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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. 00:00 Introduction: Equal vs. Equitable Care00:23 Case Study: CPR Training Disparities01:09 Understanding Barriers to Equitable Care03:31 Guest Introduction: Ritu Sani from EMS Show Podcast04:33 Interactive Exercise: Demonstrating Inequity06:36 Quality Improvement: Focusing on Outcomes08:09 Challenges in Achieving Equitable Care09:25 Diversifying EMS Workforce10:11 Systemic Factors and Data-Driven Solutions11:03 Starting with Equitable Care11:17 Key Areas to Focus On11:26 Analyzing Data for Disparities12:12 Addressing Provider Reactions13:00 Implementing Quality Improvement13:35 Implicit Bias and Introspection14:17 Patient Outcome Driven Approach14:33 Challenges and Structural Abnormalities15:16 Conclusion and Final Thoughts Gear We LikeGood Stethoscope - https://amzn.to/3YJJrf2Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn Notepad for taking notes on calls - https://amzn.to/3Z1X21JSunglasses - https://frontline-optics.com/discount/EMSCAST15Books we recommend - The Dichotomy of Leadership - https://amzn.to/4fiCAjNExtreme Ownership - https://amzn.to/3O1FWfa Managing the Unexpected: Sustained Performance in a Complex World - https://amzn.to/3V7BwYfThinking Fast and Slow - https://amzn.to/4fiJG85A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back - https://amzn.to/3YJJrf2Guest/Cast/Crew information-Guest- Ritu Sani, MD and Co-host of The EMS Show podcastHost- Ross Orpet, Chris Pfingsten from EMS 20/20Catch up with us after the showInstagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com
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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.
00:00 Emergency Field Amputation: A Real-Life Scenario00:25 The Reality of Unlikely Medical Emergencies02:04 Introducing Today's Episode and Guest04:26 Dr. Eric Adler's Experience and Protocol Development05:46 Indications and Procedures for Field Amputation10:50 Challenges in Creating a Field Amputation Protocol14:23 Final Thoughts and PreparednessResources
Website show notes link (picture of the kit and copy of the protocol): https://emspodcast.com/life-over-limb-field-amputation-preparing-for-the-unthinkable/Other episodes you might like: Episode 31- You Were Taught Wrong, Traumas Not AlgorithmicGear We Like
Good Stethoscope - https://amzn.to/3YJJrf2Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn Notepad for taking notes on calls - https://amzn.to/3Z1X21JSunglasses - https://frontline-optics.com/discount/EMSCAST15Books we recommend - The Dichotomy of Leadership - https://amzn.to/4fiCAjNExtreme Ownership - https://amzn.to/3O1FWfa Managing the Unexpected: Sustained Performance in a Complex World - https://amzn.to/3V7BwYfThinking Fast and Slow - https://amzn.to/4fiJG85A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back - https://amzn.to/3YJJrf2Guest/Cast/Crew information-Guest- Erik AdlerHost- Ross Orpet, Avery MackenzieCatch up with us after the show
Instagram- @emscastWebsite- www.emspodcast.com -
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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. 00:00 Introduction: The Impact of EMS on Organ Donation00:43 Ethical Considerations in Organ Donation01:10 Current Research and EMS's Role02:04 Guest Introduction: Chris Meeks05:04 Ethical Dilemmas and Future Directions08:25 Organ Donation Criteria and Processes13:28 Conclusion: The Importance of EMS in Organ Donation
Guest/Cast/Crew information-
Guest- Chris Meeks, Critical Care Flight Paramedic, Organ Recovery Coordinator
Host- Ross Orpet, Will Berry
Catch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com -
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.
Guest/Cast/Crew information-
Guest- Chris Pfingsten, Co-host of EMS 20/20
Host- Ross Orpet, Will Berry
Resources
Other episodes you might likeEp. 72 From Errors to Excellence with Geoff Murphy, Master Your MedicsBooksJust Culture- https://amzn.to/4eOMN7wCrucial Conversations- https://amzn.to/3BRBnRI YouTube Videos- Why do Errors Happen? How can we prevent them?How can a system get organized for improvement?Catch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com -
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. Resources and linksThis episode was inspired by an article on EMSAirway.com- Friday Night Lights- Shift 9 Steak Night EMScast15 - code for 15% off an awesome pair of sunglasses Help Us By Filling Out Our Audience Survey Medic Box - awesome medical gear shipped directly to your door Articles-
American Society for Gastrointestinal Endoscopy- Guidelines for ingested foreign bodies
Glucagon for Relief of Acute Esophageal Foreign Bodies and Food Impactions: A Systematic Review and Meta-Analysis.
Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial
Conservative management of oesophageal soft food bolus impaction
Esophageal Food Impaction: A Retrospective Chart Review
Food Bolus Impaction- Question and Answer Review
Guest/Cast/Crew information-
Host- Ross Orpet, Will Berry
Catch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com 00:00 Introduction to Esophageal Foreign Bodies00:43 Audience Survey and Sunglasses Giveaway01:46 Interview with Contest Winner06:11 A Choking Incident at Mile High Stadium09:02 Discussion on Esophageal Obstructions11:46 Life-Saving Story at Denver International Airport13:28 A Life-Saving Outcome14:11 The Choking Incident at the Tavern14:57 Assessing the Patient's Condition19:38 Understanding Esophageal Food Impaction21:49 Treatment Options and Challenges29:01 The Role of Endoscopy37:45 Managing Esophageal Impactions in the Field39:32 Final Thoughts -
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 of a small team, to the significance of continuous learning and the dynamic nature of safety, these insights are invaluable for enhancing clinical practice. Tune in to learn how these lessons can be applied to improve how you approach the job.
EMScast15 - code for 15% off an awesome pair of sunglasses Tell us about you and how we can make this show better Medic Box - awesome medical gear shipped directly to your doorGuest/Cast/Crew information-
Guest- Dr. Mike Lauria
Host- Ross Orpet, Will Berry
Resources
Other episodes you might likeThird-party websites where you can learn morePodcast announcementsCatch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com -
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 volumes, the episode balances medical data and personal narrative. Bobby Sue shares the highs and lows of her entrepreneurial path, from initial prototype development to eventual licensing, offering valuable insights for aspiring inventors in the medical field. Resources Mentioned in the Show-VT Select Bag Valve MaskA Review of Ventilation in OHCA
Pediatric BVM Delivers More Ideal Volumes in Mannequins
Small BVMs Lead to Decreased Survival in a Small Real World Study
00:00 The Problem with Overventilation00:53 Introduction to the VT Select Device02:01 Meet the Inventor: Bobby Sue McCollum05:06 The Journey of Invention12:10 How the VT Select Works14:04 Challenges and Triumphs27:37 Advice for Aspiring Inventors31:15 Conclusion and Final Thoughts -
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.
Resource linksEpisode Blog Post / Show Notes AMAX4 websiteAnaphylaxis deep diveUpdated Anaphylaxis Definition EMScast15 - code for 15% off an awesome pair of sunglasses Help us learn how to make this show better for you Medic Box - awesome medical gear shipped directly to your doorGuest/Cast/Crew information-
Guest- Bruce Hoffman- Goodwin University Program Director and Assistant Professor, FlightBridgeED senior educator, Bay State Health Critical Care RN and Paramedic
Host- Ross Orpet, Will Berry
Catch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com -
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 foster a psychologically safe environment where mistakes are openly discussed and used as invaluable learning tools to enhance professional development and patient care. This insightful discussion is a must-watch for anyone looking to elevate their skills and create a high-performing EMS team.
EMScast15 - code for 15% off an awesome pair of sunglassesEnter to Win a FREE Pair of Frontline Optics SunglassesMedic Box - awesome medical gear shipped directly to your doorGuest/Cast/Crew information-
Guest- Geoff Murphy, founder of Master Your Medics
Host- Ross Orpet, Will Berry
Resources
Ep. 31 You Were Taught Wrong, Traumas Not AlgorithmicMasterYourMedics.comCatch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com00:00 Introduction: The Power of Discussing Mistakes
00:38 Welcome to EMS Cast
00:52 Today's Topic: How Mistakes Can Save Lives
01:16 Embracing Failure: Insights from Jeff Murphy
01:37 Creating a Culture of Safety and Vulnerability
06:29 The Fearless Organization: High vs. Low Performing Teams
11:49 Personal Stories: Learning from Mistakes
19:15 Master Your Medics: The Journey and Vision
23:43 Conclusion: The Path to Mastery
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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.
Website show notes linkEMScast15 - code for 15% off an awesome pair of sunglassesEnter to Win a FREE Pair of Frontline Optics SunglassesMedic Box - awesome medical gear shipped directly to your doorGuest/Cast/Crew information-
Guest- Dr. Nik Matsler
Host- Dr. Ross Orpet and Critical Care Paramedic Will Berry
Resources
Other episodes you might likeEpisode 26: Snake BitesEpisode 25: Cocaine OverdoseThird-party websites where you can learn moreMarine Envenomations Journal Article5 Step Approach to Marine EnvenomationsCatch up with us after the show
Instagram- @emscastTwitter- @ems_castWebsite- www.emspodcast.com -
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.
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Blog Post and Critical Runner Algorithm- The Critical Care of the Sick Runner
00:00 Introduction and Hosts00:39 Conference Recap01:03 Guest Introduction: Dr. Whitney Barrett01:29 Understanding the Sick Runner02:29 Medical Considerations for Ultra Marathons08:15 Common Issues in Ultra Runners12:45 Responding to Sick Runners19:42 Fluid Management and Hyponatremia35:10 Handling Hyperthermia and Hypothermia44:05 Dealing with Collapsed Runners53:36 Final Thoughts and Takeaways -
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.
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Blog Post- How to Master the Resuscitation
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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!
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Blog Post- Building Better Providers
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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 types of mushrooms—non-toxic edible varieties, toxic species, and psilocybin-containing "magic mushrooms." Learn the practical tips for EMS professionals on managing mushroom poisoning, including supportive care strategies and specific interventions for severe cases.
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Episode Blog Post- The Perils and Pleasures of Mushrooms
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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.
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Blog Post- Electrical Injuries and Lightning Strikes
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.
Photo examples- Variety of pictures
As mentioned at the end, fireworks safety- https://www.safefireworksnc.com/
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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.
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Blog Post- Stroke Care on the Streets
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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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Blog post- The Critically Burned PatientKey Topics CoveredComplexity of Burn Injuries: Derek begins by explaining why burn patients require a unique approach compared to other trauma patients. He highlights the potential for burns to mask other critical injuries, underscoring the necessity of a thorough and trauma-informed initial assessment.
The 'Big Three' Considerations: The conversation shifts to what Derek refers to as the "big three" — polytrauma, airway loss, and inhalation injuries — which are crucial early considerations in burn care. He stresses the importance of recognizing these potentially life-threatening conditions alongside the burn injury itself.
Fluid Resuscitation: A significant portion of the discussion is dedicated to fluid resuscitation, a critical aspect of burn care. Derek talks about the Parkland formula for calculating fluid needs based on the total body surface area affected by burns but a better simpler method is-
500 ml/hr for an adult (<13 yo)250 ml/hr for a young kid (6-13 yo)125 ml/hr for a child (<5 yo)Pain Management and Ethical Concerns: Derek addresses the ethical and practical aspects of pain management in burn victims. Effective pain control not only improves patient comfort but also aids in overall patient management and long term healing, making it a critical component of the initial response.
Assessment Tools and Techniques: Various assessment tools such as the Rule of Nines and the Palmer Method are discussed. Derek explains their applications and limitations, emphasizing that while these tools are helpful for initial assessments, more detailed evaluations are typically conducted at specialized burn centers. A link from ABA that may be helpful: https://ameriburn.org/resources/burnreferral/ Includes brief overview of severity/depth (with diagrams, not pictures), Rule of Nines & Palmar Method, plus a link for ABA referral criteria.Here is another great article for a deeper dive into pros & cons of different methods of estimating TBSA, although not exhaustive, per se.
Gretchen C., Burn size estimation: A remarkable history with clinical practice implications,Burns Open, Volume 8, Issue 2, 2024, Pages 47-52, ISSN 2468-9122
Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations, The Journal of Emergency Medicine, Volume 65, Issue 4, 2023, Pages e320-e327.Burn depth estimates: There are free diagrams out there, but for actual real wound pictures, very little is open-license. UpToDate has a decent starting place, with four pictures embedded, and likely accessible for most.https://www.uptodate.com/contents/assessment-and-classification-of-burn-injury?search=burn%20depth&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1
Other Scientific papers mentioned-
Burn resuscitation
First article is an overview of evolution of burn fluid resuscitation formulas & philosophy – although again, not exhaustive, per se.
Bacomo, F. K., & Chung, K. K. (2011). A primer on burn resuscitation. Journal of emergencies, trauma, and shock, 4(1), 109–113.
Next article underscores the risks of fluid creep. Starting too high, being reluctant to titrate down, and the fact that giving too much fluid can actually CAUSE an increased need for fluids (vicious cycle).
Chung KK, Wolf SE, Cancio LC, Alvarado R, Jones JA, McCorcle J, King BT, Barillo DJ, Renz EM, Blackbourne LH. Resuscitation of severely burned military casualties: fluid begets more fluid. J Trauma. 2009 Aug;67(2):231-7; discussion 237. doi: 10.1097/TA.0b013e3181ac68cf. PMID: 19667873.
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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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**CORRECTION** In the summary at the end of the episode, the rule of 5's was inappropriately attributed to the pediatric population. Rule of Fives is meant for morbidly obese adults, not for kids. Lund-Browder is great tool for peds of different age ranges, though still doesn’t address body morphology (obese kids).
Resource- Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations, The Journal of Emergency Medicine, Volume 65, Issue 4, 2023, Pages e320-e327.Blog post- The Critically Burned PatientKey Topics CoveredComplexity of Burn Injuries: Derek begins by explaining why burn patients require a unique approach compared to other trauma patients. He highlights the potential for burns to mask other critical injuries, underscoring the necessity of a thorough and trauma-informed initial assessment.
The 'Big Three' Considerations: The conversation shifts to what Derek refers to as the "big three" — polytrauma, airway loss, and inhalation injuries — which are crucial early considerations in burn care. He stresses the importance of recognizing these potentially life-threatening conditions alongside the burn injury itself.
Fluid Resuscitation: A significant portion of the discussion is dedicated to fluid resuscitation, a critical aspect of burn care. Derek talks about the Parkland formula for calculating fluid needs based on the total body surface area affected by burns but notes that real-time adjustments are often necessary to avoid complications like over-resuscitation.
Pain Management and Ethical Concerns: Derek addresses the ethical and practical aspects of pain management in burn victims. Effective pain control not only improves patient comfort but also aids in overall patient management and long term healing, making it a critical component of the initial response.
Assessment Tools and Techniques: Various assessment tools such as the Rule of Nines and the Palmer Method are discussed. Derek explains their applications and limitations, emphasizing that while these tools are helpful for initial assessments, more detailed evaluations are typically conducted at specialized burn centers. A link from ABA that may be helpful: https://ameriburn.org/resources/burnreferral/ Includes brief overview of severity/depth (with diagrams, not pictures), Rule of Nines & Palmar Method, plus a link for ABA referral criteria.Here is another great article for a deeper dive into pros & cons of different methods of estimating TBSA, although not exhaustive, per se.
Gretchen C., Burn size estimation: A remarkable history with clinical practice implications,Burns Open, Volume 8, Issue 2, 2024, Pages 47-52, ISSN 2468-9122
Burn depth estimates: Unfortunately, all of my favorite wound pictures for discussing 1st/2nd/3rd degree (superficial; both superficial & deep varieties of partial-thickness; full-thickness) are copyrighted, etc. There are free diagrams out there, but for actual real wound pictures, very little is open-license. UpToDate has a decent starting place, with four pictures embedded, and likely accessible for most.https://www.uptodate.com/contents/assessment-and-classification-of-burn-injury?search=burn%20depth&source=search_result&selectedTitle=1%7E150&usage_type=default&display_rank=1
Part 2: This is just part 1. Part 2 will be coming May 1st. We will simplify our approach to fluid resuscitation and dive into some nuances of burns and burn care.
Other Scientific papers mentioned-
Burn resuscitation
First article is an overview of evolution of burn fluid resuscitation formulas & philosophy – although again, not exhaustive, per se.
Bacomo, F. K., & Chung, K. K. (2011). A primer on burn resuscitation. Journal of emergencies, trauma, and shock, 4(1), 109–113.
Next article underscores the risks of fluid creep. Starting too high, being reluctant to titrate down, and the fact that giving too much fluid can actually CAUSE an increased need for fluids (vicious cycle).
Chung KK, Wolf SE, Cancio LC, Alvarado R, Jones JA, McCorcle J, King BT, Barillo DJ, Renz EM, Blackbourne LH. Resuscitation of severely burned military casualties: fluid begets more fluid. J Trauma. 2009 Aug;67(2):231-7; discussion 237. doi: 10.1097/TA.0b013e3181ac68cf. PMID: 19667873.
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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.
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Articles-
Sequence of Epinephrine and Advanced Airway Placement After Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2024 Feb 5;7(2):e2356863. doi: 10.1001/jamanetworkopen.2023.56863.
Association of timing of epinephrine administration with outcomes in adults with out-of-hospital cardiac arrest. JAMA Netw Open. 2021;4(8):e2120176. doi:10.1001/jamanetworkopen.2021.20176
Epinephrine in Out of Hospital Cardiac Arrest: A Network Meta-analysis and Subgroup Analyses of Shockable and Nonshockable Rhythms. Chest. 2023 Aug;164(2):381-393. DOI: 10.1016/j.chest.2023.01.033
A Randomized Trial of Epinephrine in Out of Hospital Cardiac Arrest. (PARAMEDIC2) New Eng J Med. DOI: 10.1056/NEJMoa1806842
The influence of time to adrenaline administration in the Paramedic 2 randomised controlled trial. Intensive Care Med. 2020;46(3):426-436. doi:10.1007/s00134-019-05836-2
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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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Blog Post- Toxic Alcohols
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