Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

NEW NAME! The podcast gets a new name, find out what and why...

Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey.

Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our podcast, originally named EMS Cast. Each year we have become more and more dedicated to our mission. However, as time passed, it became clear that our name didn't quite capture the essence of what we stand for—our mission or our identity as educators in the EMS field.

Will and I devoted significant effort into clarifying our mission this last year. Determining how we could create a framework to help you navigate the inevitable uncertainties in EMS, to put an emphasis on what truly and what principles will guide you through the uncertainty. This framework is going to allow us  to bring you even better content with clearer messaging. We wanted a name that resonates with our commitment to provide in-depth discussions that extend beyond paramedic school learning but yet never loses sight of the fundamentals and guiding principles that actually matter. After months of brainstorming and reflection, Loud & Clear: EMS Guiding Principles felt like the perfect match—an embodiment of our dedication to make every lesson resonate strongly and clearly with you, the listener.

In the world of EMS, ‘loud and clear’ is a phrase many of us know very well, whether you’re checking in with dispatch over the radio at the start of your shift or confirming the receiving hospital can clearly understand you. It signifies that there is clarity and understanding in the message that is received. We aim to bring this clarity  to every topic we discuss. Reinforcing our commitment to delivering information that is easy to comprehend and apply in real-life EMS situations, even when uncertainty abounds.

While our name may have changed and our episode framework has evolved, our mission has not. We will continue to provide high level education, seeking to teach you principles that enrich your knowledge beyond the textbooks you read in paramedic school, preparing you for the unexpected scenarios you’ll face in the field. You won’t find cookie-cutter approaches here—we’re dedicated to helping you understand and fall back on an understanding of fundamental principles that allow you to navigate the uncertainty and chaos with confidence.

Each episode of Loud & Clear will present high-level discussions about pathophysiology and treatment options. But more than that, every episode will guide you back to those time-tested EMS principles crucial for effective decision-making. This year promises ever more engaging content rich episodes, with an updated name, cover art, social media presence, and more as we embrace this exciting transition.

We can't wait to embark on this new journey with you, our dedicated listeners. Thank you for your support and enthusiasm. Remember—we’re here to ensure your learning experience is loud and clear.

Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes

Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers the guiding principles syncope- a good history, physical exam findings, and the ECG. It also delves into common presentations, risk stratifying strategies, and real-world cases to equip EMS providers with the knowledge needed to manage syncope calls effectively. 

 

00:00 Intro

01:07 Welcome to EMS Cast, host and guest introductions

04:51 Guiding Principles for Syncope Assessment

07:22 High-Risk Syncope Patients

09:14 Initial Approach to Syncope Patients

15:15 Syncope vs. Seizure

20:08 Physical Exam and EKG Importance

25:14 Identifying Arrhythmias in Syncope Patients

26:37 Understanding Wolf Parkinson White Disease

27:46 QT Prolongation and Its Implications

29:49 Left Ventricular Hypertrophy and Its Risks

31:28 Recognizing Brugada Pattern

32:02 Arrhythmogenic Right Ventricular Dysplasia

33:04 Bifascicular Block and Its Dangers

35:00 EKG Interpretation and Syncope Risk Stratification

39:53 Emergency Department Workups for Syncope

55:49 Case Studies and Memorable Syncope Calls

 

Resources

• The Resus Tailor
• EMS Cast Syncope Blog Post
• Other episodes you might like: Wide Complex Tachycardia
• Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES
• Survey- Help us learn what content you want

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
    • Extreme Ownership - https://amzn.to/3O1FWfa
    •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
    • Thinking Fast and Slow - https://amzn.to/4fiJG85
    • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-Host
Hosts- Ross Orpet, Will Berry 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

Creative Commons - Attribution 3.0 Unported - CC BY 3.0
Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo
Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic

Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS

Let's discuss the pressing issue of mental health among first responders, particularly within the EMS community. Will gets vulnerable and shares a personal story of trauma on the job to highlight the urgent need for mental health resources and support. Unfortunately, his story is not unique, we will all experience some level of emotional trauma while on the job. This episode features Jessica Nelson, the coordinator of the groundbreaking program and first of its kind state legislation, PATH4EMS. PATH4EMS provides free and confidential mental health care for EMS professionals. We delve into strategies for normalizing mental health conversations, the importance of trauma-informed care, and the benefits of proactive mental health practices. The discussion also covers the need for tailored, evidence-based resources and the unique challenges faced by rural first responders. Tune in to learn about the vital steps being taken to ensure the well-being of those who brave the front lines.

 

00:00 The Struggles of First Responders

00:53 A Personal Story of Trauma

04:57 The Turning Point: Seeking Therapy

05:42 Introduction to EMScast

06:34 Meet Jessica Nelson: A Pioneer in EMS Mental Health

09:54 The Importance of Confidentiality and Specialized Care

12:17 Effective Mental Health Practices for EMS Providers

19:54 Path for EMS: A Groundbreaking Initiative

30:37 Future Directions and Final Thoughts

 

Resources

• PATH4EMS website
• Today's Sponsor- The Resus Tailor
• Today's episode blog post
• Podcast announcements- We're rebranding! New name will be- Loud & Clear: EMS Guideline Principles. Look out for the changes coming soon.
• Survey- Help us learn what content you want

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
    • Extreme Ownership - https://amzn.to/3O1FWfa
    •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
    • Thinking Fast and Slow - https://amzn.to/4fiJG85
    • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Jessica Nelson, PATH4EMS coordinator
Host- Ross Orpet, Will Berry 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

 

Wide Complex Tachycardia: Get Comfortable With Uncertainty

Learn a systematic approach to management of wide complex tachycardia that doesn't rely on exact rhythm identification or scoring systems with guest Dr. Kevin Butler. By understanding the physiology rather than memorizing a score or algorithm you can use Kevin's approach and ABCD mnemonic to help differentiate between ventricular tachycardia, SVT with aberrancy, and other arrhythmias. Learn how not to miss the vital mimics with his SPAM filter. And finally by understanding which treatments are safe and which treatments potentially dangerous you can understand how to move forward even when you're not exactly sure what the arrhythmia is. Whether you're an EMT, paramedic, or emergency physician, this episode provides the essential principles and stepwise strategies to ensure effective and safe patient management.

00:00 Introduction to Arrhythmia Management

00:29 Personal Anecdote: Lessons from Paramedic School

02:04 Introducing Dr. Kevin Butler

02:16 Sponsor Message: The Recess Tailor

03:35 Welcome to EMS Cast

04:04 Understanding Wide Complex Tachycardia

05:37 Approach to Arrhythmia Management

07:02 Principles of Managing Wide Complex Tachycardia

08:39 Pathophysiology of Wide Complex Tachycardia

18:30 Identifying and Treating Mimics

26:55 Regular vs. Irregular Wide Complex Tachycardia

29:59 Understanding Torsades and Its Management

30:25 Identifying Atrial Fibrillation with Pre-Excitation

32:14 Treatment Considerations for AFib with WPW

35:02 Distinguishing Between VT and SVT with Aberrancy

37:09 Physiological Approach to ECG Interpretation

40:24 ABCD Mnemonic for VT Diagnosis

47:49 EMS Treatment Protocols for Wide Complex Tachycardia

51:54 Pre-Hospital Cardioversion Tips

55:22 Emergency Department Approach to Wide Complex Tachycardia

58:00 Final Thoughts and Key Takeaways

Resources

• The Resus Tailor
• Episode Blog Post with EKG examples
• Survey- Help us learn what content you want

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
  • Extreme Ownership - https://amzn.to/3O1FWfa
  •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
  • Thinking Fast and Slow - https://amzn.to/4fiJG85
  • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculum
Host- Ross Orpet, Will Berry 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

 

Trailer - Loud & Clear: EMS Guiding Principles

You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there for someone on the worst day of their life. To change an outcome that would have otherwise been catastrophic if you weren’t there.

There’s no resource for the practicing paramedic to plug the holes that were left behind by paramedic school. Everything seems stuck in basic algorithms of “A” then “do B” but what do you do when "A” wasn’t in the book. We need to get away from the algorithmic thinking and instead shift to understanding the principles behind WHY if A then B.

The truth is, you can’t learn it all. Emergency Medicine includes too many pathologies and 911 calls are too unique and chaotic to know the answer to every situation. Instead of trying to learn every answer to every call, you need guiding principles for your knowledge to stand on. If you build these principles they become the foundation for every call no matter the complaint, for every situation, no matter the chaos surrounding you.

If you have the foundation you can be stable when the storm comes. You can know when to push forward or when to change course. And then each additional piece of advanced content that you learn can be added to that foundation to build on, because mastery is not a destination, it’s a journey and the journey never ends.

We are your hosts, Ross Orpet & Will Berry and this is EMS Cast.

Come on this journey with us to mastering emergency medicine. We will cover topics in more depth than you learned in paramedic school, we will teach one step further and talk about what will happen to that patient in the Emergency Department after you drop them off. And we will connect all of this back to the principles that will guide you not just on this call but on all the calls. These principles will allow you to answer the question, at the end of the day, what’s really important to me, the paramedic, in the field, in that moment.

You may not feel ready, you may not feel like you know enough, but you can understand the principles and that will make all the difference. Because what you do matters.

From Novice to Navigator: Mastering the Art of EMS Field Training

Joined by Josh, Cody, and Moose from the AlertMedicOne podcast, we explore key principles of good training, leadership, and the importance of making mistakes in a safe learning environment. We discuss strategies to foster critical thinking, introspection, and continuous improvement among trainees in the EMS field. A big part of EMS is learning to be a leader and a teacher no matter what level you are at so whether you are a trainee, a field trainer, teach students during their rides, or merely work with a partner there's something for everyone to learn in this one. Tune in for an insightful discussion on how to develop and become excellent EMS professionals through solid training and leadership.

 

00:00 Whitewater Rafting Adventure

00:25 The Importance of Training

01:02 Creating a Safe Learning Environment

01:43 Introducing the AlertMedicOne Podcast

02:06 Meet the Hosts

04:37 Whitewater Rafting Lessons for EMS

05:48 Encouraging Autonomy in Training

08:01 Balancing Guidance and Independence

10:25 The Role of Field Training Officers

15:03 Ownership and Leadership in EMS Training

24:50 Handling Mistakes and Failures

31:33 Striving for Continuous Improvement

34:11 Embracing Continuous Improvement

34:34 Learning from Experienced Paramedics

35:35 The Importance of Preparation

36:47 Humility and Self-Awareness

38:23 Handling Mistakes and Growth

40:12 Training and Mental Health

41:54 Effective Preceptorship

43:13 Teaching Techniques in Action

45:12 Building Confidence in Trainees

47:21 The Role of a Trainer

01:03:06 Final Thoughts and Reflections

 

Resources

• Contact The Resus Tailor
• Watch this episode on YouTube
• Read the blog post for this episode
• Other episodes you might like:
  • Values Driven Leadership with Chris Pfingsten from EMS 20/20 podcast
  • 10 lessons from a real austere rescue
  • How to Master the Resuscitation - EMCRITs Scott Weingart
• Podcast announcements- Big news coming in 2025! Stay Tuned!
• Survey- Help us learn what content you want

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
    • Extreme Ownership - https://amzn.to/3O1FWfa
    •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
    • Thinking Fast and Slow - https://amzn.to/4fiJG85
    • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Josh, Cody, Moose
Host- Ross Orpet, Will Berry 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

 
 

 

The Difference Between Equal and Equitable Care

Explore the crucial distinction between providing equal care versus equitable care within emergency medical services (EMS). We give you an in-depth discussion with Ritu Sani from The EMS Show podcast, highlighting the importance of focusing on outcome-driven quality improvement projects and addressing disparities in care. Learn how different demographics face unique barriers to healthcare, and why recognizing these differences is essential to improving outcomes across various communities. Watch as real-life examples illustrate the need for equitable interventions and the systemic factors that contribute to inequities in EMS.

 

00:00 Introduction: Equal vs. Equitable Care

00:23 Case Study: CPR Training Disparities

01:09 Understanding Barriers to Equitable Care

03:31 Guest Introduction: Ritu Sani from EMS Show Podcast

04:33 Interactive Exercise: Demonstrating Inequity

06:36 Quality Improvement: Focusing on Outcomes

08:09 Challenges in Achieving Equitable Care

09:25 Diversifying EMS Workforce

10:11 Systemic Factors and Data-Driven Solutions

11:03 Starting with Equitable Care

11:17 Key Areas to Focus On

11:26 Analyzing Data for Disparities

12:12 Addressing Provider Reactions

13:00 Implementing Quality Improvement

13:35 Implicit Bias and Introspection

14:17 Patient Outcome Driven Approach

14:33 Challenges and Structural Abnormalities

15:16 Conclusion and Final Thoughts

 

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
  • Extreme Ownership - https://amzn.to/3O1FWfa
  •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
  • Thinking Fast and Slow - https://amzn.to/4fiJG85
  • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Ritu Sani, MD and Co-host of The EMS Show podcast
Host- Ross Orpet, Chris Pfingsten from EMS 20/20

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

Life Over Limb: Field Amputation, Preparing for the Unthinkable

Dr. Avery McKenzie interviews Dr. Eric Adler, regional medical director for Flight for Life, about the challenging and rare procedure of field amputations. They discuss the importance of being prepared for the unexpected, the steps involved in developing a protocol for such emergencies, and the logistical challenges faced during the process. Dr. Adler shares insights from real-life cases and emphasizes the critical need for planning and knowing the resources available in urgent scenarios.

 

00:00 Emergency Field Amputation: A Real-Life Scenario

00:25 The Reality of Unlikely Medical Emergencies

02:04 Introducing Today's Episode and Guest

04:26 Dr. Eric Adler's Experience and Protocol Development

05:46 Indications and Procedures for Field Amputation

10:50 Challenges in Creating a Field Amputation Protocol

14:23 Final Thoughts and Preparedness

 

Resources

• Website show notes link (picture of the kit and copy of the protocol): https://emspodcast.com/life-over-limb-field-amputation-preparing-for-the-unthinkable/
• Other episodes you might like: Episode 31- You Were Taught Wrong, Traumas Not Algorithmic

Gear We Like

• Good Stethoscope - https://amzn.to/3YJJrf2
• Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
• Notepad for taking notes on calls - https://amzn.to/3Z1X21J
• Sunglasses - https://frontline-optics.com/discount/EMSCAST15
• Books we recommend - 
  • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
  • Extreme Ownership - https://amzn.to/3O1FWfa
  •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
  • Thinking Fast and Slow - https://amzn.to/4fiJG85
  • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

Guest/Cast/Crew information-
Guest- Erik Adler
Host- Ross Orpet, Avery Mackenzie

Catch up with us after the show

• Instagram- @emscast
• Website- www.emspodcast.com

 

The Untold Impact of EMS on Organ Donation: Transforming Tragedy into Hope

In this episode, we discuss the profound impact that one patient's organ donation can have on society. Even when not every patient gets to go home, the ability to donate organs can positively affect up to 80 people, multiplying our impact and service to the community. Guest Chris Meeks, a critical care flight paramedic and organ recovery coordinator discusses the ethical considerations and the surprising impact EMS has on the potential for organ donation, even in cases that appear to be 'lost causes'. Tune in to understand how your work in EMS may have more far-reaching positive effects than you realize.

 

00:00 Introduction: The Impact of EMS on Organ Donation

00:43 Ethical Considerations in Organ Donation

01:10 Current Research and EMS's Role

02:04 Guest Introduction: Chris Meeks

05:04 Ethical Dilemmas and Future Directions

08:25 Organ Donation Criteria and Processes

13:28 Conclusion: The Importance of EMS in Organ Donation

 

Guest/Cast/Crew information-

Guest- Chris Meeks, Critical Care Flight Paramedic, Organ Recovery Coordinator

Host- Ross Orpet, Will Berry 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com

Values-Driven Leadership Within A Just Culture- Chris Pfingsten from EMS 20/20

Creating lasting behavioral changes in the workplace by moving beyond consequence-based policies. Chris discusses the importance of aligning personal and company values, highlighting 'just culture' in EMS and its role in understanding motivations and systemic issues. The conversation covers leadership in EMS, focusing on the significance of fostering supportive relationships with staff and avoiding fear-based management. Additionally, Chris shares his journey from paramedic to Field Training Officer, offering advice on effective training and mutual support. This episode is packed with valuable insights for anyone in the EMS field aiming to enhance performance, commitment, and team dynamics. Don't forget to check below for further resources on just culture and motivational learning.

 

Guest/Cast/Crew information-

Guest- Chris Pfingsten, Co-host of EMS 20/20

Host- Ross Orpet, Will Berry 

 

Resources

• Other episodes you might like
  • Ep. 72 From Errors to Excellence with Geoff Murphy, Master Your Medics
• Books
  • Just Culture- https://amzn.to/4eOMN7w
  • Crucial Conversations- https://amzn.to/3BRBnRI 
• YouTube Videos- 
  • Why do Errors Happen? How can we prevent them?
  • How can a system get organized for improvement? 

 

Catch up with us after the show

• Instagram- @emscast
• Twitter- @ems_cast
• Website- www.emspodcast.com