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Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Loud & Clear: EMS Guiding Principles is a continuing-education podcast for paramedics, EMTs and other prehospital care providers. Hosted by Ross Orpet, a paramedic turned EMS physician, it moves past rigid treatment algorithms to explore the underlying principles that explain why we do what we do. Episodes feature discussions with experts, reviews of evidence-based best practices and real-world case studies drawn from emergency calls. Each topic is tied back to the guiding question of what actually matters to the patient in front of you. The goal is to help clinicians build a decision-making framework that holds up when a call does not fit the textbook.
Episodes
Shock in Trauma: What Paramedics Need To Recognize
A trauma patient is hypotensive. Is it hemorrhage? Tension pneumothorax? Cardiac injury? Neurogenic shock? In the first few minutes, the differential can get wide fast, but some causes need to stay at the very top of the list.
Recorded at UNC Chapel Hill’s May Day Trauma Conference, Will talks with emergency physician Dr. Maglin Halsey-Nichols about a principle-driven approach to shock in trauma.
When You Can’t Stop the Bleeding: Inside A Massive Trauma Case
A mangled extremity, uncontrolled bleeding, bad weather grounding every helicopter nearby, and a trauma center nearly an hour away. Sometimes the biggest challenge is figuring out what to do when the ideal plan is no longer available.
Ross talks with critical care flight paramedic Jim Phipps about a severe farm-auger injury that pushed
multiple teams to adapt in real time. Jim walks through how
Maternal Trauma Emergencies: What Changes in the Pregnant Patient
Pregnancy can make even experienced clinicians second-guess decisions. Can you image the patient? Can you cardiovert? Should the trauma assessment change? And at what point does the fetus become part of the resuscitation?
Will talks with maternal-fetal medicine physician Dr. Johanna Quist-Nelson about what matters when caring for a pregnant trauma patient, where fetal assessment fits into the tra
Training for the Big Call: How Emergency Teams Can Build Better Performance Under Pressure
The hardest calls fall apart when communication is unclear, roles blur, feedback feels personal, and the team starts working around each other instead of with each other.
Today, Ross and Will talk with Dr. Daryl Johnson, Adult Trauma Medical Director for the UNC Health Trauma Program, about what it takes to build teams that can perform consistently under pressure, how leaders can manage disagreem
From Tractor Rollovers to Grain Entrapment: A Field Guide to Farm Emergencies
The mechanism behind agricultural emergencies can completely change the risk to both the patient and the responders arriving to help.
Ross talks with Jessica Wilburn, Agromedicine Nurse Coordinator, and Maggie Denning, Outreach Coordinator with the North Carolina Agromedicine Institute, about the injuries and environmental hazards first responders may encounter in agricultural communities. They c
The First 60 Seconds After ROSC: How To Prevent Re-Arrest
The First 60 Seconds After ROSC: How To Prevent Re-Arrest
How do you improve your resuscitation systems beyond the ACLS algorithm?
Will talks with Ian Blanchard, Senior Scientist for Alberta’s provincial EMS system about the “frame of survival” and why rehearsing equipment placement and vector change can make critical actions nearly automatic when the call comes in.
Then, Ross talks with Mike Hum
Post-ROSC Care and Pacing: Prove the Perfusion
Getting a pulse back feels like a win. Seeing pacer spikes and something that resembles a pulse feels reassuring. But in both situations, the monitor can make you feel better before the patient actually is.
Geoff Murphy of Master Your Medics breaks down the fragile minutes after return of spontaneous circulation. He explains why hypotension deserves immediate attention, how falling end-tidal CO2
Burn Care in EMS: What Actually Matters in the First 15 Minutes
Burn patients can create a disproportionate amount of anxiety. The calls are uncommon, the injuries can be visually overwhelming, and it is easy to get distracted by the burn itself.
Ross and Will talk with Mark Johnston, a longtime Advanced Burn Life Support instructor and burn program leader at Regions Hospital, about simplifying prehospital burn care. Mark explains how most burn patients shoul
Readiness Beyond the Medicine: Neurodivergence, Pediatrics, and Better Communication
Readiness is about more than knowing the medicine. It’s about creating the conditions for patients, families, and clinicians to feel safer and more capable when the situation is unfamiliar, overwhelming, or high risk.
First up, Boston MedFlight flight nurse Nicole King discusses neurodivergence, sensory overload, and how traditional EMS behaviors can unintentionally escalate distress. She explain
Heat Stroke: Recognition, Cooling, and Transport Decisions
What differentiates heat stroke from heat exhaustion? Once central nervous system dysfunction appears, every minute spent at an elevated core temperature increases the risk of permanent neurologic injury or death.
Ross and Will talk with emergency physician and wilderness medicine specialist Dr. Greg Doctor about the full spectrum of heat-related illness – from heat cramps, rash, and edema to syn
The Pursuit of Mastery: Preparation, Mentorship, and Learning From Mistakes
Most people picture a master clinician as the person in the room who knows every answer. In reality, mastery looks like the opposite, and admitting what you do not know.
Ross talks with FlightBridgeED co-founder Eric Bauer about the “rage to mastery”, the advice that kept him in EMS after a series of difficult calls nearly drove him away, why expertise is perishable, and how ego creates resistanc
Mass Casualty Readiness, Burn Decisions, and the Fundamentals That Save Lives
The calls that scare clinicians the most are often the ones they have the fewest opportunities to practice.
So what happens during a rare, high consequence emergency? First, Jennifer Barnhart of Austin-Travis County EMS and Sergeant Luke Serrato of the Austin Police Department discuss the response to a mass casualty shooting on Austin’s Sixth Street.
Then, Ross talks with Allen Wolfe about thre
What the Evidence Really Says About Cervical Collars with Dr. Jeff Jarvis and Dr. Ben Abo
The hardest part of evidence-based medicine is not finding a paper. It is deciding whether that paper should change what you do on your next shift.
First, we talk with Dr. Jeff Jarvis about how to evaluate medical literature beyond the headline, abstract, conclusion, or p-value. You’ll hear about the PICO framework and why patient-oriented outcomes should matter more than the numbers that are eas
The Three Building Blocks of Trust in EMS
Trust is the architecture behind every patient interaction you run.
Dr. Cory Scheer, author of Closing the Trust Gap, has identified three evidence-based building blocks of trust: competency, problem-solving, and care for others. It turns out EMS providers already use all three the moment they step on scene.
In this episode, we unpack the gap between senior leaders and frontline EMS workers, what
The Skill Is Not The Hard Part
The hardest part of a bad call is rarely the algorithm. In two different interviews I explore some human traps of running an EMS call. I talk with Danny and Rance from DNR Prehospital Education about a choking arrest, a difficult field intubation, and the trainer-trainee dynamic that made the call more complicated than the procedure itself. Then Bobby breaks down the CAFE pneumonic of heuristic tr
Treat Mom First: Amniotic Fluid Embolus and Other Peri-partum Emergencies
A postpartum patient does not need to look dramatic to be in real danger. In this episode from FAST 26, Ross talks with Amy Loucks about pregnancy-related deaths, maternal care deserts, postpartum warning signs, hypertension, cardiomyopathy, infection, and the calls EMS can easily miss. Then Elizabeth Garchar walks through amniotic fluid embolism, now often framed as an anaphylactoid reaction of p
Pressure Matters: Oxygenation vs. Ventilation in Pre-Oxygenation with Scott Weingart
Pre-Oxygenation is not just putting oxygen on the patient and hoping the sat buys you enough time. In this episode, Ross talks with Scott Weingart after his FAST26 talk on preventing peri-intubation arrest.
They get into why many peri-intubation arrests are predictable and preventable, why shunt physiology requires pressure and not just FiO2, and how EMS clinicians can build a field-ready setup wi
Your Checklist Is Making You Worse: Why Pilots Use Checklists and Paramedics Don't
A checklist should reduce cognitive load. So why does yours make things worse? Airline pilot and safety officer Glenn Fisher breaks down how aviation refined checklists over decades of crash data and human factors research — from verification-only flows to abnormal read-and-do procedures to defining the criteria for what should actually earn a spot on the card.
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Pediatric Sepsis with Dr. Peter Antevy
Pediatric sepsis is easy to miss because the first hour often looks ordinary. Kids compensate, until they don't. In this episode, Will Berry talks with Dr. Peter Antevy about the case that still bothers him and why fluids, vasopressors, antibiotics, and hospital feedback all have to be treated as one resuscitation system.
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How to Build Procedural Skills - That Actually Stick
Most EMS skills training creates an illusion of competence. You drill a procedure, check a box, and move on. But what does the research actually show about competency and retention?
Dr. Jason Hine (EM physician, SimKit founder) breaks down the actual science of procedural skill acquisition: S-curves, encoding and consolidation, retrieval practice, and why expensive simulation labs often underperfo
How to Fail Better in EMS: A Framework for Growth
Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it.
In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus is a warning, not a role model. Why the best clinicians you'll ever work with have made bigger mistakes than you have. Why high-functioning organizations report mistakes ten times m
The Call Nobody Trained You For — Jim Schmidt on Domestic Violence Recognition
Most medics walk onto a domestic violence scene armed with instinct and not much else. Jim Schmidt thought 20 years in the fire service had prepared him for anything — until he had to identify his stepdaughter Gabby Petito's body in 2021. In the months and years after he realized how little EMS is prepared to recognize and treat domestic violence victims. What he's learned since has rewritten what
Great Mentors Shape Better Clinicians
Don't Be A Field Training Officer Be A Field Training Mentor.
Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down with Ben Tacy onsite at FASTCAN to talk about the origins of field training and why Ben prefers the language of mentorship over “field training officer”.
If you care about leadership
Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite
Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective.
Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and whe
Suction First: Dr. DuCanto on the SALAD Technique for the Contaminated Airway and What Comes Next
The contaminated airway is one of the most unforgiving calls in prehospital medicine. Blood, vomit, debris — your laryngoscope goes in and you're blind. For decades, paramedics managed this with tools designed for a clean OR and training that never got close to the real thing.
Dr. Jim DuCanto decided that was unacceptable. He's the anesthesiologist who invented the DuCanto catheter and SALAD (Suct
Wired to Fail: The Science of Human Error in EMS
What if the mistake wasn't your fault... but it's still your responsibility?
That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actu
Dump Kits and Checklists: Why Expert Paramedics Still Crash
Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. Yo
Feeling Behind the Curve? Understanding the EMS Power Curve Will Help You Stay Ahead
Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This
Stupidity in EMS: The causes and remedies
You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them.
Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science
Anaphylaxis + Asthma: When Standard Anaphylaxis Treatment May Not Be Enough (AMAX4 Explained)
This episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine m
The Habit Loop: How Master EMS Clinicians Build Unconscious Competence Through Habits
Struggling to remember every protocol in high-pressure medical situations? You're not alone—and memorizing everything isn't the answer.
Join us for this game-changing conversation with Jean Francois Couture, co-founder of Parys Medical, as we unpack the science of habit formation for EMS and healthcare providers. Recorded live at FAST 25, Jean breaks down the "habit loop" (cue, routine, reward)
Hypothermia Rescue: Cardiac Arrest in a Tree Well
What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits.
This wasn't luck. Miles breaks down the critical decision to defy tr
When The Anatomy Is Gone: Facial Trauma Airway Management
What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality.
Critical care transport legend Allen Wolfe joins us to dissect a real case, a conscious patient with a self-inflicted shotgun wound—no mandible, no nose, no midface—just open tissue and blood
Stop Building Resilience, Strengthen Your Resistance
Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever).
Recorded on-site at Fast25, James Boomhower, founder of StayFit4Duty, breaks down why the EMS culture of "pushing through" is fundamentally flawed. Using the metaphor of muscle training, he explains
What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS
Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vulnerable stories about impostor syndrome, burnout, and finding your way as a new paramedic.
Sophie's path to EMS started in the most unexpected way—from a 39-day hospitalization th
Why Those With Addiction Don't "Just Change" - Opioid Crisis Reality for EMS
Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment
"Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.
Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challeng
When to Act: Mastering Vasopressors in 2025
What do you do when the blood pressure monitor shows a number you don’t like? Most providers hit the button again—but what if it’s real? In this episode, we’re joined by critical care transport specialist James Boomhower from Boston MedFlight, recorded live at the FASTCAN conference in Calgary, to break down modern vasopressor management.
We explore how norepinephrine replaced dopamine as the fi
The 5 Levels of EMS Mental Breakdown & How to Escape Them
Why do some paramedics stay unshakable under pressure while others crumble on the exact same call? The answer isn't about years of experience—it's about understanding the neuroscience of stress and having the right mental tools.
Cody Winterford delivers an incredible breakdown of the five psychological "circles of hell" that providers face in high-stress situations. Starting with the amygdala hi
Following Evidence or Following the Crowd? The Truth About Evidence-Based Medicine with Dr. Eddy Lang
What if the evidence hierarchy you learned in school is incomplete? Dr. Eddie Lang, who helped develop the GRADE system now used by WHO and major resuscitation councils, explains why clinical practice guidelines—not RCTs or meta-analyses—should guide your practice decisions.
Join us at FASTCAN 25 as Dr. Lang, who's helped shap guidelines for the World Health Oganization (WHO) and the Internation
Toxidromes Demystified
Understanding the toxidromes provides you with vital diagnostic tools in high-stakes environments. In this episode, we break down the clinical patterns that define.
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Rescue Breaths: Demystifying the Physiology of Safe and Effective BVM Ventilation
Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques. This episode highlights common mistakes like insufficient exhalation time, discusses driving pressure, and explains the importance of proper technique to avoid lung injury. We also explore the nuances of endotracheal tube size, laminar flow, and the transition from BVM to mechanical ventilation. From FASTCAN in Calg
Prehospital Blood, Trauma Arrest, Hypertension in Pregnancy, and Diltiazem in Afib with RVR
Dr. Jeff Jarvis, EMS medical director and host of the EMS Lighthouse Project, delves into the latest emerging EMS literature and guidelines from the National Association of EMS Physicians. We explore best practices for blood use in trauma, up-to-date trauma arrest recommendations, postpartum hemorrhage, and severe hypertension in pregnancy. Additionally, we discuss recent studies on field intubati
Unlocking the Hidden Keys to Calm Under Chaos: How Simple Tools Like A Checklist Can Elevate Your Care
What's the real difference between paramedics who stay calm under pressure and those who panic when everything goes wrong? It's the ability to already know what comes next. In this episode we explore the power of consistency and how one simple tool, often dismissed, can improve patient care and outcomes. Geoff Murphy, founder of Master Medics, sat down with us onsite at FAST25 to discuss how check
EXCITING NEWS! FIND OUT WHAT WE'VE BEEN WORKING ON.
Were have we been? Well, the truth is, we've been incredibly busy working on some really exciting projects.
If you're interested in joining the founding members cohort of The Loud & Clear Fellowship Course reach out to me at ross@emspodcast.com before August 15th.
Project #1: Understanding New Paramedic Challenges
We launched a research project diving deep into understanding exactly what newe
Engineering Simplicity in Crisis: Mastering Airway Management Through Systematic Approaches With Dr. Rich Levitan
Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance.
Resources
YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw
The Resus Tailor - https
The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use
We dive into the latest emergency medicine research evaluating the complications following pre-hospital tourniquet use. Dr. Ben Li, an expert in emergency medicine literature reviews a 2023 study titled 'The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use,' exploring its implications for EMS providers. From infection to compartment syndrome, we discuss the potential do
Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It
A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar?
In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift.
Our guest, Glen, a commercial airline pilot a
The Art of Managing Agitated Patients
Effective agitated patient management requires a fundamental shift from viewing these encounters as behavioral problems to recognizing them as medical emergencies with underlying pathophysiological processes. By systematically addressing safety, identifying root causes, selecting appropriate pharmacological interventions, and maintaining rigorous post-sedation monitoring, EMS providers can drama
Upper GI Bleed: Rescue Strategies From Recognition to Stabilization
Let's delve into the critical steps required to manage an upper GI bleed in the field. This episode breaks down the recognition of risk factors, vital airway and circulation interventions, and best practices for transporting and notifying the hospital. We discuss important historical clues and provide insights on airway handling and circulatory support. Learn how to navigate these time-sensitive
These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS
These challenging scenarios represent opportunities to provide truly patient-centered care at life's most vulnerable moments. By combining your medical expertise with thoughtful communication, you can help ensure patients' wishes are honored while supporting families through difficult transitions. In this episode we dive into the complex ethical and legal dilemmas faced by EMS providers when arri
BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There.
Get 10% off FAST25 with promo code- loud&clear. In this special episode of Loud & Clear: EMS Guiding Principles, we learn from the wisdom of 2 industry leaders with nearly 70 years worth of combined experience, Allen Wolfe and Michael Frakes. This episode explores the evolution of EMS education, effective training strategies, and the importance of lifelong learning. Whether you're an educa
Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature
Let's discuss the intricacies of evidence-based medicine (EBM) with Dr. Ben Li. The conversation dives deep into understanding different types of medical studies, their hierarchies, and how EMS providers can apply them to their practice. The episode covers evaluating research, the importance of study design, confounders, sample size, and how to discern the relevance and applicability of researc
How Equipment Design Can Save Lives: Why Your Bag Organization Matters More Than You Think
We discuss the importance of equipment design in EMS with Adam LaChapelle, founder of The Resus Tailor. Together we delve into the impact that effective design has on performance and patient outcomes, exploring principles such as reducing friction and visual checklists. Adam shares compelling stories and practical tips on organizing your equipment to enhance efficiency and care. The episode also
NEW NAME! The podcast gets a new name, find out what and why...
Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey.
Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our
Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes
Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers t
Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS
Let's discuss the pressing issue of mental health among first responders, particularly within the EMS community. Will gets vulnerable and shares a personal story of trauma on the job to highlight the urgent need for mental health resources and support. Unfortunately, his story is not unique, we will all experience some level of emotional trauma while on the job. This episode features Jessica Nels
Wide Complex Tachycardia: Get Comfortable With Uncertainty
Learn a systematic approach to management of wide complex tachycardia that doesn't rely on exact rhythm identification or scoring systems with guest Dr. Kevin Butler. By understanding the physiology rather than memorizing a score or algorithm you can use Kevin's approach and ABCD mnemonic to help differentiate between ventricular tachycardia, SVT with aberrancy, and other arrhythmias. Learn how no
Trailer - Loud & Clear: EMS Guiding Principles
You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there
From Novice to Navigator: Mastering the Art of EMS Field Training
Joined by Josh, Cody, and Moose from the AlertMedicOne podcast, we explore key principles of good training, leadership, and the importance of making mistakes in a safe learning environment. We discuss strategies to foster critical thinking, introspection, and continuous improvement among trainees in the EMS field. A big part of EMS is learning to be a leader and a teacher no matter what level you
The Difference Between Equal and Equitable Care
Explore the crucial distinction between providing equal care versus equitable care within emergency medical services (EMS). We give you an in-depth discussion with Ritu Sani from The EMS Show podcast, highlighting the importance of focusing on outcome-driven quality improvement projects and addressing disparities in care. Learn how different demographics face unique barriers to healthcare, and w
Life Over Limb: Field Amputation, Preparing for the Unthinkable
Dr. Avery McKenzie interviews Dr. Eric Adler, regional medical director for Flight for Life, about the challenging and rare procedure of field amputations. They discuss the importance of being prepared for the unexpected, the steps involved in developing a protocol for such emergencies, and the logistical challenges faced during the process. Dr. Adler shares insights from real-life cases and empha
The Untold Impact of EMS on Organ Donation: Transforming Tragedy into Hope
In this episode, we discuss the profound impact that one patient's organ donation can have on society. Even when not every patient gets to go home, the ability to donate organs can positively affect up to 80 people, multiplying our impact and service to the community. Guest Chris Meeks, a critical care flight paramedic and organ recovery coordinator discusses the ethical considerations and the sur
Values-Driven Leadership Within A Just Culture- Chris Pfingsten from EMS 20/20
Creating lasting behavioral changes in the workplace by moving beyond consequence-based policies. Chris discusses the importance of aligning personal and company values, highlighting 'just culture' in EMS and its role in understanding motivations and systemic issues. The conversation covers leadership in EMS, focusing on the significance of fostering supportive relationships with staff and avoidin
Are They Choking? Esophageal Foreign Body
We delve into the management of esophageal foreign body obstructions, a common yet often misunderstood medical emergency. We discuss the symptoms and causes of esophageal food impactions, sometimes referred to as 'Steakhouse Syndrome,' and differentiate it from tracheal obstructions. We explore the protocols, potential treatments, and if there's any rationale behind treatments such as glucagon ad
10 Lessons From A Real Austere Rescue That Apply To You, No Matter Where You Work
Delve into a real-life rescue mission conducted by the U.S. Air Force Pararescue Jumpers (PJs) in the North Atlantic Ocean and learn ten crucial lessons for enhancing EMS practice. Dr. Michael Lauria shares these ten critical lessons from this challenging scenario that are essential for medical professionals working in any prehospital environment. From the importance of preparation and the power o
Bonus: A Better BVM? How I Built This EMS Cast Style- A Crazy Story About an Emergency Nurses Invention and Battle to Save Lives and Prevent Harm.
In this special bonus episode of EMS Cast, we delve into the story of Bobby Sue McCollum, an emergency nurse turned inventor. Learn about the critical issue of over ventilation in emergency medicine, the innovative VT Select device designed to address this problem, and the crazy inspiring journey of its creation. With discussions on the challenges of finding the optimal ventilation rates and volum
The Critical Four Minutes: AMAX4 framework for Anaphylaxis
Explore anaphylaxis care from the basics to the critical approach to managing severe anaphylaxis with Bruce Hoffman, FlightBridge ED senior educator. Find out what it means to be aggressive with anaphylaxis care explained through the AMAX4 framework. Learn how the framework can help reverse anaphylactic shock and prevent catastrophic outcomes. Hear the impactful story behind the framework and gai
From Errors to Excellence: Master Your Medics Geoff Murphy on the role of mistakes in EMS education
The Power of Embracing Mistakes- Special guest Geoff Murphy, founder of Master Your Medics, shares how acknowledging and learning from mistakes can save lives in the field of prehospital medicine. Recorded at the Fast 24 conference, this episode emphasizes the importance of cultivating a culture of safety, vulnerability, and continuous learning within EMS teams. Discover actionable strategies to f
Poisons of the Sea: Not Just a Coastal Problem
Think you only need to worry about toxicities that exist in the sea if you live by an ocean? Think again. No matter where you are fish may be on the menu, or there may be a zoo nearby, or a marine enthusiast with an elaborate home aquarium. These toxicities can be seen in Colorado. They can be in Australia or in the US. No matter where you are you have the potential to see one or many of these. Fr
The Critically Sick Runner: Unraveling the Mystery at an Ultra-endurance Event with Dr. Whitney Barrett
Dr. Whitney Barrett, the Medical Director of the Highlonsome 100 mile ultra endurance race, discusses the critical considerations for EMS providers when encountering sick runners during endurance events. Insights on managing ultra-endurance athletes, focusing on conditions such as hyponatremia, dehydration, electrolyte imbalances, and the unique challenges presented by high-altitude races. Learn
EMCRITs Scott Weingart on How to Master the Resuscitation
EMCRIT's Scott Weingart discusses the concept of being a true resuscitationist. The mindset necessary for providing aggressive, excellent care outside hospital boundaries and the emphasis on the importance of preparation, critical thinking, and meticulous attention to detail in emergency medical situations. Dr. Weingart shares insights on mental simulation, embracing challenges, handling crises ef
Building Better Providers: Eric Bauer, Lessons from FlightBridgeED
Will and I recently attended FAST24, an educational conference hosted by FlightBridgeED in Wilmington, North Carolina. We had a fantastic time meeting industry top speakers, including Eric Bauer, one of the original founders of FlightBridgeED. In today's episode, we delve into Eric's journey in EMS education, how FlightBridgeED was conceived, and the importance of continuous learning. We also disc
Mushrooms: The Perils and Pleasures with Toxicologist Dr. Nik Matsler
In this episode, we delve into the fascinating and often perilous world of mushrooms. Join us as we explore with Dr. Nik Matsler how these fungi can be a culinary delight, a source of psychedelic experiences, or a deadly hazard. We discuss the challenges of identifying mushrooms, even for experts, and why toxicologists rely on mycologists for accurate identification. We'll break down the different
Electrical Injuries and Lightning strikes
Derek Miller, outreach coordinator for the UNC JC Burn Center, joins us again to explore electrical injuries and lightning strikes. We discuss the various types of electrical injuries, the mechanisms behind these injuries, and the essential steps EMS providers must take to ensure their safety and provide effective patient care. Through real-life case studies and expert insights, this episode delve
Stroke Care on the Streets, What Actually Matters? Bridging Research and Real-World EMS
Explore the nuances of stroke assessments, the challenges EMS professionals face in the field, and the impact of prehospital interventions on patient outcomes. Coco Wham, a former paramedic who's transitioned to a physician, and Dr. Layne Dylla, an associate professor of emergency medicine join us to dive into their ongoing research efforts aimed at defining what matters in prehospital stroke care
The Critically Burned Patient Part 2- What You learned About Fluids Was Wrong, A Simpler Approach
This is Part 2. Derek, an experienced clinician in burn care, joins us to delve into the intricacies and challenges of treating burn patients. This discussion provides valuable insights into the unique aspects of burn injuries, the importance of a comprehensive assessment, and the latest trends in burn treatment.
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The Critically Burned Patient - Part 1
Derek, an experienced clinician in burn care, joins us to delve into the intricacies and challenges of treating burn patients. This discussion provides valuable insights into the unique aspects of burn injuries, the importance of a comprehensive assessment, and the latest trends in burn treatment.
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Rethinking Priorities in Out-of-Hospital Cardiac Arrest - Which Comes First Epi or Airway?
Which comes first epinephrine or airway? Out of hospital cardiac arrests involve critical and often complex decisions with sequence and timing of various procedure. What should you prioritize? We examine the nuances of advanced interventions, such as epinephrine and advanced airway placement, through the lens of recent studies, including a notable piece of research published recently in JAMA Netwo
Toxic Alcohols: Hidden Danger in Everyday Products and an Everyday Call
Toxicologist Dr. Nik Matsler teaches us the critical topic of toxic alcohol poisoning. The discussion sheds light on the dangers lurking in everyday household and industrial products that contain methanol, ethylene glycol, and isopropyl alcohol—substances not far removed from the alcohol found in beverages yet capable of causing severe, sometimes fatal, health issues.
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Art of Laryngoscopy- The SALAD technique (Suction-Assisted Laryngoscopy and Airway Decontamination)
In the high-stakes environment of prehospital medicine, the ability to perform a successful intubation on the first attempt is critical. The complexity of prehospital airway management cannot be understated, given the challenging conditions and the acuity of patients encountered. This episode delves into the strategies and techniques that can significantly improve the success rates of prehospital
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