All tagged Emergency Medicine

Episode 108: DEI in EMS with Dr. Tristan Glenn and Dr. Alicia Rouff

Episode 108: DEI in EMS with Dr. Tristan Glenn and Dr. Alicia Rouff

Ed Bauter
Controversy, Interview, Medicine, Mental Health

A Block

 

Dr. Tristan Glenn discusses diversity, equity, and inclusion (DEI) in the context of EMS. He emphasizes the importance of understanding and valuing individual identities and lived experiences. Microaggressions are explored as harmful behaviors that communicate negative appraisals of individuals. The lack of diversity in EMS is highlighted, and the need for purposeful recruitment and community engagement is discussed. Dr. Glenn suggests embedding DEI principles throughout the entire organization and utilizing technology, such as mixed reality simulations, for training. Overcoming resistance to DEI initiatives requires cultivating a consciousness of the impact each individual has on creating an equitable and inclusive environment.

 

Takeaways

 

DEI involves understanding and valuing individual identities and lived experiences.

Microaggressions are harmful behaviors that communicate negative appraisals of individuals.

Recruitment and community engagement are essential for increasing diversity in EMS.

Embedding DEI principles throughout the organization and utilizing technology can support DEI initiatives.

Overcoming resistance to DEI requires cultivating a consciousness of the impact each individual has on creating an equitable and inclusive environment.

 

B Block

 

Dr. Alicia Rouff joins the podcast to discuss diversity, equity, and inclusion (DEI) in emergency medicine and EMS. The conversation explores the current state of DEI in the field, the challenges faced by underrepresented groups, and the need for proactive change. The importance of recruitment and creating opportunities for people of color in EMS is highlighted. The discussion also emphasizes the importance of cultural understanding and respect when interacting with patients from diverse backgrounds. The episode concludes with a message of showing up as your authentic self and promoting kindness in healthcare.

 

Takeaways

 

DEI in emergency medicine and EMS is an ongoing challenge that requires proactive change.

Recruitment and creating opportunities for people of color in EMS is crucial for increasing diversity in the field.

Cultural understanding and respect are essential when interacting with patients from diverse backgrounds.

Showing up as your authentic self and promoting kindness in healthcare can make a positive impact.

 

Episode 100 (!): Dr. Mark Merlin on Where We've Been and Where We're Going

Episode 100 (!): Dr. Mark Merlin on Where We've Been and Where We're Going

Ed Bauter
FOAMed, Interview, MD1

For our 100th episode, we sat down with a friend of the show Dr. Mark Merlin of MD1 to discuss how far EMS has come in the last 5 years and where EMS might go in the next 5 years. Dr. Merlin talks about his 2009 study using the MAR method to estimate blood loss as well as the recent Emergency Medicine Match dilemma. Take a listen and let us know what you think. Has EMS gotten better in the last 5 years? What can we do to improve our practice over the next 5 years?

Episode 96: Chief John Moon and Freedom House EMS

Episode 96: Chief John Moon and Freedom House EMS

Daniel Schwester
Interview

We had an amazing talk with Chief John Moon, (ret) of Pittsburgh EMS and Freedom House Ambulance, one of the first paramedics in the United States.

If you don't know the story of Freedom House, you should. Before Seattle, Miami, and yes, even Squad 51, Freedom House was providing bleeding-edge care to the citizens of the Hill and greater Pittsburgh, in a world where they were not regarded as equals in emergency services or healthcare.

With the guidance of Dr. Peter Safar and Dr. Nancy Caroline, (yes, THAT Dr. Caroline) Freedom House showed that timely EMS intervention contributed to improved outcomes.

We owe them all a debt that cannot be repaid.

Buy the book here:

https://www.amazon.com/American-Sirens-Incredible-Americas-Paramedics/dp/0306926075/ref=sr_1_1?crid=3K2DH5O0LSFHY&keywords=american+sirens&qid=1676859470&sprefix=american+sirens%2Caps%2C96&sr=8-1

Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

Episode 94: Better CPR at the end of the year with Josh Lupton and Ken Milne

Ed Bauter
Cardiac Arrest

We end the year with 2 great interviews about cardiac arrest. Josh Lupton is a physician in Oregon who found in 2021 that there might be an ideal number of rescuers for OHCA. Hint: It's more than you think.

Then Ken Milne joins us from the Skeptics Guide to Emergency Medicine to discuss whether heads-up CPR with a commercial device is ready for prime time.

This is our last episode of the year and we wanted to thank everyone for listening. Check out the website, subscribe to the podcast, and keep an eye out during 2023. Lots of more exciting stuff coming!

Episode 92: American Sirens with Kevin Hazzard

Episode 92: American Sirens with Kevin Hazzard

Daniel Schwester
Interview

Kevin Hazzard is a paramedic and author who wrote the book A Thousand Naked Strangers, detailing his time as a ground paramedic in Atlanta. He's back with a new story, one that you absolutely need to read.

American Sirens: The Incredible Story of the Black Men who Became America's First Paramedics is the story of a handful of Black men from Pittsburgh who were chosen to become paramedics. It's a story about perseverance, grace under pressure, and dignity that every EMS clinician should read. We were lucky to have Kevin on to speak about the book and his experience in telling the story, and why it matters.

Episode 83: Fundamentals of Bag Mask Ventilation with Rommie Duckworth

Episode 83: Fundamentals of Bag Mask Ventilation with Rommie Duckworth

Daniel Schwester
Airway Management, FOAMed, Interview

One of the most misunderstood pieces of equipment we have is the bag valve mask. Easy to operate, but hard to master, it’s one of the fundamental skills we need to master.

Rommie Duckworth is a nationally-known paramedic and educator in Connecticut who is truly passionate about education and ventilation, and Dan gets to pick his brain and talk about what really matters when we have to breathe for our patients who can’t do it for themselves.

Check out Rommie here:

https://romduck.com

If we’re talking airway or ventilation, Dr. Jim DuCanto isn’t far from the discussion. We talk about his method of BVM grip in the episode, and you can learn more here:

https://www.hmpgloballearningnetwork.com/site/emsworld/original-contribution/edge-there-better-grip-face-mask-ventilation

Here’s a paper Dan did with some colleagues showing smaller sized BVMs gave a more physiologically appropriate tidal volume and pressure:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234703/

The Refresh 2021 program is still available until March 31…..EMTs and Paramedics should jump on this, it’s totally FREE!

https://www.prodigyems.com/refresh2021

Episode 72: Prehospital Burn Care

Episode 72: Prehospital Burn Care

Daniel Schwester
Medicine, Trauma, Pediatrics

Ed and Dan are back, this time talking about care of burn patients outside of the hospital. Burn injuries are high-acuity, low occurrence events (HALO), and it’s easy to miss things that may have a bigger impact on your patient than previously thought.

We talk about initial basic care, why wet dressings are bad for anything more than a very small burn, fluid resuscitation and the drama that surrounds it, and pain management (in a word, YES).

Dr. Peter Antevy comes in with a Pedatric Pearl, as well…

Episode 70: Pediatric Cardiac Arrest and Improving Outcomes with Dr. Peter Antevy

Episode 70: Pediatric Cardiac Arrest and Improving Outcomes with Dr. Peter Antevy

Daniel Schwester
Conference, FOAMed, Interview

For most places in EMS, how we treat cardiac arrests in adults is drastically different than how we do it in pediatric patients. And the results show it.

Ed and Dan sit down with Dr. Peter Antevy and talk about how we can do better with pediatric arrests. Dr. Antevy’s programs in Florida have dramatically improved their pediatric survival from cardiac arrest, by focusing on the basics, staying on scene to resuscitate before moving to the hospital, and by engaging parents with WHY we are doing what we do on scene.

This is a critically important topic that we don't talk about. But we need to prepare for these low-frequency, high-stress events to give out patients every possible chance to survive.

On another note, go to https://www.prodigyems.com/refresh2021 to see the talk that inspired this episode. This is some of the best paramedic level training out there today, and it’s NREMT approved, and FREE!

Check out Dr. Antevy’s stuff at:

https://www.handtevy.com

Early epinephrine administration improving outcomes:

https://www.ahajournals.org/doi/epub/10.1161/JAHA.119.014330

We talk about the AHA PALS guidelines for 2020, here they are:

https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000000901

The Polk County study on pediatric OHCA:

https://pubmed.ncbi.nlm.nih.gov/30412719/

Time on scene in pediatric arrest matters:

https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.116.023821


Episode 65: Bringing Battlefield Care to the Street with Dr. Andrew Fisher

Episode 65: Bringing Battlefield Care to the Street with Dr. Andrew Fisher

Daniel Schwester
Trauma, FOAMed, Interview

On this episode, Dan gets to sit down virtually with Dr. Andrew Fisher, otherwise known as “Saint” Fisher, of the Saint Fisher Church of Evidence Based Medicine. He’s been an EMT, Paramedic, PA, surgical PGY-1, Army Ranger, and author of a lot of what works in trauma care, especially in prehospital environments.

This is long episode, but there’s a TON of information…everything from tourniquets, pain management, blood vs. crystalloid, “scoop and run”, and much, much more. We also talk about education, and how The Church is looking to educate while still having a laugh or two.

Dr. Fisher’s Twitter feed:

https://twitter.com/fisherad1?lang=en

Kotwal, et al. study on the 75th Ranger Regiment:

https://pubmed.ncbi.nlm.nih.gov/21844425/

the PAMPER trial on prehospital plasma:

https://www.nejm.org/doi/full/10.1056/NEJMoa1802345

Fisher on ketamine:

https://pubmed.ncbi.nlm.nih.gov/25399363/

Ketamine and PTSD:

https://pubmed.ncbi.nlm.nih.gov/18376165/

Stop the Bleed information:

https://www.stopthebleed.org

https://www.dhs.gov/stopthebleed

https://community.fema.gov/until-help-arrives

Episode 64: Ketamine and Dunning-Kruger

Episode 64: Ketamine and Dunning-Kruger

Daniel Schwester
Drugs, Controversy

In the FOAMed world, nothing is more loved than ketamine. There have been multiple podcasts and talks about the drug, and it’s acquired a mythic status on the Internet med ed word.

But is what we think we know causing problems? Is the promise of ketamine as a drug the does it all lull us, and especially new clinicians, into a false sense of security? Has FOAMed put us on the wrong side of the Dunning-Kruger curve?

Episode 60: Art, Communication, and Healing

Episode 60: Art, Communication, and Healing

Daniel Schwester
Interview, Medicine, Health and Safety

Ed and Dan sit down with fellow colleague and paramedic Kate Bergen about her art series that she created during COVID-19, and how she uses art to help manage her stress levels working in the challenging environment of EMS in the US today, and chronicle the amazing work that EMS has done in this new world.

The important thing to take from this episode is that everyone in EMS NEEDS to have some form of healthy release, a way to quiet your brain and recharge. Whatever you do, it is worth it. YOU are worth it.

Kate's work can be found at:

https://www.jbergenstudios.com/jbergenstudios

Kate has been working with Mission Hope, an organization to help clinicians and responders in the NJ area with mental health. Find out more about them at:

About Us

Kate's spot on ABC:

https://abcnews.go.com/Lifestyle/video/paramedic-turned-paint-brush-cope-pandemic-70770797

Kate's cover story in Real Woman magazine:

Working on the Front Lines of COVID-19 is as Scary as It Sounds

Episode 57: Beercast 4-ICD-10 and Pockets....

Episode 57: Beercast 4-ICD-10 and Pockets....

Daniel Schwester

We get it. The FOAMed world has been a little COVID-19 heavy. You need a small break from the information flooding us all, and a laugh or two might be just the thing for you.

So, we pulled this episode out of the vault!

On the newest Beercast, the gang kicks back with some refreshments, and start off by talking about some of the most out there ICD-10 codes you can find. For example, did you ever wonder how they code your patient involved in a spacecraft accident? We went digging, so you don’t have to!

We also talk about the little things that people carry in their pockets on duty; and why…

Get ready for a change of pace, and an afternoon of fun with the gang!

Episode 55: Outbreak EMS

Episode 55: Outbreak EMS

Daniel Schwester
Airway Management, Controversy, FOAMed, Health and Safety, MD1

Dan and Ed sit down on short notice to get some information together about what we as EMS clinicians are up against with the arrival of novel coronavirus.

This is a totally off-label discussion about personal protective equipment, airway management, patient assessment, and items that we are seeing on social media and the FOAMed world.

Please follow your local policies and guidelines, and involve your medical director and leadership with any modifications to your practice.

Follow us at Overrun Productions' YouTube channel, and the MD1 Program YouTube channel for daily updates and practice tips. Leave us questions in the comments section, and we can have our medical director, Dr. Mark Merlin, share his answers on them!

The Overrun is on YouTube at:

https://www.youtube.com/channel/UCGqDBcqJl3B0HLigT5Wl9AA

MD1 Program on YouTube:

https://www.youtube.com/channel/UC93VE2Sr9AC3sMCN0W7uLQA

We're using the Johns Hopkins University Coronavirus Resource center for our data:

https://coronavirus.jhu.edu/map.html

Twitter has been a good resource for FOAMed lately; here's some of the experts we're following:

Minh LeCong: @ketaminh

Salim R. Rezaie, MD:@srrezaie (www.rebelem.com)

Episode 47: What The Actual?

Episode 47: What The Actual?

Daniel Schwester

Anna and Dan talk about some of the more...let's say "out there" news items in EMS, and how culture and social media can hurt us as professionals.

This is a controversial topic, and yes, we hope that we get some discussion on it. But the bottom line:

If you're not doing the right thing for your patient; you're wrong.

Article on starting IV on 13 year old:

https://www.lancastereaglegazette.com/story/news/local/2019/08/20/one-firefighter-fired-another-suspended-after-april-incident/2024532001/

Firefighters bringing dead patients to station for practice in endotracheal intubation:

https://www.bellinghamherald.com/news/local/article218955030.html

Check out suppurative thrombophlebitis:

https://www.uptodate.com/contents/suppurative-septic-thrombophlebitis

IV access and pain:

https://www.ncbi.nlm.nih.gov/pubmed/29772984

Dr John Hinds was a master clinician, and we miss him every day. Please watch this and see if you don't learn anything.

https://litfl.com/crack-the-chest-get-crucified/

Check out the MD1 program at:

https://md1program.org



Episode 44: Our Cric Show

Episode 44: Our Cric Show

Ed Bauter
FOAMed, Medicine, Airway Management

We talk about a wide variety of all things cricothyroidotomy: mental prep and training, the difference in the techniques that are out there, which one might work better, and lots of other stuff. We also shoutout to a LOT of other resources that will help you to really understand this low frequency, but critical procedure.

If this is in your scope of practice; or possibly in a situation where a clinician will use this; you need to know about this to be able to care for your patient.

Dr. Rich Levitan’s website:

https://www.airwaycam.com

Dr. Scott Weingart’s website:

https://emcrit.org

The EMCrit podcast can be found on iTunes (just like us!)…it’s one of the best around with literally hundreds of topics!

SMACC was an amazing prehospital/emergency/and critical care conference that changed how many of us looked at conferences and learning. Check out their stuff here:

https://smacc.net.au/blog/

New England Journal of Medicine paper on comparing cric techniques:

https://www.jwatch.org/em200503300000002/2005/03/30/open-cricothyroidotomy-vs-seldinger-technique

Here’s the case study about the NG tube going into the spinal column…

https://www.sciencedirect.com/science/article/abs/pii/S0196070911000755

Episode 41: Fluids and Pressors

Episode 41: Fluids and Pressors

Daniel Schwester

Ed, Mike and Dan get nerdy again talking about IV fluids and vasopressors! What works, why, and what do you need to know about the stuff we put into patients…and why it may be hurting more than helping!

2008 JAMA article on fluid resuscitation:

Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults

R Bellomo, C Hegarty, D Story, L Ho, M Bailey – Jama, 2012 – jamanetwork.com… “Normal” 0.9 per cent salt solution is neither “normal” nor physiological. JAMA … The
biochemical effects of restricting chloride-rich fluids in intensive care. Crit Care Med … Crit
Care Resusc. 2008;10(3):225-23018798721PubMedGoogle

Cochrane Review on colloids or crystalloids:

Colloids or crystalloids for fluid replacement in critically people …

https://www.cochrane.org/…/INJ_colloids-or-crystalloids-fluid-replacement-critically-…

Costs involved in using colloids:

Albumin Use Guidelines and Outcome in a Surgical … – JAMA Network

https://jamanetwork.com/journals/jamasurgery/fullarticle/401980

ATLS 10th edition changes:

ATLS 10th edition offers new insights into managing trauma patients



SPECIAL EPISODE-RECAP of the EMS/MD1 Fellowship Conference!

SPECIAL EPISODE-RECAP of the EMS/MD1 Fellowship Conference!

Daniel Schwester
FOAMed, Conference, MD1

Dan recaps the MD1 EMS Conference and shares what he learned from a room full of EM/EMS physicians speaking to EMS clinicians! If you saw the Facebook Live and Instagram streams from this show; you know there was an enormous amount of knowledge being put out!

Check out Dr. Mark Merlin on Twitter at : @ccareanywhere

The NJ EMS and Disaster Medicine Fellowship can be found at: www.emsfellowship.com

The MD1 physician response program: www.md1program.org

Dr. Qasim is on Twitter at: @emeddoc

Dr. Callelo: @DrDianeC, @njpoisoncenter, also at @ToxAndHound

The COMBAT trial for prehospital plasma:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31553-8/fulltext

The PAMPHER trial:

https://www.nejm.org/doi/full/10.1056/NEJMoa1802345

BOKUTOH criteria study:

https://www.jem-journal.com/article/S0736-4679(17)30471-7/pdf

PARAMEDIC2 study of Epinephrine in OHCA:

https://www.nejm.org/doi/full/10.1056/NEJMoa1806842

Pediatric airway management in cardiac arrest:

https://www.ncbi.nlm.nih.gov/pubmed/30862528

Heads up CPR in OHCA:

https://www.jems.com/articles/supplements/special-topics/state-of-the-future-of-resuscitation/head-up-cpr-may-improve-neurologically-intact-survival-rates.html

And, why it may NOT be ready for EMS use, yet…..

https://www.ems1.com/ems-products/cpr-resuscitation/articles/393699048-Why-heads-up-CPR-is-NOT-ready-for-out-of-hospital-cardiac-arrest-care/

Ultrasound in Cardiac Arrest:

https://www.cureus.com/articles/18740-does-point-of-care-ultrasound-use-impact-resuscitation-length-rates-of-intervention-and-clinical-outcomes-during-cardiac-arrest-a-study-from-the-sonography-in-hypotension-and-cardiac-arrest-in-the-emergency-department-shoc-ed-investigators


Episode 36-Sepsis and Prehospital Care

Episode 36-Sepsis and Prehospital Care

Daniel Schwester
Medicine, FOAMed

Ed, Jess, and Dan discuss where we've been with sepsis, where we are, and maybe where we're going. Fluids, pressers, scoring....there's a LOT of information out there, and we try to sort through it for you

The Early Goal-Directed Therapy paper from 2001:

https://www.nejm.org/doi/full/10.1056/NEJMoa010307

Listen to Dr. Weingart (@emcrit) tale with the author himself in a two-part interview:

Podcast 054 – Dr. Rivers on Severe Sepsis – Part I

https://emcrit.org/emcrit/rivers-sepsis-i/

Copy and paste this URL into your WordPress site to embed

Podcast 055 – Dr. Rivers on Severe Sepsis – Part II

https://emcrit.org/emcrit/rivers-sepsis-ii/

Center for Disease Control sepsis information:

https://www.cdc.gov/sepsis/clinicaltools/index.html

Dutch PHANTASi trial:

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(17)30469-1.pdf

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