The SWORBHP Podcast

Dr. Colin Evans, newly minted staff emergency physician here in London, joins us to discuss prehospital care from the lens of one of his five careers, as a Paramedic with Middlesex London Paramedic Service. He is also one of the founding members of the PreHospital and Retrieval Medicine (PHARMers) group, with the goal to provide education to optimize prehospital care. Their first meeting was based on optimizing trauma resuscitation. In his latest career, as an academic emergency medicine physician, he has a strong research interest in optimizing and measuring team cognition in acute care action teams. In today’s podcast, he lends his knowledge and multiple career experience, to takes us through optimizing prehospital trauma care though team cognition and developing mental models.   Disclaimer: Dr. Evans takes us through how he would optimize prehospital care in trauma and gives some examples throughout. His practice now includes in-hospital management which may differ from prehospital management. The Please follow the BLS PCS and ALS PCS care direction. Example: Dr. Evans discusses judicious fluid administration after the patient becomes normotensive. As a reminder, the OBHG Companion Document highlights that, “Once a bolus has been initiated, a minimum volume of 100 ml in pediatrics and 250 ml in adults may be administered prior to discontinuing the fluid bolus should the patient become normotensive.”

In this episode of The SWORBHP Podcast, Dr. Lauren Valdis, Medical Director of Education at SWORBHP and Dr. Jakob Domm (PGY-4 FRCPC Emergency Medicine resident at Western) review the current medical directive for CPAP use in Ontario, asthma physiology, and discuss why CPAP or BiPAP is sometimes used for asthma exasperation in the hospital setting but is not indicated in the prehospital setting, in Ontario. Show Notes

In this episode of The SWORBHP Podcast, Dr. Lauren Valdis and Jason Constable review the T's of the H's and T's of Cardiac Arrest.

In this episode of The SWORBHP Podcast, Dr. Lauren Valdis and Jason Constable review the H's of the H's and T's of Cardiac Arrest.

It’s no secret that receiving an audit from SWORBHP can spark a lot of anxiety, but should it? Dr. Sean Doran (Local Medical Director) and Dwayne Cottel (Prehospital Care Specialist) discuss this in our latest podcast. A variety of topics are discussed, including: Why self-reporting is the best option and the importance of it The auditing process and how things work behind the scenes Feedback requests, why we reach out and the value in a prompt response These questions and answers cover most of what you, as a Paramedic, should know about auditing and its process. We hope you enjoy and learn a lot from this great conversation! If you have any other topics you want to see discussed on the SWORBHP Podcast, let us know by submitting them through our website: SWORBHP Podcasts – Southwest Ontario Regional Base Hospital Program (SWORBHP)

In this episode Dr. Lauren Valdis and Dr. Taylor Bechamp discuss the topic of Penetrating Chest Trauma in Prehospital Medicine.

Dr. Matthew Davis and Dr. Sarah Cocco review changes to the Cardiac Arrest Medical Directive. These changes were outlined in a memo sent out to SWORBHP paramedics on July 19th. More details can be found on our website: www.sworbhp.ca

In this episode of our SWORBHP Webinar series Dr. Lauren Valdis talks to Dr. Erfun Hatam about Trauma in Pregnancy as it relates to the prehospital world.   Caution: This subject matter, Trauma in Pregnancy, may be upsetting or distressing to some viewers. Please keep this in mind prior to watching.

Caution: This subject matter, pediatric trauma, may be upsetting or distressing to some listeners. A theoretical case of a pediatric patient who experienced a traumatic injury is discussed to help frame important learning points. Please keep this in mind prior to listening. Description: In this episode of the SWORBHP Podcast Dr. Lauren Valdis is joined by our special guest Dr. Brett Plouffe, a Pediatric EM Fellow. This episode discusses pediatric trauma as it pertains to your practice. References: Harcke, H. T., Lawrence, L. L., Gripp, E. W., Kecskemethy, H. H., Kruse, R. W., & Murphy, S. G. (2019). Adult tourniquet for use in school-age emergencies. Pediatrics, 143(6). Ross, E. M., Mapp, J. G., Redman, T. T., Brown, D. J., Kharod, C. U., & Wampler, D. A. (2018). The tourniquet gap: a pilot study of the intuitive placement of three tourniquet types by laypersons. The Journal of Emergency Medicine, 54(3), 307-314. Cunningham, A., Auerbach, M., Cicero, M., & Jafri, M. (2018). Tourniquet usage in prehospital care and resuscitation of pediatric trauma patients—Pediatric Trauma Society position statement. Journal of Trauma and Acute Care Surgery, 85(4), 665-667. Russell, R. T., Esparaz, J. R., Beckwith, M. A., Abraham, P. J., Bembea, M. M., Borgman, M. A., ... & Spinella, P. C. (2023). Pediatric traumatic hemorrhagic shock consensus conference recommendations. Journal of Trauma and Acute Care Surgery, 94(1S), S2-S10. Sokol, K. K., Black, G. E., Azarow, K. S., Long, W., Martin, M. J., & Eckert, M. J. (2015). Prehospital interventions in severely injured pediatric patients: rethinking the ABCs. Journal of trauma and acute care surgery, 79(6), 983-990.

On this episode, Dr. Lauren Valdis and guest Dr. Rob Sogetrop present a webinar focusing on antidepressant overdoses in the world of prehospital medicine.

In this episode of the SWORBHP Podcast our very own Dr. Lauren Valdis and Dwayne Cottel discuss PICC lines and CVAD access. References: Ask MAC: https://askmac.sworbhp.ca/271 OBHG Companion Document (see pages 70/71): https://ontariobasehospitalgroup.ca/wp-content/uploads/2022/02/2022_02_ESC-Companion-Document-v4.9_final_v16_Feb-8-2022.pdf

Description:  In this episode, Special Guest Dr. Alexander Chase (Western Pediatric Emergency Medicine Fellow) sits down to talk to Dr. Lauren Valdis (Medical Director of Education at SWORBHP) about pediatric endotracheal intubation. Together they discuss the evidence behind the switch from uncuffed to cuffed tubes, along with some of the other recent changes to pediatric airway management. Myths are debunked, evidence is unpacked. Join us for this deep dive into pediatric airway management!   Associated TOTW: Pediatric ETT Size Equation Changes with Cuffed Tube   Resources for Pediatric Intubations Webinar: · De Orange FA, et al. Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. Cochrane Database of Systematic Reviews 2017, Issue 11. Art. No.: CD011954. DOI: 10.1002/14651858.CD011954.pub2 · Eschertzhuber S, et al. Cuffed endotracheal tubes in children reduce sevoflurane and medical gas consumption and related costs. Acta Anaesthesiol Scand. 2010 Aug;54(7):855-8. doi: 10.1111/j.1399-6576.2010.02261.x. Epub 2010 Jun 15. PMID: 20560884. · Khine HH, et al. Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia. Anesthesiology. 1997 Mar;86(3):627-31; discussion 27A. doi: 10.1097/00000542-199703000-00015. PMID: 9066329. · Topjian AA, et al. Pediatric Basic and Advanced Life Support Collaborators. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S469-S523. doi: 10.1161/CIR.0000000000000901. Epub 2020 Oct 21. PMID: 33081526. · Wampler DA. Capnography as a clincal tool. August 2011. EMSWorld. From https://www.hmpgloballearningnetwork.com/site/emsworld/article/10287447/capnography-clinical-tool · Weiss M, et al. Comparison of cuffed and uncuffed preformed oral pediatric tracheal tubes. Paediatr Anaesth. 2006 Jul;16(7):734-42. doi: 10.1111/j.1460-9592.2006.01844.x. PMID: 16879515.

Special Guest Dr. Sara-Pier Piscopo (Western Pediatric Emergency Medicine Fellow) sits down to talk to Dr. Lauren Valdis (Medical Director of Education at SWORBHP) to discuss the latest evidence and best practices in resuscitation of pediatric out of hospital cardiac arrest.  Topics include: Considerations in when to transport, when to consider IO vs. IV access and some hot-off-the-press local data to share.   March 2022 - Ask MAC referenced: SWORBHP Ask MAC   References: Burgert, JM et al.  An Evidence-Based Review of Epinephrine Administered via the Intraosseous Route in Animal Models of Cardiac Arrest, Military Medicine, Volume 179, Issue 1, January 2014, Pages 99–104, Hansen HL et al. Time to epinephrine administration and survival from nonshockable out-of-hospital cardiac arrest among children and adults. Circulation. 2018; 137:2032-2040 Nguyen L et al. Effect of intravenous versus intraosseous access in prehospital cardiac arrest. Air Medical Journal. 2019; 38:147-149 Matsuyama T et al. Pre-hospital administration of epinephrine in pediatric patients with out-of-hospital cardiac arrest. JACC. 2020; 75:194-204 Meyers LA et al. Prehospital peripheral intravenous vascular access success rates in children. Prehosp emerg care. 2013; 17:425-428 Meyers LA et al. Semiautomatic intraosseous devices in pediatric prehospital care. Prehosp emerg care. 2011; 15:473-476 Reades R et al. Comparison of first-attempt success between tibial and humeral intraosseous insertions during out-of-hospital cardiac arrest. Prehosp Emerg Care. 2011 Apr-Jun;15(2):278-81. doi: 10.3109/10903127.2010.545479. Epub 2011 Jan 28. PMID: 21275573. Tijssen, JA et al. Time on the scene and Interventions are associated with improved survival in pediatric out-of-hospital cardiac arrest. Resuscitation. 2015; 94:1-7 Wampler D et al. Paramedics successfully perform humeral EZ-IO intraosseous access in adult out-of-hospital cardiac arrest patients. Am J Emerg Med. 2012 Sep;30(7):1095-9. doi: 10.1016/j.ajem.2011.07.010. Epub 2011 Oct 24. PMID: 22030185.

In this episode our Medical Director of Education Dr. Lauren Valdis, and our Education Coordinator Gabby Willems, answer your questions from the 2021 MCME.

In this Podcast, Prehospital Care Specialist Dwayne Cottel sits down with Dr. Matthew Davis, SWORBHP Regional Medical Director, to discuss Base Hospital Physician (BHP) patching. SWORBHP recently conducted a pilot project to test the feasibility of Centralized Patching. This podcast highlights SWORBHP’s historical model of BHP patching and the impetus to move to Centralized Patching. “What exactly is Centralized Patching?” and “What are some of the perceived benefits and drawbacks to this model?” are some of the questions that will be explored, and answered, in this podcast. In addition, how Centralized Patching will impact you as a frontline SWORBHP paramedic is discussed.  An overview of some of the lessons learned from our pilot project as well as some upcoming developments with BHP patching will be shared. Read the Patching Post to keep up with all of the latest news regarding SWORBHP's centralized patching initiative: https://www.lhsc.on.ca/southwest-ontario-regional-base-hospital-program/the-patching-post

Prehospital Care Specialists Melissa Burgess and Dwayne Cottel sit down to review some of the highlights from the 2020 MCME. In this episode Dwayne also goes over some cardiac cases and how they relate to the precourse from last year. - 9 Steps to Rhythm Strip Interpretation - STEMI Locations and Reciprocal Changes

Compassion Fatigue and Vicarious Trauma This episode of the SWORBHP Podcast features Nancy Lawrence (Manager - Just Culture, Wellness & Staff Support at LHSC), Ryan Hall  (Deputy Chief - Oxford County Paramedic Services), and Ted Sanders (Paramedic and Peer Support Team Member - Oxford County Paramedic Services). The topic of this episode is Compassion Fatigue and Vicarious Trauma. Nancy, Ryan, and Ted dive deep into this topic as they discuss real-world scenarios from their own personal experiences, and talk about how it relates to you as a paramedic.   Resources: Professional Quality of Life Scale: https://proqol.org/uploads/ProQOL_5_English_Self-Score.pdf Continuum Self Check: https://theworkingmind.ca/continuum-self-check Continuum Self Check Graphic: https://i0.wp.com/safehouseapp.info/wp-content/uploads/2017/07/continuum-mobile.gif Low Impact Debriefing: https://www.tendacademy.ca/wp-content/uploads/2019/07/Low-Impact-Debriefing-2019.pdf

Special Guest Dr. David Morden (PGY-4 Western Emergency Medicine Resident) takes us through the background of recent practice change in administration of IM Epi, per the Considerations for Paramedics Managing Patients During the COVID-19 Pandemic (https://www.lhsc.on.ca/media/9082/download). 

Dr. Danielle Kelton presents the first Western University Division of Emergency Medicine Grand Rounds of the year. These rounds, titled "Stayin' Alive', cover the evidence for and against the use of mechanical CPR both in the pre-hospital and emergency department settings. Interested in more excellent and informative grand rounds, like Dr. Kelton's? Email [email protected] to be placed on the Email list for the Western University Division of Emergency Medicine Grand Rounds, to ensure you're not missing out!

This podcast is a chock-full of information including evidence and recommendations for the use of Sodium Bicarbonate in prehospital care.   Hosted by: Dr. Lauren Valdis Dr. Shane Freeman

In this episode our Education Coordinator Lyndsey Longeway and Medical Director of Education Dr. Lauren Valdis review some of your questions from this years MCME.

In this episode Dr. Lauren Valdis talks to special guest Dr. Danielle Kelton about tracheostomies and your Tracheostomy Tube Reinsertion Medical Directive.

Inaugural SWORBHP Podcast - Discussing initial COVID-19 Changes For EMS Providers in the South West Ontario Region. Music attribution There It Is by Kevin MacLeod Link: incompetech.filmmusic.io/song/4519-there-it-is License: creativecommons.org/licenses/by/4.0/

In this episode hosts Dr. Sean Doran and Dr. Matt Davis discuss the changes that were released on May 6th 2020 and concerns regarding patching while wearing PPE during the COVID19 pandemic.