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

Which is Better, Midazolam IV, IM or IN?

In this episode we look at a recent observational study out of the journal of neurology looking at the effectiveness of midazolam when comparing the IV vs IM vs IN routes. We'll discuss the study as well as other studies involving status epilepticus to tease out best practices for your next shift. 

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This Episodes Journal article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930617/

RAMPART trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3211107/

American Epilepsy Society Algorithm: https://www.aesnet.org/clinical-care/clinical-guidance/guideline-prolonged-seizures?_gl=1*1lmlmse*_ga*MTIzMDc0MjA2NC4xNzAwMDM0ODUx*_ga_GV192D9FPY*MTcwMDAzNDg1MS4xLjAuMTcwMDAzNDg1MS42MC4wLjA.

Blog post: 

Non-Invasive Ventilation - Do You Understand the Physiology?

There are few treatments in our tool box that can have more of a positive impact than non-invasive ventilation. This episode is designed to help you better understand the physiology of how it works and how to use it more effectively. Dr. Bo Burns, the Chair of Emergency Medicine at the University of Oklahoma School of Community Medicine, joins us again for another great discussion. 

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Blog post- https://emspodcast.com/non-invasive-ventilation-understanding-the-physiology/

Intubation checklist mentioned at the end of the episode- https://emspodcast.com/ou-em-intubation-checklist/

Can End Tidal CO2 Predict Mortality in Hemorrhagic Shock? Part 2 with Paramedic Courtney ”Coco” Wham

Coco Wham is a paramedic at the Denver Health Paramedic Division. She is also a 4th year medical student and has a masters in integrated sciences.  She is an author on a recent study in the American Journal of Surgery with our previous guest, Dr. Eric Campion.  Their latest study looked at prehospital ETCO2 values and if they were predictive of death and need for massive transfusion as compared to commonly accepted measurements, such as systolic blood pressure and shock index.  The new study is titled, "Prehospital ETCO₂ is predictive of death in intubated and non-intubated patients."  We discuss this study with her and what's next for this research.  We also touch on why prehospital providers should get involved with research.

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What Can End Tidal CO2 Tell Us About Hemorrhagic Shock? Part 1 with Trauma Surgeon Dr. Eric Campion

Dr. Eric Campion is an attending trauma surgeon at Denver Health Medical Center in Denver, Colorado. He has several studies published on the utilization of End Tidal CO2 (ETCO2) in critically injured hemorrhagic shock patients.  As a former paramedic, Dr. Campion has also been studying this data's application to the prehospital setting.  In this episode we discuss the results of two specific studies which lead to his most recent study with Paramedic Courtney "Coco" Wham.  There will be a companion episode released later this month!

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Recognizing Individual Differences: Personalized Approaches to Pain Management

Dr. Spencer Tomberg, a physician in the Department of Emergency Medicine and Orthopedics at Denver Health, discusses pain management and the complex nature of pain perception, highlighting the physical and emotional components. He describes how individuals may have different perceptions of pain due to variations in the action potential and synaptic regions. He dives into the etiology and routes of pain signals from the visceral system and how that contributes to referred pain. He also discusses the differences in treatment when approaching acute, subacute, and chronic pain. Ultimately, it's important to consider the individuality of pain experiences when treating patients and not take a one size fits all approach. Check out another great lecture from the Rocky Mountain Trauma and Emergency Medicine Conference.

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See more from the blog post on our website at:

https://emspodcast.com/pain-perception-is-complex/

Legendary Trauma Surgeon Dr. Gene Moore - how REBOA is changing trauma resuscitative care

In the high-stakes world of emergency medicine, innovations continually push the boundaries of what's possible. One such groundbreaking procedure is Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Dr. Ernest E Moore, who has literally written the book on trauma surgery, teaches us what REBOA is and how it is being used to save lives in critical situations. Another episode from the Rocky Mountain Trauma and Emergency Medicine Conference. 

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See more on this topic from the blog post on our website:

https://emspodcast.com/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa/

 

Are you sure you're prepared for your next intubation? Dr. Stacey Trent Reviews the most up-to-date literature for intubation best practices.

Dr. Stacy Trent, an Associate Professor of Emergency Medicine at the Denver Health Emergency Department, discusses the importance of proper airway management in the emergency setting and introduces the mnemonic SOAPME (suction, oxygen, airway assessment, pharmacy and plan, monitor and equipment) for intubations. Dr. Trent brings with her the most up to date literature about optimizing success and decreasing adverse events during intubation. In this episode we delve deep into the often overlooked aspects of pre-oxygenation and airway assessment, emphasizing the need for thorough preparation and the potential consequences of neglecting these steps.

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More on our website at: https://emspodcast.com/are-you-prepared-for-your-next-intubation/

Plus check out this new trail on DL vs VL for intubation that Dr. Trent eludes to at the end of this episode: https://www.nejm.org/doi/pdf/10.1056/NEJMoa2301601

Disasters Don't Just Involve Adults. Are You Prepared For a Pediatric Disaster? Get Prepared with Dr. Jeffery Upperman

Is your EMS agency prepared for a pediatric disaster? In this episode of EMS CAST, Dr. Jeffrey Upperman joins the hosts live at the Rocky Mountain Trauma and Emergency Medicine Conference. Dr. Upperman gave an entertaining and engaging lecture on what you need to start thinking about to be prepared for a pediatric disaster in your area. After his lecture he joined our podcast to discuss his passion for pediatric disaster preparedness and the journey he has taken over the past 15 years to develop educational platforms in this area. There are some easy steps you can take to make sure that you and your crew are prepared should a disaster strike. Tune in to learn more about Dr. Upperman's work and the importance of being prepared for emergencies involving children.

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EMS Cast Blog Post:

https://emspodcast.com/pediatric-disaster-preparedness/

Video of the Childrens Hospital Los Angeles disaster Olympix-

https://www.youtube.com/watch?v=sZVgdRj-bCc

And check out some more great resources here -

https://www.chla.org/trauma-program/pediatric-disaster-resource-and-training-center

It's Not Just Back Pain. Spinal Emergencies with Dr. Bo Burns.

Stop blowing off back pain patients! There may be a true emergency lurking underneath. Dr. Bo Burns teaches us why we should take atraumatic back pain so seriously. We're back with another episode from the RMTEMC. We dive deep into the topic of epidural abscesses and cauda equina. These are true spinal emergencies, so we should understand them. Our expert guest, Dr. Bo Burns shares valuable insights on how to recognize and diagnose, emphasizing the importance of a high index of suspicion. We also explore the role of pre-hospital providers in identifying at-risk patients and providing crucial information to the emergency department. Join us as we unravel the complexities of spinal emergencies and learn about the latest clinical decision tools and treatment options. 

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Blog post- https://emspodcast.com/spinal-emergencies-a-closer-look-at-back-pain/

Errors, Needs, and Communication in The Pediatric Trauma Call with Pediatric Surgeon Dr. David Bliss

In this episode of EMSCast, hosts Ross Orpet and Will Berry discuss a lecture given by Dr. David Bliss on taking care of pediatric trauma patients. Dr. Bliss emphasizes the importance of supporting the psychosocial needs of pediatric patients, as they may not have the same coping skills as adults. He also discusses the unique challenges of treating pediatric trauma patients, including the need for specialized equipment, medication errors, and issues with diagnosis and communication. Listeners are encouraged to follow EMSCast on Instagram and visit their website emspodcast.com for more educational content.

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https://emspodcast.com/taking-care-of-pediatric-trauma-patients-with-dr-david-bliss/