MCHD Paramedic Podcast

Latest Episodes:

Episode 198 - Dyspnea - The Next 30 Minutes Sep 07, 2026

Show notes

We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with shortness of breath once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next 30 minutes" for the serial killer dyspneic patient.

Episode 197 - Altered Mental Status - The Next 30 Minutes Aug 10, 2026

Show notes

We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with an altered patient once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next 30 minutes" for the serial killer AMS patient.

Episode 196 - Cervical Spine Immobilization In 2026: Evidence Vs. Dogma Jul 13, 2026

Show notes

We recently made some cervical spine immobilization protocol changes here at MCHD. Dr. Patrick and Dr. DePasquale discuss the history and literature that provide the foundation for rigid cervical collar use, along with the new MCHD protocol implementation. This has been a collaborative process with our local hospital partners, which has definitely involved give-and-take on both sides. REFERENCES 1. Davies G, Deakin C, Wilson A. The effect of a rigid collar on intracranial pressure. Injury. 1996 Nov;27(9):647-9. 2. Mobbs RJ, Stoodley MA, Fuller J. Effect of cervical hard collar on intracranial pressure after head injury. ANZ J Surg. 2002 Jun;72(6):389-91. 3. Hunt K, Hallworth S, Smith M. The effects of rigid collar placement on intracranial and cerebral perfusion pressures. Anaesthesia. 2001 Jun;56(6):511-3. 4. Lerner EB, Billittier AJ 4th, Moscati RM. The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care. 1998 Apr-Jun;2(2):112-6. 5. Totten VY, Sugarman DB. Respiratory effects of spinal immobilization. Prehosp Emerg Care. 1999 Oct-Dec;3(4):347-52 6. Mitra B, Bernard S, Yankoff C, Somesh A, Stewart C, Koolstra C, Talarico C, Nehme Z, Fitzgerald MC, Cameron PA. Change from semi-rigid to soft collars for prehospital management of trauma patients: An observational study. J Am Coll Emerg Physicians Open. 2024 Jul 17;5(4):e13239. 7. Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K. Prehospital use of cervical collars in trauma patients: a critical review. J Neurotrauma. 2014 Mar 15;31(6):531-40. 8. 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. 9. Ramasamy A. Advanced trauma life support 2025: A brief review of updates. Injury. 2026 Apr;57(4):113079. doi: 10.1016/j.injury.2026.

Episode 195 - Cold Water Immersion For Heatstroke - Lessons From Phoenix Jun 15, 2026

Show notes

Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of cooling directly correlates with mortality reduction. Learn how to implement CWI in your service. It's the best of all worlds: inexpensive, impactful, and applies to all EMS clinician levels. REFERENCES 1. Comp G, Finch C, Kupanoff K, Sandoval M, Lloyd M, Aldaco N, Kirk D, Pugsley P, Nordstrom L, Koenig BW, Narang A, Snow J, Kamer M, Foster A, Patel G, Stowell JR. Fighting Fire with Ice: A Multisite Collaboration to Evaluate the Impact of Prehospital Cold Water Immersion on Heat Stroke Patients. Prehosp Emerg Care. 2026 Mar 13:1-11.

Episode 194 - Mental Health Matters In EMS With Dr. Joe Gill May 18, 2026

Show notes

MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some concrete solutions for the future.

Episode 193 - What Can EMS Learn From An Emergency Pharmacist? - Part 2 Apr 20, 2026

Show notes

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. This is the second episode of our two-part series! REFERENCES 1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.

Episode 192 - What Can EMS Learn From An Emergency Pharmacist? - Part 1 Mar 23, 2026

Show notes

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. The episode went so well, we had to create a two-part series! REFERENCES 1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.

Episode 191 - EMS Protocols 101 Feb 23, 2026

Show notes

As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are the potentially risky decisions? What should the MCHD field paramedics know about the process? Have a listen to better understand the true foundation of EMS clinical practice.

Episode 190 - Geriatric Considerations In EMS With Dr. Maia Dorsett Jan 26, 2026

Show notes

The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehospital setting. What are the common mistakes? What tools can be implemented to improve patient outcomes? Why does geriatric care even matter? This episode is packed with high-yield information that will make all of us better clinicians. REFERENCES 1. Dorsett M, Allen H, Garbacz H, Sensenbach B, Kumar S, Jones CMC, Cushman JT. Timeline for Repeat EMS Encounters Resulting in Transport Following "Lift Assist" in a Suburban EMS System. Prehosp Emerg Care. 2025 May 29:1-6. 2. Haussner WK, Breyre AM, Bascombe K, Barrett WJ, Camacho MA, Overton-Harris P, Williams S, Lyng JW, Martin-Gill C, Colwell C. Prehospital Trauma Compendium: Management of Geriatric Trauma Patients - A Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. 2025 Sep 25:1-10.

Episode 189 - EMS Airway Updates 2025 - Part 2 Dec 29, 2025

Show notes

There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. This is part two of a two-part series. REFERENCES 1. Jarvis JL, Jarvis SE, Kennel J. The Association Between Out-of-Hospital Drug-Assisted Airway Management Approach and Intubation First-Pass Success. Ann Emerg Med. 2025 Nov;86(5):521-530. 2. Spigner MF, Wang HE, Carlson JN. One and Done? Rethinking "First-Pass Success" in Out-of-Hospital Airway Management. Ann Emerg Med. 2025 Nov;86(5):531-532. 3. Maia IWA, Besen BAMP, Silva LOJE, et al; BARCO group. Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study. Crit Care. 2025 Apr 17;29(1):155.

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