Happy EMS Week! We got together to discuss our worst EMS Week gifts, why night shift never gets any fresh food, and why we should change EMS Week to better work for our profession!
Episode 72: Prehospital Burn Care
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 71: What The Actual, Sedgwick?
Ed and Dan are the hosts for our latest “What The Actual…” episode, where we take a look at an EMS train wreck and try to learn from it…or at least try to figure out what the heck happened.
This time, we travel to Sedgwick County, Kansas, where a prehospital attempt at palliative care goes way off the rails, resulting in everyone involved being sanctioned…except the one you’d think
Episode 70: Pediatric Cardiac Arrest and Improving Outcomes with Dr. Peter Antevy
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:
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 69: The Problem with Media and EMS
Have you ever wondered why the news media gets EMS stories so messed up? Do you cringe each time you see a news story talk about “ambulance drivers”? Is your agency concerned with sharing your work with the community because of “HIPAA”?
Dan sits down with journalist and clinician Rich Huff (@richmhuff) as well as our good friend Margaret Keavney (www.keavneystreger.com) to discuss the problems with EMS and media, and solutions we can use to tell our stories better to the people we serve.
“We don’t have to be first; we have to be better.”
The story on LA County cardiac arrest transport:
EMS Aegis is a great source for training and information for both individual clinicians and agencies looking to do better:
Episode 68: Transgender Awareness with Taylor Sprecher and Matt Streger
The transgender population is a part of your patient population, and we all need to know how to assess and communicate therapeutically with our trans patients.
Matt Streger introduces us to Taylor Sprecher, a trans man and EMT who has taken the lead in trying to educate clinicians about trans patients, and some clinical pearls for us to utilize.
Did you know that almost one in FOUR trans people avoid seeking out health care because of their fear of how they’ll be treated? Or that trans teens have a significantly higher rate of suicide attempts? Do you know how to address your trans patients’ needs?
Read the stats here:
https://transequality.org/issues/us-trans-survey
Taylor’s webpage, which is a treasure trove of resources:
https://911transedu.com
Streger and Keavney is one of the pre-eminent EMS law firms in the USA, and a good friend of the show. Check them out at:
https://keavneystreger.com
https://emsaegis.com
Episode 67: Dr. Salim Rezaie on 2020 Part 2
Dr. Salim Rezaie joins The Overrun to further discuss the most important papers of 2020.
Episode 66: Dr. Salim Rezaie on 2020 Part 1
Dr. Salim Rezaie joins The Overrun to discuss the most important papers of 2020 that are not related to the pandemic.
SPECIAL: COVID-19 Vaccination
They have finally arrived, and while it’s not the beginning of the end; it may be the end of the beginning. The gang gets together to talk about the truths and rumors behind the COVID-19 vaccine, and why we think every clinician should give serious thought to taking it.
Episode 65: Bringing Battlefield Care to the Street with Dr. Andrew Fisher
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:
Episode 64: Ketamine and Dunning-Kruger
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 63: Universal Truths with THE ADMIN
Meme culture has come to EMS. And few are doing it better than the meme lord known to his many thousands of followers as simply, THE ADMIN.
His Facebook page, Burned Out Memes for EMS Teams, has over 40,000 followers who check out the material he puts out daily, and more join the page each day. THE ADMIN is one of a small group of EMS clinicians who use the medium of Internet memes as a way to point out inequities, share frustrations, and generally provide a group outlet for a profession trying to get through a pandemic, in addition to the usual job issues, and come out with a smile.
How did this get started? Where is it going? And how does THE ADMIN put out funny stuff on the regular that still makes you think and calls out substandard EMS? Kevin, Jess, and Dan sit down remotely and try to get a side of THE ADMIN you just may not know.
Check out his page on Facebook, or his Teespring store:
https://teespring.com/stores/burned-out-memes-for-ems-teams
Also check out:
Level Zero:
Saint Fisher Church of Evidence Based Medicine:
http://stfisherchurchofebm.com/
We will post some of our favorites on our social media as well....
Episode 62: Surviving PTSD with Chris Divver
September is Suicide Awareness and Prevention Month. Dan sits down with Chris Divver, paramedic and fire officer who shares his story about trauma, stress, and growth. Chris is someone who by example has shown people in emergency services that post-trauma stress and survival can be done. We talk about therapy, EMDR, and other tools he’s used to help him survive the injury.
Next Rung is a emergency services focused agency to help those of us with trauma or PTSD. Check them out here:
Ashley Fitzpatrick from Episode 61:
https://www.jems.com/2020/07/28/first-responders-and-ptsd-a-literature-review/
Episode 61: First Responders and PTSD with Ashley Fitzpatrick
Ed goes solo to interview Ashley Fitzpatrick, BSN, RN, EMT who was recently published in JEMS. Ashley's paper "First Responders and PTSD" addresses difficult issues with EMS and PTSD, specifically that there is precious little research in the United States about the topic.
Episode 60: Art, Communication, and Healing
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:
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 59: Protest and Empathy
We got a chance to speak with Taylor and Anthony, you may have seen them on social media as the crew who joined a Black Lives Matter protest in New York City a little more than a week ago.
Episode 58: Scot Phelps Interview
“If we don’t sell ourselves, don’t expect others to sell for us”
This is an interview that’s been in the works for quite a while. Dan sits down with Scot Phelps, paramedic, historian, former Office of EMS Director, and attorney to discuss where we are going as a profession, how we need to look back and share our history with our newcomers (it’s much more than 50+ years), and what we must do to move our profession forward.
It’s probably one of the longest episodes we’ve ever had on the show; but it won’t disappoint.
Episode 57: Beercast 4-ICD-10 and Pockets....
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 56- Coronavirus Fireside Chat
In this episode, Ed, Dan and Mike discuss new information about the novel coronavirus. Covid-19 has changed the way EMS has to respond to numerous patient populations, and may in fact be the first #foamed disease. Check it out and let us know what you think!
Ken Safren’s video from EmRap can be found here
MD1 program on youtube
T: OverrunEMS
FB/IG: Overrunproductions
Check out our other programs:
Episode 55: Outbreak EMS
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)