The Delegate Series

What if the most important thing about the 2025 ACLS guidelines isn't what changed — but what the science is already outpacing? In this episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin walk through the latest American Heart Association updates and hold them up against what the evidence is actually telling us.Dr. Ekin breaks down the official changes — from the atropine dose that quietly doubled to the oxygen saturation target that finally got specific — while the delegates weigh in on where AHA is playing it safe. Double sequential defibrillation showed a 30% survival-to-discharge rate in its landmark trial, but the guidelines won't commit. Calcium for hyperkalemia? Three delegates and decades of clinical experience respectfully disagree with "insufficient evidence."Along the way, the conversation lands on what might matter most: the growing recognition that BLS owns the cardiac arrest. Early CPR and rapid defibrillation still move the survival needle more than any drug or advanced airway — and the delegates make the case that an i-gel and uninterrupted compressions beat a heroic intubation attempt every time. Dr. Brenner previews emerging research on CPR hand positioning that could change what we teach about compressions, and the group tackles the post-ROSC tightrope of blood pressure targets, ventilation goals, and why a second hypotensive episode can undo everything you just fought for.Join the Kitsap physician delegates for an episode that separates what's settled from what's evolving — and reminds us that in ACLS, the most dangerous thing isn't a wrong answer. It's an old one you never thought to question.

 What if the most dangerous call you run today isn't the cardiac arrest or the multi-vehicle pileup — but the 82-year-old who "just fell"? In this eye-opening episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin tackle the patient population that makes up nearly half of all EMS contacts — and the one most likely to hide life-threatening pathology behind seemingly normal vital signs. Dr. Bennett walks us through a landmark review from the Journal of Emergency Medicine, exposing the clinical landmines lurking in every geriatric call: the shock that masquerades as a normal blood pressure, the cervical spine fracture hiding behind a simple "lift assist," and the massive subdural that presents with a perfect GCS of 15. With nearly 70 million Americans now over 65, these aren't edge cases — they're your bread and butter. The delegates break down the art and science of slowing down in a profession built on speed — why shutting your mouth for two minutes gets you better information than rapid-fire questioning ever will, how a shock index below one can still spell disaster in an elderly patient, and why the single most high-yield question you can ask might just be, "Did your doctor change your medicines?" From the deceptive normalcy of geriatric vital signs to the hidden dangers of the "routine" lift assist, this episode arms you with the clinical street smarts that separate good providers from great ones. Join us for an episode that proves the unsexy calls are where real clinicians are made. Because in geriatric EMS, what looks like nothing can kill — and the provider who slows down is the one who catches it.  

What if the most routine interventions in emergency medicine weren’t as simple as we thought? In this episode of Physician Delegates, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin take a rapid-fire tour through some of the most important emergency medicine research of 2025 — and what it actually means for the crews working in the field.From the subtle science behind something as basic as oxygen, to the evolving strategies for pre-oxygenation before intubation, the delegates unpack new evidence that could change how EMS providers manage the sickest patients. They tackle the long-standing debate between ketamine and etomidate for rapid sequence intubation, explore surprising new research on ketamine’s role in stopping refractory seizures, and examine how ultrasound may uncover hidden shockable rhythms during cardiac arrest.Along the way, they also highlight practical updates every EMS provider should know — from choking treatment in infants, to safer oxygen targets, to the quiet return of an old emergency medicine favorite: Droperidol.Join the Kitsap physician delegates for a fast-moving conversation that connects cutting-edge research to real-world EMS practice. Because sometimes the biggest improvements in patient care come from re-examining the things we thought we already understood,

What if your judgment could mean the difference between life and death - or a lawsuit? In this razor-sharp episode of Physician Delegates, Dr. Adam Brenner, Dr. Martin Bennett, and Dr. Scott Ekin unravel the high-stakes world of patient refusal and shared decision-making in emergency medical services.Imagine a scene where everything looks fine on the surface - normal vitals, a seemingly stable patient - but beneath those numbers lies a potential medical minefield. The Kitsap Delegates exposes the dangerous cognitive traps that can lead EMS providers to make fatal mistakes: group think, personality dynamics, and the seductive illusion of "it's probably nothing."Drawing from years of frontline experience, Dr. Brenner, Dr Bennett, and Dr. Ekin break down the exact strategies that can save both patient lives and provider licenses. How do you create a structured pause that gives every team member a voice? Why does transporting a patient become the safest option when there's even a hint of disagreement? And what checklist could prevent you from becoming the next cautionary tale in emergency medicine?Join us for an episode that goes beyond protocols and delves into the human elements of medical decision-making. Because in EMS, what you don't see can absolutely hurt you.

Postpartum Hemorrhage: When Every Second CountsWhat if your worst nightmare call - imminent childbirth - turned into two critical patients and a race against time? In this intense episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin tackle one of EMS's most anxiety-producing scenarios: postpartum hemorrhage in the field.Dr. Bennett walks us through a harrowing case that starts with a precipitous delivery in a bathroom - baby not breathing, mom pale and hypotensive, blood on the floor, and only minutes to figure out which patient needs you first. It's the ultimate "divide and conquer" moment that tests every provider's clinical judgment and composure.The delegates break down the critical interventions that can turn a disaster into a save, tackle the system issues that complicate these calls, and share honest perspectives on why these cases still make even experienced providers sweat. They discuss the "Four T's" of postpartum hemorrhage, proper management techniques, and why having a checklist - even if it's Googled on scene - beats trying to remember everything in the moment.Join us for an episode that embraces the discomfort, acknowledges that "something will go wrong," and arms you with the knowledge and confidence to handle one of EMS's most challenging calls. Because when mom and baby both need you, there's no room for hesitation.

What if everything you thought you knew about cardiac arrest was wrong? In this game-changing episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin blow up the traditional ACLS approach to PEA - revealing why "pulseless" doesn't always mean what we think it does.Dr. Brenner takes us on a journey beyond the cookbook protocols, challenging the very definition of PEA and exposing a shocking truth: our fingers are terrible at detecting pulses. With studies showing we miss actual pulses nearly 50% of the time and hallucinate non-existent ones 35% of the time, it's clear we need better tools and smarter approaches.The delegates explore the critical difference between true PEA (where the heart isn't moving at all) and pseudo-PEA (where patients are just profoundly hypotensive). They dive into cutting-edge strategies using end-tidal CO2 and pulse oximetry as objective measures of perfusion, discuss why high-dose pressors should be standard in PEA management, and explain why the mantra for these patients should be "PEA - don't stay and play."From the promise of ultrasound in the field to understanding why CPR might actually harm some PEA patients, this episode delivers practical, modern approaches that go far beyond the outdated "epi-CPR-epi" cycle.Join us for an episode that will fundamentally change how you think about and treat one of EMS's most challenging presentations.

Ever wonder why most addicts aren't actually trying to get high anymore? In this episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Eakin dive deep into toxicology and addiction medicine - exploring the cutting-edge science behind why humans make the decisions they do and how new treatments are revolutionizing addiction care.Fresh from an addiction medicine conference, Dr. Eakin shares groundbreaking insights about the anti-reward pathway, the neurochemistry of withdrawal, and why most people using substances are actually trying to avoid pain rather than chase pleasure. The delegates tackle the latest treatments for alcohol, tobacco, and opioid addiction, including revolutionary medications like acampersate, varenicline, and buprenorphine that are changing the game for EMS providers.Dr. Bennett presents a fascinating case of diabetic ketoacidosis with normal blood sugar - a tricky presentation from the new SGLT inhibitor medications that's becoming increasingly common. The episode also features Dr. Brenner's dramatic case of a body stuffer who swallowed massive doses of fentanyl and methamphetamine, highlighting the critical differences between packers, stuffers, and pushers.So sit back and join us for another educational episode designed to provide practical insights for EMS providers throughout Kitsap County, as we explore the complex world of toxicology and the promising future of addiction medicine.

Ever wonder how someone can survive when their kidneys completely fail? In this episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Eakin dive deep into nephrology - moving from the "plumbing" we covered in our urology episode to the more complex "engineering and chemistry" of how kidneys actually work.The delegates tackle kidney failure, renal replacement therapies including hemodialysis and peritoneal dialysis, the critical anatomy of AV fistulas and grafts, and kidney transplantation. They emphasize the pathophysiology behind uremia, electrolyte imbalances, and volume overload, while providing practical field guidance for managing these complex patients who rely on modern medical miracles to stay alive.So sit back and join us for another educational episode designed to provide practical insights for EMS providers throughout Kitsap County, as we explore the fascinating and complex world of nephrology.

In this episode, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, EMS Delegates for Kitsap County, WA, return for the third episode of the 2025 season. The delegates tackle the topic of urology, covering kidney stones, urinary retention, and various catheter types, with Dr. Ekin sharing both medical expertise and personal experiences. Their discussion emphasizes the pathophysiology, diagnostic considerations, and appropriate EMS interventions for these conditions. The episode introduces a new feature called "Field Notes," where a Kitsap Paramedic presented a case involving a suspected pulmonary embolism that he managed with Dr. Brenner's medical direction. Dr. Bennett also provides a brief educational clarification regarding umbilical line placement techniques from the recent Medic Skills Lab.  So sit back and join us for another educational episode designed to provide practical insights for EMS providers throughout Kitsap County. 

In this episode, Dr. Martin Bennett, Dr. Scott Ekin, and Dr. Adam Brenner, EMS Delegates for Kitsap County, WA  welcome Dr. Alfred Wang as a guest expert to discuss the topic of dizziness in elderly patients. They share their enthusiasm for treating these patients and emphasize the importance of understanding the nuances of dizziness, including differentiating between various types and potential underlying causes. The discussion highlights the challenges EMS providers face in assessing dizziness and the critical need for thorough evaluations to identify serious conditions such as strokes. The episode aims to provide educational insights and practical tips for EMS providers.

Join the Kitsap County EMS Delegates, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin as they embrace the chill of winter and delve into the critical topic of hypothermia. In this episode, the team shares personal anecdotes from their snowy childhoods, while also discussing the medical intricacies of treating hypothermia in emergency situations. From the importance of accurate temperature readings to the challenges of resuscitation in cold environments, they provide valuable insights and practical tips for EMS professionals. Whether you're in the field or just interested in emergency medicine, this episode is filled with essential knowledge and engaging stories to keep you informed and entertained.

Welcome to the Delegates Podcast! Join Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, as they take a lighter approach this month, diving into the world of orthopedics. After exploring the complexities of neurology, they're ready to tackle lower extremity injuries just in time for football season. From knee dislocations to ligament tears, the team shares clinical vignettes, insights, and a few laughs along the way. Whether you're a medical professional or just curious about orthopedic injuries, this episode is packed with valuable information and entertaining anecdotes.

Continuing our journey into advanced neurology, the Kitsap County EMS Podcast presents the second installment of our in-depth series! Join Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, as they delve deeper into complex neurological disorders that EMS professionals may encounter in the field.In this episode, our experts explore three significant neurological conditions in-depth, Multiple Sclerosis, Parkinson's Disease, and Dementia, from the perspective of what is going on in the brain and what it looks like with this disease.  Whether you're an EMS healthcare professional looking to enhance your clinical knowledge or simply curious about these neurological disorders, this episode provides invaluable insights to expand your understanding of the brain and nervous system.Tune in to deepen your neurology knowledge and improve patient care with the Kitsap County EMS Podcast!

In response to your requests for advanced neurology topics, we’re excited to present a special episode of the Kitsap County EMS Podcast! Join Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, MS, as they embark on the first installment of a three-part series exploring the intricate world of the brain, central nervous system, and peripheral nervous system.In this episode, Dr. Brenner lays the groundwork by covering essential neuroanatomy, including the structure and function of the brain and cranial nerves. Additionally, we’ll touch on key illnesses associated with the central nervous system, setting the stage for the advanced discussions to come.Whether you’re an EMS healthcare professional or simply curious about neurology, this episode is designed to enhance your understanding and appreciation of the nervous system. Tune in and expand your knowledge with us!

In this episode, join Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, MS physician delegates for Kitsap County EMS in Washington, as they explore a diverse array of critical medical topics. First, they'll dive into the realm of reproductive emergencies, focusing on testicular and ovarian torsion. Discover the key signs, symptoms, and diagnostic techniques for these time-sensitive conditions that require swift intervention to prevent long-term complications. Next, the discussion will shift to the often-overlooked category of non-diabetic endocrine emergencies. From thyroid storm to adrenal crisis, the expert panel will guide you through the recognition and management of these complex cases. Gain a deeper understanding of the hormonal imbalances that can lead to life-threatening situations and learn the essential treatment strategies to stabilize patients effectively. Whether you're a seasoned emergency medicine practitioner or a medical student eager to expand your knowledge, this episode promises to deliver a wealth of valuable insights. Tune in for a thought-provoking discussion that will enhance your ability to handle a wide range of endocrine and reproductive emergencies in the clinical setting.

In this episode, join Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, EMS physician delegates for Kitsap County EMS in Washington, as they delve into two compelling medical topics. First, they'll provide a brief overview of cannabinoid hyperemesis syndrome, exploring its various signs and symptoms. Then, they'll shift gears to the critical subject of anaphylaxis, focusing on cases that can lead to respiratory arrest. Prepare to gain valuable insights into the theory behind the  Northwest EMS  anaphylaxis protocol and the AMAX 4 procedure, designed to address these life-threatening situations. Don't miss this informative discussion that could prove invaluable in emergency medical scenarios.

This month, our hosts, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin. who serve as EMS physician delegates for Kitsap County EMS in Washington have a special guest Robin Kallas, a pediatric emergency physician who previously was at Mary Bridge and is now at Kaiser in Tacoma.

What do you do when the new evidence points us away from the standard of care that we have done forever? Join us for an enlightening conversation as we dive into an interesting literature review, that may change your minds on EMS medicine with hosts Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin. who serve as EMS physician delegates for Kitsap County EMS in Washington.

In the fast-paced world of emergency medical services (EMS), the health and well-being of our dedicated providers often take a back seat to the urgent needs of others. But what happens when the heroes need a rescue too? Join us for an enlightening conversation as we dive into the crucial topic of EMS provider wellness, with hosts Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin. who serve as EMS physician delegates for Kitsap County EMS in Washington.Our hosts will share their insights and experiences, shedding light on the need to discuss and prioritize EMS provider wellness to help avoid EMS provider burnout. They'll offer practical advice for EMS individuals no matter how many years you have on the job, to ensure that the individuals who come to our rescue are themselves well-supported and equipped to continue their life-saving work.

Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, emergency physicians and the Emergency EMS delegates for Kitsap County EMS in Washington, impart their wisdom on trauma.  From the vast topic of trauma, they narrow their focus on some new research, the pitfalls, and some spinal immobilization. 

Get stressed on an OB call? Lower your anxiety, by listening to Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, emergency physicians and the Emergency EMS delegates for Kitsap County EMS in Washington, discuss OB/GYN Emergencies in the first part of their series. 

Part Two of the Delegates OB Emergencies series.  Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, emergency physicians and the Emergency EMS delegates for Kitsap County EMS in Washington, discuss OB/GYN Emergencies in critical situations.  All EMS providers are stressed on these types of calls. Knowing more about them can help lower this stress. 

In episode three of our third season, Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, emergency physicians, and  Kitsap EMS Delegates discuss the presentation and management of patients presenting with massive and severe submassive pulmonary embolism, massive hemoptysis, and upper airway obstructions. 

 Dr. Martin Bennett, Dr. Adam Brenner, and Dr. Scott Ekin, emergency physicians and the Emergency EMS delegates for Kitsap County EMS in Washington, discuss respiratory pitfall and killer respiratory illness. Not everything short of breath is Asthma. 

This episode covers a wide range of topics of the things that can hang you up during a call dealing with psych patients :PsychGeriatricsAgitated PatientsConsent and capacity to treatMandatory reportingLift assists 

EMS Delegates in Kitsap County, Washington State, discuss respiratory and infectious diseases. 

In the conclusion of this topic, the Kitsap County EMS Medical Program Director physician delegates Dr. Adam Brenner, Dr. Martin Bennett, and Dr. Scott Ekin continue to tackle the expansive subject of your guts, everything from the lips to the anus.  They pick up the topic of discussing the liver. 

In the multi-part series, the Kitsap County EMS Medical Program Director Delegates Dr. Adam Brenner, Dr. Martin Bennett, and Dr. Scott Ekin tackle the expansive subject of your guts, everything from the lips to the anus.  The delegates cover diseases and things EMS providers need to know regarding the gastrointestinal tract. 

Dr. Adam Brenner, Dr. Martin Bennett, and Scott Ekin conclude the two-part series discussion on the causes of altered mental status and their treatment according to Northwest Region protocols. 

Various issues can cause altered mental status. In a two-part series covering episodes three and four of season two, Kitsap EMS Delegates Martin Bennett, Adam Brenner, and Scott Ekin discuss the symptoms and treatment of altered mental status according to Northwest Region protocols. 

The pandemic has been hard on the EMS community. How do we address and talk about this issue?  In the second episode of season two, Kitsap EMS Delegates Martin Bennett, Adam Brenner, and Scott Ekin discuss the signs and symptoms of burnout. 

Kitsap EMS Delegates Martin Bennett, Adam Brenner, and Scott Ekin ring in 2022, discussing the topic of Toxicology discussing the common poisonings and how to treat these ailments. 

Kitsap EMS Delegates Martin Bennett, Adam Brenner, and Scott Ekin delve into the fantasizing world of the brain and focus on a few topics in Neurology. They conclude their two-part series, by their exploration in the pre-hospital management of neurology patients, specifically those with suspected intracranial hemorrhage and seizures.

Kitsap EMS Delegates Martin Bennett, Adam Brenner, and Scott Ekin delve into the fantasizing world of the brain and focus on a few topics in Neurology with this two-part series. In Part One, Dr. Bennett begins with a deep dive into the topic of strokes and non-hemorrhagic CVA, TIA, and some stroke mimics. 

The Kitsap EMS Delegates conclude their cardiac discussions with aortic dissections in this two-part series in episodes five and six. Now that you recognize an aortic dissection what do you do? This is the topic of discussion for the delegates in the conclusion cardiac episode. 

The Kitsap EMS Delegates conclude their cardiac discussions with aortic dissections in this two-part series in episodes five and six. In episode five the delegates discuss how to recognize an aortic dissection and how it sounds. 

The Kitsap EMS Delegates continue their cardiology discussion from episode three.  Discussions surround a myriad of topics, ranging from dysrhythmias and heart fibrillation to conclude with a general approach to chest pain and devices. 

In episode three, the delegates tackle the topic of cardiology.  Starting off the episode,  the delegates explore general cardiovascular topics for the EMS provider ranging from pit crew mentality of cardiac arrest to atrial fibrillation.  Lastly, they discuss the EMS provider's approach to chest pain and the determination of who is sick or not sick. 

In the Delegate's second episode they discuss the issues of critical care facing the EMS providers. 

In their debut episode the Medical Director Delegates Delegates, Dr. Bennet, Dr. Brenner, and  Dr. Ekin, of Kitsap County, WA discuss a wide range of Pulmonary topics. Everything from the Pathophysiology of  Asthama to all stages of Intubation is covered.