Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

PODCAST · education

Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your

  1. 121

    How to Build Procedural Skills - That Actually Stick

    Most EMS skills training creates an illusion of competence. You drill a procedure, check a box, and move on. But what does the research actually show about competency and retention? Dr. Jason Hine (EM physician, SimKit founder) breaks down the actual science of procedural skill acquisition: S-curves, encoding and consolidation, retrieval practice, and why expensive simulation labs often underperform cheap, high-rep lo-fi tools. Plus: a big announcement about SimKit and the Paramedic Confidence Builder. Book a Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter at emspodcast.com/newsletter   SimKit - https://simkit.co Made to Stick - https://amzn.to/4d5B5qA

  2. 120

    How to Fail Better in EMS: A Framework for Growth

    Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it. In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus is a warning, not a role model. Why the best clinicians you'll ever work with have made bigger mistakes than you have. Why high-functioning organizations report mistakes ten times more often than average ones. Why self-identified perfectionists only ever climb to "moderately successful."  Book Your Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter - emspodcast.com/newsletter 

  3. 119

    The Call Nobody Trained You For — Jim Schmidt on Domestic Violence Recognition

    Most medics walk onto a domestic violence scene armed with instinct and not much else. Jim Schmidt thought 20 years in the fire service had prepared him for anything — until he had to identify his stepdaughter Gabby Petito's body in 2021. In the months and years after he realized how little EMS is prepared to recognize and treat domestic violence victims. What he's learned since has rewritten what first responders should be doing on these calls. Jim walks us through the red flags, why strangulation may leave no external marks but signals a 750% jump in homicide risk, how to document, how to treat and talk to the patient, and what patterns we can recognize. Resources DomesticShelters.org — find local DV/SA orgs by address National DV Hotline — 1-800-799-SAFE · text START to 88788 JEMS article by Jim Schmidt on educating first responders to recognize domestic violence: https://www.jems.com/ems-training/domestic-violence-educating-first-responders/  Jim Hopper, PHD on the neurobiology of trauma and sexual assault: https://www.youtube.com/@JimHopperPhD  Want to go deeper? Book a Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter: emspodcast.com/newsletter  

  4. 118

    Great Mentors Shape Better Clinicians

    Don't Be A Field Training Officer Be A Field Training Mentor. Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down with Ben Tacy onsite at FASTCAN to talk about the origins of field training and why Ben prefers the language of mentorship over “field training officer”. If you care about leadership, education, workplace culture, or building better medics, this conversation is worth your time. If you want deeper discussions on topics just like this subscribe to our weekly newsletter - emspodcast.com/newsletter  Want some individualized mentorship? Book a free coaching call with us - emspodcast.com/free-coaching-call 

  5. 117

    Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite

    Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective. Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and when to bypass your local ED for a tertiary care center. Whether you’re running urban calls or wilderness rescues, you may see this and this episode will help inform how you approach cold injury.   Want more? Subscribe to The Confidence Dispatch, our free weekly newsletter for paramedics who want to get 1% better every shift: →  https://loudandclear.kit.com/d45b012fae   Want to go even further? The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance. The stuff nobody teaches you in school. If that sounds like what you've been looking for, book a free 30-minute coaching call and we'll talk about whether it's the right fit. Even if it’s not we’ll give you actionable advice on the call so that you still walk away with something valuable: →  calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

  6. 116

    Suction First: Dr. DuCanto on the SALAD Technique for the Contaminated Airway and What Comes Next

    The contaminated airway is one of the most unforgiving calls in prehospital medicine. Blood, vomit, debris — your laryngoscope goes in and you're blind. For decades, paramedics managed this with tools designed for a clean OR and training that never got close to the real thing. Dr. Jim DuCanto decided that was unacceptable. He's the anesthesiologist who invented the DuCanto catheter and SALAD (Suction Assisted Laryngoscopy and Airway Decontamination). Will Berry sat down with Dr. DuCanto at the FASTCAN conference for a conversation. In this episode we cover: - The SALAD technique, step by step - Why paramedic OR training should default to video laryngoscopy - The downsides of SALAD that Dr. DuCanto himself will tell you about - What a new portable suction device does differently Guest: Dr. Jim DuCanto anesthesiologist, inventor of the DuCanto catheter and the SALAD technique   Want more? Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae   Want to go even further? The Paramedic Confidence Builder is a year-long course and coaching community for medics who want to close the gap between what school taught them and what the job actually demands.  Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school. If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder

  7. 115

    Wired to Fail: The Science of Human Error in EMS

    What if the mistake wasn't your fault... but it's still your responsibility? That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actually do about it. WHAT YOU'LL LEARN: Task Brackets — Your brain bundles repetitive actions into smooth automated sequences. The First Habit Rule — The first habit is permanently ingrained. Old habits lurk underneath new ones and surface under stress. Get it right the first time. Goal-Oriented Stimulus — Don't ask "Do I have everything?" Ask "Where are the things I need?" and physically point to them. The Preceptor Problem — Most preceptors feel unprepared. The goal isn't to make "mini me", it's to create independent critical thinkers. Shift Fatigue — Cognitive function degrades meaningfully at 16 hours. Just Culture — Human error is inevitable. Punishment doesn't fix the system. The guilty already feel terrible. They need peer support and system redesign.   RESOURCES: Join our Paramedic Confidence Builder    CONNECT WITH US: - Instagram- @emsloudandclear - YouTube- https://www.youtube.com/@EMSLoudandClear - Website- www.emspodcast.com    CONNECT WITH SHEA: - TikTok: @flightnurseshay - Instagram: @flightnurseshay

  8. 114

    Dump Kits and Checklists: Why Expert Paramedics Still Crash

    Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. You'll learn the challenge-response checklist protocol that speeds up your intubation time (not slows it down), the HEAVEN criteria's six specific warning signs that predict difficult airways before you attempt, and why dump kits create muscle memory that works in the dark. David shares the story that started his human factors obsession and proves that expertise doesn't protect you from error—systems do. This is operational excellence: building checklists that think for you when tunnel vision sets in.   Want more? Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae Want to go even further? The Paramedic Confidence Builder is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Built by an ER doc who runs medical direction for 5 rural Colorado agencies and has talked with hundreds of paramedics about exactly where that gap shows up. Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school. If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder Resources   Paramedic Confidence Builder - emspodcast.com/program  To see the actual checklist - https://www.airmedandrescue.com/latest/long-read/medical-insight-latest-tools-ensure-successful-first-pass-intubation    Guest/Cast/Crew information- Guest- David Olvera Host- Ross Orpet, Will Berry    Catch up with us after the show - Instagram- @emsloudandclear - YouTube- https://www.youtube.com/@EMSLoudandClear - Website- www.emspodcast.com   Books we recommend - The Dichotomy of Leadership - https://amzn.to/4fiCAjN - Extreme Ownership - https://amzn.to/3O1FWfa -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf - Thinking Fast and Slow - https://amzn.to/4fiJG85   Gear We Like - Good Stethoscope - https://amzn.to/3YJJrf2 - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  - Notepad for taking notes on calls - https://amzn.to/3Z1X21J

  9. 113

    Feeling Behind the Curve? Understanding the EMS Power Curve Will Help You Stay Ahead

    Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This episode breaks down the exact framework to chunk calls into five critical phases. When you understand phases you understand what is needed during each point of the call and how to stay ahead. How to build if-then statements that eliminate decision fatigue. The psychological safety that lets you reset after screwing up in the apartment. And why 80% of medical errors tie back to the one phase—the hospital handoff. Stop reverting to chaos. Build the system that keeps you ahead. Guest/Cast/Crew information- Guest- Moose and Josh from Alert Medic 1 podcast Host- Ross Orpet, Will Berry  Catch up with us after the show - Instagram- @emsloudandclear  YouTube- https://www.youtube.com/@EMSLoudandClear   Website- www.emspodcast.com   Books we recommend - The Dichotomy of Leadership - https://amzn.to/4fiCAjN - Extreme Ownership - https://amzn.to/3O1FWfa -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf - Thinking Fast and Slow - https://amzn.to/4fiJG85 Gear We Like - Good Stethoscope - https://amzn.to/3YJJrf2 - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn    - Notepad for taking notes on calls - https://amzn.to/3Z1X21J    Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our bi-weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  10. 112

    Stupidity in EMS: The causes and remedies

    You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them. Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science behind high-stakes decision-making in emergency medicine.   Guest/Cast/Crew information- Guest- Kris Kaull, FP-C Host- Ross Orpet Catch up with us after the show - Instagram- @emsloudandclear  YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Books we recommend - The Dichotomy of Leadership - https://amzn.to/4fiCAjN - Extreme Ownership - https://amzn.to/3O1FWfa -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf - Thinking Fast and Slow - https://amzn.to/4fiJG85 Gear We Like - Good Stethoscope - https://amzn.to/3YJJrf2 - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn   - Notepad for taking notes on calls - https://amzn.to/3Z1X21J    Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  11. 111

    Anaphylaxis + Asthma: When Standard Anaphylaxis Treatment May Not Be Enough (AMAX4 Explained)

    This episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine may not be enough, and why this is the time to be aggressive. But this isn't simply about memorizing another algorithm. It's about developing the operational confidence to recognize when standard approaches may fail and override your impulse to "try the book answer one more time." You'll learn to identify time-critical scenarios, build red-flag combination awareness, and make high-stakes decisions without second-guessing yourself.  Want to systematically build this decision-making confidence? Discover the Paramedic Confidence Builder at emspodcast.com/program —where we teach the operational skills your school didn't.   Guest/Cast/Crew information- Guest- Bruce Hoffman, Associate Professor, Critical Care RN and Paramedic Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Books we recommend The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  12. 110

    The Habit Loop: How Master EMS Clinicians Build Unconscious Competence Through Habits

    Struggling to remember every protocol in high-pressure medical situations? You're not alone—and memorizing everything isn't the answer.   Join us for this game-changing conversation with Jean Francois Couture, co-founder of Parys Medical, as we unpack the science of habit formation for EMS and healthcare providers. Recorded live at FAST 25, Jean breaks down the "habit loop" (cue, routine, reward) and introduces the concept of the "meta-habit"—a habit of habits that transforms how you access critical information during emergencies.   Learn why the best clinicians don't memorize everything but know exactly where to find what they need when seconds count. Discover practical strategies for mental simulation, protocol familiarization, and building muscle memory with your cheat sheets. Jean shares actionable steps including planning your clinical scenarios, scheduling regular practice sessions, and developing unconscious competence through repetition.   Whether you're new to EMS or a seasoned veteran, this episode provides a roadmap for achieving clinical excellence through deliberate practice and smart information management.   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  13. 109

    Hypothermia Rescue: Cardiac Arrest in a Tree Well

    What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits. This wasn't luck. Miles breaks down the critical decision to defy transport protocols and how they managed a failed field intubation when her torso sank into the snow during compressions. The case became a catalyst for building Teaam Aeromedical, a progressive nonprofit wilderness air ambulance saves time, lives, and healthcare dollars. Learn the physiology of hypothermic cardiac arrest, why less intervention is sometimes more, and how to package patients in snow to prevent further heat loss. Whether you work in wilderness medicine or urban EMS, the principles here apply: know the science, challenge protocols when they don't serve your patient, and get them to the right place at the right time. Interested in our Paramedic Confidence Builder course? Check us out at - emspodcast.com Guest/Cast/Crew information- Guest- Miles Randell, Paramedic, Founder of TEAAM Aeromedical, for more go to teaam.ca  Host- Ross Orpet   Catch up with us after the show - Instagram- @emsloudandclear - YouTube- https://www.youtube.com/@EMSLoudandClear - Website- www.emspodcast.com   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our bi-weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  14. 108

    When The Anatomy Is Gone: Facial Trauma Airway Management

    What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality. Critical care transport legend Allen Wolfe joins us to dissect a real case, a conscious patient with a self-inflicted shotgun wound—no mandible, no nose, no midface—just open tissue and blood spraying everywhere. This conversation covers the Lefort facial injury classification, why the cervical collar is often more harmful than helpful in penetrating trauma, delayed sequence intubation techniques, and intubating in atypical positions. Allen also explains cerebral perfusion pressure through the Monroe-Kelley hypothesis, and why hypotension can be devastating in traumatic brain injury. But beyond the technical skills, this episode is about leadership under pressure, verbalizing your thought process to your team, and having backup plans A through Z before you need them. It's about deliberate practice and mental simulation so you don't freeze when chaos hits. Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Guest/Cast/Crew information- Guest- Allen Wolfe, CFRN Host- Ross Orpet, MD   Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  15. 107

    Stop Building Resilience, Strengthen Your Resistance

    Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever).    Recorded on-site at Fast25, James Boomhower, founder of StayFit4Duty, breaks down why the EMS culture of "pushing through" is fundamentally flawed. Using the metaphor of muscle training, he explains that continuing to stress a system without recovery doesn't build strength—it causes injury. The recovery time from a torn mental health muscle is exponentially longer than if you'd simply rested appropriately.    With over 20 years in New England EMS including training to become a licensed mental health counselor, James brings a perspective that's desperately needed in emergency medicine. He provides the missing manual for sustainable careers in emergency medicine. In this episode he discusses why the 5 pillars of resilience should really be the 5 pillars of resistance. He shares vulnerable stories from his own journey, including the colleague who grabbed him by the collar to stop him from burning out while helping others, and even some relationship strategies to prevent your worst shift from destroying your home life.   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Resources Learn more about StayFit4Duty and connect with James on instagram at @stay_fit4duty on Instagram Get The Relationship Action Plan Document  Supplemental Blog post for this episode   Guest/Cast/Crew information- Guest- James Boomhower, LMHC-A, MS, FP-C, NR-P, C- NPT, CCISM Host- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  16. 106

    What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS

    Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vulnerable stories about impostor syndrome, burnout, and finding your way as a new paramedic.   Sophie's path to EMS started in the most unexpected way—from a 39-day hospitalization that included being intubated over the holidays to signing up for EMT school from her hospital bed. But becoming a paramedic brought new challenges: crushing self-doubt, constant anxiety before shifts, and the fear that everyone would discover she was a "fraud." Sound familiar? You're not alone. This conversation dives deep into the psychological struggles that plague EMS providers, especially new medics who lose their support structure after paramedic school.   Learn the difference between destructive doubt and healthy doubt, discover cognitive reframing techniques to combat catastrophizing and black-and-white thinking, and understand why bravery means doing things scared. Sophie emphasizes one crucial truth: you cannot fight impostor syndrome alone. So hit play and let’s do this together.    **If you're struggling with confidence as a new paramedic, our Paramedic Confidence Builder Course can help. To learn more, reach out via email at [email protected] or through our contact page at emspodcast.com or via DM on IG @emsloudandclear**   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae     Guest/Cast/Crew information- Guest- Sophie Fuller, EMS, HEMS  Host- Ross Orpet   Catch up with us after the show  Instagram- @emsloudandclear  YouTube- https://www.youtube.com/@EMSLoudandClear  Website- www.emspodcast.com

  17. 105

    Why Those With Addiction Don't "Just Change" - Opioid Crisis Reality for EMS

    Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment   "Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.   Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challenge how EMS providers think about opioid overdoses. The one-year mortality rate after an overdose requiring Narcan? A staggering 6-7%—worse than the one-year mortality after a STEMI. Yet we invest far less in these patients than cardiac emergencies.   This episode covers the evidence-based treatments that actually work (methadone and buprenorphine have incredibly low numbers-needed-to-treat to save a life), how EMS can initiate life-saving treatment in the field, and why "tough love" and waiting for patients to "hit rock bottom" is a dangerous myth. Learn how just an extra 6-minutes on scene could save lives, why patients on buprenorphine need MORE pain medication during trauma, and how breaking the stigma starts with you.   Ready to make a real difference? Discover how EMS providers are uniquely positioned to interrupt the deadly cycle of opioid use disorder.   Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at [email protected] or through our contact page at emspodcast.com or via DM on IG @emsloudandclear    Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Guest/Cast/Crew information- Guest- Jason Hoppe, D.O.   Hosts - Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  18. 104

    When to Act: Mastering Vasopressors in 2025

    What do you do when the blood pressure monitor shows a number you don’t like? Most providers hit the button again—but what if it’s real? In this episode, we’re joined by critical care transport specialist James Boomhower from Boston MedFlight, recorded live at the FASTCAN conference in Calgary, to break down modern vasopressor management.   We explore how norepinephrine replaced dopamine as the first-line vasopressor, the evidence behind those changes, and what to do when your patient is on three drips and the pressure still won’t budge. James shares practical, real-world insights from the space between the ED and ICU, where seconds matter and protocols are stress-tested in real time.   Key takeaways include: when to trust your BP reading and act, how to choose and sequence pressors based on evidence and logistics, why norepinephrine reduces arrhythmias and improves outcomes, and when to add adjuncts like steroids, sodium bicarb, or methylene blue. We also explore hidden factors like ventilator settings and underlying causes that can sabotage even the best pharmacology.   Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at [email protected] or through our contact page at emspodcast.com or via DM on IG @emsloudandclear    Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our bi-weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae     Guest/Cast/Crew information- Guest- James Boomhower, LMHC-A, FP-C https://www.stayfit4duty.org/    Host- Ross Orpet   Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  19. 103

    The 5 Levels of EMS Mental Breakdown & How to Escape Them

    Why do some paramedics stay unshakable under pressure while others crumble on the exact same call? The answer isn't about years of experience—it's about understanding the neuroscience of stress and having the right mental tools.   Cody Winterford delivers an incredible breakdown of the five psychological "circles of hell" that providers face in high-stress situations. Starting with the amygdala hijack that triggers your fight-or-flight response, through the crisis of confidence that makes you question everything you've trained for, to analysis paralysis where you're drowning in information but can't make a decision—each level has specific warning signs and proven techniques to overcome it.   We explore why mental simulation is so effective and why elite athletes and the blue angels rely on it to perform at their peak. We discuss tactical breathing techniques, the power of self-talk and focus phrases (even inappropriate ones!), and how to recognize when life distractions are creating "brain fog" that prevents you from accessing your clinical knowledge.   This isn't theory—it's practical, field-tested mental performance strategies adapted from military and elite athletic training, specifically applied to EMS providers. If you've ever felt overwhelmed on scene, doubted your abilities during a critical call, or watched a partner struggle mentally, this episode provides the framework to understand and overcome those challenges.   Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at [email protected] or through our contact page at emspodcast.com or via DM on IG @emsloudandclear    Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae     Episode Blog Post- The 5 Levels of EMS Mental Breakdown and How to Escape Them   Guest/Cast/Crew information- Guest- Cody Winniford, EMT-P, CCP-P, FP-C @ordinary_ops_medic @alertmedic1   Host- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  20. 102

    Following Evidence or Following the Crowd? The Truth About Evidence-Based Medicine with Dr. Eddy Lang

    What if the evidence hierarchy you learned in school is incomplete? Dr. Eddie Lang, who helped develop the GRADE system now used by WHO and major resuscitation councils, explains why clinical practice guidelines—not RCTs or meta-analyses—should guide your practice decisions.   Join us at FASTCAN 25 as Dr. Lang, who's helped shap guidelines for the World Health Oganization (WHO) and the International Liaison Committee on Resuscitation (ILCOR), dismantles common misconceptions about evidence-based medicine and explains how it has evolved over the years. It's no longer "whatever the study says"—it's now carefully evaluating research limitations, considering patient values, and assessing feasibility, acceptability, and equity. Clinical practice guidelines sometimes get a bad rap but Dr. Lang explains why they ultimately should sit atop the evidence hierarchy.   We also discuss game-changing AI applications in EMS: consolidated electronic health records enabling precision prehospital care, automated documentation, predictive analytics for patient destination, and an AI tool providing evidence synthesis with references in seconds.    Whether you're a paramedic, nurse, or physician, this episode has the power to change how you evaluate and apply clinical evidence.   Subscribe for more evidence-based EMS content that cuts through the noise so that you never lose sight of the forest through the trees. Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Guest/Cast/Crew information- Guest- Eddy Lang, MD Hosts- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  21. 101

    Toxidromes Demystified

    Understanding the toxidromes provides you with vital diagnostic tools in high-stakes environments. In this episode, we break down the clinical patterns that define. Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae toxidromes- the clusters of signs and symptoms that point to poisoning or overdose. We explore the hallmark features of the most common toxidromes, highlight common pitfalls in recognition, and explain how early pattern recognition changes patient outcomes. But not all symptoms are what they seem. In this episode, we peel back the layers of toxidromes to show how overlapping signs can mislead even experienced providers. From pinpoint pupils to altered mental status, we examine which clues you can trust and which demand a deeper look. Packed with real-world relevance, this discussion will sharpen your clinical instincts and prepare you for the next toxicological mystery.     Guest/Cast/Crew information- Hosts- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  22. 100

    Rescue Breaths: Demystifying the Physiology of Safe and Effective BVM Ventilation

    Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques. This episode highlights common mistakes like insufficient exhalation time, discusses driving pressure, and explains the importance of proper technique to avoid lung injury. We also explore the nuances of endotracheal tube size, laminar flow, and the transition from BVM to mechanical ventilation. From FASTCAN in Calgary this episode will enhance your understanding and skills in respiratory care. Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Resources Episode supplemental blog post and show notes Melody’s Free Book on mechanical ventilation  Guest/Cast/Crew information- Guest- Melody Bishop, RRT, CCAA Host- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  23. 99

    Prehospital Blood, Trauma Arrest, Hypertension in Pregnancy, and Diltiazem in Afib with RVR

    Dr. Jeff Jarvis, EMS medical director and host of the EMS Lighthouse Project, delves into the latest emerging EMS literature and guidelines from the National Association of EMS Physicians. We explore best practices for blood use in trauma, up-to-date trauma arrest recommendations, postpartum hemorrhage, and severe hypertension in pregnancy. Additionally, we discuss recent studies on field intubation times, pre-hospital treatment of AFib with RVR, and pre-treating with calcium before diltiazem for patients in AFib. This episode is packed with crucial, evidence-based information for best practices in the prehospital setting. Don't miss out! Website show notes link Episode on YouTube   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Resources EMS Light House episode on pretreatment with calcium before diltiazem in Afib The Resus Tailor  Guest/Cast/Crew information- Guest- Dr. Jeff Jarvis Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2

  24. 98

    Unlocking the Hidden Keys to Calm Under Chaos: How Simple Tools Like A Checklist Can Elevate Your Care

    What's the real difference between paramedics who stay calm under pressure and those who panic when everything goes wrong? It's the ability to already know what comes next. In this episode we explore the power of consistency and how one simple tool, often dismissed, can improve patient care and outcomes. Geoff Murphy, founder of Master Medics, sat down with us onsite at FAST25 to discuss how checklists can not only save lives but allow you to remain confident in knowing what is next on scene. Not to mention they're a great training tool as well. Resources Episode supplemental blog post- https://emspodcast.com/the-power-of-a-simple-tool-in-high-stakes-environments/  The Resus Tailor - https://www.theresustailor.com/ Podcast announcements: Our Paramedic Confidence Builder Program is officially underway. Stay tuned for updates on how everything is going. If you want to join a waitlist to be able join in the next cohort email us at [email protected] Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Geoff Murphy Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com   Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  25. 97

    EXCITING NEWS! FIND OUT WHAT WE'VE BEEN WORKING ON.

    Were have we been? Well, the truth is, we've been incredibly busy working on some really exciting projects. If you're interested in joining the founding members cohort of  the Paramedic Confidence Builder Course reach out to me at [email protected] before August 15th. Project #1: Understanding New Paramedic Challenges We launched a research project diving deep into understanding exactly what newer paramedics struggle with as they make that transition from school into the real world of EMS. We all remember that feeling - you graduate paramedic school, you pass your registry, you get your first job, and then... reality hits. The textbook scenarios suddenly become real patients with real families, real emergencies, and real consequences and it turns out none of those patients read the textbook. There's this gap between what you learned in class and what you need to know to be truly confident and effective on the streets. We've been talking to new paramedics, experienced providers, educators, and EMS leaders to really understand where those gaps are. What are the specific challenges? What makes the difference between a new paramedic who struggles and one who thrives? This research has been fascinating, and it's going to inform not just the educational episodes we create going forward, but it's also led us to our next project. Project #2: The Paramedic Confidence Builder Course This is what we're most excited about - we've developed what we're calling right now the Paramedic Confidence Builder Course. This isn't just another continuing education program. This isn’t just a set of pre-recorded lectures. This is about taking everything we've learned from our research and creating a comprehensive program to help bridge that gap between school and street confidence. I'm talking about mentorship, coaching, practical scenarios, decision-making frameworks, and most importantly - building the kind of unshakeable confidence that lets you walk into any call knowing you've got the tools and mindset to handle whatever comes your way. We've got a fantastic group of paramedics signed up for our founding members cohort, and we're about to launch in one week. If this sounds like something that might be a good fit for you, we do have a very short window left and only a few spots remaining in this founding cohort, but f you're interested, send me an email before August 15th at [email protected] and we can chat about whether the course might be right for you. Project #3: Continuing Education Credits The third project we've been working on is the ability to get continuing education credits for listening to our episodes. We're currently beta testing this system, and I'm optimistic that we'll have it ready to launch by the end of the year.  Looking Ahead So that's what we've been up to.  The good news is we're back on track. We hope to have our next regular episode released next week, so tune in for some more of that high-level continuing education you've come to expect from us here at Loud and Clear. Thank you again for being such an incredible community. Your support, your feedback, your engagement - it all matters. It's what drives us to keep pushing forward and finding new ways to serve you better. Until next time, stay safe out there, keep learning, and remember - every call, no matter how big or small, is an opportunity to make a difference. Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  26. 96

    Engineering Simplicity in Crisis: Mastering Airway Management Through Systematic Approaches With Dr. Rich Levitan

    Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance. Resources YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw The Resus Tailor - https://www.theresustailor.com/ Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae Guest/Cast/Crew information- Guest- Dr. Rich Levitan Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

  27. 95

    The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use

    We dive into the latest emergency medicine research evaluating the complications following pre-hospital tourniquet use. Dr. Ben Li, an expert in emergency medicine literature reviews a 2023 study titled 'The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use,' exploring its implications for EMS providers. From infection to compartment syndrome, we discuss the potential downstream complications and we do so reviewing step by step guide on how to critically appraise current literature. Tune in to ensure your evidence-based care starts in the streets.   01:10 Introducing the Study 03:48 Understanding Study Design and Quality 06:19 Diving into the Study's Context and Background 09:04 Using Appraisal Checklists to Evaluate the Study 10:31 Cohort Study Design and Its Implications 15:31 Selection Bias and Generalizability 22:36 Measurement and Classification Bias 24:45 Understanding Confounding Variables 25:51 Evaluating Study Methods and Follow-Up 27:43 Analyzing Study Results 31:21 Complications and Their Implications 34:33 Multivariable Analysis Insights 36:49 Practical Applications and Future Research 46:24 Final Thoughts   Resources The Resus Tailor - https://www.theresustailor.com/  Critical Appraisal Checklists- https://casp-uk.net/casp-tools-checklists/    Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Books We Recommend The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Dr. Ben Li Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.co Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  28. 94

    Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It

    A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar? In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift. Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence. Key Concepts Covered: Crew Resource Management (CRM) Just Culture principles Aviation Safety Action Program (ASAP) Power distance in medical teams Human factors in emergency medicine Error prevention strategies Books Mentioned by Glen: Just Culture by Sidney Dekker - https://amzn.to/3Su0A9Y The Myth of Multitasking: How "doing it all" gets nothing done - https://amzn.to/4dAFa4E  Crew Resource Management Practice and Principles- https://amzn.to/3ZIjXzZ Threat & Error Management resources - https://skybrary.aero/articles/threat-and-error-management-tem Other Resources: The Resus Tailor - https://www.theresustailor.com/  This Episodes Blog Post- https://emspodcast.com/what-airplane-crashes-teach-us-about-saving-lives-in-ems-lessons-in-crew-resource-management-and-just-culture-from-the-aviation-industry/  Gear We Like: Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Other books we recommend: The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Glen Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  29. 93

    The Art of Managing Agitated Patients

    Effective agitated patient management requires a fundamental shift from viewing these encounters as behavioral problems to recognizing them as medical emergencies with underlying pathophysiological processes. By systematically addressing safety, identifying root causes, selecting appropriate pharmacological interventions, and maintaining rigorous post-sedation monitoring, EMS providers can dramatically improve outcomes for these challenging patients. Remember: you cannot talk someone out of a hypoglycemic crisis, hypoxic emergency, or sympathomimetic overdose. When verbal de-escalation fails, it's not your failure as a provider—it's an indication that medical intervention is required to address the underlying pathophysiology driving the patient's agitation. The goal isn't just to control behavior—it's to provide definitive medical care that addresses the root cause of the patient's distress while maintaining safety for everyone involved.   Our guest is Patrick Hendley, a practicing paramedic and an expert in agitated patient management. We'll explore the pathophysiology behind agitation and essential strategies for EMS providers faced with these calls. We'll also examine sedation choices, restraint use, and post-sedation care through a lens of real-world EMS principles. Join us as we look at more than just de-escalation, but understanding and acting effectively and ethically to safeguard everyone involved.   Don't forget to check out our sponsor, The Resus Tailor, for custom bag designs tailored to your EMS needs. Reach out to them at theresustailor.com.    00:00 Introduction to Loud and Clear EMS 00:27 Today's Topic: Managing the Agitated Patient 01:00 Guest Introduction: Patrick Henley 02:17 Sponsor Message: The Recess Tailor 03:01 Case Study: Agitated Patient Scenario 06:04 Understanding Agitation and Safety Principles 08:12 Sympathetic Nervous System and Agitation 10:00 Factors Contributing to Agitation 13:02 Drug Influence on Agitation 19:05 Safety Hierarchy in EMS 30:34 Transport Safety and Patient Management 33:07 Treating Underlying Causes of Agitation 39:08 Managing Patient Anxiety with Fentanyl and Oxygen 39:45 Using Ketamine for Pain Control and Sedation 40:25 Addressing Mixed Presentations: Schizophrenia and Substance Use 41:38 Treating Sympathomimetic Overdose and Psychosis 42:56 The Importance of Post-Sedation Monitoring 43:51 Verbal De-escalation and Benzodiazepines 45:00 Using Time as a Tool for Postictal Patients 46:11 Understanding Benzodiazepines and GABA Receptors 47:59 Antipsychotics and Ketamine: When Benzos Aren't Enough 59:17 The Role of Physical Restraints in Patient Management 01:08:43 Effective Handoff and Continuity of Care 01:18:11 Final Thoughts and Core Principles   Resources The Resus Tailor - https://www.theresustailor.com/ The Art of Managing Agitated Patients Supplemental Blog Post - https://emspodcast.com/the-art-of-managing-agitated-patients/ Gear We Like Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Guest/Cast/Crew information- Guest- Patrick Hendley Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  30. 92

    Upper GI Bleed: Rescue Strategies From Recognition to Stabilization

    Let's delve into the critical steps required to manage an upper GI bleed in the field. This episode breaks down the recognition of risk factors, vital airway and circulation interventions, and best practices for transporting and notifying the hospital. We discuss important historical clues and provide insights on airway handling and circulatory support. Learn how to navigate these time-sensitive emergencies with speed and thoroughness to improve patient outcomes.  00:30 Host Introduction and Episode Overview 01:22 Recognizing Upper GI Bleeds 01:45 Sponsor Message: The Resus Tailor 02:38 Four Clues to Identify GI Bleeds 06:17 Critical Questions for GI Bleed Patients 09:47 Airway Management Strategies 15:21 Circulatory Support and IV Access 19:26 Medication Considerations 22:28 Transport and Hospital Notification 23:41 Conclusion and Viewer Engagement   Resources Get 10% off FAST25 with promo code- loud&clear The Resus Tailor - https://www.theresustailor.com/ Website show notes link Other episodes you might like: Podcast announcements Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest-  Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  31. 91

    These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS

    These challenging scenarios represent opportunities to provide truly patient-centered care at life's most vulnerable moments. By combining your medical expertise with thoughtful communication, you can help ensure patients' wishes are honored while supporting families through difficult transitions. In this episode we dive into the complex ethical and legal dilemmas faced by EMS providers when arriving on scenes involving Do Not Resuscitate (DNR) and goals of care forms. With special guest Dr. Daniel Markwalter, an emergency physician and hospice/palliative care expert, the discussion touches on understanding the importance of these forms, the challenges of making decisions without clear directives, and strategies for effective communication with family members when they suddenly disagree with the form. This episode provides valuable insights and practical advice for EMS professionals who can be faced with these sometimes challenging scenarios.   00:00 Introduction: The Ethical Dilemma in EMS 00:49 Sponsor Message: The Recess Tailor 01:53 Case Study: Evening Shift Dilemma 03:33 Expert Insights: Dr. Daniel Mark Walter 04:40 Understanding Hospice and DNR 09:48 Advanced Directives and Code Status 19:20 Challenges with Comfort Care and Advanced Directives 26:19 Aligning Medical Knowledge with Patient Goals 28:34 Understanding Goals of Care 29:03 Respecting Autonomy in Medical Decisions 30:02 Effective Communication with Families 31:45 Navigating Family Overrides in Critical Moments 32:36 Legal Aspects of Surrogate Decision Making 36:00 Exploring Illness Understanding and Prognosis 45:46 Symptom Management in Palliative Care 49:43 Final Thoughts and Summary   Resources Get 10% off FAST25 with promo code- loud&clear The Resus Tailor Todays Episode Show Notes Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Daniel Markwalter, MD Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  32. 90

    BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There.

    Get 10% off FAST25 with promo code- loud&clear. In this special episode of Loud & Clear: EMS Guiding Principles, we learn from the wisdom of 2 industry leaders with nearly 70 years worth of combined experience, Allen Wolfe and Michael Frakes. This episode explores the evolution of EMS education, effective training strategies, and the importance of lifelong learning. Whether you're an educator, a learner, or just passionate about EMS, you'll find valuable insights on how to improve your skills and knowledge. Enjoy this bonus episode filled with expert advice, engaging discussions, and practical tips to level up your EMS game!    00:00 Episode Quotes 00:38 Welcome to Loud and Clear EMS 01:19 Upcoming Fast 25 Conference 02:10 Meet the Guests: Allen Wolfe and Michael Frakes 04:20 Allen's Background and Experience 05:41 Changes in Clinical Education 07:51 Future of Education: VR and Edutainment 09:09 Advice for Education Directors 11:34 Field Training Officer Tips 15:08 Choosing the Right Workplace for Critical Care Experience 16:31 Real-Life Trauma Cases and Lessons Learned 19:36 The Importance of Self-Education and Lifelong Learning 21:48 Michael Frakes Introduction- Insights from a Career in Critical Care Transport 22:44 Advancements and Challenges in Medical Education 27:59 Final Thoughts and Key Takeaways Resources The Resus Tailor - https://www.theresustailor.com/ Get 10% off FAST25 with promo code- loud&clear Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Allen Wolfe, Michael Frakes Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  33. 89

    Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature

    Let's discuss the intricacies of evidence-based medicine (EBM) with Dr. Ben Li. The conversation dives deep into understanding different types of medical studies, their hierarchies, and how EMS providers can apply them to their practice. The episode covers evaluating research, the importance of study design, confounders, sample size, and how to discern the relevance and applicability of research findings. Dr. Li provides practical advice for critically appraising literature and emphasizes doing so in a way that is personally relevant to the listener's practice. This episode is essential for anyone in EMS or emergency medicine looking to deepen their understanding of medical research and how it impacts patient care. Enter to win Airpods, Cric-a-lot, and a belt buckle! Resources that can help Critical appraisal guides: https://casp-uk.net/casp-tools-checklists/ (my personal favorite) https://jbi.global/critical-appraisal-tools Reporting guidelines (similar to appraisal guides, but more are standards for the investigators to use and follow): https://www.equator-network.org/reporting-guidelines   00:00 Introduction and Priorities 00:34 Show Restructure Announcement 01:42 The Evolution of EMS Practices 03:57 Understanding Evidence-Based Medicine 05:23 Interview with Dr. Ben Lee 07:20 Approaching and Appraising Medical Studies 08:14 Challenges in EMS Research 13:47 Study Design and Hierarchy 31:33 Applying Research to Practice 39:26 Final Thoughts and Takeaways   Resources The Resus Tailor Enter to win Airpods, Cric-a-lot, and a belt buckle! Website show notes link Other episodes you might like: Podcast announcements Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest-  Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  34. 88

    How Equipment Design Can Save Lives: Why Your Bag Organization Matters More Than You Think

    We discuss the importance of equipment design in EMS with Adam LaChapelle, founder of The Resus Tailor. Together we delve into the impact that effective design has on performance and patient outcomes, exploring principles such as reducing friction and visual checklists. Adam shares compelling stories and practical tips on organizing your equipment to enhance efficiency and care. The episode also includes a special giveaway announcement for listeners. SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle   00:00 Introduction to Bag Design Challenges 00:44 Real-Life Emergency Scenario 02:33 The Importance of Equipment Layout 03:15 Exciting Announcements and Rebranding 04:00 Meet the Hosts and Today's Guest 05:27 Adam LaChapelle's Journey and Passion 11:32 The SCRAM Bag and Its Impact 16:20 Principles of Effective Design 21:42 Innovative Bag Design for Quality Care 22:19 The Importance of Iteration in EMS Gear 23:49 Key Considerations for Bag Design 28:05 Reducing Friction in Emergency Response 30:46 Challenges and Solutions in EMS Bag Design 35:33 Customizing Bags for Specific Needs 36:54 Practical Tips for EMS Providers 39:40 Partnering with Recess Tailor for Custom Solutions 42:45 Exciting Giveaway Announcement 44:03 Summary and Key Takeaways   Resources SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle The Resus Tailor Website show notes link Podcast announcements- NEW NAME, Loud & Clear: EMS Guiding Principles Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Adam LaChapelle, Founder and CEO of The Resus Tailor Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- @emsloudandclear Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Creative Commons - Attribution 3.0 Unported - CC BY 3.0 Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic

  35. 87

    NEW NAME! The podcast gets a new name, find out what and why...

    Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey. Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our podcast, originally named EMS Cast. Each year we have become more and more dedicated to our mission. However, as time passed, it became clear that our name didn't quite capture the essence of what we stand for—our mission or our identity as educators in the EMS field. Will and I devoted significant effort into clarifying our mission this last year. Determining how we could create a framework to help you navigate the inevitable uncertainties in EMS, to put an emphasis on what truly and what principles will guide you through the uncertainty. This framework is going to allow us  to bring you even better content with clearer messaging. We wanted a name that resonates with our commitment to provide in-depth discussions that extend beyond paramedic school learning but yet never loses sight of the fundamentals and guiding principles that actually matter. After months of brainstorming and reflection, Loud & Clear: EMS Guiding Principles felt like the perfect match—an embodiment of our dedication to make every lesson resonate strongly and clearly with you, the listener. In the world of EMS, ‘loud and clear’ is a phrase many of us know very well, whether you’re checking in with dispatch over the radio at the start of your shift or confirming the receiving hospital can clearly understand you. It signifies that there is clarity and understanding in the message that is received. We aim to bring this clarity  to every topic we discuss. Reinforcing our commitment to delivering information that is easy to comprehend and apply in real-life EMS situations, even when uncertainty abounds. While our name may have changed and our episode framework has evolved, our mission has not. We will continue to provide high level education, seeking to teach you principles that enrich your knowledge beyond the textbooks you read in paramedic school, preparing you for the unexpected scenarios you’ll face in the field. You won’t find cookie-cutter approaches here—we’re dedicated to helping you understand and fall back on an understanding of fundamental principles that allow you to navigate the uncertainty and chaos with confidence. Each episode of Loud & Clear will present high-level discussions about pathophysiology and treatment options. But more than that, every episode will guide you back to those time-tested EMS principles crucial for effective decision-making. This year promises ever more engaging content rich episodes, with an updated name, cover art, social media presence, and more as we embrace this exciting transition. We can't wait to embark on this new journey with you, our dedicated listeners. Thank you for your support and enthusiasm. Remember—we’re here to ensure your learning experience is loud and clear.   Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  36. 86

    Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes

    Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers the guiding principles syncope- a good history, physical exam findings, and the ECG. It also delves into common presentations, risk stratifying strategies, and real-world cases to equip EMS providers with the knowledge needed to manage syncope calls effectively.    00:00 Intro 01:07 Welcome to EMS Cast, host and guest introductions 04:51 Guiding Principles for Syncope Assessment 07:22 High-Risk Syncope Patients 09:14 Initial Approach to Syncope Patients 15:15 Syncope vs. Seizure 20:08 Physical Exam and EKG Importance 25:14 Identifying Arrhythmias in Syncope Patients 26:37 Understanding Wolf Parkinson White Disease 27:46 QT Prolongation and Its Implications 29:49 Left Ventricular Hypertrophy and Its Risks 31:28 Recognizing Brugada Pattern 32:02 Arrhythmogenic Right Ventricular Dysplasia 33:04 Bifascicular Block and Its Dangers 35:00 EKG Interpretation and Syncope Risk Stratification 39:53 Emergency Department Workups for Syncope 55:49 Case Studies and Memorable Syncope Calls   Resources The Resus Tailor EMS Cast Syncope Blog Post Other episodes you might like: Wide Complex Tachycardia Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-Host Hosts- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae   Creative Commons - Attribution 3.0 Unported - CC BY 3.0 Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic

  37. 85

    Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS

    Let's discuss the pressing issue of mental health among first responders, particularly within the EMS community. Will gets vulnerable and shares a personal story of trauma on the job to highlight the urgent need for mental health resources and support. Unfortunately, his story is not unique, we will all experience some level of emotional trauma while on the job. This episode features Jessica Nelson, the coordinator of the groundbreaking program and first of its kind state legislation, PATH4EMS. PATH4EMS provides free and confidential mental health care for EMS professionals. We delve into strategies for normalizing mental health conversations, the importance of trauma-informed care, and the benefits of proactive mental health practices. The discussion also covers the need for tailored, evidence-based resources and the unique challenges faced by rural first responders. Tune in to learn about the vital steps being taken to ensure the well-being of those who brave the front lines.   00:00 The Struggles of First Responders 00:53 A Personal Story of Trauma 04:57 The Turning Point: Seeking Therapy 05:42 Introduction to EMScast 06:34 Meet Jessica Nelson: A Pioneer in EMS Mental Health 09:54 The Importance of Confidentiality and Specialized Care 12:17 Effective Mental Health Practices for EMS Providers 19:54 Path for EMS: A Groundbreaking Initiative 30:37 Future Directions and Final Thoughts   Resources PATH4EMS website Today's Sponsor- The Resus Tailor Today's episode blog post Podcast announcements- We're rebranding! New name will be- Loud & Clear: EMS Guideline Principles. Look out for the changes coming soon. Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Jessica Nelson, PATH4EMS coordinator Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  38. 84

    Wide Complex Tachycardia: Get Comfortable With Uncertainty

    Learn a systematic approach to management of wide complex tachycardia that doesn't rely on exact rhythm identification or scoring systems with guest Dr. Kevin Butler. By understanding the physiology rather than memorizing a score or algorithm you can use Kevin's approach and ABCD mnemonic to help differentiate between ventricular tachycardia, SVT with aberrancy, and other arrhythmias. Learn how not to miss the vital mimics with his SPAM filter. And finally by understanding which treatments are safe and which treatments potentially dangerous you can understand how to move forward even when you're not exactly sure what the arrhythmia is. Whether you're an EMT, paramedic, or emergency physician, this episode provides the essential principles and stepwise strategies to ensure effective and safe patient management. 00:00 Introduction to Arrhythmia Management 00:29 Personal Anecdote: Lessons from Paramedic School 02:04 Introducing Dr. Kevin Butler 02:16 Sponsor Message: The Recess Tailor 03:35 Welcome to EMS Cast 04:04 Understanding Wide Complex Tachycardia 05:37 Approach to Arrhythmia Management 07:02 Principles of Managing Wide Complex Tachycardia 08:39 Pathophysiology of Wide Complex Tachycardia 18:30 Identifying and Treating Mimics 26:55 Regular vs. Irregular Wide Complex Tachycardia 29:59 Understanding Torsades and Its Management 30:25 Identifying Atrial Fibrillation with Pre-Excitation 32:14 Treatment Considerations for AFib with WPW 35:02 Distinguishing Between VT and SVT with Aberrancy 37:09 Physiological Approach to ECG Interpretation 40:24 ABCD Mnemonic for VT Diagnosis 47:49 EMS Treatment Protocols for Wide Complex Tachycardia 51:54 Pre-Hospital Cardioversion Tips 55:22 Emergency Department Approach to Wide Complex Tachycardia 58:00 Final Thoughts and Key Takeaways Resources The Resus Tailor Episode Blog Post with EKG examples Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculum Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae    

  39. 83

    Trailer - Loud & Clear: EMS Guiding Principles

    You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there for someone on the worst day of their life. To change an outcome that would have otherwise been catastrophic if you weren’t there. There’s no resource for the practicing paramedic to plug the holes that were left behind by paramedic school. Everything seems stuck in basic algorithms of “A” then “do B” but what do you do when "A” wasn’t in the book. We need to get away from the algorithmic thinking and instead shift to understanding the principles behind WHY if A then B. The truth is, you can’t learn it all. Emergency Medicine includes too many pathologies and 911 calls are too unique and chaotic to know the answer to every situation. Instead of trying to learn every answer to every call, you need guiding principles for your knowledge to stand on. If you build these principles they become the foundation for every call no matter the complaint, for every situation, no matter the chaos surrounding you. If you have the foundation you can be stable when the storm comes. You can know when to push forward or when to change course. And then each additional piece of advanced content that you learn can be added to that foundation to build on, because mastery is not a destination, it’s a journey and the journey never ends. We are your hosts, Ross Orpet & Will Berry and this is EMS Cast. Come on this journey with us to mastering emergency medicine. We will cover topics in more depth than you learned in paramedic school, we will teach one step further and talk about what will happen to that patient in the Emergency Department after you drop them off. And we will connect all of this back to the principles that will guide you not just on this call but on all the calls. These principles will allow you to answer the question, at the end of the day, what’s really important to me, the paramedic, in the field, in that moment. You may not feel ready, you may not feel like you know enough, but you can understand the principles and that will make all the difference. Because what you do matters.   Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  40. 82

    From Novice to Navigator: Mastering the Art of EMS Field Training

    Joined by Josh, Cody, and Moose from the AlertMedicOne podcast, we explore key principles of good training, leadership, and the importance of making mistakes in a safe learning environment. We discuss strategies to foster critical thinking, introspection, and continuous improvement among trainees in the EMS field. A big part of EMS is learning to be a leader and a teacher no matter what level you are at so whether you are a trainee, a field trainer, teach students during their rides, or merely work with a partner there's something for everyone to learn in this one. Tune in for an insightful discussion on how to develop and become excellent EMS professionals through solid training and leadership.   00:00 Whitewater Rafting Adventure 00:25 The Importance of Training 01:02 Creating a Safe Learning Environment 01:43 Introducing the AlertMedicOne Podcast 02:06 Meet the Hosts 04:37 Whitewater Rafting Lessons for EMS 05:48 Encouraging Autonomy in Training 08:01 Balancing Guidance and Independence 10:25 The Role of Field Training Officers 15:03 Ownership and Leadership in EMS Training 24:50 Handling Mistakes and Failures 31:33 Striving for Continuous Improvement 34:11 Embracing Continuous Improvement 34:34 Learning from Experienced Paramedics 35:35 The Importance of Preparation 36:47 Humility and Self-Awareness 38:23 Handling Mistakes and Growth 40:12 Training and Mental Health 41:54 Effective Preceptorship 43:13 Teaching Techniques in Action 45:12 Building Confidence in Trainees 47:21 The Role of a Trainer 01:03:06 Final Thoughts and Reflections   Resources Contact The Resus Tailor Watch this episode on YouTube Read the blog post for this episode Other episodes you might like: Values Driven Leadership with Chris Pfingsten from EMS 20/20 podcast 10 lessons from a real austere rescue How to Master the Resuscitation - EMCRITs Scott Weingart Podcast announcements- Big news coming in 2025! Stay Tuned! Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Josh, Cody, Moose Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae    

  41. 81

    The Difference Between Equal and Equitable Care

    Explore the crucial distinction between providing equal care versus equitable care within emergency medical services (EMS). We give you an in-depth discussion with Ritu Sani from The EMS Show podcast, highlighting the importance of focusing on outcome-driven quality improvement projects and addressing disparities in care. Learn how different demographics face unique barriers to healthcare, and why recognizing these differences is essential to improving outcomes across various communities. Watch as real-life examples illustrate the need for equitable interventions and the systemic factors that contribute to inequities in EMS.   00:00 Introduction: Equal vs. Equitable Care 00:23 Case Study: CPR Training Disparities 01:09 Understanding Barriers to Equitable Care 03:31 Guest Introduction: Ritu Sani from EMS Show Podcast 04:33 Interactive Exercise: Demonstrating Inequity 06:36 Quality Improvement: Focusing on Outcomes 08:09 Challenges in Achieving Equitable Care 09:25 Diversifying EMS Workforce 10:11 Systemic Factors and Data-Driven Solutions 11:03 Starting with Equitable Care 11:17 Key Areas to Focus On 11:26 Analyzing Data for Disparities 12:12 Addressing Provider Reactions 13:00 Implementing Quality Improvement 13:35 Implicit Bias and Introspection 14:17 Patient Outcome Driven Approach 14:33 Challenges and Structural Abnormalities 15:16 Conclusion and Final Thoughts   Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Ritu Sani, MD and Co-host of The EMS Show podcast Host- Ross Orpet, Chris Pfingsten from EMS 20/20 Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  42. 80

    Life Over Limb: Field Amputation, Preparing for the Unthinkable

    Dr. Avery McKenzie interviews Dr. Eric Adler, regional medical director for Flight for Life, about the challenging and rare procedure of field amputations. They discuss the importance of being prepared for the unexpected, the steps involved in developing a protocol for such emergencies, and the logistical challenges faced during the process. Dr. Adler shares insights from real-life cases and emphasizes the critical need for planning and knowing the resources available in urgent scenarios.   00:00 Emergency Field Amputation: A Real-Life Scenario 00:25 The Reality of Unlikely Medical Emergencies 02:04 Introducing Today's Episode and Guest 04:26 Dr. Eric Adler's Experience and Protocol Development 05:46 Indications and Procedures for Field Amputation 10:50 Challenges in Creating a Field Amputation Protocol 14:23 Final Thoughts and Preparedness   Resources Website show notes link (picture of the kit and copy of the protocol): https://emspodcast.com/life-over-limb-field-amputation-preparing-for-the-unthinkable/ Other episodes you might like: Episode 31- You Were Taught Wrong, Traumas Not Algorithmic Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Erik Adler Host- Ross Orpet, Avery Mackenzie Catch up with us after the show Instagram- @emscast Website- www.emspodcast.com  

  43. 79

    The Untold Impact of EMS on Organ Donation: Transforming Tragedy into Hope

    In this episode, we discuss the profound impact that one patient's organ donation can have on society. Even when not every patient gets to go home, the ability to donate organs can positively affect up to 80 people, multiplying our impact and service to the community. Guest Chris Meeks, a critical care flight paramedic and organ recovery coordinator discusses the ethical considerations and the surprising impact EMS has on the potential for organ donation, even in cases that appear to be 'lost causes'. Tune in to understand how your work in EMS may have more far-reaching positive effects than you realize.   00:00 Introduction: The Impact of EMS on Organ Donation 00:43 Ethical Considerations in Organ Donation 01:10 Current Research and EMS's Role 02:04 Guest Introduction: Chris Meeks 05:04 Ethical Dilemmas and Future Directions 08:25 Organ Donation Criteria and Processes 13:28 Conclusion: The Importance of EMS in Organ Donation   Guest/Cast/Crew information- Guest- Chris Meeks, Critical Care Flight Paramedic, Organ Recovery Coordinator Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  44. 78

    Values-Driven Leadership Within A Just Culture- Chris Pfingsten from EMS 20/20

    Creating lasting behavioral changes in the workplace by moving beyond consequence-based policies. Chris discusses the importance of aligning personal and company values, highlighting 'just culture' in EMS and its role in understanding motivations and systemic issues. The conversation covers leadership in EMS, focusing on the significance of fostering supportive relationships with staff and avoiding fear-based management. Additionally, Chris shares his journey from paramedic to Field Training Officer, offering advice on effective training and mutual support. This episode is packed with valuable insights for anyone in the EMS field aiming to enhance performance, commitment, and team dynamics. Don't forget to check below for further resources on just culture and motivational learning.   Guest/Cast/Crew information- Guest- Chris Pfingsten, Co-host of EMS 20/20 Host- Ross Orpet, Will Berry    Resources Other episodes you might like Ep. 72 From Errors to Excellence with Geoff Murphy, Master Your Medics Books Just Culture- https://amzn.to/4eOMN7w Crucial Conversations- https://amzn.to/3BRBnRI  YouTube Videos-  Why do Errors Happen? How can we prevent them? How can a system get organized for improvement?    Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae  

  45. 77

    Are They Choking? Esophageal Foreign Body

    We delve into the management of esophageal foreign body obstructions, a common yet often misunderstood medical emergency. We discuss the symptoms and causes of esophageal food impactions, sometimes referred to as 'Steakhouse Syndrome,' and differentiate it from tracheal obstructions. We explore the protocols, potential treatments, and if there's any rationale behind treatments such as glucagon administration. Join us as we also share real-life scenarios to better illustrate the challenges and solutions when dealing with such medical cases.   Resources and links This episode was inspired by an article on EMSAirway.com- Friday Night Lights- Shift 9 Steak Night  EMScast15 - code for 15% off an awesome pair of sunglasses  Help Us By Filling Out Our Audience Survey  Medic Box - awesome medical gear shipped directly to your door  Articles- American Society for Gastrointestinal Endoscopy- Guidelines for ingested foreign bodies   Glucagon for Relief of Acute Esophageal Foreign Bodies and Food Impactions: A Systematic Review and Meta-Analysis.   Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial   Conservative management of oesophageal soft food bolus impaction   Esophageal Food Impaction: A Retrospective Chart Review Food Bolus Impaction- Question and Answer Review     Guest/Cast/Crew information- Host- Ross Orpet, Will Berry    Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae       00:00 Introduction to Esophageal Foreign Bodies 00:43 Audience Survey and Sunglasses Giveaway 01:46 Interview with Contest Winner 06:11 A Choking Incident at Mile High Stadium 09:02 Discussion on Esophageal Obstructions 11:46 Life-Saving Story at Denver International Airport 13:28 A Life-Saving Outcome 14:11 The Choking Incident at the Tavern 14:57 Assessing the Patient's Condition 19:38 Understanding Esophageal Food Impaction 21:49 Treatment Options and Challenges 29:01 The Role of Endoscopy 37:45 Managing Esophageal Impactions in the Field 39:32 Final Thoughts

  46. 76

    10 Lessons From A Real Austere Rescue That Apply To You, No Matter Where You Work

    Delve into a real-life rescue mission conducted by the U.S. Air Force Pararescue Jumpers (PJs) in the North Atlantic Ocean and learn ten crucial lessons for enhancing EMS practice. Dr. Michael Lauria shares these ten critical lessons from this challenging scenario that are essential for medical professionals working in any prehospital environment. From the importance of preparation and the power of a small team, to the significance of continuous learning and the dynamic nature of safety, these insights are invaluable for enhancing clinical practice. Tune in to learn how these lessons can be applied to improve how you approach the job.  EMScast15 - code for 15% off an awesome pair of sunglasses  Tell us about you and how we can make this show better  Medic Box - awesome medical gear shipped directly to your door  Guest/Cast/Crew information- Guest- Dr. Mike Lauria Host- Ross Orpet, Will Berry  Resources Other episodes you might like Third-party websites where you can learn more Podcast announcements Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  47. 75

    Bonus: A Better BVM? How I Built This EMS Cast Style- A Crazy Story About an Emergency Nurses Invention and Battle to Save Lives and Prevent Harm.

    In this special bonus episode of EMS Cast, we delve into the story of Bobby Sue McCollum, an emergency nurse turned inventor. Learn about the critical issue of over ventilation in emergency medicine, the innovative VT Select device designed to address this problem, and the crazy inspiring journey of its creation. With discussions on the challenges of finding the optimal ventilation rates and volumes, the episode balances medical data and personal narrative. Bobby Sue shares the highs and lows of her entrepreneurial path, from initial prototype development to eventual licensing, offering valuable insights for aspiring inventors in the medical field.   Resources Mentioned in the Show- VT Select Bag Valve Mask A Review of Ventilation in OHCA Pediatric BVM Delivers More Ideal Volumes in Mannequins Small BVMs Lead to Decreased Survival in a Small Real World Study  00:00 The Problem with Overventilation 00:53 Introduction to the VT Select Device 02:01 Meet the Inventor: Bobby Sue McCollum 05:06 The Journey of Invention 12:10 How the VT Select Works 14:04 Challenges and Triumphs 27:37 Advice for Aspiring Inventors 31:15 Conclusion and Final Thoughts   Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  48. 74

    The Critical Four Minutes: AMAX4 framework for Anaphylaxis

    Explore anaphylaxis care from the basics to the critical approach to managing severe anaphylaxis with Bruce Hoffman, FlightBridge ED senior educator. Find out what it means to be aggressive with anaphylaxis care explained through the AMAX4 framework.  Learn how the framework can help reverse anaphylactic shock and prevent catastrophic outcomes. Hear the impactful story behind the framework and gain insight into the most effective practices for treating unresponsive anaphylactic and asthmatic patients. Special thanks to the McKenzie family for their mission-driven educational work.  Resource links Episode Blog Post / Show Notes  AMAX4 website Anaphylaxis deep dive Updated Anaphylaxis Definition  EMScast15 - code for 15% off an awesome pair of sunglasses  Help us learn how to make this show better for you  Medic Box - awesome medical gear shipped directly to your door  Guest/Cast/Crew information- Guest- Bruce Hoffman- Goodwin University Program Director and Assistant Professor, FlightBridgeED senior educator, Bay State Health Critical Care RN and Paramedic Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  49. 73

    From Errors to Excellence: Master Your Medics Geoff Murphy on the role of mistakes in EMS education

    The Power of Embracing Mistakes- Special guest Geoff Murphy, founder of Master Your Medics, shares how acknowledging and learning from mistakes can save lives in the field of prehospital medicine. Recorded at the Fast 24 conference, this episode emphasizes the importance of cultivating a culture of safety, vulnerability, and continuous learning within EMS teams. Discover actionable strategies to foster a psychologically safe environment where mistakes are openly discussed and used as invaluable learning tools to enhance professional development and patient care. This insightful discussion is a must-watch for anyone looking to elevate their skills and create a high-performing EMS team. EMScast15 - code for 15% off an awesome pair of sunglasses Enter to Win a FREE Pair of Frontline Optics Sunglasses Medic Box - awesome medical gear shipped directly to your door Guest/Cast/Crew information- Guest- Geoff Murphy, founder of Master Your Medics Host- Ross Orpet, Will Berry    Resources Ep. 31 You Were Taught Wrong, Traumas Not Algorithmic MasterYourMedics.com Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com 00:00 Introduction: The Power of Discussing Mistakes 00:38 Welcome to EMS Cast 00:52 Today's Topic: How Mistakes Can Save Lives 01:16 Embracing Failure: Insights from Jeff Murphy 01:37 Creating a Culture of Safety and Vulnerability 06:29 The Fearless Organization: High vs. Low Performing Teams 11:49 Personal Stories: Learning from Mistakes 19:15 Master Your Medics: The Journey and Vision 23:43 Conclusion: The Path to Mastery Resources: Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

  50. 72

    Poisons of the Sea: Not Just a Coastal Problem

    Think you only need to worry about toxicities that exist in the sea if you live by an ocean? Think again. No matter where you are fish may be on the menu, or there may be a zoo nearby, or a marine enthusiast with an elaborate home aquarium. These toxicities can be seen in Colorado. They can be in Australia or in the US. No matter where you are you have the potential to see one or many of these. From scombroid poisoning to puffer fish, irukandji syndrome, jellyfish, and sea snakes- tune in to this week's episode to learn all about the various poisons that come from the sea with toxicologist Nik Matsler. Website show notes link EMScast15 - code for 15% off an awesome pair of sunglasses Enter to Win a FREE Pair of Frontline Optics Sunglasses Medic Box - awesome medical gear shipped directly to your door Guest/Cast/Crew information- Guest- Dr. Nik Matsler Host- Dr. Ross Orpet and Critical Care Paramedic Will Berry  Resources Other episodes you might like Episode 26: Snake Bites Episode 25: Cocaine Overdose Third-party websites where you can learn more Marine Envenomations Journal Article 5 Step Approach to Marine Envenomations Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Want to stay ahead of the top 1% in EMS and build real confidence in the field? 👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: https://calendly.com/d/cq38-87r-fkk/paramedic-confidence-builder 📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

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ABOUT THIS SHOW

Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your

HOSTED BY

Ross Orpet, Paramedic turned EMS Physician

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