The podcast crew is joined by a special guest, Dr. Andrew Partain, an EMS Fellow from UTSW in Dallas. We will dissect his recent data surrounding ketamine-only intubation from MedStar in Fort Worth. This is not just another boring data rehash.

Episode 166 - The MCHD EKG Manifesto - Part 1

Mar 25th, 2024 35m 25s

Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of h

Episode 165 - Intracerebral Hemorrhage

Feb 26th, 2024 32m 6s

We've spent countless hours (rightfully so) discussing ischemic stroke management over the past several years. Sometimes, the other 20% of strokes, the hemorrhagic version, can get neglected. No, we don't have stroke-mobiles at MCHD to diagnose

Episode 164 - EMS HOCUS POCUS

Jan 29th, 2024 29m 20s

MCHD's POCUS program has definitely involved both forward progress and lessons learned. In this episode, we'll discuss some of the reasons POCUS can be a game changer in the prehospital setting. However, unintended consequences do exist. We've

Episode 163 - Back Pain Beware

Jan 2nd, 2024 35m 16s

MCHD paramedic Wes Hall joins the podcast crew to discuss a recent seemingly mundane back pain call. Please listen to find out how avoidance of premature closure, a thorough exam, and professional patient advocacy led to an excellent outcome in

Episode 162 - Post-ROSC Pressor Choice

Dec 4th, 2023 30m 39s

We recently made a significant vasopressor protocol change at MCHD, prioritizing norepinephrine in all shock situations except anaphylaxis and bradycardia. The evidence supporting norepinephrine in septic and even cariogenic shock is relatively

Episode 161 - MMQ#9 - The Angioedema Airway

Nov 6th, 2023 32m 57s

MCHD District Chief April Currie joins the podcast crew to discuss an angioedema case that repeatedly left more questions than answers. Dr. Patrick was tasked with managing the airway and definitely has some lessons learned to share with the l

Episode 160 - ST Elevation in aVR With Diffuse ST Depression

Oct 9th, 2023 23m 53s

The podcast crew dives deep into one of the early "STEMI equivalent" ECG patterns: ST elevation in aVR with diffuse ST depression. What does the evidence say about this pattern? Is there a FOAM lesson to be learned? How should we incorporate th

Episode 159 - MMQ#8 - The Head and the Heart

Sep 11th, 2023 25m 24s

Dr. Dickson leads the discussion with recent cases involving the PECARN pediatric head injury decision rule and some super sneaky toxicology. There is some high-level detective work happening during this episode. Listen so you don't miss vita

Episode 158 - Terrible Tracheostomy 2023

Aug 14th, 2023 21m 52s

The podcast crew is joined by MCHD In-Charge Paramedics, Ben Breaux, and Jesus Contreras to discuss a critical case that demonstrates why continuing education and intentional mental reps are vital in emergency care. We've discussed the "how-to

Episode 157 - Cardiac Arrest During EMS Care - Making MOVES

Jul 17th, 2023 23m 39s

There is nothing more stressful than seeing EMS peri-arrest progress to pulseless. CARES data suggest that cardiac arrest during transport is not an uncommon event. Additionally, there is new evidence that these patients may not be as difficu

Episode 156 - MMQ#7 A Shocking Save And Sneaky Serial Killer

Jun 19th, 2023 23m 50s

Sometimes it's easy on the individual level to miss the positive drift within EMS as systems of care evolve and change toward positive innovation. Dr. Patrick hits the hot seat on this episode to discuss two recent cases where some of MCHD's f

Episode 155 - MMQ#6 - A Rapid AFib Riddle

May 22nd, 2023 29m 12s

Join the podcast crew as they discuss one of the more sticky situations in all of emergency care: stable vs. unstable narrow complex tachycardia.1. How do we even define unstable?2. Is it cardiac versus an underlying illness?3. How do we app

Episode 154- Death Notification Lessons Learned

Apr 24th, 2023 21m 37s

The concept of emphasizing, discussing, and training on giving prehospital death notification is, unfortunately for medics and our patient's families, a relatively new concept. Additionally, newer evidence shows that an increased frequency of

Episode 153 - MMQ#5 From The PNW - Spokane Frozen Solid

Mar 27th, 2023 30m 11s

The Podcast Crew is joined by Spokane Valley Fire Paramedic Noah Martinez to discuss a recent patient that he delivered to Dr. Patrick. After you hear what Noah found on the scene, this story will likely not end exactly how you expect. Learn

Episode 152 - The MCHD SNORES Sedation Safety Bundle

Mar 13th, 2023 29m 35s

Chemical sedation is one of the riskiest decisions made in EMS clinical care, period. We've been working overtime at MCHD over the past couple of years to decrease the risk and improve our safety profile for the entire clinical package when we

Episode 151 - MMQ#4 - Dr. Dickson's Strokes

Feb 27th, 2023 38m 48s

Join us as Dr. Dickson brings a couple of extremely difficult recent emergency department cases to take a hard look in his own clinical mirror. These will highlight the difficult and often dynamic nature of assessing airway patency and protect

Episode 150 - Hyperkalemia, BRASH syndrome, And Amiodarone BEWARE

Feb 13th, 2023 30m 31s

MCHD paramedic, Lily Trosclair, joins the podcast to discuss some in-depth hyperkalemia treatment details, including BRASH syndrome. We'll also pivot to the dangers of giving amiodarone to a hyperkalemic patient that's mistaken for ventricular

Episode 149 - Finding Joy In The Common

Jan 30th, 2023 27m 12s

This may seem like a curveball-type episode upon your initial listen, but this topic should be core material for all emergency medical clinicians. Too much time and emphasis within paramedic education are placed on rare presentations. Dr. Dick

Episode 148 - ET3 And Beyond With Dr. Gerad Troutman

Jan 16th, 2023 35m 30s

The podcast crew is joined, live at Texas EMS 2022, by Dr. Gerad Troutman to discuss the world of alternate destination EMS transports, EMS-facilitated telehealth, nurse navigation, and "hospital at home." Dr. Troutman leads the ET3 initiative

Episode 147 - MMQ#3 - CAB For The Win

Jan 2nd, 2023 36m 25s

MCHD medics Kelcie Adams and Rich Serra join the podcast to discuss a critically ill trauma patient they delivered to Dr. Patrick in the emergency department. Our default is so often airway, airway, airway first, but prioritizing circulation f

Episode 146 - NTG In RVMI With Matt Wilkinson-Stokes

Dec 19th, 2022 36m 3s

Special guest alert!! We're lucky to have superstar Aussie medic and University of Melbourne Ph.D. candidate Matt Wilkison-Stokes, on this episode to discuss his recent paper looking at the risk of hypotension with nitroglycerin administration

Episode 145 - Where Do We Look? Who Do We Trust?

Dec 5th, 2022 34m 14s

We have MCHD Cpt. Megan Powell to thank for this episode as she posed an excellent question about where and how to look for trusted educational information as a practicing paramedic interested in continuing clinical growth and progression. Wit

Episode 144 - The TBI "H-Bombs" With Dr. Al Lulla

Nov 21st, 2022 34m 54s

Join this discussion of some of the recent literature surrounding EMS care of traumatic brain injury with Dr. Al Lulla. This is the perfect confluence of advancing evidence, relatively straightforward interventions, and a patient population wh

Episode 143: Adrenal Crisis in EMS

Nov 7th, 2022 34m 8s

When it comes to exciting educational topics in EMS, oftentimes, the endocrine system, specifically the adrenal glands, can be left off the list. Dr. Patrick is joined by one of our local emergency/trauma nurses, Melanie Gander, to discuss her