Dr. Jamie Kennel is a paramedic and EMS educator in Oregon that focuses on the role of racism in EMS. His researchrecently won the Research Award at the 2022 EMSWorld and has important insights into our unconscious biases in the field. Take a listen and let us know what you think. Do our biases work against us?
In August 2022 two EMT-Cardiacs in Rhode Island found themselves in a situation that resulted in their suspensions. In this episode, the gang discusses the swiss cheese model of failure, and what we can do as an industry to improve systems and providers to ensure that we treat parents and newborns properly in the field.
Greg Friese is the Editorial Director of EMS1.com among other things. He brings a very interesting view of how EMS providers should be compensated for the work they do. In January of 2022, he wrote a piece discussing the importance of EMS providers not just receiving a living wage, but rather for EMS workers to make much greater than a living wage. He recently wrote about the dismal raise that Austin EMS providers received to provide a voice to workers who felt voiceless.
Dan Gerard is a man of many hats. He is the current President of the IAEMSC as well as the EMS Coordinator for Alameda county in California. He has spent his lengthy EMS career pursuing new advancements in pre-hospital medicine and is currently piloting a program in Alameda county that may be a game changer when it comes to recognizing and treating seizures in the field. Ceribell is a device that wraps around a patient's head like a headband and produces real-time EEG tracings that can be interpreted by an EMS clinician with little to no training. The best part about this system is that it is already FDA approved and is being used in hospitals with encouraging results. Take a listen and let us know what you think!
GLAM is back, taking on the aftermath of Roe v. Wade. Jess, Anna, and their guest Judyth Brown have a multigenerational conversation about women’ health and rights, where we go from here, and how we can get involved.
Natalie Zink is a paramedic and medical student in Georgia who speaks extensively on women's rights and the medical treatment of abortion. Her work can be found in EMSWorld and in other publications. This episode, recorded May 22, 2022 discusses the leaked Supreme Court brief suggesting the overturn of 1973's Roe v. Wade and 1992's Casey v. Planned Parenthood. Ed and Natalie discuss what field providers can expect and how to treat abortions in the field. This episode is wide-ranging from the logistics of certain legislation to how it effects healthcare providers. Countries such as Poland have attempted similar legislation to no avail. Abortion is a safe and (currently) legal intervention that will occur regardless of the current laws. It is important that EMS and pre-hospital providers know how to treat these patients and what they can expect moving forward should this case become law.
Hilary gates is a real life educator at American University who happened to join EMS and fall in love with it. The program she works with, Prodigy EMS, is at the forefront of EMS education. As we move forward out of our collective nightmare that has been the past two years, Ed and Anna discuss how EMS education can grow from here. Hilary speaks with focus and passion about expanding the role of EMTs and medics moving forward and what we can do as educators and providers in the classroom to take the lessons from the past two years and implement them to make systems better for their patients. #FOAMED #FOAMEMS.
If you haven't heard of these two individuals, you may be very soon. The reason why? They may have just built the BVM we all wish we had, and the potential to help patients is very high.
Dan sits down with Jonathan and Adam from Compact Medical, and talks about their new Butterfly BVM™ and the advantages it will bring to a tool that really hasn't changed in 50 years.
It's currently in the process of FDA review and approval, and a lot of stuff is still being sorted out; but Kevin and Dan got to see it at EMSWorld last October, and it's an impressive piece of kit.
Imagine one device being able to set tidal volume, pressure, and even rate! It's also able to be used as a CPAP, and one size will actually fit everyone from pediatric to adult.
The better mousetrap as they say, might just be around the corner...
Compact Medical Solutions is here, check it out:
Here's a study on tidal volume in adult and pediatric BVMs:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234703/
EMS1 had a good piece on avoiding problems with BVM ventilation:
We LOVE Life in the Fast Lane...here's their BVM info:
https://litfl.com/bag-valve-mask-bvm-ventilation/
If you've been anywhere in this world the last few weeks, you know what's been going on in Ukraine. Once again, military medicine has taken front row. But what actually is military medicine about? What are some of the misconceptions? And what can we as civilians take away from our colleagues in service?
On this episode, Dan and Ed are civilians talking medicine in the military to Dr. Andrew Fisher, MAJ USA, and the namesake of the Saint Fisher Church of Evidence Based Medicine; and our good friend Peter D'Antuono, who served in combat as a medic with the 173rd Airborne Brigade. We get to shine a light on something not many civilians get to hear about...and why it's important.
Check out the Church here:
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:
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:
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!
Remle Crowe is a statistics rockstar. Her primary areas of research in EMS include burnout, and how to improve performance in our industry. There's a lot to cover, and a lot we discussed, so everything is listed below. Take some time to listen to the episode and read all the studies linked below. It'll make your practice better. Promise.
If you were at the National Association of EMS Physicians Conference this past week, you would have been able to see Dr. Michael Lauria speak. Mike is a USAF veteran, Pararescueman, flight paramedic, and currently an emergency medicine physician in the US. He has appeared on the EMCrit podcast and numerous others to talk about stress and managing it in the field of medicine.
Dan got to sit with him and discuss how keeping cool on scene in stressful situations actually is better for you and your patients, some simple techniques to use, and why we need to incorporate stress inoculation into all our EMS training.
The stuff we talked about is proven to help you think more clearly and function better when things are going into the weeds....it's definitely worth the time!
Dan got to sit down with paramedic and member of Hatzolah Sim Shain to talk about the organization, its response model, the culture, and a lot of questions that were answered. No, it hasn't been studied; (as most of EMS hasn't), but it is impressive. And their commitment to saving lives is admirable. It's actually a fundamental part of Judaism:
Why was man created alone? Is it not true that the creator could have created the whole of humanity? But man was created alone to teach you that whoever kills one life kills the world entire, and whoever saves one life saves the world entire.
—paraphrased from the Talmud
A little background from Wikipedia:
https://en.wikipedia.org/wiki/Hatzalah
Here's a PubMed link to a paper showing increased cardiac arrest survival:
https://pubmed.ncbi.nlm.nih.gov/17576181/
Check out Hatzala in Israel:
Here's a city that has adopted Hatzolah ideas into their response model:
After the Halloween episode, we take a more serious turn with Matt Streger of Keavney Streger Law Firm and talk about what happened in the Elijah McClain case.
Bottom line: We need to take care of our patients; regardless of the circumstances we find them in, and we need to understand our role in keeping everyone safe and out of danger.
Take the time to at least estimate weight:
Body camera video from the incident:
Paramedics indicted by a grand jury:
The Colorado Sun on the case:
https://coloradosun.com/2021/05/26/ketamine-paramedics-police-elijah-mcclain/
USA Today with some disturbing data:
Reuben Strayer is an EM physician in New York City, and he's done great stuff on ketamine. Check him out here:
https://emupdates.com/jon-cole-on-ketamine-for-agitation/
https://www.statnews.com/2021/04/06/excited-delirium-medicalized-racism-organized-medicine-take-a-stand/
Halloween is special time of year. Spooky skeletons and vampires everywhere! But how would you treat a vampire? Do werewolves exist? In this episode the gang blurs the lines between horror and medicine and discuss how to treat some truly weird and spooky conditions.
Horror movies based on true stories: https://www.scoopwhoop.com/inothernews/horror-movies-based-on-true-stories/
So many are based on Ed Gein (Texas chainsaw massacre, Psycho, Deranged)
A lot of possession movies
2011 possession case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063265/
1998 20 Chinese subjects: https://ps.psychiatryonline.org/doi/full/10.1176/ps.49.3.360
2009 history of possession: https://muse.jhu.edu/article/362860
2016: dissociative trance: https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12425
Demonic possession is in the DSM V (2017): https://www.tandfonline.com/doi/abs/10.1080/13648470.2017.1389168
Humans acting like vampires: https://www.livescience.com/28266-7-strange-ways-humans-act-like-vampires.html
Porphyria Cunea tarda causes skin lesion when exposed to the sun
Xeroderma pigmentosa does this too
Frankenstein: https://www.bbc.com/news/magazine-12711091
Werewolves: https://dnascience.plos.org/2012/12/27/the-curious-genetics-of-werewolves/
Hypertrichosis effects a couple hundred people, but is not widespread
Bearded Lady: https://www.health.com/condition/pcos/women-embracing-bears-body-hair-pcos
PCOS leads to increased hair growth in females
Plague still exists: https://www.healthline.com/health-news/seriously-dont-worry-about-the-plague
Leprosy
Now called Hansen’s disease after the doctor that discovered mycobacterium leprae
Most historical conditions of leprosy were not actually leprosy, but contagious skin conditions
Molluscum, shingles, impetigo, HSV
https://web.stanford.edu/group/parasites/ParaSites2005/Leprosy/history.htm
Buried alive
In old Britain, coffins were found with scratch marks in them
People used to get absolutely hammered and pass out and no one knew if they were dead or not
https://www.mentalfloss.com/article/55688/6-widely-repeated-phrase-origins-debunked
2017: man “dies” from root canal: https://metro.co.uk/2017/10/27/family-of-dead-man-stunned-after-he-starts-breathing-during-his-funeral-7033009/
Was treated with Diazepam then died for real shortly thereafter
Woman “dies” is buried, and is found to have moved, torn off her clothes and given birth
Historical death measurements
https://historycollection.com/buried-alive-common-victorian-era-doctors-used-10-methods-prevent/
The flag one is the best. Stick a needle in the chest and see if the flag waves
Twitter: OverrunEMS
FB/IG: OverrunProductions
Dr. Antevy's website: handtevy.com
Dr. Jim Ducanto is an anesthesiologist that discusses airway management like it's the final scene of an action movie. It's very exciting, and your learn a lot without even realizing it. When we initially recorded this interview, we considered breaking it into two separate parts, but there's just too much good information in this show to break it apart. You're going to want to listen to this episode twice: once to listen, and once to take notes. Dr. Ducanto makes airway management exciting, and we're thrilled to have him on the show. As a fun bonus, at the end of the episode you'll be able to used to acronym BEEF SALAD correctly and impress all your friends.
We know. We hate it too.
SARS-CoV-2 is still rampant in the United States, and with the emergence of the Delta variant, and the FDA approval of the Pfizer/BioNTech vaccine we thought it would be a good time to update the data.
What medications work? Are steroids useful? Dr. Antevy jumps in to discuss how to manage kids with Covid.
Give a listen, let us know what your shop is doing to keep their sanity during this time.
Recovery (Dexamethasone Study)
Let us know how you're doing: @OverrunEMS
FB/IG: Overrunproductions
Ed Van Wagner works with DT4EMS, a program that teaches self-defense tactics for EMS personnel. We, as an industry are not very good at defending ourselves when the time comes for it. The DT4EMS program shows providers how to defend themselves when a scene becomes unsafe.
Dr. Peter Antevy (@handtevyMD) gives us Pediatric Pearl about children with altered mental status.
#Selfdefense
#Dobetter
IG/FB: The Overrun
T: OverrunEMS
Michael Greco is the Vice President of Local 2507, who represents the EMTs, Paramedics and Fire Inspectors of the Fire Department of the City of New York. You may remember we had him on last in Episode 29, and unfortunately, conditions have not improved much since our last talk.
The FDNY*EMS members will be boycotting the ticker-tape parade held for the City’s “Hometown Heroes”, because quite simply, while New York City will give them a parade; they will not pay them a fair living for the critical job they do in one of the most expensive places to live in the world.
We’re going to circle back to our mental health for this episode! Anna sits down with Troy Longo, paramedic and licensed counselor, and Dan Gaudette from Hackensack Meridian JFK EMS; who is a critical care transport nurse with a background in psychiatric emergency care.
They discuss what post-traumatic stress is; how you recognize it, and they get into the basics of therapy and why it can be a real help.
We also have another segment of Pediatric Pearls with none other than Dr. Peter Antevy! This one talks about the importance of accurate fluid resuscitation for kids…it’s en eye-opener!
Troy’s practice is located at:
Anna has written for EMS1, you can find her articles here:
