The Heavy Lies the Helmet® Podcast is by critical care professionals, for critical care professionals. Hosted by Mike Boone, Dan Rauh, and Dr. Amanda Humphries, we dive deep into the realities of emergency and critical care medicine.
Our conversations are raw, honest, and practical — cutting through the noise to focus on real-world challenges, clinical decision-making, and the human side of high-acuity care. Whether we’re unpacking complex patient scenarios, discussing the nuances of teamwork and leadership, or highlighting the mental and emotional weight of the job, our podcast offers a space where providers can learn, connect, and feel understood.
No fluff. No corporate agendas. Just real talk for real clinicians.
Last refreshed: ⓘ
Follow this podcast in the Metacast mobile app to refresh it and see new episodes.
Don't just listen to podcasts. Learn from them with transcripts, summaries, and chapters for every episode. Skim, search, and bookmark insights. Learn more
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may en...
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may en...
Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an advanced airway, some clinicians may not be mindful of cerebral perfusion pressure and how to optimize it effectively. In this podcast episode, we provide you with the recording of Bryan's presentation from ICON (IA MED Conference Online) 2021. After introducing a case study, he breaks down the various neuro assessment techniques that can be used when...
This episode delves into the controversial topic of pre-hospital traumatic arrest resuscitation with Dr. Amanda Humphries. The discussion covers distinguishing traumatic from medical arrests, the paucity of evidence guiding interventions, and the importance of a low threshold for critical procedures like chest decompression and pelvic binding. It challenges common dogmas, advocating against epinephrine and often CPR in these patients, while emphasizing nuanced, goal-directed care focused on reversible causes and proper timing of interventions.
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. *Reference the show notes for this episode at heavyliesthehelmet.com/068 for the x-ray images we discuss. Get CE hours for our podcast e...
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. Get CE hours for our podcast episodes HERE ! ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavylies...
Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this podcast episode where we discuss the SAR and relief work he was a part of during that dire time. We highlight mission preparation, prioritization of victims, and several high risk incidents that will help you be a safer crew person. Get CE hours for our podcast episodes HERE ! ----...
Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altered mental status is usually the only notable deficit, so it's important to know how to identify and treat this life-threatening disorder. Tune in to find out how through a casual discussion and real-life example. Get CE hours for our podcast episodes HERE ! ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesth...
Acquiring a job in flight medicine is only the beginning. In this presentation to the 2020 Flight Crew Academy graduating class, Mike discusses three archetypes of new hires. He highlights positive and negative behaviors, systematically addressing incompetence, and how to ultimately get off orientation successfully. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliesthehelmet YouTube / heavyliesthehelmet Website heavyliestheh...
With the upcoming respiratory season, many of us will be caring for an increased number of pediatric and adult patients with pulmonary disease processes. Obstructive physiology, specifically, can result in an increased strain of resources to effectively care for this critically ill population. In this webinar, Mike, Bryan, and Jordan focus on status asthmaticus and COPD exacerbation. They discuss etiology, diagnostic criteria, and the latest evidence-based treatment ranging from medication admin...
Chris Stevenson is back for a third go-round, so I think that makes him a regular guest on the show. This time, he came at us with a non-clinical topic that peeked our interest... Likely over the years, we find ourselves giving or receiving advice related to flight medicine. As our years of experience have accumulated, so has the length of our rules and mantras related to flying. From military to mentors to pop culture, these are our 'Rules for Surviving Flight Medicine'. *We take no credit for ...
Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a discussion based on what-would-have-been our Yacht Club presentation. Everyone carries a card that says they know how to manage tachydysrhythmias. But what happens when your interventions don’t work? In this podcast episode, we focus on recent evidence suggesting alternate means o...
Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the privilege of welcoming the infamous Dr. Cliff Reid to the show to discuss his and Sydney HEMS' approach to all of these areas. Tune in and learn how to be a high level transport provider from one of the best in our industry. Get CE hours for our podcast episodes HERE ! ------------------------------------------------ Twitter @ heavyhelmet Facebook @ h...
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is the opposite of complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the cha...
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the chain, and ultimate...
High flow nasal cannula is an increasingly popular modality for Acute Respiratory Distress and Failure. Previously, we saw it used mostly in the pediatric population. But as time has went on, especially with the COVID-19 outbreak, this has become an effective means of O2 delivery in all patient groups. With its increased frequency of use, it is only natural that we as transport providers will adopt this therapy. Tune in to Mike's ICON 2020 presentation regarding this topic. Get CE hours for our ...
How do you calculate your drug dosages? What do you base it on? In this podcast episode, we are joined by Lynn Lamkin, EM pharmacist, to discuss weight based versus non-weight based drug dosages. We also breakdown when true body weight (TBW), ideal body weight (IBW), lean body weight (LBW) or adjusted body weight (ABW) is a more appropriate option. Get CE hours for our podcast episodes HERE ! ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Ins...
You asked. We answered. In a follow-up to our burn resuscitation podcast episode , we are joined by Chris Stevenson and his burn center Medical Director, Dr. Mike Feldman, to discuss inhalation injuries. Tune in as we discuss the mechanism surrounding inhalation injuries and how to treat them affectively based on anatomical location and poison type. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliesthehelmet YouTube / heavyl...
Titrating intravenous drips is a source of contention for many providers. This is, in part, due to a wide range of approaches depending on the patient's condition. Further attribution is based on each individual's comfort level and respective professional background (e.g. ICU versus EMS). But what does the literature say regarding this topic? In this podcast episode, we are joined by our CMO and After the Call host, Jordan White, to discuss appropriate titration of vasopressors, inotropes, and c...
With the rising number of COVID-19 patients, many of our listeners have requested additional information regarding transporting patients in the prone position. Despite refractory hypoxemia, many of these patients are benefiting from the prone position. Based on Episode 17 of the podcast, we updated our information in presentation-form. The following is a live recording of our talk being given at AMTC19. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesth...
Recently, Bryan was asked to present at a local EMS conference. The majority of the audience was ground personnel and student nurses, so he decided to present the why and how of measuring waveform capnography. EtCO2 truly should be the 5th vital sign, so we hope you appreciate this recording. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliesthehelmet YouTube / heavyliesthehelmet Website heavyliesthehelmet.com Email contact@...
Due to a recent outbreak, influenza and COVID-19 have been in the forefront of people's minds. Influenza, in particular, continues to affect all age groups despite it being late in the typical season. In this podcast episode, we discuss the entire course of this disease process; from positive nasopharyngeal swab to downstream ARDS and the complex ventilator management associated with refractory hypoxemia. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavylies...
In this podcast episode, we are joined by Dr. Deep Sharma, Interventional Pulmonologist, to answer listener questions in a rapid fire format. We cover everything from modes of ventilation to respiratory decompensation to snorting sugar dust. You asked. He answers. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliesthehelmet YouTube / heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Discla...
Proper fluid management in burns is critical to survival. But what happens when we administer too little or too much fluid therapy? In this podcast episode, we are joined by Chris Stevenson to discuss epidemiology and appropriate resuscitation for the prehospital provider. Our discussion includes an assessment of past and current formularies and what you should be using. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliestheh...
Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to discuss this technique and his most recent Air Medical Journal study aimed at investigating its usefulness in training prehospital emergency providers to improve their ability to intubate a contaminated airway. Video of Matt's colleague Will Hicks performing the SALAD technique with ...
The Annual Sim Cup at the Air Medical Transport Conference (AMTC) is a prestigious event that gathers flight clinicians from all over the world to compete. Jason Peng (ED and Flight NP) and Ellen Parsley (Flight Nurse) of University of Cincinnati Air Care joined forces and took home the 1st place trophy at AMTC19. We use this opportunity to sit down with them and discuss their experience, the preparation leading up to their participation, and their approach to the various scenarios that ultimate...
RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medical management and aircraft safety considerations surrounding the patient with acute agitation, excited delirium, and/or drug-induced psychosis. We also touch on Droperidol; an old drug that is finding its way back into the Pyxis and hearts of emergency providers everywhere. ------------------------------------------------ Twitter @ heavyhelmet Fac...
Making her second debut on the podcast, Dr. Cynthia Griffin joins us at AMTC19 to discuss the utility of ultrasound/POCUS. Cynthia presented on this topic and highlighted its indication when following your XABC's (Hemorrhage, Airway, Breathing, Circulation) exam. Are you currently using ultrasound in your practice? If not, are you actively trying to convince your medical director to implement it? If so, you don't want to miss this episode! ------------------------------------------------ Twitter...
As an air medical provider, our bread and butter is interfacility transports. Whether at the referring or receiving facility, we deal with Intensivists on a regular basis. What are their expectations? How can we provide the best care for our ICU level patients while simultaneously pleasing the facility staff? Our resident nocturnal Intensivist, Dan Rauh, leads a discussion in this podcast episode regarding 10 random things that your Intensivist wants you to know when caring for their patients. C...
The title says it all. We hope you will join us. *Standby for more information regarding this unique opportunity to expand your knowledge. ------------------------------------------------ Twitter @ heavyhelmet Facebook @ heavyliesthehelmet Instagram @ heavyliesthehelmet YouTube / heavyliesthehelmet Website heavyliesthehelmet.com Email heavyliesthehelmet@gmail.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the indivi...
