The World’s Okayest Medic Podcast

Saturday Coffee Talk (5/30/26)

Mike — Sat, 30 May 2026 20:30:29 +0000

Listener discretion is advised!

References: Buttner & Arlanger. (May 3, 2022). ST depression does not localise. Available: https://litfl.com/st-depression-does-not-localise/

Cannon, J. W., Khan, M. A., Raja, A. S., et al. (2017). Damage control resuscitation in patients with severe traumatic hemorrhage. Journal of Trauma and Acute Care Surgery, 82, 605-617.

Kabra, R., Acharya, S., Kamat, S., & Kumar, S. (2022). ST-Segment Elevation in Lead aVR With Global ST-Segment Depression: Never Neglect Left Main Coronary Artery (LMCA) Occlusion. Cureus.

Lee, G.-K., Hsieh, Y.-P., Hsu, S.-W., Lan, S.-J., & Soni, K. (2019). Value of ST‐segment change in lead aVR in diagnosing left main disease in Non‐ST‐elevation acute coronary syndrome—A meta‐analysis. Annals of Noninvasive Electrocardiology, 24.

Morrison, C. A., Carrick, M. M., Norman, M. A., et al. (2011). Hypotensive Resuscitation Strategy Reduces Transfusion Requirements and Severe Postoperative Coagulopathy in Trauma Patients With Hemorrhagic Shock: Preliminary Results of a Randomized Controlled Trial. Journal of Trauma: Injury, Infection & Critical Care, 70, 652-663.

Rossaint, R., Afshari, A., Bouillon, B., et al. (2023). The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Critical Care, 27.

Tamura, A. (2014). Significance of lead aVR in acute coronary syndrome. World Journal of Cardiology, 6(7), 630.

Uthamalingam, S., Zheng, H., Leavitt, M., Pomerantsev, E., Ahmado, I., Gurm, G. S., & Gewirtz, H. (2011). Exercise-Induced ST-Segment Elevation in ECG Lead aVR Is a Useful Indicator of Significant Left Main or Ostial LAD Coronary Artery Stenosis. JACC: Cardiovascular Imaging, 4, 176–186.

Weymouth, W., Long, B., Koyfman, A., & Winckler, C. (2019). Whole Blood in Trauma: A Review for Emergency Clinicians. The Journal of Emergency Medicine, 56, 491-498.

Wang, A., Singh, V., Duan, Y., Su, X., Su, H., Zhang, M., & Cao, Y. (2020). Prognostic implications of ST‐segment elevation in lead aVR in patients with acute coronary syndrome: A meta‐analysis. Annals of Noninvasive Electrocardiology, 26.

(Late) Sunday Coffee Talk (5/24/26)

Mike — Sun, 24 May 2026 18:56:29 +0000

LISTENER DISCRETION IS ADVISED!!!!!

References:

Hair Tourniquet: PMID: 29092968

ACEP. (2025). A Worthy Investment: What Every EM Resident Needs to Know About Reimbursement in 2025. Available: https://www.acep.org/administration/reimbursement/what-every-graduating-resident-needs-to-know-about-reimbursement

Dan Magdziarz. (Jan 5, 2021). High-Yield RVU Generation in Emergency Medicine. Emergency Physicians Monthly. Available: https://epmonthly.com/article/high-yield-rvu-generation-in-emergency-medicine/

John Proctor. Gauging Emergency Physician Productivity: Are RVUs the Answer? Available: https://www.acep.org/imports/clinical-and-practice-management/resources/reimbursement-imported/gauging-emergency-physician-productivity-are-rvus-the-answerEmer

LATE Saturday Evening Coffee Talk (5/16/26)

Mike — Sun, 17 May 2026 03:26:58 +0000

Listener discretion is advised!

References: ACEP. (2025). A Worthy Investment: What Every EM Resident Needs to Know About Reimbursement in 2025. Available: https://www.acep.org/administration/reimbursement/what-every-graduating-resident-needs-to-know-about-reimbursement

Dan Magdziarz. (Jan 5, 2021). High-Yield RVU Generation in Emergency Medicine. Emergency Physicians Monthly. Available: https://epmonthly.com/article/high-yield-rvu-generation-in-emergency-medicine/

Dr. Mario Rugna & Kirk Smith, RT: Using the Vent on 911 Calls Should be Standard

Mike — Mon, 11 May 2026 10:20:56 +0000

Listener discretion is advised.

Dr. Rugna's Article: https://assets-che.mkt.dynamics.com/82359f7e-b7af-4cc1-a9fe-c8a35b467194/digitalassets/standaloneforms/7a39198e-7127-f011-8c4d-0022480cd54d#div_id

Friday (Early) Coffee Talk (5/8/26)

Mike — Fri, 08 May 2026 20:49:16 +0000

Listener discretion is advised. Language. Adult themes.

References: Anand Swaminathan, "Clinical Conundrum: Should We Always Treat Fever in Patients with Sepsis?", REBEL EM blog, December 17, 2024. Available at: https://rebelem.com/clinical-conundrum-should-we-always-treat-fever-in-patients-with-sepsis/.

Jibril F, Sharaby S, Mohamed A, Wilby KJ. Intravenous versus Oral Acetaminophen for Pain: Systematic Review of Current Evidence to Support Clinical Decision-Making. Can J Hosp Pharm. 2015 May-Jun;68(3)

Scott Weingart, MD FCCM. EMCrit 132 – MoTR – Toughness Part I with Michael Lauria. EMCrit Blog. Published on September 6, 2014. Accessed on May 8th 2026. Available at [https://emcrit.org/emcrit/toughness-michael-lauria-i/ ].

Rick Maricle: Leadership at a New Agency

Mike — Tue, 05 May 2026 01:29:30 +0000

Listener discretion is advised.

Saturday Coffee Talk (5/1/26)

Mike — Fri, 01 May 2026 17:33:38 +0000

Listener discretion is advised: language, adult themes

Reference: Boland, Hokanson, et. al. (2016). Prehospital lactate measurement by EMS in patients meeting sepsis criteria. Western J. EM (17)5.

Dan Rauh: Lactate, Troponin, I-Stat, Sepsis, and More

Mike — Mon, 27 Apr 2026 00:29:44 +0000

Listener discretion is advised.

Saturday Coffee Talk (4/25/26)

Mike — Fri, 24 Apr 2026 23:06:04 +0000

Listener discretion is advised.

Jeremy Ulrich: 10 Things the EMS Student Needs to Know

Mike — Mon, 20 Apr 2026 18:15:51 +0000

Listener discretion is advised.

Saturday Coffee Talk (4/18/26)

Mike — Fri, 17 Apr 2026 20:27:26 +0000

LISTENER DISCRETION IS ADVISED. Sensitive themes. Language.

References: Rautaharju PM, Park L, Rautaharju FS, Crow R. A standardized procedure for locating and documenting ECG chest electrode positions: consideration of the effect of breast tissue on ECG amplitudes in women. J Electrocardiol. 1998 Jan;31(1):17-29.

Bill Berlin RN: Communicating with the Chronically Sick Kid and Family

Mike — Mon, 13 Apr 2026 14:24:23 +0000

Bill Berlin is a flight nurse and serves in the USAF. His daughter is currently battling Leukemia and Bill was kind enough to come on to the podcast to talk about what this journey has taught him about being a health care provider.

Listener discretion is advised.

Saturday Coffee Talk (4/11/26)

Mike — Sat, 11 Apr 2026 17:32:28 +0000

Listener discretion is advised.

References: Cook CE, Thigpen CA. Five good reasons to be disappointed with randomized trials. J Man Manip Ther. 2019 May;27(2):63-65. doi: 10.1080/10669817.2019.1589697. Epub 2019 Mar 14. PMID: 30935322

Fernainy P, Cohen AA, Murray E, Losina E, Lamontagne F, Sourial N. Rethinking the pros and cons of randomized controlled trials and observational studies in the era of big data and advanced methods: a panel discussion. BMC Proc. 2024 Jan 18;18(Suppl 2):1. doi: 10.1186/s12919-023-00285-8. Erratum in: BMC Proc. 2024 Aug 16;18(1):16. doi: 10.1186/s12919-024-00299-w. PMID: 38233894

Ramchurn TP, Nundy S. Randomised clinical trials in surgery: are we at a crossroads? Ann Med Surg (Lond). 2023 Nov 7;86(1):3-6. doi: 10.1097/MS9.0000000000001457. PMID: 38222736

Conversation with a Newer EMT

Mike — Mon, 06 Apr 2026 16:04:39 +0000

Listener discretion is advised. Sensitive language and themes.

Saturday Coffee Talk (4/4/26)

Mike — Sat, 04 Apr 2026 04:47:50 +0000

LISTENER DISCRETION IS ADVISED. Language. Sensitive themes.

Study Citation: Vattipally VN, Ran KR, Myneni S, Jo J, Margolis A, Nasr IW, Robinson S, Cohen AR, Azad TD. Emergency Medical Services Time on Scene Associated with Reduced Dead-on-Arrival Status Among Pediatric Patients with Severe Traumatic Brain Injury. Prehosp Emerg Care. 2026 Jan 21:1-9. doi: 10.1080/10903127.2025.2605648. Epub ahead of print. PMID: 41418045.

Peds: Safe Transport and Pro Tips with Molly Harper

Mike — Mon, 30 Mar 2026 16:14:06 +0000

Listener discretion is advised.

Saturday Coffee Talk (3/28/26)

Mike — Fri, 27 Mar 2026 19:22:11 +0000

LISTENER DISCRETION IS ADVISED! ADULT THEMES. LANGUAGE.

References: Smith, J. E., Cardigan, R., Sanderson, E., Silsby, L., Rourke, C., Barnard, E. B. G., Basham, P., Antonacci, G., Charlewood, R., Dallas, N., Davies, J., Goodwin, E., Hawton, A., Hudson, C., Lucas, J., Keen, K., Lyon, R. M., & Nolan, B. (2026). Prehospital whole blood in traumatic hemorrhage — a randomized controlled trial. The New England Journal of Medicine. https://doi.org/10.1056/nejmoa2516043

Dr. Antevy's Discussion Thread on LinkedIN: https://www.linkedin.com/posts/peter-antevy-md-faems-a9b11726_the-swift-trial-just-published-in-nejm-group-activity-7440071242285625344-1HZP?utm_source=share&utm_medium=member_desktop&rcm=ACoAAF6Ls6YBtNzvNfxmvsyVNOMy6QNK6Bc_pj4

Case Study: PE Presenting as Left Breast Pain

Mike — Thu, 26 Mar 2026 19:38:11 +0000

Listener discretion is advised.

Saturday Coffee Talk (3/21/26)

Mike — Sat, 21 Mar 2026 18:50:29 +0000

Listener discretion is advised.

(Early) Coffee Talk 3/12/26

Mike — Thu, 12 Mar 2026 22:55:32 +0000

Listener discretion is advised.

Conversation with a Medical Director: Nate Zahustecher

Mike — Tue, 10 Mar 2026 16:25:03 +0000

Listener discretion is advised.

Saturday Coffee Talk (3/7/26)

Mike — Sat, 07 Mar 2026 11:06:49 +0000

Listener discretion is advised.

Japanese Airway Study: Kubo A, Kunitatsu K, Nakashima T, Horitani R, Kajimoto Y, Inoue S, Hironishi M. Association between endotracheal intubation and outcomes of nonshockable out-of-hospital cardiac arrest in Japan. BMC Emerg Med. 2025 Sep 24;25(1):185. doi: 10.1186/s12873-025-01341-6. PMID: 40993541; PMCID: PMC12462024.

BONUS Mini Episode: Burn Intubation

Mike — Mon, 02 Mar 2026 22:08:03 +0000

Listener discretion is advised.

Jen Brennan and Ben Podsiadlo

Mike — Mon, 02 Mar 2026 22:07:06 +0000

Listener discretion is advised.

Saturday Coffee Talk (2/28/26)

Mike — Sat, 28 Feb 2026 05:57:36 +0000

Listener discretion is advised.

The Coffee Talk is EARLY THIS WEEK (2/19/26)

Mike — Thu, 19 Feb 2026 16:08:36 +0000

Listener discretion is advised.

References:

Varney J, Motawea KR, Mostafa MR, AbdelQadir YH, Aboelenein M, Kandil OA, Ibrahim N, Hashim HT, Murry K, Jackson G, Shah J, Boury M, Awad AK, Patel P, Awad DM, Rozan SS, Talat NE. Efficacy of heads-up CPR compared to supine CPR positions: Systematic review and meta-analysis. Health Sci Rep. 2022 May 24;5

Norii T, Lukas G, Samantaray A, Yabuki M, Olasveengen TM, Bray JE; International Liaison Committee on Resuscitation ILCOR Basic Life Support Task Force. Effects of head-up CPR on survival and neurological outcomes: A systematic review. Resusc Plus. 2025 Jun 16

Kim DW, Choi JK, Won SH, Yun YJ, Jo YH, Park SM, Lee DK, Jang DH. A new variant position of head-up CPR may be associated with improvement in the measurements of cranial near-infrared spectroscopy suggestive of an increase in cerebral blood flow in non-traumatic out-of-hospital cardiac arrest patients: A prospective interventional pilot study. Resuscitation.

Huang CC, Chen KC, Lin ZY, Chou YH, Chen WL, Lee TH, Lin KT, Hsieh PY, Chen CH, Chou CC, Lin YR. The effect of the head-up position on cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2021 Oct 30;25(1):376.

Swaminathan, A., Mohan, M. (2023). Heads Up! Data Dredging Coming Through: Heads Up Cardiopulmonary Resuscitation Does Not Improve Outcomes. February 2023 Annals of Emergency Medicine Journal Club

Subarachnoid Hemorrhage

Mike — Tue, 17 Feb 2026 19:01:46 +0000

Listener discretion is advised.

References: Decorticate and Decerebrate Posturing. (Dec 18, 2025). David Goldemund. “Stroke Manual.” Available: https://www.stroke-manual.com/decorticate-and-decerebrate-posturing/

Schmutzhard, E. (2019). Central breathing disturbances in stroke. J. Neuro Sciences, 405 suppl.

Torres AC, Bebarta VS, April MD, Maddry JK, Herson PS, Sciorilli JV, Rossi YI, Dos Reis Schevz R, da Silva DBP, Lee J, Gallani F, Maegele M. Is ketamine safe for traumatic brain injury? A systematic review and meta-analysis. J Crit Care. 2026 Feb;91:155347.

Sal Cortez and ISTM

Mike — Mon, 16 Feb 2026 15:18:25 +0000

Listener discretion is advised.

Saturday Coffee Talk (2/14/26)

Mike — Sat, 14 Feb 2026 03:41:41 +0000

Listener discretion is advised.

Nicole Hooser

Mike — Mon, 09 Feb 2026 10:55:24 +0000

Listener discretion is advised.

SUNDAY (Late) Coffee Talk (2/8/26)

Mike — Sun, 08 Feb 2026 19:18:22 +0000

Listner discretion is advised.

Dan Koloden

Mike — Mon, 02 Feb 2026 13:37:27 +0000

Listener discretion is advised.

Saturday Coffee Talk (1/31/26)

Mike — Sat, 31 Jan 2026 18:20:00 +0000

Listener discretion is advised.

Ryan Bolger

Mike — Mon, 26 Jan 2026 02:07:18 +0000

Listener discretion is advised.

Saturday Coffee Talk (1/24/26)

Mike — Fri, 23 Jan 2026 21:51:40 +0000

Listener discretion is advised.

References: Bona & Friedman. (Apr 3, 2018). Ambulance Lights and Sirens Should Only Be Used When the Benefit Outweighs the Risks. Available: https://https://www.acepnow.com/article/ambulance-lights-and-sirens-should-only-be-used-when-the-benefit-outweighs-the-risks/

NTSB Preliminary Report: Available: https://verticalavi.org/wp-content/uploads/2026/01/Report_ERA26FA035_201974_1_21_2026-12_05_27-AM.pdf

PMID 30648537, 20845321, 11339726

Zavadasky, M. (June 2, 2025). Culture shift: Reducing lights and siren vehicle operation. Available: https://www.ems1.com/safe-transport-point-b/articles/culture-shift-reducing-lights-and-siren-vehicle-operation-XDonsygscixIghQT/

Sal Cortez

Mike — Mon, 19 Jan 2026 20:32:24 +0000

Sal Cortez has over forty years of experience as a paramedic and LEO. He has responded to two major active shooter incidents, worked as a flight medic, served on the California Governor's protection detail, and now runs TEMS training at the International School of Tactical Medicine.

Listener discretion is advised.

Saturday Coffee Talk (1/17/26)

Mike — Fri, 16 Jan 2026 21:42:58 +0000

Listener discretion is advised.

References: PMID 12776641, 29463461

Dr. Nate Zahustecher: EMS Awareness of Medetomidine Overdose and Withdrawal

Mike — Mon, 12 Jan 2026 17:05:51 +0000

Listener discretion is advised.

Saturday Coffee Talk (1/10/26)

Mike — Sat, 10 Jan 2026 07:43:29 +0000

Listener discretion is advised.

Saturday Coffee Talk (1/3/26)

Mike — Sat, 03 Jan 2026 03:06:59 +0000

Listener discretion is advised.

Saturday Coffee Talk (12/27/25)

Mike — Sat, 27 Dec 2025 15:39:50 +0000

Listener discretion is advised.

Saturday Coffee Talk (12/20/25)

Mike — Sat, 20 Dec 2025 14:11:57 +0000

Listener discretion is advised.

CORRECTION: I mentioned that Precedex is an alpha antagonist. I misspoke and meant to say that it is an "agonist."

References: Ehrman-Dupre R, Kaigh C, Salzman M, Haroz R, Peterson LK, Schmidt R. Management of Xylazine Withdrawal in a Hospitalized Patient: A Case Report. J Addict Med. 2022 Sep-Oct 01;16(5):595-598. doi: 10.1097/ADM.0000000000000955. Epub 2022 Jan 11. PMID: 35020700.

London KS, Huo S, Murphy L, Warrick-Stone T, Goodstein D, Montesi M, Carter M, Butt S, Alexander K, Satz W, Tasillo A, Xu L, Arora M, Casey E, McKeever R, Lowenstein M, Durney P, Hart B, Perrone J. Severe Fentanyl Withdrawal Associated With Medetomidine Adulteration: A Multicenter Study From Philadelphia, PA. J Addict Med. 2025 Aug 1. doi: 10.1097/ADM.0000000000001560. Epub ahead of print. PMID: 40747932.

Reel B, Maani CV. Dexmedetomidine. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513303/

Saturday Coffee Talk (12/13/25)

Mike — Sun, 14 Dec 2025 02:24:19 +0000

Listener discretion is advised.

References: Casey, J., Seitz, K., et al. (2025). Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. NEJM. Available: https://www.nejm.org/doi/full/10.1056/NEJMoa2511420?query=featured_home

Farkas. (Dec 10, 2025). PulmCrit: Hot take on RSI trial of ketamine vs etomidate. Available: https://emcrit.org/pulmcrit/rsitrial/

Srivatsa S, Chawla M, Hernandez M, et al. Helicopter transport of trauma patients continues to be overutilized: a call for universal transport criterion. Am Surg. Published online September 13, 2025:31348251378910. doi:10.1177/00031348251378910.

HEMS Utilization and Safety Panel

Mike — Tue, 09 Dec 2025 21:09:18 +0000

Listener discretion is advised.

FRIDAY Coffee Talk (12/5/25)

Mike — Fri, 05 Dec 2025 02:02:11 +0000

LISTENER DISCRETION IS ADVISED.

Kim YG, Choi YY, Han KD, Min K, Choi HY, Shim J, Choi JI, Kim YH. Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias. Sci Rep. 2021 Sep 13;11(1):18111. doi: 10.1038/s41598-021-97335-y. PMID: 34518592

Ren J, Yang Y, Zhu J, Wu S, Wang J, Zhang H, Shao X. The use of intravenous amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2021 Jan;44(1):35-43. doi: 10.1111/pace.14113. Epub 2020 Dec 9. PMID: 33118640.

TEMS Chat with PrepMedic

Mike — Mon, 01 Dec 2025 17:15:52 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (11/29/25)

Mike — Sat, 29 Nov 2025 15:27:09 +0000

Listener discretion is advised.

Greenhaw, R. & Jamali, M. (2021). Medical Helicopter Accident Review: Causes and Contributing Factors. Available: https://libraryonline.erau.edu/online-full-text/faa-aviation-medicine-reports/AM21-19.pdf

Hinkelbein J, Schwalbe M, Genzwuerker HV. Helicopter emergency medical services accident rates in different international air rescue systems. Open Access Emerg Med. 2010;2:45-49.

Millin MG, Innes JC, King GD, Abo BN, Kelly SM, Knoles CL, Vezzetti R, White CC 4th, Yee A, Gallagher JM. Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries - A NAEMSP Comprehensive Review and Analysis of the Literature. Prehosp Emerg Care. 2025 Aug 7:1-13.

Drs. Mark Piehl & Peter Antevy: Peds Trauma, Blood, and Much More

Mike — Tue, 18 Nov 2025 11:13:01 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (11/15/25)

Mike — Sat, 15 Nov 2025 14:30:26 +0000

Listener discretion is advised.

James Johns: Mobile Stroke Units

Mike — Tue, 11 Nov 2025 15:31:24 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (11/8/25)

Mike — Sat, 08 Nov 2025 11:29:33 +0000

Listener discretion is advised.

Artificial Intelligence in EMS (with a Wilderness Paramedic)

Mike — Mon, 03 Nov 2025 17:01:41 +0000

Listener discretion is advised.

Thank you to Mike Damkot for coming onto the podcast. Check him out on his podcast "EMS On the Mountain."

Saturday Morning Coffee Talk (11/1/25)

Mike — Sat, 01 Nov 2025 09:28:13 +0000

Listener discretion is advised.

Drs. Scott Weingart and Nick Ghionni: Approaching the Really Sick Pulmonary Patient

Mike — Tue, 28 Oct 2025 01:41:50 +0000

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

Saturday Morning Coffee Talk (10/25/25)

Mike — Sat, 25 Oct 2025 10:44:43 +0000

Listener discretion is advised.

The AHA 2025 Updates are a Nothingburger

Mike — Fri, 24 Oct 2025 02:23:17 +0000

Listener discretion is advised.

DOSE VF Trial: PMID 36342151 PARAMEDIC: PMID 25467566 Heads Up CPR: PMID 39442790.

Paul Sheats: Education, Effective Sim

Mike — Tue, 21 Oct 2025 16:27:19 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (10/18/25)

Mike — Sat, 18 Oct 2025 13:06:36 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (10/11/25)

Mike — Sat, 11 Oct 2025 13:02:33 +0000

Listener discretion is advised.

References: Christine Witten. Airway Jedi Blog. Available: https://airwayjedi.com/2019/01/24/etco2-valuable-vital-sign-perfusion/

Dubin A, Murias G, Estenssoro E, Canales H, Sottile P, Badie J, Barán M, Rossi S, Laporte M, Pálizas F, Giampieri J, Mediavilla D, Vacca E, Botta D. End-tidal CO2 pressure determinants during hemorrhagic shock. Intensive Care Med. 2000 Nov;26(11):1619-23. doi: 10.1007/s001340000669. PMID: 11193267.

Öztürk Örmeci G, Yiğit Ö, Eray O. Utility of ETCO2 to predict hemorrhagic shock in multiple trauma patients. Turk J Med Sci. 2022 Feb;52(1):206-215. doi: 10.3906/sag-2103-206. Epub 2022 Feb 22. PMID: 36161601; PMCID: PMC10734833.

Wahba RW, Tessler MJ, Béïque F, Kleiman SJ. Changes in PCO2 with acute changes in cardiac index. Can J Anaesth. 1996 Mar;43(3):243-5. doi: 10.1007/BF03011742. PMID: 8829863

Warner KJ, Cuschieri J, Garland B, Carlbom D, Baker D, Copass MK, Jurkovich GJ, Bulger EM. The utility of early end-tidal capnography in monitoring ventilation status after severe injury. J Trauma. 2009 Jan;66(1):26-3

The Intubation Decision

Mike — Tue, 07 Oct 2025 17:27:51 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (10/4/25)

Mike — Sat, 04 Oct 2025 16:42:15 +0000

Listener discretion is advised.

Saturday Morning Coffee Talk (9/27/25)

Mike — Sat, 27 Sep 2025 12:13:27 +0000

Listener discretion is advised.

The EMT's Perspective

Mike — Fri, 26 Sep 2025 18:14:50 +0000

Listener discretion is advised.

@PulmToilet's Crusade Against SCAPE and High-Dose Nitroglycerin

Mike — Wed, 24 Sep 2025 09:59:51 +0000

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

Sunday Coffee Talk (9/21/25)

Mike — Sun, 21 Sep 2025 18:10:04 +0000

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

Debriefing the New England Whole Blood Summit

Mike — Fri, 19 Sep 2025 19:12:12 +0000

Listener discretion is advised.

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

LIVE at Crash and Learn with the HLTH Crew

Mike — Wed, 17 Sep 2025 15:59:57 +0000

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

Listener discretion is advised.

Saturday Morning Coffee Talk (9/13/25)

Mike — Sat, 13 Sep 2025 10:29:59 +0000

Listener discretion is advised.

Community Paramedics: Sam Magill and Cody Winniford

Mike — Tue, 09 Sep 2025 17:22:31 +0000

Listener discretion is advised.

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

Saturday Morning Coffee Talk (9/6/25)

Mike — Sat, 06 Sep 2025 16:12:44 +0000

Listener discretion is advised.

Rambling about a range of topics:

Nobody cares that you work in the big city
Clipboards, tablets, charting in front of the patient
Video laryngoscopy
The vallecula
Stupid supervisors
Dealing with stupid supervisors
Needle decompression

Precepting, Orientation (and More) with Kayla Katt

Mike — Thu, 04 Sep 2025 12:10:52 +0000

Listener discretion is advised.

Yes, That Wide Complex Tach is Probably VT

Mike — Fri, 29 Aug 2025 05:21:27 +0000

LISTENER DISCRETION IS ADVISED.

References:

Buxton. Sustained Monomorphic VT: Clinical Manifestations, Diagnosis, and Evaluation. Up-to-Date.

Farré J, Rubio JM, Sternick EB. Confounding factors leading to misdiagnosing ventricular tachycardia as supraventricular in the emergency room. Indian Pacing Electrophysiol J. 2023;23(1):1-13. doi:10.1016/j.ipej.2022.11.002

Kashou AH, Evenson CM, Noseworthy PA, et al. Differentiating wide complex tachycardias: A historical perspective. Indian Heart J. 2021;73(1):7-13. doi:10.1016/j.ihj.2020.09.006

Salim Rezaie, "SVT With Aberrancy Versus VT", REBEL EM blog, November 22, 2013. Available at: https://rebelem.com/svt-aberrancy-versus-vt/.  Steinman RT, Herrera C, Schuger CD, Lehmann MH. Wide QRS tachycardia in the conscious adult. Ventricular tachycardia is the most frequent cause. JAMA. 1989 Feb 17;261(7):1013-6. PMID: 2915409.

Vereckei A. Current algorithms for the diagnosis of wide QRS complex tachycardias. Curr Cardiol Rev. 2014 Aug;10(3):262-76. doi: 10.2174/1573403x10666140514103309. PMID: 24827795; PMCID: PMC4040878.

Listener Questions, NEMSAC Termination

Mike — Wed, 20 Aug 2025 01:08:11 +0000

LISTENER DISCRETION IS ADVISED.

Random Ramblings: Dan Rauh

Mike — Sun, 10 Aug 2025 09:11:40 +0000

Listener discretion is advised.

Case Study: Subarachnoid Hemorrhage

Mike — Sun, 03 Aug 2025 16:24:55 +0000

Listener discretion is advised.

References: Cook AM, Morgan Jones G, Hawryluk GWJ, Mailloux P, McLaughlin D, Papangelou A, Samuel S, Tokumaru S, Venkatasubramanian C, Zacko C, Zimmermann LL, Hirsch K, Shutter L. Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients. Neurocrit Care. 2020 Jun;32(3):647-666. doi: 10.1007/s12028-020-00959-7. PMID: 32227294; PMCID: PMC7272487.

Desai A, Damani R. Hyperosmolar therapy: A century of treating cerebral edema. Clin Neurol Neurosurg. 2021 Jul;206:106704. doi: 10.1016/j.clineuro.2021.106704. Epub 2021 May 20. PMID: 34045110.

Mount CA, Das JM. Cerebral Perfusion Pressure. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537271/

Susanto M, Riantri I. Optimal Dose and Concentration of Hypertonic Saline in Traumatic Brain Injury: A Systematic Review. Medeni Med J. 2022 Jun 23;37(2):203-211. doi: 10.4274/MMJ.galenos.2022.75725. PMID: 35735001; PMCID: PMC9234368.

Jake Potter & Josh Cooke

Mike — Fri, 01 Aug 2025 17:50:24 +0000

Listener discretion is advised.

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

Surgical Airway Debrief

Mike — Mon, 28 Jul 2025 20:19:00 +0000

Listener discretion is advised.

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

Case Study: 84 Year Old with Chest Pain

Mike — Wed, 23 Jul 2025 11:25:44 +0000

Listener discretion is advised.

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

Conversation with a 911 Telecommunicator

Mike — Sun, 20 Jul 2025 16:58:47 +0000

Listener discretion is advised.

July Listener Questions (Clinical)

Mike — Sun, 13 Jul 2025 15:40:32 +0000

LISTENER DISCRETION IS ADVISED.

More thoughts on OB Learning 12-leads Paralytic choices ALS for AMS

Cash RE, Kaimal AJ, Samuels-Kalow ME, Boggs KM, Swanton MF, Camargo CA Jr. Epidemiology of Emergency Medical Services-Attended out-of-Hospital Deliveries and Complications in the United States. Prehosp Emerg Care. 2024;28(7):890-897.

Dexter F, Epstein RH, Wachtel RE, Rosenberg H. Estimate of the relative risk of succinylcholine for triggering malignant hyperthermia. Anesth Analg. 2013 Jan;116(1):118-22.

Nunnally ME, O'Connor MF, Kordylewski H, Westlake B, Dutton RP. The incidence and risk factors for perioperative cardiac arrest observed in the national anesthesia clinical outcomes registry. Anesth Analg. 2015 Feb;120(2):364-70.

Hard Hitting Listener Questions

Mike — Sat, 28 Jun 2025 14:50:19 +0000

Listener discretion is advised.

We will address three topics on this episode:

Burnout: "I hate my patients."
Managers who don't handle a low performing employee
"I don't feel accepted by my new team."

Introspection, Discourse, and Whiny Dispatchers

Mike — Sat, 21 Jun 2025 22:10:47 +0000

LISTENER DISCRETION IS ADVISED.

Dan Rauh: Really Sick Acidotic Patients

Mike — Thu, 12 Jun 2025 13:34:00 +0000

Listener discretion is advised.

EMS Content Creators

Mike — Sat, 07 Jun 2025 01:22:09 +0000

Listener discretion is advised.

Random Ramblings: 6/1/25

Mike — Sun, 01 Jun 2025 21:08:34 +0000

Listener discretion is advised.

No BS: "I Want to Be a Flight Medic (or Nurse)"

Mike — Wed, 28 May 2025 01:08:17 +0000

Listener discretion is advised.

May Listener Questions

Mike — Fri, 23 May 2025 16:19:25 +0000

Listener discretion is advised!

Jake Potter: Sedation, Agitation, and Rabbit-holes

Mike — Thu, 15 May 2025 18:00:18 +0000

Listener discretion is advised.

"ChiLdBiRth iS a bLs CaLL"

Mike — Sun, 11 May 2025 23:33:45 +0000

Listener discretion is advised.

Dr. Bert Schiffer: Random Ramblings with a Physician Medical Director

Mike — Thu, 08 May 2025 05:05:55 +0000

Listener discretion is advised.

Random Ramblings with Mustafa Sidik

Mike — Fri, 02 May 2025 01:17:30 +0000

Listener discretion is advised.

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

The Crashing CHF Patient with Collin Grothaus, NP

Mike — Fri, 25 Apr 2025 18:08:52 +0000

Listener discretion is advised.

Life Advice, Jumping Ship, & The Death of Crozer EMS

Mike — Thu, 24 Apr 2025 01:48:13 +0000

Listener discretion is advised.

April Listener Questions

Mike — Sun, 20 Apr 2025 17:39:56 +0000

Listener discretion is advised.

Avoiding Complacency

Mike — Fri, 11 Apr 2025 00:41:40 +0000

Listener discretion is advised.

Pass the FP-C (or CCP-C)

Mike — Fri, 04 Apr 2025 18:20:59 +0000

Listener discretion is advised.

Dr. Stephen Wood

Mike — Fri, 28 Mar 2025 04:13:50 +0000

LISTENER DISCRETION IS ADVISED.

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

Trauma Rantings

Mike — Tue, 25 Mar 2025 02:51:02 +0000

Listener discretion is advised.

References: Ball CG, Lord J, Laupland KB, Gmora S, Mulloy RH, Ng AK, Schieman C, Kirkpatrick AW. Chest tube complications: how well are we training our residents? Can J Surg. 2007 Dec;50(6):450-8. PMID: 18053373

Hannon L, St Clair T, Smith K, Fitzgerald M, Mitra B, Olaussen A, Moloney J, Braitberg G, Judson R, Teague W, Quinn N, Kim Y, Bernard S. Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service. Emerg Med Australas. 2020 Aug;32(4):650-656.

Harrison J, Bhardwaj A, Houck O, Sather K, Sekiya A, Knack S, Saarunya Clarke G, Puskarich MA, Tignanelli C, Rogers L, Marmor S, Beilman G. Emergency medical services level of training is associated with mortality in trauma patients: A combined prehospital and in hospital database analysis. J Trauma Acute Care Surg. 2025 Mar 1;98(3):402-409.

Life in the Fast Lane Article: https://litfl.com/finger-thoracostomy/

Patel, S., Green, A. Death by p-value: the overreliance on p-values in critical care research. Crit Care 29, 73 (2025). https://doi.org/10.1186/s13054-025-05307-9

Taming the SRU Blog Article: https://www.tamingthesru.com/blog/acmc/finger-thoracostomy

UVA Needle Decompression Presentation: https://www.vdh.virginia.gov/content/uploads/sites/23/2022/09/EMS-Needle-Decompression-PI-Project.pdf

@PulmToilet and Melody Bishop RT

Mike — Sat, 15 Mar 2025 17:46:29 +0000

Listener discretion is advised.

You want to be a good EMT? DO EMT THINGS.

Mike — Mon, 10 Mar 2025 21:35:57 +0000

LISTENER DISCRETION IS ADVISED.

DnR Prehospital Education: Canadian Paramedics TAKE OVER the Podcast!

Mike — Mon, 10 Mar 2025 00:26:53 +0000

Listener discretion is advised.

Listener Questions: March 2025

Mike — Mon, 03 Mar 2025 13:23:01 +0000

LISTENER DISCRETION IS ADVISED.

Mini Episode: Epidural Hematoma

Mike — Tue, 25 Feb 2025 14:57:35 +0000

Random Ramblings 2/21

Mike — Fri, 21 Feb 2025 17:13:18 +0000

LISTENER DISCRETION IS ADVISED.

COPD Follow-Up with Melody Bishop, RT

Mike — Tue, 18 Feb 2025 13:24:52 +0000

Listener discretion is advised.

Thanks to Melody for coming back on the podcast to tie up some loose ends re: the COPD episode.

The COPD Episode

Mike — Sun, 16 Feb 2025 17:07:39 +0000

Listener discretion is advised (language).

References: Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323.

Bonilla Arcos D, Krishnan JA, et al. High-Dose Versus Low-Dose Systemic Steroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Systematic Review. Chronic Obstr Pulm Dis. 2016 Feb 17;3(2):580-588.

Fawzy A, Wise RA. Pulse Oximetry Misclassifies Need for Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2023 Nov;20(11):1556-1557.

Goldberg P, Reissmann H, Maltais F, Ranieri M, Gottfried SB. Efficacy of noninvasive CPAP in COPD with acute respiratory failure. Eur Respir J. 1995 Nov;8(11):1894-900.

Jennifer T. Thibodeau, Mark H. Drazner. The Role of the Clinical Examination in Patients With Heart Failure,JACC: Heart Failure, Volume 6, Issue 7, 2018, Pages 543-551.

Kartal M, Goksu E, Eray O, et al. The value of ETCO2 measurement for COPD patients in the emergency department. Eur J Emerg Med. 2011 Feb;18(1):9-12.

Ni, H., Aye, S., Naing, C. Magnesium sulfate for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2022 May 26; 2022(5):CD013506.

Pertzov, B., Ronen, M., Rosengarten, D. et al. Use of capnography for prediction of obstruction severity in non-intubated COPD and asthma patients. Respir Res 22, 154 (2021).

Pu X, Liu L, Feng B, Wang M, Dong L, Zhang Z, Fan Q, Li Y, Wang G. Efficacy and Safety of Different Doses of Systemic Corticosteroids in COPD Exacerbation. Respir Care. 2021 Feb;66(2):316-326.

Tyagi D, Govindagoudar MB, et al. Correlation of PaCO2 and ETCO2 in COPD Patients with Exacerbation on Mechanical Ventilation. Indian J Crit Care Med. 2021 Mar;25(3):305-309.

van Gestel AJ, Steier J. Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD). J Thorac Dis. 2010 Dec;2(4):215-22. doi: 10.3978/j.issn.2072-1439.2010.02.04.5.

"BuT iT's AnOthEr ToOL"

Mike — Fri, 07 Feb 2025 18:46:37 +0000

Listener discretion is advised.

Random Ramblings 2/4/25

Mike — Tue, 04 Feb 2025 17:28:23 +0000

LISTENER DISCRETION IS ADVISED

Ashley's Back! Listener Questions

Mike — Sat, 25 Jan 2025 19:12:58 +0000

LISTENER DISCRETION IS ADVISED

EMS Education with "Dialed Medics"

Mike — Sun, 19 Jan 2025 16:05:34 +0000

Listener discretion is advised.

Thanks to Adam from "Dialed Medics" for coming onto the podcast and talking about EMS education. Follow them on social media @dialedmedics.

Prehospital Docs and Paramedics vs. Paramedics Alone

Mike — Fri, 17 Jan 2025 14:42:17 +0000

LISTENER DISCRETION IS ADVISED.

Lavery MD, Aulakh A, Christian MD. Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2025 Jan 6;33(1)

Other Citations: Bujak K, et al. Does the presence of physician-staffed emergency medical services improve the prognosis in out-of-hospital cardiac arrest? A propensity score matching analysis. Kardiol Pol. 2022;80(6)

Fukuda T, et al.. Association of Prehospital Advanced Life Support by Physician With Survival After Out-of-Hospital Cardiac Arrest With Blunt Trauma Following Traffic Collisions: Japanese Registry-Based Study. JAMA Surg. 2018 Jun 20;153(6)

Garner et al.. The Head Injury Retrieval Trial (HIRT): a single-centre randomised controlled trial of physician prehospital management of severe blunt head injury compared with management by paramedics only. Emerg Med J. 2015 Nov;32(11)

Den Hartog et al.. Survival benefit of physician-staffed helicopter emergency medical services (HEMS) assistance for severely injured patients. Injury. 2015;46(7)

Hesselfeldt R,et al.. Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study. Acta Anaesthesiol Scand. 2013 May;57(5):

Lyons J, et al. Impact of a physician - critical care practitioner pre-hospital service in Wales on trauma survival. Anaesthesia. 2021 Nov;76(11)

Maddock A, et al. Prehospital critical care is associated with increased survival in adult trauma patients in Scotland. Emerg Med J. 2020 Mar;37(3):141-145.

Moors XRJ, et al. A Physician-Based Helicopter Emergency Medical Services Was Associated With an Additional 2.5 Lives Saved per 100 Dispatches of Severely Injured Pediatric Patients. Air Med J. 2019 Jul-Aug;38(4)

Yeguiayan JM, et al. Medical pre-hospital management reduces mortality in severe blunt trauma. Crit Care. 2011;15(1)

Endocarditis

Mike — Sat, 11 Jan 2025 19:28:39 +0000

Listener discretion is advised.

References:

Gutierrez, E. (2023). The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals.

Hu W, Wang X, Su G. Infective endocarditis complicated by embolic events: Pathogenesis and predictors. Clin Cardiol. 2021 Mar;44(3):307-315. doi: 10.1002/clc.23554. Epub 2021 Feb 1. PMID: 33527443; PMCID: PMC7943911.

Marik PE, Farkas JD. The Changing Paradigm of Sepsis: Early Diagnosis, Early Antibiotics, Early Pressors, and Early Adjuvant Treatment. Crit Care Med. 2018 Oct;46(10):1690-1692. doi: 10.1097/CCM.0000000000003310. PMID: 30216303.

Resuscitate Before You Intubate (Coop's Question)

Mike — Fri, 03 Jan 2025 01:50:00 +0000

LISTENER DISCRETION IS ADVISED.

REFERENCES:

Ferrada P, García A, Duchesne J, Brenner M, Liu C, Ordóñez C, Menegozzo C, Salamea JC, Feliciano D. Comparing outcomes in patients with exsanguinating injuries: an Eastern Association for the Surgery of Trauma (EAST), multicenter, international trial evaluating prioritization of circulation over intubation (CAB over ABC). World J Emerg Surg. 2024 Apr 25;19(1):15. doi: 10.1186/s13017-024-00545-8. PMID: 38664763; PMCID: PMC11044388.

Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypotension Kills (Part 1 of 3)", REBEL EM blog, September 26, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypotension-kills-part-1-of-3/.

Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – Hypoxemia Kills (Part 2 of 3)", REBEL EM blog, September 29, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-hypoxemia-kills-part-2-of-3/.

Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

Scott Weingart, MD FCCM. EMCrit 30 – Hemorrhagic Shock Resuscitation. EMCrit Blog. Published on August 15, 2010. Accessed on December 27th 2024. Available at [https://emcrit.org/emcrit/trauma-resuscitation-dutton/ ].

More Cardiac Arrest with Josh Cooke

Mike — Tue, 31 Dec 2024 16:53:27 +0000

Josh Cooke from the Alert Medic One Podcast came back to the podcast to talk more about his favorite topic, cardiac arrest. We discuss the recent articles on naloxone in cardiac arrest. Listener discretion is advised.

References: PMID 39163042 PMID 38848964

Wrap Up: Leadership, Accountability, Resiliency, Coaching

Mike — Mon, 23 Dec 2024 20:10:11 +0000

LISTENER DISCRETION IS ADVISED.

Cody Winniford - Ordinary Ops Medic

Mike — Fri, 20 Dec 2024 16:37:00 +0000

LISTENER DISCRETION IS ADVISED.

Good Leadership in EMS

Mike — Mon, 16 Dec 2024 19:22:41 +0000

LISTENER DISCRETION IS ADVISED.

Random Ramblings 12/10

Mike — Wed, 11 Dec 2024 02:45:54 +0000

LISTENER DISCRETION IS SERIOUSLY ADVISED.

I'm traveling (again) and decided to record a random ramblings episode with some thoughts that have been on my mind. Nothing clinical on this episode: mostly leadership topics.

Chest Pain Differential Diagnosis

Mike — Wed, 04 Dec 2024 17:08:58 +0000

Listener discretion is advised.

References: PMID 28196622 PMID 35166796 PMID 26062607 Salim Rezaie, "Does My Patient with Chest Pain Have Acute Coronary Syndrome?", REBEL EM blog, November 23, 2015. Available at: https://rebelem.com/does-my-patient-with-chest-pain-have-acute-coronary-syndrome/.

TEMS Wrap-Up

Mike — Fri, 29 Nov 2024 16:24:42 +0000

LISTENER DISCRETION IS ADVISED.

Steve Wood: TEMS, Trauma, & More

Mike — Tue, 26 Nov 2024 15:19:53 +0000

LISTENER DISCRETION IS ADVISED.

Steve Wood came back to the podcast to talk about TEMS and more. Check out his new podcast, The Tac Medic Whiskey Podcast, available on Podbean and Apple Podcasts.

Dr. Patrick Sullivan: Metabolic Health, First Responder Health

Mike — Thu, 21 Nov 2024 02:11:05 +0000

Tactical EMS: Lessons Learned and Concept Evolution

Mike — Fri, 15 Nov 2024 04:32:30 +0000

Listener discretion is advised.

Chris Wright: Lessons in Trauma from Ukraine

Mike — Mon, 11 Nov 2024 04:09:38 +0000

Listener discretion is advised.

Chris Wright is a flight paramedic who spent a few months working as a medic in the Ukranian conflict. He came on to talk about tourniquet conversion but we ended up going into all kinds of trauma lessons he learned from his time.

The Five Things that Make a Good EMS Provider

Mike — Tue, 05 Nov 2024 16:40:24 +0000

LISTENER DISCRETION IS ADVISED.

Responding to the Keyboard Warriors, Minor Chest Pain from Minor MVAs

Mike — Tue, 29 Oct 2024 15:56:42 +0000

LISTENER DISCRETION IS ADVISED.

Drs. Mark Piehl & Peter Antevy on the Prehospital Blood Debate

Mike — Fri, 18 Oct 2024 17:50:26 +0000

It was an honor and a privilege to record an episode with Dr. Mark Piehl and Dr. Peter Antevy. They came on to discuss prehospital blood product administration and their recent letter to the editor in Academic Emergency Medicine.

Sick Little Kids - Redux

Mike — Sun, 13 Oct 2024 15:18:48 +0000

Listener discretion is advised.

References:

CHOP Croup Clincial Pathway: https://pathways.chop.edu/clinical-pathway/croup-emergency-department-and-inpatient-clinical-pathway

General Peds Reference: Lucking, S. Maffei, F., Tamburro, R., & Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide.

Pediatric Fluid Maintenance: Somers, Michael. (2022). Maintenance intravenous fluid therapy in children. Up-to-Date.

Racemic vs. Standard Epi: PMID: 1734400

Do the Ordinary Extraordinarily Well

Mike — Mon, 30 Sep 2024 17:48:32 +0000

Listener discretion is advised

Intubation Ramblings: Protocols, Devices, Techniques

Mike — Fri, 27 Sep 2024 00:58:33 +0000

LISTENER DISCRETION IS ADVISED

References: Anand Swaminathan, "REBEL Cast Ep107: The BOUGIE Trial – Bougie First in All Emergency Intubations?", REBEL EM blog, February 17, 2022. Available at: https://rebelem.com/rebel-cast-ep107-the-bougie-trial-bougie-first-in-all-emergency-intubations/.

AirTraq vs. Bougie: PMID 28515522

McGrath vs. AirTraq: PMID 28781449

Bougie vs. Stylet: PMID 29800096

Rigid vs. Standard Stylet: PMID 22273475

Random Talk: Sept 17, 2024

Mike — Tue, 17 Sep 2024 17:14:13 +0000

LISTENER DISCRETION IS VERY ADVISED

Topics: Meta-Analysis Fallout, NREMT stuff, Offensive idiot at EMS Expo

Thoughts on a Meta-Analysis Casting Doubt on Prehospital Blood

Mike — Mon, 09 Sep 2024 20:33:35 +0000

LISTENER DISCRETION IS REALLY ADVISED.

References: Meta-Analysis Civ Prehospital Transfusion: PMID 38517320 COMBAT: PMID 30032977 PamPER: PMID 30044935 RePhill: PMID 35271808 COMBAT/PamPER Post-Hoc Analysis: PMID 31851290

Blood Stuff with Rick Maricle

Mike — Sat, 07 Sep 2024 11:54:17 +0000

Listener discretion is advised.

EMS training guru Rick Maricle came onto talk about the regional blood program in Southern Texas and to talk unscripted about prehospital blood.

"StArT a MeDiC 4 HyPeRtEnSiON"

Mike — Sat, 31 Aug 2024 21:57:03 +0000

LISTENER DISCRETION IS ADVISED

Gauer, R. (2017). Severe Asymptomatic Hypertension: Evaluation and Treatment. Am Family Physician. 95(8).

Oras, et. Al. (2019). Elevated BP in the ED. Hypertension 75(1).

Yaphe, J, Atzema, C, Helman, A. Hypertensive Emergencies. Emergency Medicine Cases. February, 2014.

Listener Clinical Questions (Prologue: HEMS Rant)

Mike — Sat, 24 Aug 2024 17:23:47 +0000

LISTENER DISCRETION IS ADVISED References: Mag Sulfate for A-Fib: PMID 17449500, 34950320 Eclampsia: PMID 21154341

The First Two Years of Being a Medic are Hard

Mike — Tue, 20 Aug 2024 17:09:35 +0000

Listener discretion is advised.

Two "newer" medics - Ashlynn and Cameron (my partner) come onto the podcast to talk about the struggles and growth potential of being a new paramedic.

Culture of Safety, Culture of Stupidity

Mike — Thu, 15 Aug 2024 01:28:09 +0000

LISTENER DISCRETION IS ADVISED.

Safety: culture of safety, buzzword, HEMS safety, ground safety, and more

Winning Paramedic School: Hard Work

Mike — Tue, 06 Aug 2024 16:25:18 +0000

Listener discretion is advised.

MORE Rethinking Traumatic Arrest

Mike — Sat, 27 Jul 2024 21:42:03 +0000

Listener discretion is advised.

References (PMID):

Compressions: 29132577, 35549924

Junctional TQ/Pelvic Binders: 31910475, 29889959, 38226570, 30507857

Vasopressors: 33908898, 23697682, 28716309

Blood: 34390843, Hazelton, et. al. (2022). Whole blood vs. component therapy for transufsion in trauma pts., McCartney (2023). Whole blood in resuscitating trauma is making a comeback.

Glitchy Virtual Happy Hour with Wes

Mike — Fri, 26 Jul 2024 16:27:00 +0000

Random talk with Wes Nelson...listener discretion is advised

Podcast Therapy: Me, My Story, & How the Podcast Started

Mike — Fri, 19 Jul 2024 01:10:09 +0000

Listener discretion is REALLY advised.

Random Talk: Teaching in Baltimore with Cody and Moose

Mike — Thu, 18 Jul 2024 04:08:51 +0000

Listener discretion is advised

Cody (@ordinaryopsmedic) and Moose - both from the Alert Medic One team - came on to have a totally random and agendaless discussion about....well....give it a listen...

Trauma, Blood, & Politics

Mike — Fri, 12 Jul 2024 17:33:01 +0000

Paramedic, Nurse Practitioner, Associate Professor, and Bioethicist Stephen Wood came onto the podcast to talk about implementing prehospital blood and to do what I love: dispelling "the narrative."

"Scoop & Run:" Police Trauma Transport

Mike — Mon, 01 Jul 2024 21:17:39 +0000

LISTENER DISCRETION IS ADVISED

References: Band RA, Salhi RA, Holena DN, Powell E, Branas CC, Carr BG. Severity-adjusted mortality in trauma patients transported by police. Ann Emerg Med. 2014 May;63(5):608-614.e3. doi: 10.1016/j.annemergmed.2013.11.008. Epub 2014 Jan 2. PMID: 24387925; PMCID: PMC5912155.

Inaba K, Jurkovich GJ. Police Transport for Penetrating Trauma-Lessons From Patients in Philadelphia. JAMA Netw Open. 2021 Jan 4;4(1):e2035122. doi: 10.1001/jamanetworkopen.2020.35122. PMID: 3349Time 2370.

Maher, et. Al. (2021). Police transport of Firearm-Injured patients- more often and more injured. Journal of Acute Care Surgery. PMID 34108420

Winter, et al. (2021). Association of Police Transport with Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania. JAMA Open Network. PMID 33492375

Winter E, Byrne JP, Hynes AM, Geng Z, Seamon MJ, Holena DN, Malhotra NR, Cannon JW. Coming in hot: Police transport and prehospital time after firearm injury. J Trauma Acute Care Surg. 2022 Nov 1;93(5):656-663. doi: 10.1097/TA.0000000000003689. Epub 2022 May 20. PMID: 36282621.

Code Debrief with Josh from Alert Medic One

Mike — Sun, 30 Jun 2024 16:00:20 +0000

Josh from the Alert Medic One Podcast came on to debrief a recent cardiac arrest call he ran and discuss some cardiac arrest topics.

Random Ramblings: 6/20/24

Mike — Fri, 21 Jun 2024 01:37:13 +0000

LISTENER DISCRETION IS ADVISED

Scene Flight: Masive Facial Trauma

Mike — Sun, 16 Jun 2024 21:07:59 +0000

Listener discretion is advised.

References:

Grossman, Dave. (2004). On Combat. http://www.litfl.com http://deployedmedicine.com PMID: 26566339 (Pelvic Ring) PMID 2025808 (LeFort and anatomical pathology) PMID: 36147139 (Lefort III Management) PMID: 31626153 (CICO)

More Respiratory! Melody Bishop RT is back!

Mike — Fri, 07 Jun 2024 12:18:06 +0000

The enchanting and brilliant Melody Bishop, RT came back on to the podcast to answer your respiratory/vent/blood gas/monitoring questions. We are also joined by one of my mentors, Dave Salati (flight nurse, ER nurse, pediatric nurse, and OG urban paramedic) who made his podcasting debut.

"Drop Off Imposter Syndrome"

Mike — Mon, 27 May 2024 20:54:01 +0000

LISTENER DISCRETION IS ADVISED

Random Talk: Cardiac Monitors, Life & Death, LODDs

Mike — Fri, 17 May 2024 17:27:27 +0000

LISTNER DISCRETION (IS REALLY) ADVISED

Random Talk: FOAMed, Social Media, "Progressive" Agencies

Mike — Mon, 13 May 2024 23:52:00 +0000

LISTENER DISCRETION IS ADVISED

Fire-Based EMS

Mike — Thu, 09 May 2024 13:12:11 +0000

Alert Medic One Podcast's Josh came on to discuss the good and the bad about fire-based EMS. Spoiler alert, there's more good. The old paradigm of "F EMS" is changing (in many places).

Kirk from Hamilton: Bringing the ICU Vent to the Ambulance

Mike — Sun, 05 May 2024 02:15:10 +0000

Kirk Smith, RT from Hamilton Medical came onto the podcast to talk about the Hamilton T1 and how EMS agencies from CCT to IFT to 911 services are using it.

I Pivoted on POCUS

Mike — Mon, 29 Apr 2024 21:11:24 +0000

LISTENER DISCRETION IS ADVISED

Peds Resus and The Tortured Paramedics Department

Mike — Sat, 27 Apr 2024 20:39:49 +0000

LISTENER DISCRETION IS ADVISED PMID: 35832199

Ashlynn O'Dell, Being a Young Paramedic, Imposter Syndrome

Mike — Tue, 23 Apr 2024 17:38:44 +0000

Expert Panel: Mental Health

Mike — Mon, 15 Apr 2024 21:26:19 +0000

Alex Jabr from Emergency Resilience and James Boomhower from StayFit4Duty came onto the podcast to have some unscripted real talk about first responder mental health. Listener discretion is advised.

Mini Episode: Can't See the Cords

Mike — Thu, 11 Apr 2024 13:40:28 +0000

Questioning the Prehospital Airway Narrative

Mike — Tue, 09 Apr 2024 16:45:11 +0000

Listener Discretion is Advised.

References: FPS ED: PMID 31843066 Improving ED FPS: PMID 34494654 HEMS FPS: PMID 36411447 HEMS MD vs. Medic FPS: PMID 24841771 Wang and Kupas: PMID 12837645 Wang's Next Paper: PMID 16531595

Nurse Gwenny Takes Over the Podcast

Mike — Mon, 01 Apr 2024 15:39:03 +0000

LISTENER DISCRETION IS ADVISED. NurseGwenny takes over the podcast and interviews Mike (not like you don't hear enough from him...)

The Fine Print: Mechanical CPR Devices and SGAs (briefly)

Mike — Sat, 30 Mar 2024 02:42:56 +0000

SAVE: PMID: 35179588 AIRWAYS-2: PMID: 30167701 PART: PMID: 30167699 2021 Devices: PMID: 35353993 2022 OCHA Mechanical devices: PMID: 35268537

Random Talk: Nurse Gwenny

Mike — Wed, 27 Mar 2024 20:11:23 +0000

Listener discretion is advised

Boomer Medics

Mike — Wed, 20 Mar 2024 19:24:33 +0000

LISTENER DISCRETION IS ADVISED

The Boomer Medic Boogeyman: Albuterol and Flash Pulmonary Edema

Mike — Sat, 09 Mar 2024 13:15:52 +0000

Listener discretion is advised.

References: PMID 27863863 PMID 18572345 PMID 30582477

Ashley is Back with Listener Questions

Mike — Wed, 06 Mar 2024 01:46:06 +0000

LISTENER DISCRETION IS ADVISED

REFERENCES CITED: PMID 36180168 PMID 26033128 PMID 30996631 PMID 32663410 PMID 33552437 OMI Manifesto. http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html

Random Talk

Mike — Fri, 23 Feb 2024 22:46:23 +0000

LISTENER DISCRETION IS ADVISED

Topics: Bad Day to Be a SGA, Sim Labs, PA EMS Drama

Making the Transition from 911 Paramedic to Critical Care

Mike — Sun, 18 Feb 2024 16:50:37 +0000

Right Heart Disasters with The Critical Care NP

Mike — Thu, 15 Feb 2024 22:08:40 +0000

Probably the Best Vent Podcast Ever Made with Melody Bishop RT

Mike — Thu, 01 Feb 2024 14:47:14 +0000

Read Melody's ventilator book! Available at https://ecampusontario.pressbooks.pub/mechanicalventilators/

Delayed Sequence Intubation

Mike — Sun, 21 Jan 2024 16:48:46 +0000

Listener discretion is advised. References: PMID 37058727, 25447559, 29405806

Mental Health: Patrick Sullivan, DO and Ketamine Therapy

Mike — Mon, 15 Jan 2024 02:37:41 +0000

My doctor. My story. My brain.

The Aorta did What?

Mike — Wed, 10 Jan 2024 01:11:34 +0000

Listener discretion is advised. PMID 27407401, 25231423, 16890849,275945 Black & Drews & Rabkin (2022). Up-to-Date.

Journal Club with Gwenny

Mike — Tue, 02 Jan 2024 18:12:50 +0000

Listener discretion is advised.

Discussing: Thompson G, Miller B, Lenz TJ. Comparing Intubation Success Between Flight Nurses and Flight Paramedics in Helicopter Emergency Medical Services. Air Med J. 2023 Nov-Dec;42(6):436-439. doi: 10.1016/j.amj.2023.07.004. Epub 2023 Aug 10. PMID: 37996178.

Unscripted Critical Care Talk with Ryan Bolger

Mike — Sat, 30 Dec 2023 03:22:45 +0000

Ryan Bolger is a flight paramedic and soon-to-be nurse.

The Elijah McClain Case

Mike — Sat, 23 Dec 2023 19:27:14 +0000

Listener discretion advised

Where is EMS Headed and Who is Driving?

Mike — Wed, 20 Dec 2023 02:28:16 +0000

Listener discretion is advised.

Unscripted Listener Questions with Wes

Mike — Thu, 14 Dec 2023 00:21:28 +0000

Too Sick for Transfer?

Mike — Sun, 10 Dec 2023 22:18:01 +0000

Huge Pleural Effusion and Vile ABGs

Mike — Sat, 02 Dec 2023 15:59:26 +0000

REFERENCES:

PMID 31315808 PMID 29530870 PMID 29372629 Strange, C. (2023). Epidemiology, clinical presentation, and diagnostic evaluation of parapneumonic effusion and empyema in adults. Up-To-Date.

Culture, Attitude, Professionalism with Rick Maricle

Mike — Sun, 26 Nov 2023 16:31:33 +0000

CPR Induced Consciousness, Education, and Leadership

Mike — Tue, 21 Nov 2023 16:50:02 +0000

Jake makdes his debut on the podcast.

Shock Trauma

Mike — Wed, 15 Nov 2023 21:55:50 +0000

Listner Questions 11/1/23

Mike — Wed, 01 Nov 2023 15:11:28 +0000

Answering listener questions..Topics:

Pain management
C-spine injuries
Impact EMS rebranding
Instructor pet peeves

Resus Sequence Intubation

Mike — Sun, 15 Oct 2023 17:45:17 +0000

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

Degrees, The Paramedic Practitioner

Mike — Sun, 01 Oct 2023 16:58:16 +0000

Tools, Toys, and Patient Assessment

Mike — Sat, 16 Sep 2023 18:16:44 +0000

Friday Night Randomness

Mike — Sat, 09 Sep 2023 02:41:30 +0000

Random rantings and thoughts:

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

Case Study: AIDS/ARDS/Sepsis/TB Guy

Mike — Tue, 29 Aug 2023 16:59:54 +0000

References:

AIDS and TB: PMID 7629858

Owens, William. (2021). The Ventilator Book.

Leadership: It's Up to Us

Mike — Fri, 18 Aug 2023 15:49:51 +0000

Raising the Bar for Paramedic Education - Part 2: Leadership, Sim, Stats

Mike — Tue, 15 Aug 2023 17:11:14 +0000

References:

Low-Fi Sim > HiFi: PMID 33872104

HiFi not necessarily better: PMID 27215280

Clincial outcomes and sims: PMID 19642147

Raising the Bar for Paramedic Education: Part 1 - The Right People

Mike — Tue, 08 Aug 2023 19:01:37 +0000

References:

Collins, Jim. Good to Great.

Attrition Rates: PMID 37034493 Accreditation: PMID 16531381 Flipped Programs: PMID 33328795

Mentoring & Precepting: A "Philosophical" Discussion

Mike — Fri, 28 Jul 2023 16:01:28 +0000

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

Unscripted: Urban EMS

Mike — Fri, 28 Jul 2023 15:57:39 +0000

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

LVADs

Mike — Tue, 11 Jul 2023 14:56:52 +0000

Cabrera, Daniel. (Nov 2, 2014). A Basic Approach to the LVAD Patient in the Emergency Department. Available: https://emblog.mayo.edu/2014/11/02/a-basic-approach-to-the-lvad-patient-in-the-emergency-department/

Tchantchaleishvili V, Sagebin F, Ross RE, Hallinan W, Schwarz KQ, Massey HT. Evaluation and treatment of pump thrombosis and hemolysis. Ann Cardiothorac Surg. 2014 Sep;3(5):490-5. doi: 10.3978/j.issn.2225-319X.2014.09.01. PMID: 25452909; PMCID: PMC4229473.

10 Rules for BLS Providers

Mike — Thu, 06 Jul 2023 20:24:50 +0000

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

Toolbags, Haters, FOAMed, & EBM

Mike — Tue, 27 Jun 2023 19:04:38 +0000

Air Medical Ops: The Reality

Mike — Sun, 11 Jun 2023 02:23:54 +0000

References: Miles MVP, Beasley JR, Reed HE, Miles DT, Haiflich A, Beckett AR, Lee YL, Bowden SE, Panacek EA, Ding L, Brevard SB, Simmons JD, Butts CC. Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure. J Surg Res. 2022 May;273:211-217. doi: 10.1016/j.jss.2021.12.038. Epub 2022 Jan 29. PMID: 35093837.

Roman J, Shank W, Demirjian J, Tang A, Vercruysse GA. Overutilization of Helicopter Transport in the Minimally Burned-A Healthcare System Problem That Should Be Corrected. J Burn Care Res. 2020 Jan 30;41(1):15-22. doi: 10.1093/jbcr/irz143. PMID: 31504602.

Adcock AK, Minardi J, Findley S, Daniels D, Large M, Power M. Value Utilization of Emergency Medical Services Air Transport in Acute Ischemic Stroke. J Emerg Med. 2020 Nov;59(5):687-692. doi: 10.1016/j.jemermed.2020.08.005. Epub 2020 Oct 1. PMID: 33011044; PMCID: PMC8006070.

Chen X, Gestring ML, Rosengart MR, Peitzman AB, Billiar TR, Sperry JL, Brown JB. Logistics of air medical transport: When and where does helicopter transport reduce prehospital time for trauma? J Trauma Acute Care Surg. 2018 Jul;85(1):174-181. doi: 10.1097/TA.0000000000001935. PMID: 29787553.

Chen X, Gestring ML, Rosengart MR, Billiar TR, Peitzman AB, Sperry JL, Brown JB. Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport. J Trauma Acute Care Surg. 2018 Apr;84(4):549-557. doi: 10.1097/TA.0000000000001769. PMID: 29251708.

Nighttime Chatter with Ashley

Mike — Fri, 09 Jun 2023 02:03:28 +0000

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

Product Review: Tempus Pro

Mike — Wed, 31 May 2023 16:52:14 +0000

Sick Little Kids

Mike — Mon, 29 May 2023 15:15:10 +0000

Gwenny and Ashley came on the podcast to talk about dealing with sick pediatric patients.

References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/.

Lucking, S. Maffei, F., Tamburro, R., & Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide.

Nagler, Joshua. Cheifetz, Ira. (2021). Initiating Mechanical Ventilation in Children. Up-to-Date.

The BLS Divide: Unscripted Ranting with Sarah

Mike — Mon, 15 May 2023 15:05:06 +0000

"Stuff About Burns"

Mike — Fri, 05 May 2023 16:34:59 +0000

Unscripted and Unprepared with Gwenny and Ashley

Mike — Fri, 28 Apr 2023 10:45:00 +0000

Rippin' Aortas

Mike — Sat, 15 Apr 2023 16:36:38 +0000

Q&A with Bill

Mike — Wed, 12 Apr 2023 14:38:21 +0000

On-Line Medical Control Must Die

Mike — Sat, 01 Apr 2023 20:58:04 +0000

Supraglottic Airway Update

Mike — Tue, 28 Mar 2023 02:37:02 +0000

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

Paramedic School

Mike — Tue, 14 Mar 2023 17:15:48 +0000

Rethinking Prehospital Trauma Arrest

Mike — Sun, 05 Mar 2023 11:59:05 +0000

REFERENCES: Nick Costain. (2018). Management Controversies in Traumatic Cardiac Arrest. EM Ottawa Blog. Available at https://emottawablog.com/2018/04/management-controversies-in-traumatic-cardiac-arrest/epi

Royal Melbourne Hospital. (2018). Traumatic Cardiac Arrest Guideline. https://www.thermh.org.au/sites/default/files/media/documents/clinical/TRM%2008.12%20Traumatic%20Arrest%20Guideline%20V1.0_08.17.pdf

Watts S, Smith JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhage-induced traumatic cardiac arrest. Resuscitation. May 2019. doi:10.1016/j.resuscitation.2019.04.048 Wongtanasarasin W, Thepchinda T, Kasirawat C, Saetiao S, Leungvorawat J, Kittivorakanchai N. Treatment Outcomes of Epinephrine for Traumatic Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis. J Emerg Trauma Shock. 2021 Oct-Dec;14(4):195-200. doi: 10.4103/JETS.JETS_35_21. Epub 2021 Nov 23. PMID: 35125783; PMCID: PMC8780637.

Yamamoto, R., Suzuki, M., Hayashida, K. et al. Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study. Scand J Trauma Resusc Emerg Med 27, 74 (2019). https://doi.org/10.1186/s13049-019-0657-8

Shooting the Breeze with Bill

Mike — Thu, 02 Mar 2023 15:21:08 +0000

Unscripted Sunday with Ashley

Mike — Sun, 19 Feb 2023 21:22:04 +0000

References: PMID 26557486

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

Naloxone: A Rational Approach

Mike — Thu, 09 Feb 2023 14:18:15 +0000

REFERENCES: Bhardwaj H, Bhardwaj B, Awab A. Revisiting opioid overdose induced acute respiratory distress syndrome. Indian J Crit Care Med. 2014 Feb;18(2):119-20. doi: 10.4103/0972-5229.126095. PMID: 24678160; PMCID: PMC3943122.

Elkattawy S, Alyacoub R, Ejikeme C, Noori MAM, Remolina C. Naloxone induced pulmonary edema. J Community Hosp Intern Med Perspect. 2021 Jan 26;11(1):139-142. doi: 10.1080/20009666.2020.1854417. PMID: 33552437; PMCID: PMC7850343.

Kummer RL, Kempainen RR, Olives TD, Leatherman JW, Prekker ME. Naloxone-associated pulmonary edema following recreational opioid overdose. Am J Emerg Med. 2022 Mar;53:41-43. doi: 10.1016/j.ajem.2021.12.030. Epub 2021 Dec 17. PMID: 34973491.

Saybolt MD, Alter SM, Dos Santos F, Calello DP, Rynn KO, Nelson DA, Merlin MA. Naloxone in cardiac arrest with suspected opioid overdoses. Resuscitation. 2010 Jan;81(1):42-6. doi: 10.1016/j.resuscitation.2009.09.016. Epub 2009 Nov 13. PMID: 19913979.

Ventura AL, White CC 4th, Braude D. Letter to the Editor in Response to "Naloxone Cardiac Arrest Decision Instruments (NACARDI) for targeted antidotal therapy in occult opioid overdose precipitated cardiac arrest". Resuscitation. 2021 Jul;164:157-158. doi: 10.1016/j.resuscitation.2021.02.044. Epub 2021 May 9. PMID: 33979667.

Unscripted with Gwenny

Mike — Wed, 08 Feb 2023 03:29:01 +0000

OMI and Prehospital 12-Lead EKGs

Mike — Sat, 04 Feb 2023 18:37:29 +0000

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

Friday Night Thoughts

Mike — Sat, 28 Jan 2023 01:24:28 +0000

REFERENCES: August, P., Siabi, B. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date.

Judy AE, McCain CL, Lawton ES, Morton CH, Main EK, Druzin ML. Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California. Obstet Gynecol. 2019 Jun;133(6):1151-1159. doi: 10.1097/AOG.0000000000003290. PMID: 31135728.

Pericarditis

Mike — Fri, 20 Jan 2023 18:35:52 +0000

Helman, A. (2022). Pericarditis and Cardiac Tamponade. Emergency Medicine Cases. Available at: https://emergencymedicinecases.com/pericarditis-cardiac-tamponade/

Imazio, M. (2022). Acute Pericarditis: Clinical Presentation and Diagnosis. Up-to-Date.

Imazio M, Cecchi E, Demichelis B, Ierna S, Demarie D, Ghisio A, Pomari F, Coda L, Belli R, Trinchero R. Indicators of poor prognosis of acute pericarditis. Circulation. 2007 May 29;115(21):2739-44. doi: 10.1161/CIRCULATIONAHA.106.662114. Epub 2007 May 14. PMID: 17502574.

Swaminathan, A. (2016). Pericarditis. Core EM Blog. Available at https://coreem.net/core/pericarditis/

The Sh*t Storm in Springfield

Mike — Fri, 13 Jan 2023 17:04:26 +0000

EPISODE WARNING: SENSITIVE TOPICS, FOUL LANGUAGE

Rapid Fire Q&A

Mike — Tue, 10 Jan 2023 18:26:31 +0000

The New NREMT Test and Passing the Boards

Mike — Sun, 01 Jan 2023 18:34:32 +0000

Transporting the Cardiac ICU Patient

Mike — Sun, 01 Jan 2023 18:33:36 +0000

Holiday Message

Mike — Sat, 24 Dec 2022 18:10:10 +0000

Woke CPR Dummies, Crying Doctors, Albuterol, & Fentanyl

Mike — Mon, 19 Dec 2022 01:29:24 +0000

Simply a commentary episode.

"You're Supposed to Get My Back" with Bill

Mike — Tue, 13 Dec 2022 18:38:27 +0000

Guest Panel Discussion

Mike — Wed, 07 Dec 2022 16:28:33 +0000

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

Things to Know if You Want to REALLY Want to Fly

Mike — Fri, 25 Nov 2022 18:15:10 +0000

High Flow Nasal Cannula

Mike — Fri, 18 Nov 2022 17:21:41 +0000

Nishimura, Masaji. (2016). High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respiratory Care, 61(4), 529-41.

Sharma S, Danckers M, Sanghavi D, et al. High Flow Nasal Cannula. [Updated 2022 Sep 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526071/

High Risk OB

Mike — Wed, 09 Nov 2022 02:47:07 +0000

August, Phyllis. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date.

Euser, A. & Cipolla, M. (2009). Magnesium sulfate for the treatment of eclampsia. Stroke, 40.

Nelson, K. (2019). Determining FHR during air transport. Available: http://survivalflighteducationblog.com/determining-fetal-heart-rate-during-air-transport/lit

NHS. The Obs Podcast. Episode: FHT - Part One.

Simhan, H. Caritis, S. (2022). Inhibition of Acute Preterm Labor. Up-to-Date.

Recent Questions from the DMsphere

Mike — Thu, 03 Nov 2022 23:41:57 +0000

Listner questions and my (rambling) answers.

REFERENCES Baize, Kohman, Stoffel, Weigartz. (2021). Albuterol versus terbutaline in emergency department management of asthma or COPD exacerbation. Critical Care Medicine 49(1 suppl 1): 410.

Busti. (2015). Nitroglycerin Use in the Initial Management of Ischemic Pain from Acute Myocardial Infarction (NSTEMI, STEMI). Available: https://www.ebmconsult.com/articles/nitroglycerin-use-in-initial-management-ischemic-pain-acute-myocardial-infarction-nstemi-stemi

Mike Sarraille, George Randle, Josh Cotton. The Talent War: How Special Operations and Great Organizations Win on Talent.

Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

Bonus: Supraglottic Airways

Mike — Sun, 23 Oct 2022 21:09:46 +0000

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

Debriefing the Code from Hell

Mike — Sun, 23 Oct 2022 18:01:55 +0000

References: Burton LV, Beier K. Papillary Muscle Rupture. [Updated 2022 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499976/

Jung J, Rice J, Bord S. Rethinking the role of epinephrine in cardiac arrest: the PARAMEDIC2 trial. Ann Transl Med. 2018 Dec;6(Suppl 2):S129. doi: 10.21037/atm.2018.12.31. PMID: 30740450; PMCID: PMC6330609.

Thiele, Holger. Abbott, J Dawn. (2022). Acute Myocardial Infarction: Mechanical Complications. Up-to-Date.

Meaningful Clinical Competencies

Mike — Wed, 19 Oct 2022 03:03:47 +0000

TAME: Fitness and Tactical EMS

Mike — Wed, 12 Oct 2022 23:13:37 +0000

PROBING the POCUS Question

Mike — Fri, 07 Oct 2022 03:22:09 +0000

The Myth of Anaphylaxis

Mike — Sat, 01 Oct 2022 19:18:09 +0000

References: Campbell & Kelso. (2022). Anaphylaxis: Emergency Treatment.

http://www.litfl.com/tip-10-pearls-for-managing-anaphylaxis

http://emcrit.org/ibcc/anaphylaxis

McLendon and Sternard. Anaphylaxis (2022). NCBI NBK482124.

PMID: 29909382, 20028373, 2931426

BLS Crews: The Good, The Bad, & The Ugly

Mike — Mon, 26 Sep 2022 01:23:38 +0000

Sarah Motley: Endocrine, Diabetic Patients

Mike — Sun, 25 Sep 2022 01:29:45 +0000

Sarah Motley, EMT, RN: instructor from IA Med comes on to shoot the breeze and talk about endocrine patients and responding to diabetics.

Unscripted: Off-the-Cuff Discussion

Mike — Sun, 18 Sep 2022 00:21:14 +0000

Mike and Ashley discuss random stuff: imposter syndrome, dispatch, and "the brand" among other topics.

"But The Cards Said She Was Changing Color!:" PMD Stinks

Mike — Tue, 13 Sep 2022 16:03:11 +0000

References: Karl A. Sporer, Nicholas J. Johnson, Clement C. Yeh & Glen M. Youngblood (2008) Can Emergency Medical Dispatch Codes Predict Prehospital Interventions for Common 9-1-1 Call Types?, Prehospital Emergency Care, 12:4, 470-478, DOI: 10.1080/10903120802290877

Torlén, K., Kurland, L., Castrén, M. et al. A comparison of two emergency medical dispatch protocols with respect to accuracy. Scand J Trauma Resusc Emerg Med 25, 122 (2017). https://doi.org/10.1186/s13049-017-0464-z

PMID: 29223194, 22824188, 18256298, 18584494, 19189610

The Liver ICU Hot Mess

Mike — Sun, 11 Sep 2022 01:31:45 +0000

REFERENCES: Farkas, Josh. (Feb 14, 2021). Acute Liver Failure. Internet Book of Critical Care. Available: https://emcrit.org/ibcc/alf/

Forkin, Katherine T. MD; Colquhoun, Douglas A. MBChB, MSc, MPH†; Nemergut, Edward C. MD,‡; Huffmyer, Julie L. MD*. The Coagulation Profile of End-Stage Liver Disease and Considerations for Intraoperative Management. Anesthesia & Analgesia: January 2018 - Volume 126 - Issue 1 - p 46-61 doi: 10.1213/ANE.0000000000002394

Mayo Clinic. Liver Function Tests. Available from: https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595

Montreif, Tom. (Nov 25, 2018). Acute Liver Failure: Evidence-Based Evaluation and Management. EM Docs blog. Available: http://www.emdocs.net/acute-liver-failure-evidence-based-evaluation-and-management/

Northup PG, Caldwell SH. Coagulation in liver disease: a guide for the clinician. Clin Gastroenterol Hepatol. 2013 Sep;11(9):1064-74. doi: 10.1016/j.cgh.2013.02.026. Epub 2013 Mar 16. PMID: 23506859.

Downtime Chat with Bill

Mike — Mon, 05 Sep 2022 17:48:37 +0000

This episode is literally just my partner Bill and I shooting the proverbial breeze with a microphone between us.

Patient Assessment vs. ASSessment

Mike — Fri, 02 Sep 2022 16:23:10 +0000

Reference: Chris Nickson. (2020). GCS. Available at http://www.litfl.com/glasgow-coma-scale

Old People Do the Darnedest Things

Mike — Tue, 30 Aug 2022 02:28:49 +0000

*READ THE TOPICS COVERED BEFORE LISTENING***

Case study of a 92 year old with delirium
Causes of delirium
Geriatric toxicology
Geriatric STI's and sexual health

REFERENCES: Alex Yartsev. Pharmacology and toxicology in old age. June 30, 2016. Deranged Physiology. Available from https://derangedphysiology.com/main/required-reading/pharmacology-and-toxicology/Chapter%201.3.4/pharmacology-and-toxicology-old-age

Frankowski AC, Clark LJ. Sexuality and Intimacy in Assisted Living: Residents' Perspectives and Experiences. Sex Res Social Policy. 2009 Dec 1;6(4):25-37. doi: 10.1525/srsp.2009.6.4.25. PMID: 25568640; PMCID: PMC4283937.

Kristen Fontes MD, Alex Koyfman MD, Brit Long MD. Common ED Medication Errors: Polypharmacy. EmDocs. July 3, 2017. Available from http://www.emdocs.net/common-ed-medication-errors-polypharmacy/

Nat. Research Council (US) Cute on Chemical Toxicology and Aging. Aging in Today’s Environment. Washington (DC): National Academies Press (US); 1987. 4, Principles of Toxicology in the Context of Aging. Available from: https://www.ncbi.nlm.nih.gov/books/nbk218724/

Rashid, M.H., Sparrow, N.A., Anwar, F. et al. Interleukin-6 mediates delirium-like phenotypes in a murine model of urinary tract infection. J Neuroinflammation 18, 247 (2021). https://doi.org/10.1186/s12974-021-02304-x Stanford Medicine 25. Website: Fundoscopic/Opthalomoscopic Exam. Available from https://stanfordmedicine25.stanford.edu/the25/fundoscopic.html

https://www.theseniorlist.com/sti-older-americans/

Friday Afternoon Clinical

Mike — Fri, 19 Aug 2022 20:15:50 +0000

Status Asthmaticus

Mike — Sun, 14 Aug 2022 00:31:02 +0000

REFERENCES: Blevins, Charles. (2021). Intubating Asthma. American Academy of Emergency Medicine. Available at https://www.aaem.org/UserFiles/file/CCMS_CSJanFeb21.pdf

Josh Farkas. (Aug 5, 2021). Waveform capnography in the intubated patient. Internet Book of Critical Care. Available at https://emcrit.org/ibcc/co2/

Pearson SD, Patel BK. Noninvasive Ventilation for Acute Asthma: The Neglected Sibling. Am J Respir Crit Care Med. 2020 Dec 1;202(11):1491-1493. doi: 10.1164/rccm.202007-2876ED. PMID: 32755489; PMCID: PMC7706170.

Vasileiadis, I., Alevrakis, E., Ampelioti, S., Vagionas, D., Rovina, N., and Koutsoukou, A. (2019). Acid-base disturbances in patients with asthma: A literature review and comments on their pathophysiology. Journal of Clinical Medicine, 8, 563.

Fixing Paramedic Education

Mike — Wed, 10 Aug 2022 16:50:58 +0000

Lies They Taught You in Paramedic School

Mike — Sat, 06 Aug 2022 16:15:26 +0000

References (I didn't alphabetize them...sorry): Bello G, De Santis P, Antonelli M. Non-invasive ventilation in cardiogenic pulmonary edema. Ann Transl Med. 2018 Sep;6(18):355. doi: 10.21037/atm.2018.04.39. PMID: 30370282; PMCID: PMC6186545.

Bendjelid K, Schütz N, Suter PM, et al. Does continuous positive airway pressure by face mask improve patients with acute cardiogenic pulmonary edema due to left ventricular diastolic dysfunction? Chest 2005;127:1053-8. 10.1378/chest.127.3.1053 

Frey, Michael. (2011). CPAP and Cardiogenic Pulmonary Edema. RT Magazine. Available at https://rtmagazine.com/disorders-diseases/chronic-pulmonary-disorders/asthma/cpap-and-cardiogenic-pulmonary-edema/

Chakraborty RK, Hamilton RJ. Calcium Channel Blocker Toxicity. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537147/

Salim Rezaie, "Pearls from ResusX Rewired 2020", REBEL EM blog, October 10, 2020. Available at: https://rebelem.com/pearls-from-resusx-rewired-2020/.

Joshua Bucher. “Cervical Collars for C-Spine Trauma: The Facts” EMDOCS Blog. Available at: http://www.emdocs.net/cervical-collars-for-c-spine-trauma-the-facts/

Jugdutt, BI, & Warnica, JW. (1988). Intravenous nitroglycerin therapy to limit infarct size, expansion, and complications. Effect of timing, dosage, and infarct location. Circulation, 78(4).

Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

http://derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/

If You Must Intubate the Patient with Metabolic Acidosis...

Mike — Sun, 31 Jul 2022 01:33:48 +0000

REFERENCES: Capone J, Gluncic V, Lukic A, Candido KD. Physiologically Difficult Airway in the Patient with Severe Hypotension and Metabolic Acidosis. Case Rep Anesthesiol. 2020 Sep 4;2020:8821827. doi: 10.1155/2020/8821827. PMID: 32953182; PMCID: PMC7487120.

Kim HJ, Son YK, An WS. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis. PLoS One. 2013 Jun 5;8(6):e65283. doi: 10.1371/journal.pone.0065283. PMID: 23755210; PMCID: PMC3673920.

https://www.openanesthesia.org/co2_transport_bicarbonate/

Creating a Culture of Idiocy

Mike — Tue, 19 Jul 2022 15:58:39 +0000

EMS Education with the Training Coordinator

Mike — Fri, 15 Jul 2022 01:16:20 +0000

Brian Collins is a paramedic, EMS training coordinator, and educator.

Baby Codes

Mike — Wed, 13 Jul 2022 02:28:01 +0000

Not a nice topic to discuss but necessary for what we do as EMS providers. References:

Adams, S., Good, M. And Defranco, G. (2009). Sudden infant death synd. American Family Physician 79(10): 870-874.

Helman, A, DeCaen, A, Crocco, A. PALS Guidelines. Emergency Medicine Cases. March, 2017. https://emergencymedicinecases.com/uti-myths-misconceptions/. Accessed [8 July 22].

PMID 30035966, 32019512

Ravera, Joe. (2022). Pediatric Small Talk - The 1, 3, 5 approach to pediatric cardiac arrest. Available from http://www.emdocs.net/pediatric-small-talk-the-135-approach-to-pediatric-cardiac-arrest/

Recipe Medic - Part Deux

Mike — Thu, 07 Jul 2022 02:11:45 +0000

The Puking Podcast

Mike — Fri, 24 Jun 2022 17:13:03 +0000

HEED THE REFERENCES: Anand Swaminathan, "REBEL Core Cast 47.0 Nausea and Vomiting", REBEL EM blog, January 13, 2021. Available at: https://rebelem.com/rebel-core-cast-47-0-nausea-and-vomiting/.

Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015; doi: http://dx.doi.org/10.1016/j.annemergmed.2015.09.031.

Furyk, J. S., Meek, R. A., & Egerton-Warburton, D. (2015). Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. The Cochrane database of systematic reviews, 2015(9), CD010106. https://doi.org/10.1002/14651858.CD010106.pub2

Mark Ramzy, "Aromatherapy vs Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients", REBEL EM blog, December 3, 2020. Available at: https://rebelem.com/aromatherapy-vs-oral-ondansetron-for-antiemetic-therapy-among-adult-emergency-department-patients/.

Phips, Ashley. (2015). Article Review: RCT of Antiemetic Efficacy in the ED. Available at http://www.emdocs.net/wp-content/uploads/2015/01/AntiemeticUseED-Phipps-.pdf

Plewa, Young, Yerman. (20 July 2008). The vomiting patient in the ED: Evaluation and management. Emergency Medicine Reports. Available from https://www.reliasmedia.com/articles/13681-the-vomiting-patient-in-the-ed-evaluation-and-management

Scorza K, Williams A, Phillips JD, Shaw J. Evaluation of nausea and vomiting. Am Fam Physician. 2007 Jul 1;76(1):76-84. PMID: 17668843.

Wegrzyniak LJ, Repke JT, Ural SH. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol. 2012;5(2):78-84.

Yartsev. (2021). Deranged Physiology: Question 10 - Describe the physiology of vomiting. Available from https://derangedphysiology.com/main/cicm-primary-exam/past-papers/2010-paper-1-saqs/question-10p2#answer-anchor

The Acute Abdomen

Mike — Tue, 21 Jun 2022 03:25:55 +0000

DAS REFERENCES: Bordeianou, L. Yeh, D. Management of SBO in adults. Available at https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults

Ellsworth Wright, "REBEL Core Cast – Basics of EM – Diffuse and Flank Abdominal Pain", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-diffuse-and-flank-abdominal-pain/.

Meadors, K. (n.d.). Abdominal Pain. Retrieved from http://www.emdocs.net/wp-content/uploads/2014/05/AbdominalPain-KMAK.pdf

Simon, E. (2017). EM@3AM - Ascending Cholangitis. Available at http://www.emdocs.net/em3am-ascending-cholangitis/

Spangler, R., Van Pham, T., Khoujah, D. et al. Abdominal emergencies in the geriatric patient. Int J Emerg Med 7, 43 (2014). https://doi.org/10.1186/s12245-014-0043-2

PMID 10987108

PMID 32362368

Vercruysse G, Busch R, Dimcheff D, et al. Evaluation and Management of Mechanical Small Bowel Obstruction in Adults [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572336/

Zeretzke-Bien, C. (2016). Appendicitis: Pearls and Pitfalls in Adult and Pediatric Populations. Available at http://www.emdocs.net/appendicitis-pearls-and-pitfalls-in-adult-and-pediatric-populations/

The "Recipe Medic"

Mike — Fri, 10 Jun 2022 01:57:13 +0000

BLS Stroke

Mike — Tue, 07 Jun 2022 01:37:04 +0000

References: PMID 9099184, 34496173, 28338314, 18584497, 15017757, 32383104, 25295027; doi:10.6274/tnd.08108

CCT: Peds Ocean Drowning

Mike — Wed, 01 Jun 2022 13:53:48 +0000

References: PMID 29606895 http://derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/

Uvalde, Mission Mindset

Mike — Thu, 26 May 2022 02:26:19 +0000

CCT 101: Trauma Transfer

Mike — Thu, 19 May 2022 23:00:26 +0000

MINI BONUS: Emerging From Darkness (First Responder Mental Health)

Mike — Fri, 13 May 2022 01:03:14 +0000

Critical Care Transport 101

Mike — Thu, 12 May 2022 01:42:50 +0000

Critical care transport is a cerebral logistics game. You need not get analysis paralysis.

100th Episode

Mike — Sun, 08 May 2022 18:24:00 +0000

Random discussion at my basement bar. Topics covered:

An old school code
Body armor
How to get into critical care EMS

GSW Logistics

Mike — Wed, 04 May 2022 03:00:49 +0000

Operational Perspectives from an EMS Pilot

Mike — Mon, 02 May 2022 19:27:49 +0000

SWAT Medic Stuff, Blood, & Gear

Mike — Mon, 25 Apr 2022 16:11:29 +0000

Follow up to my Damage Control Resus episode and random rambling. References: PMID 35082563, 21178760, 9971864

Tachyarrhythmias, Clinical Decisionmaking

Mike — Wed, 20 Apr 2022 18:35:38 +0000

Bill and I kill time at work and discuss two patients with fast heart rates. Hear us muddle awkardly through AVRC and then we go down a bunch of rabbit holes.

The NAEMSE 2022 Conference Looks Awful

Mike — Fri, 15 Apr 2022 18:53:49 +0000

"Subject Fallen"

Mike — Tue, 12 Apr 2022 16:23:32 +0000

Not a sexy topic but I talk about geriatric falls.

References: PMID 33060534 PMID 25983268 PMID 22971148 PMID 22971148

Rezaie. (2015). Minor Head Trauma in Anticoagulated Patients: Admit for Obs or D/C? RebelEM. https://rebelem.com/minor-head-trauma-in-anticoagulated-patients-admit-for-observation-or-discharge/

Damage Control Resus

Mike — Sun, 10 Apr 2022 18:59:15 +0000

References:

Bradford. (2022). RePhill. https://www.thebottomline.org.uk/summaries/icm/rephill/

Smith IM, Crombie N, Bishop JR, McLaughlin A, Naumann DN, Herbert M, Hancox JM, Slinn G, Ives N, Grant M, Perkins GD, Doughty H, Midwinter MJ; RePHILL Trial Collaborators. RePHILL: protocol for a randomised controlled trial of pre-hospital blood product resuscitation for trauma. Transfus Med. 2018 Oct;28(5):346-356. doi: 10.1111/tme.12486. Epub 2017 Nov 28. PMID: 29193548.

US Army Joint Trauma System’s Damage Control Resuscitation website: https://jts.amedd.army.mil/index.cfm/PI_CPGs/damage_control

Professionalism, Public Perception, Organizational Pride, and Angry Volunteers

Mike — Wed, 06 Apr 2022 01:34:09 +0000

Medical Errors, RaDonda Vaught, Organizational Narcissism part Deux

Mike — Tue, 29 Mar 2022 01:43:23 +0000

I wasn't going to do another episode this week but so many people reached out and asked my opinion on this case that I felt compelled to post an episode. I didn't go crazy on the editing so I apologize for the "umms" and needless Philadelphia "sooooo's."

Ketamine Is the Schiznit

Mike — Mon, 28 Mar 2022 14:25:47 +0000

Worthwhile articles I mentioned:

Bell, John. (2017). In Vogue: Ketamine for Neuroprotection in Acute Neurologic Injury. International Anesthesia Research Study. http://www.anethsesia-analgesia.org

Torres, A. C., Bebarta, V. S., April, M. D., Maddry, J. K., Herson, P. S., Bebarta, E. K., & Schauer, S. (2020). Ketamine Administration in Prehospital Combat Injured Patients With Traumatic Brain Injury: A 10-Year Report of Survival. Cureus, 12(7), e9248. https://doi.org/10.7759/cureus.9248

Zeiler FA, Teitelbaum J, West M, Gillman LM. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014 Aug;21(1):163-73. doi: 10.1007/s12028-013-9950-y. PMID: 24515638.

C-Collars Are Stupid

Mike — Thu, 24 Mar 2022 22:41:18 +0000

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Q&A: Precepting, Being Close to the Hospital, FP-C Exam

Mike — Tue, 22 Mar 2022 08:23:49 +0000

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The Chest Pain Episode

Mike — Wed, 09 Mar 2022 01:02:41 +0000

Do I need to ACS everyone that is having chest pain? Do I need to do a 12-lead on everyone who complains of chest pain? Is it BS when the chest pain is right sided or reproducible?

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My Dad Talks About Strokes

Mike — Mon, 28 Feb 2022 02:46:03 +0000

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Posterior Stroke

Mike — Wed, 23 Feb 2022 03:52:34 +0000

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A Head Full of Blood

Mike — Thu, 17 Feb 2022 02:35:49 +0000

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Analysis Paralysis

Mike — Thu, 10 Feb 2022 16:00:31 +0000

Smith, Mike. (2012). Analysis Paralysis. EMS World. https://www.hmpgloballearningnetwork.com/site/emsworld/article/10526554/analysis-paralysis

Van Horne, Riley. "Left of Bang" This podcast is hosted by ZenCast.fm

Pediatric GSW; Using Warm Bodies to Fill Spots

Mike — Tue, 08 Feb 2022 02:18:02 +0000

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Blunt Chest Trauma

Mike — Wed, 02 Feb 2022 22:11:50 +0000

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Listener Questions

Mike — Sat, 29 Jan 2022 16:35:18 +0000

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Sunday Night Debrief

Mike — Mon, 24 Jan 2022 03:20:13 +0000

Ashley and Mike debrief the randomness of the last two weeks at work. This is really an episode about nothing. Also, this is my first attempt at using two microphones - I apologize for any audio issues.

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EMS Physicians, Volunteer EMS

Mike — Thu, 20 Jan 2022 19:12:12 +0000

A discussion about prehopsital physicians in the US and volunteer EMS: the good, the bad, and the ugly. Please don't listen to this if you are easily offended. You were warned.

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More Thinking About Airway (and EBM)

Mike — Sun, 16 Jan 2022 04:37:21 +0000

Benger JR, Kirby K, Black S, Brett SJ, Clout M, Lazaroo MJ, Nolan JP, Reeves BC, Robinson M, Scott LJ, Smartt H, South A, Stokes EA, Taylor J, Thomas M, Voss S, Wordsworth S, Rogers CA. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018 Aug 28;320(8):779-791. doi: 10.1001/jama.2018.11597. PMID: 30167701; PMCID: PMC6142999.

Bernhard M, Becker TK, Gries A, Knapp J, Wenzel V. The First Shot Is Often the Best Shot: First-Pass Intubation Success in Emergency Airway Management. Anesth Analg. 2015 Nov;121(5):1389-93. doi: 10.1213/ANE.0000000000000891. PMID: 26484464.

Culbreth RE, Gardenhire DS. Manual bag valve mask ventilation performance among respiratory therapists. Heart Lung. 2021 May-Jun;50(3):471-475. doi: 10.1016/j.hrtlng.2020.10.012. Epub 2020 Nov 1. PMID: 33138977; PMCID: PMC7604178.

Ioannidis JP. Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?. Philos Ethics Humanit Med. 2008;3:14. Published 2008 May 27. doi:10.1186/1747-5341-3-14

Sackles, et. al. (2013). The importance of first pass success when performing orotracheal intubation in the ED. Acad Emerg Med, 20(1).

Wang HE, Schmicker RH, Daya MR, Stephens SW, Idris AH, Carlson JN, Colella MR, Herren H, Hansen M, Richmond NJ, Puyana JCJ, Aufderheide TP, Gray RE, Gray PC, Verkest M, Owens PC, Brienza AM, Sternig KJ, May SJ, Sopko GR, Weisfeldt ML, Nichol G. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2018 Aug 28;320(8):769-778. doi: 10.1001/jama.2018.7044. PMID: 30167699; PMCID: PMC6583103.

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Rethinking Airway

Mike — Fri, 07 Jan 2022 21:34:39 +0000

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New Year, New Dumpster Fire

Mike — Mon, 03 Jan 2022 17:34:41 +0000

Some start of a new year ramblings: EMTALA, ED wait times, COVID, royal medical directors

REFERENCES: Gulya, K. (2017). Seventh Circuit Case Highlights Potential Conflict Between Powers of Medical Director and City in Discharging EMS Staff When Losing "Credentials". National Law Review. Accessed at https://www.natlawreview.com/article/seventh-circuit-case-highlights-potential-conflict-between-powers-medical-director

Wolfberg, Wirth. (16 Nov 2021). Ambulances held hostage: Can the hospital make you stay? Accessed at https://www.ems1.com/ambulance/articles/ambulances-held-hostage-can-the-hospital-make-you-stay-jQESFoe1BQTrtUYc/

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Christmas Clinical

Mike — Mon, 20 Dec 2021 19:48:08 +0000

Carley, S. (2004). Suicide at Christmas. EMJ Online. Available at http://emj.bmj.com/content/emermed/21/6/716.full.pdf

CDC. (2004). Fall-Related Injuries During the Holiday Season --- United States, 2000–2003. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5348a1.htm

Long, Brit. (2018). EM@3AM: Esophageal Foreign Bodies. EMDocs Blog. Available at http://emdocs.net/em3am-esophageal-foreign-bodies/

Rohrer-Mirtschink S, Forster N, Giovanoli P, Guggenheim M. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland. Ann Burns Fire Disasters. 2015;28(1):71-75.

Shaw, et. al. (2018). Death and readmissions after hospital discharge during the Dec holiday period. BMJ, 363.

Shuja, Winston, Rahman, Mitty, Jaber, & Keo. Esophageal food impaction during cultural holidays and national athletic events. Gasteroenterology Report, 5(1).

Smith, Allan, Greenlaw, Findlay, & Isles. (2013). EM admissions., deaths ant weekends and the public holiday effect. Emerg Med J, 31(1).

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Happily Hypoxic

Mike — Tue, 14 Dec 2021 03:17:50 +0000

Omicron update, COVID stats, assessment of the hypoxic COVID patient

Reference: Dhont, S., Derom, E., Van Braeckel, E. et al. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 21, 198 (2020). https://doi.org/10.1186/s12931-020-01462-5

Rectal Foreign Bodies

Mike — Sun, 12 Dec 2021 17:59:53 +0000

DISCLAIMER: bad words, adult topics

Cologne, Ault. (2012). Rectal foreign bodies: what is the current standard? Clin Colon Rectal Surg, 25, 214-18.

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Thanksgiving Clinical

Mike — Thu, 25 Nov 2021 01:13:11 +0000

Not really anything Thanksgiving related....random topics and rantings

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Normalization of Deviance

Mike — Mon, 22 Nov 2021 05:33:37 +0000

References: http://www.aviationchief.com

NASA. (2014). The Cost of Silence: Normalization of Deviance and Groupthink. Retrieved from: https://sma.nasa.gov/docs/default-source/safety-messages/safetymessage-normalizationofdeviance-2014-11-03b.pdf?sfvrsn=4

Mullane, Mike. Normalization of Deviance — IAFF. Available at http://www.youtube.com/watch?v=Ljzj9Msli5o

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Differential Diagnosis

Mike — Tue, 16 Nov 2021 03:27:47 +0000

Thoughts on the "differential diagnosis."

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Lessons from My Partner Bill: A True OG

Mike — Thu, 11 Nov 2021 03:41:40 +0000

Bill is my HEMS partner, mentor, and friend. He started his career in EMS in 1976. Here is his introduction, some of his insights, and discussion on generation gaps and career progression. Also, sorry about the background noise: we were at work at the airport. Planes were taking off and the office chairs we were sitting in were creaking.

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Saturday Night Clinical

Mike — Sun, 07 Nov 2021 02:02:03 +0000

Addendums on the calcium episode and the heart failure episode...as always...random ramblings as well...

Citations: Anand IS, Gupta P. Anemia and Iron Deficiency in Heart Failure: Current Concepts and Emerging Therapies. Circulation. 2018 Jul 3;138(1):80-98. doi: 10.1161/CIRCULATIONAHA.118.030099. PMID: 29967232.

Hayes. (2013). Mythbuster: Calcium Gluconate Raises Serum Calcium as Quickly as Calcium Chloride. Retrieved at https://www.aliem.com/mythbuster-calcium-gluconate-raises-serum-calcium-as-calcium-chloride/

Calcium Chloride. RK.MD Blog. (2018). Retrieved at https://rk.md/2018/calcium-chloride/

Maak CA, Tabas JA, McClintock DE. Should acute treatment with inhaled beta agonists be withheld from patients with dyspnea who may have heart failure? J Emerg Med. 2011 Feb;40(2):135-45. doi: 10.1016/j.jemermed.2007.11.056. Epub 2008 Jun 24. PMID: 18572345.

Ponn, B. (2017). Clinical Question: Can Ventolin improve wheeze in heart failure? CanadiEM Blog. Retrieved from https://canadiem.org/can-ventolin-improve-wheeze-in-heart-failure/

Silverberg DS, Wexler D, Iaina A. The role of anemia in the progression of congestive heart failure. Is there a place for erythropoietin and intravenous iron? J Nephrol. 2004 Nov-Dec;17(6):749-61. PMID: 15593047.

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Staffing Shortages, Work Conditions, Corporate Greed

Mike — Fri, 29 Oct 2021 02:40:12 +0000

I think I might have gone a little hard in the paint on this one... TOPICS: Corporate greed Staffing shortages Incentive pay Working conditions

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EMS Organizational Narcissism

Mike — Mon, 25 Oct 2021 17:23:11 +0000

As always: real talk, no BS, and maybe controversial views of when narcissism pervades the culture in EMS agencies...

Duchon & Drake. (2009). Organizational narcissism and virtuous behavior. Journal of Business Ethics 85, 301-308.

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Calcium Facts for the EMS Provider

Mike — Fri, 22 Oct 2021 16:18:39 +0000

Faine. (n.d.). The calcium quandry. EP Monthly. http://epmonthly.com/article/the-calcium-quandry

Farkas. (2020). IBCC. Available at http://emcrit.org/ibcc

Graudins, et. al. (2016). Calcium channel antagonist and beta blocker overdose: antidotes and adjunct therapies. Br J Clin Pharm 81(3).

Nickson. (2020). Hypocalcemia. LITFL Blog. Available at http://litfl.com/hypocalcemia

Sauter, et al. (2015). Calcium disorders in the ED: independent risk factors for mortality. PLoS One 10(7).

Swaminathan. (2017). CORE EM: Hypocalcemia. Available at http://www.emdocs.net/core-em-hypocalcemia

Webster, et. al. (2016). Ionised calcium levels in major trauma patients who received blood in the ED. Emer Med J 33(8).

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Neonatal Resus, Gestalt, Heuristics

Mike — Thu, 14 Oct 2021 01:31:54 +0000

Cook C. Is clinical gestalt good enough?. J Man Manip Ther. 2009;17(1):6-7.

Jeanmonodod, Asuka, Jeanmonodod. (2021). Inborn Errors of Metabolism. Accessed https://www.ncbi.nlm.nih.gov/books/NBK459183/

Van Horne, P., & Riley, J. (2014). Left of Bang. New York: First Black Irish Entertainment

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Random Q&A

Mike — Thu, 07 Oct 2021 01:32:13 +0000

Topics discussed:

Albuterol and CHF
Staffing shortages
12-lead EKG indications
Being a "rat"
TEMS
Imposter Syndrome
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Not Killing Your TBI Patient

Mike — Wed, 06 Oct 2021 15:50:31 +0000

References: 2021 Pennsylvania EMS Protocols.

Spaite DW, Hu C, Bobrow BJ, et al. The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury. Ann Emerg Med. 2017;69(1):62-72. doi:10.1016/j.annemergmed.2016.08.007

Jain V, Choudhary J, Pandit R. Blood Pressure Target in Acute Brain Injury. Indian J Crit Care Med. 2019;23(Suppl 2):S136-S139. doi:10.5005/jp-journals-10071-23191

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When You Get Investigated or Sued

Mike — Thu, 30 Sep 2021 16:06:37 +0000

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Pelvic Trauma

Mike — Mon, 20 Sep 2021 19:59:28 +0000

References: Hsu, S. D., Chen, C. J., Chou, Y. C., Wang, S. H., & Chan, D. C. (2017). Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study. International journal of environmental research and public health, 14(10), 1217. https://doi.org/10.3390/ijerph14101217

Nickson. (2019). Weingart on Pelvic Trauma. Retrieved from https://litfl.com/weingart-on-pelvic-trauma/

Shlamovitz GZ, Mower WR, Bergman J, Chuang KR, Crisp J, Hardy D, Sargent M, Shroff SD, Snyder E, Morgan MT. How (un)useful is the pelvic ring stability examination in diagnosing mechanically unstable pelvic fractures in blunt trauma patients? J Trauma. 2009 Mar;66(3):815-20. doi: 10.1097/TA.0b013e31817c96e1. PMID: 19276759.

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Workplace Drama

Mike — Tue, 14 Sep 2021 02:36:45 +0000

This podcast references two books, both by Marlene Chism.

*No Drama Leadership, 2015 Stop Workplace Drama, 2011

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Mitigating Stupidity: Risk Management for the EMS Provider

Mike — Sun, 05 Sep 2021 20:19:53 +0000

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Burnout

Mike — Sun, 05 Sep 2021 19:53:09 +0000

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Disseminated Intravascular Coagulation, Med Twitter, Delta Variant

Mike — Sat, 21 Aug 2021 02:17:48 +0000

Hyponatremia and Other Randomness

Mike — Sat, 14 Aug 2021 23:30:32 +0000

Topics covered: Hyponatremia, crappy education, Delta variant, National Registry changes

Traumatic Shock - Part 2

Mike — Mon, 09 Aug 2021 03:51:59 +0000

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Traumatic Shock: Part 1

Mike — Fri, 06 Aug 2021 03:19:00 +0000

Stuff you need to know about traumatic shock for general practice, FP-C/CCP-C exams, etc.

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Mad Dog Leadership

Mike — Sat, 31 Jul 2021 04:07:51 +0000

Mattis, J. & West, B. (2019). Call Sign Chaos: Learning to Lead. New York: Random House.

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Splenic Trauma

Mike — Thu, 29 Jul 2021 05:28:35 +0000

Podcast for prehospital providers who aren't looking for a snoozefest.

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MCIs, Astronauts, & Checklists

Mike — Fri, 09 Jul 2021 16:59:22 +0000

Books mentioned: Col. Chris Hatfield, *An Astronaut's Guide to Life on Earth

Dr. Atul Gawande, The Checklist Manifesto

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Becoming a Flight Medic; Gear

Mike — Wed, 07 Jul 2021 00:54:27 +0000

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Cardiac Tamponade with Shayne Bierman

Mike — Fri, 21 May 2021 01:53:38 +0000

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EMS Week, EMS Education

Mike — Wed, 19 May 2021 19:40:04 +0000

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Traumatic Asphyxia, The 12-Lead EKG and the Student

Mike — Tue, 18 May 2021 16:21:33 +0000

Reference: http://www.derangedphysiology.com

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Last Week's Patient from Hell

Mike — Tue, 27 Apr 2021 03:00:34 +0000

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Sunday Night Ramblings with Mike and Mike

Mike — Mon, 26 Apr 2021 00:52:47 +0000

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The Middle of the Road Employee, COVID, Evidence Based Medicine

Mike — Mon, 22 Mar 2021 15:02:23 +0000

Looking at the importance of the employee who shows up and does his or her job; COVID discussion; looking at evidence-based medicine

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NSTEMI, Accountability, Anemia, and Amish People

Mike — Sun, 07 Mar 2021 00:15:11 +0000

Stucchi, M., Cantoni, S., Piccinelli, E., Savonitto, S., & Morici, N. (2018). Anemia and acute coronary syndrome: current perspectives. Vascular health and risk management, 14, 109–118. https://doi.org/10.2147/VHRM.S140951

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Calling Out the National Registry

Mike — Mon, 01 Mar 2021 02:40:04 +0000

Bicarb and Other Ramblings

Mike — Sat, 06 Feb 2021 20:24:48 +0000

New Updates

Mike — Mon, 18 Jan 2021 19:44:05 +0000

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Mental Health; Mike and Missy Intro

Mike — Sun, 08 Nov 2020 03:09:34 +0000

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It's Been a While: Random Ramblings, Updates

Mike — Thu, 05 Nov 2020 03:05:34 +0000

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Pediatric Upper Airway, COVID-19, New Business Venture

Mike — Fri, 16 Oct 2020 02:14:38 +0000

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Bad Co-Workers, Managing Conflict

Mike — Sat, 26 Sep 2020 00:22:52 +0000

IABP Basics and Oh S&*t!!!

Mike — Thu, 24 Sep 2020 00:01:34 +0000

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A Casual Night at the Hangar with Shayne RN

Mike — Sat, 05 Sep 2020 23:52:51 +0000

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Mini Follow-Up: Leadership is EVERYTHING

Mike — Tue, 01 Sep 2020 01:49:59 +0000

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UPS Leadership Style

Mike — Sun, 30 Aug 2020 15:43:24 +0000

Book review of "Leadership Lessons from a UPS Driver: Delivering a Culture of We, Not Me." by Ron Wallace.

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Certification Exams

Mike — Sat, 15 Aug 2020 00:46:55 +0000

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Q&A Episode 1

Mike — Sat, 01 Aug 2020 17:00:40 +0000

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Flash Pulmonary Edema

Mike — Fri, 24 Jul 2020 23:09:30 +0000

Cimen, et. al. (2017). Flash pulmonary edema: A rare cause and possible mechanisms. Turkish J EM 17(2).

Purvey & Allen. (2017). Managing acute pulmonary oedema. Aust Prescri 40(2).

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Pediatric Airway Management

Mike — Thu, 16 Jul 2020 02:20:46 +0000

References

Gebhard. (n.d.). Pediatric Airway Management. http://strac.org/files/education/2018_conference/presentations/pedi_dr_daniel_gebhard_pediatric_airway_presentation.pdf

Walls. (2012). Manual of Emergency Airway Management, 4th Ed.

http://gis.cdc.gov/grasp/covidnet/covid19_5.html

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2020 Rant

Mike — Mon, 06 Jul 2020 01:10:29 +0000

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When Chiropractors Attack, Kawasaki Disease

Mike — Wed, 01 Jul 2020 01:59:20 +0000

Kawasaki: http://kidshealth.org/en/parents/kawaski.html http://www.healthychildren.org/english/health-issues/conditions/heart/pages/kawasaki-disease.aspx Recommended: CDC, Seattle Childrens' Hospital, NIH

Chiropractic: Ernst. (2007). Adverse effects of spinal manipulation: a systematic review. J R Soc Med 100(7).

Jones, Jones, & Nugent. (2015). Vertebral artery dissections after chiropractic neck manipulation. Proc (Baylor UMC) 28(1).

Kwan-Woong Park, et. al. (2008). Vertebral artery dissection: natural history, clinical features, and therpeutic considerations. J. Korean Neurosurg Soc 44(3).

Wheeler, et. al. (2015). Risk of traumatic injury associated with clinical spinal manipulation in Medicare part B beneficiaries aged 66-99. Spine 40(4).

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TP-C: Wound Ballistics

Mike — Tue, 09 Jun 2020 02:00:11 +0000

Adcock & Chancellor. (2013). Death Investigations. New York: JB Learning.

Panagiotis, et. al. (2014). Gunshot wounds: a review of ballistics related to penetrating trauma. J. Acute Disease 14, 178-85.

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Civil Unrest, Ranting, & TP-C Exam

Mike — Wed, 03 Jun 2020 21:39:21 +0000

Bozeman & Winslow. (2004). Medical aspects of less than lethal weapons. Internet J. of Rescue and Disaster Med. 5(1).

El Warea, et. al. (2019). Riots in Beruit: description of the impact of a new type of mass casualty event on the emergency system in Lebanon. Disaster Medicine & Public Health Prep 13(5-6)

Haar, et. al. (2017). Death, injury, and disability from KIP. in crowd control settings and a systematic review. BMJ Open 7(12).

Straton. (2009). Less lethal weapon injury. http://www.mediced.com/content/pages/lectureflies/llwi_printable2009.pdf

Wei, et. al. (2017). The Little India Riot: experiences of an emergency department in Singapore. Singapore Med. J. 56(12).

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ECMO: The Good, Bad, and the Ugly

Mike — Sun, 31 May 2020 00:55:09 +0000

Makdisi & Wang. (2015). ECMO review of a lifesaving technology. J. Thoracic Dis. 7(7).

Oliver. (2009). Anticoagulation and coagulation management for ECMO. Semin Cardiothoracic Vasc Anesth 13(3).

http://litfl.com/ecmo-extra-corporeal-membrane-oxygenation

https://litfl.com/ecmo-trouble-shooting/

https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.1.3/troubleshooting-ecmo-circuit

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Eyeball Leadership, Pulmonary Embolism

Mike — Mon, 25 May 2020 22:17:34 +0000

Elliot. (1992). Pulmonary Physiology During PE. *Chest 101(4 suppl).

Rathbun, et. al. (2004). Clinical utility of d-dimer in patietns with suspected PE and non-diagnostic lung scans or negative CT findings. *Chest 125(3).

Sinek, Simon. *Leaders Eat Last.

http://derangedphysiology.com

http://emdocs.net/r-e-b-e-l-em-the-critical-pulmonary-embolus-patient

http://www.litfl.com/ecg-changes-in-pulmonary-embolism

http://www.litfl.com/pulmonary-embolism****

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Short, Rapid-Fire Case Study: Thyroid Storm

Mike — Wed, 20 May 2020 00:23:51 +0000

Cornwall & Mulfin. (2010). Endocrine and Metabolic Emergencies: Thyroid Storm. Thera. Adv. Endocrinology Metab. 1(3).

http://www.litfl.com/thyroid-storm

http://www.emcrit.org/ibcc/thyroid-storm

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Attila the Hun: What "The Scourge of God" Can Teach Us About Being Good EMS Providers and Leaders

Mike — Sun, 10 May 2020 23:51:34 +0000

Book referenced:

Roberts, Wess. (1990). Leadership Secrets of Attila the Hun.

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COVID 19 Social Media, Obstetrics, Aortic Dissection

Mike — Wed, 06 May 2020 17:34:25 +0000

Fukui. (2018). Management of acute aortic dissection and thoracic aortic rupture. Journal of Intensive Care 6(15).

http://litfl.com/acute-aortic-dissection

My notes from the ECHO Conferences and FP-C review course.

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Suicidology

Mike — Sat, 02 May 2020 13:09:37 +0000

References:

Betz & Boudreaux. (2016). Managing sucidial patients in the emergency department. Ann EM 67(2).

Jamison, K.R. (2000). Night Falls Fast: Understanding Suicide.

http://training.sprc.org

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Critical Care Transports, Don't Destroy Your Leadership Capital

Mike — Wed, 29 Apr 2020 21:25:58 +0000

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Burn Patients

Mike — Fri, 24 Apr 2020 02:34:32 +0000

My notes from the CRASH FP-C Review Course.

http://emcrit.com

Notes from lecture by William Hughes, MD. Feb 2019.

ABLS Provider Manual.

http://litfl.com/abdominal-compartment-syndrome-and-intra-abdominal-hypertension

Links mentioned in this episode:

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Sharpen Your Saw, Don't Be a Slug

Mike — Sun, 19 Apr 2020 01:30:07 +0000

Covey, S. The 7 Habits of Highly Effective People. Hadfield, C. An Astronaut's Guide to Life on Earth.

Willink, J. Discipline Equals Freedom. Field Manual.

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Ventilators for Dummies, Lessons from a Peds NP

Mike — Thu, 16 Apr 2020 01:52:48 +0000

BONUS: COVID-19 Cardiovascular Effects

Mike — Wed, 15 Apr 2020 05:07:10 +0000

References:

Clerkin, et. al. (2020) COVID-19 and CV disease. Circulation.

Guo, Fan, & Chen. (2020). CV implications of fatal outcomes of patients with COVID-19. JAMA Cardiology.

Hua, et. al. (2020). Life threatening cardiac tamponade complicating myopericarditis in COVID-19. European Heart Journal.

Meyer, et. al. (2020). Typical takotsubo syndrome triggered by SARS-CoV-2 infection. European Heart Journal.

Links mentioned in this episode:

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Atypical Stroke

Mike — Wed, 08 Apr 2020 21:28:44 +0000

REFERENCES:

Gustafson, Y., et. al. (1991). Acute confusional states (delirium) in stroke patients. Cerebrovascular Diseases 1, 257-64.

Murano, T., and Myers, K. (2019). Stroke: The subtle, atypical, and egnimatic. Emergency Medicine Reports 40(6).

Nydahl, P., Bartoszek, G., Binder, A., Paschen, L., Margraf, N. G., Witt, K., & Ewers, A. (2017). Prevalence for delirium in stroke patients: A prospective controlled study. Brain and behavior, 7(8)

Pasinska, P., Kowalska, K., Klimiec, E., Szyper-Maciejowska, A., Wilk, A., & Klimkowicz-Mrowiec, A. (2018). Frequency and predictors of post-stroke delirium in PRospective Observational POLIsh Study (PROPOLIS). Journal of neurology, 265(4), 863–870.

Shaw, R., Drozdowska, B., Taylor-Rowan, M., Elliott, E., Cuthbertson, G., Stott, D. J., & Quinn, T. J. (2019). Delirium in an Acute Stroke Setting, Occurrence, and Risk Factors. Stroke, 50(11), 3265–326

Taming the SRU. (2019). Prehospital Stroke Triage. Retrieved from http://www.tamingthesru.com/blog/2019/10/22/prehospital-stroke-triage

The Spanish Flu Pandemic of 1918

Mike — Fri, 03 Apr 2020 03:01:00 +0000

Not your typical FOAMed topic. The Spanish Flu Pandemic of 1918.

"Those who do not study history are doomed to repeat it."

Rectal Bleeding, Meet Ashley, "Non-Cardiac" Chest Pain

Mike — Mon, 30 Mar 2020 01:00:09 +0000

References: Rectal Bleeding http://emcrit.org/ibcc/gi-bleeding

http://www.litfl.com/gastrointestinal-haemorrhage

http://www.litfl.com/lower-gastrointestinal-haemorrhage-ddx

Chadhry, Singh, & Subhar. (1997). Octreotde in Gastroenterology.

Ramaekers, et. al (2019). Predictive Model for 30 Day Outcomes Among ED Patients with Lower GI Bleeding. Sildiroglu, et. al. (2018). Acute LGIB: Predictive Factors and Clinical Outcome for Patients Who Need First Time Mesenteric Clinical Angiography.

Sitrate & Gralnek. (2016). Management of Patients with Acute GI Bleeding.

"Non-Cardiac Chest Pain" El-Menyar, et. al (2010) Junghaus, et. al (2015) Ricci, et. al (2016) Spalding, et. al (2003) Swap & Nagurney (2005)

Dealing with the Alcoholic Patient

Mike — Fri, 27 Mar 2020 01:53:47 +0000

From my lecture at the Texas EMS Conference "Dealing with the Alcoholic Patient"

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ARDS, Bleeding Control, SWAT, Leadership

Mike — Fri, 27 Mar 2020 00:38:00 +0000

This week, [someone], [someone else] and [another person] cover [topic].....

Topics discussed:

Topic A
Topic B
Topic C

Links mentioned in this episode:

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Aortoenteric Fistula, COVID-19, Bad Attitudes in EMS

Mike — Sun, 22 Mar 2020 02:58:47 +0000

WARNING: EXPLICIT LANGUAGE

References:

Busuttil, Goldstone, & Drigimari. (2001). Management of AEF. Semin Vasc Surg 14(1).

Cedars-Sinai. (2019). Aortoenteric Fistula. http://cedars-sinai.edu/patients/health-conditions/aortoenteric-fistula-AEF.aspx

Schmitz, Steffen, & Grundmani. (2015). When is surgery recommended for treatment of AAA? Institute of Quality and Efficiency in Health Care. http://informedhealth.org

Xirometeritis, Dalainas, Samatakos, and Filis. (2011). Aortoenteric Fistula: Present Day Management. Int Surg 96: 266-73.

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Gear, Head Bangers, & Critical Stress Incidents

Mike — Fri, 20 Mar 2020 02:07:00 +0000

References:

Case Western Reserve University. (2006). Monro-Kellie Doctrine. http://casemed.edu/clerkships/neurology/neulrngobjectives/monroe%kellie.htm

Grossman, David. (2013). On Combat. NYC: Hatchette.

My notes from the CRASH FP-C Course: 2013 and 2016.

Werakkody & Goel. (n.d.). Monro-Kellie Hypothesis. http://radiopedia.org/articles/monro-kellie-hypothesis?lang.us

Inaugural Episode, Analgesia, Angel Dust, QA

Mike — Thu, 19 Mar 2020 09:21:55 +0000

Welcome Analgesia over sedation PCP QA Conclusion

References:

Bonomo JB, Butler AS, Lindsell CJ, Venkat A. Inadequate provision of postintubation anxiolysis and analgesia in the ED. Am J Emerg Med. 2008;26(4):469–472. doi:10.1016/j.ajem.2007.05.024

Covey, S. R. (2004). The 7 habits of highly effective people: Restoring the character ethic. New York: Free Press.

DEA. (2019). Phencyclidine. https://www.deadiversion.usdoj.gov/drug_chem_info/pcp.pdf