MCHD Paramedic Podcast

Latest Episodes:

Episode 20 - Pediatric Concussion With Dr. Greg Faris Jul 30, 2018

Show notes

Concussions and management of mild head injury are topics that are rapidly evolving. Dr. Greg Faris joins Dr. Patrick to lend his pediatric emergency expertise on these important and commonly seen injuries. With youth and high school football season coming soon, get your concussion refresher now. References: CDC Heads up. www.cdc.gov/headsup Kupperman N, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet 2009; 374: 1160-70. McCrory P, et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med 2017;0:1–10. Davis GA, et al. Sports Concussion Assessement Tool 5th Edition. Br J Sports Med 2017;0:1–8

Episode 19 - OB Part I Jul 30, 2018

Show notes

Pregnancy complications make us all a little diaphoretic and tachycardic. On this episode, Dr. Patrick and Dr. Dickson break down the must know aspects of caring for the obstetric patient prior to delivery in the EMS setting. References: https://www.acog.org/Clinical-Guidance-and-Publications/Task-Force-and-Work-Group-Reports/Hypertension-in-Pregnancy

Episode 18 - Pediatric Non-Accidental Trauma With Dr. Elizabeth Weinstein Jul 16, 2018

Show notes

Dr. Patrick is joined on this episode by Dr. Elizabeth Weinstein. Elizabeth is a dual trained in Emergency Medicine and Pediatrics, and she delivers clinical pearl after clinical pearl on how to recognize and manage non-accidental trauma in the prehospital environment. Resources: http://www.identifychildabuse.org

Episode 17 - One Pill Killers Jul 16, 2018

Show notes

Join Dr. Patrick for a discussion of common drugs, both OTC and prescription, that can be deadly to our pediatric patients in doses as small as a single pill. This knowledge will allow us to properly educate families and know when to expect a potential crashing kid. References: Michael J.B., Sztajnkrycer M.D. Deadly pediatric poisons: Nine common agents that kill at low doses. (2004). Emergency Medicine Clinics of North America, 22, 1019-1050.

Bonus Episode - Fentanyl Fever: Unnecessary Hysteria Jun 28, 2018

Show notes

Dr. Jerry Snow, a medical toxicologist and emergency medicine physician from Phoenix joins the show for an interesting discussion about the opiate crisis facing America today, with a specific emphasis on fentanyl and its derivatives. We discuss EMS/first responder exposure risks and preventative measures along with patient care pearls when treating patients with fentanyl overdose. References: American Academy of Clinical Toxicology Statement on Fentanyl Exposure Risks - https://www.acmt.net/_Library/Fentanyl_Position/Fentanyl_PPE_Emergency_Responders_.pdf https://www.whitehouse.gov/ondcp/key-issues/fentanyl/

Episode 16 - Congestive Heart Failure Part 2 - Nitro, Nitro, Nitro Jun 25, 2018

Show notes

Patients with acute pulmonary edema need rapid preload and afterload reduction and often their volume status is difficult to ascertain. Casey Patrick and Brad Ward discuss a novel approach to using our old friend nitroglycerin in these patients along with the other cornerstones of their care. References 1. Cotter G, Metzkor E, Kaluski E, et al. Randomised trial of high-dose isosorbide dinitrate plus low-dose furosemide versus high-dose furosemide plus low-dose isosorbide dinitrate in severe pulmonary oedema. Lancet. 1998;351(9100):389-93. 2. Levy P, Compton S, Welch R, et al. Treatment of severe decompensated heart failure with high-dose intravenous nitroglycerin: a feasibility and outcome analysis. Ann Emerg Med. 2007;50(2):144-52. 3. Wilson SS, Kwiatkowski GM, Millis SR, et al. Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure. Am J Emerg Med. 2017;35(1):126-31. 4. Peacock WF et al. Morphine and Outcomes in Acute Decompensated Heart Failure: An ADHERE Analysis. Emerg Med J 2008; 25: 205 – 209.

Episode 15 - Congestive Heart Failure Part 1 - The Basics Jun 25, 2018

Show notes

CHF exacerbations are bread and butter emergency medicine. Casey Patrick and Brad Ward begin with some background physiology and review of CHF. They then move on to describing a more detailed framework than the typical “CHF exacerbation” that is commonly taught. You’ll finish this podcast and think you’re a plumber as opposed to a paramedic. References https://coreem.net/core/ape/

Episode 14 - Delayed Sequence Intubation (DSI) With Dr. Jeff Jarvis Jun 19, 2018

Show notes

Today’s show is all about the changes in how we approach intubation in EMS. Dr. Jeff Jarvis will relate how he got interested in the topic of airway management and specifically the process of delayed sequence intubation. Dr. Jarvis is the EMS medical director for Williamson County Texas EMS. He will present data from the recent Annals of Emergency Medicine paper his group authored on the topic. MCHD quality lead, Kevin Crocker, will present our data following DSI Implementation in Montgomery County. Weingart Emcrit podcast and Annals of EM article https://emcrit.org/dsi/ http://dx.doi.org/10.1016/j.annemergmed.2014.09.025 Jarvis Annals paper http://www.annemergmed.com/article/S0196-0644(18)30071-4/abstract Wilco EMS: https://www.wilco.org/Departments/EMS 2017 SOCs DSI protocol DSI checklist for both WCEMS and Marble Falls Area EMS

Episode 13 - Summer Series 3: Drowning (Adult and Pediatric) Jun 12, 2018

Show notes

Join Dr. Patrick and Ashton Herring our community outreach coordinator as we discuss adult and pediatric drowning emergencies and best practices in prevention.

Episode 11 - Summer Series 1: Heat Emergencies Jun 11, 2018

Show notes

With the blazing Texas summer just around the corner, we thought it would be appropriate to discuss heat related emergencies. Dr. Patrick leads a discussion of the various terminology, physical exam findings, differential diagnoses and pre-hospital treatments for heat-illness.

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