MCHD is excited for the county wide roll out of the PulsePoint app. Community Outreach Coordinator, Ashton Herring, joins Dr. Patrick to discuss the importance of bystander CPR in increasing survival in cardiac arrest patients. After listening, download PulsePoint and let’s get hands on chest as quickly as possible which we know is a recipe for saving lives. REFERENCES 1. https://apps.apple.com/us/app/pulsepoint-respond/id500772134
Dec 02, 2019•23 min
On this episode, Dr. Patrick and MCHD Paramedic Podcast toxicologist extraordinaire, Dr. Jerry Snow, pick up where they left off in our recent discussion of the classic toxidromes. We'll branch out into some topics that veer from the textbook such as the Alpha 2 agonists that can mimic opiate toxicity and why toxicologists fear methadone ingestions. We'll also touch on some "tox" current events such as vaping associated pulmonary injury, imodium overdoses and why this is an increasing phenomenon...
Nov 18, 2019•23 min
Dr. Patrick is joined by two medics on the MCHD recruitment committee, Megan Steely and Russell Carter, to discuss the components of the "next generation" medic. We also dive in to the nuts and bolts of the EMS service of the future as well. Schedule options, compensation issues, service offerings and atmosphere are all addressed during this wide ranging conversation. Only the surface is skimmed here, so please drop a line to the podcast email if you have additional similar/related topics you'd ...
Nov 04, 2019•27 min
We're excited to announce a new educational offering - MCHD Paramedic Podcast 360. There are many topics in paramedic/EMT education better taught with visual adjuncts that the podcast format cannot provide with audio alone. Podcast 360 will be hosted on the MCHD YouTube channel (see link below) and contain brief, high yield content similar to what you get here at the MCHD Paramedic Podcast. Please subscribe to the channel and check out our initial episode - STEMI Diagnosis. MCHD YouTube Channel:...
Oct 28, 2019•2 min
We’ve recently rolled out a new epistaxis treatment protocol here at MCHD. Join the podcast team as we discuss some nosebleed background information along with the classic and emerging treatment options. Did somebody say TXA?? Yep, we have TXA and this is a perfect opportunity introduce the MCHD epistaxis/TXA treatment protocol. It’s simple, cheap and minimally invasive. With rapidly accumulating evidence that we will improve patient centered outcomes using this treatment, this is an episode tha...
Oct 21, 2019•22 min
This episode takes us back to the basics of toxic ingestions and poisonings to review the topic of toxidromes. Why do we look for specific patterns in poisonings and what are we looking for? Dr. Patrick and podcast toxicology expert, Dr. Jerry Snow, will take us through the major toxidrome groups and you’ll come out on the other side ready to sort through your next undifferentiated overdose patient. REFERENCES: 1. http://www.emdocs.net/the-approach-to-the-poisoned-patient/ 2. https://litfl.com/h...
Oct 07, 2019•36 min
On this episode, the medical directors are joined by the MCHD car seat guru, Ashton Herring. The leading cause of death in children is motor vehicle related trauma. We’ll start with some background of the car seat laws that exist here in Texas and how MCHD works in the local community to increase car seat awareness. Ashton will also educate us on some common errors that parents make when installing car seats. In closing, we’ll discuss several excellent resources for car seat education. REFERENCE...
Sep 23, 2019•19 min
REBOA is a hot topic in the world of emergency medicine and prehospital trauma care. Join the medical directors for a review of “resuscitative endovascular balloon occlusion of the aorta.” We’ll discuss the basics, the anatomy, the complications and the evidence. Who is doing this in the EMS world and what are their results? We’ll answer that question along with looking to future possibilities as well. References: 1. Brenner M, Inaba K, Aiol A, et al. Resuscitative endovascular balloon occlusion...
Sep 09, 2019•21 min
We’ve discussed airway management and our MCHD delayed sequence approach on past podcast episodes. On this episode, join the medical directors as they take a scenario based, deep dive into the finer points of tackling the difficult airway. REFERENCES: 1. https://m.youtube.com/watch?v=wVQFJR7qmrQ
Aug 26, 2019•33 min
The evolution of emergent stroke care has rapidly evolved over the past decade. With the increased emphasis on recognizing large vessel occlusion (LVO) strokes, communication and cooperation between EMS and our receiving hospitals has become vital. On this episode, Dr. Dickson is joined by an expert group of neurointerventionalists to discuss the current literature and guidelines shaping stroke management standard of care in 2019. REFERENCES: 1. https://www.thelancet.com/journals/lancet/article/...
Aug 12, 2019•43 min
Last year, we rolled out the MCHD “ROSC to Cath” protocol via the podcast. Recently, some compelling data from the COACT trial has led us to reassess and reconsider this protocol. On this episode, Dr. Patrick reviews COACT and discusses the MCHD changes coming as a result. REFERENCES: 1. https://www.nejm.org/doi/full/10.1056/NEJMoa1816897 2. http://clinicaltrialresults.org/Slides/ACC2019/Lemkes_COACT.pdf
Jul 29, 2019•9 min
During a recent continuing education session at MCHD, one of the educational points of emphasis was recognizing and reporting human trafficking as a paramedic/first responder. The podcast crew was lucky enough to have Sarah Koransky, from United Against Human Trafficking (UAHT), join us to share some of the key points when encountering this vulnerable patient group. Sarah is knowledgable and passionate about this cause and she has loads of high yield information to share on this episode. REFEREN...
Jul 15, 2019•25 min
Vital signs are called vital for a reason. On this episode, Dr. Patrick takes us through a differential for the workup of sinus tachycardia. This is a finding that we see daily in our practice, but often lack a step-wise approach when managing these patients. REFERENCES: 1. Bossart P, Fosnocht D, Swanson E. Changes in heart rate do not correlate with changes in pain intensity in emergency department patients. J Emerg Med. 2007;32(1):19–22. 2. Marco CA, Plewa MC, Buderer N, Hymel G, Cooper J. Sel...
Jul 01, 2019•24 min
We've addressed the ten most commonly encountered medications seen in EMS on a prior podcast. In this episode, Brad Ward joins Dr. Patrick to focus on a less common, but often more impactful group of medications, the antiplatelets and anticoagulants. The combination of complex pharmacology and some relatively new drugs in both classes, make this an area prime for discussion and review. REFERENCES 1. https://www.ajemjournal.com/article/S0735-6757(12)00169-6/pdf 2. http://www.emdocs.net/emin5-noac...
Jun 17, 2019•19 min
We have been fortunate here at MCHD to develop an ongoing educational partnership with Victoria University in Melbourne, Australia. A group of 11 paramedic students and instructors just finished a three-week study-abroad program here in the Greater Houston area. The podcast crew thought this would be the perfect chance for our Aussie colleagues to discuss the differences and similarities between EMS practice and education in Australia versus the United States. Our paramedic education supervisor,...
Jun 04, 2019•26 min
In recognition of EMS Week 2019, the MCHD Paramedic Podcast crew decided to directly address one of the most pressing issues in current EMS practice – paramedic and EMT wellness and burnout prevention. Dr. Remle Crowe, Research Scientist and Project Manager with ESO, joins the podcast to lend her tremendous burnout expertise. Burnout is a fluid and dynamic process that varies with time and the individual. Therefore, proactive prevention techniques have to be flexible and adaptable as well. After...
May 20, 2019•25 min
Dr. Patrick and Dr. Dickson pick up where they left off on our Back to the Basics COPD Part 1 episode. We’ll delve further into the differential diagnosis one must consider when treating patients with dyspnea and discuss some of the chameleons that can masquerade as COPD. Many of our COPD patients are far from straight forward with multiple co-morbidities. After listening, you’ll run your next dyspnea call with a clear plan and more confidence.
May 06, 2019•19 min
This episode takes us back to the basics of COPD pathophysiology and treatment. Dr. Dickson and Dr. Patrick start with the differential diagnosis of wheezing and move through the escalating COPD treatment options. We then close with a review of common abnormal breath sounds and set the stage for COPD Part 2 which will be coming soon. References: 1. http://citeseerx.ist.psu.edu/viewdoc/download doi=10.1.1.624.2777&rep=rep1&type=pdf 2. Ram, et al. NIPPV for treatment of respiratory failure...
Apr 22, 2019•24 min
One of the most difficult situations in prehospital care is the high-risk patient refusal of EMS transport. This topic is far from straight forward for both learners and teachers alike. Dr. Patrick introduces a brand new mnemonic that will, hopefully, alleviate your FEARS the next time you care for a complex patient that decides hospital transport just isn’t in the cards.
Apr 08, 2019•33 min
This episode is loaded with tactical EMS pearls. Houston Fire Department Assistant Medical Director, Dr. Kevin Schulz, joins the podcast again to lend his TEMS expertise. MCHD’s tactical leader, Patrick Langan, leads the discussion and provides a Montgomery County perspective.
Mar 26, 2019•34 min
Managing markedly elevated blood pressures has to be one of the most common EMS clinical dilemmas. Dr. Dickson joins Dr. Patrick to help dispel some long-standing and persistent hypertension management myths. The concept of “end organ damage” is also introduced as a framework to properly identify those patients with elevated blood pressures who DO warrant emergent treatment in the prehospital setting.
Mar 04, 2019•28 min
With the explosion continuing education options, how do we decide who and what to believe? Dr. Tony Seupaul, evidence based medicine expert, joins the podcast crew to discuss tips on how to best manipulate and master medical information in the social media/FOAMed era. We touch on the hierarchy of medical evidence, provide clues on how to best spot flimsy evidence, and tout some of our favorite sites and Apps to add to your educational armamentarium. References: 1. Hierarchy of medical evidence -...
Feb 20, 2019•26 min
The MCHD Podcast Crew just received word that we have a documented measles case here in Montgomery County. We decided to try and get out in front of this story and provide our listeners with some basic information on clinical presentation, transmission and prevention of the measles virus. References: 1. https://www.cdc.gov/measles/index.html 2. https://www.cdc.gov/measles/about/signs-symptoms.html 3. https://phil.cdc.gov/details.aspx?pid=132
Feb 06, 2019•16 min
The MCHD Paramedic Podcast wants to help all of our listeners stay up to date. Earlier this year, we discussed TXA (Tranexamic Acid) following our MCHD TXA protocol roll-out. New TXA research just popped up on the radar, join Dr. Patrick for a quick journal club discussion of the Cal-PAT study. References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225940/pdf/wjem-19-977.pdf
Jan 29, 2019•10 min
Despite Dr. Patrick's fear, we're delivering the second installment of our Obstetrics series. This is a potentially frightening topic that was actually requested by several MCHD medics. Part one focused on emergencies encountered prior to delivery and part two progresses into difficult deliveries and the postpartum period. References: http://www.emdocs.net/the-complicated-delivery-what-do-you-do/ https://coreem.net/core/shoulder-dystocia/
Jan 29, 2019•28 min
Join Dr. Patrick for a “phast” pharmacology update on hydromorphone/dilaudid. We’ll discuss its uses, relative strength, side-effects and the future role of dialudid at MCHD.
Jan 14, 2019•6 min
Continuing with our recent theme of increased fire related inhalational risks with colder weather, MCHD Paramedic Podcast toxicology guru, Dr. Jerry Snow, joins us again to discuss cyanide poisoning. We’ll discuss ways to recognize cyanide toxicity and when to empirically treat. Combining this episode with our recent carbon monoxide podcast will make you razor sharp when you run on your next house fire. References: 1. Curry, Steven C., and Meghan B. Spyres. "Cyanide: hydrogen cyanide, inorganic ...
Jan 14, 2019•20 min
Dr. Patrick is joined today remotely by toxicologist and friend of the podcast, Dr. Jerry Snow, to talk about the nuts and bolts of Carbon Monoxide poisoning. All of your questions are answered - from the use of portable CO devices, to the presentation and recognition of CO poisoned patients. We’ll hit on all the cold weather, carbon monoxide high yield information.
Dec 31, 2018•26 min
Dr. Patrick and Clinical Manager Jordan Anderson run down the 10 most commonly prescribed medications in the US. The medication list can often feel like one more task that’s always partial and incomplete. Jordan and Dr. Patrick try to take a more detective-like approach to demonstrate the utility of anticipating side-effects and potential diagnoses based on medication list clues. References: 1. http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery 2. Gomes T, e...
Dec 17, 2018•36 min
Shownotes: Cardiovascular medication poisoning can produce markedly unstable patient presentations. Dr. Patrick and Brad Ward review some of the basics and more recent therapeutic developments in the treatment and management of beta-blocker and calcium channel blocker toxicity. References: 1. St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Critical Care Medicine. 2017;45(3):e306-e315. 2. Wax P, Erdman ...
Dec 11, 2018•26 min
