PODCAST · science
MCHD Paramedic Podcast
by Montgomery County Hospital District
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 Director Dr. Casey Patrick invites 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.
Episodes
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Episode 199 - Olanzapine In The Field - Who, What, When, and How?
MCHD recently introduced ODT olanzapine to treat mild agitation in the field. Emergency pharmacist Kevin Mercer joins the podcast to discuss the medication’s pharmacologic foundations. How does it work? Who gets it and who doesn't? And why Olanzapine in the first place?
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Episode 198 - Dyspnea - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with shortness of breath once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss...
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Episode 197 - Altered Mental Status - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with an altered patient once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss…
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Episode 196 - Cervical Spine Immobilization In 2026: Evidence Vs. Dogma
We recently made some cervical spine immobilization protocol changes here at MCHD. Dr. Patrick and Dr. DePasquale discuss the history and literature that provide the foundation for rigid cervical collar use, along with the new MCHD protocol implementation. This has been a collaborative process…
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Episode 195 - Cold Water Immersion For Heatstroke - Lessons From Phoenix
Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of...
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Episode 194 - Mental Health Matters In EMS With Dr. Joe Gill
MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some...
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Episode 193 - What Can EMS Learn From An Emergency Pharmacist? - Part 2
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on...
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Episode 192 - What Can EMS Learn From An Emergency Pharmacist? - Part 1
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on...
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Episode 191 - EMS Protocols 101
As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are the potentially risky decisions? What should the MCHD field...
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Episode 190 - Geriatric Considerations In EMS With Dr. Maia Dorsett
The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehospital setting. What are the common mistakes? What tools can...
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Episode 189 - EMS Airway Updates 2025 - Part 2
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these...
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Episode 188 - Prehospital OB Updates 2025
Recently, some paramedics, obstetricians, and EMS medical directors were locked in a room and produced some fantastic collaborative prehospital guidelines for managing post-partum hemorrhage, eclampsia, and pre-eclampsia. Have a listen, take a look at the guidelines (links below), and we'll all...
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Episode 187 - EMS Airway Updates 2025 - Part 1
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why don't we intubate our cardiac arrest patients like we used to?" "MCHD has been hyper-focused on recording video laryngoscopy over the past year. Why?" Join the podcast crew to…
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Episode 186 - A Paramedic's Guide To The Opiate Epidemic
We're lucky to have a special guest on this podcast episode to discuss a topic that, unfortunately, all of us in emergency care encounter all too frequently: the opiate epidemic. Peter Canning is a paramedic who has lived through the epidemic while working on the ambulance in the New England...
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Episode 185 - Chest Pain - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with chest pain once the ER doctor takes over? How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next...
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Episode 184 - Recording Video Laryngoscopy In EMS
On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD. What device did you use? How did you train? What lessons have you learned? All these and more will be addressed and answered. REFERENCES: 1. Zhao, Y., Zang, B., & Wang, Q....
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Episode 183 - Pain Control In EMS - The MCHD Analgesia Ladder
The podcast crew takes on the topic of prehospital analgesia. What pain medication do we choose when facing a complex patient with all analgesics available? Are there better options for hypotensive patients? What about pregnancy and the elderly? On this episode, we'll walk through our MCHD pain...
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Episode 182 - Traumatic Arrest With The Prehospitalist
Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case,...
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Episode 181 - Why You Should Attend The Resuscitation Academy
We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve…
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Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?
Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in...
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Episode 179 - Transcutaneous Pacing Pearls and Pitfalls
On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics...
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Episode 178 - A STEMI Unlike Any Other
We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to...
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Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration
This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release. This…
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Episode 176 - Antibiotics & Open Fractures
MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES: Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour,...
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Episode 174 - Push Dose Norepinephrine
We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild....
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Episode 175 - The Rear View Mirror - Tunnel Vision
Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the positives that can come if we get past our egos and allow...
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Episode 173 - Med Minute - Magnesium
We're working on a new series focusing on high-yield pharmacology reviews. Dr. Patrick starts us off with some background, mechanism of action discussion and common uses for magnesium sulfate. Mag is one of the true pharmacologic swiss army knives of emergency care. REFERENCES 1. Touyz RM, de…
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Episode 172 - The MCHD EKG Manifesto - Part 3
Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge. REFERENCES 1....
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Episode 171 - Surgical Airway Lessons With Dr. Al Lulla
One of the most fear-inducing procedures in all of emergency care is the surgical cricothyrotomy. Dr. Al Lulla from Dallas Fire joins the podcast to discuss our recent collaboration on a retrospective look at MCHD's surgical airway experience over the past decade. Can paramedics successfully...
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Episode 170 - The MCHD EKG Manifesto - Part 2
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is...
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Episode 169 - Agitation Awareness - Fixed-Dose Ketamine
We've initiated a multi-pronged, system wide overhaul of our agitation management at MCHD. This included a move to fixed-dose ketamine for the severely agitated patients. Evidently we weren't the only ones thinking of this as there is exciting new data from Buffalo supporting this approach. Join...
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Episode 168 - The VTach FACTs
We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge. Learn the V-Tach FACT, and you'll feel more comfortable with your next wide rhythm at a rate of 185. REFERENCES 1....
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Episode 167 - Ketamine Only Intubations With Dr. Andrew Partain
The podcast crew is joined by a special guest, Dr. Andrew Partain, an EMS Fellow from UTSW in Dallas. We will dissect his recent data surrounding ketamine-only intubation from MedStar in Fort Worth. This is not just another boring data rehash. There are some vital and applicable pearls that must…
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Episode 166 - The MCHD EKG Manifesto - Part 1
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is...
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Episode 165 - Intracerebral Hemorrhage
We've spent countless hours (rightfully so) discussing ischemic stroke management over the past several years. Sometimes, the other 20% of strokes, the hemorrhagic version, can get neglected. No, we don't have stroke-mobiles at MCHD to diagnose an ICH in the field, but there are some patient care...
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Episode 164 - EMS HOCUS POCUS
MCHD's POCUS program has definitely involved both forward progress and lessons learned. In this episode, we'll discuss some of the reasons POCUS can be a game changer in the prehospital setting. However, unintended consequences do exist. We've begun to make the move to utilizing carotid…
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Episode 163 - Back Pain Beware
MCHD paramedic Wes Hall joins the podcast crew to discuss a recent seemingly mundane back pain call. Please listen to find out how avoidance of premature closure, a thorough exam, and professional patient advocacy led to an excellent outcome in a SCARY case. REFERENCES 1....
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Episode 162 - Post-ROSC Pressor Choice
We recently made a significant vasopressor protocol change at MCHD, prioritizing norepinephrine in all shock situations except anaphylaxis and bradycardia. The evidence supporting norepinephrine in septic and even cariogenic shock is relatively solid. However, recent data has emerged suggesting...
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Episode 161 - MMQ#9 - The Angioedema Airway
MCHD District Chief April Currie joins the podcast crew to discuss an angioedema case that repeatedly left more questions than answers. Dr. Patrick was tasked with managing the airway and definitely has some lessons learned to share with the listeners.
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Episode 160 - ST Elevation in aVR With Diffuse ST Depression
The podcast crew dives deep into one of the early "STEMI equivalent" ECG patterns: ST elevation in aVR with diffuse ST depression. What does the evidence say about this pattern? Is there a FOAM lesson to be learned? How should we incorporate this ECG into our practice? REFERENCES 1. Harhash AA,...
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Episode 159 - MMQ#8 - The Head and the Heart
Dr. Dickson leads the discussion with recent cases involving the PECARN pediatric head injury decision rule and some super sneaky toxicology. There is some high-level detective work happening during this episode. Listen so you don't miss vital clues in your clinical practice. REFERENCES 1....
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Episode 158 - Terrible Tracheostomy 2023
The podcast crew is joined by MCHD In-Charge Paramedics, Ben Breaux, and Jesus Contreras to discuss a critical case that demonstrates why continuing education and intentional mental reps are vital in emergency care. We've discussed the "how-to" when approaching the crashing tracheostomy patient....
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Episode 157 - Cardiac Arrest During EMS Care - Making MOVES
There is nothing more stressful than seeing EMS peri-arrest progress to pulseless. CARES data suggest that cardiac arrest during transport is not an uncommon event. Additionally, there is new evidence that these patients may not be as difficult to recognize as we might've thought. Join the…
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Episode 156 - MMQ#7 A Shocking Save And Sneaky Serial Killer
Sometimes it's easy on the individual level to miss the positive drift within EMS as systems of care evolve and change toward positive innovation. Dr. Patrick hits the hot seat on this episode to discuss two recent cases where some of MCHD's favorite initiatives come together to improve patient...
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Episode 155 - MMQ#6 - A Rapid AFib Riddle
Join the podcast crew as they discuss one of the more sticky situations in all of emergency care: stable vs. unstable narrow complex tachycardia. 1. How do we even define unstable? 2. Is it cardiac versus an underlying illness? 3. How do we approach undifferentiated rapid atrial tachycardia in…
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Episode 154- Death Notification Lessons Learned
The concept of emphasizing, discussing, and training on giving prehospital death notification is, unfortunately for medics and our patient's families, a relatively new concept. Additionally, newer evidence shows that an increased frequency of fatality exposure increases EMS burnout rates....
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Episode 153 - MMQ#5 From The PNW - Spokane Frozen Solid
The Podcast Crew is joined by Spokane Valley Fire Paramedic Noah Martinez to discuss a recent patient that he delivered to Dr. Patrick. After you hear what Noah found on the scene, this story will likely not end exactly how you expect. Learn some foundational hypothermia management pearls AND why...
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Episode 152 - The MCHD SNORES Sedation Safety Bundle
Chemical sedation is one of the riskiest decisions made in EMS clinical care, period. We've been working overtime at MCHD over the past couple of years to decrease the risk and improve our safety profile for the entire clinical package when we sedate patients for severe agitation in Montgomery...
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Episode 151 - MMQ#4 - Dr. Dickson's Strokes
Join us as Dr. Dickson brings a couple of extremely difficult recent emergency department cases to take a hard look in his own clinical mirror. These will highlight the difficult and often dynamic nature of assessing airway patency and protection in real time. Speaking of dynamic, vascular...
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Episode 150 - Hyperkalemia, BRASH Syndrome, And Amiodarone BEWARE
MCHD paramedic, Lily Trosclair, joins the podcast to discuss some in-depth hyperkalemia treatment details, including BRASH syndrome. We'll also pivot to the dangers of giving amiodarone to a hyperkalemic patient that's mistaken for ventricular tachycardia. REFERENCES 1....
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ABOUT THIS SHOW
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 Director Dr. Casey Patrick invites 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.
HOSTED BY
Montgomery County Hospital District
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Frequently Asked Questions
How many episodes does MCHD Paramedic Podcast have?
MCHD Paramedic Podcast currently has 203 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is MCHD Paramedic Podcast about?
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 Director Dr. Casey Patrick invites you to explore the many aspects of prehospital care. Along the way you can expect guest appearances...
How often does MCHD Paramedic Podcast release new episodes?
MCHD Paramedic Podcast publishes regularly with 203 episodes available. Check the episode list for the typical release schedule.
Where can I listen to MCHD Paramedic Podcast?
You can listen to MCHD Paramedic Podcast on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts MCHD Paramedic Podcast?
MCHD Paramedic Podcast is created and hosted by Montgomery County Hospital District.
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