Critical Levels

Pediatric Cardiac Arrest - Dr. Janice Tijssen

On this month’s episode, we’re joined by Dr. Janice Tijssen to discuss pediatric cardiac arrest. During the episode, you’ll hear us cover: The importance of our early interventions What is cardiac arrest incidence/epidemiology etiology  risk factors/past medical history outcomes sociodemographics Differences between adult and pediatric cardiac arrest Simplifying our response Symptomatic bradycardia The importance of scene time The importance of CPR/ventilation IV vs I...

Suboxone - Dr Louisa Marion-Bellemare

On this month’s episode, we’re joined by Dr. Louisa Marion-Bellemare to discuss Suboxone (buprenorphine/naloxone) and managing patients who use illicit and controlled drugs. During the episode, you’ll hear us cover: history of the drug crisis  lay of the land of the current drug crisis historical treatments opiate pharmacology  healthcare utilization  stigma  suboxone use  patient advocacy

Wilderness Medicine - Matt Smith

On this month's episode, we chat with Matt Smith about wilderness medicine.  As we shift from a high resource to a low resource setting, there are 3 main concepts to consider: - Ideal to real - High risk to low risk - Stable to unstable These concepts are important as we shift our practice and prepare ourselves.  For this patient context, we need to focus on the things we can't replace, and learn to manage that. Our approach to these patients need to be algorithmic, and focus o...

Episode 35 - ACS - Dr. Jesse McLaren

On this month’s episode, we discuss acute coronary syndrome (ACS) with Dr. Jess McLaren We define ACS, we cover pathophysiology, and some common causes. Importantly we discuss the assessment of this patient population - paying attending to both objective and subjectives signs and symptoms. We spend some time talking about electrocardiograms, and perhaps most importantly, we chat about the management of this patient. 

Anaphylaxis - Drs. Hendin & Lanoue

A Dive Into Drowning - Dr. James Gilbertson

On this episode, we’re joined by Dr. James Gilbertson with the Ottawa Hospital, and Cst. Caroline Gallant with The Ottawa Police Marine, Dive and Trails (MDT) Unit. We take a dive into drowning and cover: What drowning is The scale of the problem Drowning pathophysiology The medical management of drowning patients Prognostication Lastly, we speak to drowning prevention 

Substance Use and the Paramedic Role - Jen Bolster

In British Columbia 7 people per day are dying as a result of a highly contaminated toxic supply of drugs. Since the announcement of the public health crisis related to illicit drug toxicity deaths in 2016 over 12,000 people have lost their lives. Despite previous misconceptions that the toxic drug crisis is confined to Vancouver’s lower mainland and the downtown east side, Jen is sounding the alarm that not a square inch of the province of BC has been unaffected by the crisis. Working on ...

No Statistical Difference - Dr. Ken Milne

“No statistical difference” On today’s episode of Critical Levels, we chat with Dr. Ken Milne of the Skeptics’ Guide to Emergency Medicine (https://thesgem.com; @thesgem). We start with a high-level discussion and literature and evidence, and then apply these concepts to ‘lyse’ and ‘bust’ some of the predominate prehospital myths. Find links to the primary literature on our website. We examine: 2:00 - The importance of primary literature 4:10 - Why?  10:10 – Literature, critica...

Preparing Paramedics: Palliative Care - Cheryl Cameron Tyne Lunn

Paramedics receive little education on grief and bereavement. As paramedicine integrates palliative approaches to care, it has become very apparent paramedics are under-prepared for the crucial role they play in supporting patients and families in grief and recognizing and responding to their own grief reactions. In this episode we talk to Cheryl Cameron and Tyne Lunn about how paramedicine is evolving to include the provision of palliative care. We start by defining palliative care and ta...

Episode 29 - High Performance Cardiac Arrest Management - Adam Perrett and Mike Humphrey

On today’s episode, we carry on last month’s conversation about cardiac arrest management and care.    Recorded at the Paramedicine Across Canada Expo (PACE) Conference in Saskatoon in September 2022, we’re sitting down with Mike Humphrey and Adam Perrett of Lethbridge Fire and Emergency Services to talk about how they’ve revolutionized the care provided to the citizens of Lethbridge, Alberta.    We walk through how they train, evaluate, and feedback data with respect to cardiac arre...

DOSE VF with Dr. Sheldon Cheskes

On today's episode, we chat with Dr. Sheldon Cheskes, principal investigator of the landmark DOSE VF trial.  In this study, published in the New England Journal of Medicine, Dr. Cheskes and his team wanted to evaluate DSED and VC defibrillation as compared with standard defibrillation in patients who remain in refractory ventricular fibrillation during out-of-hospital cardiac arrest. In this episode, we walk through the study design, methodology, results, and perhaps most importantly, cr...

Episode 27 - Pediatric Pain with Dr. Samina Ali

Pain is a condition that we often see in the prehospital world, yet for a variety of reasons, we're bad at treating it. On today's episode with pain expert Dr. Samina Ali, we go through what pain is, pain assessment, barriers to providing analgesia, and then discuss how we actually treat pain, using both non-pharmacologic and pharmacologic interventions

First Responder Mental Health with Dr. Simon Hatcher

Join us this month as we chat with Dr. Simon Hatcher, psychiatrist at the Ottawa Hospital and Ottawa Inner City Health, about First Responder Mental Health   Who gets PTSD, what’s the pathway/differences to mental health professionals, how do we heal, and how do we get people back to work are all topics we cover, plus more!

IveGotYourBack911

IVEGOTYOURBACK911 was started by paramedics Jill Foster & Shaun Taylor in 2014. The goal of the campaign is to spread social awareness worldwide in regards to First Responder mental health issues. On this month’s episode of Critical Levels, we sit down with Jill & Shaun to learn a little bit more about how and why they started the company, and some of the amazing work that they’re doing to help first responders.

Prehospital Trauma Care with Dr. Brodie Nolan

On today’s episode, we chat with Dr. Brodie Nolan, an emergency physician and trauma team leader at St. Michael's Hospital (one of Canada’s largest trauma centres), and a transport medicine physician for ORNGE. We discuss what trauma is, and how we define hemorrhagic shock. We discuss that trauma triad of death, and why it’s important to get these patients to a lead trauma centre. These patients ultimately need blood products, so Dr. Nolan walks us through blood/fluid resuscitation, as w...

PICU & Organ Donation with Dr. Sonny Dhanani

On today’s episode we sit down with Dr. Sonny Dhanani, Chief of the Pediatric Intensive Care Unit (PICU) at the Children’s Hospital of Eastern Ontario (CHEO). We discuss the approach and management of the critically ill child, with an in-depth discussion on the A-B-Cs. With respect to airway, we chat tips/tricks for airway management, as well as intubation. On the topic of breathing, we chat about bagging and some of the physiological cardio-respiratory concerns of our efforts. We also...

Human Trafficking - Dr. Lindsay Cheskes

The United Nations (UN) defines human trafficking (HT) as “the recruitment, transport, transfer, harbouring, or receipt of a person by such means as threat or use of force or other forms of coercion, abduction, fraud, or deception for the purpose of exploitation“. What is human trafficking? How prevalent is it? What are the red flags? How can I use the history and assessment to raise my index of suspicion? How do I advocate for my patient? Join our conversation with Dr. Lindsay Cheskes, ...

Canadian Medical Emergency Response Team with Lt. Col. Leilani Doyle MD

After the War in Afghanistan, the Chief of Defence Staff of the Canadian Armed Forces decided to create a brand new forward aeromedical evacuation capability. This is where our episode’s guest comes in. We speak with Dr. Leilani Doyle, Lt. Col. with the Canadian Armed Forces about her role in the creation of CMERT - the Canadian Medical Emergency Response Team. Not only are we going to cover the development, roles, training, and capabilities of the team, we’re also going to discuss how t...

Good Medicine in Bad Places – Sierra Team & SAR Techs

Not all paramedics respond to just 911 calls. On today’s episode, we’re chatting with Matt Cruchet and Sgt. Gregory Hudson Matt is a key member of the Country of Renfrew Paramedic Service’s Sierra Team – essentially their special operations arm. Sgt. Hudson is a Search and Rescue Technician (SAR Tech) with the 424 Transport and Rescue Squadron based out of CFB Trenton. Covering more than 10 million sq km, the 424 Transport and Rescue Squadron has a huge responsibility for maritime and ae...

ROSC with Dr. Kyeremanteng

On today's episode with Dr. Kyeremanteng, we're covering all things ROSC: what is ROSC? How do we optimize our patient's physiology (the A-B-Cs) post-arrest? What happens next - what's TTM, how does neuroprognostication happen? Lastly, we cover what is the impact to the healthcare system at large. Thanks to Zoll Medical for sponsoring this episode!

Prehospital Obstetrics with Dr. Glenn Posner

Obstetrics. Arguably one of the scarier and uncomfortable things we do as paramedics, at least that’s what I think.  If you’re looking for a way to make this tremendously stressful call just a little bit easier, then I think you’ve come to the right spot. On this engaging episode of Critical Levels, we’re talking with Dr. Glenn Posner about the prehospital OB assessment, the uncomplicated birth, and how to handle some of the more complicated presentations in the field.

Stroke with Dr. Grant Stotts

CVA are amongst the top 5 causes of death, and number 1 cause of disability in N.A. Given the associated morbidity and mortality, rapid recognition and aggressive management is of the utmost importance.  The American Heart Association (AHA) and the American Stroke Association (ASA), characterizes stroke as a neurological deficit attributed to an acute focal injury of the central nervous system (CNS) by a vascular cause, including cerebral infarction, intracerebral hemorrhage (ICH), and suba...

Critical Care Paramedicine and ORNGE with Natalie Lavergne

Join us as we sit down with Critical Care Paramedic Natalie Lavergne with ORNGE - to discuss exactly that: critical care paramedicine and ORNGE, the Ontario air ambulance service. In this episode, we cover: What is a critical care paramedic and how are they different?  What type of training/continuing education do they receive?  What is ORNGE? What types of calls do they attend? How do they attend?  Optimizing the patient and scene for an ORNGE arrival  How is the patient physi...

The Hamilton Verdict | A Legal Analysis with Chris Robertson

On June 8th 2021, The Honourable Mr. Justice H.S. Arrell gave his judgment finding 2 Hamilton paramedics, Christopher Marchant & Steven Snively, guilty of failing to provide the necessaries of life to Yosif Al-Hasnawi (19), who died on December 2 2017. In this episode, we chat with former paramedic and current lawyer Christopher Robertson, where we cover the background, the legal analysis, and what this precedent means to the profession.

Bruises, Breaks, and Burns: Child & Youth Maltreatment with Dr. Michelle Ward

Is it an accident or is it abuse? Tune in with Dr. Michelle Ward,  Division Head of Child and Youth Protection at the Children's Hospital of Eastern Ontario, as we discuss what paramedics need to know about child & youth maltreatment

Managing the Critically Ill Paediatric Patient with Jon Lee

Tune in with Jon Lee, formerly from the ORNGE Pediatric Critical Care Transport Team as he discusses his approach to the critically ill child

The ABCs of Cardiac Arrest Management with Dr. Ian Drennan | Part 2

Continue our conversation with Dr. Drennan about cardiac arrest care. We've reached the end of our algorithms - what can we do next? 

The ABCs of Cardiac Arrest Management with Dr. Ian Drennan

We claim to practice evidence-based medicine, but what does the evidence actually say about how we manage our cardiac arrests? Tune in to our discussion to find out

Tactical Paramedicine with Benoit Jolicoeur

Tactical paramedicine, rescue task force, tourniquets, and massive life-threatening hemorrhage. Tune in to our conversation about these topics with Ben Jolicoeur of the Ottawa Paramedic Service Paramedic Tactical Unit 

Cognitive Bias and Metacognition with Dr. Vanessa Bohn

How do we make decisions? How does our bias impact patient care? Listen in to our conversation with Dr. Vanessa Bohn as we discuss cognitive errors, metacognition, and cognitive bias 

COVID-19: What Paramedics Need to Know!

Join us as we chat with Jason Buick, the lead author of the recent article published in the Canadian Journal of Emergency Medicine (CJEM) - COVID 19: What Paramedics Need to Know! 

We Speak For The Dead: Dr. Louise McNaughton-Filion

In this episode, we sit down with Dr. Louis McNaughton-Filion, Regional Supervision Coroner for Eastern Ontario. We cover death investigations, what paramedics need to be aware of on suspicious scenes, and some of the pathophysiology/body changes after death.

Calming the Chaos with Will Johnston - Part 2

In part 2 of our conversation with Will Johnston about Calming the Chaos, we discuss the importance of a pre-brief, the zero-point survey, communication/language, graded assertiveness, debriefing, and working with our allied partners.     

Calming the Chaos with Will Johnston - Part 1

Listen to part 1 of our conversation with Will Johnston about Calming the Chaos. In this episode, we cover some of the physiological responses to stress and it's the impact on team performance as well as individual performance, as well as how to mitigate that response. We also covered what makes up highly competent teams. Tune in soon for part 2 to continue the chat :)

Novel Coronavirus (COVID-19) with Dr. Vera Etches from Ottawa Public Health

Tune in as we chat with Dr. Vera Etches, Medical Officer of Health from Ottawa Public Health about coronavirus, how OPH is preparing, and how local healthcare partners are working together

Pediatric Respiratory Illnesses with Dr. Allan Shefrin

Join Dr. Allan Shefrin, a pediatric emergency physician at the Children's Hospital of Eastern Ontario (CHEO) discuss pediatric respiratory illnesses. Detailed show notes can be found on our website: www.criticallevels.ca

Episode 1 - An Introduction

Check out our first episode - a brief introduction to the new "Critical Levels" podcast series - a podcast directed at paramedics, for paramedics, with a Canadian and local bias.

Pediatric Concussion with Dr. Roger Zemek

Join Dr. Roger Zemek, a pediatric emergency physician at the Children's Hospital of Eastern Ontario (CHEO) and researcher at the CHEO Research Institute discuss pediatric concussion.  Detailed show notes can be found on our website: www.criticallevels.ca

Episode 1 - Place Holder

This is a place holder song for the upcoming Critical Levels Podcast. Stay tuned for some episodes soon

1. An Introduction

Welcome to Critical Levels! This episode, our inaugural episode, is an introduction to the new podcast. Please stay tuned for a our first episode:)  Please email [email protected] for any suggestions/feedback/comments