MCHD Paramedic Podcast

Latest Episodes:

Episode 118 - A Conversation on Clinical Consults Nov 19, 2021

Show notes

Within EMS, significant time is spent learning high risk, low frequency procedures and the pharmacology and physiology surround these events. In most EMS services consultations or checklist verifications are required in some fashion surrounding these events. Often times, though, we tend to overlook and fail to provide a structure for best practices in how to complete a clear and concise clinical consultation. MCHD District Chief, Ashley Fillmore, joins the podcast to discuss a framework for successful EMS consultations. REFERENCES 1. https://bit.ly/3HEhJXJ

Episode 117 - Prehospital IV Tylenol Nov 08, 2021

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With the recent transition of IV acetaminophen from patent to generic, it's a good time to discuss MCHD's 2021 NAEMSP abstract describing our prehospital experience with IV tylenol for pain. If you've not looked into bringing this tool into your service, listen today to be convinced why IV Tylenol is an option worth considering across EMS. REFERENCES 1. Mahshidfar B, Rezai M, et al. Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomized Clinical Trial. Adv J Emerg Med. 2019 May 8;3(4):e37 2.Bijur PE, Friedman BW, et al. Randomized Clinical Trial of Intravenous (IV) Acetaminophen as an Adjunct to IV Hydromorphone for Acute Severe Pain in Emergency Department Patients. Acad Emerg Med. 2020 Aug;27(8):717-724.

Episode 116 - Hyperacute T Waves Oct 25, 2021

Show notes

Everything occlusion MI isn't always STEMI. After a recent discussion of "STEMI equivalents" during MCHD continuing education, Dr. Patrick cared for a textbook hyperacute T wave patient in his emergency department practice. On this episode, we review some hyperacute T wave tips, in addition to addressing how to deal with resistant consultants. REFERENCES: 1. https://tinyurl.com/3aser4j5 2. Tzimas, Georgios et al. “Atypical Electrocardiographic Presentations in Need of Primary Percutaneous Coronary Intervention.” The American journal of cardiology 124.8 (2019): 1305–1314 3. Aslanger EK, ET AL. DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction (DIFOCCULT Study). Int J Cardiol Heart Vasc. (2020) Jul 30;30:100603 4. Pendell Meyers H, ET AL. Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction. Int J Cardiol Heart Vasc. (2021) Apr 12;33:100767

Episode 115 - Digging Up Droperidol Oct 11, 2021

Show notes

We’ve recently rolled out a new medication protocol here at MCHD. Join the medical directors to discuss the why, when, and how behind MCHD’s droperidol protocol. Like many pharmacologic treatments in emergency medicine, old becomes new again! REFERENCES 1. Page CB, Parker LE, et al. A Prospective Before and After Study of Droperidol for Prehospital Acute Behavioral Disturbance. Prehosp Emerg Care. 2018 Nov-Dec;22(6):713-721. 2. https://www.mchd-tx.org/media/podcasts/MCHDPP-115.pdf

Episode 114 - COVID And Asystole? Sep 27, 2021

Show notes

It seems as though each week brings some crazy and bizarre COVID-19 related news. MCHD Cpt. Megan Powell joins the podcast to spread the word about a harrowing COVID related case that made us all stop and do a literature search. Listen and in and learn yet another clinical consideration when caring for complex COVID-19 patients. REFERENCES 1. Wang Y, Wang Z, Tse G, Zhang L, Wan EY, Guo Y, Lip GYH, Li G, Lu Z, Liu T. Cardiac arrhythmias in patients with COVID-19. J Arrhythm. 2020 Jul 26;36(5):827-836. doi: 10.1002/joa3.12405. 2. https://www.tandfonline.com/doi/full/10.1080/10903127.2021.1924325

Episode 113 - The "AHORA" Stroke Scale With Dr. Remle Crowe Sep 13, 2021

Show notes

**NOTE - THIS EPISODE WAS RECORDED PRIOR TO THE DELTA SURGE** The MCHD clinical crew (Pre-Delta, obviously)attended an actual in-person EMS meeting – EAGLES 2021. One of the most interesting talks was by friend of the podcast/EMS research superstar, Dr. Remle Crowe. Join Dr. Patrick and Dr. Crowe as they discuss the “AHORA” stroke tool and how it has the potential to positively impact prehospital stroke care. REFERENCES 1. Keenan KJ, Kircher C, McMullan JT. Prehospital Prediction of Large Vessel Occlusion in Suspected Stroke Patients. Curr Atheroscler Rep. 2018 May 21;20(7):34. 2. https://www.ems1.com/stroke-care/articles/the-time-for-spanish-language-stroke-community-outreach-efforts-is-ahora-xxJdr9dKClRMXJn5/ 3. https://www.mchd-tx.org/blog-post/mchd-ems-joins-campaign-to-bring-stroke-education-to-the-spanish-speaking-community/

Episode 112 - Awake And Paralyzed...BEWARE Aug 30, 2021

Show notes

Join the podcast crew as they discuss a recent study investigating the risk of being awake while paralyzed when intubated in the emergency department setting. This is definitely an under-discussed topic in the EMS world, especially considering the recent swing from succinylcholine to rocuronium for prehospital medication assisted intubation. This conversation should make us all a bit nervous and better focused the next time we intubate. REFERENCES 1. https://www.annemergmed.com/article/S0196-0644(20)31314-7/fulltext

Episode 111 - Attacking Pandemic ED Wall Time Delays Aug 16, 2021

Show notes

Like the rest of the country and world, our Montgomery County hospital partners and ED's have been under severe strain due to a myriad of factors related to the COVID-19 pandemic. This had led to a significant increase in EMS wall times which, in turn, places that severe strain back on the prehospital system. The podcast crew takes an operational turn with MCHD Chief of Operations, Jacob Shaw, to discuss some of our operational adaptations to try and combat our ED delays. We'd love for this episode to open up discussions on how listeners are approaching these problems with their services.

Episode 110 - EMS Charting Pearls And Pitfalls Aug 02, 2021

Show notes

Charting is one of the more neglected skills from an EMS educational emphasis standpoint. As a result, what the medical director ends up reading during chart review is often wildly variable. Join the MCHD Paramedic Podcast team as they discuss some charting pitfalls to avoid and some specific tips on improving your ePCR narratives.

Episode 109 - Bradycardia Breakdown Jul 19, 2021

Show notes

The best clinical discussions always stem from real-life cases. MCHD paramedic Jarrett Kenning had a run of recent bradycardia patients and developed the idea for a bradycardia breakdown with the podcast crew. Bradycardia treatment can vary wildly depending on the underlying cause(s). Joint Jarrett and Dr. Patrick as they discuss several bradycardia cases and present a framework for creating your differential the next time you run on a patient with a pulse in the 30's. REFERENCES https://www.mchd-tx.org/media/podcasts/MCHDPP-109-Final-PDF.pdf

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