MCHD Paramedic Podcast

Latest Episodes:

Episode 99 - Pediatric General Assessment Triangle Feb 12, 2021

Show notes

Nothing scares an emergency provider quite as much as the “sick infant.” During today’s episode, Dr. Patrick and Dr. Dickson walk through the pediatric general assessment triangle and discuss the finer points that make up each side. They’ll also discuss the singular/#1 Law of the Pediatric Exam. Your next pediatric run will be a breeze after this review. REFERENCES: 1. Leeper, Christine M. MD, MS; McKenna, Christine MSN; Gaines, Barbara A. MD Too little too late: Hypotension and blood transfusion in the trauma bay are independent predictors of death in injured children, Journal of Trauma and Acute Care Surgery: October 2018 - Volume 85 - Issue 4 - p 674-678 2. Balamuth F, Alpern ER, Abbadessa MK, et al. Improving Recognition of Pediatric Severe Sepsis in the Emergency Department: Contributions of a Vital Sign-Based Electronic Alert and Bedside Clinician Identification. Ann Emerg Med. 2017;70(6):759-768. 3. Mottled Skin - http://empem.org/wp-content/uploads/2011/12/EMPEM-mottled-legs.jpg 4. Startle Reflex - https://www.youtube.com/watch?v=PhOleckx1-Y 5. Moro Reflex - https://www.youtube.com/watch?v=PTz-iVI2mf4

Episode 98 - EMS Legal Questions With Andrew James Feb 01, 2021

Show notes

Emergency medical providers are comfortable in the chaos of a crashing medical or trauma patient. We know how to systematically address dangerous medical conditions like hypotension, hypoxia and bradycardia. However, when asked to dip our toes into the legal realm, we are often paralyzed with fear. On this episode, the podcast crew is joined by local legal expert, Andrew James. Mr. James is the vehicular crimes chief with the Montgomery County DA's office, and he has extensive experience working with medics and first responders in the courtroom. Listen and learn some of the basics of what happens when you're called to court as witness.

Episode 97 - Autism And EMS Jan 18, 2021

Show notes

Anytime we arrive on scene with blaring sirens and flashing lights, this can be exceedingly stressful on patients and families. This is especially true for our patients with autism. We're lucky to have Jennifer Dantzler on the podcast today to discuss autism basics along with some tools that we can use in the prehospital setting to better care for and communicate with our autistic patients. Jennifer is the director of the Including Kids Autism Center and a true expert in the field of autism spectrum disorder. REFERENCES 1. https://www.includingkids.org/our-story/helpful-resources/ 2. https://www.autismspeaks.org

Episode 96 - Medical Director Myths - Part 1 Jan 04, 2021

Show notes

Around the MCHD Clincial Department we’ve had some recurrent themes pop up over the past few months that always make the medical directors shake their heads. During this episode, Dr. Dickson and Dr. Patrick take a shot at dispelling some “medical director myths."

Episode 95 - ECMO ALERT! The ARREST Trial Dec 21, 2020

Show notes

Electrical storm has dismal outcomes. It is most frustrating because we know the cause is very likely coronary occlusion (~75%)! We have added esmolol to our tool belt here at MCHD to try and improve refractory VF outcomes. Others are trying early ECMO in this patient population. Prior eCPR studies have all been retrospective. Join the podcast crew as they discuss a recent Lancet article looking at eCPR vs. standard ACLS in refractory VF. Randomized, prospective, and quite amazing. REFERENCES https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32338-2/fulltext

Episode 94 - Freestanding ED Mythbusters Dec 05, 2020

Show notes

Freestanding emergency departments are becoming more and more common across the United States. Here at MCHD, we feel that EMS transport to these sites can be beneficial to both our system and the community as well. During today's episode, Dr. Patrick is joined by multiple hospital partners for some enlightening FSED myth-busting.

Episode 93 - COVID-19 Vaccine Update Nov 23, 2020

Show notes

Thankfully, we finally have some positive COVID-19 news to discuss. Join the medical directors for a discussion of vaccine basics and some of the specific issues EMS and public health will likely encounter with COVID-19 vaccine administration. REFERENCES 1. https://podcasts.apple.com/us/podcast/stimulus/id1501107371?i=1000494006283 2. https://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/prevent-covid 3. https://www.cdc.gov/vaccines/imz-managers/downloads/COVID-19-Vaccination-Program-Interim_Playbook.pdf

Episode 92 - Resilience in EMS With Kris Kaull Nov 09, 2020

Show notes

We’ve discussed burnout on the podcast in the past. When thinking about ways to combat burnout, a word that often comes up is resilience. Emergency care was stressful enough, then 2020 decided to add COVID to the mix. Join the podcast crew and special guest Kris Kaull as we talk about ways to foster resilience as an EMS provider which will hopefully extinguish burnout before it spreads. REFERENCES 1. https://www.kevinmd.com/blog/2020/08/7-habits-of-highly-resilient-physicians.html 2. https://www.amazon.com/When-Breath-Becomes-Paul-Kalanithi/dp/081298840X/ref=sr_1_1?crid=2O1RTLPJFYHVE&dchild=1&keywords=breath+becomes+air&qid=1604872706&sprefix=breath+be%2Caps%2C191&sr=8-1 3. https://podcasts.apple.com/us/podcast/the-accumulation-of-marginal-gains-with-salim-rezaie/id1501107371?i=1000487654581

Episode 91 - SVT Updates Oct 26, 2020

Show notes

Sometimes in medicine, we do things just because they’ve always been done that way, which is terrible reasoning. Valsalva maneuver followed by the two-syringe technique for adenosine administration has been standard practice in PSVT management for decades. Recent data suggests that both of these approaches may have better alternatives. Join Dr. Patrick and Brad Ward as they provide updates on both non-pharmacologic and pharmacologic management of PSVT. REFERENCES 1. McDowell M et al. Single-Syringe Administration of Diluted Adenosine. Acad Emerg Med 2020, Jan;1:62-63. 2. Choi SC et al. A Convenient Method of Adenosine Administration for Paroxysmal Supraventricular Tachycardia. J Korean Soc Emerg Med 2003, Aug;14(3):224-227. 3. Weberding NT, Saladino RA, Minnigh MB, et al. Adenosine administration with a stopcock technique delivers lower-than-intended drug doses. Ann Emerg Med 2018;71:220–4. 4. https://www.youtube.com/watch?v=8DIRiOA_OsA

Episode 90 - Bolus Dose Nitroglycerin With Mike Perlmutter Oct 12, 2020

Show notes

If there is one topic that we love at MCHD, it’s discussing bolus dose nitroglycerin in acute pulmonary edema patients. We’re lucky to have more positive evidence supporting it’s use thanks to Mike Perlmutter and his colleagues from North Memorial in Minneapolis. Join Dr. Patrick and Mike as they geek out over high dose nitrate use in EMS. REFERENCES 1. https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/prehospital-treatment-of-acute-pulmonary-edema-with-intravenous-bolus-and-infusion-nitroglycerin/B7B78C8CC0A32A2E0048AECCC177DF69/share/3b38ce9a134027bde58af415173c72b9f3fe8ac4 2. https://www.tandfonline.com/doi/full/10.1080/10903127.2020.1711834

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