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Learn what they didn't teach you in paramedic school

A podcast for EMS providers, we cover topics in more depth than you learned in paramedic school and connect this all back to the guiding principle of what actually matters to you the provider in the field.

“Wish I could give 6 stars. These guys are the Bob Ross of emergency care.”

Shangsnek

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About Us

Ross Orpet, MD

A board certified emergency medicine physician practicing in Colorado, I completed my residency at Denver Health Medical Center, as well as a fellowship in Emergency Medical Services. I got my start in emergency medicine working as a paramedic at the Denver Health Paramedic Division..

Will Berry, FP-C, NR-P

I have worked in EMS for 13 years and caught the bug to be involved in emergency response after working as a wilderness guide in Colorado. Most of my career was with the Denver Health Paramedic Division where I spent several years as a Lieutenant. I am currently a practicing critical care paramedic in North Carolina.

What People Are Saying

Great Podcast!

“I have been a nurse for 10 years, most of that in the emergency department. The information on this podcast is not only helpful for paramedics, but applies to ER nursing as well! I always encourage our new nurses and experienced nurses to listen to this podcast!”

Shane G33

08/31/2023

Great For First Responders

“Paramedic of 3 years here. This is the podcast I keep coming back to. I get a great mix of in-depth information beyond my scope as well as lots of practical information for me as a provider in the field.”

Rjbaker022

07/06/2023

Most Recent Episode Breakdowns

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.

Ross Orpet
May 25, 2025
Podcast Episodes
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Prehospital Management of Upper GI Bleeds: A Guide for EMTs and Paramedics

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)

Ross Orpet
May 7, 2025
Podcast Episodes
No Comments

DNR and Advanced Directives in the Prehospital Setting: These Conversations aren’t always Black and White

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

Understanding and Evaluating Medical Literature: A Guide for EMS Practitioners

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,

Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes

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

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

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Loud & Clear: EMS Guiding Principles – Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A… do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters.

Loud & Clear: EMS Guiding Principles is an EMS Cast LLC production

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 first-line vasopressor, the evidence behind those changes, and what to do when your patient is on three drips and the pressure still won’t budge. James shares practical, real-world insights from the space between the ED and ICU, where seconds matter and protocols are stress-tested in real time.

Key takeaways include: when to trust your BP reading and act, how to choose and sequence pressors based on evidence and logistics, why norepinephrine reduces arrhythmias and improves outcomes, and when to add adjuncts like steroids, sodium bicarb, or methylene blue. We also explore hidden factors like ventilator settings and underlying causes that can sabotage even the best pharmacology.

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at [email protected] or through our contact page at emspodcast.com or via DM on IG @emsloudandclear

Guest/Cast/Crew information-

Guest- James Boomhower, LMHC-A, FP-C

https://www.stayfit4duty.org/

Host- Ross Orpet

Catch up with us after the show