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Science & Medicine

MCHD Paramedic Podcast

Updated about 1 month ago

Science & Medicine
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The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick invite you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

Read more

The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick invite you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

iTunes Ratings

67 Ratings
Average Ratings
65
0
1
1
0

MCHD Paramedic podcast

By robsmith77 - Jul 11 2018
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An excellent podcast full of useful information no matter what your EMS level may be !

Perfect for busy people

By lgrillon - Apr 22 2018
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Great listen for the car, gym or home. Interesting and relevant topics with some excellent guests.

iTunes Ratings

67 Ratings
Average Ratings
65
0
1
1
0

MCHD Paramedic podcast

By robsmith77 - Jul 11 2018
Read more
An excellent podcast full of useful information no matter what your EMS level may be !

Perfect for busy people

By lgrillon - Apr 22 2018
Read more
Great listen for the car, gym or home. Interesting and relevant topics with some excellent guests.
Cover image of MCHD Paramedic Podcast

MCHD Paramedic Podcast

Updated about 1 month ago

Read more

The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Directors Dr. Robert Dickson and Dr. Casey Patrick invite you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

Rank #1: Episode 37 - Top Ten Meds

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Dr. Patrick and Clinical Manager Jordan Anderson run down the 10 most commonly prescribed medications in the US. The medication list can often feel like one more task that’s always partial and incomplete. Jordan and Dr. Patrick try to take a more detective-like approach to demonstrate the utility of anticipating side-effects and potential diagnoses based on medication list clues.
References:
1. http://discovermagazine.com/2010/mar/07-dr-drank-broth-gave-ulcer-solved-medical-mystery
2. Gomes T, et al (2017) Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study. PLoS Med 14(10): e1002396
Dec 17 2018
35 mins
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Rank #2: Episode 45 - Hypertensive Emergencies - To Treat Or Not To Treat

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Managing markedly elevated blood pressures has to be one of the most common EMS clinical dilemmas. Dr. Dickson joins Dr. Patrick to help dispel some long-standing and persistent hypertension management myths. The concept of “end organ damage” is also introduced as a framework to properly identify those patients with elevated blood pressures who DO warrant emergent treatment in the prehospital setting.
Mar 04 2019
28 mins
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Rank #3: Episode 15 - Congestive Heart Failure Part 1 - The Basics

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CHF exacerbations are bread and butter emergency medicine. Casey Patrick and Brad Ward begin with some background physiology and review of CHF. They then move on to describing a more detailed framework than the typical “CHF exacerbation” that is commonly taught. You’ll finish this podcast and think you’re a plumber as opposed to a paramedic.
References

https://coreem.net/core/ape/
Jun 25 2018
15 mins
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Rank #4: Episode 36 - Calcium Channel Blocker And Beta Blocker Toxcicity

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Shownotes:
Cardiovascular medication poisoning can produce markedly unstable patient presentations. Dr. Patrick and Brad Ward review some of the basics and more recent therapeutic developments in the treatment and management of beta-blocker and calcium channel blocker toxicity.

References:

1. St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Critical Care Medicine. 2017;45(3):e306-e315.

2. Wax P, Erdman A, Chyka P, et al. Beta-blocker ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005; 43(3):131-146.
Dec 11 2018
26 mins
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Rank #5: Episode 28 - Shock States - B2B

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Many of the sickest of the sick patients that we see as EMS providers are hypotensive. These folks are often altered and come with spotty histories at best. This episode turns our B2B series to the prehospital management and recognition of shock. How can we better classify then treat our undifferentiated patients in shock? Dr. Patrick and Dr. Dickson build a framework around common sense pathophysiology and treatment.
Sep 26 2018
32 mins
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Rank #6: Episode 16 - Congestive Heart Failure Part 2 - Nitro, Nitro, Nitro

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Patients with acute pulmonary edema need rapid preload and afterload reduction and often their volume status is difficult to ascertain. Casey Patrick and Brad Ward discuss a novel approach to using our old friend nitroglycerin in these patients along with the other cornerstones of their care.
References

1. Cotter G, Metzkor E, Kaluski E, et al. Randomised trial of high-dose isosorbide dinitrate plus low-dose furosemide versus high-dose furosemide plus low-dose isosorbide dinitrate in severe pulmonary oedema. Lancet. 1998;351(9100):389-93.
2. Levy P, Compton S, Welch R, et al. Treatment of severe decompensated heart failure with high-dose intravenous nitroglycerin: a feasibility and outcome analysis. Ann Emerg Med. 2007;50(2):144-52.
3. Wilson SS, Kwiatkowski GM, Millis SR, et al. Use of nitroglycerin by bolus prevents intensive care unit admission in patients with acute hypertensive heart failure. Am J Emerg Med. 2017;35(1):126-31.
4. Peacock WF et al. Morphine and Outcomes in Acute Decompensated Heart Failure: An ADHERE Analysis. Emerg Med J 2008; 25: 205 – 209.
Jun 25 2018
16 mins
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Rank #7: Episode 46 - Tactical EMS Pearls With Dr. Kevin Schulz

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This episode is loaded with tactical EMS pearls. Houston Fire Department Assistant Medical Director, Dr. Kevin Schulz, joins the podcast again to lend his TEMS expertise. MCHD’s tactical leader, Patrick Langan, leads the discussion and provides a Montgomery County perspective.
Mar 26 2019
33 mins
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Rank #8: Episode 19 - OB Part I

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Pregnancy complications make us all a little diaphoretic and tachycardic. On this episode, Dr. Patrick and Dr. Dickson break down the must know aspects of caring for the obstetric patient prior to delivery in the EMS setting.

References:
https://www.acog.org/Clinical-Guidance-and-Publications/Task-Force-and-Work-Group-Reports/Hypertension-in-Pregnancy
Jul 30 2018
25 mins
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Rank #9: Episode 31 - Hyperoxygenation - Too Much of a Good Thing??

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Too much of a good thing can always end up being bad. On this episode, Dr. Patrick summarizes the ever increasing evidence that not only does supplemental oxygen not help in patients with reasonable O2 saturations, it likely is harmful in many commonly encountered disease states. Join us for some first-class mythbusting.

References:
1. https://dundeechest.wordpress.com/2009/08/12/why-do-copd-patients-retain-co2-when-given-too-much-oxygen/

2. Chu DK et al. Mortality and Morbidity in Acutely Ill Adults Treated with Liberal Versus Conservative Oxygen Therapy (IOTA): A Systematic Review and Meta-Analysis. Lancet 2018.
Oct 08 2018
29 mins
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Rank #10: Episode 21 - Ketamine For Control

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Dr. Dickson and Dr. Patrick take on one of our favorite topics here at MCHD - Ketamine and the agitated patient. Agitated patients come in a wide spectrum of severity. This discussion starts with a framework for stratifying agitated patients. We discuss the MCHD ketamine experience along with a less discussed patient population that may need ketamine control quicker than we often think. Remember that Ketamine is only to be used for patient protection and is never intended to be used out of convenience.

References:
1. https://www.ems1.com/medical-clinical/articles/78100048-Ketamine-for-Excited-Delirium-Syndrome-Results-of-a-3-year-case-series/
2. Green et al. Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation. Ann Emerg Med. 2011; 57:449-61
3. Cole J et al. A prospective study of ketamine as primary therapy for prehospital profound agitation. Am J Emerg Med. October 2017
4. Parsch C et al. Ketamine reduces the need for intubation in patients with acute severe mental illness and agitation requiring transport to definitive care: An observational study. Emerg Med Australas. 2017;29(3):291-296

Aug 14 2018
18 mins
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Rank #11: Episode 27 - Slips, Trips, And Falls

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Falls are one of our most common calls in the EMS world. The potential disease processes and injuries can be wide ranging and difficult to sort. Join Dr. Patrick and Dr. Dickson as they break falls down into two main questions that must be answered on every fall patient. Learn the high risk characteristics and diagnoses to consider and rule out.
Sep 10 2018
29 mins
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Rank #12: Episode 29 - Pediatric Arrest With Dr. Greg Faris

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Peds EMS wizard, Dr. Greg Faris, joins us again on the podcast to discuss pediatric out-of-hosiptal cardiac arrest. This topic gives us all a bit of nausea and tachycardia. We’ll review some recent literature that will, hopefully, nudge us to change the practice of “scoop and run” in our pediatric cardiac arrests.

Pediatric OHCA References
Tijssen JA, et al. Time on the scene and interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest. Resuscitation. 2015 September; 94: 1-7.

Munoz MG, et al. An ethical justification for termination of resuscitation protocols for pediatric patients. Pediatric Emerg Care 2017; 33: 505-515.

American College of Surgeons Committee on, T., et al. (2014). "Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest." Pediatrics 133(4): e1104-1116.

Goto, Y., et al. (2016). "Duration of Prehospital Cardiopulmonary Resuscitation and Favorable Neurological Outcomes for Pediatric Out-of-Hospital Cardiac Arrests: A Nationwide, Population-Based Cohort Study." Circulation 134(25): 2046-2059.

Capizzani AR, et al. Assessment of termination of trauma resuscitation guidelines: are children small adults. J of Peds Surg; 2010: 45, 903-907.
Sep 28 2018
20 mins
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Rank #13: Episode 22 - TXA (Tranexamic Acid)

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Tranexamic Acid (TXA) has been a hot topic in emergency medicine over the past several years with increasing acceptance for use in patients with hemorrhagic shock. Casey Patrick and Jordan Anderson review the pharmacology of TXA, discuss the literature supporting its use, and close with MCHD’s TXA administration protocol.

References

1. Gayet-Ageron A et al. Effect of Treatment Delay on the Effectiveness and Safety of Antifibrinolytics in Acute Severe Haemorrhage: A Meta-Analysis of Individual Patient-Level Data From 40138 Bleeding Patients. Lancet 2017.

2. Effects of Tranexamic Acid on Death, Vascular Occlusive Events, And Blood Transfusion in Trauma Patients With Significant Haemorrhage (CRASH-2): A Randomised, Placebo-Controlled Trial. Lancet 2010.

3. Effect of Early Tranexamic Acid Administration on Mortality, Hysterectomy, and Other Morbidities in Women with Post-Partum Haemorrhage (WOMAN): An International, Randomised, Double-Blind, Placebo-Controlled Trial. Lancet 2017.
Aug 14 2018
21 mins
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Rank #14: Bonus Episode - Fentanyl Fever: Unnecessary Hysteria

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Dr. Jerry Snow, a medical toxicologist and emergency medicine physician from Phoenix joins the show for an interesting discussion about the opiate crisis facing America today, with a specific emphasis on fentanyl and its derivatives. We discuss EMS/first responder exposure risks and preventative measures along with patient care pearls when treating patients with fentanyl overdose.
References:

American Academy of Clinical Toxicology Statement on Fentanyl Exposure Risks - https://www.acmt.net/_Library/Fentanyl_Position/Fentanyl_PPE_Emergency_Responders_.pdf https://www.whitehouse.gov/ondcp/key-issues/fentanyl/
Jun 28 2018
23 mins
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Rank #15: Episode 13 - Summer Series 3: Drowning (Adult and Pediatric)

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Join Dr. Patrick and Ashton Herring our community outreach coordinator as we discuss adult and pediatric drowning emergencies and best practices in prevention.
Jun 12 2018
21 mins
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