxygenate - A lot of ARDS and a little bit of COVID Why You Can't Oxygenate - A lot of ARDS and a little bit of COVID https://loudandclear.podbean.com/e/ep-9-a-lot-of-ards-and-a-little-bit-of-covid/ https://loudandclear.podbean.com/e/ep-9-a-lot-of-ards-and-a-little-bit-of-covid/#comments Mon, 30 Nov 2020 12:15:38 -0700 emscast.podbean.com/8744c350-ed34-31a8-acf6-4a9baebb393b Dr. Wright joins us to discuss acute respiratory distress syndrome (ARDS). There has been a lot said about ARDS recently given some of it's similarities to the COVID-19 disease process. That being said ARDS has been around for a long time and is very much its own disease process. We discuss how to define it, how to recognize it, and how we treat it. There are some great media and pictures to help illustrate the points made in this episode on our website. Check out the show notes at https://emspodcast.com/acute-respiratory-distress-syndrome. 

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    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. Wright joins us to discuss acute respiratory distress syndrome (ARDS). There has been a lot said about ARDS recently given some of it's similarities to the COVID-19 disease process. That being said ARDS has been around for a long time and is very much its own disease process. We discuss how to define it, how to recognize it, and how we treat it. There are some great media and pictures to help illustrate the points made in this episode on our website. Check out the show notes at https://emspodcast.com/acute-respiratory-distress-syndrome. 

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    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

    ]]>     emscast true No 1844 9 full     Misdiagnosed- in-depth look at how problems with blood sugar gets missed Misdiagnosed- in-depth look at how problems with blood sugar gets missed https://loudandclear.podbean.com/e/ep-8-diabetes-with-chief-harper/ https://loudandclear.podbean.com/e/ep-8-diabetes-with-chief-harper/#comments Mon, 19 Oct 2020 13:24:36 -0600 emscast.podbean.com/fef83c4b-282c-35f9-836d-e016f08a0aba Undiagnosed or misdiagnosed diabetes is common because of how vague the symptoms can be. Chief Harper from Denver Paramedics tells us his incredible personal story dealing with his son's diagnoses, his path to becoming an expert on diabetes, and how we should think about this as prehospital providers.

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    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

    ]]>     Undiagnosed or misdiagnosed diabetes is common because of how vague the symptoms can be. Chief Harper from Denver Paramedics tells us his incredible personal story dealing with his son's diagnoses, his path to becoming an expert on diabetes, and how we should think about this as prehospital providers.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

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    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

    ]]>     emscast true No 2200 8 full     Making the call - tips on calling for medical direction Making the call - tips on calling for medical direction https://loudandclear.podbean.com/e/ep-7-making-the-call-tips-on-calling-for-medical-direction/ https://loudandclear.podbean.com/e/ep-7-making-the-call-tips-on-calling-for-medical-direction/#comments Fri, 18 Sep 2020 09:08:34 -0600 emscast.podbean.com/8f31b865-fc6f-3d95-9d5a-3764a9eee2cf This month we sit down with Assistant Medical Director Whitney Barrett to discuss the dos and don'ts of calling in for medical control. 

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    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 month we sit down with Assistant Medical Director Whitney Barrett to discuss the dos and don'ts of calling in for medical control. 

    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

    ]]>     emscast true No 1241 7 full     The WTF Approach to the Tracheostomy The WTF Approach to the Tracheostomy https://loudandclear.podbean.com/e/ep-6-approach-to-the-tracheostomy/ https://loudandclear.podbean.com/e/ep-6-approach-to-the-tracheostomy/#comments Mon, 10 Aug 2020 17:32:40 -0600 emscast.podbean.com/91312c78-b84d-3e80-bdcc-95dbacd272b4 This is still included in the A of ABCs but I got essentially no training on this in paramedic school. I honestly didn’t get much formal training on this after becoming an ED doc either. I just had to bug RTs and ICU docs to learn what I know now.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

    Airway problems are terrifyring without an approach to solve them. But when you have an approach you can fall back on that with a calm confidence. It’s like we’ve always heard: we don’t rise to the occasion, we fall to the level of training. With trach’s, we unfortunately have to train ourselves.

    Check out our new website at emspodcast.com! We will have pictures and show notes corresponding to this episode there. 

     

    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 still included in the A of ABCs but I got essentially no training on this in paramedic school. I honestly didn’t get much formal training on this after becoming an ED doc either. I just had to bug RTs and ICU docs to learn what I know now.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

    Airway problems are terrifyring without an approach to solve them. But when you have an approach you can fall back on that with a calm confidence. It’s like we’ve always heard: we don’t rise to the occasion, we fall to the level of training. With trach’s, we unfortunately have to train ourselves.

    Check out our new website at emspodcast.com! We will have pictures and show notes corresponding to this episode there. 

     

    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

    ]]>     emscast true No 1759 6 full     Confusion Leads To Harm- Clear Communication Counts Confusion Leads To Harm- Clear Communication Counts https://loudandclear.podbean.com/e/communication-pitfalls/ https://loudandclear.podbean.com/e/communication-pitfalls/#comments Wed, 08 Jul 2020 12:33:47 -0600 emscast.podbean.com/e06a66ae-c317-5fff-bd79-d763450419a6 We discuss where things go wrong with how we talk to each other and how we can do better.

    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 discuss where things go wrong with how we talk to each other and how we can do better.

    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

    ]]>     emscast true No 1794 5 full     The Critically Sick Kid The Critically Sick Kid https://loudandclear.podbean.com/e/ep-4-taking-care-of-the-critically-ill-kid/ https://loudandclear.podbean.com/e/ep-4-taking-care-of-the-critically-ill-kid/#comments Sat, 06 Jun 2020 10:07:03 -0600 emscast.podbean.com/d8a1db84-de80-5c29-b5fd-239cc33ac855 EMS physician Whitney Barrett joins us to discuss some of the scariest and emotional calls we can go on and how we can manage these situations better. 

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

     

    Caring for the critically ill pediatric patient is scary for all emergency providers. We discussed our approach to these calls with attending EM/EMS physician Dr. Whitney Barrett.

    Background

    • 2015 study: review of trip sheets showed wrong intervention, dosing errors in up to 65% of interventions on pediatric calls
    • PREPARE Trial: only 34% of pediatric cardiac arrest patients received epinephrine
    • EMS training in pediatrics is probably inadequate!

    Human Factors

    • Potential stressors:
      • Math is hard, especially when you’re stressed
      • Paradigm that “pediatric patients are not small adults” may lead providers to overthink resuscitation
    • “Thinking Fast and Slow,” by Daniel Kahnemann: breaks down thought processes
      • System 1: unconscious, second nature
      • System 2: conscious, requires mental effort and focus
      • If we exhaust system 2 with calculations, we can’t effectively focus on patient care and scene control  
      • How can we turn system 2 thinking into system 1 thinking?
    • The culture of pride in EMS may prevent some providers from using quick references or “cheat sheets.” There’s no shame in looking something up!
    • Our own stress may contribute to a “hectic scene” as much as the scene itself
      • Don’t automatically “load and go”
      • Early ventilations and compressions—not early transport—save lives

    Solutions

    • Cheat sheets: have a pocket reference with normal pediatric vitals and doses by volume, which may be specific for your system. Using this sheet on every peds call you run—whether or not you need it—will help familiarize you with its contents for when you really need that info.
    • Pediatric reference systems exist and are designed to help with cognitive offloading
      • Handtevy: estimated weight, vitals, doses, and necessary equipment separated by age. Used by the Denver Health Paramedic Division.
      • Broselow Tape: estimated weight, vitals, and doses listed on a length-based measuring tape. Designed for hospital use, EMS doses often much higher. Old school pearl: tape it flat to the pram so it’s ready for the patient.    
      • PediStat App
      • Pearl: age correlates very well with weight, and parents often know the weight!
    • Pre-arrival visualization: on the way to the call, run it in your head based off dispatch information. Pull out your cheat sheet. What is your differential? What treatments might you need?

    Takeaways

    • Prehospital management of critical pediatric patients needs improvement
    • Prepare for stress by anticipating it.
      • Pediatric reference systems help minimize system 2 thinking and should be used whenever possible.
      • Math is hard, and cheating should be encouraged. Have a cheat sheet and familiarize yourself with it.
      • On the way to the call, consider differentials and treatment plans.
    • If all else fails, pump the brakes. If this were an adult, what would I do right now? Fall back on your ABC’s.

    Sample Cheat Sheet

    • This Handtevy “badge buddy” doesn’t have vitals, but it does have estimated weight by age, doses by volume, and airway adjunct sizing. It’s also color-coded and easy to follow.

    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

    ]]>     EMS physician Whitney Barrett joins us to discuss some of the scariest and emotional calls we can go on and how we can manage these situations better. 

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

     

    Caring for the critically ill pediatric patient is scary for all emergency providers. We discussed our approach to these calls with attending EM/EMS physician Dr. Whitney Barrett.

    Background

    • 2015 study: review of trip sheets showed wrong intervention, dosing errors in up to 65% of interventions on pediatric calls
    • PREPARE Trial: only 34% of pediatric cardiac arrest patients received epinephrine
    • EMS training in pediatrics is probably inadequate!

    Human Factors

    • Potential stressors:
      • Math is hard, especially when you’re stressed
      • Paradigm that “pediatric patients are not small adults” may lead providers to overthink resuscitation
    • “Thinking Fast and Slow,” by Daniel Kahnemann: breaks down thought processes
      • System 1: unconscious, second nature
      • System 2: conscious, requires mental effort and focus
      • If we exhaust system 2 with calculations, we can’t effectively focus on patient care and scene control  
      • How can we turn system 2 thinking into system 1 thinking?
    • The culture of pride in EMS may prevent some providers from using quick references or “cheat sheets.” There’s no shame in looking something up!
    • Our own stress may contribute to a “hectic scene” as much as the scene itself
      • Don’t automatically “load and go”
      • Early ventilations and compressions—not early transport—save lives

    Solutions

    • Cheat sheets: have a pocket reference with normal pediatric vitals and doses by volume, which may be specific for your system. Using this sheet on every peds call you run—whether or not you need it—will help familiarize you with its contents for when you really need that info.
    • Pediatric reference systems exist and are designed to help with cognitive offloading
      • Handtevy: estimated weight, vitals, doses, and necessary equipment separated by age. Used by the Denver Health Paramedic Division.
      • Broselow Tape: estimated weight, vitals, and doses listed on a length-based measuring tape. Designed for hospital use, EMS doses often much higher. Old school pearl: tape it flat to the pram so it’s ready for the patient.    
      • PediStat App
      • Pearl: age correlates very well with weight, and parents often know the weight!
    • Pre-arrival visualization: on the way to the call, run it in your head based off dispatch information. Pull out your cheat sheet. What is your differential? What treatments might you need?

    Takeaways

    • Prehospital management of critical pediatric patients needs improvement
    • Prepare for stress by anticipating it.
      • Pediatric reference systems help minimize system 2 thinking and should be used whenever possible.
      • Math is hard, and cheating should be encouraged. Have a cheat sheet and familiarize yourself with it.
      • On the way to the call, consider differentials and treatment plans.
    • If all else fails, pump the brakes. If this were an adult, what would I do right now? Fall back on your ABC’s.

    Sample Cheat Sheet

    • This Handtevy “badge buddy” doesn’t have vitals, but it does have estimated weight by age, doses by volume, and airway adjunct sizing. It’s also color-coded and easy to follow.

    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

    ]]>     emscast false No 1354 4 full     Penetrating Neck Wounds Penetrating Neck Wounds https://loudandclear.podbean.com/e/ep-3-penetrating-neck-wounds/ https://loudandclear.podbean.com/e/ep-3-penetrating-neck-wounds/#comments Fri, 01 May 2020 12:23:28 -0600 emscast.podbean.com/20348d51-6858-5dd5-9946-927db5adff34 Maria Moreira joins us to to discuss the intricacies to managing penetrating neck wounds. There are a lot of important structures in the neck and damage to these structures are often life threatening and require quick action to stabilize. We break down how to organize these structures in your mind and develop a treatment plan based on what you're seeing on exam. We'll also take it one step further and discuss how we're going to care for these patients once they hit our doors in the ED.

    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

    ]]>     Maria Moreira joins us to to discuss the intricacies to managing penetrating neck wounds. There are a lot of important structures in the neck and damage to these structures are often life threatening and require quick action to stabilize. We break down how to organize these structures in your mind and develop a treatment plan based on what you're seeing on exam. We'll also take it one step further and discuss how we're going to care for these patients once they hit our doors in the ED.

    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

    ]]>     emscast false No 1783 3 full     Large Vessel Occlusions (LVO) Large Vessel Occlusions (LVO) https://loudandclear.podbean.com/e/large-vessel-occlusions/ https://loudandclear.podbean.com/e/large-vessel-occlusions/#comments Wed, 01 Apr 2020 18:40:47 -0600 emscast.podbean.com/44d1bdfd-49bd-5c42-b38c-d88a31ae171a First and foremost, we would like to thank all pre-hospital providers for the work you do. You are all underpaid, understaffed, and under appreciated. However, the unsung work that you do matters now more than ever. We go to work every day in order to be there when the public needs us. Much of the focus as of late has been on COVID. And probably rightfully so. But patients continue to have MI’s, strokes, overdoses and many other emergencies. And these emergencies still deserve our excellent care and diligence not to miss. So although we plan to have another special-edition, COVID-update episode we don’t want to neglect these other emergencies. So let's talk about Large Vessel Occlusions.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

     

    Ep. 2 Large Vessel Occlusion (LVO) Show Notes

     

    First and foremost we would like to thank all prehospital providers for the work you do. You are all underpaid, understaffed, and under appreciated. However, the unsung work you do now more than ever matters. We go to work every day in order to be there when the public needs us. Much of the focus as of late has been on COVID. And probably rightfully so. But that being said, patients continue to have MI’s, strokes, overdoses and many other emergencies. And these emergencies too still deserve our excellent care and diligence not to miss. So although we plan to have another special edition COVID update episode soon we don’t want to neglect these other emergencies. This month we talk Large Vessel Occlusions.

     

    • How is EST performed? 
      • A catheter is guided through one of the femoral arteries and up through the carotid and into the distal internal carotid, anterior cerebral artery or the middle cerebral artery
      • A clot retrieval device is fed through the catheter in order to retrieve the clot
      • Unlike tPA which has only shown very marginal benefit in just a few studies that were admittedly methodologically flawed. EST has recently had multiple strongly positive trials showing impressive benefits (although these benefits are likely over estimated, see the link above for a deep dive on the researches strengths and weaknesses)

     

    • Who Qualifies for EST?
      • Similar to the early days of PCI for myocardial infarctions when cath lab centers were farer and fewer between
      • Will likely vary based on your stroke center and may change with future studies so make sure you stay up to date with your local protocols.
        • Initial studies looked at less than 6 hour time window and is what the American stroke guidelines currently recommend. 
        • A lot of places have started pushing this time window further out and locally here we us a cut off of less than 24 hours
      • Initially studies for all comers with stroke receiving EST found no benefit
      • It wasn’t until they identified a subset of patients with Large Vessel Occlusions (LVO) that they began to see these impressive benefits
      • An LVO is defined as clot located in either the distal internal carotid, proximal anterior cerebral artery (ACA), or the proximal middle cerebral artery (MCA)
      • Not every stroke center has the capability to perform EST
      • What is the timeline to qualify for EST
    • So do we need to start re-organizing our transport priorities and transporting all of our suspected strokes to EST centers similarly to how we transport all of our STEMI’s to cath centers?
      • With STEMI we have a clear diagnostic tool with our EKG to determine if somebody needs the cath lab. 
        • In order to know for sure if our patient would need EST we would need a CT scanner. And not just CT but also the ability to do CT with contrast in order to see which vessel the clot is in.
        • If there is even a clot at all. Given so many mimickers of stroke on a very small percentage of patients evaluated for concern for stroke actually end up having a stroke
      • Which brings us to the second point of why we don’t want to start transporting to only EST centers: Only a select number of stroke patients, those with clots in the large proximal vessels, will benefit from this therapy. 
        • It wasn’t until later trials when they narrowed the patients they were treating to those with identified LVO in the arteries mentioned before: distal internal carotid, proximal ACA, and proximal MCA that they started finding benefit. 
        • It turns out that only 1 in 770 of stroke patients will have an occlusion meeting criteria for EST. 
        • And that's in patients who WE KNOW are having a stroke. Can you imagine what that number would be if we included everyone we just suspected of having a stroke? We would overwhelm the hospital. 
        • Early trials from 2013 looked at utilizing this therapy for all comers with stroke and found no benefit when compared to tPA alone. 
        • So even if we were sure our patient was having a stroke based on our exam they still would only benefit from transport to an EST if it was in one of these specific large and proximal vessels.
      • No, here’s where we don’t wanna get ahead of ourselves

     

    • So are there any physical exam findings to help us determine those likely to have a LVO and thus should be transported to one of these centers?
      • There’s not strong enough evidence to suggest such a protocol yet so for now keep transporting to your nearest local stroke center per your protocol 
      • But there are researchers looking at some prehospital scores to help with this question and we should be aware of and keep on the lookout for future data and research on this. See some of the prehospital scores and their associated ealy research below.
        • VAN score - vision, aphasia, neglect
          • 62 patients, 31% (19) were VAN positive
          • 90% of those had an LVO and no LVO’s occured in the VAN neg group. 
          • This is a small feasibility study. This means it was a smaller study done solely to determine if a larger more robust trial should be completed. Feasibility trials should not be used to change current care.
          • Start with bilateral arm raise for 10 seconds
            •  if any drift then proceed with the VAN assessment, 
          • If any of the following are positive in a patient with arm drift then they are considered VAN positive
            • Check all 4 quadrants one eye at a time
            • I cover one eye and ask 1 or 2 fingers in each quadrant. 
            • If the patient is having difficulty cooperating you can blink to threat in all quadrants. 
              • Move your hand quickly towards their eye from the quadrant you are testing (but don’t actually hit them).
              • If they blink you assume the vision is intact.
              • Blink to threat
            • Aphasia either expressive or receptive. 
              • Can’t say words or doesn’t say the right words 
              • Unable to understand what you are saying. 
              • Expressive
              • Receptive
            • Important: 
              • Aphasia is different from dysarthria which is slurred speech.
              • Dysarthria is not what we are testing or scoring here.
            • Have the patient close both eyes and then you touch both of their arms with your fingers and ask which arm you are touching, if the patient fails to identify the weak arm (the arm you identified with a drift earlier) this is considered neglect. 
            • Other signs of neglect are an inability to track your finger beyond midline or a forced gaze deviation to one side. 
            • Visual fields
            • The next component is Aphasia
            • Finally Neglect

     

    https://www.heart.org/en/professional/quality-improvement/mission-lifeline/mission-lifeline-stroke

    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

    ]]>     First and foremost, we would like to thank all pre-hospital providers for the work you do. You are all underpaid, understaffed, and under appreciated. However, the unsung work that you do matters now more than ever. We go to work every day in order to be there when the public needs us. Much of the focus as of late has been on COVID. And probably rightfully so. But patients continue to have MI’s, strokes, overdoses and many other emergencies. And these emergencies still deserve our excellent care and diligence not to miss. So although we plan to have another special-edition, COVID-update episode we don’t want to neglect these other emergencies. So let's talk about Large Vessel Occlusions.

    Enter to Win a FREE Pair of Frontline Optics Sunglasses

    EMScast15 for 15% Off Frontline Optics Sunglasses

     

    Ep. 2 Large Vessel Occlusion (LVO) Show Notes

     

    First and foremost we would like to thank all prehospital providers for the work you do. You are all underpaid, understaffed, and under appreciated. However, the unsung work you do now more than ever matters. We go to work every day in order to be there when the public needs us. Much of the focus as of late has been on COVID. And probably rightfully so. But that being said, patients continue to have MI’s, strokes, overdoses and many other emergencies. And these emergencies too still deserve our excellent care and diligence not to miss. So although we plan to have another special edition COVID update episode soon we don’t want to neglect these other emergencies. This month we talk Large Vessel Occlusions.

     

    • How is EST performed? 
      • A catheter is guided through one of the femoral arteries and up through the carotid and into the distal internal carotid, anterior cerebral artery or the middle cerebral artery
      • A clot retrieval device is fed through the catheter in order to retrieve the clot
      • Unlike tPA which has only shown very marginal benefit in just a few studies that were admittedly methodologically flawed. EST has recently had multiple strongly positive trials showing impressive benefits (although these benefits are likely over estimated, see the link above for a deep dive on the researches strengths and weaknesses)

     

    • Who Qualifies for EST?
      • Similar to the early days of PCI for myocardial infarctions when cath lab centers were farer and fewer between
      • Will likely vary based on your stroke center and may change with future studies so make sure you stay up to date with your local protocols.
        • Initial studies looked at less than 6 hour time window and is what the American stroke guidelines currently recommend. 
        • A lot of places have started pushing this time window further out and locally here we us a cut off of less than 24 hours
      • Initially studies for all comers with stroke receiving EST found no benefit
      • It wasn’t until they identified a subset of patients with Large Vessel Occlusions (LVO) that they began to see these impressive benefits
      • An LVO is defined as clot located in either the distal internal carotid, proximal anterior cerebral artery (ACA), or the proximal middle cerebral artery (MCA)
      • Not every stroke center has the capability to perform EST
      • What is the timeline to qualify for EST
    • So do we need to start re-organizing our transport priorities and transporting all of our suspected strokes to EST centers similarly to how we transport all of our STEMI’s to cath centers?
      • With STEMI we have a clear diagnostic tool with our EKG to determine if somebody needs the cath lab. 
        • In order to know for sure if our patient would need EST we would need a CT scanner. And not just CT but also the ability to do CT with contrast in order to see which vessel the clot is in.
        • If there is even a clot at all. Given so many mimickers of stroke on a very small percentage of patients evaluated for concern for stroke actually end up having a stroke
      • Which brings us to the second point of why we don’t want to start transporting to only EST centers: Only a select number of stroke patients, those with clots in the large proximal vessels, will benefit from this therapy. 
        • It wasn’t until later trials when they narrowed the patients they were treating to those with identified LVO in the arteries mentioned before: distal internal carotid, proximal ACA, and proximal MCA that they started finding benefit. 
        • It turns out that only 1 in 770 of stroke patients will have an occlusion meeting criteria for EST. 
        • And that's in patients who WE KNOW are having a stroke. Can you imagine what that number would be if we included everyone we just suspected of having a stroke? We would overwhelm the hospital. 
        • Early trials from 2013 looked at utilizing this therapy for all comers with stroke and found no benefit when compared to tPA alone. 
        • So even if we were sure our patient was having a stroke based on our exam they still would only benefit from transport to an EST if it was in one of these specific large and proximal vessels.
      • No, here’s where we don’t wanna get ahead of ourselves

     

    • So are there any physical exam findings to help us determine those likely to have a LVO and thus should be transported to one of these centers?
      • There’s not strong enough evidence to suggest such a protocol yet so for now keep transporting to your nearest local stroke center per your protocol 
      • But there are researchers looking at some prehospital scores to help with this question and we should be aware of and keep on the lookout for future data and research on this. See some of the prehospital scores and their associated ealy research below.
        • VAN score - vision, aphasia, neglect
          • 62 patients, 31% (19) were VAN positive
          • 90% of those had an LVO and no LVO’s occured in the VAN neg group. 
          • This is a small feasibility study. This means it was a smaller study done solely to determine if a larger more robust trial should be completed. Feasibility trials should not be used to change current care.
          • Start with bilateral arm raise for 10 seconds
            •  if any drift then proceed with the VAN assessment, 
          • If any of the following are positive in a patient with arm drift then they are considered VAN positive
            • Check all 4 quadrants one eye at a time
            • I cover one eye and ask 1 or 2 fingers in each quadrant. 
            • If the patient is having difficulty cooperating you can blink to threat in all quadrants. 
              • Move your hand quickly towards their eye from the quadrant you are testing (but don’t actually hit them).
              • If they blink you assume the vision is intact.
              • Blink to threat
            • Aphasia either expressive or receptive. 
              • Can’t say words or doesn’t say the right words 
              • Unable to understand what you are saying. 
              • Expressive
              • Receptive
            • Important: 
              • Aphasia is different from dysarthria which is slurred speech.
              • Dysarthria is not what we are testing or scoring here.
            • Have the patient close both eyes and then you touch both of their arms with your fingers and ask which arm you are touching, if the patient fails to identify the weak arm (the arm you identified with a drift earlier) this is considered neglect. 
            • Other signs of neglect are an inability to track your finger beyond midline or a forced gaze deviation to one side. 
            • Visual fields
            • The next component is Aphasia
            • Finally Neglect

     

    https://www.heart.org/en/professional/quality-improvement/mission-lifeline/mission-lifeline-stroke


    Resources:

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    ]]>     emscast true No 1622 2 full     Toxidromes Toxidromes https://loudandclear.podbean.com/e/episode-1-toxidromes/ https://loudandclear.podbean.com/e/episode-1-toxidromes/#comments Tue, 10 Mar 2020 14:38:39 -0600 emscast.podbean.com/f0b5a204-4a91-59b7-8547-f41c1aa46ab8 We talk about toxidromes with emergency physician and toxicologist, Dr. Janetta Iwanicki.

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    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 talk about toxidromes with emergency physician and toxicologist, Dr. Janetta Iwanicki.

    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

    ]]>     emscast true No 1799 1 full     Why We Started A Podcast Why We Started A Podcast https://loudandclear.podbean.com/e/episode-0-we-started-a-podcast/ https://loudandclear.podbean.com/e/episode-0-we-started-a-podcast/#comments Tue, 10 Mar 2020 14:26:26 -0600 emscast.podbean.com/06e87c27-5d73-5589-a557-da9f9a53b6a9 Matt Mendes and Ross Orpet talk about why they started this podcast.

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    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

    ]]>     Matt Mendes and Ross Orpet talk about why they started this podcast.

    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

    ]]>     emscast true No 444 bonus