0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.","type":"unstyled","depth":0,"inlineStyleRanges":[],"entityRanges":[],"data":{}}],"entityMap":{},"VERSION":"9.3.6"}"> What aspects of temperature-targeted management are most important to EMS, and how should EMS guide sedation for the patient with a return of sponta...
Feb 06, 2023•32 min
We just finished re-recording our pediatric arrest class in Studio and decided to play the unedited version of my discussion with Dr. Paul Banerjee. Banerjee is a prolific researcher and medical director in Florida with a particular emphasis on pediatric arrest. Check out the class in Studio for more information on the logistics.
Jan 16, 2023•24 min
Sam Henne is the creator of Mind Over Medic and a co-worker of mine at Life Link III. In this episode, we discuss the components of critical incident stress and ways to reduce adrenaline during threat appraisal. Check out www.mindovermedic.com
Dec 12, 2022•56 min
EMS is well-trained in peripheral intravenous as well as intraosseous access. However, central lines remain off-limits for many clinicians in various response areas. If accessing these types of lines is allowed, it’s usually permitted when the patient is (nearly) dead. This isn’t very surprising since the scope of practice of the EMS clinician usually focuses on emergent treatments. Unless it’s learned during a critical care class, little thought is typically given to topics like central, dialys...
Dec 02, 2022•31 min
Had the opportunity to talk with Dr. Sam Slishman, the inventor of the Slishman traction splint. We had a great conversation on the idea/concept of this splint, who to apply it on, and some additional questions, which we plan on having him back on to discuss.
Nov 05, 2022•36 min
A-a gradient, a/A ratio, and P: F ratio - are all different views of the same item. These formulas do not have a complete view of oxygenation. Oxygenation is a huge topic, and there are more common values that we use: How well is the patient saturating? Is there dyspnea? How do the lungs sound (auscultation) or look (POCUS)? Where is the patient on the OHCD? What does the ABG show?
Oct 21, 2022•28 min
I ran some specific decision points when treating the REALLY BAD massiVE pulmonary embolism patient by Shane & Brian from the FOAMfrat Team. This discussion really focuses on the logistics and ideas when you are trying to get the patient from A to B without having to do CPR.
Oct 04, 2022•37 min
Theresa Bowden is a rockstar flight nurse who specializes in NICU transports. In this episode, you will listen in as Theresa explains anything and everything you have ever wondered about NICU interfacility transports. Topics include: Who gets prostaglandin? IO or IV catheter for UVC Cardiac vs. Respiratory Initial Vent Settings Get credit for this class by listening to it in FOAMfrat Studio.
Jul 14, 2022•32 min
Does IVC assessment have a role in pre-hospital ultrasound? This week we talk to one of the newest members of FOAMfrat, Shane O'Donnell.
May 22, 2022•26 min
Do specialized pediatric jump bags alienate the pediatric population? They typically don’t get used as much, and introducing a foreign bag into a low volume population may add to the stress of running a pediatric call anyway. In this episode, Sam & Tyler discuss the case against the pediatric jump bag.
Apr 17, 2022•33 min
The FOAMfrat podcast is back in 2022 with a discussion on how virtual reality can be used in EMS education. We did our first VR class a few weeks ago and here's what we learned and what we plan to do with it!
Feb 03, 2022•26 min
The thyroid is a butterfly -shaped gland. But for some, it can be more like a bullet to the neck. The number of systems that our thyroid helps regulate truly is incredible, and an over or under-active thyroid can cause a whole host of acute and chronic issues. On the one hand, imagine a patient who has a thyroid history and is cold, weak, and has a depressed level of consciousness. Why is this occurring, and what's the diagnosis and treatment? On the other hand, imagine an anxious, hyperpyrexic ...
Dec 23, 2021•47 min
I reached out to @medtwitter asking for help finding a guest to talk about the respiratory syncytial virus (RSV). It may seem weird to be talking about RSV when everyone is thinking about the current pandemic, but I find the virology and mechanism of symptoms of RSV exciting. Twitter did not let me down, my friend Ashley Liebig recommended Natalie May from Sydney, HEMS. Natalie is an EM, and Pediatric-EM trained UK doctor working in Prehospital & Retrieval Medicine in Australia. I was very e...
Dec 11, 2021•1 hr
A young pediatric patient is having nausea and vomiting at school and is said to not be 'staying awake very well.' You discover assessment findings such as hypotension, hypoglycemia, and maybe even peaked T waves on the ECG. You receive information indicating that the child has something called "CAH". Or, perhaps... An older patient is having dizziness upon standing, and persistent hypotension. You note a somewhat jaundiced appearance. They become unconscious in their kitchen while searching for...
Dec 04, 2021•45 min
In this episode, we talk with Matt Schneider, a Battalion Chief and Paramedic for the Mequon fire department in Ozaukee County. Sam and I had the privilege of sitting in on a guideline update presented by Matt a few weeks ago. One of the guidelines that caught our attention was the decision to remove nitroglycerin from the STEMI guideline. Listen in as Matt describes how their guideline committee arrived at this decision. "Matt's views, comments, and opinions expressed in this segment do not rep...
Nov 27, 2021•50 min
Nothing is scarier than watching an awake patient struggle to breathe with a trach. Do you have an approach to troubleshoot? Make sure you watch to the end to see our first FOAMfrat reaction video!
Nov 21, 2021•37 min
In this episode, Tyler & Sam discuss everything you need to know about the Bougie. Traditional use Modified pre-loaded techniques Common pitfalls.
Nov 12, 2021•31 min
Welcome to the fourth and final installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond.
Oct 06, 2021•38 min
One of my first calls as a paramedic was to our local ski hill for a 26-year-old guy who crashed into a tree while snowboarding. The ski patrol brought him down to the patrol room and we met them inside. The guy was literally screaming in pain and saying: "just put me out, man!" I could see his leg was obviously deformed below the knee. Now, this dude was covered in gear, and starting an IV was going to take a little while. I looked at my partner and remembered we had just got this new gadget th...
Sep 23, 2021•21 min
Welcome to the third installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond. Previously we've explored Cations ( located here ) and Anions ( located here ), but don't feel like you need to read these in any particular order. These blogs are meant as a reference for you to come back to. There's a lot of information in each, so they might be better absorbed in chunks. I'm writing these as the reference I wish I had when I st...
Sep 15, 2021•35 min
What does jaundiced skin, right upper quadrant pain, and a fever mean? In this episode, Dr. Cynthia Griffin and I discuss everything gallbladder and biliary colic! Check out the blog post here: https://www.foamfratblog.com/post/when-gall-bladders-attack
Sep 09, 2021•20 min
Welcome to the second installment of this metabolic panel series, where we're exploring what happens when various lab values reach their outer limits (or beyond). Each part in the series can be read on its own, but if you want to start at the beginning, go check out the first blog on cations HERE . This series of blogs and podcasts are meant as a reference for you to come back to. There is a lot of information on each one of the lab values we'll cover, so it might be best to read it in parts. As...
Sep 01, 2021•34 min
In this episode, Sam and I discuss warfarin's mechanism of action and reversal. Check out the blog for more information! https://www.foamfratblog.com/post/podcast-132-reversal-rehearsal-warfarin
Aug 20, 2021•23 min
Lab value interpretation sadly wasn't included in my initial paramedic education. I was absolutely ecstatic to attend a critical care program and learn about lab values - I had always found it very impressive when people could interpret lab values. I wanted to be a lab value wizard too! Unfortunately, in critical care class, our lectures and resources were nothing like what I had hoped for.I hope this series of blogs serve as a resource for those who are eager to learn more about the art of inte...
Aug 15, 2021•25 min
200 comment Facebook post where I asked, \"what questions would you like me to ask the NREMT?\" These are the questions that seem to be the most popular.","type":"unstyled","depth":0,"inlineStyleRanges":[],"entityRanges":[],"data":{}}],"entityMap":{},"VERSION":"8.46.0"}"> In this episode, I interview NREMT's Chief Certification Officer, Mark Terry, and Certification Manager, Megan Hollern. I really enjoyed this conversation and felt it cleared up many misconceptions and confusion surrounding ...
Aug 05, 2021•52 min
Welcome to round two! We'll be going over fewer laws than last time, but this will round things out nicely! We'll be covering the laws of Fick, Graham, and Dalton/Amagat. Mike Brown joins me again as we look at the clinical application of some lesser-known gas laws.
Jul 30, 2021•40 min
In this episode, Tyler interviews Tom Bouthillet and Dr. Stephen Smith on who exactly should get a right-sided ECG. Do not delay transport to PCI to grab a right-sided ECG. If you do decide to perform a right-sided ECG, it should not be for the decision on whether or not to give nitro. If time permits, it may be helpful and confirm your suspicions of RV involvement. Isolates RV infarcts are extremely rare. In EMT school, I was taught how to assist a patient taking their own nitroglycerin if they...
Jul 23, 2021•25 min
We've been exposed to gas laws our whole life, and we have intuition about what will happen to gas under certain conditions. For example, people notice that the pressure in their tires might become low on a very cold day. Or perhaps you've been at very high altitudes and you've been short of breath. And everyone knows that if you shake a carbonated beverage before opening it you'll be cleaning up a mess very shortly. Each of these observations has been classified into the laws, and we'll be spli...
Jul 16, 2021•39 min
The concept of taking blood out of the body, oxygenating it, removing the CO2, and then putting back in, fascinates me. A few years ago I admittedly knew very little about extracorporeal membrane oxygenation (ECMO) and its indications. I remember going to a class on ECMO at Life Link III and having questions like: Are we actually pumping blood backward through the body? What happens to the blood in the heart when using ECMO in cardiac arrest (ECPR)? What kind of vent settings should I use? I am ...
Jul 09, 2021•37 min
Before the July 4th weekend hits, I wanted to address two main questions whose answers may come in handy on a call you'll run very soon... Should EMS use a burn formula? What's the best way to manage pain for the burn patient? For a sense of a well-rounded blog on burns, I've included some quick facts about burn care at the end that are unrelated to these questions. Also, Erik Rima (CFRN and former burn center RN) left us his perspective at the end in a peer review. Be sure to check those out be...
Jul 02, 2021•33 min
