EMS: Erik & Matt Show

In this episode of The Erik and Matt Show (EMS), Erik and Matt unpack the 12 cognitive biases that quietly drive missed diagnoses and bad calls in prehospital medicine. They cover anchoring, confirmation bias, premature closure, availability bias, framing, overconfidence, diagnostic momentum, action bias, search satisfaction, the Dunning-Kruger effect, authority bias, and sunk cost. Each bias is paired with a real field story, including Erik's anxiety patient who turned out to be in florid DKA, the SVT call that was actually WPW, the prolonged extrication where the patient was secretly having a STEMI and a fractured spleen, and Erik's now famous case of lecturing his medics about not anchoring while completely missing a necrotic appendix in the back of the ambulance.

When seconds decide whether someone walks out of the hospital or never speaks again, your EMS stroke assessment has to be fast, accurate, and repeatable. In this episode of The Erik and Matt Show (EMS) with Erik Axene and Matt Ball, an emergency physician and a firefighter/paramedic break down how to recognize a stroke in the field, why "last known well" is the single most important question you can ask the family, and how to spot a Large Vessel Occlusion before you ever leave the driveway. Erik and Matt walk through Cincinnati, LAMS, and FAST, then dig into the subtle presentations that get missed: Bell's palsy mimics, posterior strokes, dizziness, and the wake-up stroke.

Get ready to laugh in this lighthearted episode of the Erik & Matt Show (EMS) as Dr. Erik Axene and Matt Ball open up and share some of their most embarrassing stories from their careers. From humorous mishaps to awkward moments, they prove that sometimes you just need to laugh at yourself. Join us for a fun and relatable episode that reminds us all of the human side of EMS work.Discover more EMS resources, training programs, and expert insights on our website: https://axenece.com.

In this episode of The Erik and Matt Show (EMS), Erik and Matt tackle one of the most common and potentially deadly emergencies in prehospital medicine: gastrointestinal bleeding. They break down the differences between upper and lower GI bleeds, what coffee ground emesis, bright red hematemesis, melena, and hematochezia each tell you about the source and severity of the bleed, and how to make critical treatment decisions in the back of the ambulance. They also cover why TXA is no longer indicated for GI bleeds, when blood transfusion is appropriate using the shock index, and how simple interventions like leg elevation can buy you time when you do not carry blood on your unit.

In this episode of the EMS Podcast. Dr. Erik Axene and Matt discuss Toxidromes. They will help you learn to recognize common toxidromes encountered in the prehospital setting. This podcast will help you understand patient presentations and apply practical management strategies.

In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball tackle the call that scares EMS providers more than almost anything else: the crashing pediatric patient with a possible cardiac emergency.Erik and Matt break down why most pediatric emergencies are actually respiratory or perfusion related, not cardiac, and how to tell the difference in the field. The conversation covers pediatric vital sign interpretation, why heart rate is the most important early warning sign in kids, the four types of shock, how congenital cardiac abnormalities present in newborns and older children, and the critical transport decisions that can make or break outcomes. They also share real field stories, including a call where bypassing the closest ER for a pediatric specialty center was the right move.This episode is a practical guide to staying calm and managing pediatric cardiac emergencies whether you are a BLS or ALS provider. Erik and Matt cover the assessment framework, when to suspect cardiogenic shock, why parents are your best diagnostic resource, and the one thing every provider should do first on every crashing kid call.

In this special episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball are joined by Patrick Pianezza, co-writer and creator of the film Code 3.Patrick shares the real-world EMS experiences that inspired the movie, from burnout and dark humor to low pay, private ambulance work, and the emotional toll of prehospital medicine. The conversation dives into EMS culture, patient experience, tension between prehospital and hospital staff, and why Code 3 resonates so strongly with paramedics, EMTs, and emergency clinicians.This episode explores why EMS burnout is so common, how storytelling can validate first responder experiences, and why accurate representation of emergency medicine matters. It’s an honest discussion about the realities of working in EMS and why supporting first responders is more important than ever.

Dr. Erik Axene and Matt Ball continue their deep dive into high-risk obstetric emergencies that EMS providers rarely encounter but must be prepared to manage.Part 2 focuses on antepartum, intrapartum, and postpartum complications, including preeclampsia, eclampsia, ectopic pregnancy, placental emergencies, delivery complications, neonatal resuscitation, and postpartum hemorrhage. The discussion emphasizes practical, prehospital decision-making, early recognition, and preparation for rare but high-risk OB calls.

This is a two part podcast where Dr. Axene and Matt Ball discuss high risk OB emergencies. They will explore the challenges and stories of OB emergencies with real-life cases, expert tips, and practical advice for EMS and healthcare providers. Learn about trauma, sepsis, and more in this engaging, informative episode.

In this episode of the EMS Show, Dr. Erik Axene and Matt Ball discuss some of the most common errors made by EMS providers. Prehospital providers make split second critical decisions everyday. Mistakes happen in these high stress low acuity environments.How can we make sure they we are providing the best care for our communities while also protecting ourselves? Erik and Matt will breakdown the common causes of these errors and how you can prevent them. as they reveal real-world errors in 911—covering medication mix-ups, documentation pitfalls, and communication failures—to help first responders deliver safer care.

In this episode of the Erik and Matt Show (EMS) Join Dr. Erik Axene and Firefighter/Paramedic Matt Ball as they dive into the essential skills and knowledge every EMS provider needs when caring for pediatric patients. In this episode, you’ll get practical tips, real-world scenarios, and expert insights to help you stay calm, confident, and effective in the field. Whether you’re a seasoned paramedic or new to EMS, tune in to learn how to improve outcomes and provide the best care for your youngest patients.

In this episode of the Erik and Matt Show (EMS), we dive into a groundbreaking article from August 2025 that questions the effectiveness of cervical collars. Analyzing data from nearly 4,000 studies, the article finds no evidence that cervical collars prevent secondary neurological deficits—a major shift for EMS practices. For years, applying a c-collar has been a fundamental protocol for trauma patients. Join Erik and Matt as they break down the findings and explore what this means for the future of EMS.EMS providers at all levels should read this article and share it with leadership and medical directors to spark critical discussions.

In this episode of the Erik and Matt Show (EMS), we dive into the unique challenges of caring for obese patients, a growing population, particularly in the U.S. We explore the complexities of treatment, proper medication dosing, and ensuring provider safety when responding to these calls. Join us as we share insights and strategies for first responders to effectively manage and support patients struggling with obesity, while keeping safety first.

In this insightful episode of the Erik and Matt Show (EMS), hosts Erik and Matt explore the complexities of providing exceptional care for patients with special needs. From overcoming barriers like hearing or vision impairments to addressing physical challenges, such as working with patients in wheelchairs, or supporting those with autism, this episode dives into practical strategies for healthcare providers. Join us as we discuss how to navigate these challenges with empathy, ensuring every patient is treated with the dignity and respect they deserve.

In this episode of the Erik and Matt Show (EMS) we discuss the age old issue of when we should stay and play or load and go. The days of "give them a dose of diesel" are fading. We need to be doing what's best for our patients.This is a complicated decision with several factors that play into it. To be a good practitioner you have to be able to make the best clinical decision for your patients. Sometimes the best thing you can do is get the patient to the hospital as quickly as possible and perform any necessary skills en route. Sometimes we need to take some time on scene to stabilize our patient and reduce their mortality. Listen is as Erik and Matt discuss this issue from both a prehospital provider perspective and a medical director perspective. 

In this episode of the Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball discuss health and wellness. There's so much misinformation out there on what it means to be "healthy." But what does it really look like to be a healthy person. It's not about having 6 pack abs or the latest diet craze. Dr. Axene has spent an extensive amount of time researching and speaking on this topic. He has personally made changes in his life that have led him to be a healthier person. Listen in as we discuss 6 pillars of health and wellness and make it simple to implement into your life.

In the episode of the Erik and Matt Show (EMS) we discuss the complex and time-critical world of submersion injuries. From drowning and near-drowning incidents to cold water immersion and secondary complications, Erik and Matt explore what really happens when the body is submerged and how to manage these patients.We'll discuss prehospital considerations, and hospital management strategies, all while breaking down the physiology behind these life-threatening events. Whether you're a healthcare provider, first responder, or just curious about the science of survival, this episode offers a deep look at one of the most urgent challenges in emergency medicine.

In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene, MD and firefighter/paramedic Matt Ball tackle a seasonally critical topic: hyperthermia. With record-breaking heat across the U.S., they break down how to recognize early signs of heat illness, differentiate heat exhaustion from heat stroke, and manage these patients effectively in the prehospital setting.They walk through thermoregulation, common risk factors (including construction workers, firefighters, athletes, and the elderly), and emphasize rapid cooling techniques like ice baths, evaporative cooling, and creative on-scene solutions. The episode also covers EMS scene priorities, cooling strategies, complications like rhabdomyolysis, and why prehydration and on-scene rehab are essential for providers.

In this episode of The Erik and Matt Show (EMS), we sit down with Fire Chief Robert Reardon of Duxbury, Massachusetts, for a powerful conversation on leadership through adversity.Chief Reardon opens up about navigating some of the toughest calls of his career and the emotional impact those moments had—not just on the firefighters he leads, but on himself. He shares how he worked to ensure his team had the support they needed, and how he confronted the often-overlooked mental toll of the job.We dive into the critical challenge of bridging the gap between administration and operations, and how trust becomes the cornerstone of effective leadership. Without it, even the best intentions can fall flat. This is a must-listen episode for anyone in public safety—and anyone who wants to understand the human side of command.Chief Robert Reardon LinkIn Profile:www.robreardon.com

Airway management isn’t just about getting the tube, it’s about knowing when, why, and how to do it right. In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and firefighter/paramedic Matt Ball get real about what it takes to succeed in the field, from first-pass success to recognizing when not to intubate.They break down the big four: trauma, pediatric, geriatric, and obese patients, plus lessons from decades of experience and why humility may be your best airway skill.Whether you're in the ER or the back of a rig, this episode is packed with practical pearls to improve your prehospital airway game.

Sepsis kills more patients than trauma or cardiac arrest, yet it’s often missed in the field. In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and firefighter/paramedic Matt Ball break down everything EMS providers need to know about recognizing and managing sepsis before the ambulance bay doors.They cover real patient cases, why traditional screening tools fall short, and the evolving role of data, end-tidal CO₂, and even AI in improving outcomes. Whether you’re rural or urban, fire-based or private, this one’s packed with insights that could change your practice and save lives.

In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and firefighter/paramedic Matt Ball talk candidly about EMS in the modern fire service. From the glamorized expectations in recruitment ads to the daily reality of medical calls, they dig into the cultural gap between perception and practice.The episode explores how fire-based EMS providers can better embrace their role in patient care, the importance of staying clinically sharp, and why saving lives doesn’t always look like pulling someone from a burning building. It’s a real conversation about duty, ego, and what it means to do the job right.

STEMI is out. OMI is in. In this episode of The Erik and Matt Show (EMS), Dr. Axene and Matt Ball unpack the newest data on occlusive myocardial infarction (OMI) criteria—and why sticking to traditional STEMI patterns could cause you to miss up to 34% of heart attacks. They break down the April 2025 literature, discuss real-world EMS implications, and challenge every provider to rethink how they read 12-leads. Whether you're a medic, medical director, or firefighter-paramedic, this one's a must-listen.We discussed this topic several months ago but an article just came out this month with some new information. Here is a link to the article.

The record has been set—but it almost didn't happen. In this follow-up episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball break down the chaos, comedy, and close calls from their 3,200-mile ambulance journey. From mechanical failures and border stops to alligator wrangling and Chick-fil-A-fueled escape rooms, the duo recounts how this wild idea became a certified Guinness World Record.More than a stunt, the trip doubled as a mobile classroom—capturing real-world CE content tied to trauma, sepsis, medical errors, and documentation. This is EMS education, reimagined.

What does it take to set a Guinness World Record for the longest EMS ground transport? In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball reveal their ambitious plan to take the oldest licensed ambulance in the U.S. on a record-breaking journey across the country.Along the way, they’ll film content for an upcoming EMS lecture bundle, visit fire stations, and prove that education doesn’t have to be boring. But will they actually break the record? Tune in to hear their strategy, the challenges ahead, and why this adventure is unlike anything EMS has seen before.

Whole blood transfusions are gaining momentum in EMS, but how do they work in the field? In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball sit down with EMS medical directors Dr. Joshua Bobko, Dr. Mark Gamber, and Dr. Cynthia Simmons to break down the science, real-world applications, and the logistical challenges of whole blood programs. From trauma cases to medical emergencies, discover how prehospital transfusions are changing the game for paramedics and firefighters.

Massive hemorrhage is the leading cause of death in trauma, and EMS providers often have just seconds to intervene. In this episode, Erik and Matt discuss hemorrhage control techniques that save lives both in the field and in extreme environments. Whether you're a combat medic or an average citizen, it's important to know how to stop bleeding in a patient. Hemorrhage is the leading cause of death in trauma. Tune in as we discuss this simply but extremely important patient population. 

Criminal charges against EMS providers are becoming more common, and the latest case out of Sioux City has the EMS world on edge. A paramedic is facing manslaughter charges after mistakenly administering a paralytic instead of a sedative—resulting in a tragic patient outcome.Are EMS providers now at legal risk for honest mistakes? What can we learn from this case? And how can EMS professionals protect themselves while providing lifesaving care?

In this episode of The Erik and Matt Show, we tackle one of the most common questions we get: Should paramedics go to nursing school or med school? Erik and Matt share their personal journeys through nursing and medical school, comparing them to their time in paramedic school. What’s different? What’s harder? What should you expect? Whether you’re looking to advance your EMS career or are simply curious about these career paths, this episode is packed with insights, advice, and a healthy dose of humor.

Mass casualty incidents (MCIs) have unfortunately become a more frequent reality. In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball reflect on the tragic New Orleans attack that left 15 dead and dozens injured. They dive into the principles of effective MCI response, emphasizing the importance of triage, hemorrhage control, and teamwork. Whether you're an EMT, paramedic, or simply looking to understand the challenges first responders face, this episode is packed with actionable insights.

As first responders, EMS professionals often encounter situations others don’t—inside homes, in unsafe environments, and during moments of crisis. In this sobering episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball explore the critical role EMS plays in recognizing and reporting child abuse. From physical exam patterns to the "Ten Four Faces P" mnemonic, this discussion equips first responders with tools to protect children and navigate one of the most challenging aspects of the job.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball emphasize the importance of consistent exercise and forming healthy habits tailored for first responders. They delve into practical strategies for breaking through fitness plateaus, building discipline, and leveraging community support to stay motivated and achieve lasting results.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball tackle the critical topic of vitality, the fifth pillar of the THRIVE series. They dive into how mental health impacts overall well-being, sharing personal stories, strategies for resilience, and the importance of community support for EMS professionals facing frequent trauma.

For first responders and medical professionals, holidays often mean more than festive celebrations—they mean sacrifices and balancing acts. In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball share their unique experiences working through Christmas, Thanksgiving, and even Super Bowl Sunday. From trading shifts to finding joy in unconventional holiday celebrations, this episode highlights the challenges and rewards of serving others during the most festive times of the year.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball dive into the fourth pillar of THRIVE: Intake. They explore how choices around food, drink, and even mental stimuli impact overall health and wellness. With insights into the benefits of a balanced diet, tips for choosing whole foods, and the dangers of processed foods, this discussion equips EMS professionals with practical advice for a healthier lifestyle.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball focus on the importance of Rest as the third pillar of THRIVE for health and wellness. They discuss the science behind sleep, share practical tips for managing sleep apnea, and highlight restorative practices like meditation and hobbies that EMS professionals can use to recharge. Understanding rest's role in overall health is essential for high-stress professions like EMS, where recovery impacts both performance and long-term health.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball dive into the second pillar of THRIVE—health.  Covering key points like weight tracking, blood pressure checks, cancer screenings, and cholesterol management, this episode is a must-listen for those dedicated to their health and long-term success as first responders. Stay informed, proactive, and ready for any emergency with these vital health insights. 

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball dive into the first pillar of THRIVE—team. They explore how building strong relationships and community among EMS professionals can improve both personal and professional well-being. From the importance of accountability to the unique camaraderie in the EMS field, this episode sheds light on how teamwork drives better health outcomes for first responders.

In this episode of the Erik & Matt Show (EMS), Dr. Erik Axene and Matt Ball discuss the critical importance of health and wellness for first responders. Erik, who has spoken across the country on this topic, emphasizes that keeping ourselves healthy is one of the best ways to serve others. He introduces the THRIVE acronym, which outlines the six pillars of health and wellness. Join us over the next several weeks as Erik and Matt dive into each pillar and explore this essential topic for EMS professionals.Discover more EMS resources, wellness tips, and training programs on our website: https://axenece.com

In this episode of The Erik and Matt Show (EMS), Dr. Erik Axene and Matt Ball explore the crucial components of mega code paramedic training. From the perspective of a medical director and a seasoned FTO, they discuss the challenges and strategies for passing a mega code evaluation. Whether you're a new paramedic in training or an experienced first responder, this episode provides valuable insights into mastering EMS skills under pressure.

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball continue to discuss the vital differences between Occlusive Myocardial Infarction (OMI) and STEMI, two critical conditions that can make the difference between life and death in pre-hospital care. While STEMI recognition has long been the standard, new research shows that focusing solely on STEMI could lead to missing up to 25% of heart attack patients. Tune in as Erik and Matt discuss essential EKG patterns and what every EMS provider needs to know to provide the best care possible.Explore more EMS resources, training programs, and expert insights on our website: https://axenece.com

In this episode of The Erik and Matt Show, Dr. Erik Axene and Matt Ball break down the vital differences between Occlusive Myocardial Infarction (OMI) and STEMI, two critical conditions that can make the difference between life and death in pre-hospital care. While STEMI recognition has long been the standard, new research shows that focusing solely on STEMI could lead to missing up to 25% of heart attack patients. Tune in as Erik and Matt discuss essential EKG patterns and what every EMS provider needs to know to provide the best care possible.Explore more EMS resources, training programs, and expert insights on our website: https://axenece.com

In this episode of the Erik & Matt Show (EMS), Dr. Erik Axene shares his unique experience as an Airway Management Physician (AMP) with the Dallas Cowboys. The NFL employs AMPs to be on the sidelines at every game, ready to respond to any medical emergency. Tune in to hear about Erik’s role, the responsibilities of an AMP, and the critical importance of airway management in professional sports.Discover more EMS resources, training programs, and expert insights on our website: https://axenece.com

In this episode of the Erik & Matt Show (EMS), Dr. Erik Axene and Matt Ball dive into the world of tattoos. Getting a tattoo is a big decision, and Matt, who has several tattoos, shares his experiences while Erik, who is considering getting one, explores the pros and cons. From designing tattoos in college to working in a tattoo removal clinic, Erik discusses the medical side of getting inked, while Matt provides insights from his extensive time under the needle. Tune in for a balanced discussion on the art and science of tattoos.Discover more EMS resources, training programs, and expert insights on our website: https://axenece.com

In this episode of the Erik & Matt Show (EMS), Dr. Erik Axene and Matt Ball share their philosophy on EMS education. With Dr. Axene’s extensive background as an educator—holding a master’s degree in education and experience as a physics teacher before becoming a physician—and Matt’s experience teaching EMS in college settings and providing continuing education to hundreds of firefighters, EMTs, and paramedics, they offer a unique and effective approach to teaching. If you’ve ever seen one of their online courses, you’ll recognize the impact of their innovative methods. Tune in to learn more about their approach to EMS education.Explore our EMS courses, resources, and more on our website: https://axenece.com

On this very special episode of the Erik & Matt Show (EMS), Dr. Erik Axene and Matt Ball reflect on where they were on September 11, 2001. As we honor the 23rd anniversary of the 9/11 attacks, we take a moment to remember the heroes and civilians who perished that day. Join us as we pause, reflect, and ensure that we never forget the sacrifices made on that tragic day.

In this episode of the Erik & Matt Show (EMS), hosts Dr. Erik Axene and Matt Ball share effective strategies for tackling major exams like the National Registry, NCLEX, and MCAT. Drawing from their extensive experience, Erik and Matt provide valuable tips and insights to help you succeed. Whether you’re an aspiring EMS professional, nurse, or medical student, this episode is packed with practical advice to boost your confidence and improve your test-taking skills.Dr. Erik Axene is the Chief Medical Officer for Axene Health Partners and the founder of Axene Continuing Education, LLC, while Matt Ball is a firefighter, paramedic, and registered nurse.Explore our EMS courses, resources, and more on our website: https://axenece.com

Get ready to laugh in this lighthearted episode of the Erik & Matt Show (EMS) as Dr. Erik Axene and Matt Ball open up and share some of their most embarrassing stories from their careers. From humorous mishaps to awkward moments, they prove that sometimes you just need to laugh at yourself. Join us for a fun and relatable episode that reminds us all of the human side of EMS work.Discover more EMS resources, training programs, and expert insights on our website: https://axenece.com.

In this episode of the Erik & Matt Show (EMS), Dr. Erik Axene and Matt Ball tackle the pressing issue of burnout in the healthcare and prehospital world. Since the COVID pandemic, burnout has become an increasingly critical problem for healthcare providers. Erik and Matt explore the causes of burnout, its impact on EMS professionals, and discuss possible solutions to help mitigate this widespread issue. Tune in for an important conversation on how to support those on the front lines.Explore more EMS resources, training programs, and expert insights on our website: https://axenece.com.

In this episode of the Erik & Matt Show (EMS), hosts Dr. Erik Axene and Matt Ball revisit the hot topic of the 48/96 shift schedule. After initially discussing this over a year ago, Matt shares his personal experience working this schedule for over 6 months. They explore the pros and cons of the 48/96 schedule, focusing on its impact from a medical standpoint, personnel health, family relationships, and its effects on a department or community. Tune in for a comprehensive update on this controversial shift schedule.Explore more EMS resources, training programs, and expert insights on our website: https://axenece.com