MCHD Paramedic Podcast

Latest Episodes:

Episode 40 - Phast Pharma - Dilaudid Jan 14, 2019

Show notes

Join 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 Jan 14, 2019

Show notes

Continuing 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, inorganic cyanide salts, and nitriles." Critical care toxicology (2016): 1-21. 2. Purvis, M. V., et al. "Prehospital hydroxocobalamin for inhalation injury and cyanide toxicity in the United States-analysis of a database and survey of ems providers." Annals of burns and fire disasters 30.2 (2017): 126. 3. Kaita, Yasuhiko, et al. "Cyanide poisoning is a possible cause of cardiac arrest among fire victims, and empiric antidote treatment may improve outcomes." The American journal of emergency medicine 36.5 (2018): 851-853. 4. Parker-Cote, J. L., et al. "Challenges in the diagnosis of acute cyanide poisoning." Clinical Toxicology 56.7 (2018): 609-617.

Episode 38 - Carbon Monoxide Poisoning - An EMS Perspective Dec 31, 2018

Show notes

Dr. 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 Dec 17, 2018

Show notes

Dr. 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. Gomes T, et al (2017) Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study. PLoS Med 14(10): e1002396

Episode 36 - Calcium Channel Blocker And Beta Blocker Toxcicity Dec 11, 2018

Show notes

Shownotes: 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. Wax P, Erdman A, Chyka P, et al. Beta-blocker ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005; 43(3):131-146.

Episode 35 - Live From Texas EMS Conference, It's Saturday Night! Nov 27, 2018

Show notes

Join 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 Nov 08, 2018

Show notes

What 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 33 - Paralytic Pharma Phun Oct 22, 2018

Show notes

The 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 Rapid Sequence Induction Intubation. Cochrane Database Syst Rev 2015. 2. Shoenberger JM, Mallon WK. Rocuronium Versus Succinylcholine Revisited: Succinylcholine Remains the Best Choice. Ann Emerg Med 2018; 71(3): 398-9. 3. Swaminathan A, Mallemat H. Rocuronium Should Be the Default Paralytic in Rapid Sequence Intubation. Ann Emerg Med 2018; 71(3): 397-8.

Episode 32 - EMS Opiate Interventions With Dr. Dan O'Donnell Oct 22, 2018

Show notes

Dr. 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 31 - Hyperoxygenation - Too Much of a Good Thing?? Oct 08, 2018

Show notes

Too 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 Acutely Ill Adults Treated with Liberal Versus Conservative Oxygen Therapy (IOTA): A Systematic Review and Meta-Analysis. Lancet 2018.

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