MCHD Paramedic Podcast
The MCHD Paramedic Podcast is a show for prehospital providers, covering best practices and clinical insights in emergency medical services. Hosted by MCHD Medical Director Dr. Casey Patrick, it explores various aspects of prehospital care. The podcast features guest appearances from influential figures in modern EMS.
Episodes
Episode 197 - Altered Mental Status - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with an altered patient once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next 30 minutes" for the serial killer AMS patient.
Episode 196 - Cervical Spine Immobilization In 2026: Evidence Vs. Dogma
We recently made some cervical spine immobilization protocol changes here at MCHD. Dr. Patrick and Dr. DePasquale discuss the history and literature that provide the foundation for rigid cervical collar use, along with the new MCHD protocol implementation. This has been a collaborative process with our local hospital partners, which has definitely involved give-and-take on both sides.
REFERENCE
Episode 195 - Cold Water Immersion For Heatstroke - Lessons From Phoenix
Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of cooling directly correlates with mortality reduction. Learn how to implement CWI in your service. It's t
Episode 194 - Mental Health Matters In EMS With Dr. Joe Gill
MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some concrete solutions for the future.
Episode 193 - What Can EMS Learn From An Emergency Pharmacist? - Part 2
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things
Episode 192 - What Can EMS Learn From An Emergency Pharmacist? - Part 1
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things
Episode 191 - EMS Protocols 101
As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are the potentially risky decisions? What should the MCHD field paramedics know about the process? Have a listen to better understand the true foundation of EMS
Episode 190 - Geriatric Considerations In EMS With Dr. Maia Dorsett
The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehospital setting. What are the common mistakes? What tools can be implemented to improve patient outcomes? Why does geriatric care even matter? This episode is pac
Episode 189 - EMS Airway Updates 2025 - Part 2
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. This is part two of a two-part series.
REFERENCES
1. Jarvis JL
Episode 188 - Prehospital OB Updates 2025
Recently, some paramedics, obstetricians, and EMS medical directors were locked in a room and produced some fantastic collaborative prehospital guidelines for managing post-partum hemorrhage, eclampsia, and pre-eclampsia. Have a listen, take a look at the guidelines (links below), and we'll all take better care of our pregnant/post-partum patients.
REFERENCES
1. https://naemsp.org/news/now-availa
Episode 187 - EMS Airway Updates 2025 - Part 1
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why don't we intubate our cardiac arrest patients like we used to?" "MCHD has been hyper-focused on recording video laryngoscopy over the past year. Why?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. T
Episode 186 - A Paramedic's Guide To The Opiate Epidemic
We're lucky to have a special guest on this podcast episode to discuss a topic that, unfortunately, all of us in emergency care encounter all too frequently: the opiate epidemic. Peter Canning is a paramedic who has lived through the epidemic while working on the ambulance in the New England epicenter. This discussion navigates Peter's progression through newer terminology like stigma and harm r
Episode 185 - Chest Pain - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with chest pain once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next 30 minutes" for the serial killer chest pain patient.
Episode 184 - Recording Video Laryngoscopy In EMS
On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD. What device did you use? How did you train? What lessons have you learned? All these and more will be addressed and answered.
REFERENCES:
1. Zhao, Y., Zang, B., & Wang, Q. (2024). The Effectiveness of Bougie Use on First-Attempt Success in Tracheal Intubations. Annals o
Episode 183 - Pain Control In EMS - The MCHD Analgesia Ladder
The podcast crew takes on the topic of prehospital analgesia. What pain medication do we choose when facing a complex patient with all analgesics available? Are there better options for hypotensive patients? What about pregnancy and the elderly? On this episode, we'll walk through our MCHD pain medication options, take a moment for a BLS reminder, and discuss some specific situations where cer
Episode 182 - Traumatic Arrest With The Prehospitalist
Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case, asked some hard questions, and will provide solid answers—our favorite recipe for a jam-packed educatio
Episode 181 - Why You Should Attend The Resuscitation Academy
We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank.
REFERENCES
1. https://www.resuscitationac
Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?
Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in EMS? Could standing a patient to check their heart rate actually be harmful? Join the podcast crew as t
Episode 179 - Transcutaneous Pacing Pearls and Pitfalls
On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence. What th
Episode 178 - A STEMI Unlike Any Other
We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to our daily care.
REFERENCES
1. https://www.mchd-tx.org/media/podcasts/SITUS-Fig-1.pdf
2. https://www.m
Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration
This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release. This episode has been out in the world on Medic Mindset for a couple of months, but we wanted to offer it to our
Episode 176 - Antibiotics & Open Fractures
MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol.
REFERENCES:
Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour, R. B., Sims, S., Kellam, J. F., & Bosse, M. J. (2015). Type III open tibia fractures: immediate anti
Episode 174 - Push Dose Norepinephrine
We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild.
REFERENCES:
1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Nore
Episode 175 - The Rear View Mirror - Tunnel Vision
Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the positives that can come if we get past our egos and allow ourselves to have insight for future cases.
Episode 173 - Med Minute - Magnesium
We're working on a new series focusing on high-yield pharmacology reviews. Dr. Patrick starts us off with some background, mechanism of action discussion and common uses for magnesium sulfate. Mag is one of the true pharmacologic swiss army knives of emergency care.
REFERENCES
1. Touyz RM, de Baaij JHF, Hoenderop JGJ. Magnesium Disorders. N Engl J Med. 2024 Jun 6;390(21):1998-2009. doi: 10.1056/N
Episode 172 - The MCHD EKG Manifesto - Part 3
Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge.
REFERENCES
1. https://www.emdocs.net/ecg-pointers-stemi-equivalents-from-the-american-college-of-cardiology/
Episode 171 - Surgical Airway Lessons With Dr. Al Lulla
One of the most fear-inducing procedures in all of emergency care is the surgical cricothyrotomy. Dr. Al Lulla from Dallas Fire joins the podcast to discuss our recent collaboration on a retrospective look at MCHD's surgical airway experience over the past decade. Can paramedics successfully perform cricothyrotomies? Who needs surgical airway placement in the field? What can we learn for our next
Episode 170 - The MCHD EKG Manifesto - Part 2
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is vital as well. Join the podcast crew as they start at the end with the killer/"can't miss" EKG pattern
Episode 169 - Agitation Awareness - Fixed-Dose Ketamine
We've initiated a multi-pronged, system wide overhaul of our agitation management at MCHD. This included a move to fixed-dose ketamine for the severely agitated patients. Evidently we weren't the only ones thinking of this as there is exciting new data from Buffalo supporting this approach. Join the podcast crew as they review the recent literature and MCHD protocol changes.
REFERENCES
1. O'Brien
Episode 168 - The VTach FACTs
We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge. Learn the V-Tach FACT, and you'll feel more comfortable with your next wide rhythm at a rate of 185.
REFERENCES
1. https://litfl.com/vt-versus-svt-ecg-library/
2. https://www.youtube.com/watch?v=UXh8PS9dtmo
3. Marill KA, Wolfr
Episode 167 - Ketamine Only Intubations With Dr. Andrew Partain
The podcast crew is joined by a special guest, Dr. Andrew Partain, an EMS Fellow from UTSW in Dallas. We will dissect his recent data surrounding ketamine-only intubation from MedStar in Fort Worth. This is not just another boring data rehash. There are some vital and applicable pearls that must be applied to the world of prehospital airway management.
REFERENCES:
1. Driver BE, Prekker ME, Rea
Episode 166 - The MCHD EKG Manifesto - Part 1
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is vital as well. Join the podcast crew as they start at the end with the killer/"can't miss" EKG pattern
Episode 165 - Intracerebral Hemorrhage
We've spent countless hours (rightfully so) discussing ischemic stroke management over the past several years. Sometimes, the other 20% of strokes, the hemorrhagic version, can get neglected. No, we don't have stroke-mobiles at MCHD to diagnose an ICH in the field, but there are some patient care keys to emphasize for EMS when we suspect non-traumatic, acute intracranial bleeding.
REFERENCES
1. Q
Episode 164 - EMS HOCUS POCUS
MCHD's POCUS program has definitely involved both forward progress and lessons learned. In this episode, we'll discuss some of the reasons POCUS can be a game changer in the prehospital setting. However, unintended consequences do exist. We've begun to make the move to utilizing carotid ultrasound in OHCA, and we'll tell you exactly why.
REFERENCES
1. Badra K, Coutin A, Simard R, Pinto R, Lee JS,
Episode 163 - Back Pain Beware
MCHD paramedic Wes Hall joins the podcast crew to discuss a recent seemingly mundane back pain call. Please listen to find out how avoidance of premature closure, a thorough exam, and professional patient advocacy led to an excellent outcome in a SCARY case.
REFERENCES
1. https://www.mchd-tx.org/media/podcasts/Image-Episode-163.jpg
Episode 162 - Post-ROSC Pressor Choice
We recently made a significant vasopressor protocol change at MCHD, prioritizing norepinephrine in all shock situations except anaphylaxis and bradycardia. The evidence supporting norepinephrine in septic and even cariogenic shock is relatively solid. However, recent data has emerged suggesting norepinephrine may be safer in post-ROSC shock as well.
REFERENCES
1. Bougouin W, Slimani K, Renaudier
Episode 161 - MMQ#9 - The Angioedema Airway
MCHD District Chief April Currie joins the podcast crew to discuss an angioedema case that repeatedly left more questions than answers. Dr. Patrick was tasked with managing the airway and definitely has some lessons learned to share with the listeners.
Episode 160 - ST Elevation in aVR With Diffuse ST Depression
The podcast crew dives deep into one of the early "STEMI equivalent" ECG patterns: ST elevation in aVR with diffuse ST depression. What does the evidence say about this pattern? Is there a FOAM lesson to be learned? How should we incorporate this ECG into our practice?
REFERENCES
1. Harhash AA, Huang JJ, Reddy S, Natarajan B, Balakrishnan M, Shetty R, Hutchinson MD, Kern KB. aVR ST Segment Elev
Episode 159 - MMQ#8 - The Head and the Heart
Dr. Dickson leads the discussion with recent cases involving the PECARN pediatric head injury decision rule and some super sneaky toxicology. There is some high-level detective work happening during this episode. Listen so you don't miss vital clues in your clinical practice.
REFERENCES
1. Kuppermann N, Holmes JF, Dayan PS, et al; Pediatric Emergency Care Applied Research Network (PECARN). Iden
Episode 158 - Terrible Tracheostomy 2023
The podcast crew is joined by MCHD In-Charge Paramedics, Ben Breaux, and Jesus Contreras to discuss a critical case that demonstrates why continuing education and intentional mental reps are vital in emergency care. We've discussed the "how-to" when approaching the crashing tracheostomy patient. Let's add an actual MCHD case and a little review on top of that previous foundation.
REFERENCES
1.ht
Episode 157 - Cardiac Arrest During EMS Care - Making MOVES
There is nothing more stressful than seeing EMS peri-arrest progress to pulseless. CARES data suggest that cardiac arrest during transport is not an uncommon event. Additionally, there is new evidence that these patients may not be as difficult to recognize as we might've thought. Join the podcast crew as we introduce the MCHD "MOVES" algorithm for a proactive approach to providing a safety net
Episode 156 - MMQ#7 A Shocking Save And Sneaky Serial Killer
Sometimes it's easy on the individual level to miss the positive drift within EMS as systems of care evolve and change toward positive innovation. Dr. Patrick hits the hot seat on this episode to discuss two recent cases where some of MCHD's favorite initiatives come together to improve patient outcomes and diagnostic recognition.
REFERENCES:
1. Dickson RL, Crowe RP, Patrick C, Crocker K, Aiken
Episode 155 - MMQ#6 - A Rapid AFib Riddle
Join the podcast crew as they discuss one of the more sticky situations in all of emergency care: stable vs. unstable narrow complex tachycardia.
1. How do we even define unstable?
2. Is it cardiac versus an underlying illness?
3. How do we approach undifferentiated rapid atrial tachycardia in the ED setting?
Episode 154- Death Notification Lessons Learned
The concept of emphasizing, discussing, and training on giving prehospital death notification is, unfortunately for medics and our patient's families, a relatively new concept. Additionally, newer evidence shows that an increased frequency of fatality exposure increases EMS burnout rates. So...everyone wins by an increased focus on improving our skills and comfort with telling families that thei
Episode 153 - MMQ#5 From The PNW - Spokane Frozen Solid
The Podcast Crew is joined by Spokane Valley Fire Paramedic Noah Martinez to discuss a recent patient that he delivered to Dr. Patrick. After you hear what Noah found on the scene, this story will likely not end exactly how you expect. Learn some foundational hypothermia management pearls AND why early emergency neuro-prognostication can be exceedingly difficult.
Episode 152 - The MCHD SNORES Sedation Safety Bundle
Chemical sedation is one of the riskiest decisions made in EMS clinical care, period. We've been working overtime at MCHD over the past couple of years to decrease the risk and improve our safety profile for the entire clinical package when we sedate patients for severe agitation in Montgomery County. Join us to learn about the MCHD SNORES safety bundle based on the 5 P's and how you can easily
Episode 151 - MMQ#4 - Dr. Dickson's Strokes
Join us as Dr. Dickson brings a couple of extremely difficult recent emergency department cases to take a hard look in his own clinical mirror. These will highlight the difficult and often dynamic nature of assessing airway patency and protection in real time. Speaking of dynamic, vascular emergencies like stroke and STEMI often progress unexpectedly.
REFERENCES
1. Nørskov AK, Rosenstock CV,
Episode 150 - Hyperkalemia, BRASH syndrome, And Amiodarone BEWARE
MCHD paramedic, Lily Trosclair, joins the podcast to discuss some in-depth hyperkalemia treatment details, including BRASH syndrome. We'll also pivot to the dangers of giving amiodarone to a hyperkalemic patient that's mistaken for ventricular tachycardia.
REFERENCES
1. https://emcrit.org/pulmcrit/brash-syndrome-bradycardia-renal-failure-av-blocker-shock-hyperkalemia/
2. https://www.youtube.c
Episode 149 - Finding Joy In The Common
This may seem like a curveball-type episode upon your initial listen, but this topic should be core material for all emergency medical clinicians. Too much time and emphasis within paramedic education are placed on rare presentations. Dr. Dickson and Dr. Patrick expand on a recent medical podcast/article (see links below), stressing the need to embrace learning and teaching the most common condit
Episode 148 - ET3 And Beyond With Dr. Gerad Troutman
The podcast crew is joined, live at Texas EMS 2022, by Dr. Gerad Troutman to discuss the world of alternate destination EMS transports, EMS-facilitated telehealth, nurse navigation, and "hospital at home." Dr. Troutman leads the ET3 initiative and is the National Medical Director for Innovative Practice at GMR, so this episode is full of successes, road bumps, and shared experiences with the impl
Episode 147 - MMQ#3 - CAB For The Win
MCHD medics Kelcie Adams and Rich Serra join the podcast to discuss a critically ill trauma patient they delivered to Dr. Patrick in the emergency department. Our default is so often airway, airway, airway first, but prioritizing circulation first was likely life-saving. This is an excellent "Monday Morning Quarterback" case to look back on and dissect with tons of educational pearls.
Episode 146 - NTG In RVMI With Matt Wilkinson-Stokes
Special guest alert!! We're lucky to have superstar Aussie medic and University of Melbourne Ph.D. candidate Matt Wilkison-Stokes, on this episode to discuss his recent paper looking at the risk of hypotension with nitroglycerin administration in acute MI. Where is NTG really more likely to cause hypotension in AMI? When is it safest? How often do isolated RVMI's occur, and what are the correc
Episode 145 - Where Do We Look? Who Do We Trust?
We have MCHD Cpt. Megan Powell to thank for this episode as she posed an excellent question about where and how to look for trusted educational information as a practicing paramedic interested in continuing clinical growth and progression. With the amazing and immense amount of free online textbook, blog, and podcast resources available, trying to keep up can be totally daunting. Join Megan and
Episode 144 - The TBI "H-Bombs" With Dr. Al Lulla
Join this discussion of some of the recent literature surrounding EMS care of traumatic brain injury with Dr. Al Lulla. This is the perfect confluence of advancing evidence, relatively straightforward interventions, and a patient population where we can definitely improve prehospital outcomes. See where the literature, education, and protocol implementation can meet to improve TBI outcomes in yo
Episode 143: Adrenal Crisis in EMS
When it comes to exciting educational topics in EMS, oftentimes, the endocrine system, specifically the adrenal glands, can be left off the list. Dr. Patrick is joined by one of our local emergency/trauma nurses, Melanie Gander, to discuss her journey as a parent of a child with congenital adrenal hyperplasia. We'll review basic adrenal physiology and discuss the caveats on how to recognize and
Episode 142 - Reducing Medication Errors
Across the world of health care, everyone is wrestling with how to reduce medication errors. With the decision in the Vanderbilt case, there is now the added fear of potential prosecution for giving an incorrect medication. Join the podcast crew as they try to better define the various types of medication errors while looking at what the literature says about medication errors in EMS.
REFEREN
Episode 141 - Podcast Q&A
Join the Podcast Crew as they answer some recent questions submitted to podcast@mchd-tx.org. We discuss a wide range of topics including epinephrine drips, IV Tylenol for pain, Knee-BOA, whole blood in EMS, the green whistle (methoxyflurane), and an awesome "S" for our loss of airway protection teaching files. Thanks to all our listeners out there!!
REFERENCES
1. O'Dochartaigh D, Picard CT, Bri
Episode 140 - MMQ#2 - A TBI Conundrum
The Podcast Crew is joined by MCHD District Chief, Spencer Hall, to discuss a recent trauma patient that Chief Hall delivered to Dr. Patrick's ED care. This one encapsulates many of our recent podcast topics including the tenets of DSI and the importance of maintaining oxygenation and blood pressure in TBI patients.
Episode 139 - Anchoring Bias In EMS
The MCHD Paramedic Podcast would like to welcome EM/EMS physician Dr. Katherine Luu, to Montgomery County. Dr. Luu joins the podcast to discuss anchoring bias and how this impacts medics in the field. Listen and learn how to describe, recognize, and prevent anchoring bias in your practice.
REFERENCES
1. https://onlinelibrary.wiley.com/doi/epdf/10.1197/aemj.9.11.1184
2. https://www.amazon.com/
Episode 138 - Beware of the BRUE - MCHD COTQ Q2 2022
Brief resolved unexplained what?? MCHD paramedic, Cpt. Clayton Smith, joins Dr. Dickson to discuss an EMS approach to BRUE's. These can often be falsely reassuring to prehospital providers because the event, by definition, has resolved prior to EMS arrival. But don't get too comfortable because up to 4-5% of BRUE's can have severe underlying diagnoses as the cause. We can never talk too much "s
Episode 137 - Monday Morning Quarterback - STEMI vs. OMI/NOMI
The Podcast crew is joined by MCHD In-Charge Paramedic Brady Walding to discuss a recent difficult STEMI case that intersected with Dr. Patrick in the ED. How do we best communicate with our consultants when we disagree? What happens when a paradigm shift is occurring without our consultants (STEMI vs. OMI/NOMI)? We are excited about our new Monday Morning Quarterback Series, where Dr. Patrick
Episode 136 - Mythbusters 2022
The podcast crew welcomes newly transplanted Texan EMS physician, Dr. Louis Fornage, to join in on some rapid-fire mythbusting for 2022. We run the gamut from post-ROSC vasopressor evidence to whether or not saying "QUIET" affects emergency department volume.
REFERENCES
1. https://www.nremt.org/News/National-Registry-of-EMT-s-Resource-Document-on-Sp#:~:text=NREMT's%20use%20of%20the%20term,mo
Episode 135 - First There Matters
Join the podcast crew as they turn their attention from the EMS transport to the First Responders here in Montgomery County. We welcome MCHD FRO Coordinator Bryan Perry and Chief Ray Vaden from Porter Fire to discuss some recent FRO initiatives and advances. It wouldn't be the MCHD Paramedic Podcast if we also didn't slip in some recent CARES research highlighting improved OHCA outcomes when fir
Episode 134 - All Things Anaphylaxis
True anaphylactic shock can be one of the most harrowing calls in all of EMS and emergency medicine. However, as is true with much of our core clinical content, dogma and myths persist. MCHD District Chief Spencer Hall joins the podcast crew to discuss anaphylaxis diagnostic criteria, treatment, and much more.
REFERENCES
1. Anagnostou K, Turner PJ. Myths, facts, and controversies in the diagno
Episode 133 - MCHD Bike Team
Join Dr. Patrick and MCHD District Chief and Bike Team lead, Scott Sanders, as they discuss the MCHD Bike Team. What does it take to be an MCHD bike team medic? How does patient care differ from the truck vs. when on the bike? Learn how the MCHD Bike Team fills multiple invaluable roles in the county.
Photo Link - https://www.mchd-tx.org/media/podcasts/Bike-Team.jpg
Episode 132 - Xylazine Update
Friend of the podcast emergency physician, addiction specialist, and toxicologist extraordinaire, Dr. Jerry Snow joins the podcast crew to discuss a scary and potentially deadly twist in the opiate crisis…xylazine. Dr. Snow will school us all about xylazine pharmacology and treatment tips and why EMS high-dose naloxone may not be ideal.
REFERENCES
1. https://www.acep.org/tacticalem/newsroom/oct-
Episode 131 - Nebulized Ketamine, What??
There is no possible way to improve ketamine, right? Join Dr. Patrick for a discussion of exciting recent literature investigating the effectiveness and safety of nebulized ketamine for emergency department analgesia. Everyone's favorite EMS medication may be primed for an enhanced delivery option.
REFERENCES
1. Dove D, et al. Comparison of Nebulized Ketamine at Three Different Dosing Regimens
Episode 130 - A Super Cool Case - MCHD COTQ Q1 2022
Join the podcast crew, District Chief Kevin Mifflin and In-Charge Payden Seals as they discuss our MCHD Case of The Quarter for Q1 2022. This case is a prime example why field providers must keep wide differentials with a keen awareness of the initial scene situational factors.
REFERENCES
1. https://coreem.net/core/hypothermia/
2. https://www.saem.org/about-saem/academies-interest-groups-affil
Episode 129 - Serial Killer Series - Trauma
The medical directors revisit one of our old favorites "The Serial Killers Series" to discuss 5 trauma killers to keep in your front brain as you are preparing or caring for a sick trauma patient. If you've not considered your differential diagnosis until patient contact and initial evaluation then you're too late. Following this episode, you'll be ready to evaluate, act and prevent acute hemorr
Episode 128 - MCI MCHD Style
Join Dr. Dickson and the podcast crew as they dive into the MCHD approach to mass casualty incidents. We're lucky to be joined by MCHD Safety and Preparedness Officer, Sean Simmonds and MCHD District Chief Ryan Davenport. These are field medics talking about actual logical field pearls for MCI management.
Episode 127 - Airway Patency Vs. Protection
Episode 127 - Airway Patency Vs. Protection by Montgomery County Hospital District
Episode 126 - Droperidol With Dr. Jeff Jarvis - Live From Texas EMS
On Episode 126, the podcast crew was able to catch up with the one and only Dr. Jeff Jarvis at Texas EMS in Austin. Dr. Jarvis is a longtime fan of droperidol for multiple uses in the prehospital setting ranging from acute headache treatment to sedation and as an anti-emetic. Let this be a warning, we're all droperidol zealots in this discussion. Listen and learn practical ways to implement dro
Episode 125 - Why No MCHD Whole Blood (Yet...)
Texas has been the epicenter of the ground-based EMS integration of whole blood programs for hemorrhagic shock in the prehospital setting. The MCHD clinical staff have been watching the evidence closely and feeling the push from our own medics. Join Dr. Dickson and Dr. Patrick as they discuss the "why" behind no whole blood at MCHD (yet...). Send any requests, questions or ideas to podcast@mchd
Episode 124 - Awful Asthma - MCHD COTQ Q4 2021
Join the podcast crew and MCHD medic Lily Trosclair as she discusses our MCHD Case of The Quarter for Q4 2021. This one began with a pediatric cardiorespiratory arrest but fortunately has a happy ending.
REFERENCES
1. Heffner AC, Swords D, Kline JA, Jones AE. The frequency and significance of postintubation hypotension during emergency airway management. J Crit Care. 2012 Aug;27(4):417.e9-13.
2
Episode 123 - Social Media and EMS - Live From Texas EMS
Wherever you turn in the world today, social media is present with constantly expanding visibility and influence. Join MCHD's Chief of EMS James Campbell and Public Information Officer Misti Willingham as they discuss some lessons and ground rules on how to successfully integrate an active social media program into your EMS service.
Episode 122 - Cardiac Arrest Literature Update
It’s time to review some recent cardiac arrest literature. Both of today’s articles come from Resuscitation and address predictors of OHCA survival. Should we take a third attempt at intubating an OHCA patient, should we intubate OHCA at all? What about PEA arrest, can ETCO2 help identify pseudo-PEA? Listen to get some hot off the press OHCA literature updates.
REFERENCES
1. Murphy DL et al.
Episode 121 - Burn Baby Burns
We sure do love myth busting on the MCHD Paramedic Podcast and there are definitely some persistent myths surrounding burn care in EMS. Join the podcast crew as they provide updates on burn staging, fluid resuscitation and the basics of burn wound care. This episode will keep you from getting burned during your next burn transport.
REFERENCES
1. Parvizi D, Kamolz LP, et al. The potential impact
Episode 120 - Live From Texas EMS - Respect The Lift Assist With Dr. Taylor Ratcliff
Join the podcast crew and Dr. Taylor Ratcliff as they discuss the dangers of the "Lift Assist" calls in EMS. These responses can be under-appreciated with hidden diagnoses such as sepsis, GI bleeding and even fractures. How can we better create checklists to better assess these calls? What are the warning signs in these patients? Do lift assists even require an ALS evaluation? Listen and get
Episode 119 - Nitrous Oxide in EMS With Dr. Corrie Chumpitazi
In this episode, we’re lucky to have a special guest from Texas Children's Hospital, pediatric sedation and pain management expert, Dr. Corrie Chumpitazi. Nitrous oxide has been in our protocols here at MCHD for some time, but probably doesn’t get the recognition and appreciation that it deserves. We’ll discuss NO history, dosing, indications, contraindications, and side effects. Listen to lea
Episode 118 - A Conversation on Clinical Consults
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
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