All in FOAMed
Gestalt. You hear it in almost anything you hear or see in pre hospital as well as the majority of medical education. It's really fancy, chic way of describing something we do every day in the field: make decisions on how and why we treat our patients. It's been termed a hunch, a gut instinct; but it's much more than that.
The gang went on the road to the National Conference on EMS to do a live-recorded episode discussing how new media is changing medical and EMS education.
Why do we continue to use things we’ve used for centuries? What is new media, and what can it bring to you and your students? How have the Internet, blogging, and podcasting made some of our techniques obsolete? And how do we move forward fearlessly to improve education for our profession? We get into it in front of a live audience!
There are a LOT of shout-outs and FOAMed colleagues that we credit in this episode, and we hope that you check out their blogs, sites, and podcasts as well!
We pull another episode out of our vault to talk about con ed...Dan, Kevin, and Jess talk about continuing education! We all have to do it; but some is better than others. Why is yours bad? Why is someone else's good? And what is the value of "alphabet soup" classes in EMS continuing education? Do we need to think about another way?
Continuing Education is more than reading slides off a page; it's about instructors with expertise and passion, sharing their experience with students and encouraging them to learn and practice the material.
PCU, the movie....since we made the reference:
https://www.imdb.com/title/tt0110759/
Bretylium is BACK! Maybe??
https://www.resus.com.au/should-we-bring-bretylium-back-in-cardiac-arrest/
Ashley Liebig on nurse-led codes at dasSMACC:
https://rebelem.com/lessons-learned-and-take-home-messages-from-dassmacc-day-2/
Anna and Dan sit down with attorney and former paramedic Margaret Keavney to discuss end-of-life issues in EMS. How do we honor patient wishes, and the law? What is our standard, and how does our culture and training sometimes work against us?
We don't get great initial training in the end of life, although EMS is present at the majority of these events. Check it out!
Keavney-Streger Law Firm can be found here:
OPALS study on cardiac arrest termination of care:
https://jamanetwork.com/journals/jama/fullarticle/182615
https://www.nejm.org/doi/full/10.1056/NEJMoa052620
New Jersey's POLST:
https://www.nj.gov/health/advancedirective/polst/
About the late Dr John Hinds and his mission to bring advanced care to the patient:
http://www.delta7hems.com
#DoBetter
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:
Dr. Scott Weingart’s website:
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
Dr. Peter Antevy joins Ed to discuss a few pearls about pediatric care and resuscitation in the field. Dr. Antevy wears many hats in EMS and has served as the medical director for Davie fire rescue, Coral Springs-Parkland Fire Rescue, Palm Beach County Fire Rescue. Additionally, he is the President of the Greater Broward EMS Medical Directors’ Association, the 2018 NAEMT Medical Director of the Year, a JEMS top-ten innovator of 2015, and an attending pediatric emergency physician at Joe Dimaggio Children’s Hospital in Hollywood, FL.
Are kids just small adults? How do we handle a pediatric cardiac arrest scene? How involved should parents be in the care of the acutely ill child? Is Ketamine safe to use on children (Spoiler: yes.) These and many more questions are discussed.
Dr. Antevy’s videos and protocols can be found here
2008 Pediatric Emergency Care- Ketamine study
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:
And, why it may NOT be ready for EMS use, yet…..
Ultrasound in Cardiac Arrest:
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
Dan sits down with flight paramedic Dave Aromin to discuss the amazing state of Alaska, and the challenges of providing emergency and retrieval care to the largest state. We discuss the logistics involved in his area, the unique clinical practice involved, and the people who take on this role in one of the most unforgiving environments in the United States and the world.
The EMS community in Alaska suffered a huge blow with the loss of a Guardian Flight fixed-wing crew on January 29, 2019, when their aircraft crashed and all aboard, including a patient were lost. There has been memorial and scholarship funds established for the families of the Guardian Flight crew, and they can be found at the following links:
https://www.customink.com/fundraising/guardianflightalaska
https://www.echoheliops.org/stacie-morse-education-scholarship
This episode is presented in the memories of:
Pilot Patrick Coyle
Flight Paramedic Margaret Langston
Flight Nurse Stacie Rae Morse
and the patient who they were caring for on their last mission.
The gang discusses the controversies and challenges over paramedic degrees. We look at the IAFC position statement, and discuss why fire science is a degree, but paramedicine isn’t.
Anna and Dan discuss provider mental health and the lack of preparation for those entering the profession.
Is it possible that our culture keeps us from achieving our goals, our place, and our future?
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We take a look at the age-old controversy….ALS or BLS? What works? What doesn’t? And what may be the future of EMS?
On today's episode we have the founder of REBEL EM, Salim Rezaie! Dr. Rezaie is a pioneer of the FOAMed movement and has a lot to say about the Paramedic2 trial and the future of #FOAM and EM education.
Rebel EM can be found at rebelem.com
WIKem can be found at https://www.wikem.org/wiki/Main_Page and in the Apple store and Google play store
T:@OverrunEMS
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IG: Overrunproductions
