Wherever you turn in the world today, social media is present with constantly expanding visibility and influence. Join MCHD's Chief of EMS James Campbell and Public Information Officer Misti Willingham as they discuss some lessons and ground rules on how to successfully integrate an active social media program into your EMS service.
It’s time to review some recent cardiac arrest literature. Both of today’s articles come from Resuscitation and address predictors of OHCA survival. Should we take a third attempt at intubating an OHCA patient, should we intubate OHCA at all? What about PEA arrest, can ETCO2 help identify pseudo-PEA? Listen to get some hot off the press OHCA literature updates. REFERENCES 1. Murphy DL et al. Fewer tracheal intubation attempts are associated with improved neurologically intact survival following ...
We sure do love myth busting on the MCHD Paramedic Podcast and there are definitely some persistent myths surrounding burn care in EMS. Join the podcast crew as they provide updates on burn staging, fluid resuscitation and the basics of burn wound care. This episode will keep you from getting burned during your next burn transport. REFERENCES 1. Parvizi D, Kamolz LP, et al. The potential impact of wrong TBSA estimations on fluid resuscitation in patients suffering from burns: things to keep in m...
Join the podcast crew and Dr. Taylor Ratcliff as they discuss the dangers of the "Lift Assist" calls in EMS. These responses can be under-appreciated with hidden diagnoses such as sepsis, GI bleeding and even fractures. How can we better create checklists to better assess these calls? What are the warning signs in these patients? Do lift assists even require an ALS evaluation? Listen and get these answers and more! REFERENCES 1. Leggatt L, Van Aarsen K, Columbus M, et al. Morbidity and mortality...
In this episode, we’re lucky to have a special guest from Texas Children's Hospital, pediatric sedation and pain management expert, Dr. Corrie Chumpitazi. Nitrous oxide has been in our protocols here at MCHD for some time, but probably doesn’t get the recognition and appreciation that it deserves. We’ll discuss NO history, dosing, indications, contraindications, and side effects. Listen to learn why we all should be incorporating more Nitrous Oxide into our daily EMS practice. https://emscimprov...
Within EMS, significant time is spent learning high risk, low frequency procedures and the pharmacology and physiology surround these events. In most EMS services consultations or checklist verifications are required in some fashion surrounding these events. Often times, though, we tend to overlook and fail to provide a structure for best practices in how to complete a clear and concise clinical consultation. MCHD District Chief, Ashley Fillmore, joins the podcast to discuss a framework for succ...
With the recent transition of IV acetaminophen from patent to generic, it's a good time to discuss MCHD's 2021 NAEMSP abstract describing our prehospital experience with IV tylenol for pain. If you've not looked into bringing this tool into your service, listen today to be convinced why IV Tylenol is an option worth considering across EMS. REFERENCES 1. Mahshidfar B, Rezai M, et al. Intravenous Acetaminophen vs. Ketorolac in Terms of Pain Management in Prehospital Emergency Services: A Randomize...
Everything occlusion MI isn't always STEMI. After a recent discussion of "STEMI equivalents" during MCHD continuing education, Dr. Patrick cared for a textbook hyperacute T wave patient in his emergency department practice. On this episode, we review some hyperacute T wave tips, in addition to addressing how to deal with resistant consultants. REFERENCES: 1. https://tinyurl.com/3aser4j5 2. Tzimas, Georgios et al. “Atypical Electrocardiographic Presentations in Need of Primary Percutaneous Corona...
We’ve recently rolled out a new medication protocol here at MCHD. Join the medical directors to discuss the why, when, and how behind MCHD’s droperidol protocol. Like many pharmacologic treatments in emergency medicine, old becomes new again! REFERENCES 1. Page CB, Parker LE, et al. A Prospective Before and After Study of Droperidol for Prehospital Acute Behavioral Disturbance. Prehosp Emerg Care. 2018 Nov-Dec;22(6):713-721. 2. https://www.mchd-tx.org/media/podcasts/MCHDPP-115.pdf
It seems as though each week brings some crazy and bizarre COVID-19 related news. MCHD Cpt. Megan Powell joins the podcast to spread the word about a harrowing COVID related case that made us all stop and do a literature search. Listen and in and learn yet another clinical consideration when caring for complex COVID-19 patients. REFERENCES 1. Wang Y, Wang Z, Tse G, Zhang L, Wan EY, Guo Y, Lip GYH, Li G, Lu Z, Liu T. Cardiac arrhythmias in patients with COVID-19. J Arrhythm. 2020 Jul 26;36(5):827...
**NOTE - THIS EPISODE WAS RECORDED PRIOR TO THE DELTA SURGE** The MCHD clinical crew (Pre-Delta, obviously)attended an actual in-person EMS meeting – EAGLES 2021. One of the most interesting talks was by friend of the podcast/EMS research superstar, Dr. Remle Crowe. Join Dr. Patrick and Dr. Crowe as they discuss the “AHORA” stroke tool and how it has the potential to positively impact prehospital stroke care. REFERENCES 1. Keenan KJ, Kircher C, McMullan JT. Prehospital Prediction of Large Vessel...
Join the podcast crew as they discuss a recent study investigating the risk of being awake while paralyzed when intubated in the emergency department setting. This is definitely an under-discussed topic in the EMS world, especially considering the recent swing from succinylcholine to rocuronium for prehospital medication assisted intubation. This conversation should make us all a bit nervous and better focused the next time we intubate. REFERENCES 1. https://www.annemergmed.com/article/S0196-064...
Like the rest of the country and world, our Montgomery County hospital partners and ED's have been under severe strain due to a myriad of factors related to the COVID-19 pandemic. This had led to a significant increase in EMS wall times which, in turn, places that severe strain back on the prehospital system. The podcast crew takes an operational turn with MCHD Chief of Operations, Jacob Shaw, to discuss some of our operational adaptations to try and combat our ED delays. We'd love for this epis...
Charting is one of the more neglected skills from an EMS educational emphasis standpoint. As a result, what the medical director ends up reading during chart review is often wildly variable. Join the MCHD Paramedic Podcast team as they discuss some charting pitfalls to avoid and some specific tips on improving your ePCR narratives.
The best clinical discussions always stem from real-life cases. MCHD paramedic Jarrett Kenning had a run of recent bradycardia patients and developed the idea for a bradycardia breakdown with the podcast crew. Bradycardia treatment can vary wildly depending on the underlying cause(s). Joint Jarrett and Dr. Patrick as they discuss several bradycardia cases and present a framework for creating your differential the next time you run on a patient with a pulse in the 30's. REFERENCES https://www.mch...
Join Dr. Dickson as he discusses all things French emergency medicine, EMS and prehospital care with Dr. Eric Revue - Emergency Department and EMS Chief - Louis Pasteur Hospital. Docs on ambulances...what???
We’re going to attempt a new recurring podcast series based around the amazing pathology seen on a daily basis by MCHD medics. Cpt. Travis Clay joins the podcast to discuss the current MCHD “Case of the Quarter”. Listen in and learn how to approach the patient with acute, bilateral lower extremity paraplegia and pain. REFERENCES 1. https://www.ems1.com/patient-assessment/articles/i-cant-feel-or-move-my-legs-mchd-critical-case-report-eVk3jFR1l6DPbwGS/
There may not be any hotter topic in EMS right now than whole blood administration for patients with hemorrhagic shock. Dr. Patrick is joined on today’s episode by Joe Cuthbertson from St. John Ambulance Service in western Australia. St. John's serves the largest land mass of any EMS service worldwide and they are on the forefront of international prehospital whole-blood administration. REFERENCES 1. https://clinical.stjohnwa.com.au/medications/packed-red-blood-cells
There has been significant development and change surrounding which patients are best served by immediate revascularization post-ROSC over the past 12-18 months. On that note, we discussed the COACT study previously on the podcast, but uncertainty still exists. OHCA and post-ROSC patients are wildly heterogenous and one size will never fit all. What if we could simply change the timing of our post-ROSC ECG and better select those with true acute coronary occlusions that warrant emergent catheter...
May is Mental Health Awareness Month, so the podcast crew decided to dedicate an entire episode to discussing EMS provider mental health issues and resources. Dr. Patrick and Sean Simmonds are joined by Justin Farris from Cypress Creek Behavioral Health Hospital. Topics range from recognizing mental health warning signs in your partner, to accessing proper mental health resources through programs such as "Honor Strong" at Cypress Creek Hospital. REFERENCES: https://www.cypresscreekhospital.com/b...
We have all been guilty of caring for labeling and judging “pseudoseizures.” First of all, this term is outdated, and this episode looks at a study examining the mortality in psychogenic seizure patients. This is a debilitating disease that needs more attention and improved treatment options. Come, have your prior assumptions shattered, and leave a better and more empathetic provider. REFERENCES: 1. https://n.neurology.org/content/95/6/e643
This episode was directly drawn from a recent MCHD educational need surrounding ventilator management and a summary of our approach to using the vent in the EMS setting. We've touched on aspects of many of these topics before, but this is our first effort at providing a true "MCHD ventilator overview." Join Dr. Patrick and Dr. Dickson as they discuss a stepwise approach to EMS ventilator management and how to first and foremost prevent patient harm.
Is there a more daunting time than those first few shifts as a new paramedic? Yes, clinical knowledge and operational knowledge are key, but how are new medics supposed to synthesize this mountain of information? Dr. Patrick is joined by Cpt. Michael Wells-Whitworth to discuss some "Rules of the Road" for new paramedics. TOP TEN RULES OF THE ROAD FOR NEW MEDICS 1. Be on time 2. Failing to prepare, is preparing to fail 3. Know your protocols 4. Pour a solid BLS foundation 5. Be like a lamprey - l...
Dr. Dickson and Patrick are joined on this special episode by EMS Medical Directors from across Texas to discuss the recent winter storm that ravaged the state. We discuss the varying ways the disaster impacted each service, multiple lessons learned statewide, several unexpected operational and clinical developments, and steps everyone plans to make to improve moving forward. Thanks to Jeff Jarvis, Jason Pickett, and Veer Vithalani for helping arrange this last-minute recording. REFERENCES 1. ht...
After 100 episodes and almost 3 years, the podcast crew decided to celebrate a little bit and look back on our successes and failures thus far. Why did we start the podcast in the first place? How has MCHD used the Paramedic Podcast within the EMS service? What have been the most successful episodes and what are the "Take home Points?" Join Dr. Dickson and Dr. Patrick as they discuss the MCHD Paramedic Podcast past, present, and future.
Nothing scares an emergency provider quite as much as the “sick infant.” During today’s episode, Dr. Patrick and Dr. Dickson walk through the pediatric general assessment triangle and discuss the finer points that make up each side. They’ll also discuss the singular/#1 Law of the Pediatric Exam. Your next pediatric run will be a breeze after this review. REFERENCES: 1. Leeper, Christine M. MD, MS; McKenna, Christine MSN; Gaines, Barbara A. MD Too little too late: Hypotension and blood transfusio...
Emergency medical providers are comfortable in the chaos of a crashing medical or trauma patient. We know how to systematically address dangerous medical conditions like hypotension, hypoxia and bradycardia. However, when asked to dip our toes into the legal realm, we are often paralyzed with fear. On this episode, the podcast crew is joined by local legal expert, Andrew James. Mr. James is the vehicular crimes chief with the Montgomery County DA's office, and he has extensive experience working...
Anytime we arrive on scene with blaring sirens and flashing lights, this can be exceedingly stressful on patients and families. This is especially true for our patients with autism. We're lucky to have Jennifer Dantzler on the podcast today to discuss autism basics along with some tools that we can use in the prehospital setting to better care for and communicate with our autistic patients. Jennifer is the director of the Including Kids Autism Center and a true expert in the field of autism spec...
Around the MCHD Clincial Department we’ve had some recurrent themes pop up over the past few months that always make the medical directors shake their heads. During this episode, Dr. Dickson and Dr. Patrick take a shot at dispelling some “medical director myths."
Electrical storm has dismal outcomes. It is most frustrating because we know the cause is very likely coronary occlusion (~75%)! We have added esmolol to our tool belt here at MCHD to try and improve refractory VF outcomes. Others are trying early ECMO in this patient population. Prior eCPR studies have all been retrospective. Join the podcast crew as they discuss a recent Lancet article looking at eCPR vs. standard ACLS in refractory VF. Randomized, prospective, and quite amazing. REFERENCES ht...
