The World’s Okayest Medic Podcast

Dr. Patrick Sullivan: Metabolic Health, First Responder Health Nov 21, 2024

Tactical EMS: Lessons Learned and Concept Evolution Nov 15, 2024

Listener discretion is advised.

Chris Wright: Lessons in Trauma from Ukraine Nov 11, 2024

Listener discretion is advised.

Chris Wright is a flight paramedic who spent a few months working as a medic in the Ukranian conflict. He came on to talk about tourniquet conversion but we ended up going into all kinds of trauma lessons he learned from his time.

The Five Things that Make a Good EMS Provider Nov 05, 2024

LISTENER DISCRETION IS ADVISED.

Responding to the Keyboard Warriors, Minor Chest Pain from Minor MVAs Oct 29, 2024

LISTENER DISCRETION IS ADVISED.

Drs. Mark Piehl & Peter Antevy on the Prehospital Blood Debate Oct 18, 2024

It was an honor and a privilege to record an episode with Dr. Mark Piehl and Dr. Peter Antevy. They came on to discuss prehospital blood product administration and their recent letter to the editor in Academic Emergency Medicine.

Sick Little Kids - Redux Oct 13, 2024

Listener discretion is advised.

References:

CHOP Croup Clincial Pathway: https://pathways.chop.edu/clinical-pathway/croup-emergency-department-and-inpatient-clinical-pathway

General Peds Reference: Lucking, S. Maffei, F., Tamburro, R., & Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide.

Pediatric Fluid Maintenance: Somers, Michael. (2022). Maintenance intravenous fluid therapy in children. Up-to-Date.

Racemic vs. Standard Epi: PMID: 1734400

Do the Ordinary Extraordinarily Well Sep 30, 2024

Listener discretion is advised

Intubation Ramblings: Protocols, Devices, Techniques Sep 27, 2024

LISTENER DISCRETION IS ADVISED

References: Anand Swaminathan, "REBEL Cast Ep107: The BOUGIE Trial – Bougie First in All Emergency Intubations?", REBEL EM blog, February 17, 2022. Available at: https://rebelem.com/rebel-cast-ep107-the-bougie-trial-bougie-first-in-all-emergency-intubations/.

AirTraq vs. Bougie: PMID 28515522

McGrath vs. AirTraq: PMID 28781449

Bougie vs. Stylet: PMID 29800096

Rigid vs. Standard Stylet: PMID 22273475

Random Talk: Sept 17, 2024 Sep 17, 2024

LISTENER DISCRETION IS VERY ADVISED

Topics: Meta-Analysis Fallout, NREMT stuff, Offensive idiot at EMS Expo

Thoughts on a Meta-Analysis Casting Doubt on Prehospital Blood Sep 09, 2024

LISTENER DISCRETION IS REALLY ADVISED.

References: Meta-Analysis Civ Prehospital Transfusion: PMID 38517320 COMBAT: PMID 30032977 PamPER: PMID 30044935 RePhill: PMID 35271808 COMBAT/PamPER Post-Hoc Analysis: PMID 31851290

Blood Stuff with Rick Maricle Sep 07, 2024

Listener discretion is advised.

EMS training guru Rick Maricle came onto talk about the regional blood program in Southern Texas and to talk unscripted about prehospital blood.

"StArT a MeDiC 4 HyPeRtEnSiON" Aug 31, 2024

LISTENER DISCRETION IS ADVISED

Gauer, R. (2017). Severe Asymptomatic Hypertension: Evaluation and Treatment. Am Family Physician. 95(8).

Oras, et. Al. (2019). Elevated BP in the ED. Hypertension 75(1).

Yaphe, J, Atzema, C, Helman, A. Hypertensive Emergencies. Emergency Medicine Cases. February, 2014.

Listener Clinical Questions (Prologue: HEMS Rant) Aug 24, 2024

LISTENER DISCRETION IS ADVISED References: Mag Sulfate for A-Fib: PMID 17449500, 34950320 Eclampsia: PMID 21154341

The First Two Years of Being a Medic are Hard Aug 20, 2024

Listener discretion is advised.

Two "newer" medics - Ashlynn and Cameron (my partner) come onto the podcast to talk about the struggles and growth potential of being a new paramedic.

Culture of Safety, Culture of Stupidity Aug 15, 2024

LISTENER DISCRETION IS ADVISED.

Safety: culture of safety, buzzword, HEMS safety, ground safety, and more

Winning Paramedic School: Hard Work Aug 06, 2024

Listener discretion is advised.

MORE Rethinking Traumatic Arrest Jul 27, 2024

Listener discretion is advised.

References (PMID):

Compressions: 29132577, 35549924

Junctional TQ/Pelvic Binders: 31910475, 29889959, 38226570, 30507857

Vasopressors: 33908898, 23697682, 28716309

Blood: 34390843, Hazelton, et. al. (2022). Whole blood vs. component therapy for transufsion in trauma pts., McCartney (2023). Whole blood in resuscitating trauma is making a comeback.

Glitchy Virtual Happy Hour with Wes Jul 26, 2024

Random talk with Wes Nelson...listener discretion is advised

Podcast Therapy: Me, My Story, & How the Podcast Started Jul 19, 2024

Listener discretion is REALLY advised.

Random Talk: Teaching in Baltimore with Cody and Moose Jul 18, 2024

Listener discretion is advised

Cody (@ordinaryopsmedic) and Moose - both from the Alert Medic One team - came on to have a totally random and agendaless discussion about....well....give it a listen...

Trauma, Blood, & Politics Jul 12, 2024

Paramedic, Nurse Practitioner, Associate Professor, and Bioethicist Stephen Wood came onto the podcast to talk about implementing prehospital blood and to do what I love: dispelling "the narrative."

"Scoop & Run:" Police Trauma Transport Jul 01, 2024

LISTENER DISCRETION IS ADVISED

References: Band RA, Salhi RA, Holena DN, Powell E, Branas CC, Carr BG. Severity-adjusted mortality in trauma patients transported by police. Ann Emerg Med. 2014 May;63(5):608-614.e3. doi: 10.1016/j.annemergmed.2013.11.008. Epub 2014 Jan 2. PMID: 24387925; PMCID: PMC5912155.

Inaba K, Jurkovich GJ. Police Transport for Penetrating Trauma-Lessons From Patients in Philadelphia. JAMA Netw Open. 2021 Jan 4;4(1):e2035122. doi: 10.1001/jamanetworkopen.2020.35122. PMID: 3349Time 2370.

Maher, et. Al. (2021). Police transport of Firearm-Injured patients- more often and more injured. Journal of Acute Care Surgery. PMID 34108420

Winter, et al. (2021). Association of Police Transport with Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania. JAMA Open Network. PMID 33492375

Winter E, Byrne JP, Hynes AM, Geng Z, Seamon MJ, Holena DN, Malhotra NR, Cannon JW. Coming in hot: Police transport and prehospital time after firearm injury. J Trauma Acute Care Surg. 2022 Nov 1;93(5):656-663. doi: 10.1097/TA.0000000000003689. Epub 2022 May 20. PMID: 36282621.

Code Debrief with Josh from Alert Medic One Jun 30, 2024

Josh from the Alert Medic One Podcast came on to debrief a recent cardiac arrest call he ran and discuss some cardiac arrest topics.

Random Ramblings: 6/20/24 Jun 21, 2024

LISTENER DISCRETION IS ADVISED

Scene Flight: Masive Facial Trauma Jun 16, 2024

Listener discretion is advised.

References:

Grossman, Dave. (2004). On Combat. http://www.litfl.com http://deployedmedicine.com PMID: 26566339 (Pelvic Ring) PMID 2025808 (LeFort and anatomical pathology) PMID: 36147139 (Lefort III Management) PMID: 31626153 (CICO)

More Respiratory! Melody Bishop RT is back! Jun 07, 2024

The enchanting and brilliant Melody Bishop, RT came back on to the podcast to answer your respiratory/vent/blood gas/monitoring questions. We are also joined by one of my mentors, Dave Salati (flight nurse, ER nurse, pediatric nurse, and OG urban paramedic) who made his podcasting debut.

"Drop Off Imposter Syndrome" May 27, 2024

LISTENER DISCRETION IS ADVISED

Random Talk: Cardiac Monitors, Life & Death, LODDs May 17, 2024

LISTNER DISCRETION (IS REALLY) ADVISED

Random Talk: FOAMed, Social Media, "Progressive" Agencies May 13, 2024

LISTENER DISCRETION IS ADVISED

Fire-Based EMS May 09, 2024

Alert Medic One Podcast's Josh came on to discuss the good and the bad about fire-based EMS. Spoiler alert, there's more good. The old paradigm of "F EMS" is changing (in many places).

Kirk from Hamilton: Bringing the ICU Vent to the Ambulance May 05, 2024

Kirk Smith, RT from Hamilton Medical came onto the podcast to talk about the Hamilton T1 and how EMS agencies from CCT to IFT to 911 services are using it.

I Pivoted on POCUS Apr 29, 2024

LISTENER DISCRETION IS ADVISED

Peds Resus and The Tortured Paramedics Department Apr 27, 2024

LISTENER DISCRETION IS ADVISED PMID: 35832199

Ashlynn O'Dell, Being a Young Paramedic, Imposter Syndrome Apr 23, 2024

Expert Panel: Mental Health Apr 15, 2024

Alex Jabr from Emergency Resilience and James Boomhower from StayFit4Duty came onto the podcast to have some unscripted real talk about first responder mental health. Listener discretion is advised.

Mini Episode: Can't See the Cords Apr 11, 2024

Questioning the Prehospital Airway Narrative Apr 09, 2024

Listener Discretion is Advised.

References: FPS ED: PMID 31843066 Improving ED FPS: PMID 34494654 HEMS FPS: PMID 36411447 HEMS MD vs. Medic FPS: PMID 24841771 Wang and Kupas: PMID 12837645 Wang's Next Paper: PMID 16531595

Nurse Gwenny Takes Over the Podcast Apr 01, 2024

LISTENER DISCRETION IS ADVISED. NurseGwenny takes over the podcast and interviews Mike (not like you don't hear enough from him...)

The Fine Print: Mechanical CPR Devices and SGAs (briefly) Mar 30, 2024

SAVE: PMID: 35179588 AIRWAYS-2: PMID: 30167701 PART: PMID: 30167699 2021 Devices: PMID: 35353993 2022 OCHA Mechanical devices: PMID: 35268537

Random Talk: Nurse Gwenny Mar 27, 2024

Listener discretion is advised

Boomer Medics Mar 20, 2024

LISTENER DISCRETION IS ADVISED

The Boomer Medic Boogeyman: Albuterol and Flash Pulmonary Edema Mar 09, 2024

Listener discretion is advised.

References: PMID 27863863 PMID 18572345 PMID 30582477

Ashley is Back with Listener Questions Mar 06, 2024

LISTENER DISCRETION IS ADVISED

REFERENCES CITED: PMID 36180168 PMID 26033128 PMID 30996631 PMID 32663410 PMID 33552437 OMI Manifesto. http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html

Random Talk Feb 23, 2024

LISTENER DISCRETION IS ADVISED

Topics: Bad Day to Be a SGA, Sim Labs, PA EMS Drama

Making the Transition from 911 Paramedic to Critical Care Feb 18, 2024

Right Heart Disasters with The Critical Care NP Feb 15, 2024

Probably the Best Vent Podcast Ever Made with Melody Bishop RT Feb 01, 2024

Read Melody's ventilator book! Available at https://ecampusontario.pressbooks.pub/mechanicalventilators/

Delayed Sequence Intubation Jan 21, 2024

Listener discretion is advised. References: PMID 37058727, 25447559, 29405806

Mental Health: Patrick Sullivan, DO and Ketamine Therapy Jan 15, 2024

My doctor. My story. My brain.

The Aorta did What? Jan 10, 2024

Listener discretion is advised. PMID 27407401, 25231423, 16890849,275945 Black & Drews & Rabkin (2022). Up-to-Date.

Journal Club with Gwenny Jan 02, 2024

Listener discretion is advised.

Discussing: Thompson G, Miller B, Lenz TJ. Comparing Intubation Success Between Flight Nurses and Flight Paramedics in Helicopter Emergency Medical Services. Air Med J. 2023 Nov-Dec;42(6):436-439. doi: 10.1016/j.amj.2023.07.004. Epub 2023 Aug 10. PMID: 37996178.

Unscripted Critical Care Talk with Ryan Bolger Dec 30, 2023

Ryan Bolger is a flight paramedic and soon-to-be nurse.

The Elijah McClain Case Dec 23, 2023

Listener discretion advised

Where is EMS Headed and Who is Driving? Dec 20, 2023

Listener discretion is advised.

Unscripted Listener Questions with Wes Dec 14, 2023

Too Sick for Transfer? Dec 10, 2023

Huge Pleural Effusion and Vile ABGs Dec 02, 2023

REFERENCES:

PMID 31315808 PMID 29530870 PMID 29372629 Strange, C. (2023). Epidemiology, clinical presentation, and diagnostic evaluation of parapneumonic effusion and empyema in adults. Up-To-Date.

Culture, Attitude, Professionalism with Rick Maricle Nov 26, 2023

CPR Induced Consciousness, Education, and Leadership Nov 21, 2023

Jake makdes his debut on the podcast.

Shock Trauma Nov 15, 2023

Listner Questions 11/1/23 Nov 01, 2023

Answering listener questions..Topics:

Pain management
C-spine injuries
Impact EMS rebranding
Instructor pet peeves

Resus Sequence Intubation Oct 15, 2023

Janz D, Casey J, Semler M, et al. Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial. Lancet Respir Med. October 2019. https://www.ncbi.nlm.nih.gov/pubmed/31585796.

Degrees, The Paramedic Practitioner Oct 01, 2023

Tools, Toys, and Patient Assessment Sep 16, 2023

Friday Night Randomness Sep 09, 2023

Random rantings and thoughts:

Reels and listener questions
SWAT medic stuff
"Worthless" trainings
ASV
Paramedic school sans EMT experience
Just can't hack it...
Tempus Pro updates

Case Study: AIDS/ARDS/Sepsis/TB Guy Aug 29, 2023

References:

AIDS and TB: PMID 7629858

Owens, William. (2021). The Ventilator Book.

Leadership: It's Up to Us Aug 18, 2023

Raising the Bar for Paramedic Education - Part 2: Leadership, Sim, Stats Aug 15, 2023

References:

Low-Fi Sim > HiFi: PMID 33872104

HiFi not necessarily better: PMID 27215280

Clincial outcomes and sims: PMID 19642147

Raising the Bar for Paramedic Education: Part 1 - The Right People Aug 08, 2023

References:

Collins, Jim. Good to Great.

Attrition Rates: PMID 37034493 Accreditation: PMID 16531381 Flipped Programs: PMID 33328795

Mentoring & Precepting: A "Philosophical" Discussion Jul 28, 2023

Wesley Nelson comes back onto the podcast to talk about mentorship and precepting.

Unscripted: Urban EMS Jul 28, 2023

Thanks to Rob Friedman for coming on the podcast and shooting the breeze about life and issues working EMS in the big city...

LVADs Jul 11, 2023

Cabrera, Daniel. (Nov 2, 2014). A Basic Approach to the LVAD Patient in the Emergency Department. Available: https://emblog.mayo.edu/2014/11/02/a-basic-approach-to-the-lvad-patient-in-the-emergency-department/

Tchantchaleishvili V, Sagebin F, Ross RE, Hallinan W, Schwarz KQ, Massey HT. Evaluation and treatment of pump thrombosis and hemolysis. Ann Cardiothorac Surg. 2014 Sep;3(5):490-5. doi: 10.3978/j.issn.2225-319X.2014.09.01. PMID: 25452909; PMCID: PMC4229473.

10 Rules for BLS Providers Jul 06, 2023

20+ year paramedic and retired fire captain Steve came on to talk about his 10 Rules for BLS Providers!

Toolbags, Haters, FOAMed, & EBM Jun 27, 2023

Air Medical Ops: The Reality Jun 11, 2023

References: Miles MVP, Beasley JR, Reed HE, Miles DT, Haiflich A, Beckett AR, Lee YL, Bowden SE, Panacek EA, Ding L, Brevard SB, Simmons JD, Butts CC. Overutilization of Helicopter Emergency Medical Services in Central Gulf Coast Region Results in Unnecessary Expenditure. J Surg Res. 2022 May;273:211-217. doi: 10.1016/j.jss.2021.12.038. Epub 2022 Jan 29. PMID: 35093837.

Roman J, Shank W, Demirjian J, Tang A, Vercruysse GA. Overutilization of Helicopter Transport in the Minimally Burned-A Healthcare System Problem That Should Be Corrected. J Burn Care Res. 2020 Jan 30;41(1):15-22. doi: 10.1093/jbcr/irz143. PMID: 31504602.

Adcock AK, Minardi J, Findley S, Daniels D, Large M, Power M. Value Utilization of Emergency Medical Services Air Transport in Acute Ischemic Stroke. J Emerg Med. 2020 Nov;59(5):687-692. doi: 10.1016/j.jemermed.2020.08.005. Epub 2020 Oct 1. PMID: 33011044; PMCID: PMC8006070.

Chen X, Gestring ML, Rosengart MR, Peitzman AB, Billiar TR, Sperry JL, Brown JB. Logistics of air medical transport: When and where does helicopter transport reduce prehospital time for trauma? J Trauma Acute Care Surg. 2018 Jul;85(1):174-181. doi: 10.1097/TA.0000000000001935. PMID: 29787553.

Chen X, Gestring ML, Rosengart MR, Billiar TR, Peitzman AB, Sperry JL, Brown JB. Speed is not everything: Identifying patients who may benefit from helicopter transport despite faster ground transport. J Trauma Acute Care Surg. 2018 Apr;84(4):549-557. doi: 10.1097/TA.0000000000001769. PMID: 29251708.

Nighttime Chatter with Ashley Jun 09, 2023

Topics: Tempus Pro, clinical competencies, bureaucratic comeuppance, IV acetaminophen

Product Review: Tempus Pro May 31, 2023

Sick Little Kids May 29, 2023

Gwenny and Ashley came on the podcast to talk about dealing with sick pediatric patients.

References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/.

Lucking, S. Maffei, F., Tamburro, R., & Zaritsky, A. (2021). Pediatric Critical Care. Text and Study Guide.

Nagler, Joshua. Cheifetz, Ira. (2021). Initiating Mechanical Ventilation in Children. Up-to-Date.

The BLS Divide: Unscripted Ranting with Sarah May 15, 2023

"Stuff About Burns" May 05, 2023

Unscripted and Unprepared with Gwenny and Ashley Apr 28, 2023

Rippin' Aortas Apr 15, 2023

Q&A with Bill Apr 12, 2023

On-Line Medical Control Must Die Apr 01, 2023

Supraglottic Airway Update Mar 28, 2023

Bartos JA, Clare Agdamag A, Kalra R, Nutting L, Frascone RJ, Burnett A, Vuljaj N, Lick C, Tanghe P, Quinn R, Simpson N, Peterson B, Haley K, Sipprell K, Yannopoulos D. Supraglottic Airway Devices are Associated with Asphyxial Physiology After Prolonged CPR in Patients with Refractory Out-of-Hospital Cardiac Arrest Presenting for Extracorporeal Cardiopulmonary Resuscitation. Resuscitation. 2023 Mar 16:109769. doi: 10.1016/j.resuscitation.2023.109769. Epub ahead of print. PMID: 36933882.

Paramedic School Mar 14, 2023

Rethinking Prehospital Trauma Arrest Mar 05, 2023

REFERENCES: Nick Costain. (2018). Management Controversies in Traumatic Cardiac Arrest. EM Ottawa Blog. Available at https://emottawablog.com/2018/04/management-controversies-in-traumatic-cardiac-arrest/epi

Royal Melbourne Hospital. (2018). Traumatic Cardiac Arrest Guideline. https://www.thermh.org.au/sites/default/files/media/documents/clinical/TRM%2008.12%20Traumatic%20Arrest%20Guideline%20V1.0_08.17.pdf

Watts S, Smith JE, Gwyther R, Kirkman E. Closed chest compressions reduce survival in an animal model of haemorrhage-induced traumatic cardiac arrest. Resuscitation. May 2019. doi:10.1016/j.resuscitation.2019.04.048 Wongtanasarasin W, Thepchinda T, Kasirawat C, Saetiao S, Leungvorawat J, Kittivorakanchai N. Treatment Outcomes of Epinephrine for Traumatic Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis. J Emerg Trauma Shock. 2021 Oct-Dec;14(4):195-200. doi: 10.4103/JETS.JETS_35_21. Epub 2021 Nov 23. PMID: 35125783; PMCID: PMC8780637.

Yamamoto, R., Suzuki, M., Hayashida, K. et al. Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study. Scand J Trauma Resusc Emerg Med 27, 74 (2019). https://doi.org/10.1186/s13049-019-0657-8

Shooting the Breeze with Bill Mar 02, 2023

Unscripted Sunday with Ashley Feb 19, 2023

References: PMID 26557486

Wood, Owen. (2017). https://www.ditchdocem.com/2017/04/17/racemic-epinephrine/

Naloxone: A Rational Approach Feb 09, 2023

REFERENCES: Bhardwaj H, Bhardwaj B, Awab A. Revisiting opioid overdose induced acute respiratory distress syndrome. Indian J Crit Care Med. 2014 Feb;18(2):119-20. doi: 10.4103/0972-5229.126095. PMID: 24678160; PMCID: PMC3943122.

Elkattawy S, Alyacoub R, Ejikeme C, Noori MAM, Remolina C. Naloxone induced pulmonary edema. J Community Hosp Intern Med Perspect. 2021 Jan 26;11(1):139-142. doi: 10.1080/20009666.2020.1854417. PMID: 33552437; PMCID: PMC7850343.

Kummer RL, Kempainen RR, Olives TD, Leatherman JW, Prekker ME. Naloxone-associated pulmonary edema following recreational opioid overdose. Am J Emerg Med. 2022 Mar;53:41-43. doi: 10.1016/j.ajem.2021.12.030. Epub 2021 Dec 17. PMID: 34973491.

Saybolt MD, Alter SM, Dos Santos F, Calello DP, Rynn KO, Nelson DA, Merlin MA. Naloxone in cardiac arrest with suspected opioid overdoses. Resuscitation. 2010 Jan;81(1):42-6. doi: 10.1016/j.resuscitation.2009.09.016. Epub 2009 Nov 13. PMID: 19913979.

Ventura AL, White CC 4th, Braude D. Letter to the Editor in Response to "Naloxone Cardiac Arrest Decision Instruments (NACARDI) for targeted antidotal therapy in occult opioid overdose precipitated cardiac arrest". Resuscitation. 2021 Jul;164:157-158. doi: 10.1016/j.resuscitation.2021.02.044. Epub 2021 May 9. PMID: 33979667.

Unscripted with Gwenny Feb 08, 2023

OMI and Prehospital 12-Lead EKGs Feb 04, 2023

REFERENCE: Meyers, P., Weingart, S., Smith, S. (2018). The OMI Manifesto. Available: http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html

Friday Night Thoughts Jan 28, 2023

REFERENCES: August, P., Siabi, B. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date.

Judy AE, McCain CL, Lawton ES, Morton CH, Main EK, Druzin ML. Systolic Hypertension, Preeclampsia-Related Mortality, and Stroke in California. Obstet Gynecol. 2019 Jun;133(6):1151-1159. doi: 10.1097/AOG.0000000000003290. PMID: 31135728.

Pericarditis Jan 20, 2023

Helman, A. (2022). Pericarditis and Cardiac Tamponade. Emergency Medicine Cases. Available at: https://emergencymedicinecases.com/pericarditis-cardiac-tamponade/

Imazio, M. (2022). Acute Pericarditis: Clinical Presentation and Diagnosis. Up-to-Date.

Imazio M, Cecchi E, Demichelis B, Ierna S, Demarie D, Ghisio A, Pomari F, Coda L, Belli R, Trinchero R. Indicators of poor prognosis of acute pericarditis. Circulation. 2007 May 29;115(21):2739-44. doi: 10.1161/CIRCULATIONAHA.106.662114. Epub 2007 May 14. PMID: 17502574.

Swaminathan, A. (2016). Pericarditis. Core EM Blog. Available at https://coreem.net/core/pericarditis/

The Sh*t Storm in Springfield Jan 13, 2023

EPISODE WARNING: SENSITIVE TOPICS, FOUL LANGUAGE

Rapid Fire Q&A Jan 10, 2023

The New NREMT Test and Passing the Boards Jan 01, 2023

Transporting the Cardiac ICU Patient Jan 01, 2023

Holiday Message Dec 24, 2022

Woke CPR Dummies, Crying Doctors, Albuterol, & Fentanyl Dec 19, 2022

Simply a commentary episode.

"You're Supposed to Get My Back" with Bill Dec 13, 2022

Guest Panel Discussion Dec 07, 2022

Mike, Sarah, Alaina, and Wes discuss various topics and go down rabbitholes.

Things to Know if You Want to REALLY Want to Fly Nov 25, 2022

High Flow Nasal Cannula Nov 18, 2022

References: Frank Lodeserto MD, "High Flow Nasal Cannula (HFNC) – Part 1: How It Works", REBEL EM blog, August 20, 2018. Available at: https://rebelem.com/high-flow-nasal-cannula-hfnc-part-1-how-it-works/.

Nishimura, Masaji. (2016). High-Flow Nasal Cannula Oxygen Therapy in Adults: Physiological Benefits, Indication, Clinical Benefits, and Adverse Effects. Respiratory Care, 61(4), 529-41.

Sharma S, Danckers M, Sanghavi D, et al. High Flow Nasal Cannula. [Updated 2022 Sep 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526071/

High Risk OB Nov 09, 2022

August, Phyllis. (2022). Preeclampsia: Clinical Features and Diagnosis. Up-to-Date.

Euser, A. & Cipolla, M. (2009). Magnesium sulfate for the treatment of eclampsia. Stroke, 40.

Nelson, K. (2019). Determining FHR during air transport. Available: http://survivalflighteducationblog.com/determining-fetal-heart-rate-during-air-transport/lit

NHS. The Obs Podcast. Episode: FHT - Part One.

Simhan, H. Caritis, S. (2022). Inhibition of Acute Preterm Labor. Up-to-Date.

Recent Questions from the DMsphere Nov 03, 2022

Listner questions and my (rambling) answers.

REFERENCES Baize, Kohman, Stoffel, Weigartz. (2021). Albuterol versus terbutaline in emergency department management of asthma or COPD exacerbation. Critical Care Medicine 49(1 suppl 1): 410.

Busti. (2015). Nitroglycerin Use in the Initial Management of Ischemic Pain from Acute Myocardial Infarction (NSTEMI, STEMI). Available: https://www.ebmconsult.com/articles/nitroglycerin-use-in-initial-management-ischemic-pain-acute-myocardial-infarction-nstemi-stemi

Mike Sarraille, George Randle, Josh Cotton. The Talent War: How Special Operations and Great Organizations Win on Talent.

Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

Bonus: Supraglottic Airways Oct 23, 2022

References: PMID 30167699, 22664746, 22504150, 220474079, 25461079, 22664746, 35001830

Debriefing the Code from Hell Oct 23, 2022

References: Burton LV, Beier K. Papillary Muscle Rupture. [Updated 2022 Jul 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499976/

Jung J, Rice J, Bord S. Rethinking the role of epinephrine in cardiac arrest: the PARAMEDIC2 trial. Ann Transl Med. 2018 Dec;6(Suppl 2):S129. doi: 10.21037/atm.2018.12.31. PMID: 30740450; PMCID: PMC6330609.

Thiele, Holger. Abbott, J Dawn. (2022). Acute Myocardial Infarction: Mechanical Complications. Up-to-Date.

Meaningful Clinical Competencies Oct 19, 2022

TAME: Fitness and Tactical EMS Oct 12, 2022

PROBING the POCUS Question Oct 07, 2022

The Myth of Anaphylaxis Oct 01, 2022

References: Campbell & Kelso. (2022). Anaphylaxis: Emergency Treatment.

http://www.litfl.com/tip-10-pearls-for-managing-anaphylaxis

http://emcrit.org/ibcc/anaphylaxis

McLendon and Sternard. Anaphylaxis (2022). NCBI NBK482124.

PMID: 29909382, 20028373, 2931426

BLS Crews: The Good, The Bad, & The Ugly Sep 26, 2022

Sarah Motley: Endocrine, Diabetic Patients Sep 25, 2022

Sarah Motley, EMT, RN: instructor from IA Med comes on to shoot the breeze and talk about endocrine patients and responding to diabetics.

Unscripted: Off-the-Cuff Discussion Sep 18, 2022

Mike and Ashley discuss random stuff: imposter syndrome, dispatch, and "the brand" among other topics.

"But The Cards Said She Was Changing Color!:" PMD Stinks Sep 13, 2022

References: Karl A. Sporer, Nicholas J. Johnson, Clement C. Yeh & Glen M. Youngblood (2008) Can Emergency Medical Dispatch Codes Predict Prehospital Interventions for Common 9-1-1 Call Types?, Prehospital Emergency Care, 12:4, 470-478, DOI: 10.1080/10903120802290877

Torlén, K., Kurland, L., Castrén, M. et al. A comparison of two emergency medical dispatch protocols with respect to accuracy. Scand J Trauma Resusc Emerg Med 25, 122 (2017). https://doi.org/10.1186/s13049-017-0464-z

PMID: 29223194, 22824188, 18256298, 18584494, 19189610

The Liver ICU Hot Mess Sep 11, 2022

REFERENCES: Farkas, Josh. (Feb 14, 2021). Acute Liver Failure. Internet Book of Critical Care. Available: https://emcrit.org/ibcc/alf/

Forkin, Katherine T. MD; Colquhoun, Douglas A. MBChB, MSc, MPH†; Nemergut, Edward C. MD,‡; Huffmyer, Julie L. MD*. The Coagulation Profile of End-Stage Liver Disease and Considerations for Intraoperative Management. Anesthesia & Analgesia: January 2018 - Volume 126 - Issue 1 - p 46-61 doi: 10.1213/ANE.0000000000002394

Mayo Clinic. Liver Function Tests. Available from: https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595

Montreif, Tom. (Nov 25, 2018). Acute Liver Failure: Evidence-Based Evaluation and Management. EM Docs blog. Available: http://www.emdocs.net/acute-liver-failure-evidence-based-evaluation-and-management/

Northup PG, Caldwell SH. Coagulation in liver disease: a guide for the clinician. Clin Gastroenterol Hepatol. 2013 Sep;11(9):1064-74. doi: 10.1016/j.cgh.2013.02.026. Epub 2013 Mar 16. PMID: 23506859.

Downtime Chat with Bill Sep 05, 2022

This episode is literally just my partner Bill and I shooting the proverbial breeze with a microphone between us.

Patient Assessment vs. ASSessment Sep 02, 2022

Reference: Chris Nickson. (2020). GCS. Available at http://www.litfl.com/glasgow-coma-scale

Old People Do the Darnedest Things Aug 30, 2022

*READ THE TOPICS COVERED BEFORE LISTENING***

Case study of a 92 year old with delirium
Causes of delirium
Geriatric toxicology
Geriatric STI's and sexual health

REFERENCES: Alex Yartsev. Pharmacology and toxicology in old age. June 30, 2016. Deranged Physiology. Available from https://derangedphysiology.com/main/required-reading/pharmacology-and-toxicology/Chapter%201.3.4/pharmacology-and-toxicology-old-age

Frankowski AC, Clark LJ. Sexuality and Intimacy in Assisted Living: Residents' Perspectives and Experiences. Sex Res Social Policy. 2009 Dec 1;6(4):25-37. doi: 10.1525/srsp.2009.6.4.25. PMID: 25568640; PMCID: PMC4283937.

Kristen Fontes MD, Alex Koyfman MD, Brit Long MD. Common ED Medication Errors: Polypharmacy. EmDocs. July 3, 2017. Available from http://www.emdocs.net/common-ed-medication-errors-polypharmacy/

Nat. Research Council (US) Cute on Chemical Toxicology and Aging. Aging in Today’s Environment. Washington (DC): National Academies Press (US); 1987. 4, Principles of Toxicology in the Context of Aging. Available from: https://www.ncbi.nlm.nih.gov/books/nbk218724/

Rashid, M.H., Sparrow, N.A., Anwar, F. et al. Interleukin-6 mediates delirium-like phenotypes in a murine model of urinary tract infection. J Neuroinflammation 18, 247 (2021). https://doi.org/10.1186/s12974-021-02304-x Stanford Medicine 25. Website: Fundoscopic/Opthalomoscopic Exam. Available from https://stanfordmedicine25.stanford.edu/the25/fundoscopic.html

https://www.theseniorlist.com/sti-older-americans/

Friday Afternoon Clinical Aug 19, 2022

Status Asthmaticus Aug 14, 2022

REFERENCES: Blevins, Charles. (2021). Intubating Asthma. American Academy of Emergency Medicine. Available at https://www.aaem.org/UserFiles/file/CCMS_CSJanFeb21.pdf

Josh Farkas. (Aug 5, 2021). Waveform capnography in the intubated patient. Internet Book of Critical Care. Available at https://emcrit.org/ibcc/co2/

Pearson SD, Patel BK. Noninvasive Ventilation for Acute Asthma: The Neglected Sibling. Am J Respir Crit Care Med. 2020 Dec 1;202(11):1491-1493. doi: 10.1164/rccm.202007-2876ED. PMID: 32755489; PMCID: PMC7706170.

Vasileiadis, I., Alevrakis, E., Ampelioti, S., Vagionas, D., Rovina, N., and Koutsoukou, A. (2019). Acid-base disturbances in patients with asthma: A literature review and comments on their pathophysiology. Journal of Clinical Medicine, 8, 563.

Fixing Paramedic Education Aug 10, 2022

Lies They Taught You in Paramedic School Aug 06, 2022

References (I didn't alphabetize them...sorry): Bello G, De Santis P, Antonelli M. Non-invasive ventilation in cardiogenic pulmonary edema. Ann Transl Med. 2018 Sep;6(18):355. doi: 10.21037/atm.2018.04.39. PMID: 30370282; PMCID: PMC6186545.

Bendjelid K, Schütz N, Suter PM, et al. Does continuous positive airway pressure by face mask improve patients with acute cardiogenic pulmonary edema due to left ventricular diastolic dysfunction? Chest 2005;127:1053-8. 10.1378/chest.127.3.1053 

Frey, Michael. (2011). CPAP and Cardiogenic Pulmonary Edema. RT Magazine. Available at https://rtmagazine.com/disorders-diseases/chronic-pulmonary-disorders/asthma/cpap-and-cardiogenic-pulmonary-edema/

Chakraborty RK, Hamilton RJ. Calcium Channel Blocker Toxicity. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537147/

Salim Rezaie, "Pearls from ResusX Rewired 2020", REBEL EM blog, October 10, 2020. Available at: https://rebelem.com/pearls-from-resusx-rewired-2020/.

Joshua Bucher. “Cervical Collars for C-Spine Trauma: The Facts” EMDOCS Blog. Available at: http://www.emdocs.net/cervical-collars-for-c-spine-trauma-the-facts/

Jugdutt, BI, & Warnica, JW. (1988). Intravenous nitroglycerin therapy to limit infarct size, expansion, and complications. Effect of timing, dosage, and infarct location. Circulation, 78(4).

Salim Rezaie, "The Death of MONA in ACS: Part III – Nitroglycerin", REBEL EM blog, November 5, 2017. Available at: https://rebelem.com/death-mona-acs-part-iii-nitroglycerin/.

http://derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/

If You Must Intubate the Patient with Metabolic Acidosis... Jul 31, 2022

REFERENCES: Capone J, Gluncic V, Lukic A, Candido KD. Physiologically Difficult Airway in the Patient with Severe Hypotension and Metabolic Acidosis. Case Rep Anesthesiol. 2020 Sep 4;2020:8821827. doi: 10.1155/2020/8821827. PMID: 32953182; PMCID: PMC7487120.

Kim HJ, Son YK, An WS. Effect of sodium bicarbonate administration on mortality in patients with lactic acidosis: a retrospective analysis. PLoS One. 2013 Jun 5;8(6):e65283. doi: 10.1371/journal.pone.0065283. PMID: 23755210; PMCID: PMC3673920.

https://www.openanesthesia.org/co2_transport_bicarbonate/

Salim Rezaie, "Critical Care Updates: Resuscitation Sequence Intubation – pH Kills (Part 3 of 3)", REBEL EM blog, October 3, 2016. Available at: https://rebelem.com/critical-care-updates-resuscitation-sequence-intubation-ph-kills-part-3-of-3/.

Creating a Culture of Idiocy Jul 19, 2022

EMS Education with the Training Coordinator Jul 15, 2022

Brian Collins is a paramedic, EMS training coordinator, and educator.

Baby Codes Jul 13, 2022

Not a nice topic to discuss but necessary for what we do as EMS providers. References:

Adams, S., Good, M. And Defranco, G. (2009). Sudden infant death synd. American Family Physician 79(10): 870-874.

Helman, A, DeCaen, A, Crocco, A. PALS Guidelines. Emergency Medicine Cases. March, 2017. https://emergencymedicinecases.com/uti-myths-misconceptions/. Accessed [8 July 22].

PMID 30035966, 32019512

Ravera, Joe. (2022). Pediatric Small Talk - The 1, 3, 5 approach to pediatric cardiac arrest. Available from http://www.emdocs.net/pediatric-small-talk-the-135-approach-to-pediatric-cardiac-arrest/

Recipe Medic - Part Deux Jul 07, 2022

The Puking Podcast Jun 24, 2022

HEED THE REFERENCES: Anand Swaminathan, "REBEL Core Cast 47.0 Nausea and Vomiting", REBEL EM blog, January 13, 2021. Available at: https://rebelem.com/rebel-core-cast-47-0-nausea-and-vomiting/.

Beadle KL, Helbling AR, Love SL, April MD, Hunter CJ. Isopropyl Alcohol Nasal Inhalation for Nausea in the Emergency Department: A Randomized Controlled Trial. Ann Emerg Med. 2015; doi: http://dx.doi.org/10.1016/j.annemergmed.2015.09.031.

Furyk, J. S., Meek, R. A., & Egerton-Warburton, D. (2015). Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. The Cochrane database of systematic reviews, 2015(9), CD010106. https://doi.org/10.1002/14651858.CD010106.pub2

Mark Ramzy, "Aromatherapy vs Oral Ondansetron for Antiemetic Therapy Among Adult Emergency Department Patients", REBEL EM blog, December 3, 2020. Available at: https://rebelem.com/aromatherapy-vs-oral-ondansetron-for-antiemetic-therapy-among-adult-emergency-department-patients/.

Phips, Ashley. (2015). Article Review: RCT of Antiemetic Efficacy in the ED. Available at http://www.emdocs.net/wp-content/uploads/2015/01/AntiemeticUseED-Phipps-.pdf

Plewa, Young, Yerman. (20 July 2008). The vomiting patient in the ED: Evaluation and management. Emergency Medicine Reports. Available from https://www.reliasmedia.com/articles/13681-the-vomiting-patient-in-the-ed-evaluation-and-management

Scorza K, Williams A, Phillips JD, Shaw J. Evaluation of nausea and vomiting. Am Fam Physician. 2007 Jul 1;76(1):76-84. PMID: 17668843.

Wegrzyniak LJ, Repke JT, Ural SH. Treatment of hyperemesis gravidarum. Rev Obstet Gynecol. 2012;5(2):78-84.

Yartsev. (2021). Deranged Physiology: Question 10 - Describe the physiology of vomiting. Available from https://derangedphysiology.com/main/cicm-primary-exam/past-papers/2010-paper-1-saqs/question-10p2#answer-anchor

The Acute Abdomen Jun 21, 2022

DAS REFERENCES: Bordeianou, L. Yeh, D. Management of SBO in adults. Available at https://www.uptodate.com/contents/management-of-small-bowel-obstruction-in-adults

Ellsworth Wright, "REBEL Core Cast – Basics of EM – Diffuse and Flank Abdominal Pain", REBEL EM blog, June 1, 2022. Available at: https://rebelem.com/rebel-core-cast-basics-of-em-diffuse-and-flank-abdominal-pain/.

Meadors, K. (n.d.). Abdominal Pain. Retrieved from http://www.emdocs.net/wp-content/uploads/2014/05/AbdominalPain-KMAK.pdf

Simon, E. (2017). EM@3AM - Ascending Cholangitis. Available at http://www.emdocs.net/em3am-ascending-cholangitis/

Spangler, R., Van Pham, T., Khoujah, D. et al. Abdominal emergencies in the geriatric patient. Int J Emerg Med 7, 43 (2014). https://doi.org/10.1186/s12245-014-0043-2

PMID 10987108

PMID 32362368

Vercruysse G, Busch R, Dimcheff D, et al. Evaluation and Management of Mechanical Small Bowel Obstruction in Adults [Internet]. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572336/

Zeretzke-Bien, C. (2016). Appendicitis: Pearls and Pitfalls in Adult and Pediatric Populations. Available at http://www.emdocs.net/appendicitis-pearls-and-pitfalls-in-adult-and-pediatric-populations/

The "Recipe Medic" Jun 10, 2022

BLS Stroke Jun 07, 2022

References: PMID 9099184, 34496173, 28338314, 18584497, 15017757, 32383104, 25295027; doi:10.6274/tnd.08108

CCT: Peds Ocean Drowning Jun 01, 2022

References: PMID 29606895 http://derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/

Uvalde, Mission Mindset May 26, 2022

CCT 101: Trauma Transfer May 19, 2022

MINI BONUS: Emerging From Darkness (First Responder Mental Health) May 13, 2022

Critical Care Transport 101 May 12, 2022

Critical care transport is a cerebral logistics game. You need not get analysis paralysis.

100th Episode May 08, 2022

Random discussion at my basement bar. Topics covered:

An old school code
Body armor
How to get into critical care EMS

GSW Logistics May 04, 2022

Operational Perspectives from an EMS Pilot May 02, 2022

SWAT Medic Stuff, Blood, & Gear Apr 25, 2022

Follow up to my Damage Control Resus episode and random rambling. References: PMID 35082563, 21178760, 9971864

Tachyarrhythmias, Clinical Decisionmaking Apr 20, 2022

Bill and I kill time at work and discuss two patients with fast heart rates. Hear us muddle awkardly through AVRC and then we go down a bunch of rabbit holes.

The NAEMSE 2022 Conference Looks Awful Apr 15, 2022

"Subject Fallen" Apr 12, 2022

Not a sexy topic but I talk about geriatric falls.

References: PMID 33060534 PMID 25983268 PMID 22971148 PMID 22971148

Rezaie. (2015). Minor Head Trauma in Anticoagulated Patients: Admit for Obs or D/C? RebelEM. https://rebelem.com/minor-head-trauma-in-anticoagulated-patients-admit-for-observation-or-discharge/

Damage Control Resus Apr 10, 2022

References:

Bradford. (2022). RePhill. https://www.thebottomline.org.uk/summaries/icm/rephill/

Smith IM, Crombie N, Bishop JR, McLaughlin A, Naumann DN, Herbert M, Hancox JM, Slinn G, Ives N, Grant M, Perkins GD, Doughty H, Midwinter MJ; RePHILL Trial Collaborators. RePHILL: protocol for a randomised controlled trial of pre-hospital blood product resuscitation for trauma. Transfus Med. 2018 Oct;28(5):346-356. doi: 10.1111/tme.12486. Epub 2017 Nov 28. PMID: 29193548.

US Army Joint Trauma System’s Damage Control Resuscitation website: https://jts.amedd.army.mil/index.cfm/PI_CPGs/damage_control

Professionalism, Public Perception, Organizational Pride, and Angry Volunteers Apr 06, 2022

Medical Errors, RaDonda Vaught, Organizational Narcissism part Deux Mar 29, 2022

I wasn't going to do another episode this week but so many people reached out and asked my opinion on this case that I felt compelled to post an episode. I didn't go crazy on the editing so I apologize for the "umms" and needless Philadelphia "sooooo's."

Ketamine Is the Schiznit Mar 28, 2022

Worthwhile articles I mentioned:

Bell, John. (2017). In Vogue: Ketamine for Neuroprotection in Acute Neurologic Injury. International Anesthesia Research Study. http://www.anethsesia-analgesia.org

Torres, A. C., Bebarta, V. S., April, M. D., Maddry, J. K., Herson, P. S., Bebarta, E. K., & Schauer, S. (2020). Ketamine Administration in Prehospital Combat Injured Patients With Traumatic Brain Injury: A 10-Year Report of Survival. Cureus, 12(7), e9248. https://doi.org/10.7759/cureus.9248

Zeiler FA, Teitelbaum J, West M, Gillman LM. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014 Aug;21(1):163-73. doi: 10.1007/s12028-013-9950-y. PMID: 24515638.

C-Collars Are Stupid Mar 24, 2022

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Q&A: Precepting, Being Close to the Hospital, FP-C Exam Mar 22, 2022

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The Chest Pain Episode Mar 09, 2022

Do I need to ACS everyone that is having chest pain? Do I need to do a 12-lead on everyone who complains of chest pain? Is it BS when the chest pain is right sided or reproducible?

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My Dad Talks About Strokes Feb 28, 2022

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Posterior Stroke Feb 23, 2022

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A Head Full of Blood Feb 17, 2022

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Analysis Paralysis Feb 10, 2022

Smith, Mike. (2012). Analysis Paralysis. EMS World. https://www.hmpgloballearningnetwork.com/site/emsworld/article/10526554/analysis-paralysis

Van Horne, Riley. "Left of Bang" This podcast is hosted by ZenCast.fm

Pediatric GSW; Using Warm Bodies to Fill Spots Feb 08, 2022

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Blunt Chest Trauma Feb 02, 2022

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Listener Questions Jan 29, 2022

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Sunday Night Debrief Jan 24, 2022

Ashley and Mike debrief the randomness of the last two weeks at work. This is really an episode about nothing. Also, this is my first attempt at using two microphones - I apologize for any audio issues.

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EMS Physicians, Volunteer EMS Jan 20, 2022

A discussion about prehopsital physicians in the US and volunteer EMS: the good, the bad, and the ugly. Please don't listen to this if you are easily offended. You were warned.

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More Thinking About Airway (and EBM) Jan 16, 2022

Benger JR, Kirby K, Black S, Brett SJ, Clout M, Lazaroo MJ, Nolan JP, Reeves BC, Robinson M, Scott LJ, Smartt H, South A, Stokes EA, Taylor J, Thomas M, Voss S, Wordsworth S, Rogers CA. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018 Aug 28;320(8):779-791. doi: 10.1001/jama.2018.11597. PMID: 30167701; PMCID: PMC6142999.

Bernhard M, Becker TK, Gries A, Knapp J, Wenzel V. The First Shot Is Often the Best Shot: First-Pass Intubation Success in Emergency Airway Management. Anesth Analg. 2015 Nov;121(5):1389-93. doi: 10.1213/ANE.0000000000000891. PMID: 26484464.

Culbreth RE, Gardenhire DS. Manual bag valve mask ventilation performance among respiratory therapists. Heart Lung. 2021 May-Jun;50(3):471-475. doi: 10.1016/j.hrtlng.2020.10.012. Epub 2020 Nov 1. PMID: 33138977; PMCID: PMC7604178.

Ioannidis JP. Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?. Philos Ethics Humanit Med. 2008;3:14. Published 2008 May 27. doi:10.1186/1747-5341-3-14

Sackles, et. al. (2013). The importance of first pass success when performing orotracheal intubation in the ED. Acad Emerg Med, 20(1).

Wang HE, Schmicker RH, Daya MR, Stephens SW, Idris AH, Carlson JN, Colella MR, Herren H, Hansen M, Richmond NJ, Puyana JCJ, Aufderheide TP, Gray RE, Gray PC, Verkest M, Owens PC, Brienza AM, Sternig KJ, May SJ, Sopko GR, Weisfeldt ML, Nichol G. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2018 Aug 28;320(8):769-778. doi: 10.1001/jama.2018.7044. PMID: 30167699; PMCID: PMC6583103.

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Rethinking Airway Jan 07, 2022

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New Year, New Dumpster Fire Jan 03, 2022

Some start of a new year ramblings: EMTALA, ED wait times, COVID, royal medical directors

REFERENCES: Gulya, K. (2017). Seventh Circuit Case Highlights Potential Conflict Between Powers of Medical Director and City in Discharging EMS Staff When Losing "Credentials". National Law Review. Accessed at https://www.natlawreview.com/article/seventh-circuit-case-highlights-potential-conflict-between-powers-medical-director

Wolfberg, Wirth. (16 Nov 2021). Ambulances held hostage: Can the hospital make you stay? Accessed at https://www.ems1.com/ambulance/articles/ambulances-held-hostage-can-the-hospital-make-you-stay-jQESFoe1BQTrtUYc/

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Christmas Clinical Dec 20, 2021

Carley, S. (2004). Suicide at Christmas. EMJ Online. Available at http://emj.bmj.com/content/emermed/21/6/716.full.pdf

CDC. (2004). Fall-Related Injuries During the Holiday Season --- United States, 2000–2003. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5348a1.htm

Long, Brit. (2018). EM@3AM: Esophageal Foreign Bodies. EMDocs Blog. Available at http://emdocs.net/em3am-esophageal-foreign-bodies/

Rohrer-Mirtschink S, Forster N, Giovanoli P, Guggenheim M. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland. Ann Burns Fire Disasters. 2015;28(1):71-75.

Shaw, et. al. (2018). Death and readmissions after hospital discharge during the Dec holiday period. BMJ, 363.

Shuja, Winston, Rahman, Mitty, Jaber, & Keo. Esophageal food impaction during cultural holidays and national athletic events. Gasteroenterology Report, 5(1).

Smith, Allan, Greenlaw, Findlay, & Isles. (2013). EM admissions., deaths ant weekends and the public holiday effect. Emerg Med J, 31(1).

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Happily Hypoxic Dec 14, 2021

Omicron update, COVID stats, assessment of the hypoxic COVID patient

Reference: Dhont, S., Derom, E., Van Braeckel, E. et al. The pathophysiology of ‘happy’ hypoxemia in COVID-19. Respir Res 21, 198 (2020). https://doi.org/10.1186/s12931-020-01462-5

Rectal Foreign Bodies Dec 12, 2021

DISCLAIMER: bad words, adult topics

Cologne, Ault. (2012). Rectal foreign bodies: what is the current standard? Clin Colon Rectal Surg, 25, 214-18.

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Thanksgiving Clinical Nov 25, 2021

Not really anything Thanksgiving related....random topics and rantings

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Normalization of Deviance Nov 22, 2021

References: http://www.aviationchief.com

NASA. (2014). The Cost of Silence: Normalization of Deviance and Groupthink. Retrieved from: https://sma.nasa.gov/docs/default-source/safety-messages/safetymessage-normalizationofdeviance-2014-11-03b.pdf?sfvrsn=4

Mullane, Mike. Normalization of Deviance — IAFF. Available at http://www.youtube.com/watch?v=Ljzj9Msli5o

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Differential Diagnosis Nov 16, 2021

Thoughts on the "differential diagnosis."

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Lessons from My Partner Bill: A True OG Nov 11, 2021

Bill is my HEMS partner, mentor, and friend. He started his career in EMS in 1976. Here is his introduction, some of his insights, and discussion on generation gaps and career progression. Also, sorry about the background noise: we were at work at the airport. Planes were taking off and the office chairs we were sitting in were creaking.

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Saturday Night Clinical Nov 07, 2021

Addendums on the calcium episode and the heart failure episode...as always...random ramblings as well...

Citations: Anand IS, Gupta P. Anemia and Iron Deficiency in Heart Failure: Current Concepts and Emerging Therapies. Circulation. 2018 Jul 3;138(1):80-98. doi: 10.1161/CIRCULATIONAHA.118.030099. PMID: 29967232.

Hayes. (2013). Mythbuster: Calcium Gluconate Raises Serum Calcium as Quickly as Calcium Chloride. Retrieved at https://www.aliem.com/mythbuster-calcium-gluconate-raises-serum-calcium-as-calcium-chloride/

Calcium Chloride. RK.MD Blog. (2018). Retrieved at https://rk.md/2018/calcium-chloride/

Maak CA, Tabas JA, McClintock DE. Should acute treatment with inhaled beta agonists be withheld from patients with dyspnea who may have heart failure? J Emerg Med. 2011 Feb;40(2):135-45. doi: 10.1016/j.jemermed.2007.11.056. Epub 2008 Jun 24. PMID: 18572345.

Ponn, B. (2017). Clinical Question: Can Ventolin improve wheeze in heart failure? CanadiEM Blog. Retrieved from https://canadiem.org/can-ventolin-improve-wheeze-in-heart-failure/

Silverberg DS, Wexler D, Iaina A. The role of anemia in the progression of congestive heart failure. Is there a place for erythropoietin and intravenous iron? J Nephrol. 2004 Nov-Dec;17(6):749-61. PMID: 15593047.

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Staffing Shortages, Work Conditions, Corporate Greed Oct 29, 2021

I think I might have gone a little hard in the paint on this one... TOPICS: Corporate greed Staffing shortages Incentive pay Working conditions

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EMS Organizational Narcissism Oct 25, 2021

As always: real talk, no BS, and maybe controversial views of when narcissism pervades the culture in EMS agencies...

Duchon & Drake. (2009). Organizational narcissism and virtuous behavior. Journal of Business Ethics 85, 301-308.

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Calcium Facts for the EMS Provider Oct 22, 2021

Faine. (n.d.). The calcium quandry. EP Monthly. http://epmonthly.com/article/the-calcium-quandry

Farkas. (2020). IBCC. Available at http://emcrit.org/ibcc

Graudins, et. al. (2016). Calcium channel antagonist and beta blocker overdose: antidotes and adjunct therapies. Br J Clin Pharm 81(3).

Nickson. (2020). Hypocalcemia. LITFL Blog. Available at http://litfl.com/hypocalcemia

Sauter, et al. (2015). Calcium disorders in the ED: independent risk factors for mortality. PLoS One 10(7).

Swaminathan. (2017). CORE EM: Hypocalcemia. Available at http://www.emdocs.net/core-em-hypocalcemia

Webster, et. al. (2016). Ionised calcium levels in major trauma patients who received blood in the ED. Emer Med J 33(8).

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Neonatal Resus, Gestalt, Heuristics Oct 14, 2021

Cook C. Is clinical gestalt good enough?. J Man Manip Ther. 2009;17(1):6-7.

Jeanmonodod, Asuka, Jeanmonodod. (2021). Inborn Errors of Metabolism. Accessed https://www.ncbi.nlm.nih.gov/books/NBK459183/

Van Horne, P., & Riley, J. (2014). Left of Bang. New York: First Black Irish Entertainment

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Random Q&A Oct 07, 2021

Topics discussed:

Albuterol and CHF
Staffing shortages
12-lead EKG indications
Being a "rat"
TEMS
Imposter Syndrome
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Not Killing Your TBI Patient Oct 06, 2021

References: 2021 Pennsylvania EMS Protocols.

Spaite DW, Hu C, Bobrow BJ, et al. The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury. Ann Emerg Med. 2017;69(1):62-72. doi:10.1016/j.annemergmed.2016.08.007

Jain V, Choudhary J, Pandit R. Blood Pressure Target in Acute Brain Injury. Indian J Crit Care Med. 2019;23(Suppl 2):S136-S139. doi:10.5005/jp-journals-10071-23191

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When You Get Investigated or Sued Sep 30, 2021

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Pelvic Trauma Sep 20, 2021

References: Hsu, S. D., Chen, C. J., Chou, Y. C., Wang, S. H., & Chan, D. C. (2017). Effect of Early Pelvic Binder Use in the Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study. International journal of environmental research and public health, 14(10), 1217. https://doi.org/10.3390/ijerph14101217

Nickson. (2019). Weingart on Pelvic Trauma. Retrieved from https://litfl.com/weingart-on-pelvic-trauma/

Shlamovitz GZ, Mower WR, Bergman J, Chuang KR, Crisp J, Hardy D, Sargent M, Shroff SD, Snyder E, Morgan MT. How (un)useful is the pelvic ring stability examination in diagnosing mechanically unstable pelvic fractures in blunt trauma patients? J Trauma. 2009 Mar;66(3):815-20. doi: 10.1097/TA.0b013e31817c96e1. PMID: 19276759.

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Workplace Drama Sep 14, 2021

This podcast references two books, both by Marlene Chism.

*No Drama Leadership, 2015 Stop Workplace Drama, 2011

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Mitigating Stupidity: Risk Management for the EMS Provider Sep 05, 2021

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Burnout Sep 05, 2021

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Disseminated Intravascular Coagulation, Med Twitter, Delta Variant Aug 21, 2021

Hyponatremia and Other Randomness Aug 14, 2021

Topics covered: Hyponatremia, crappy education, Delta variant, National Registry changes

Traumatic Shock - Part 2 Aug 09, 2021

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Traumatic Shock: Part 1 Aug 06, 2021

Stuff you need to know about traumatic shock for general practice, FP-C/CCP-C exams, etc.

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Mad Dog Leadership Jul 31, 2021

Mattis, J. & West, B. (2019). Call Sign Chaos: Learning to Lead. New York: Random House.

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Splenic Trauma Jul 29, 2021

Podcast for prehospital providers who aren't looking for a snoozefest.

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MCIs, Astronauts, & Checklists Jul 09, 2021

Books mentioned: Col. Chris Hatfield, *An Astronaut's Guide to Life on Earth

Dr. Atul Gawande, The Checklist Manifesto

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Becoming a Flight Medic; Gear Jul 07, 2021

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Cardiac Tamponade with Shayne Bierman May 21, 2021

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EMS Week, EMS Education May 19, 2021

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Traumatic Asphyxia, The 12-Lead EKG and the Student May 18, 2021

Reference: http://www.derangedphysiology.com

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Last Week's Patient from Hell Apr 27, 2021

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Sunday Night Ramblings with Mike and Mike Apr 26, 2021

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The Middle of the Road Employee, COVID, Evidence Based Medicine Mar 22, 2021

Looking at the importance of the employee who shows up and does his or her job; COVID discussion; looking at evidence-based medicine

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NSTEMI, Accountability, Anemia, and Amish People Mar 07, 2021

Stucchi, M., Cantoni, S., Piccinelli, E., Savonitto, S., & Morici, N. (2018). Anemia and acute coronary syndrome: current perspectives. Vascular health and risk management, 14, 109–118. https://doi.org/10.2147/VHRM.S140951

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Calling Out the National Registry Mar 01, 2021

Bicarb and Other Ramblings Feb 06, 2021

New Updates Jan 18, 2021

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Mental Health; Mike and Missy Intro Nov 08, 2020

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It's Been a While: Random Ramblings, Updates Nov 05, 2020

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Pediatric Upper Airway, COVID-19, New Business Venture Oct 16, 2020

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Bad Co-Workers, Managing Conflict Sep 26, 2020

IABP Basics and Oh S&*t!!! Sep 24, 2020

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A Casual Night at the Hangar with Shayne RN Sep 05, 2020

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Mini Follow-Up: Leadership is EVERYTHING Sep 01, 2020

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UPS Leadership Style Aug 30, 2020

Book review of "Leadership Lessons from a UPS Driver: Delivering a Culture of We, Not Me." by Ron Wallace.

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Certification Exams Aug 15, 2020

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Q&A Episode 1 Aug 01, 2020

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Flash Pulmonary Edema Jul 24, 2020

Cimen, et. al. (2017). Flash pulmonary edema: A rare cause and possible mechanisms. Turkish J EM 17(2).

Purvey & Allen. (2017). Managing acute pulmonary oedema. Aust Prescri 40(2).

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Pediatric Airway Management Jul 16, 2020

References

Gebhard. (n.d.). Pediatric Airway Management. http://strac.org/files/education/2018_conference/presentations/pedi_dr_daniel_gebhard_pediatric_airway_presentation.pdf

Walls. (2012). Manual of Emergency Airway Management, 4th Ed.

http://gis.cdc.gov/grasp/covidnet/covid19_5.html

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2020 Rant Jul 06, 2020

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When Chiropractors Attack, Kawasaki Disease Jul 01, 2020

Kawasaki: http://kidshealth.org/en/parents/kawaski.html http://www.healthychildren.org/english/health-issues/conditions/heart/pages/kawasaki-disease.aspx Recommended: CDC, Seattle Childrens' Hospital, NIH

Chiropractic: Ernst. (2007). Adverse effects of spinal manipulation: a systematic review. J R Soc Med 100(7).

Jones, Jones, & Nugent. (2015). Vertebral artery dissections after chiropractic neck manipulation. Proc (Baylor UMC) 28(1).

Kwan-Woong Park, et. al. (2008). Vertebral artery dissection: natural history, clinical features, and therpeutic considerations. J. Korean Neurosurg Soc 44(3).

Wheeler, et. al. (2015). Risk of traumatic injury associated with clinical spinal manipulation in Medicare part B beneficiaries aged 66-99. Spine 40(4).

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TP-C: Wound Ballistics Jun 09, 2020

Adcock & Chancellor. (2013). Death Investigations. New York: JB Learning.

Panagiotis, et. al. (2014). Gunshot wounds: a review of ballistics related to penetrating trauma. J. Acute Disease 14, 178-85.

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Civil Unrest, Ranting, & TP-C Exam Jun 03, 2020

Bozeman & Winslow. (2004). Medical aspects of less than lethal weapons. Internet J. of Rescue and Disaster Med. 5(1).

El Warea, et. al. (2019). Riots in Beruit: description of the impact of a new type of mass casualty event on the emergency system in Lebanon. Disaster Medicine & Public Health Prep 13(5-6)

Haar, et. al. (2017). Death, injury, and disability from KIP. in crowd control settings and a systematic review. BMJ Open 7(12).

Straton. (2009). Less lethal weapon injury. http://www.mediced.com/content/pages/lectureflies/llwi_printable2009.pdf

Wei, et. al. (2017). The Little India Riot: experiences of an emergency department in Singapore. Singapore Med. J. 56(12).

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ECMO: The Good, Bad, and the Ugly May 31, 2020

Makdisi & Wang. (2015). ECMO review of a lifesaving technology. J. Thoracic Dis. 7(7).

Oliver. (2009). Anticoagulation and coagulation management for ECMO. Semin Cardiothoracic Vasc Anesth 13(3).

http://litfl.com/ecmo-extra-corporeal-membrane-oxygenation

https://litfl.com/ecmo-trouble-shooting/

https://derangedphysiology.com/main/required-reading/cardiothoracic-intensive-care/Chapter%206.1.3/troubleshooting-ecmo-circuit

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Eyeball Leadership, Pulmonary Embolism May 25, 2020

Elliot. (1992). Pulmonary Physiology During PE. *Chest 101(4 suppl).

Rathbun, et. al. (2004). Clinical utility of d-dimer in patietns with suspected PE and non-diagnostic lung scans or negative CT findings. *Chest 125(3).

Sinek, Simon. *Leaders Eat Last.

http://derangedphysiology.com

http://emdocs.net/r-e-b-e-l-em-the-critical-pulmonary-embolus-patient

http://www.litfl.com/ecg-changes-in-pulmonary-embolism

http://www.litfl.com/pulmonary-embolism****

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Short, Rapid-Fire Case Study: Thyroid Storm May 20, 2020

Cornwall & Mulfin. (2010). Endocrine and Metabolic Emergencies: Thyroid Storm. Thera. Adv. Endocrinology Metab. 1(3).

http://www.litfl.com/thyroid-storm

http://www.emcrit.org/ibcc/thyroid-storm

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Attila the Hun: What "The Scourge of God" Can Teach Us About Being Good EMS Providers and Leaders May 10, 2020

Book referenced:

Roberts, Wess. (1990). Leadership Secrets of Attila the Hun.

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COVID 19 Social Media, Obstetrics, Aortic Dissection May 06, 2020

Fukui. (2018). Management of acute aortic dissection and thoracic aortic rupture. Journal of Intensive Care 6(15).

http://litfl.com/acute-aortic-dissection

My notes from the ECHO Conferences and FP-C review course.

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Suicidology May 02, 2020

References:

Betz & Boudreaux. (2016). Managing sucidial patients in the emergency department. Ann EM 67(2).

Jamison, K.R. (2000). Night Falls Fast: Understanding Suicide.

http://training.sprc.org

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Critical Care Transports, Don't Destroy Your Leadership Capital Apr 29, 2020

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Burn Patients Apr 24, 2020

My notes from the CRASH FP-C Review Course.

http://emcrit.com

Notes from lecture by William Hughes, MD. Feb 2019.

ABLS Provider Manual.

http://litfl.com/abdominal-compartment-syndrome-and-intra-abdominal-hypertension

Links mentioned in this episode:

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Sharpen Your Saw, Don't Be a Slug Apr 19, 2020

Covey, S. The 7 Habits of Highly Effective People. Hadfield, C. An Astronaut's Guide to Life on Earth.

Willink, J. Discipline Equals Freedom. Field Manual.

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Ventilators for Dummies, Lessons from a Peds NP Apr 16, 2020

BONUS: COVID-19 Cardiovascular Effects Apr 15, 2020

References:

Clerkin, et. al. (2020) COVID-19 and CV disease. Circulation.

Guo, Fan, & Chen. (2020). CV implications of fatal outcomes of patients with COVID-19. JAMA Cardiology.

Hua, et. al. (2020). Life threatening cardiac tamponade complicating myopericarditis in COVID-19. European Heart Journal.

Meyer, et. al. (2020). Typical takotsubo syndrome triggered by SARS-CoV-2 infection. European Heart Journal.

Links mentioned in this episode:

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Atypical Stroke Apr 08, 2020

REFERENCES:

Gustafson, Y., et. al. (1991). Acute confusional states (delirium) in stroke patients. Cerebrovascular Diseases 1, 257-64.

Murano, T., and Myers, K. (2019). Stroke: The subtle, atypical, and egnimatic. Emergency Medicine Reports 40(6).

Nydahl, P., Bartoszek, G., Binder, A., Paschen, L., Margraf, N. G., Witt, K., & Ewers, A. (2017). Prevalence for delirium in stroke patients: A prospective controlled study. Brain and behavior, 7(8)

Pasinska, P., Kowalska, K., Klimiec, E., Szyper-Maciejowska, A., Wilk, A., & Klimkowicz-Mrowiec, A. (2018). Frequency and predictors of post-stroke delirium in PRospective Observational POLIsh Study (PROPOLIS). Journal of neurology, 265(4), 863–870.

Shaw, R., Drozdowska, B., Taylor-Rowan, M., Elliott, E., Cuthbertson, G., Stott, D. J., & Quinn, T. J. (2019). Delirium in an Acute Stroke Setting, Occurrence, and Risk Factors. Stroke, 50(11), 3265–326

Taming the SRU. (2019). Prehospital Stroke Triage. Retrieved from http://www.tamingthesru.com/blog/2019/10/22/prehospital-stroke-triage

The Spanish Flu Pandemic of 1918 Apr 03, 2020

Not your typical FOAMed topic. The Spanish Flu Pandemic of 1918.

"Those who do not study history are doomed to repeat it."

Rectal Bleeding, Meet Ashley, "Non-Cardiac" Chest Pain Mar 30, 2020

References: Rectal Bleeding http://emcrit.org/ibcc/gi-bleeding

http://www.litfl.com/gastrointestinal-haemorrhage

http://www.litfl.com/lower-gastrointestinal-haemorrhage-ddx

Chadhry, Singh, & Subhar. (1997). Octreotde in Gastroenterology.

Ramaekers, et. al (2019). Predictive Model for 30 Day Outcomes Among ED Patients with Lower GI Bleeding. Sildiroglu, et. al. (2018). Acute LGIB: Predictive Factors and Clinical Outcome for Patients Who Need First Time Mesenteric Clinical Angiography.

Sitrate & Gralnek. (2016). Management of Patients with Acute GI Bleeding.

"Non-Cardiac Chest Pain" El-Menyar, et. al (2010) Junghaus, et. al (2015) Ricci, et. al (2016) Spalding, et. al (2003) Swap & Nagurney (2005)

Dealing with the Alcoholic Patient Mar 27, 2020

From my lecture at the Texas EMS Conference "Dealing with the Alcoholic Patient"

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ARDS, Bleeding Control, SWAT, Leadership Mar 27, 2020

This week, [someone], [someone else] and [another person] cover [topic].....

Topics discussed:

Topic A
Topic B
Topic C

Links mentioned in this episode:

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Aortoenteric Fistula, COVID-19, Bad Attitudes in EMS Mar 22, 2020

WARNING: EXPLICIT LANGUAGE

References:

Busuttil, Goldstone, & Drigimari. (2001). Management of AEF. Semin Vasc Surg 14(1).

Cedars-Sinai. (2019). Aortoenteric Fistula. http://cedars-sinai.edu/patients/health-conditions/aortoenteric-fistula-AEF.aspx

Schmitz, Steffen, & Grundmani. (2015). When is surgery recommended for treatment of AAA? Institute of Quality and Efficiency in Health Care. http://informedhealth.org

Xirometeritis, Dalainas, Samatakos, and Filis. (2011). Aortoenteric Fistula: Present Day Management. Int Surg 96: 266-73.

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Gear, Head Bangers, & Critical Stress Incidents Mar 20, 2020

References:

Case Western Reserve University. (2006). Monro-Kellie Doctrine. http://casemed.edu/clerkships/neurology/neulrngobjectives/monroe%kellie.htm

Grossman, David. (2013). On Combat. NYC: Hatchette.

My notes from the CRASH FP-C Course: 2013 and 2016.

Werakkody & Goel. (n.d.). Monro-Kellie Hypothesis. http://radiopedia.org/articles/monro-kellie-hypothesis?lang.us

Inaugural Episode, Analgesia, Angel Dust, QA Mar 19, 2020

Welcome Analgesia over sedation PCP QA Conclusion

References:

Bonomo JB, Butler AS, Lindsell CJ, Venkat A. Inadequate provision of postintubation anxiolysis and analgesia in the ED. Am J Emerg Med. 2008;26(4):469–472. doi:10.1016/j.ajem.2007.05.024

Covey, S. R. (2004). The 7 habits of highly effective people: Restoring the character ethic. New York: Free Press.

DEA. (2019). Phencyclidine. https://www.deadiversion.usdoj.gov/drug_chem_info/pcp.pdf