MCHD Paramedic Podcast

Latest Episodes:

Episode 12 - Summer Series 2: Snake Bites Jun 10, 2018

Show notes

Dr. Jerry Snow, a medical toxicologist and emergency medicine physician from Phoenix joins the show for a fact-filled and often hilarious talk on prehospital management of snakebites. This episode involves copperheads, water moccasins and even unsuccessful car battery therapy (yep, you read that correctly). Stay until the end - you won’t be sorry you did!

Episode 10 - Stroke Systems Of Care Featuring Dr. Peter Antevy May 29, 2018

Show notes

In the past 24 months, stroke care has evolved in the way we evaluate strokes in the pre-hospital space and how they are worked up and treated in the hospital. Large vessel Occlusion (LVO) stoke is a large caliber vessel clot causing stroke symptoms. New techniques and devices in endovascular retrieval of these clots along with intravenous Tpa has shown great success in five randomized trials published in 2015.(1) The number we need to treat for one improved neurologic outcome at 90 days according to data from these trials is 2.6 patients. This is a massive breakthrough in the way we approach acute stroke care. Improved outcomes in these trials are directly associated with times to reperfusion therapy and EMS must change the way we diagnose and rank stroke patients in order to get them an endovascular capable facility when appropriate. In the first podcast our team will review all of the pertinent data from these trials and suggest how EMS should approach this LVO stroke diagnosis. In the second part of our stroke awareness series we talk with Dr. Peter Antevy, an EMS medical director from Florida who is an expert of developing regional systems of care for these LVO stroke patients. He will discuss development of their system and exciting new data that demonstrates a treatment benefit up to 24 hours after onset of symptoms in some subsets of these stroke patients. (2, 3) References 1.Hermes Collaboration: Lancet 2016 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00163-X/abstract 2. Dawn Trial: NEJM 2018 http://www.nejm.org/doi/full/10.1056/NEJMoa1706442 3. DEFUSE 3 Trial: NEJM 2018 http://www.nejm.org/doi/full/10.1056/NEJMoa1713973

Episode 9 - The State Of EMS Stroke Care In 2018 May 29, 2018

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Episode 8 - Anaphylaxis Kits For EMT's - MCHD Back To Basics Series May 14, 2018

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Anaphylaxis is a common life threatening disease that prehospital providers encounter on a regular basis. These patients are in need of early treatment with Epinephrine. In today’s episode Dr. Casey Patrick, along with Kevin Crocker and Ashton Herring, will be discussing MCHD’s deployment of Epinephrine to the Fire Departments within Montgomery County. This discussion will cover basic information on what anaphylaxis is and how to best treat it. We will also discuss how MCHD built Epi kits and how we trained the fire departments in how to safely and effectively manage these anaphylactic patients. References https://www.ems1.com/epinephrine/articles/381400048-Anaphylaxis-kits-Easy-epinephrine-deployment-for-first-on-scene/ https://www.dovepress.com/cr_data/article_fulltext/s121000/121733/img/DHPS_121733_F001.jpg

Episode 7 - ROSC To Cath Lab Activations Apr 27, 2018

Show notes

Join Dr. Casey Patrick and Brad Ward as they discuss a county wide initiative to expedite ROSC patients to definitive care in the cardiac cath lab. They will be discussing the literature and science on why these patients have better outcomes when they are quickly taken to the cath lab. They will also be addressing how MCHD has partnered with our hospitals to implement our new ROSC Cath Lab Activation. References AHA Updates http://circ.ahajournals.org/content/132/18_suppl_2/S465 Tanveer Rab, Karl B. Kern, Jacqueline E. Tamis-Holland, Timothy D. Henry, Michael McDaniel, Neal W. Dickert, Joaquin E. Cigarroa, Matthew Keadey, Stephen Ramee, Cardiac Arrest: A Treatment Algorithm for Emergent Invasive Cardiac Procedures in the Resuscitated Comatose Patient, Journal of the American College of Cardiology, Volume 66, Issue 1, 2015, Pages 62-73, ISSN 0735-1097, https://doi.org/10.1016/j.jacc.2015.05.009.

Episode 6 - MCHD Ironman Medicine 2018 Featuring Dr. Kevin Schulz Apr 24, 2018

Show notes

It's Memorial Hermann Ironman Texas time here in Montgomery County, and our MCHD crews are preparing to staff the 140.6 mile triathlon. After fielding multiple questions about hyponatremia and hypothermia in ultra-endurance athletes, we decided that a podcast discussion was in order. The MCHD Paramedic Podcast crew were lucky enough to have Dr. Kevin Schulz, Medical Director for Memorial Hermann Ironman Texas, join us to talk Ironman medicine. Sit back, relax and enjoy the ride...we promise it won't hurt as bad as 112 miles on a bike! References: Hew-Butler T, Rosner MH, et al. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Clin J Sport Med. 2015 Jul;25(4):303-20.

Episode 5 - Mobile Integrated Health/Community Paramedicine Featuring Dr. Peter Antevy Apr 17, 2018

Show notes

EMS implementation of Community Paramedicine and Mobile Integrated Health programs is exploding. Dr. Peter Antevy joins Dr. Dickson for an informative discussion surrounding the role of Community Paramedicine and Mobile Integrated Health in today’s EMS systems. Dr. Antevy has built an impressive CP program from the ground up in South Florida. He shares his experiences and thoughts on both the ideal role and future of CP.

Episode 4 - Hyperkalemia Management Apr 09, 2018

Show notes

Hyperkalemia can send our patients to cardiac arrest in an instant. Casey Patrick and Jordan Anderson begin with some background physiology review on the importance of potassium to cellular function. They then move on to describing specific patient characteristics and ECG findings found in patients with hyperkalemia, and close with MCHD’s current protocol to preemptively treat these patients en route to the hospital. PDF Summary: https://www.mchd-tx.org/media/podcasts/MCHDPP-04.pdf

Episode 3 - Syncope Apr 02, 2018

Show notes

Syncope is a common and often confusing presentation. Dr. Casey Patrick leads a lecture style discussion with tips to approaching the syncopal patient in the prehospital setting. ECG pointers and an impossible to forget “crappy” mnemonic will leave you with a more focused approach to your next syncopal patient. References 1. http://www.jem-journal.com/article/S0736-4679(17)30868-5/pdf LINKS: 1. WPW - https://lifeinthefastlane.com/ecg-library/pre-excitation-syndromes/ 2. Brugada syndrome - https://www.aliem.com/2013/06/brugada-syndrome-an-ecg-pattern-you-need-to-know/ 3. Prolonged QT interval - https://lifeinthefastlane.com/wp-content/uploads/2011/01/waves-of-the-ecg.gif 4. Hypertrophic Obstructive Cardiomyopathy - http://www.wikidoc.org/images/b/b0/Hypertrophic_cardiomyopathy.jpg

Episode 2 - Pediatric Resuscitation Featuring Dr. Peter Antevy Apr 02, 2018

Show notes

Featuring Dr. Peter Antevy Today’s show will focus on the evolution in the EMS approach to pediatric resuscitations. Historically these high stress resuscitations focused on rapid transport of these children to the hospital and have resulted in sub par resuscitation efforts and increased stress for both providers and families. There is mounting evidence that mirrors the adult resuscitation data that staying on scene and providing focused resuscitation efforts improves outcomes in these patients. Dr. Antevy provides a unique perspective as both a pediatric EM specialist/EMS medical director and inventor of the Handtevy pediatric resuscitation system. https://www.handtevy.com

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