In this episode, Tyler Christifulli sits down with cardiac perfusionist Brian Cress to dig into the physiology of coronary perfusion, the mechanics of the intra-aortic balloon pump (IABP), and the clinical finesse of diastolic augmentation. Whether you're just starting to encounter balloon pumps or want to sharpen your transport strategy, this discussion is packed with visual metaphors, waveform analysis, and real-world pearls.
Jun 13, 2025•49 min
In this conversation, Dr. Peter Weimersheimer discusses various techniques and tips for performing cardiac ultrasound in emergency medicine. He emphasizes the importance of understanding probe movements such as sliding, fanning, and rocking to optimize cardiac views. The discussion also covers troubleshooting common challenges in cardiac imaging, the critical role of gel in obtaining clear images, and the transition between different cardiac views. Dr. Weimersheimer emphasizes the importance of ...
May 17, 2025•1 hr 17 min
Stroke assessment tools like BEFAST are crucial for swiftly identifying symptoms and expediting treatment. However, language barriers can hinder prompt care for non-English speakers, particularly in the Hispanic community. Developed through a collaborative effort, AHORA adapts the traditional stroke assessment to be culturally and linguistically appropriate for the Spanish-speaking population. Designing Ahora The need for a specific tool became apparent when traditional tools like BEFAST were fo...
Apr 29, 2025•34 min
Does medicine have dangerous side effects for women? Are the "normal" values we have set for diagnostics possibly endangering specific populations? In this episode of the FOAMfrat podcast, Tyler sits down with Dr.Alyson McGregor, emergency physician and author of Sex Matters, and Tim Redding, EMS educator and lecturer, to discuss the discrepancies in medical testing, diagnosis, and treatment between male and female patients. Dr. McGregor shares her journey of discovering gender bias in medicine,...
Apr 15, 2025•53 min
In this episode of the FOAMfrat podcast, join as we discuss mass casualty management with Chief Robert Luckritz of Austin Travis County EMS and Justin Soulier from Travis County Star Flight. Explore the strategies and challenges in mass casualty responses in one of the fastest-growing urban areas in the U.S.
Mar 14, 2025•50 min
Join Rommie Duckworth and FOAMfrat as we discuss the mental framing and big-picture thought process behind the first five minutes of any mass casualty incident (MCI). Rommie Duckworth, a fire captain and shift commander, is a wealth of knowledge on this topic and speaks globally to prepare emergency responders for these events.
Feb 07, 2025•42 min
In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.
Jan 21, 2025•41 min
The integration of point-of-care ultrasound (POCUS) is transforming emergency medical services (EMS) by enhancing diagnostic capabilities and improving accuracy in answering important clinical questions. Recently, I had the opportunity to discuss this topic extensively with Allen Wolfe, the Senior Director of Education at Life Link III. A significant challenge in incorporating ultrasound technology within EMS has been overcoming initial barriers to adoption. Many programs, burdened by cost conce...
Dec 29, 2024•47 min
In this episode, Dr Banerjee and I discuss a new traumatic brain injury (TBI) protocol his department is trialing for pediatric patients with moderate to severe TBI in collaboration with Arnold Palmer Hospital. This protocol involves administering Keppra and 3% saline in the pre-hospital setting.
Dec 10, 2024•30 min
Matt Hoffman is the editor-in-chief of PulmCCM, a blog that frequently updates its readers on evidence and best practices in critical care medicine. I have always wondered how our work in the field affects a patient's care downstream. Do pulmonologists ever sigh to themselves and think, "God, I wish paramedics would just start/stop doing ____________?" It turns out that this is not the case, but the discussion was super interesting, and I thank Dr. Hoffman for coming to the show.
Nov 26, 2024•57 min
In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies. If you're an EMS...
Oct 27, 2024•45 min
In this episode, I sit down with Dr. Jeffrey Jarvis , author of a fascinating paper on the impact of lights and siren (L&S) use in EMS responses. If you’re like most of us, when you hear those blaring sirens and see flashing lights, you think, “Wow, someone’s really in trouble!” But the truth, according to Dr. Jarvis’ study, might surprise you.
Oct 06, 2024•42 min
In this podcast, we discuss the nuances and strategy of the T1 ventilator with RRT, Joe Hylton. Whether you're a paramedic or a healthcare professional involved in critical care transport, understanding the nuances of this advanced ventilator is essential to safe and effective patient transport. We break down the pressure-controlled ventilation with volume adaptive options and offer practical guidance on managing obstructive lung conditions like asthma during transport. Plus, we cover essential ...
Sep 16, 2024•1 hr
Thoracic dissections are surgical emergencies that require precise temporizing measures until surgery can be performed. In this session, participants will gain critical knowledge on recognizing key symptoms such as ripping back pain and unequal pulses, indicative of thoracic dissections. The discussion will focus on anti-impulse therapy, emphasizing using beta-blockers like esmolol and calcium channel blockers like nicardipine to control blood pressure and prevent further damage. Pain management...
Aug 25, 2024•25 min
In this conversation, Tyler and Dr. Cynthia Griffin discuss the finger thoracostomy procedure. They cover topics such as when to choose finger thoracostomy over needle decompression, the equipment needed for the procedure, the technique for performing the procedure, and potential complications and tips for success. They also touch on the use of chest tubes and the management of tension physiology. Overall, the conversation provides a comprehensive overview of the finger thoracostomy procedure.
Jul 02, 2024•34 min
Alaina Martini, a flight nurse at Allegheny Life Flight, shares her expertise on transporting patients with external ventricular drains (EVDs). She explains the indications for EVD insertion, such as aneurysmal subarachnoid hemorrhage and obstructive hydrocephalus. Alaina discusses the importance of assessing the color and texture of the cerebrospinal fluid (CSF) to detect changes and potential rebleeding. She also explains the process of inserting the EVD and how it is guided by CT scans to avo...
Jun 20, 2024•46 min
Dr. John Aho discusses needle decompression and the procedure's indications, techniques, and potential pitfalls. He emphasizes the importance of high clinical suspicion and the limitations of external signs in diagnosing tension pneumothorax. The conversation also covers the choice of needle insertion sites, the use of ultrasound, and the need for proper training and practice. Dr. Aho provides insights into the anatomical considerations and common mistakes made during needle decompression. He al...
May 21, 2024•39 min
An iceberg typically shows only 10% of its mass above water. To appreciate the other 90%, you need to dive deep. That’s precisely what we’re doing in this series—discovering the deeper knowledge about obstetric topics. These topics can be massive, and much of the information is below the ‘surface-level’ knowledge that EMS is presented with. In this episode, Demi Wilkes & I will discuss Placenta Previa and the closely associated Placenta Accrete Spectrum.
May 06, 2024•18 min
The conversation is about a paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. They conducted a retrospective study and found that paramedics often mistakenly believe they have electrical capture when they do not. They emphasize the importance of confirming electrical capture before assuming mechanical capture. They also discuss ...
Apr 25, 2024•52 min
In this episode we discuss whether the concept of having a "max dose" of your pressor has any evidence or physiological backing. Joining me in this discussion are Dan Rauh, Shane O'Donnell, and Shad Ruby.
Feb 02, 2024•51 min
How do you talk to a patient experiencing suicidal ideation? What if you're the one having these thoughts? We're interviewing James Boomhower from Stay Fit 4 Duty in this episode. We discuss suicidal ideation, therapeutic communication, and verbal de-escalation.
Nov 18, 2023•33 min
Chris Carlstrom is a flight nurse at Life Link III and also works part-time at a ketamine infusion clinic. We’ve had some interesting conversations on shift regarding his experiences with ketamine in the clinic versus emergency medicine and I finally was able to get one of these conversations recorded for the podcast. Enjoy Podcast 163 - What Can We Learn From A Ketamine Infusion Clinic? w/ Chris Carlstrom.
Oct 30, 2023•18 min
When I became a paramedic, being able to provide pain management was one of the "new interventions" that I looked forward to most. As an EMT, I remember countless times I was without ALS resources and had to watch a patient suffering in pain until we got to the hospital. Trying to obtain any history or perform an assessment on someone writhing in pain can be nearly impossible. As a BLS provider, I would attempt non-pharmacological ways to relieve pain, such as ice packs, warm packs, elevating ex...
Sep 29, 2023•31 min
Taking on pharmacology in EMT school is a big hurdle. We wanted to write something that not only explained the basics of the medications but also helped bridge the gap between what EMTs are taught and what paramedics learn when they go back over these medications in paramedic pharmacology. Each chapter discusses how the medications work, why they're given for specific indications, and the logistics of medication administration! We've also included medication profiles, tips and tricks from experi...
Aug 18, 2023•29 min
I had the privilege to bring on two passionate fathers of children with Autism to help me better understand how to approach and communicate with a neuro-diverse child. This episode is chock-full of insight, tips, tricks, and logistics of approaching a child in the field with Autism. Josh Chan is a Life Link III flight paramedic/base lead and a Glenwood FD firefighter. Matthew Yelton is a flight paramedic/base lead for Mercy Flight Central and works as a fire captain at Constableville Ambulance I...
Aug 03, 2023•48 min
EMS providers encounter various infectious diseases daily and need to know the routes of exposure, risks, and preventive measures to protect themselves and their families. In this episode, We talk with Dr. Hudson Garrett, an infectious disease expert with the medical college of Louisville University, to discuss the practical points of infectious disease for the everyday provider. Want CE for this episode? Sign up for FOAMfrat Studio and access 300+ hours of continuing education for EMS & Nur...
Jun 14, 2023•44 min
In this episode, Dan Rauh & Mike Boone from Heavy Lies The Helmet join me to hash out our workflows and drugs of choice for four particular scenarios you may come across. The combative head injury patient that needs to be intubated but has five firefighters holding them down and is actively trying to rip off his collar and IV. The septic hypotensive patient is no longer protecting their airway but also needs resuscitation prior to induction. The snoring head bleed with a BP of 220/140 The "a...
Apr 12, 2023•1 hr 8 min
Moments after the heart stops the entire circulatory system finally has a chance to bring venous and arterial pressures to equilibrium. Cardiac arrest resuscitation requires the provider to have a strong mental model of physiology and the logistics to carry out a series of interventions crucial to preserving life. This class will serve not as a routine basic life support model, but as a deeper understanding and framework to guide resuscitation during your next cardiac arrest.
Mar 03, 2023•46 min
AI will be integrated into everything we do in medicine, perhaps sooner than we think. It will help keep our patients safe, our providers informed, and our communications connected, and change how we think about how we care for patients (if implemented correctly). Systems like ChatGPT are only the beginning, and many companies are already working on or have already integrated with other healthcare specialties. We will see the same integration happen with EMS. While the response to this might be ...
Feb 25, 2023•33 min
In this episode, Tyler is joined by Shaylah Montgomery to discuss decision-making, human factors, and mental shortcuts utilizing pattern detection. Shaylah is a flight nurse and paramedic for Pafford Air One and a member of the FOAMfrat team.
Feb 15, 2023•26 min
