Foamfrat Podcast

The conversation is about a paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. They conducted a retrospective study and found that paramedics often mistakenly believe they have electrical capture when they do not. They emphasize the importance of confirming electrical capture before assuming mechanical capture. They also discuss the challenges of pulse palpation and the need for more rigorous research in EMS and ED settings. The conversation discusses the challenges and considerations in transcutaneous pacing, specifically focusing on the verification of mechanical capture. The speakers explore the use of various methods to confirm mechanical capture, such as feeling for a pulse, using pulse oximetry, and utilizing ultrasound. They also discuss the difficulty of accurately assessing mechanical capture and the potential for false electrical cap

In this episode we discuss whether the concept of having a "max dose" of your pressor has any evidence or physiological backing. Joining me in this discussion are Dan Rauh, Shane O'Donnell, and Shad Ruby.  

How do you talk to a patient experiencing suicidal ideation? What if you're the one having these thoughts? We're interviewing James Boomhower from Stay Fit 4 Duty in this episode. We discuss suicidal ideation, therapeutic communication, and verbal de-escalation.

Chris Carlstrom is a flight nurse at Life Link III and also works part-time at a ketamine infusion clinic.  We’ve had some interesting conversations on shift regarding his experiences with ketamine in the clinic versus emergency medicine and I finally was able to get one of these conversations recorded for the podcast. Enjoy Podcast 163 - What Can We Learn From A  Ketamine Infusion Clinic? w/ Chris Carlstrom.

Taking on pharmacology in EMT school is a big hurdle. We wanted to write something that not only explained the basics of the medications but also helped bridge the gap between what EMTs are taught and what paramedics learn when they go back over these medications in paramedic pharmacology. Each chapter discusses how the medications work, why they're given for specific indications, and the logistics of medication administration! We've also included medication profiles, tips and tricks from experienced providers, and flashcards for each medication to help you hone your med knowledge base! In this book, we're coving:   Oxygen   Albuterol and Atrovent Epinephrine   Aspirin Nitroglycerin   Naloxone   Oral Glucose Gel and Glucagon + Flashcards in the back!       This book is for students, EMTs, and paramedics who want an in-depth review of EMT medications! You can download the book for free at foamfrat.com

I had the privilege to bring on two passionate fathers of children with Autism to help me better understand how to approach and communicate with a neuro-diverse child. This episode is chock-full of insight, tips, tricks, and logistics of approaching a child in the field with Autism. Josh Chan is a Life Link III flight paramedic/base lead and a Glenwood FD firefighter. Matthew Yelton is a flight paramedic/base lead for Mercy Flight Central and works as a fire captain at Constableville Ambulance Inc.

EMS providers encounter various infectious diseases daily and need to know the routes of exposure, risks, and preventive measures to protect themselves and their families. In this episode, We talk with Dr. Hudson Garrett, an infectious disease expert with the medical college of Louisville University, to discuss the practical points of infectious disease for the everyday provider. Want CE for this episode? Sign up for FOAMfrat Studio and access 300+ hours of continuing education for EMS & Nursing.  www.foamfrat.com

In this episode, Dan Rauh & Mike Boone from Heavy Lies The Helmet join me to hash out our workflows and drugs of choice for four particular scenarios you may come across.   The combative head injury patient that needs to be intubated but has five firefighters holding them down and is actively trying to rip off his collar and IV.   The septic hypotensive patient is no longer protecting their airway but also needs resuscitation prior to induction.   The snoring head bleed with a BP of 220/140   The "almost dead, but needs a tube" population (induction med?)

Moments after the heart stops the entire circulatory system finally has a chance to bring venous and arterial pressures to equilibrium. Cardiac arrest resuscitation requires the provider to have a strong mental model of physiology and the logistics to carry out a series of interventions crucial to preserving life. This class will serve not as a routine basic life support model, but as a deeper understanding and framework to guide resuscitation during your next cardiac arrest.

AI will be integrated into everything we do in medicine, perhaps sooner than we think. It will help keep our patients safe, our providers informed, and our communications connected, and change how we think about how we care for patients (if implemented correctly).  Systems like ChatGPT are only the beginning, and many companies are already working on or have already integrated with other healthcare specialties. We will see the same integration happen with EMS. While the response to this might be fear of losing our knowledge base, over-automating decision-making, cheating on tests and papers, and the like, we could adopt a very different outlook. We could view this as an opportunity to improve patient safety, offload menial work, automate documentation and communications, and always have an intelligent partner in our pockets we can bounce ideas off of.  One day, we'll wonder how we ever lived without it.

In this episode, Tyler is joined by Shaylah Montgomery to discuss decision-making, human factors, and mental shortcuts utilizing pattern detection. Shaylah is a flight nurse and paramedic for Pafford Air One and a member of the FOAMfrat team.

0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.

We just finished re-recording our pediatric arrest class in Studio and decided to play the unedited version of my discussion with Dr. Paul Banerjee. Banerjee is a prolific researcher and medical director in Florida with a particular emphasis on pediatric arrest. Check out the class in Studio for more information on the logistics.

Sam Henne is the creator of Mind Over Medic and a co-worker of mine at Life Link III. In this episode, we discuss the components of critical incident stress and ways to reduce adrenaline during threat appraisal. Check out www.mindovermedic.com   

EMS is well-trained in peripheral intravenous as well as intraosseous access. However, central lines remain off-limits for many clinicians in various response areas. If accessing these types of lines is allowed, it’s usually permitted when the patient is (nearly) dead. This isn’t very surprising since the scope of practice of the EMS clinician usually focuses on emergent treatments. Unless it’s learned during a critical care class, little thought is typically given to topics like central, dialysis, and PICC lines in EMS. Why not?

Had the opportunity to talk with Dr. Sam Slishman, the inventor of the Slishman traction splint. We had a great conversation on the idea/concept of this splint, who to apply it on, and some additional questions, which we plan on having him back on to discuss. 

A-a gradient, a/A ratio, and P: F ratio - are all different views of the same item. These formulas do not have a complete view of oxygenation. Oxygenation is a huge topic, and there are more common values that we use: How well is the patient saturating? Is there dyspnea? How do the lungs sound (auscultation) or look (POCUS)? Where is the patient on the OHCD? What does the ABG show?

I ran some specific decision points when treating the REALLY BAD massiVE pulmonary embolism patient by Shane & Brian from the FOAMfrat Team. This discussion really focuses on the logistics and ideas when you are trying to get the patient from A to B without having to do CPR.

Theresa Bowden is a rockstar flight nurse who specializes in NICU transports. In this episode, you will listen in as Theresa explains anything and everything you have ever wondered about NICU interfacility transports. Topics include: Who gets prostaglandin? IO or IV catheter for UVC Cardiac vs. Respiratory Initial Vent Settings Get credit for this class by listening to it in FOAMfrat Studio.