
EMS 20/20
EMS 20/20 is a podcast hosted by two experienced paramedics, Spencer Oliver and Christopher Pfingsten. They discuss real emergency calls run by actual responders and extract lessons that go beyond what is found in textbooks. The show is aimed at paramedic students, seasoned paramedics looking to refresh their knowledge, and anyone interested in a deeper understanding of pre-hospital healthcare. Each episode provides practical insights drawn from real-world EMS experiences.
Episodes

Unexplained Resuscitation
What happens when you drag a coded patient across the carpet at break neck speed? Can you defib a cigarette? All this and more on this weeks episode as a Canadian crew handles a code down a looooooooong hallway.

Special Edition: BOLDY GOING... (...to the ER for lab values)
In a first ever to EMS 20/20, we invite a listener to the show to participate in our Master Your Medics Special Edition! As a voluntary sacrificial Red Shirt, Kate joins the crew and is given a patient! And then another... or maybe just one? Wait, why are we going to the hospital?

Pregnancy Trouble is Afoot!
HOOLLDD ME NOW, I'M 8cm FROM THE EDGE... Chris and Spence follow the surprise of a lifetime as a crew navigates a pregnancy call where things get... stuck.

Special Edition: Mired Chris Incident
Spencer gives Chris perhaps this last MYM scenario: an MPS/MCI in which Chris must Command! How does he do? Let us know how his performance was as it may perhaps be the last time! Check out our IG for Spencer's hand drawn map!

Prime Time Medicine
In what has to be the most challenging photoshop job Chris has ever done, the guys tackle a call where a near ethereal patient gives no clues to what could be wrong. And gang, we have follow up... and wow. Just wow.

Special Edition: Zoo SNAFU
Spencer is in the hotseat! And this call is really, really wild. Quick, do you think a heard of elephants can clearly mark an LZ?

The Emperor Needs a New Attitude
Today we hear the tale of Paramedic that has the self awareness of a monarch wearing some new fangled, conditionally visible fabric. Does this bode well for the patient and their partner? Listen and find out!

Special Edition: Bringing Back the Bagel
Chris is in the hotseat as Spencer gives him a call with strong ties to a past episode. Does Chris figure it out in time? Or does he KILL HIS CREW?!?!?!

Kemento
Chris discovers a sound board as Spencer goes through the call... backwards? Start at the end and end at the beginning for the wild ride, complete with dramatic movie quotes.

Special Edition | CSI: Truck Stop
Spencer is in the hot seat and performs quite well! He has the world's most annoying intern, but thankfully a helpful partner and PD as well. How does he do? Listen and find out!

My Heart Will (Not) Go On
Friend of the Show QANTU joins us for a Titanic Sized episode! Will the efforts to pace a patient be the life boat that's needed? Or will this patient be kicked off the floating door and die an icy death?

Lives Out: An EMS 20/20 Mystery
Dr. Will Heuser join the crew in a an altered LOC mystery! Intubation, a mystery of a history, and a blood pressure that is not cooperating with authorities. Will and the guys will also be at FAST26, get your tickets now! fbefast.com

Do Not Pass ER
Special Guest GEOFF MURPHY of Master Your Medics fame joins the guys for a trip around the game board as a Canadian crew navigate the harsh realities of the unknown reasons someone could be altered... with a STEMI. Maybe.

This Call is Baulder's Dash
Chris finds the effects button on the mixer as Spencer relays a call that shows everything that can go wrong when systemic, cultural apathy sets in deep in a system.

Special Edition: Stroke of (un)Luck
Chris has his worst luck yet, as he finds an altered patient, and angry wife, and absolutely no help. How does he do? Vote on our IG! @ems2020show!

Gravitating Towards Anaphylaxis?
A rapidly swelling tongue and plummeting saturations point a crew into EXACTLY the... wrong? Direction? Can you figure it out before the guys do? Let us know!

SUPER Special Edition: Split the Party!
TODAY IS AWESOME! For the first time ever, neither of us are in the hotseat! Instead, the crew from The RideAlong EMT School Podcast join us in an epic collab event! How does a pair of newly minted EMT's and an experienced Paramedic do against the madness that besets them? And no, we don't go easy on them...

Shake N Bake Boys, I Think We Got a BBQ
The guys welcome Special Guest Dr. Mike Lauria to the show! A crew attends a patient that is perfectly alive, but does NOT stay that way! Can this crew get in sync with what the patient needs, or do they head down a spiral of doom? And can Spencer and Lauria STOP adding movie references?

PREVIEW: Stranger Lungs
To the whole STRANGER LUNGS episode, head over ems2020.com and get signed up for the EMS 2020 CE platform!

Special Edition: Reacting to the Lake
Spencer is given a call that has everything from boats to mystery homemade sunscreen... how does he do? Check out our IG at @ems2020show and vote today!

Twisted Tongue Trauma (ish...)
The guys review a call that has blood coming from... somewhere in the mouth. Maybe. Maybe deeper. But there's a lot! Enough to cause some shock? Maaayyyybbeeeee....

Special Edition: Chris Sucks at Electrolytes
Chris gets a call that he... isn't the most proud of. But Spencer feels he did OK+ ! What do you think? Vote now on Instagram!

Philip Gets Fried
A pediatric airway/neuro/ewww call! Can Chris and Spencer get this figured out? An error occurs... does the agency step up and future proof themselves? Or do they fall to the old ways of the past?

Special Edition: The Bottom Drops Out
Spencer is in the hotseat and for the life of him (or his pretend patient) him simply cannot get a good role. Did he do a good job, or will you score him lower than the dice did?

The Last POLST Bender
The guys handle a code that gets maybe too handled? Or not handled enough? When does a POLST form count? Listen and find out!

Special Edition: Signs Point to Fracture
Spencer causes Chris to bounce off the walls by giving him a pediatric trauma patient with a clueless dad! How does he manage? Vote now!

In The Wake of Stabby McStabberface
The guys take a stab (lol) at a very chaotic scene that involves AT LEAST one stabbing... and little to know scene safety. Just how bad can a stand by go? Listen and find out?

Special Edition: I Have Better Things To Do
Chris gives Spencer the greatest challenge of all: a distracted Supervisor as a partner. Can Spencer redirect a partner who clearly has more important things to do? Or will he lose his famous cool?

Red Dead Redemption Too?
In a gunslinging adventure, the bullets may not be the biggest problem that comes from today's episode. Did we give up before we even got started? Listen and find out!

Special Edition: Fierce Resistance, Betrayal
Chris is given a scenario with a stubborn patient and… a stubborn ambulance Paramedic? Spencer puts Chris on the fire engine this time around, let’s see if he burns! Vote!

When Things Get Skrewy
How do you convince an unaltered but still kind of altered patient to go to the hospital? Especially when they claim they are being tormented by random people who are stealing their sandwich fixings? Listen and find out!

Special Edition: Branching Diagnosis
In a traumatic twist, Spencer finds himself planning to extricate a patient from... a tree? Does he make the right call? Can he remove this patient from a STICKy situation? Vote now on Instagram!

Control Bleeding and Emotions
The guys put themselves in the shoes of a crew that enters a chaotic and potentially dangerous scene. So come on down and meet some friends of mine as Special Guest Dave Horowitz, author of Medic - A Diary, joins the guys in this harrowing tale.

Special Edition: Sepsis on Shaky Ground
Chris digs deep on a patient assessment and also on the structural integrity of the building he's in. Will he do a commendable job, or will his plans... fall through?

Code Alone
Holy wow is this episode... wild. Every calamity that can occur, will occur, especially if you are unprepared. It's almost as though being unprepared invites a swinging paint can to the face. How does today's crew handle a heat related call? Or is it an MI... or is it respiratory?

Special Edition: Drowning Fool
Can Spencer manage some absolutely wrecked lungs? Or will he drown in the salty sea? Vote and let us know what you think! @ems2020show on Instagram!

The Toxicity of This Lady
Dr. Ryan Feldman from The Poison Lab joins us again to talk about a patient that took... all of it. Like all of it. All gone. Can she be saved?

Special Edition: Pregnant Pause
Chris is in the hotseat as Spencer gives him a chest pain call... that is interrupted by an MVA... that is interrupted by a pregnancy call... that is interrupted by a seizure call...

L.A.S.T. Call
The guys fumble through an interesting call with many odd findings... including a high-end hotel that is well prepared for the arrival of EMS. Can this all BLS crew come to the right conclusion?

Special Edition: The Shootout
Today Chris takes aim at Spencer with a call that is all about scene management and lotsa blood! Does Spencer hit the bullseye? Vote on our Instagram!

Freedom From Incompetence!
The guys follow a crew that is mired with questionable choices and potentially a lack in leadership? Should this call have ever been ran? Will the mighty bald eagle weep for this patient? Listen and find out!

Special Edition: Did They Slip or Knot?
On today's special edition, Chris is put in the hotseat by Spencer on an altered LOC patient with a significant language barrier. Can Chris translate this difficult call into a success? Vote now on Instagram!

Trouble In The PlayPlace
Special guest Patrick Pianezza, the writer of CODE 3 (streaming now on Apple and Amazon) joins the guys on a pediatric case with ever so helpful 'nurse' bystander. Do the guys sort things out and figure out what's what (and importantly, whose who)? Listen and find out!

Slay Thy Assumptions!
Spencer brings a call riddled with stumbles from both the patient and a seasoned Paramedic. Does this field training need some training of their own? Listen and find out!

Special Edition: Heated Reaction
Spencer finds himself in the hot seat on a hot day in a hot field with unresponsive patient. What could be the problem? Or problems? Does Chris make things harder? Of course he does. VOTE now!

Altered Addison's
A crew runs a call with an altered patient. Could it be a rare endocrine disorder? Hypotension? Hypoglycemia? Bad cyberware? Find out on this week's episode!

Special Edition: Unhappy Meal
Chris is in the hotseat as he does a call hungry, making each roll harder and each success a little more out of reach. Are his efforts a super sized success, or does his clinical skill belong on the dollar menu? Vote now!

Hot Pursuit, Hotter Patient with RAINN WILSON
RAINN WILSON joins Chris and Spencer (no, really) as they discuss a methamphetamine marathon runner who gets brought up to medium rare. Can an EMT push against the tide to get the right thing done? Can Chris expand his vocabulary? Check out CODE 3 starring RAINN WILSON in select theaters NOW!

Special Edition: Damnit Jerry!
Spencer is in the hot seat, but this time he has the help of Jerry the helpful RN at the local nursing facility / rehab / pit of despair! How does he do? Visit our Instagram to find out!

Ding Dong, The Patient's... Dead?
When a code 99 comes in for a frequent flyer, a crew finds themself in a classic case of "there's more than meets the eye". Do they follow the yellow brick road to get their questions answered? Click your rube red slippers three times and be transported away to a land of not quite death but maybe some destruction.

Special Edition: It Can't Be THAT Simple... Can It?
Chris is in the hotseat and immediately starts over thinking a call involving a possible stroke... or UTI... or hypoglycemia... or alcohol? Check out @ems2020show in Instagram and vote on his performance!

Paralyzing Yourself to Refuse
What does Carhart pants, Fireball Whiskey, weed, and an allergy to authority have in common? They're all in this episode! Follow the Paramedic of Darkness into the fray as we sort out and angry MVA patient that has more issues than they realize.

Special Edition: Oops! All Trauma!
Spencer is in the hotseat trying to fix all the problems with a severe trauma patient. Also, Chris cannot count. Vote on Instagram now!

Self Inflicted Surgery
Hands down, this is the weirdest episode. So many twists and turns. Chris rants about TXA again (start the emails), Spencer gets weird about barnyard animals, and a goat is suspect for attempted murder. Maybe.

Special Edition: Face the Pain
Chris is in the hot seat! Spencer pulls out a rare but immediately life threatening disorder that threatens to crush Chris under the weight of airway management. Does Chris prevail? VOTE NOW ON INSTAGRAM! @ems2020show

Bold Strategy Cotton
An interfacility call that seems like your basic, everyday call... until it isn't. A patient goes from walking and talking to huffing and puffing to gasping and... dying?

Special Edition: Little Altered Man
Spencer is given a 'kitchen sink' type call as Chris leaves him looking around every corner to see if he can walk down Holland road. Does Spencer eek out a 2, or is he leaving you waiting for more? Vote on IG!

Sus 4 CO
Hey wait... that's not Oxygen! Call an emergency meeting! Does the crew in this week's episode get to the bottom of the problem BEFORE it's too late? Listen and find out on this OD turned CO!

Special Edition: Recipe for Disaster
Spencer attempts to trip Chris up with a chaotic flight call! An IFT where a small hospital is struggling to keep up with a severe trauma patient's needs. Is Chris the missing ingredient that ties the whole dish together, or does he completely ruin the flavor profile? VOTE ON INSTAGRAM!

Bullet(s) With Butterfly Wings
A team of responders enter a scene made safe(ish) by PD to find a very unhappy gunshot victim. Are they able to calm his rage and treat appropriately? Listen and find out!

Special Edition: He's Choking Now
Time's up! Over! BLAU? Spencer is in the hot seat as an unconscious unresponsive patient is presented to him. Does he choke? Does he handle it with grace? Let us know and vote on our IG! @ems2020show

Prepare for Unforeseen Consequences
The guys analyze a crew that walks into self-imposed traps. Do they figure it out before it's too late, or do they find themselves at the bottom of a hidden pit? Listen and find out!

Special Edition: Gambling with Grumpy
Spencer rolls the dice for Chris as he presents him with one grumpy customer... can Chris get through the interpersonal obstacles or will he fall flat on his face? Vote on our Instagram!

Get Out of My Head!
Is it an overdose? Is it trauma? Is it... something else entirely unhinged? Yes. Listen and find out what the guys have to deal with in today's exciting and surprising episode!

No Right Answers!
Chris gives Spencer a maze with no end... or a maze with too many endings? Can Spencer pull his patient out of jeopardy and save the day? Or will he miss a vital intervention that leads to a dead end?

Rage Against The EKG
Is this EKG even for the right patient? A wild call with everything from pediatric to... significant OLMC considerations causes the guys to call in some backup... this time in the form of Dr. Michael Lauria! Can the team find some useful lessons with a little help? Listen and find out!

Special Edition: Crafting a Plan
Chris is given the mother of all scenarios where a pediatric patients takes... well, all the medications. PLUS! We introduce the coveted DICE ROLL to spice things up! Just because Chris asks for it doesn't mean he'll get it! Luck of the draw is at play in this week's episode. VOTE ON INSTAGRAM!

Disappearing Leadership
A discharge home for a patient is difficult for all the wrong reasons. Chris... defends the bad guy? Nuance is key as Chris and Spence discuss the wrong time and place in this week's episode.

Special Edition: Bled Too Much? Is That A Thing?
SPENCER is back in the hotseat! Is it trauma? Is it childbirth? Is it both? Is it a code? Vote now on our Instagram and let Spencer know how you feel!

Only Anaphylaxis... and Nothing More..?
Is this a case of a LETHAL distracting injury? Can there ever be such a thing? Is an amped up responder with a "just-go" mentality in the right? Listen and find out!

Special Edition: Respiratory Kombat
Chris is in the hotseat and his patient is in respiratory distress and making alllll the sounds. How does Chris hold up to this onslaught of respiratory trouble? Vote on our Instagram at @ems2020podcast!

Phony Chest Pain
Chest pain? Check. Sus ECG? Check. STEMI? Not check. A very tired Chris and a nerded out Spencer (12-leads... go figure) give MAXIMUM effort in today's call with a curious conclusion.

Special Edition: Frat House Fever
Can Spencer handle the heat? Or really... can his patient? How does Spencer do when faced with a "tough" frat bro who has a fever that just won't quit? Vote now on our Instagram!

The EMT and The Sea
...of bodily fluid. The guys set sail on an adventure to see what they can find on a particularly... sticky... call. Also... IT ENDS WITH A SONG!

Special Edition: Look at This Patient's Sats
Spencer puts Chris in the hotseat with an... anxiety call? Does Chris wind up being a big rockstar or will he never make it as a wise man? Check out @ems2020show on Instagram and VOTE!

Rocko's Modern Wreck
Oh no... apathy strikes again in this week's episode as two cars attempt to occupy the same space in traffic. An ALS fly car responds to sort out the chaos... do they achieve this goal? Listen and find out!

Special Edition: Who Wants To Be Not Dead?
Spencer winds his mind around a call where a patient is heroically pulled from a fire! But they are, unfortunately, lacking a pulse. How does Spencer stack up? Check our IG to vote!

Neo Leaves the Matrix
Chris and Spence try and figure out what's real and what's not on a call where an altered man wounds up getting taken to the way wrong place. The result? Not good. Not good at all.

Special Edition: Honey, I Shrunk the Airway
Spencer fires off a devious pediatric call where Chris is forced to weight something versus nothing! Vote on Chris' performance on Instagram!

The View From Halfway Down
**WARNING this episode deals with the topic of suicide** Clinical Toxicologist and host of The Poison Lab Dr. Ryan Feldman is BACK! The thruple review a call where the patient intentionally ingests Sodium Nitrate and an EMS crew struggles to keep up with the patients rapid decline. What, if anything, can they do? Listen and find out!
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