The best clinical discussions always stem from real-life cases.   MCHD paramedic Jarrett Kenning had a run of recent bradycardia patients and developed the idea for a bradycardia breakdown with the podcast crew.    Bradycardia treatment can vary wildly depending on the underlying cause(s).  Joint Jarrett and Dr. Patrick as they discuss several bradycardia cases and present a framework for creating your differential the next time you run on a patient with a pulse in the 30's.

REFERENCES

https://www.mchd-tx.org/media/podcasts/MCHDPP-109-Final-PDF.pdf

Episode 109 - Bradycardia Breakdown

Charting is one of the more neglected skills from an EMS educational emphasis standpoint.  As a result, what the medical director ends up reading during chart review is often wildly variable.  Join the MCHD Paramedic Podcast team as they discuss some charting pitfalls to avoid and some specific tips on improving your ePCR narratives.

Episode 110 - EMS Charting Pearls And Pitfalls

Join the podcast crew as they discuss a recent study investigating the risk of being awake while paralyzed when intubated in the emergency department setting.  This is definitely an under-discussed topic in the EMS world, especially considering the recent swing from succinylcholine to rocuronium for prehospital medication assisted intubation.  This conversation should make us all a bit nervous and better focused the next time we intubate.

REFERENCES
1.  https://www.annemergmed.com/article/S0196-0644(20)31314-7/fulltext

Episode 112 - Awake And Paralyzed...BEWARE

**NOTE - THIS EPISODE WAS RECORDED PRIOR TO THE DELTA SURGE**
The MCHD clinical crew (Pre-Delta, obviously)attended an actual in-person EMS meeting – EAGLES 2021.  One of the most interesting talks was by friend of the podcast/EMS research superstar, Dr. Remle Crowe.  Join Dr. Patrick and Dr. Crowe as they discuss the “AHORA” stroke tool and how it has the potential to positively impact prehospital stroke care.

REFERENCES
1.  Keenan KJ, Kircher C, McMullan JT. Prehospital Prediction of Large Vessel Occlusion in Suspected Stroke Patients. Curr Atheroscler Rep. 2018 May 21;20(7):34.

2.  https://www.ems1.com/stroke-care/articles/the-time-for-spanish-language-stroke-community-outreach-efforts-is-ahora-xxJdr9dKClRMXJn5/

3.  https://www.mchd-tx.org/blog-post/mchd-ems-joins-campaign-to-bring-stroke-education-to-the-spanish-speaking-community/

Episode 113 - The "AHORA" Stroke Scale With Dr. Remle Crowe

Everything occlusion MI isn't always STEMI.  After a recent discussion of "STEMI equivalents" during MCHD continuing education, Dr. Patrick cared for a textbook hyperacute T wave patient in his emergency department practice.  On this episode, we review some hyperacute T wave tips, in addition to addressing how to deal with resistant consultants.

REFERENCES:
1. https://tinyurl.com/3aser4j5

2. Tzimas, Georgios et al. “Atypical Electrocardiographic Presentations in Need of Primary Percutaneous Coronary Intervention.” The American journal of cardiology 124.8 (2019): 1305–1314

3. Aslanger EK, ET AL. DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction (DIFOCCULT Study). Int J Cardiol Heart Vasc. (2020) Jul 30;30:100603

4. Pendell Meyers H, ET AL. Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction. Int J Cardiol Heart Vasc. (2021) Apr 12;33:100767

Episode 116 - Hyperacute T Waves

In this episode, we’re lucky to have a special guest from Texas Children's Hospital, pediatric sedation and pain management expert, Dr. Corrie Chumpitazi.  Nitrous oxide has been in our protocols here at MCHD for some time, but probably doesn’t get the recognition and appreciation that it deserves.  We’ll discuss NO history, dosing, indications, contraindications, and side effects.   Listen to learn why we all should be incorporating more Nitrous Oxide into our daily EMS practice.

https://emscimprovement.center/education-and-resources/peak/peak-pediatric-pain/

https://www.acep.org/patient-care/map/map-nitrous-oxide-tool/

REFERENCES
1.	Ducassé JL et al (2013). Nitrous oxide for early analgesia in the emergency setting: a randomized, double-blind multicenter prehospital trial. Acad Emerg Med. 2013 Feb;20(2):178-84.
2.	Annequin D and Carbajal R, et al; Fixed 50% Nitrous Oxide Oxygen Mixture for Painful Procedures: A French Survey. Pediatrics. 2000; 105; e47.
3.	 Collado V, Emmanuel N, et al; Expert Opinion: a Review of the Safety of 50% Nitrous Oxide/Oxygen in Conscious Sedation. Drug Safety. 2007, 6(5): 559-571. 
4.	Sanders R, Weimann J, Maze M; Biologic Effects of Nitrous Oxide. Anesthesiology. 2008, 109: 707-722 
5.	Gall O, Annequin D, et al; Adverse Events of Premixed Nitrous Oxide and Oxygen for Procedural Sedation in Children. Lancet. 2001; 358: 1514-15. 
6.	Tobias, JD, Review Article: Applications of Nitrous Oxide for Procedural Sedation in the Pediatric Population. Pediatric Emergency Care. 2013; 29: 245-265. 
7.	Onody P, Gil P, Hennequin M. Safety of Inhalation of a 50% Nitrous Oxide/Oxygen Premix: A Prospective Study of 35,828 Administrations. Drug Safety. 2006; 29(7):633-640. 
8.	American Academy of Pediatric Dentistry. (2013). Guideline on use of nitrous oxide for pediatric dental patients. Retrieved September 3, 2013, from www.aapd.org: http://www.aapd.org/media/Policies_Guidelines/G_Nitrous.pdf 
9.	Heinrich M, Menzel C, Hoffmann F, et al. Self-administered procedural analgesia using nitrous oxide/oxygen (50:50) in the pediatric surgery emergency room: effectiveness and limitations. Eur J Pediatr Surg. 2015;25(3):250-6.
10.	28.	Pasaron R, Burnweit C, Zerpa J, et al. Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients. Pediatr Surg Int. 2015;31(2):173-80.
11.	29.	Zier JL, Liu M. Safety of high-concentration nitrous oxide by nasal mask for pediatric procedural sedation: experience with 7802 cases. Pediatr Emerg Care. 2011;27(12):1107-12.
12.	30.	Gamis AS, Knapp JF, Glenski JA. Nitrous oxide analgesia in a pediatric emergency department. Ann Emerg Med. 1989;18(2):177-81.
13.	31.	Martin HA, Noble M, Wodo N. The Benefits of Introducing the Use of Nitrous Oxide in the Pediatric Emergency Department for Painful Procedures. J Emerg Nurs. 2018;44(4):331-5.

Episode 119 - Nitrous Oxide in EMS With Dr. Corrie Chumpitazi

Join the podcast crew and MCHD medic Lily Trosclair as she discusses our MCHD Case of The Quarter for Q4 2021.  This one began with a pediatric cardiorespiratory arrest but fortunately has a happy ending.

REFERENCES
1. Heffner AC, Swords D, Kline JA, Jones AE. The frequency and significance of postintubation hypotension during emergency airway management. J Crit Care. 2012 Aug;27(4):417.e9-13.

2. http://www.emdocs.net/critical-asthma-patient-pearlspitfalls-of-management/

Episode 124 - Awful Asthma - MCHD COTQ Q4 2021

Episode 127 - Airway Patency Vs. Protection

True anaphylactic shock can be one of the most harrowing calls in all of EMS and emergency medicine.  However, as is true with much of our core clinical content, dogma and myths persist. MCHD District Chief Spencer Hall joins the podcast crew to discuss anaphylaxis diagnostic criteria, treatment, and much more.  

REFERENCES
1. Anagnostou K, Turner PJ. Myths, facts, and controversies in the diagnosis and management of anaphylaxis. Arch Dis Child. 2019 Jan;104(1):83-90.
2. Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy. 2000 Aug;30(8):1144-50.
3. Prince BT, Mikhail I, Stukus DR. Underuse of epinephrine for the treatment of anaphylaxis: missed opportunities. J Asthma Allergy. 2018 Jun 20;11:143-151.

Episode 134 - All Things Anaphylaxis

Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is vital as well. Join the podcast crew as they start at the end with the killer/"can't miss" EKG patterns and combine those with common chief complaints. Hopefully, this framework will click for you.

REFERENCES
1. https://www.youtube.com/watch?v=UXh8PS9dtmo

2. Walker P, Jenkins CA, Hatcher J, Freeman C, Srica N, Rosell B, Hanna E, March C, Seamens C, Storrow A, McCoin N. 2022. Seamens’ Sign: a novel electrocardiogram prediction tool for left ventricular hypertrophy. PeerJ 10:e13548

Episode 166 - The MCHD EKG Manifesto - Part 1

We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge.  Learn the V-Tach FACT, and you'll feel more comfortable with your next wide rhythm at a rate of 185.

REFERENCES
1. https://litfl.com/vt-versus-svt-ecg-library/

2. https://www.youtube.com/watch?v=UXh8PS9dtmo

3. Marill KA, Wolfram S, Desouza IS, Nishijima DK, Kay D, Setnik GS, Stair TO, Ellinor PT. Adenosine for wide-complex tachycardia: efficacy and safety. Crit Care Med. 2009 Sep;37(9):2512-8.

Episode 168 - The VTach FACTs

We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild.

REFERENCES:
1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Norepinephrine a Better Choice? The western journal of emergency medicine, 25(5), 708–714. 

2. Permpikul, C., Tongyoo, S., Viarasilpa, T., Trainarongsakul, T., Chakorn, T., & Udompanturak, S. (2019). Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial. American journal of respiratory and critical care medicine, 199(9), 1097–1105. 

Episode 174 - Push Dose Norepinephrine

This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release.  This episode has been out in the world on Medic Mindset for a couple of months, but we wanted to offer it to our MCHD Paramedic Podcast listeners as well.  Also, like, subscribe to and follow Medic Mindset wherever you listen to podcasts.

REFERENCES
1. https://medicmindset.com
2. Elam, K., & Bolar-Softich, K. L. (1997). Dilemmas in the acute pharmacologic treatment of uncontrolled atrial fibrillation. The American journal of emergency medicine, 15(4), 418–419. 
3. Abarbanell, N. R., & Marcotte, M. A. (1997). Prehospital use of intravenous diltiazem (cardizem Lyo-Ject) in the treatment of rapid atrial fibrillation. The American journal of emergency medicine, 15(6), 618–619. 
4. Abarbanell, N. R., Marcotte, M. A., Schaible, B. A., & Aldinger, G. E. (2001). Prehospital management of rapid atrial fibrillation: recommendations for treatment protocols. The American journal of emergency medicine, 19(1), 6–9. 
5. Wang, H. E., O'connor, R. E., Megargel, R. E., Schnyder, M. E., Morrison, D. M., Barnes, T. A., & Fitzkee, A. (2001). The use of diltiazem for treating rapid atrial fibrillation in the out-of-hospital setting. Annals of emergency medicine, 37(1), 38–45. 
6. Luk, J. H., Walsh, B., & Yasbin, P. (2013). Safety and efficacy of prehospital diltiazem. The western journal of emergency medicine, 14(3), 296–300. 
7. Rodriguez, A., Hunter, C. L., Premuroso, C., Silvestri, S., Stone, A., Miller, S., Zuver, C., & Papa, L. (2019). Safety and Efficacy of Prehospital Diltiazem for Atrial Fibrillation with Rapid Ventricular Response. Prehospital and disaster medicine, 34(3), 297–302. 
8. Fornage, L. B., O'Neil, C., Dowker, S. R., Wanta, E. R., Lewis, R. S., & Brown, L. H. (2024). Prehospital Intervention Improves Outcomes for Patients Presenting in Atrial Fibrillation with Rapid Ventricular Response. Prehospital emergency care, 28(7), 910–919.


Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration

We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode!  MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to our daily care.

REFERENCES
1. https://www.mchd-tx.org/media/podcasts/SITUS-Fig-1.pdf
2. https://www.mchd-tx.org/media/podcasts/SITUS-Fig-2.pdf
3. https://montgomerycountypolicereporter.com/mchd-celebrates-survival-of-one-in-a-million-patient-first-responders-please-read/
4. https://pubmed.ncbi.nlm.nih.gov/34317454/


Episode 178 - A STEMI Unlike Any Other

On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence.  What they found should motivate us all to be skeptical when it comes to determining if TCP is actually working. 

REFERENCES
1. https://www.mchd-tx.org/media/podcasts/TCP-Podcast-Figures.pdf
2. Kimbrell, J., Kreinbrook, J., Poke, D., Kalosza, B., Geldner, J., Shekhar, A. C., Miele, A., Bouthillet, T., & Vega, J. (2024). False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series. Prehospital emergency care, 28(7), 928–936. 
3. https://www.ems12lead.com/post/tcp-in-transit-part-i
4. https://www.ems12lead.com/post/transcutaneous-pacing-part-2
5. https://www.ems12lead.com/post/transcutaneous-pacing-part-3

Episode 179 - Transcutaneous Pacing Pearls and Pitfalls

Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in EMS? Could standing a patient to check their heart rate actually be harmful? Join the podcast crew as they address these questions and more. 

REFERENCES
1. White, JL, Hollander, JE, Chang, AM, et al. (2019). Orthostatic vital signs do not predict 30-day serious outcomes in older emergency department patients with syncope: A multicenter observational study. The American journal of emergency medicine, 37(12), 2215–2223. 
2. Shen W, Sheldon R, Yancy C, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of The American College Of Cardiology. August 1, 2017;70(5):e39-e110. Available from: MEDLINE, Ipswich, MA. Accessed May 1, 2018.
3. Cohen E, Grossman E, Sapoznikov B, et al. Assessment of orthostatic hypotension in the emergency room. Blood Press. 2006;15(5):263-267.
4. Aronow WS, Lee NH, Sales FF, Etienne F. Prevalence of postural hypotension in elderly patients in a long-term health care facility. Am J Cardiol. 1988;62(4):336.
5. Ooi WL, Barrett S, Hossain M, et al. Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population. JAMA. 1997;277(16):1299-1304.


Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?

We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start?  How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank.

REFERENCES
1. https://www.resuscitationacademy.org

Episode 181 - Why You Should Attend The Resuscitation Academy

Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case, asked some hard questions, and will provide solid answers—our favorite recipe for a jam-packed educational session.

REFERENCES
1. Witt, C. E., Shatz, D. V., Robinson, B. R. H., Campion, E. M., Shapiro, M. L., Bui, E. H., Meizoso, J. P., & Dorlac, W. C. (2025). Epinephrine in Prehospital Traumatic Cardiac Arrest-Life Saving or False Hope?. Prehospital emergency care, 1–9.

2. Breyre, A. M., George, N., Nelson, A. R., Ingram, C. J., Lardaro, T., Vanderkolk, W., & Lyng, J. W. (2025). Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest - A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP. Prehospital emergency care, 1–15.

3. https://www.anzcor.org/assets/anzcor-guidelines/guideline-11-10-1-management-of-cardiac-arrest-due-to-trauma-253.pdf


Episode 182 - Traumatic Arrest With The Prehospitalist

On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD.  What device did you use?  How did you train?  What lessons have you learned?  All these and more will be addressed and answered.

REFERENCES:
1. Zhao, Y., Zang, B., & Wang, Q. (2024). The Effectiveness of Bougie Use on First-Attempt Success in Tracheal Intubations. Annals of emergency medicine, 84(3), 331–332. 
2. Weingart, S. D., Barnicle, R. N., Janke, A., Bhagwan, S. D., Tanzi, M., McKenna, P. J., Bracey, A., & Resuscitationists Research Group (2023). A taxonomy of key performance errors for emergency intubation. The American journal of emergency medicine, 73, 137–144. 

Episode 184 - Recording Video Laryngoscopy In EMS

The podcast crew takes on the topic of prehospital analgesia.  What pain medication do we choose when facing a complex patient with all analgesics available?  Are there better options for hypotensive patients?  What about pregnancy and the elderly?  On this episode, we'll walk through our MCHD pain medication options, take a moment for a BLS reminder, and discuss some specific situations where certain medications are the best fit.

REFERENCES
1. McArthur, R., Cash, R. E., Rafique, Z., Dickson, R., Crocker, K., Crowe, R. P., Wells, M., Chu, K., Nguyen, J., & Patrick, C. (2024). Intravenous Acetaminophen Versus Ketorolac for Prehospital Analgesia: A Retrospective Data Review. The Journal of emergency medicine, 67(3), e259–e267. 

2. McArthur, R., Cash, R. E., Anderson, J., De La Rosa, X., Peckne, P., Hogue, D., Badawood, L., Secrist, E., Andrabi, S., & Patrick, C. (2025). Fentanyl versus nebulized ketamine for prehospital analgesia: A retrospective data review. The American journal of emergency medicine, 89, 124–128. 

3. Powell, J. R., Browne, L. R., Guild, K., Shah, M. I., Crowe, R. P., Lindbeck, G., Braithwaite, S., Lang, E. S., Panchal, A. R., & Technical Expert Panel (2023). Evidence-Based Guidelines for Prehospital Pain Management: Literature and Methods. Prehospital emergency care, 27(2), 154–161. 

4. Aceves, A., Crowe, R. P., Zaidi, H. Q., Gill, J., Johnson, R., Vithalani, V., Fairbrother, H., & Huebinger, R. (2023). Disparities in Prehospital Non-Traumatic Pain Management. Prehospital emergency care, 27(6), 794–799. 

Episode 183 - Pain Control In EMS -  The MCHD Analgesia Ladder

We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with chest pain once the ER doctor takes over?  How does the workup advance? What imaging is ordered? What labs? Join us to discuss the "next 30 minutes" for the serial killer chest pain patient.

Episode 185 - Chest Pain - The Next 30 Minutes

We're lucky to have a special guest on this podcast episode to discuss a topic that, unfortunately, all of us in emergency care encounter all too frequently: the opiate epidemic.  Peter Canning is a paramedic who has lived through the epidemic while working on the ambulance in the New England epicenter.  This discussion navigates Peter's progression through newer terminology like stigma and harm reduction in an effort to provide compassionate and best-practice care for our OUD patients.

REFERENCES
1. https://www.press.jhu.edu/books/title/12438/killing-season?srsltid=AfmBOopOX3Wpf9blJDuiJbwOCKyNCACoxU2IixIMtLg1N1a-wYTGeEmr

2. https://www.press.jhu.edu/books/title/53796/friends-and-family-guide-opioid-overdose-epidemic


Episode 186 - A Paramedic's Guide To The Opiate Epidemic

There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why don't we intubate our cardiac arrest patients like we used to?"   "MCHD has been hyper-focused on recording video laryngoscopy over the past year. Why?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips.  This is part one of a two-part series.

REFERENCES
1. Galinski, M., Tazi, G., Wrobel, M., Boyer, R., Reuter, P. G., Ruscev, M., Debaty, G., Bagou, G., Dehours, E., Bosc, J., Lorendeau, J. P., Goddet, S., Marouf, K., Simonnet, B., & Gil-Jardiné, C. (2025). Risk factors for failure of the first intubation attempt during cardiopulmonary resuscitation in out-of-hospital emergency settings: What about chest compression?. Resuscitation, 214, 110623. 
2. Brenne, N., Brünjes, N., Rupp, D., Sassen, M. C., Jerrentrup, A., Wulf, H., Heuser, N., & Volberg, C. (2025). Success of airway management in out-of-hospital cardiac arrest using different devices - a prospective, single-center, observational study comparing professions. Scandinavian journal of trauma, resuscitation and emergency medicine, 33(1), 109. 
3. Bryan, A., Feltes, J., Sweetser, P. W., Winsten, S., Hunter, I., & Yamane, D. (2025). Hyperangulated video laryngoscopy in the emergency department: An analysis of errors and factors leading to prolonged apnea time. The American journal of emergency medicine, 95, 153–158. 

Episode 187 - EMS Airway Updates 2025 - Part 1

Welcome to MCHD's Paramedic Podcast - a biweekly podcast dedicated to EMS Providers across the world.

Introduction to THE MCHD Paramedic Podcast

Featuring Dr. Peter Antevy

Today’s show will focus on the evolution in the EMS approach to pediatric resuscitations. Historically these high stress resuscitations focused on rapid transport of these children to the hospital and have resulted in sub par resuscitation efforts and increased stress for both providers and families. There is mounting evidence that mirrors the adult resuscitation data that staying on scene and providing focused resuscitation efforts improves outcomes in these patients. Dr. Antevy provides a unique perspective as both a pediatric EM specialist/EMS medical director and inventor of the Handtevy pediatric resuscitation system.

https://www.handtevy.com

Episode 2 - Pediatric Resuscitation Featuring Dr. Peter Antevy

Dr. Patrick is joined on this episode by Dr. Elizabeth Weinstein.  Elizabeth is a dual trained in Emergency Medicine and Pediatrics, and she delivers clinical pearl after clinical pearl on how to recognize and manage non-accidental trauma in the prehospital environment.

Resources:
http://www.identifychildabuse.org

Episode 18 - Pediatric Non-Accidental Trauma With Dr. Elizabeth Weinstein

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled.  But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with.  To go from a chaotic chest pain scene with unstable vitals then filter to a differential of #1 PE, #2 ACS, #3 TAD is often quite challenging.  The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider.  We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed.  That’s where we, as emergency providers, must begin.  Today we’ll kick things off with acute chest pain.


REFERENCES
1.	http://www.emdocs.net/em-in-5-approach-to-chest-pain/

2.	https://litfl.com/ecg-findings-in-massive-pericardial-effusion/

3.     https://www.mchd-tx.org/media/podcasts/MCHDPP-79.pdf

Episode 79 - Serial Killer Series - Chest Pain

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled.  But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with.  To go from a chaotic scene with unstable vitals then filter to an organized differential.  The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider.  We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed.  That’s where we, as emergency providers, must begin.  Today we’ll address the killers associated with the dyspneic patient.

REFERENCES

https://www.ebmedicine.net/media_library/files/Calculated%20Decisions%20E1212%20PERC%20Rule.pdf

https://www.mchd-tx.org/media/podcasts/MCHDPP-80-Final-PDF.pdf

Episode 80 - Serial Killer Series - Shortness of Breath

We often start with a diagnosis and teach from there – for example CHF, asthma, and COPD are all podcast topics we have previously tackled.  But, how to get to the final diagnosis is often a process that all levels of emergency providers struggle with.  To go from a chaotic scene with unstable vitals then filter to an organized differential.  The “Serial Killer Series” is going to target the most common chief complaints and the killer diagnoses that you should always consider.  We’re not going to spend time with non-emergent/chronic diagnoses, just the ones that are deadly when missed.  That’s where we, as emergency providers, must begin.  Today we’ll wrap up the series with the killers associated with acute altered mental status.

Episode 82 - Serial Killer Series - Altered Mental Status

We have all been guilty of caring for labeling and judging “pseudoseizures.”  First of all, this term is outdated, and this episode looks at a study examining the mortality in psychogenic seizure patients.  This is a debilitating disease that needs more attention and improved treatment options.  Come, have your prior assumptions shattered, and leave a better and more empathetic provider.

REFERENCES:
1.	https://n.neurology.org/content/95/6/e643

Episode 103  - The Artist Formerly Known As Pseudoseizure - An EMS Perspective

The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Director Dr. Casey Patrick invites you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

MCHD Paramedic Podcast

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