PODCAST · health
The EMS Lighthouse Project
by Jeffrey L. Jarvis, MD
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Dr. Jeff Jarvis and Mike Verkest as they shine the bright light of science on EMS practice in an informative and fun way.
Episodes
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Tragic News
Tragic news from Houston about a friend, mentor, and colleague, Dr David Persse.
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An update on the state of the podcast, and it's future
Jeff gives a brief update on the podcast. Where it's been what is changing, and what the future holds. Web site: emslighthouseproject.org Information: [email protected] or [email protected] YouTube: YouTube.com/@emslighthouseproject
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Ep113 - AI Use in Research
AI is everywhere in popular culture right now. Most of us are confronted with it daily and most of us are either excited or horrified. Is it helpful or harmful? If we are going to use it, how should we? What is the ethical and pragmatic use of AI in research? Drs Remle Crowe and Henry Wang join…
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Ep112 - TOWAR with Dr Frank Guyette, Part 2
Whole blood is the current bright, shiny thing in EMS medicine. It works in the hospital and is what our patients are bleeding out onto the road so it just seems to make sense that we should put back what they’re loosing. But… is it any better than blood components? That’s the question the…
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Ep 111 - The TOWAR Trial w Dr Frank Guyette, Part I
Whole blood is the current bright, shiny thing in EMS medicine. It works in the hospital and is what our patients are bleeding out onto the road so it just seems to make sense that we should put back what they’re loosing. But… is it any better than blood components? That’s the question the…
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Ep110 - Smida Defends Resuscitation, Part II
Join Dr. Jeff Jarvis for part II of his interview with podcase friend and frequent contributor, now-Dr Tanner Smida where we discuss his defense of his PhD. Dr Smida discusses four papers that inform cardiac arrest resuscitation, as well as lessons he learned about conducting well-designed...
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Ep109 - Smida Defends Resuscitation, Part I
Join Dr. Jeff Jarvis as he interviews podcase friend and frequent contributor, now-Dr Tanner Smida for the first of a two-part interview where we discuss his defense of his PhD. Dr Smida discusses four papers that inform cardiac arrest resuscitation, as well as lessons he learned about conducting...
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Ep108 - 3 Pods In 1
This is a special version of the EMS Lighthouse, live from Ashland, OR. We are joined by Mike Verkest and Dr Ritu Sahni from The EMS Show, and Jimmy Apple from The EMS Avenger at the State of Jefferson Conference in Southern Oregon. We had a blast and covered a to of ground. I hope y'all enjoy!
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Ep107 - 3 Papers With Dr Crowe
Dr Remle Crowe returns to the podcast to discuss three new papers with Dr Jarvis: Two papers on epinephrine in cardiact arrest (including one on trauma!) and one on pulse oximetry in hypoxemic patients with darker skin. We might nerd out a bit on methodology, tacos, and have a few book...
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Ep 106 - Succ vs Roc in Hyperkalemia
We were all taught succinylcholine is contraindicated in hyperkalemia because it can cause potassium release, exacerbating the problem. But does it? Does it really? Dr. Jarvis discusses a recent paper that seems to compare mortality within 24 hours of RSI in hyperkalemic patients between those...
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Ep 105 - The RSI Trial
You've read about how this groundbreaking trial on ketamine vs etomidate for RSI "Changes Everything!" on the socials. Or perhaps "it's horribly biased and unnecessary... we're already knew all this!". Why? Well.. social media. Listen in as Dr Jarvis discusses not just this trial, but what the...
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Ep 104 - The IV vs IO Trials
Right on the heels of the release of the 2025 AHA guidelines, including one on preferentially using IVs over IOs, comes two RCTs in the same edition of NEJM that compare intial attempts with IVs to IOs in out of hospital cardiac arrest. Dr Jarvis discusses these two papers while answer a…
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Ep 103 - Preeclampsia, Eclampsia, and Postpartum Hemorrhage
ACOG, the American College of Obstetricians and Gynecologists, recently published EMS guidelines for treatment of hypertension in pregnancy/pre-eclampsia, eclampsia, and postpartum hemorrhage. Drs. Jenna White and Christopher Zahn join Dr Jarvis to discuss the science behind these recommendations...
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Ep 102 - Ketamine for Agitation with Dr Crowe
You use ketamine. I use ketamine. We all use ketamine. But… how safe it is, really? A new study out of Toronto suggests 30% of patients who receive ketamine have adverse events, a rate higher than seen in the ED. What are we to make of this? I bring Dr Remle Crowe on to discuss… Citations: 1.…
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Ep 101 - PreOxygenation and Why Words Matter
We've covered pre-oxygenation strategies and intubation alot on this podcast, mayber more than anyting else. We covered the definition of FPS in E74, the DEVICE trial on DL vs VL in E75, and the PREOXI trial of NIV vs Mask Pre-oxygenation in E86. Now we have another Preoxygenation paper, this one...
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Ep 100 - Amio v Lido in OHCA w Tanner Smida
The 2017 NEJM study, ALPS, compared amiodarone, lidocaine, and placebo for refractory shockable rhythms in adults with out of hospital cardiac arrest. They found no significant difference in survival to hospital discharge or functional survival between any of the arms. If that study has left you...
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Ep 99 - Adenosine or Diltiazem for SVT?
We just got a new paper that compares initial treatment with adenosine compared with diltiazem for the treatment of adults with SVT in the ED. Wouldn’t it be great if it turned out that diltiazem was just as effective, if not more effective, as adenosine without the crappy feeling? Yeah, that’d…
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Ep 98 - Does the Sequence of RSI Medications Matter
The next time you go to intubate a patient, should you give the sedation before the paralytic or the paralytic before the sedative? Does it matter? And what the hell does Bayes have to do with any of this? Dr Jarvis reviews a paper that uses Bayesian statistics to calculate the association…
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E97 - Bayes and Calcium Before Diltiazem in Atrial Fibrillation
We covered a paper in episode 81 that suggested treating atrial fibrillation with rapid ventricular response in the field could lower mortality. But it also drops BP a bit. Could pretreating these patients with calcium lower the risk of hypotension? Dr Jarvis puts on his nerd hat and uses…
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E96 - MCD Wrap Up
Wrapping up a series of 5 episodes, Dr Jarvis finishes his discussion of mechanical CPR devices (MCDs) talking about papers from Utah, Vienna, Anchorage, and Cincinnati and then gives his take on how to interpret the literature and put it into practice. Papers discussed: 1) Youngquist ST, Ockerse...
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E95 - LUCAS Literature
Last episode we described the literature showing no survival benefit to patients with the AutoPulse device. Fear not, I wasn’t ignoring the LUCAS, I just felt it deserved it’s own episode. We’ll cover the LINC and PARAMEDIC randomized controlled trials and the secondary analysis of LINC in...
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E94 - AutoPulse Literature
Our story so far.. episode 92 looked at a study showing lower survival from in-hospital cardiac arrest in patients treated with mechanical compression devices. Episode 93 discussed an implementation study of implementing LUCAS devices in a system with high quality pit crew CPR also showing lower...
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E93 - LUCAS: The Austin Experience
Ever wonder what would happen to cardiac arrest survival after a system implements LUCAS devices and trains really hard to deploy them appropriately? Wonder no more. Dr Jarvis reviews a paper from the Austin/Travis County EMS System that will shed some light on the question. This is the second...
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Ep 92 - Mechanical CPR in InHospital Arrest
We know the literature on mechanical CPR devices on mortality in out of hospital cardiac arrest (we DO know this literature, right?), but what about in-hospital arrest? Dr. Jarvis reviews a recent paper that uses the AHA Get With The Guidelines - Resuscitation registry to assess the association...
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Ep 91 - The Bloody Details
New Orleans implemented a blood program and assessed the impact of the program on mortality. Dr Jarvis dives into the details of the paper and then Dr Remle Crowe joins in for a discussion on why studying blood in the field is so difficult. Citation: Broome JM, Nordham KD, Piehl M, Tatum D…
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Ep90 - IV vs IO in OHCA
We've reviewed several papers in the past that suggest there might be an advantage to using IV access compared to IO access for medications in cardiac arrest. Is that really a thing? Wouldn't it be great if we had some randomized controlled trials to help answer the questions? Funny you should...
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Ep 89 - IM Epi in OHCA, Part II
Back in episode 80 we discussed a feasibility study out of Salt Lake City that showed IM epi resulted in 3-minute faster administration in cardiac arrest. It was underpowered to show survival, however. Fortunately, the great folks in Salt Lake City is back with a larger bite at the statistical...
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Ep88 - Naloxone in Cardiac Arrest?
Do you give naloxone to patients who are in cardiac arrest? Should you? Can it possibly provide any benefit at all once you are already providing effective ventilations? Well, Dr. Jarvis certainly thought not. He might have even thought it out loud. Like, loudly out loud. Based on two recent…
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Ep87 - Those CPR Pauses, Though...
Remember when we learned interruptions in compressions take a long time to recover blood pressure from? And how, to avoid these, we should do continuous compressions to avoid them. And ventilations aren’t all that important. Right? Right? Well, about that. Maybe the stories of the importance of...
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Ep86 - The PREOXI Trial
What’s the best way to pre-oxygenate our patients prior to intubation? The evidence for this question has been mixed for some time. Dr Jarvis discusses the PREOXI Trial, which directly compares preoxygenation with non-invasive ventilation compared to a face mask to see which provides the best...
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Ep85 - Intubation: Is More Better?
There is evidence that clinician experience with intubation is associated with improved success rates and evidence that missed intubation attempts are associated with worse survival, at least in cardiac arrest. The recent Airway EBG paper recommends EMS agencies with low intubation proficiency...
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Ep84 - Nebulized Ketamine?
Description: Let’s say you were looking for a safe and effective BLS option for analgesia. Something other than oral acetaminophen or ibuprofen. You want the Green Whistle (methoxyflurane), but you can’t get the Green Whistle (thanks, FDA!). How about sub-dissociative ketamine by nebulizer?…
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Ep 83 - EtCO2 in Cardiac Arrest
What value does EtCO2 have when predicting survival from cardiac arrest? We all know a sharp spike in EtCO2 is associated with ROSC, but what about persistently elevated levels? What does this mean for decision-making regarding the termination of resuscitation? Join Drs. Jeff Jarvis, Remle Crowe,...
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E82 - Ketamine v Etomidate for RSI: A Bayesian Meta-Analysis
The debate about which drug to use for sedation before RSI will... not… die. Advocates for both ketamine and etomidate approach the argument with near-religious zeal. There have been studies. We’ve even covered some here. We need a systematic review and meta-analysis, preferably using an analysis...
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Ep81 - Treatment of Atrial Fib with RVR
Atrial Fibrillation with rapid ventricular response is a common cause of EMS activations and ED visits. It is associated with chest discomfort, palpitations, and hypotension. Treatment is aimed at either rhythm or rate control, with rate control being the most common first-line approach. EMS has...
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LHP E80 – IM Epi in Cardiac Arrest
Dr. Jarvis is joined by OG co-host Mike Verkest and Dr. Brent Myers from NAEMSP 2024. We discuss an intriguing concept in cardiac arrest… giving the initial dose of epinephrine IM instead of starting an IV or IO. They discuss a 2021 paper that compared this approach to standard dosing in a...
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LHP E79 - Head Up CPR – Not So FAST
EMS History is full of interventions we've rapidly adopted, often at great expense and with disruption of existing processes, that later turned out to, how should I say this..... not work. Want examples? MAST and high-volume crystalloids in trauma. Mechanical compression devices, high-dose...
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LHP E78 – Racial Disparities in EMS Analgesia
What would you say if I told you that Black patients were less likely to receive pain medication compared with white patients? My guess is you’d either question the methods, assume it isn’t possible, or ask why. Regardless of what your answer is, you’re going to want to listen to this episode....
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LHP E77 – Should We Reduce Sedative Dosing In RSI Of Hypotensive Patients?
Have you heard that you’re supposed to decrease the dose of your sedative when performing RSI on hypotensive patients? First, avoid asking why you haven’t addressed the hypotension before intubating.. maybe there’s a reason. Maybe. But, regardless of why, intubate you will. What about those…
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EMS LHP – E76 – One and Done Epinephrine
Y’all know I have thoughts on epinephrine in cardiac arrest. Perhaps you might have heard me say epinephrine “saves the heart at the expense of the brain.” I’ve also said I don’t have an issue with any epinephrine in arrest, just how we give it currently, and have wondered if less epi might do…
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LHP E75 - The Device Trial
We’ve spoken a lot recently about intubation First-Pass Success, including the definition. We’ve also discussed different papers about the impact the type of laryngoscope, video or direct, has on first-pass success. A new paper compares video vs. direct laryngoscopy directly. Join us to discuss…
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LHP – E74 – What Even IS First Pass Success
What even is FPS? There's been a long-running argument about the definition of FPS. By argument, I mean mostly established in the literature, with some people not liking it. FPS is successful ET passage through the cords within 1 attempt at laryngoscopy or when the blade passes the teeth. That...
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Ep73 - Post-Mortem CT in Blunt Trauma
A new study describes the utility of post-mortem CT panscans in patients who died either in the field or in the ED to identify mortal and potentially mortal injuries. This paper has a couple of surprising findings that can help EMS focus our efforts on caring for these patients. Citations: 1.…
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EMS LHP E72 - DSI vs RSI
DSI (delayed sequence intubation) has been proposed as an alternative to RSI (rapid sequence intubation) for patients who can't tolerate interventions needed to properly pre-oxygenate patients. But does it work? There have been several observational studies (blatant bias acknowledgment: I wrote…
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Ep 71 - SGA Cage Match: Round 2
In episode 69, we interviewed Tanner Smida about his very interesting paper using the ESO dataset. It looked at the association between survival from out-of-hospital cardiac arrest and the type of SGA used (iGel vs. KingLT). He found 36% higher odds of survival with iGel. The ink was barely dry…
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Ep 70 - Crossover with the EMS Show from Ashland, Oregon!
Man, did we have fun recording this one? I found myself in a hotel room in Ashland, Oregon, with Drs. Ed Racht, Maia Dorsett, and Ritu Sahni talking about Sepsis. We decided this would make for a great crossover episode with The EMS Show, minus our buddy Mikey V. Anytime I get together with this...
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Ep 69 - iGel vs King LT in OHCA
The cage match you've all been waiting for! iGel vs King LT in cardiac arrest. Which is associated with higher survival? Airways-2 was an RCT of iGel vs. ETI in OHCA and found no difference. PART was an RCT of King LT vs. ETI in OHCA and found a slight difference favoring King LT. How about those...
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EMS LHP - Episode 68 - The SAVE Trial
Remember AIRWAYS-2, the British RCT comparing iGel to ETI in adults with cardiac arrest? Have you wondered if those results would hold up in a different prehospital population? Wonder no more! Dr. Jarvis reviews the SAVE Trial, another RCT of adult, non-traumatic cardiac arrest, comparing iGel to...
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EMS LHP EP67 - DOSED-VF
If one is good, two must be better, right? If it applies to cookies and ice cream, why not defibrillators? That’s the question the DOSED-VF trial set out to answer. We’ve covered this topic in episodes 12 and 27, including going over the pilot trial of DOSED-VF. But now the full meal deal is...
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EMS LHP Episode 65: SpO2 vs SaO2 Variations Between Races
Dr. Crowe returns to the EMS Lighthouse Project Podcast from our “vacation” in Mexico to discuss the impact of variations between pulse oximetry and blood gas values across races. Citations: Sudat SEK, Wesson P, Rhoads KF, et al. Racial Disparities in Pulse Oximeter Device Inaccuracy and…
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ABOUT THIS SHOW
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Dr. Jeff Jarvis and Mike Verkest as they shine the bright light of science on EMS practice in an informative and fun way.
HOSTED BY
Jeffrey L. Jarvis, MD
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Frequently Asked Questions
How many episodes does The EMS Lighthouse Project have?
The EMS Lighthouse Project currently has 115 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is The EMS Lighthouse Project about?
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Dr. Jeff Jarvis and Mike Verkest as they shine the bright light of science on EMS practice in an informative and fun way.
How often does The EMS Lighthouse Project release new episodes?
The EMS Lighthouse Project publishes regularly with 115 episodes available. Check the episode list for the typical release schedule.
Where can I listen to The EMS Lighthouse Project?
You can listen to The EMS Lighthouse Project 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 The EMS Lighthouse Project?
The EMS Lighthouse Project is created and hosted by Jeffrey L. Jarvis, MD.
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