MCHD Paramedic Podcast
180 episodes - English - Latest episode: 8 days ago - ★★★★★ - 250 ratingsThe MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick invite you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.
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Episodes
Episode 75 - Attacking The COVID Airway - Part 1
March 25, 2020 23:27 - 26 minutes - 36.2 MBWe've had continued rapid local and national developments over the past week surrounding COVID-19. On this special release, the podcast crew reconvenes to update our listeners on the most current evidence surrounding airway management in the era of COVID-19. REFERENCES 1. https://www.cdc.gov/coronavirus/2019-ncov/index.html 2. https://emcrit.org/emcrit/some-additional-covid-airway-management-thoughts/ 3. https://www.safeairwaysociety.org/covid19/ 4. VALLEY, T ET AL. ASSOCIATION BETWEEN ...
Episode 74 - COVID-19 UPDATE
March 11, 2020 21:55 - 27 minutes - 37.3 MBWe've had rapid local and national developments over the past week surrounding COVID-19. On this special release, the podcast crew reconvenes to update our listeners on the most current evidence. REFERENCES 1. https://www.cdc.gov/coronavirus/2019-ncov/index.html
Episode 73 - Febrile Seizures And BRUEs With Dr. Manish Shah
March 09, 2020 10:00 - 31 minutes - 43.4 MBChoking babies, seizing kids, and floppy infants turning blue...all of these events are significantly anxiety inducing for both emergency providers and families alike. On this episode, Dr. Patrick is joined by Dr. Manish Shah, a pediatric emergency medicine physician and research expert from Texas Children's Hospital. The discussion will begin with the finer points of febrile seizures and then branch off into the "artist formerly known as ALTE" - the BRUE. Follwing this episode you'll be m...
Episode 72 - Esmolol And Electrical Storm
February 22, 2020 11:00 - 12 minutes - 17.2 MBWe all love cardiac arrest with VF as the presenting rhythm. These are the ones that walk out of the hospital. But, what happens when you shock, shock, shock and still VF? Today the podcast team addresses refractory ventricular fibrillation/electrical storm and specifically the role of esmolol in this condition. Esmolol is an emerging treatment for refractory VF that makes absolute physiologic sense, however the data is limited. Dr. Patrick addresses the pathophysiology, evidence and MCH...
Episode 71 - Safe Sleep Pearls With Dr. Lisa Owens
February 11, 2020 04:05 - 27 minutes - 37.6 MBA proper sleeping environment is vital for infant safety. On this episode Dr. Patrick is joined by two "safe sleep" experts - MCHD's own, Aston Herring and Dr. Lisa Owens from Texas Children's Hospital. After listening, you'll know how to recognize what exactly constitutes unsafe sleep and more importantly understand the impact that sleep environment can have on otherwise healthy infants. Join us as we attempt to shine a light on a potentially deadly problem with surprisingly simple soluti...
Episode 70 - The 2019 Novel Coronavirus: What EMS Needs To Know
January 28, 2020 19:06 - 15 minutes - 20.7 MBOver the past week we’ve had several local false alarms with possible patients presenting with the 2019 Novel Coronovirus. On this special release, the podcast crew will discuss the impact of this worrisome viral infection on EMS providers. REFERENCES 1. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html 2. https://jamanetwork.com/journals/jama/pages/jama-author-interviews
Episode 69 - The 2019 Novel Coronavirus: What EMS Needs To Know
January 28, 2020 19:06 - 15 minutes - 20.7 MBOver the past week we’ve had several local false alarms with possible patients presenting with the 2019 Novel Coronovirus. On this special release, the podcast crew will discuss the impact of this worrisome viral infection on EMS providers. REFERENCES 1. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html 2. https://jamanetwork.com/journals/jama/pages/jama-author-interviews
Episode 69 - The Terrible Tracheostomy
January 27, 2020 11:00 - 25 minutes - 34.8 MBTracheostomy patients can be intimidating and confusing with complex recent medical histories and unfamiliar terminology surrounding the surgical hole placed in their neck. Join Dr. Patrick as he attempts to demystify the tracheostomy tube and provide a framework to utilize when approaching the crashing trached patient. REFERENCES 1. http://www.tracheostomy.org.uk/storage/files/Patent%20Airway%20Algorith m.pdf 2. http://www.tracheostomy.org.uk 3. Mcgrath BA et al. Guidelines Multidisc...
Episode 68 - Texas CARES With Dr. Jeff Jarvis
January 13, 2020 11:00 - 28 minutes - 39 MBWhile attending the 2019 Texas EMS Conference, Dr. Dickson and Chief Crocker were lucky enough to sit down with Dr. Jeff Jarvis from Williamson County EMS to discuss the background and evolution of the Texas CARES registry. We'll introduce the purpose of Texas CARES along with the ways in which it can benefit your service. REFERENCES 1. https://tx-cares.com
Episode 67 - Posterior Stroke Basics With Dr. Jeremiah Johnson
December 30, 2019 11:00 - 22 minutes - 31.5 MBContinuing with the dizziness theme for the 2019 holiday season, Dr. Dickson is joined on episode 67 by Dr. Jeremiah Johnson. Dr. Johnson is a neurosurgeon here in Montgomery County where he's the Director of the Comprehensive Stroke program at CHI-St. Luke's Hospital in The Woodlands. We all recognize the combination of aphasia with face and extremity weakness that occurs in anterior circulation strokes. But, how do posterior strokes present? How common are they? Are posterior strokes t...
Episode 66 - Dizzy From Down Under With Dr. Alastair Meyer
December 30, 2019 11:00 - 30 minutes - 41.3 MBJoin Dr. Dickson as he takes a trip down under to talk with Dr. Alastair Meyer about the often dreaded chief complaint of dizziness. Dr. Meyer is the Director of Emergency Medicine for Monash Health in Melbourne. The differential diagnosis for the commonly encountered dizzy patient is broad and consists of many non-emergent conditions along with deadly pathology as well. This combination can be a recipe for disaster. This episode will leave listeners with the deadly dizzy diseases and a ...
Episode 65 - Managing The LVAD Patient
December 16, 2019 15:34 - 28 minutes - 38.5 MBOur population is aging, and heart failure is only going to increase. This will inevitably lead to an increase of patients with left ventricular assist devices. New technology can be intimidating and confusing with complex recent medical histories and unfamiliar terminology surrounding the various LVAD brands. Join the podcast crew as we attempt to simply an EMS approach to the LVAD patient. REFERENCES: 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123099/pdf/wjem-19-834.pdf 2. ...
Episode 64 - Bystander CPR - The Future Is Here
December 02, 2019 11:55 - 22 minutes - 31.4 MBMCHD is excited for the county wide roll out of the PulsePoint app. Community Outreach Coordinator, Ashton Herring, joins Dr. Patrick to discuss the importance of bystander CPR in increasing survival in cardiac arrest patients. After listening, download PulsePoint and let’s get hands on chest as quickly as possible which we know is a recipe for saving lives. REFERENCES 1. https://apps.apple.com/us/app/pulsepoint-respond/id500772134
Episode 63 - "Beyond The Toxidrome" With Dr. Jerry Snow
November 18, 2019 11:00 - 22 minutes - 31.4 MBOn this episode, Dr. Patrick and MCHD Paramedic Podcast toxicologist extraordinaire, Dr. Jerry Snow, pick up where they left off in our recent discussion of the classic toxidromes. We'll branch out into some topics that veer from the textbook such as the Alpha 2 agonists that can mimic opiate toxicity and why toxicologists fear methadone ingestions. We'll also touch on some "tox" current events such as vaping associated pulmonary injury, imodium overdoses and why this is an increasing pheno...
Episode 62 - The Next Generation Medic
November 04, 2019 12:29 - 27 minutes - 37.6 MBDr. Patrick is joined by two medics on the MCHD recruitment committee, Megan Steely and Russell Carter, to discuss the components of the "next generation" medic. We also dive in to the nuts and bolts of the EMS service of the future as well. Schedule options, compensation issues, service offerings and atmosphere are all addressed during this wide ranging conversation. Only the surface is skimmed here, so please drop a line to the podcast email if you have additional similar/related topics...
MCHD Paramedic Podcast 360 - UPDATE!!
October 28, 2019 18:33 - 1 minute - 2.19 MBWe're excited to announce a new educational offering - MCHD Paramedic Podcast 360. There are many topics in paramedic/EMT education better taught with visual adjuncts that the podcast format cannot provide with audio alone. Podcast 360 will be hosted on the MCHD YouTube channel (see link below) and contain brief, high yield content similar to what you get here at the MCHD Paramedic Podcast. Please subscribe to the channel and check out our initial episode - STEMI Diagnosis. MCHD YouTube...
Episode 61 - An EMS Approach To Epistaxis
October 21, 2019 11:43 - 22 minutes - 30.9 MBWe’ve recently rolled out a new epistaxis treatment protocol here at MCHD. Join the podcast team as we discuss some nosebleed background information along with the classic and emerging treatment options. Did somebody say TXA?? Yep, we have TXA and this is a perfect opportunity introduce the MCHD epistaxis/TXA treatment protocol. It’s simple, cheap and minimally invasive. With rapidly accumulating evidence that we will improve patient centered outcomes using this treatment, this is an epi...
Episode 60 - Toxidromes Part 1 - Back To The Basics
October 07, 2019 14:09 - 35 minutes - 48.8 MBThis episode takes us back to the basics of toxic ingestions and poisonings to review the topic of toxidromes. Why do we look for specific patterns in poisonings and what are we looking for? Dr. Patrick and podcast toxicology expert, Dr. Jerry Snow, will take us through the major toxidrome groups and you’ll come out on the other side ready to sort through your next undifferentiated overdose patient. REFERENCES: 1. http://www.emdocs.net/the-approach-to-the-poisoned-patient/ 2. https://litfl...
Episode 59 - Car Seat Safety
September 23, 2019 12:58 - 18 minutes - 25.6 MBOn this episode, the medical directors are joined by the MCHD car seat guru, Ashton Herring. The leading cause of death in children is motor vehicle related trauma. We’ll start with some background of the car seat laws that exist here in Texas and how MCHD works in the local community to increase car seat awareness. Ashton will also educate us on some common errors that parents make when installing car seats. In closing, we’ll discuss several excellent resources for car seat education. ...
Episode 58 - REBOA Basics
September 09, 2019 12:04 - 21 minutes - 28.9 MBREBOA is a hot topic in the world of emergency medicine and prehospital trauma care. Join the medical directors for a review of “resuscitative endovascular balloon occlusion of the aorta.” We’ll discuss the basics, the anatomy, the complications and the evidence. Who is doing this in the EMS world and what are their results? We’ll answer that question along with looking to future possibilities as well. References: 1. Brenner M, Inaba K, Aiol A, et al. Resuscitative endovascular balloon...
Episode 57 - The Art of the Airway
August 26, 2019 13:35 - 33 minutes - 45.6 MBWe’ve discussed airway management and our MCHD delayed sequence approach on past podcast episodes. On this episode, join the medical directors as they take a scenario based, deep dive into the finer points of tackling the difficult airway. REFERENCES: 1. https://m.youtube.com/watch?v=wVQFJR7qmrQ
Episode 56 - Large Vessel Occlusion Stroke - 2019 Updates
August 12, 2019 11:17 - 42 minutes - 58.9 MBThe evolution of emergent stroke care has rapidly evolved over the past decade. With the increased emphasis on recognizing large vessel occlusion (LVO) strokes, communication and cooperation between EMS and our receiving hospitals has become vital. On this episode, Dr. Dickson is joined by an expert group of neurointerventionalists to discuss the current literature and guidelines shaping stroke management standard of care in 2019. REFERENCES: 1. https://www.thelancet.com/journals/lancet/a...
Episode 55 - The COACT Study - Journal Club Mini
July 29, 2019 11:11 - 8 minutes - 12.2 MBLast year, we rolled out the MCHD “ROSC to Cath” protocol via the podcast. Recently, some compelling data from the COACT trial has led us to reassess and reconsider this protocol. On this episode, Dr. Patrick reviews COACT and discusses the MCHD changes coming as a result. REFERENCES: 1. https://www.nejm.org/doi/full/10.1056/NEJMoa1816897 2. http://clinicaltrialresults.org/Slides/ACC2019/Lemkes_COACT.pdf
Episode 54 - Human Trafficking - An EMS Perspective
July 15, 2019 12:36 - 24 minutes - 33.9 MBDuring a recent continuing education session at MCHD, one of the educational points of emphasis was recognizing and reporting human trafficking as a paramedic/first responder. The podcast crew was lucky enough to have Sarah Koransky, from United Against Human Trafficking (UAHT), join us to share some of the key points when encountering this vulnerable patient group. Sarah is knowledgable and passionate about this cause and she has loads of high yield information to share on this episode. R...
Episode 53 - The Fast And The Furious - How To Approach Sinus Tachycardia
July 01, 2019 13:04 - 24 minutes - 33 MBVital signs are called vital for a reason. On this episode, Dr. Patrick takes us through a differential for the workup of sinus tachycardia. This is a finding that we see daily in our practice, but often lack a step-wise approach when managing these patients. REFERENCES: 1. Bossart P, Fosnocht D, Swanson E. Changes in heart rate do not correlate with changes in pain intensity in emergency department patients. J Emerg Med. 2007;32(1):19–22. 2. Marco CA, Plewa MC, Buderer N, Hymel G, Cooper...
Episode 52 - Anticoagulant and Antiplatelet Meds - Phast Pharma
June 17, 2019 12:24 - 19 minutes - 26.1 MBWe've addressed the ten most commonly encountered medications seen in EMS on a prior podcast. In this episode, Brad Ward joins Dr. Patrick to focus on a less common, but often more impactful group of medications, the antiplatelets and anticoagulants. The combination of complex pharmacology and some relatively new drugs in both classes, make this an area prime for discussion and review. REFERENCES 1. https://www.ajemjournal.com/article/S0735-6757(12)00169-6/pdf 2. http://www.emdocs.net...
Episode 51 - EMS Education Down Under
June 04, 2019 12:42 - 25 minutes - 35.3 MBWe have been fortunate here at MCHD to develop an ongoing educational partnership with Victoria University in Melbourne, Australia. A group of 11 paramedic students and instructors just finished a three-week study-abroad program here in the Greater Houston area. The podcast crew thought this would be the perfect chance for our Aussie colleagues to discuss the differences and similarities between EMS practice and education in Australia versus the United States. Our paramedic education super...
Episode 50 - Recognizing and Treating EMS Burnout With Dr. Remle Crowe
May 20, 2019 10:00 - 24 minutes - 33.8 MBIn recognition of EMS Week 2019, the MCHD Paramedic Podcast crew decided to directly address one of the most pressing issues in current EMS practice – paramedic and EMT wellness and burnout prevention. Dr. Remle Crowe, Research Scientist and Project Manager with ESO, joins the podcast to lend her tremendous burnout expertise. Burnout is a fluid and dynamic process that varies with time and the individual. Therefore, proactive prevention techniques have to be flexible and adaptable as well...
Episode 49 - Back To The Basics - COPD Part 2
May 06, 2019 20:00 - 18 minutes - 25.9 MBDr. Patrick and Dr. Dickson pick up where they left off on our Back to the Basics COPD Part 1 episode. We’ll delve further into the differential diagnosis one must consider when treating patients with dyspnea and discuss some of the chameleons that can masquerade as COPD. Many of our COPD patients are far from straight forward with multiple co-morbidities. After listening, you’ll run your next dyspnea call with a clear plan and more confidence.
Episode 48 - Back To The Basics - COPD Part I
April 22, 2019 14:00 - 24 minutes - 33.3 MBThis episode takes us back to the basics of COPD pathophysiology and treatment. Dr. Dickson and Dr. Patrick start with the differential diagnosis of wheezing and move through the escalating COPD treatment options. We then close with a review of common abnormal breath sounds and set the stage for COPD Part 2 which will be coming soon. References: 1. http://citeseerx.ist.psu.edu/viewdoc/download doi=10.1.1.624.2777&rep=rep1&type=pdf 2. Ram, et al. NIPPV for treatment of respiratory ...
Episode 47 - High Risk EMS Refusals
April 08, 2019 13:00 - 32 minutes - 45.1 MBOne of the most difficult situations in prehospital care is the high-risk patient refusal of EMS transport. This topic is far from straight forward for both learners and teachers alike. Dr. Patrick introduces a brand new mnemonic that will, hopefully, alleviate your FEARS the next time you care for a complex patient that decides hospital transport just isn’t in the cards.
Episode 46 - Tactical EMS Pearls With Dr. Kevin Schulz
March 26, 2019 14:05 - 33 minutes - 46.3 MBThis episode is loaded with tactical EMS pearls. Houston Fire Department Assistant Medical Director, Dr. Kevin Schulz, joins the podcast again to lend his TEMS expertise. MCHD’s tactical leader, Patrick Langan, leads the discussion and provides a Montgomery County perspective.
Episode 45 - Hypertensive Emergencies - To Treat Or Not To Treat
March 04, 2019 21:00 - 28 minutes - 38.6 MBManaging markedly elevated blood pressures has to be one of the most common EMS clinical dilemmas. Dr. Dickson joins Dr. Patrick to help dispel some long-standing and persistent hypertension management myths. The concept of “end organ damage” is also introduced as a framework to properly identify those patients with elevated blood pressures who DO warrant emergent treatment in the prehospital setting.
Episode 44 - Medical Literature 101 With Dr. Tony Seupaul
February 20, 2019 18:46 - 25 minutes - 35.6 MBWith the explosion continuing education options, how do we decide who and what to believe? Dr. Tony Seupaul, evidence based medicine expert, joins the podcast crew to discuss tips on how to best manipulate and master medical information in the social media/FOAMed era. We touch on the hierarchy of medical evidence, provide clues on how to best spot flimsy evidence, and tout some of our favorite sites and Apps to add to your educational armamentarium. References: 1. Hierarchy of medical evi...
Episode 43 - SPECIAL RELEASE: Measles in Montgomery County
February 06, 2019 18:54 - 16 minutes - 22.3 MBThe MCHD Podcast Crew just received word that we have a documented measles case here in Montgomery County. We decided to try and get out in front of this story and provide our listeners with some basic information on clinical presentation, transmission and prevention of the measles virus. References: 1. https://www.cdc.gov/measles/index.html 2. https://www.cdc.gov/measles/about/signs-symptoms.html 3. https://phil.cdc.gov/details.aspx?pid=132
Episode 42 - Cal-PAT TXA Review - Journal Club Mini
January 29, 2019 15:23 - 10 minutes - 14.3 MBThe MCHD Paramedic Podcast wants to help all of our listeners stay up to date. Earlier this year, we discussed TXA (Tranexamic Acid) following our MCHD TXA protocol roll-out. New TXA research just popped up on the radar, join Dr. Patrick for a quick journal club discussion of the Cal-PAT study. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225940/pdf/wjem-19-977.pdf
Episode 41 - OB Part 2 - To Delivery and Beyond
January 29, 2019 15:19 - 27 minutes - 38.4 MBDespite Dr. Patrick's fear, we're delivering the second installment of our Obstetrics series. This is a potentially frightening topic that was actually requested by several MCHD medics. Part one focused on emergencies encountered prior to delivery and part two progresses into difficult deliveries and the postpartum period. References: http://www.emdocs.net/the-complicated-delivery-what-do-you-do/ https://coreem.net/core/shoulder-dystocia/
Episode 40 - Phast Pharma - Dilaudid
January 14, 2019 13:47 - 6 minutes - 8.75 MBJoin Dr. Patrick for a “phast” pharmacology update on hydromorphone/dilaudid. We’ll discuss its uses, relative strength, side-effects and the future role of dialudid at MCHD.
Episode 39 - Cyanide Poisoning
January 14, 2019 13:45 - 20 minutes - 28.1 MBContinuing with our recent theme of increased fire related inhalational risks with colder weather, MCHD Paramedic Podcast toxicology guru, Dr. Jerry Snow, joins us again to discuss cyanide poisoning. We’ll discuss ways to recognize cyanide toxicity and when to empirically treat. Combining this episode with our recent carbon monoxide podcast will make you razor sharp when you run on your next house fire. References: 1. Curry, Steven C., and Meghan B. Spyres. "Cyanide: hydrogen cyanide, ino...
Episode 38 - Carbon Monoxide Poisoning - An EMS Perspective
December 31, 2018 20:01 - 26 minutes - 36.2 MBDr. Patrick is joined today remotely by toxicologist and friend of the podcast, Dr. Jerry Snow, to talk about the nuts and bolts of Carbon Monoxide poisoning. All of your questions are answered - from the use of portable CO devices, to the presentation and recognition of CO poisoned patients. We’ll hit on all the cold weather, carbon monoxide high yield information.
Episode 37 - Top Ten Meds
December 17, 2018 18:43 - 35 minutes - 48.9 MBDr. Patrick and Clinical Manager Jordan Anderson run down the 10 most commonly prescribed medications in the US. The medication list can often feel like one more task that’s always partial and incomplete. Jordan and Dr. Patrick try to take a more detective-like approach to demonstrate the utility of anticipating side-effects and potential diagnoses based on medication list clues. References: 1. http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery 2. G...
Episode 36 - Calcium Channel Blocker And Beta Blocker Toxcicity
December 11, 2018 13:45 - 26 minutes - 36.3 MBShownotes: Cardiovascular medication poisoning can produce markedly unstable patient presentations. Dr. Patrick and Brad Ward review some of the basics and more recent therapeutic developments in the treatment and management of beta-blocker and calcium channel blocker toxicity. References: 1. St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Critical Care Medicine. 2017;45(3):e306-e315. 2....
Episode 35 - Live From Texas EMS Conference, It's Saturday Night!
November 27, 2018 18:36 - 38 minutes - 52.6 MBJoin Dr. Dickson and Dr. Patrick live from the Texas EMS Conference with a special guest! Today we’ll discuss prehospital ventilator management as a precursor to the lectures Dr. Patrick and Clinical Chief Jordan Anderson will be giving at the conference.
Episode 34 - Field Amputations With Dr. Justin Hensley
November 08, 2018 23:51 - 14 minutes - 20.1 MBWhat would you do if you encountered a patient who you were unable to transport or even extract due to extremity entrapment? At MCHD, we asked ourselves this exact question and decided provide an answer in the form of a field amputation protocol. Dr. Justin Hensley joins the MCHD medical directors to discuss the details and pitfalls associated with implementing a plan to amputate a limb in the field.
Episode 32 - EMS Opiate Interventions With Dr. Dan O'Donnell
October 22, 2018 17:01 - 21 minutes - 48.6 MBDr. Dan O’Donnell serves as the Medical Director for Indianapolis EMS, as well as Medical Director for the Indianapolis Metropolitan Police S.W.A.T. team. Central Indiana has been one of the epicenters for the growing opiate epidemic and Dan joins us to discuss a novel approach that IEMS has taken to combat this devastating public health crisis.
Episode 33 - Paralytic Pharma Phun
October 22, 2018 17:01 - 30 minutes - 42.3 MBThe decision to administer paralytics may well be the most significant decision that we make as emergency providers. We have to understand and know paralytic pharmacology 100% stone cold. Join Dr. Patrick today for a review of our two most commonly encountered paralytic medications - succinylcholine and rocuronium. Homage to the old school and an investigation of newer practice shifts will be given equal airtime. References: 1. Tran DT et al. Rocuronium Versus Succinylcholine for ...
Episode 31 - Hyperoxygenation - Too Much of a Good Thing??
October 08, 2018 19:59 - 29 minutes - 41.1 MBToo much of a good thing can always end up being bad. On this episode, Dr. Patrick summarizes the ever increasing evidence that not only does supplemental oxygen not help in patients with reasonable O2 saturations, it likely is harmful in many commonly encountered disease states. Join us for some first-class mythbusting. References: 1. https://dundeechest.wordpress.com/2009/08/12/why-do-copd-patients-retain-co2-when-given-too-much-oxygen/ 2. Chu DK et al. Mortality and Morbidity in Acute...
Episode 30 - Lung Protective Ventilation With Dr. Nick Mohr
October 08, 2018 19:45 - 26 minutes - 37 MBLowering tidal volumes in effort to reduce lung injury following initiation of mechanical ventilation is far from a new idea, the original ARDS-NET data are nearly 20 years old. Lung protective ventilatory strategies have progressively been shown, from the ICU and now into the ED setting, to decrease ventilator days, ICU/hospital stay and overall mortality. This discussion covers the original ARDS-NET study, causes of ventilator induced lung injury, and closes with MCHD’s efforts to initiat...
Episode 29 - Pediatric Arrest With Dr. Greg Faris
September 28, 2018 11:24 - 20 minutes - 46.3 MBPeds EMS wizard, Dr. Greg Faris, joins us again on the podcast to discuss pediatric out-of-hosiptal cardiac arrest. This topic gives us all a bit of nausea and tachycardia. We’ll review some recent literature that will, hopefully, nudge us to change the practice of “scoop and run” in our pediatric cardiac arrests. Pediatric OHCA References Tijssen JA, et al. Time on the scene and interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest. Resuscitation....
Episode 28 - Shock States - B2B
September 26, 2018 14:36 - 32 minutes - 45.1 MBMany of the sickest of the sick patients that we see as EMS providers are hypotensive. These folks are often altered and come with spotty histories at best. This episode turns our B2B series to the prehospital management and recognition of shock. How can we better classify then treat our undifferentiated patients in shock? Dr. Patrick and Dr. Dickson build a framework around common sense pathophysiology and treatment.