MCHD Paramedic Podcast

Latest Episodes:

Episode 89 - Oral Boards Breakdown Sep 28, 2020

Show notes

When thinking of what strikes fear in paramedics, most would think of answers like pediatric arrests, precipitous deliveries, and unstable bradycardias. A hidden source of misery here at MCHD is the fear of the oral scenario exams for advancement. Yes, these are artificial and do not always reflect reality, but they are a necessary evil. Join Dr. Dickson and Dr. Patrick as they try and provide some framework for attacking and succeeding when taking oral scenario exams. REFERENCES https://www.mchd-tx.org/media/podcasts/MCHD-Oral-Board-Prep-Sheet.pdf

Episode 88 - End Tidal Capnography - Back To The Basics Sep 14, 2020

Show notes

The capnography tracing is an excellent tool that gives us insight into cellular metabolism, perfusion, and ventilation. This can yield vital information in multiple critical patient care decision processes. Join Dr. Patrick and Dr. Dickson as they walk through some ETCO2 interpretation basics. We are limited on the amount of objective information available during prehospital care, don’t ignore this vital piece of our puzzle. REFERENCES 1. https://www.cambridge.org/core/journals/prehospital-and-disaster-medicine/article/utilizing-endtidal-carbon-dioxide-to-diagnose-diabetic-ketoacidosis-in-prehospital-patients-with-hyperglycemia/DE85722FCDD5C24D7949C2FCCBC58E99 2. http://www.emdocs.net/interpreting-waveform-capnography-pearls-and-pitfalls/

Episode 87 - COVID Worldwide Aug 29, 2020

Show notes

Join Dr. Dickson and our esteemed colleagues from across the globe to hear how their systems have responded to the COVID-19 pandemic and what they have learned from the experience thus far. Dr. Colin Graham is an EM specialist from Hong Kong who practiced there for the first SARS outbreak and is now tackling Corona Part 2. Additionally, we’ll be joined by Dr. Al Meyer, an EM specialist in Melbourne, Australia. This episode truly gives us a worldwide COVID-19 perspective. Colin Graham qualified from the University of Glasgow in 1994 and completed basic surgical training and then specialist training in emergency medicine in Scotland. He came to the Accident and Emergency Medicine Academic Unit at the Chinese University of Hong Kong in 2004; he was promoted to Professor in 2007 and was appointed Director in 2015. He has broad research interests within emergency medicine and has published widely. Dr. Graham is an active clinical teacher and he co-authors the Oxford Handbook of Emergency Medicine. He is also currently Editor-in-Chief of the European Journal of Emergency Medicine (since 2009) and has served on the Executive and Council of the European Society for Emergency Medicine. Dr. Graham was elected to the Council of the Hong Kong College of Emergency Medicine in 2013 and 2016 and has served as Dean of Students at Morningside College in CUHK since 2016. Dr. Alastair Meyer completed his specialist training in emergency medicine in Scotland and has worked in academic emergency medicine in Melbourne Australia. He is currently the emergency department director at Casey Hospital in Melbourne. He has numerous peer reviewed publications and has lectured both with AU and internationally. Dr. Meyer is an avid cyclist and word traveler in his spare time.

Episode 86 - Red Lights and Sirens With Dr. Jeff Jarvis Aug 17, 2020

Show notes

We're joined by a special guest, Dr. Jeff Jarvis, to talk about his recent PEC manuscript investigating potential life-saving interventions in the prehospital setting and their association with "lights and sirens" usage. Be prepared for some dogma challenging discussion! REFERENCES: https://www.tandfonline.com/doi/abs/10.1080/10903127.2020.1797963

Episode 85 - COVID-19 Summer Roundup Aug 03, 2020

Show notes

The firehose of information that is COVID-19 has slowed somewhat since we last discussed the pandemic, but the first wave has obviously persisted. On this episode, Dr. Patrick and Dr. Dickson address some of the recent COVID developments in treatment, return-to-work policy updates from the CDC and crazy complications seen in pediatric patients. REFERENCES 1. https://www.cebm.net/covid-19/what-is-the-effectiveness-of-protective-gowns-and-aprons-against-covid-19-in-primary-care-settings/ 2. https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html 3. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infographic-mis-c.html 4. https://www.nejm.org/doi/full/10.1056/NEJMoa2021436 5. https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

Episode 84 - TXA For GI Bleeds: The HALT-IT Study Jul 20, 2020

Show notes

We’ve discussed TXA, both for trauma and for epistaxis, on the podcast previously. Medics often ask about TXA in the acute GI bleed patients who are in hemorrhagic shock...“What can it hurt? It’s worth a try, right?” While TXA may seem like a harmless hail Mary, on this episode, Dr. Patrick reviews the HALT-IT study and discusses why TXA for acute GI bleeds is likely harmful and probably dead in the water as a treatment option. REFERENCES: 1. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30848-5/fulltext

Episode 83 - Stupidity In EMS With Kris Kaull Jul 06, 2020

Show notes

This episode tackles the definition of "stupidity" and how this relates to prehospital medical care. Dr. Patrick is joined by Kris Kaull to discuss the definition of stupid, risk factors for making stupid moves and how to possibly prevent these in the EMS setting. REFERENCES 1. Episode inspiration - https://fs.blog/2019/01/how-not-to-be-stupid/ 2. Checklist Manifesto - http://atulgawande.com/book/the-checklist-manifesto/ https://www.amazon.com/gp/product/0312430000/ 3. Avalanche TedX talk - https://www.youtube.com/watch?v=kWOgyyDUD2w

Episode 82 - Serial Killer Series - Altered Mental Status Jun 22, 2020

Show notes

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled. But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with. To go from a chaotic scene with unstable vitals then filter to an organized differential. The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider. We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed. That’s where we, as emergency providers, must begin. Today we’ll wrap up the series with the killers associated with acute altered mental status.

Episode 81 - Serial Killer Series - Abdominal Pain Jun 09, 2020

Show notes

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled. But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with. To go from a chaotic scene with unstable vitals then filter to an organized differential. The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider. We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed. That’s where we, as emergency providers, must begin. Today we’ll address the killers associated with acute abdominal pain.

Episode 80 - Serial Killer Series - Shortness of Breath May 25, 2020

Show notes

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled. But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with. To go from a chaotic scene with unstable vitals then filter to an organized differential. The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider. We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed. That’s where we, as emergency providers, must begin. Today we’ll address the killers associated with the dyspneic patient. REFERENCES https://www.ebmedicine.net/media_library/files/Calculated%20Decisions%20E1212%20PERC%20Rule.pdf https://www.mchd-tx.org/media/podcasts/MCHDPP-80-Final-PDF.pdf

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