Let me say that again—you already have resilience. Every paramedic, EMT, and flight medic reading this possesses it. You’ve proven it a hundred times over. But […]

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).

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.

Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques and mechanical ventilation tips. 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 Calgary this episode will enhance your understanding and skills in respiratory care.

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 intubation times, pre-hospital treatment of AFib with RVR, and pre-treating with calcium before diltiazem for patients in AFib. This episode is packed with crucial, evidence-based information for best practices in the prehospital setting. Don't miss out!

Aviation transformed from a dangerous endeavor to the safest form of transportation through systematic approaches to human error. The checklist was central to this transformation, not because it eliminated the need for skill and judgment, but because it freed professionals to apply their expertise where it matters most. As paramedics, we face similar complexity and similar stakes. The question isn't whether we're capable professionals—we are. The question is whether we're willing to adopt proven tools that help capable professionals perform even better when it matters most.

How breaking procedures into achievable and believable steps transforms crisis performance and reduces burnout. Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management.

How the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this post, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence.

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 dramatically improve outcomes for these challenging patients.

In emergency medicine, few scenarios are as immediately concerning as arriving on scene to find a patient actively vomiting bright red blood. Upper gastrointestinal (GI) bleeding represents a unique challenge for EMS providers—these patients aren't trauma victims, yet they're bleeding like trauma patients. They require both the rapid intervention of trauma care and the thorough assessment of a medical patient. This guide breaks down the essential principles of managing an upper GI bleed in the prehospital setting, where your actions during those critical first minutes can significantly impact patient outcomes.

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.

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 research findings. Dr. Li provides practical advice for critically appraising literature and emphasizes doing so in a way that is personally relevant to the listener's practice. This episode is essential for anyone in EMS or emergency medicine looking to deepen their understanding of medical research and how it impacts patient care.

Syncope, is a symptom that many emergency medical personnel encounter. It's sometimes tricky to differentiate from seizures, and it's essential to understand that syncope is not a standalone diagnosis. It's a symptom of an underlying cause, which can be benign or life-threatening. Let's delve into the world of syncope, explore its clinical significance, and discuss how EMS providers can effectively assess and risk stratify patients who experience it.

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 Nelson, the coordinator of the groundbreaking program and first of its kind state legislation, PATH4EMS. PATH4EMS provides free and confidential mental health care for EMS professionals. We delve into strategies for normalizing mental health conversations, the importance of trauma-informed care, and the benefits of proactive mental health practices. The discussion also covers the need for tailored, evidence-based resources and the unique challenges faced by rural first responders. Tune in to learn about the vital steps being taken to ensure the well-being of those who brave the front lines.

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 not to miss the vital mimics with his SPAM filter. And finally by understanding which treatments are safe and which treatments potentially dangerous you can understand how to move forward even when you're not exactly sure what the arrhythmia is.

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 are at so whether you are a trainee, a field trainer, teach students during their rides, or merely work with a partner there's something for everyone to learn in this one. Tune in for an insightful discussion on how to develop and become excellent EMS professionals through solid training and leadership.

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 why recognizing these differences is essential to improving outcomes across various communities. Watch as real-life examples illustrate the need for equitable interventions and the systemic factors that contribute to inequities in EMS.

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 emphasizes the critical need for planning and knowing the resources available in urgent scenarios.

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 surprising impact EMS has on the potential for organ donation, even in cases that appear to be 'lost causes'. Tune in to understand how your work in EMS may have more far-reaching positive effects than you realize.

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 avoiding fear-based management. Additionally, Chris shares his journey from paramedic to Field Training Officer, offering advice on effective training and mutual support. This episode is packed with valuable insights for anyone in the EMS field aiming to enhance performance, commitment, and team dynamics. Don't forget to check below for further resources on just culture and motivational learning.

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 administration. Join us as we also share real-life scenarios to better illustrate the challenges and solutions when dealing with such medical cases.

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 discusses these lessons, derived from a real-life experience in delivering critical care in a challenging austere environment, emphasizing both technical and mental preparedness.

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 gain insight into the most effective practices for treating unresponsive anaphylactic and asthmatic patients. Special thanks to the McKenzie family for their mission-driven educational work. 

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. From scombroid poisoning to puffer fish, irukandji syndrome, jellyfish, and sea snakes- tune in to this week's episode to learn all about the various poisons that come from the sea with toxicologist Nik Matsler.

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 about effective rehydration and cooling strategies, and the critical role of context in diagnosing and treating affected runners.

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 efficiently, and continuous self-improvement. We conclude our discussion by exploring the philosophy 'Amor Fati' and underscore the broader impact EMS professionals can have beyond simply saving lives.

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 discuss the challenges of becoming an expert in the field and tips on improving your skills incrementally. Join us as we explore these valuable insights and look forward to upcoming episodes featuring more stellar guests from FAST24!

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.

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 delves into the complexities of managing electrical burn patients, the importance of immediate interventions, and the potential long-term sequelae of such injuries. Tune in for practical advice and essential knowledge to enhance your skills in handling electrical emergencies. Here are some additional resources: Electrical Injuries Overview- Nice overview, though not limited to EMS specifically. The references list at end is also a good jumping off spot for those wanting more.

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 and refining stroke response protocols. Hear firsthand how evidence-based practices are developed from the ground up in EMS settings. This episode is packed with valuable information to enhance your practice and understanding of stroke care in prehospital environments.

Burn injuries are among the most intimidating emergencies faced by prehospital care providers. The intricacies of managing such cases were vividly discussed in our recent podcast featuring Derek Miller, an experienced burn nurse with a deep understanding of burn care. This post delves into the key takeaways from the podcast, offering practical guidance and insight to enhance the care of burn patients in the prehospital setting.

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 Network Open. Take a deep dive into the practicalities and philosophies that underpin prehospital cardiac arrest management, emphasizing the significance of basic life support skills and the role of advanced techniques in the pre-hospital setting. This episode engages, educates, and challenges EMS providers on the best practices that could potentially save lives during those critical first minutes of a cardiac emergency.

In the ever-evolving landscape of emergency medicine and prehospital care, it's crucial for EMS providers to stay informed about less common but potentially lethal exposures. One such category is toxic alcohols, which can be misleading due to their presence in household and industrial products rather than just the beverages we typically associate with alcohol ingestion. In this episode, we delve into the critical information about toxic alcohols, with guest toxicologist Dr. Nik Matsler.

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 article delves into the strategies and techniques that can significantly improve the success rates of prehospital intubations, focusing on preparation, positioning, and the SALAD (Suction-Assisted Laryngoscopy and Airway Decontamination) method.

Despite the allure of consistent compressions and reduced provider fatigue, does the data actually show that mechanical CPR devices improve outcomes? Tune in for a nuanced exploration of evidence-based practice in emergency medical services.

Welcome to the world of neonatal resuscitation, a realm where quick thinking and decisive action are essential. In this episode of EMS cast, Dr. Avery MacKenzie, […]

We delve into the high-stakes world of postpartum hemorrhage management with the esteemed Dr. Maria Moreira. Joins us to demystify the management of postpartum hemorrhage in the pre-hospital setting. Dr. Moreira presents a systematic approach to intervention. Learn about the four T's of postpartum hemorrhage and on-field strategies like tranexamic acid and uterotonic administration. Dr. Moreira guides us through a concise roadmap for effective pre-hospital care. Tune in for critical insights and be prepared for any obstetric emergency!

In this episode Dr. Maria Moreira joins us to talk us through prehospital pregnancy difficult deliveries. We'll discuss how to handle nuchal cords, cord prolapse, breech presentations, and shoulder dystocias.

Non-invasive positive pressure ventilation. Non-invasive positive pressure ventilation (NIPPV) is a therapy that has revolutionized emergency medicine. NIPPV, also known as non-invasive ventilation, BiPAP (Bi-Level Positive […]

Hemorrhagic shock, characterized by a significant loss of blood volume, characterized by end organ dysfunction as the result of inadequate tissue profusion. It is a life-threatening medical emergency that requires rapid assessment and intervention. Timely recognition of its severity and continuous monitoring of the patient's condition are paramount to guide appropriate treatment strategies. One valuable emerging tool in this critical setting is the measurement of end-tidal carbon dioxide (ETCO2) levels. ETCO2 monitoring provides crucial information about a patient's cardiovascular status and can aid healthcare providers in making informed decisions for resuscitation and management. In this article, we will explore the role of ETCO2 in the context of hemorrhagic shock and review some of Dr. Eric Campion's research in this field.

Dr. Spencer Tomberg, a physician in the Department of Emergency Medicine and Orthopedics at Denver Health, discusses pain management and the complex nature of pain perception, highlighting the physical and emotional components. He describes how individuals may have different perceptions of pain due to variations in the action potential and synaptic regions. He dives into the etiology and routes of pain signals from the visceral system and how that contributes to referred pain. He also discusses the differences in treatment when approaching acute, subacute, and chronic pain. Ultimately, it's important to consider the individuality of pain experiences when treating patients and not take a one size fits all approach. Check out another great lecture from the Rocky Mountain Trauma and Emergency Medicine Conference.

In the high-stakes world of emergency medicine, innovations continually push the boundaries of what's possible. One such groundbreaking procedure is Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Dr. Ernest E Moore, who has literally written the book on trauma surgery, teaches us what REBOA is and how it is being used to save lives in critical situations. Another lecture from the Rocky Mountain Trauma and Emergency Medicine Conference. 

Prehospital intubation, Airway management, Emergency medical services (EMS), Endotracheal intubation, Tracheal intubation, Advanced airway management, Rapid sequence intubation (RSI), Paramedic procedures, Critical care transport, Respiratory distress, Intubation equipment, Laryngoscope, Endotracheal tube (ETT), Tube placement verification, Difficult airway, Medication-assisted intubation, Sedation and paralysis, Prehospital emergency care, Complications of intubation, Ventilator support, Patient safety in intubation, Prehospital airway assessment, Intubation checklist, First responder skills, Training for prehospital intubation, Intubation success rates, Pediatric intubation, Geriatric intubation, Best practices for intubation, Intubation in trauma cases, Intubation in cardiac arrest, Intubation in respiratory failure, Prehospital intubation guidelines, Prehospital intubation vs. bag-valve-mask ventilation, Role of intubation in prehospital care, Prehospital intubation case studies, Prehospital intubation challenges, Prehospital intubation outcomes, Prehospital intubation controversies, Future trends in prehospital airway management.

Is your EMS agency prepared for a pediatric disaster? In this episode of EMS CAST, Dr. Jeffrey Upperman joins the hosts live at the Rocky Mountain Trauma and Emergency Medicine Conference. Dr. Upperman gave an entertaining and engaging lecture on what you need to start thinking about to be prepared for a pediatric disaster in your area. After his lecture he joined our podcast to discuss his passion for pediatric disaster preparedness and the journey he has taken over the past 15 years to develop educational platforms in this area. There are some easy steps you can take to make sure that you and your crew are prepared should a disaster strike. Tune in to learn more about Dr. Upperman's work and the importance of being prepared for emergencies involving children.

Stop blowing off back pain patients! There may be a true emergency lurking underneath. Dr. Bo Burns teaches us why we should be take atraumatic back pain so seriously. Join us as we unravel the complexities of spinal emergencies and learn about the latest clinical decision tools and treatment options. 

Dr. David Bliss, pediatric trauma surgeon, joins us to discuss the challenges of treating pediatric trauma patients and how we can overcome our fears and be successful. 

Earlier this month Ross and Will visited the Rocky Mountain Trauma and Emergency Medicine Conference. In addition to trauma games and sim wars, there were so […]

What is the ACS? It is important to listen to experts in the field, and the American College of Surgeons (ACS) is a great example of […]

EKGs from the case Nitroglycerin for acute coronary syndrome. Nitroglycerin is a medication commonly used to treat acute coronary syndrome, a condition in which the coronary […]

The Glasgow Coma Score (GCS) was developed in the 1970s initially as a research tool for admitted Neurosurgery patients. The original authors of the score and research advocated against it's widespread use in acute care but nevertheless here we are: it is widely used in acute trauma and medical care. Other than a score of 3 or a score of 15, there are multiple combinations of numbers that can get you various scores. This results in a poor ability to know what the patient is actually doing.

You arrive on scene to find an unconscious patient with pinpoint pupils and slow breathing. You administer naloxone. Nothing happens. The patient remains apneic. What now? […]

Serotonin Toxicity is a spectrum. Early recognition and treatment is key to preventing bad outcomes.

Diabetic Medications There are a myriad of diabetic drugs out there, all with strange and difficult to pronounce names. So how do we keep this straight? […]

Episode Transcript  Ross: Welcome to EMS Cast, where we provide high level education for you, the providers on the streets. I’m your host Ross Orpet  Matt: […]

Are you running your traumas as efficiently as you should? Dave Edwards shares with us the ideal approach/philosophy/teaching tool to how theses calls should ideally go. This document is years in the making with input from Trauma Surgeons, Emergency Physicians, and Paramedics to help clearly delineate our priorities in trauma.

The sick asthmatic is one of the scariest calls you may run. You need to understand this is different from other respiratory distress. Your treatments can have a profoundly negative impact on the patient if you don’t understand the physiology. But if you do understand what is going on, you can make a real difference and save a life.

It seems like there are new drugs hitting the streets every month. That's because there are and there's a reason for that! Come learn why and what we need to look out for and be aware of on the streets. Welcome back Dr. Nik Matsler who's going to take us through how novel drugs escape our legal system and what the dangers are. And a new update on good ol' meth too!

Ben Fisher, paramedic and NEMSIS guru, joins us to talk about what NEMSIS is and it’s importance to the career field. The National EMS Information System […]

Dr. Wright joins us to discuss acute respiratory distress syndrome (ARDS). There has been a lot said about ARDS recently given some of it’s similarities to […]

Tips on calling medical control. Assistant Medical Director Whitney Barrett discusses the dos and don'ts of calling in for medical control. 

This is still included in the A of ABCs but I got essentially no training on this in paramedic school. Airway problems are terrifyring without an approach to solve them. But when you have an approach you can fall back on that with a calm confidence. It’s like we’ve always heard: we don’t rise to the occasion, we fall to the level of training. With trach’s, we unfortunately have to train ourselves.

We have important information to share. Where do our communication skills fail us and how can we be better?

Caring for the critically ill pediatric patient is scary for all emergency providers. We discussed our approach to these calls with attending EM/EMS physician Dr. Whitney Barrett.

Maria "The Hammer" Moreira breaks down our approach to penetrating neck wounds.

Dan Willner breaks down the latest and greatest endovascular therapy since PCI.

Toxicology specialist, Dr. Janetta Iwanicki, joins us to discuss toxidromes and all the fun they bring us.

So we started a podcast. But why?