Episodit
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Matt and Will continue discussing the use of fibrinolytics with several other disease processes we commonly see in emergency medicine. This includes STEMIs and pulmonary emboli. As we go through the uses and dosing Will and Matt talk about some of the indications and thought processes that go into using these medications and when to pull the tirgger on utilization.
This is part 2 of 2 with fibrinolytic use.
As always, please feel free to email us at [email protected] for any questions, comments, or concerns with our podcast.
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Matt and Will take the first step in a deep dive into the use of fibrinolytics in the emergent setting. This episode covers some history and considerations when using and discussing fibrinolytic use in patients. We also take an in-depth look at the contraindications and why they are what they are.
This episode primarily focuses on the current most common use of fibrinolytics with strokes. Matt and Will go into discussing as well what to consider and watch for after using one of these medications.
This is part 1 of 2 with fibrinolytic use.
As always, please feel free to email us at [email protected] for any questions, comments, or concerns with our podcast.
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Puuttuva jakso?
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In this episode, we take a little different path than our usual clinical realm and look at spatial disorientation. This is a relatively common occurrence in the aviation world, but also has many other applications from ground EMS to everyday life. We are joined by John Barnes who is the lead pilot at our AirCare 4 base in Greenwood with a military background and single pilot instrument flight rated (SPIFR). Will and John discuss many experiences with spatial disorientation and what we can do remain safe through occurrences like these in the HEMS and EMS industry.
As always any suggestions, comments, or otherwise please email us at [email protected]
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In this episode, Adyn, Dr. Nathan Freeman, and Will discuss some of the biggest aspects of pediatric sepsis, and specifically early identification and management of septic shock. Everything from basic recognition of sick to pressors of choice and standard dosing is discussed by the three. Early identification and management is key to improving the morbidity, mortality and length of stay of some of these challenging patients.
As always if you have any question or want to give feedback to our team, please contact us at [email protected]
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We are joined in this episode by Dr. Jessie Harvey of UMMC Critical Care along with Davis and Will to discuss some of the basics behind ventilators and their management. These devices can really make or break a patient's day often times and they are an important tool to be utilized in emergency and critical care medicine.
The group discusses everything from non-invasive to invasive modalities, including what some of the basic rational for "why they do what they do" with respect to changin modalities and settings. Come along with us as we discuss vents!
As always if you have any questions, comments, or concerns, please feel free to email us a [email protected]
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Matt and Will discuss adrenals and the disease processes often found in the emergency medicine world that can really cloud a picture clinically. These patients are often very complex and can be quite difficult to diagnose, especially pre-hospital or with limited ability for testing.
Take a deep dive as we discuss topics like, adrenal insufficiency and Cushing's Syndrome.
As always if you have any feedback or comments please feel free to reach out via email at [email protected]
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We take a step back from the clinical side in this episode to focus on the clinician and the clinical care team. Cori, Brad, and Will all dive into discussions on defining PTSI and PTSD in the healthcare world, especially with such a heavy spotlight to awareness brought on through COVID. Each share personal experiences, resources, and different avenues to how to identify and work on mental health in public safety and healthcare.
As always if there is anything you would like to comment on please drop us an email below.
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In this episode of Blue Crew Medicine Will is joined by Matt and Michael to discuss the ups and downs of thyroids and how these disease processes matter in emergency medicine and the critical care transport realm. Everything from thyroid storm basics on down to considerations in medication utilization are discussed with these patients.
As always, feel free to reach out if you have any questions to our email below.
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This is a continuation of our episode at the MS Trauma Foundation Symposium in May of 2023.
This part of the episode starts with Beth who discusses PTSD and trauma and their correlation.We then wrap up the episode talking with Michelle who discusses some great insights into pediatric concussions and their management.
Beth Huffmaster NP
Dr. Michelle Goreth NP
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Since we were down at the MS Trauma Foundation Symposium May 1st-4th, we had the opportunity to sit down with several people throughout emergency and critical care and discuss some of the hot topics in the trauma, emergency medicine, EMS, and rural healthcare realm.
John Gardner - MTF Executive Director
Mike Cole - Director Covington County EMS
Todd Jones - Manager Covington County EMS
Dr. Benji Sessums - Program Director JCJC EMS Program
Kacey Jones - Nurse Practitioner
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This episode highlights the importance of looking at the entire patient during the airway management process and the utilization of hemodynamics in clinical assessment and management. Charlie, Davis and Will discuss in depth some of the findings and adjunct they utilize to help facilitate airway management.
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Dr. Doherty and Dr. Duran (PGY5 Neurosurgery Resident) join Will in discussing all things with acute spinal cord injuries. They dive into definitions and differentiations between neurogenic and spinal shock along with assessment and management of these often complex patients.
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In this episode we are joined by Emily Wells and Lauren Russell. These are two of the awesome neonatal nurses who have been a part of AirCare and our neonatal team for the last several years. Will talks with them about some of the basics of neonatal care. Some of the things discussed include APGARs, Dextrose, STABLE, Ventilation and Respiratory management. This episode takes a deep dive into some of the simplest things that these tiny little ones need.
Mixing Dextrose
https://ajemjournal-test.com.marlin-prod.literatumonline.com/article/S0735-6757(19)30220-7/fulltext
https://pemcincinnati.com/blog/521-50-dextrose-volume-hypoglycemia/#:~:text=To%20make%20D10%25%20from%20an,D25%25%20or%20D10%25%20solutions.
ETT Sizes
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Assisting_with_elective_intubation_of_the_neonate_on_the_Butterfly_Ward/
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This is a bonus episode expanding on our Liver Failure episode with Dr. Taylor Wachs, Michael Griggs PharmD, and Will Appleby CCP. We discuss the ever mysterious Blakemore tubes and how one would go about using them.
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We are joined once again by Michael Griggs PharmD, Dr. Taylor Wachs, and Will Appleby to discuss liver failure and its management and complications. We discuss everything from resuscitation management, pharmacology of course, and what are we really mitigating here.
Definition ALF - INR>1.5 with hepatic encephalopathy and no underlying cirrhosis
AST - Liver, cardiac, skeletal, kidney, brain, pancreas
ALT - SPECIFIC to liver damage
AST/ALT Ratio = 1 = Ischemia
AST/ALT Ratio > 2.5 = Alcoholism
AST/ALT Ratio < 1 = Viral, Ischemia, Toxic
HRS = Hepatorenal Syndrome
NAC (Mucomyst)
Tylenol Dosing - 150mg/kg over 1 hour, 50 mg/kg over 4 hour
ALF mitigating transplant - 150mg/kg over 15 min, 12.5mg/kg/hr for 4 hours then 6.25 mg/kg/hr for 72 hours
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This episode includes Davis, Mark, and Will discussing different types of insulins and how they are used in medical practice. This also includes how they come into play with management of patients in the critical care settings and in resuscitation management.
The graphs reference in the episodes can be found at the following:
https://www.rn.com/nursing-news/understanding-insulin-administration/
https://www.acoi.org/sites/default/files/uploads/Langer.pdf
If you have any questions please feel free to email us at [email protected]
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This is episode 2 of 2 on pediatric toxicology. This episode again discusses peds tox, but more poly-pharmacy and "skittles" induced situations that may arise. Dr. Matt, Brad, Paul, and Will go into depth on many points and tricks they have learned or picked up along the way getting to take care of these patients.
If you have any questions or additional requests, please feel free to email us at [email protected]
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This is episode 1 of 2 on pediatric toxicology discussed by Dr. Matt, Brad, Paul, and Will. This includes several cases and subjects from environmental and situational toxicology.
Please feel free to reach out to us if you have any additional questions or requests for future episodes at [email protected]
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In this episode we are joined by Dr. Rachael Morris of UMMC Maternal and Fetal Medicine along with Davis and Will. This episode goes into detail on recognition and management of mothers pre and post partum who are at risk or have preeclampsia and may progress to eclampsia.
We discuss our STORK class in this episode and if you would like to attend or are interested in more information about STORK or our MCES app, please contact us at [email protected]
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in this episode Will is joined by Dr. Weiland from the UMMC Pediatric Cardiology department. We will discuss some of what are CHDs, what are some of the management and recognition tricks. How each diagnosis presents can sometimes be a challenge, and some of stuff we discuss is the more "later onset" of these patients two to three weeks after birth. These patients also have several considerations when transporting to a tertiary center, there is some discussion about transport considerations as well.
We also discuss several management techniques and pharmacological management of several of these patients between surgeries and how complex some of those patients can be.
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