FOAMfrat podcast

Fitness Tyler Christifulli Sam Ireland Sam I Am Emergency Medicine Science Medicine FOAMfrat

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Inhalt bereitgestellt von FOAMfrat Podcast, Tyler Christifulli, and Sam Ireland. Alle Podcast-Inhalte, einschließlich Episoden, Grafiken und Podcast-Beschreibungen, werden direkt von FOAMfrat Podcast, Tyler Christifulli, and Sam Ireland oder seinem Podcast-Plattformpartner hochgeladen und bereitgestellt. Wenn Sie glauben, dass jemand Ihr urheberrechtlich geschütztes Werk ohne Ihre Erlaubnis nutzt, können Sie dem hier beschriebenen Verfahren folgen https://de.player.fm/legal.

TED Tech

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How AI is saving billions of years of human research time | Max Jaderberg 19:15

vor 20 weeks19:15

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19:15

Can AI compress the years long research time of a PhD into seconds? Research scientist Max Jaderberg explores how “AI analogs” simulate real-world lab work with staggering speed and scale, unlocking new insights on protein folding and drug discovery. Drawing on his experience working on Isomorphic Labs' and Google DeepMind's AlphaFold 3 — an AI model for predicting the structure of molecules — Jaderberg explains how this new technology frees up researchers' time and resources to better understand the real, messy world and tackle the next frontiers of science, medicine and more. For a chance to give your own TED Talk, fill out the Idea Search Application: ted.com/ideasearch . Interested in learning more about upcoming TED events? Follow these links: TEDNext: ted.com/futureyou TEDAI Vienna: ted.com/ai-vienna Hosted on Acast. See acast.com/privacy for more information.…

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Prehospital emergency and critical care podcast by Tyler Christifulli & Sam Ireland

152 Episoden

#Fitness #Tyler Christifulli #Sam Ireland #Sam I Am #Emergency Medicine #Science #Medicine #FOAMfrat

FOAMfrat Podcast

FOAMfrat Podcast explicit

78 subscribers

updated vor 16 Tagen

Serie-Home•Feed

Prehospital emergency and critical care podcast by Tyler Christifulli & Sam Ireland

152 Episoden

#Fitness #Tyler Christifulli #Sam Ireland #Sam I Am #Emergency Medicine #Science #Medicine #FOAMfrat

Alle Folgen

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Podcast 185 - Eating Disorders w Hanna Thompson 32:58

vor 16 Tagen32:58

32:58

In this episode, Tyler sits down with Hanna Thompson to discuss a critical yet often overlooked topic in EMS—eating disorders. Drawing from personal experience and clinical insight, they explore how these conditions present both medically and behaviorally, especially in prehospital and interfacility transport settings. They break down the subtle physical signs that EMS providers can look for—such as Russell's sign, lanugo, unexplained bradycardia, and electrolyte disturbances—and emphasize the importance of sensitive history taking. The conversation also dives into the dangers of refeeding syndrome, slow correction strategies, fluid choice, and the clinical significance of thiamine, magnesium, and phosphate replacement. What You’ll Learn: How eating disorders can manifest in EMS calls Why you may be treating the consequences, not the disorder itself Red flags like bradycardia, lanugo, and Russell’s sign How to handle refeeding syndrome safely Why dextrose, fluids, and electrolyte replacement should be approached cautiously The connection between electrolyte shifts and seizures or arrhythmias Key Takeaway: Patients with eating disorders are medically and psychologically fragile. In EMS, we often encounter them through the effects of the disorder—not the diagnosis itself. Recognizing subtle clues and avoiding aggressive interventions could save a life. Resources Mentioned: Hannah's blog on EMS considerations in eating disorders Data on post-COVID spikes in eating disorder incidence Guidelines for electrolyte correction and refeeding syndrome Disclaimer: This podcast is for educational purposes only and not a substitute for clinical protocols or medical direction. Always consult your agency’s guidelines and medical control.…

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Podcast 184 - Diastolic Augmentation w/ Brian Cress 48:53

vor 6 weeks48:53

48:53

In this episode, Tyler Christifulli sits down with cardiac perfusionist Brian Cress to dig into the physiology of coronary perfusion, the mechanics of the intra-aortic balloon pump (IABP), and the clinical finesse of diastolic augmentation. Whether you're just starting to encounter balloon pumps or want to sharpen your transport strategy, this discussion is packed with visual metaphors, waveform analysis, and real-world pearls.…

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Podcast 183 - Cardiac Ultrasound w/ Dr. Weimersheimer 1:16:42

vor 10 weeks1:16:42

1:16:42

In this conversation, Dr. Peter Weimersheimer discusses various techniques and tips for performing cardiac ultrasound in emergency medicine. He emphasizes the importance of understanding probe movements such as sliding, fanning, and rocking to optimize cardiac views. The discussion also covers troubleshooting common challenges in cardiac imaging, the critical role of gel in obtaining clear images, and the transition between different cardiac views. Dr. Weimersheimer emphasizes the importance of identifying cardiac pathologies through ultrasound and shares techniques for obtaining the apical four-chamber view. The conversation concludes with insights into the impact of ultrasound on patient care and decision-making in emergency situations. In this conversation, Dr. Peter Weimersheimer shares his expertise on cardiac ultrasound techniques, with a focus on the apical four-chamber view and the importance of understanding ventricular shape and function. He discusses practical tips for navigating ultrasound views in critical situations, optimizing imaging techniques, and utilizing patient physiology to enhance imaging quality. The conversation also covers the interpretation of right ventricular size in cardiac arrest and differentiating between the inferior vena cava (IVC) and aorta during ultrasound imaging.…

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Podcast 182 - AHORA Spanish Stroke Assessment 34:11

vor 13 weeks34:11

34:11

Stroke assessment tools like BEFAST are crucial for swiftly identifying symptoms and expediting treatment. However, language barriers can hinder prompt care for non-English speakers, particularly in the Hispanic community. Developed through a collaborative effort, AHORA adapts the traditional stroke assessment to be culturally and linguistically appropriate for the Spanish-speaking population. Designing Ahora The need for a specific tool became apparent when traditional tools like BEFAST were found to be ineffective for those who did not speak English. After discarding the complex "Rapido," Banerjee’s team crafted Ahora, including Marcia Wilson, MD, and Remley Crowe, PhD. This tool was made to mirror BEFAST but is simplified for practical use within the Spanish-speaking population.…

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Podcast 181 - Discrepancies in Testing & Treatment 53:02

vor 15 weeks53:02

53:02

Does medicine have dangerous side effects for women? Are the "normal" values we have set for diagnostics possibly endangering specific populations? In this episode of the FOAMfrat podcast, Tyler sits down with Dr.Alyson McGregor, emergency physician and author of Sex Matters, and Tim Redding, EMS educator and lecturer, to discuss the discrepancies in medical testing, diagnosis, and treatment between male and female patients. Dr. McGregor shares her journey of discovering gender bias in medicine, particularly how women’s symptoms are often dismissed or mislabeled as psychiatric in nature. The discussion explores how male-centric research has shaped clinical guidelines, leading to underdiagnosis and undertreatment of women across a wide range of conditions—from heart attacks to strokes and even pain management.…

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Podcast 180 - MCI Collaboration w/ ATCEMS & Travis County Star Flight 49:36

vor 19 weeks49:36

49:36

In this episode of the FOAMfrat podcast, join as we discuss mass casualty management with Chief Robert Luckritz of Austin Travis County EMS and Justin Soulier from Travis County Star Flight. Explore the strategies and challenges in mass casualty responses in one of the fastest-growing urban areas in the U.S.…

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Podcast 179 - Your First 5 Minutes of an MCI w/ Rommie Duckworth 41:32

vor 24 weeks41:32

41:32

Join Rommie Duckworth and FOAMfrat as we discuss the mental framing and big-picture thought process behind the first five minutes of any mass casualty incident (MCI). Rommie Duckworth, a fire captain and shift commander, is a wealth of knowledge on this topic and speaks globally to prepare emergency responders for these events.…

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Podcast 178 - ECPR Eligibility and Preparation w/ Alec Wilcox 41:06

vor 27 weeks41:06

41:06

In this episode, Alec Wilcox & I discuss ECPR eligibility & preparation. ECPR, or extracorporeal cardiopulmonary resuscitation, involves taking a patient in cardiac arrest, sucking blood from their venous system, oxygenating it externally, and then pumping it back into their arterial system. This procedure helps maintain blood circulation and oxygen delivery during cardiac arrest, serving as a bridge to further therapy.…

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Podcast 177 - Implementing Ultrasound w/ Allen Wolfe 46:46

vor 30 weeks46:46

46:46

The integration of point-of-care ultrasound (POCUS) is transforming emergency medical services (EMS) by enhancing diagnostic capabilities and improving accuracy in answering important clinical questions. Recently, I had the opportunity to discuss this topic extensively with Allen Wolfe, the Senior Director of Education at Life Link III. A significant challenge in incorporating ultrasound technology within EMS has been overcoming initial barriers to adoption. Many programs, burdened by cost concerns and technological intimidation, have historically relegated ultrasound units to the back shelves. However, as Allen outlined, strategic changes in accessibility and training can dramatically alter this landscape.…

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Podcast 176 - Pediatric TBI Protcol w/ Dr. Banerjee 29:39

vor 33 weeks29:39

29:39

In this episode, Dr Banerjee and I discuss a new traumatic brain injury (TBI) protocol his department is trialing for pediatric patients with moderate to severe TBI in collaboration with Arnold Palmer Hospital. This protocol involves administering Keppra and 3% saline in the pre-hospital setting.

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Podcast 175 - The Things We Do w/ PulmCCM 56:46

vor 35 weeks56:46

56:46

Matt Hoffman is the editor-in-chief of PulmCCM, a blog that frequently updates its readers on evidence and best practices in critical care medicine. I have always wondered how our work in the field affects a patient's care downstream. Do pulmonologists ever sigh to themselves and think, "God, I wish paramedics would just start/stop doing ____________?" It turns out that this is not the case, but the discussion was super interesting, and I thank Dr. Hoffman for coming to the show.…

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Podcast 174 - "I Rolled My Ambulance" Interview w/ Kyle Rice 45:06

vor 39 weeks45:06

45:06

In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies. If you're an EMS provider, this episode is a must-listen for understanding the real-life risks of complacency and how to prevent accidents.…

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Podcast 173 - Rethinking Lights & Sirens w/ Jeff Jarvis & Jonathon Jenkins 41:30

vor 42 weeks41:30

41:30

In this episode, I sit down with Dr. Jeffrey Jarvis , author of a fascinating paper on the impact of lights and siren (L&S) use in EMS responses. If you’re like most of us, when you hear those blaring sirens and see flashing lights, you think, “Wow, someone’s really in trouble!” But the truth, according to Dr. Jarvis’ study, might surprise you.…

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Podcast 172- Hamilton T1 Hacks & Strategies w/ Joe Hylton 1:00:16

vor 45 weeks1:00:16

1:00:16

In this podcast, we discuss the nuances and strategy of the T1 ventilator with RRT, Joe Hylton. Whether you're a paramedic or a healthcare professional involved in critical care transport, understanding the nuances of this advanced ventilator is essential to safe and effective patient transport. We break down the pressure-controlled ventilation with volume adaptive options and offer practical guidance on managing obstructive lung conditions like asthma during transport. Plus, we cover essential troubleshooting techniques to help you address common issues when things don’t go as planned.…

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Podcast 171 - Thoracic Dissection Goals w/ Alex Greene 24:42

vor 48 weeks24:42

24:42

Thoracic dissections are surgical emergencies that require precise temporizing measures until surgery can be performed. In this session, participants will gain critical knowledge on recognizing key symptoms such as ripping back pain and unequal pulses, indicative of thoracic dissections. The discussion will focus on anti-impulse therapy, emphasizing using beta-blockers like esmolol and calcium channel blockers like nicardipine to control blood pressure and prevent further damage. Pain management strategies and the selective use of nitroprusside will also be explored. The class will address the unique challenges of managing blood pressure in prehospital settings, stressing the importance of a well-prepared plan.…

FOAMfrat Podcast

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Podcast 170 - Finger Thoracostomy w/ Dr. Cynthia Griffin 33:46

vor 1 year33:46

33:46

In this conversation, Tyler and Dr. Cynthia Griffin discuss the finger thoracostomy procedure. They cover topics such as when to choose finger thoracostomy over needle decompression, the equipment needed for the procedure, the technique for performing the procedure, and potential complications and tips for success. They also touch on the use of chest tubes and the management of tension physiology. Overall, the conversation provides a comprehensive overview of the finger thoracostomy procedure.…

FOAMfrat Podcast

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Podcast 169 - EVD Transport Logistics w/ Alaina Martini 45:39

vor 1 year45:39

45:39

Alaina Martini, a flight nurse at Allegheny Life Flight, shares her expertise on transporting patients with external ventricular drains (EVDs). She explains the indications for EVD insertion, such as aneurysmal subarachnoid hemorrhage and obstructive hydrocephalus. Alaina discusses the importance of assessing the color and texture of the cerebrospinal fluid (CSF) to detect changes and potential rebleeding. She also explains the process of inserting the EVD and how it is guided by CT scans to avoid damaging important brain tissue. Alaina emphasizes the need to know if the aneurysm is secure before adjusting the EVD drain level, as opening it too low can increase the risk of rebleeding. She also discusses the use of hypertonic saline and osmotic therapy to manage increased intracranial pressure. Tyler and Alaina discuss various aspects of managing patients with external ventricular drains (EVDs) during transport in this conversation. They cover topics such as the clamping of EVDs, positioning the patient's head, troubleshooting common issues, and securing the EVD during transport. Alaina provides insights and recommendations based on her experience as a neurocritical care nurse.…

FOAMfrat Podcast

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Podcast 168 - Procedure Preppers (Needle Decompression) w/ Dr. Aho 38:38

vor 1 year38:38

38:38

Dr. John Aho discusses needle decompression and the procedure's indications, techniques, and potential pitfalls. He emphasizes the importance of high clinical suspicion and the limitations of external signs in diagnosing tension pneumothorax. The conversation also covers the choice of needle insertion sites, the use of ultrasound, and the need for proper training and practice. Dr. Aho provides insights into the anatomical considerations and common mistakes made during needle decompression. He also explores the possibility of instant feedback to confirm successful decompression. The conversation discusses the problem of needle decompression failure rates and the need for a reliable indicator of successful decompression. The guest introduced the Cap-No-Spot, a device that uses colorimetric indicator paper to detect CO2 and determine if a needle decompression procedure was successful. The device has been shown to have higher sensitivity and specificity than human judgment. The conversation also touches on the importance of proper training and the device's potential applications beyond pneumothorax detection.…

FOAMfrat Podcast

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Podcast 167 - Placenta Previa w- Demi Wilkes 18:00

vor 1 year18:00

18:00

An iceberg typically shows only 10% of its mass above water. To appreciate the other 90%, you need to dive deep. That’s precisely what we’re doing in this series—discovering the deeper knowledge about obstetric topics. These topics can be massive, and much of the information is below the ‘surface-level’ knowledge that EMS is presented with. In this episode, Demi Wilkes & I will discuss Placenta Previa and the closely associated Placenta Accrete Spectrum.…

FOAMfrat Podcast

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Podcast 166 - Transcutaneous Pacing & False Capture 51:51

vor 1 year51:51

51:51

The conversation is about a paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. They conducted a retrospective study and found that paramedics often mistakenly believe they have electrical capture when they do not. They emphasize the importance of confirming electrical capture before assuming mechanical capture. They also discuss the challenges of pulse palpation and the need for more rigorous research in EMS and ED settings. The conversation discusses the challenges and considerations in transcutaneous pacing, specifically focusing on the verification of mechanical capture. The speakers explore the use of various methods to confirm mechanical capture, such as feeling for a pulse, using pulse oximetry, and utilizing ultrasound. They also discuss the difficulty of accurately assessing mechanical capture and the potential for false electrical capture. The conversation concludes with a discussion on the transfer of pacing from one device to another and the importance of verifying capture during the process.…

FOAMfrat Podcast

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Podcast 165 - Should Pressors Have A Max Dose? 50:38

vor 1 year50:38

50:38

In this episode we discuss whether the concept of having a "max dose" of your pressor has any evidence or physiological backing. Joining me in this discussion are Dan Rauh, Shane O'Donnell, and Shad Ruby.

FOAMfrat Podcast

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Podcast 164 - Suicidal Ideation w/ James Boomhower 32:35

vor 2 years32:35

32:35

How do you talk to a patient experiencing suicidal ideation? What if you're the one having these thoughts? We're interviewing James Boomhower from Stay Fit 4 Duty in this episode. We discuss suicidal ideation, therapeutic communication, and verbal de-escalation.

FOAMfrat Podcast

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Podcast 163 - What Can We Learn From A Ketamine Infusion Clinic? w/ Chris Carlstrom 18:09

vor 2 years18:09

18:09

Chris Carlstrom is a flight nurse at Life Link III and also works part-time at a ketamine infusion clinic. We’ve had some interesting conversations on shift regarding his experiences with ketamine in the clinic versus emergency medicine and I finally was able to get one of these conversations recorded for the podcast. Enjoy Podcast 163 - What Can We Learn From A Ketamine Infusion Clinic? w/ Chris Carlstrom.…

FOAMfrat Podcast

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Podcast 162 - Multimodal Pain Management w/ Shane O' Donnell 31:00

vor 2 years31:00

31:00

When I became a paramedic, being able to provide pain management was one of the "new interventions" that I looked forward to most. As an EMT, I remember countless times I was without ALS resources and had to watch a patient suffering in pain until we got to the hospital. Trying to obtain any history or perform an assessment on someone writhing in pain can be nearly impossible. As a BLS provider, I would attempt non-pharmacological ways to relieve pain, such as ice packs, warm packs, elevating extremities, and sometimes simply trying to distract them with conversation. While these methods should not be discounted, I will never forget the first time I could provide pain medication to an elderly woman who fell and fractured her hip. I started an IV right there on the floor of the assisted living facility, administered some fentanyl, and comfortably got her to the stretcher. Analgesia did not save this lady's life. Still, it did make her trip to the hospital a little more comfortable and allowed me to obtain an accurate history, including the dizziness and dyspnea she felt before falling. Performing an adequate assessment and obtaining pertinent medical history can be difficult when a patient is experiencing intense pain. For this reason, pain should be managed to a level that allows for comfort & communication. Total pain relief is ideal but may not always be feasible, given hemodynamics and underlying causes. Check out this episode with Tyler & Shane as they discuss multimodal pain management strategies.…

FOAMfrat Podcast

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Podcast 161 - EMT Pharmacology 28:53

vor 2 years28:53

28:53

Taking on pharmacology in EMT school is a big hurdle. We wanted to write something that not only explained the basics of the medications but also helped bridge the gap between what EMTs are taught and what paramedics learn when they go back over these medications in paramedic pharmacology. Each chapter discusses how the medications work, why they're given for specific indications, and the logistics of medication administration! We've also included medication profiles, tips and tricks from experienced providers, and flashcards for each medication to help you hone your med knowledge base! In this book, we're coving: Oxygen Albuterol and Atrovent Epinephrine Aspirin Nitroglycerin Naloxone Oral Glucose Gel and Glucagon + Flashcards in the back! This book is for students, EMTs, and paramedics who want an in-depth review of EMT medications! You can download the book for free at foamfrat.com…

FOAMfrat Podcast

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Podcast 160 - Autism Communication w/ Joshua Chan & Matthew Yelton 47:39

vor 2 years47:39

47:39

I had the privilege to bring on two passionate fathers of children with Autism to help me better understand how to approach and communicate with a neuro-diverse child. This episode is chock-full of insight, tips, tricks, and logistics of approaching a child in the field with Autism. Josh Chan is a Life Link III flight paramedic/base lead and a Glenwood FD firefighter. Matthew Yelton is a flight paramedic/base lead for Mercy Flight Central and works as a fire captain at Constableville Ambulance Inc.…

FOAMfrat Podcast

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Podcast 159 - Close Encounters of the Infectious Kind w/ Dr. Hudson Garrett 43:48

vor 2 years43:48

43:48

EMS providers encounter various infectious diseases daily and need to know the routes of exposure, risks, and preventive measures to protect themselves and their families. In this episode, We talk with Dr. Hudson Garrett, an infectious disease expert with the medical college of Louisville University, to discuss the practical points of infectious disease for the everyday provider. Want CE for this episode? Sign up for FOAMfrat Studio and access 300+ hours of continuing education for EMS & Nursing. www.foamfrat.com…

FOAMfrat Podcast

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Podcast 158 - RSI Cocktail w/ Heavy Lies The Helmet 1:08:01

vor 2 years1:08:01

1:08:01

In this episode, Dan Rauh & Mike Boone from Heavy Lies The Helmet join me to hash out our workflows and drugs of choice for four particular scenarios you may come across. The combative head injury patient that needs to be intubated but has five firefighters holding them down and is actively trying to rip off his collar and IV. The septic hypotensive patient is no longer protecting their airway but also needs resuscitation prior to induction. The snoring head bleed with a BP of 220/140 The "almost dead, but needs a tube" population (induction med?)…

FOAMfrat Podcast

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Podcast 157 - Ventilation & Cardiac Arrest w/ Tom Bouthillet 46:02

vor 2 years46:02

46:02

Moments after the heart stops the entire circulatory system finally has a chance to bring venous and arterial pressures to equilibrium. Cardiac arrest resuscitation requires the provider to have a strong mental model of physiology and the logistics to carry out a series of interventions crucial to preserving life. This class will serve not as a routine basic life support model, but as a deeper understanding and framework to guide resuscitation during your next cardiac arrest.…

FOAMfrat Podcast

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Podcast 156 - Is using AI cheating? EMS and AI 33:20

vor 2 years33:20

33:20

AI will be integrated into everything we do in medicine, perhaps sooner than we think. It will help keep our patients safe, our providers informed, and our communications connected, and change how we think about how we care for patients (if implemented correctly). Systems like ChatGPT are only the beginning, and many companies are already working on or have already integrated with other healthcare specialties. We will see the same integration happen with EMS. While the response to this might be fear of losing our knowledge base, over-automating decision-making, cheating on tests and papers, and the like, we could adopt a very different outlook. We could view this as an opportunity to improve patient safety, offload menial work, automate documentation and communications, and always have an intelligent partner in our pockets we can bounce ideas off of. One day, we'll wonder how we ever lived without it.…

FOAMfrat Podcast

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Podcast 155 - Pattern Recognition vs. Autopilot w/ Shaylah Montgomery 26:20

vor 2 years26:20

26:20

In this episode, Tyler is joined by Shaylah Montgomery to discuss decision-making, human factors, and mental shortcuts utilizing pattern detection. Shaylah is a flight nurse and paramedic for Pafford Air One and a member of the FOAMfrat team.

FOAMfrat Podcast

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Podcast 154 - ROSC Temp & Sedation w/ Dr. Leon Eydelman 32:17

vor 2 years32:17

32:17

0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.

FOAMfrat Podcast

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Podcast 153 - Pediatric Arrest w/ Dr. Banerjee 23:43

vor 3 years23:43

23:43

We just finished re-recording our pediatric arrest class in Studio and decided to play the unedited version of my discussion with Dr. Paul Banerjee. Banerjee is a prolific researcher and medical director in Florida with a particular emphasis on pediatric arrest. Check out the class in Studio for more information on the logistics.…

FOAMfrat Podcast

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Podcast 152 - CISM & Processing w/ Sam Henne 56:03

vor 3 years56:03

56:03

Sam Henne is the creator of Mind Over Medic and a co-worker of mine at Life Link III. In this episode, we discuss the components of critical incident stress and ways to reduce adrenaline during threat appraisal. Check out www.mindovermedic.com

FOAMfrat Podcast

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Podcast 151 - Central Line Access for EMS w/ Austin Brook 30:33

vor 3 years30:33

30:33

EMS is well-trained in peripheral intravenous as well as intraosseous access. However, central lines remain off-limits for many clinicians in various response areas. If accessing these types of lines is allowed, it’s usually permitted when the patient is (nearly) dead. This isn’t very surprising since the scope of practice of the EMS clinician usually focuses on emergent treatments. Unless it’s learned during a critical care class, little thought is typically given to topics like central, dialysis, and PICC lines in EMS. Why not?…

FOAMfrat Podcast

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Podcast 150 - Slishman Traction 36:27

vor 3 years36:27

36:27

Had the opportunity to talk with Dr. Sam Slishman, the inventor of the Slishman traction splint. We had a great conversation on the idea/concept of this splint, who to apply it on, and some additional questions, which we plan on having him back on to discuss.

FOAMfrat Podcast

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Podcast 149 - P:F vs. A-a & Oxygenation Strategies 28:18

vor 3 years28:18

28:18

A-a gradient, a/A ratio, and P: F ratio - are all different views of the same item. These formulas do not have a complete view of oxygenation. Oxygenation is a huge topic, and there are more common values that we use: How well is the patient saturating? Is there dyspnea? How do the lungs sound (auscultation) or look (POCUS)? Where is the patient on the OHCD? What does the ABG show?…

FOAMfrat Podcast

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Podcast 148 - Crashing PE Logistics w/ Shane & Brian 36:50

vor 3 years36:50

36:50

I ran some specific decision points when treating the REALLY BAD massiVE pulmonary embolism patient by Shane & Brian from the FOAMfrat Team. This discussion really focuses on the logistics and ideas when you are trying to get the patient from A to B without having to do CPR.

FOAMfrat Podcast

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Podcast 147 - NICU Q&A w/ Theresa Bowden 32:04

vor 3 years32:04

32:04

Theresa Bowden is a rockstar flight nurse who specializes in NICU transports. In this episode, you will listen in as Theresa explains anything and everything you have ever wondered about NICU interfacility transports. Topics include: Who gets prostaglandin? IO or IV catheter for UVC Cardiac vs. Respiratory Initial Vent Settings Get credit for this class by listening to it in FOAMfrat Studio.…

FOAMfrat Podcast

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Podcast 146 - IVC Assessment w/ Shane O'Donnell 26:22

vor 3 years26:22

26:22

Does IVC assessment have a role in pre-hospital ultrasound? This week we talk to one of the newest members of FOAMfrat, Shane O'Donnell.

FOAMfrat Podcast

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Podcast 145 - Pediatric Bags 32:31

vor 3 years32:31

32:31

Do specialized pediatric jump bags alienate the pediatric population? They typically don’t get used as much, and introducing a foreign bag into a low volume population may add to the stress of running a pediatric call anyway. In this episode, Sam & Tyler discuss the case against the pediatric jump bag.…

FOAMfrat Podcast

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Podcast 144 - VR & EMS Education 26:00

vor 3 years26:00

26:00

The FOAMfrat podcast is back in 2022 with a discussion on how virtual reality can be used in EMS education. We did our first VR class a few weeks ago and here's what we learned and what we plan to do with it!

FOAMfrat Podcast

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Podcast 143 - Thyroid Disorders 47:16

vor 4 years47:16

47:16

The thyroid is a butterfly -shaped gland. But for some, it can be more like a bullet to the neck. The number of systems that our thyroid helps regulate truly is incredible, and an over or under-active thyroid can cause a whole host of acute and chronic issues. On the one hand, imagine a patient who has a thyroid history and is cold, weak, and has a depressed level of consciousness. Why is this occurring, and what's the diagnosis and treatment? On the other hand, imagine an anxious, hyperpyrexic patient in atrial fibrillation. Both patients have thyroid issues, but why do these patients present so differently? Let's see what happens when the scales tip either way for a few of the systems that the thyroid helps control!…

FOAMfrat Podcast

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Podcast 142 - EBM Guide To RSV w/ Natalie May 59:46

vor 4 years59:46

59:46

I reached out to @medtwitter asking for help finding a guest to talk about the respiratory syncytial virus (RSV). It may seem weird to be talking about RSV when everyone is thinking about the current pandemic, but I find the virology and mechanism of symptoms of RSV exciting. Twitter did not let me down, my friend Ashley Liebig recommended Natalie May from Sydney, HEMS. Natalie is an EM, and Pediatric-EM trained UK doctor working in Prehospital & Retrieval Medicine in Australia. I was very excited to have a chance to speak with Dr. May regarding RSV & Bronchiolitis and what the current evidence suggests for treatment.…

FOAMfrat Podcast

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Podcast 141 - Adrenal Emergency 44:52

vor 4 years44:52

44:52

A young pediatric patient is having nausea and vomiting at school and is said to not be 'staying awake very well.' You discover assessment findings such as hypotension, hypoglycemia, and maybe even peaked T waves on the ECG. You receive information indicating that the child has something called "CAH". Or, perhaps... An older patient is having dizziness upon standing, and persistent hypotension. You note a somewhat jaundiced appearance. They become unconscious in their kitchen while searching for a salty snack, and they appear rather sick. Or... A middle-aged patient has suddenly stopped taking their high-dose prednisone for their asthma and is now feeling very weak and cannot stand. We already know what this episode is about - adrenal insufficiency. However, what if those scenarios up above were in the form of a test question? Or worse yet, a real patient? Would we be aware of what's causing the signs and symptoms, and what the appropriate treatment is? Endocrinology does not get the respect it deserves in EMS, probably due to its low volume - we just do not see that many patients with endocrine emergencies outside of diabetes. Or do we, and we just don't notice?…

FOAMfrat Podcast

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Podcast 140 - "We Removed Nitro From Our STEMI Guideline" w/ Matt Schneider 50:05

vor 4 years50:05

50:05

In this episode, we talk with Matt Schneider, a Battalion Chief and Paramedic for the Mequon fire department in Ozaukee County. Sam and I had the privilege of sitting in on a guideline update presented by Matt a few weeks ago. One of the guidelines that caught our attention was the decision to remove nitroglycerin from the STEMI guideline. Listen in as Matt describes how their guideline committee arrived at this decision. "Matt's views, comments, and opinions expressed in this segment do not represent the position of his employer(s), or associated agencies/institutions".…

FOAMfrat Podcast

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Podcast 139 - Tracheostomy Management 37:24

vor 4 years37:24

37:24

Nothing is scarier than watching an awake patient struggle to breathe with a trach. Do you have an approach to troubleshoot? Make sure you watch to the end to see our first FOAMfrat reaction video!

FOAMfrat Podcast

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Podcast 138 - Bad & Bougie 31:07

vor 4 years31:07

31:07

In this episode, Tyler & Sam discuss everything you need to know about the Bougie. Traditional use Modified pre-loaded techniques Common pitfalls.

FOAMfrat Podcast

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Podcast 137 - Glucose (Outer Limits) 38:05

vor 4 years38:05

38:05

Welcome to the fourth and final installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond.

FOAMfrat Podcast

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Podcast 136 - Intranasal Delivery (or not) 20:46

vor 4 years20:46

20:46

One of my first calls as a paramedic was to our local ski hill for a 26-year-old guy who crashed into a tree while snowboarding. The ski patrol brought him down to the patrol room and we met them inside. The guy was literally screaming in pain and saying: "just put me out, man!" I could see his leg was obviously deformed below the knee. Now, this dude was covered in gear, and starting an IV was going to take a little while. I looked at my partner and remembered we had just got this new gadget that connects to the end of a syringe and lets you inject medication into someone's nose. It was called a mucosal atomizer device (MAD). I pulled up 100 mcg (2 ml) and gave 1 ml per nare. I told the guy that he would be feeling reeeeallll good anytime now. we waited.. and waited..…

FOAMfrat Podcast

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Podcast 135 - Renal Labs! (Outer Limits) 35:12

vor 4 years35:12

35:12

Welcome to the third installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond. Previously we've explored Cations ( located here ) and Anions ( located here ), but don't feel like you need to read these in any particular order. These blogs are meant as a reference for you to come back to. There's a lot of information in each, so they might be better absorbed in chunks. I'm writing these as the reference I wish I had when I started learning lab values. This week we're going to tackle the renal values on our chemistry panel! Renal physiology can be more than a little intimidating, but you're going to totally understand these labs by the time we're done! Because this renal section is a little different than the other sections, I'm going to start us off with a little refresher on the nephron, using a couple of illustrations.…

FOAMfrat Podcast

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Podcast 134 - When Gallbladders Attack w/ Cynthia Griffin 20:04

vor 4 years20:04

20:04

What does jaundiced skin, right upper quadrant pain, and a fever mean? In this episode, Dr. Cynthia Griffin and I discuss everything gallbladder and biliary colic! Check out the blog post here: https://www.foamfratblog.com/post/when-gall-bladders-attack

FOAMfrat Podcast

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Podcast 133 - Outer Limits: Anions 33:55

vor 4 years33:55

33:55

Welcome to the second installment of this metabolic panel series, where we're exploring what happens when various lab values reach their outer limits (or beyond). Each part in the series can be read on its own, but if you want to start at the beginning, go check out the first blog on cations HERE . This series of blogs and podcasts are meant as a reference for you to come back to. There is a lot of information on each one of the lab values we'll cover, so it might be best to read it in parts. As I mentioned in the last blog, I'm writing these as the reference that I wish I had when I started learning to interpret lab values. In this portion of the series we'll be discussing anions - the negative changes in the serum. We'll be starting off with chloride, which accounts for the majority of the negative charge in our blood!…

FOAMfrat Podcast

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Podcast 132 - Reversal Rehearsal "Warfarin" 22:43

vor 4 years22:43

22:43

In this episode, Sam and I discuss warfarin's mechanism of action and reversal. Check out the blog for more information! https://www.foamfratblog.com/post/podcast-132-reversal-rehearsal-warfarin

FOAMfrat Podcast

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Podcast 131- Outer Limits - Cations 24:38

vor 4 years24:38

24:38

Lab value interpretation sadly wasn't included in my initial paramedic education. I was absolutely ecstatic to attend a critical care program and learn about lab values - I had always found it very impressive when people could interpret lab values. I wanted to be a lab value wizard too! Unfortunately, in critical care class, our lectures and resources were nothing like what I had hoped for.I hope this series of blogs serve as a resource for those who are eager to learn more about the art of interpreting labs. I wouldn't recommend tackling this whole thing in one sitting ;) We'll be starting with the positive charges (cations) in this blog, then handling the other parts of the basic metabolic panel in weeks to come (negative charges, renal, and glucose). Before we get started, I want to get us in the right headspace for learning about lab values. This stuff is kind of dense, and there are a lot of different conditions that will cause lab values to reach their outer limits, or beyond. While I'll present a lot of information for each lab value abnormality, the theory of what's going on is far more important. Once you understand the theory of why a problem occurs, you can find a formula, calculator, or treatment guideline to get you the rest of the way. Now let's what happens when cations reach their outer limits!…

FOAMfrat Podcast

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Podcast 130 - Getting To Know The NREMT "Certification Questions" 52:27

vor 4 years52:27

52:27

200 comment Facebook post where I asked, "what questions would you like me to ask the NREMT?" These are the questions that seem to be the most popular. 200 comment Facebook post where I asked, \"what questions would you like me to ask the NREMT?\" These are the questions that seem to be the most popular.","type":"unstyled","depth":0,"inlineStyleRanges":[],"entityRanges":[],"data":{}}],"entityMap":{},"VERSION":"8.46.0"}"> 1. Besides reciprocity amongst select states, what is the benefit of maintaining your NREMT? 2. If I let my NREMT lapse, or never even got my NR, what is the process in order for me to get it back? 3. The hour requirements are broken down into general categories (i.e. trauma, cardiology, etc.), are the subcategories mandatory or suggested? 4. Do you ever see the instructor-led hour requirements coming back?…

FOAMfrat Podcast

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Podcast 129 - NoBull Gas Laws (Part Two!) 40:10

vor 4 years40:10

40:10

Welcome to round two! We'll be going over fewer laws than last time, but this will round things out nicely! We'll be covering the laws of Fick, Graham, and Dalton/Amagat. Mike Brown joins me again as we look at the clinical application of some lesser-known gas laws.

FOAMfrat Podcast

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Podcast 128 - Who Gets A Right-Sided ECG? w/ Dr. Stephen Smith & Tom Bouthillet 25:04

vor 4 years25:04

25:04

In this episode, Tyler interviews Tom Bouthillet and Dr. Stephen Smith on who exactly should get a right-sided ECG. Do not delay transport to PCI to grab a right-sided ECG. If you do decide to perform a right-sided ECG, it should not be for the decision on whether or not to give nitro. If time permits, it may be helpful and confirm your suspicions of RV involvement. Isolates RV infarcts are extremely rare. In EMT school, I was taught how to assist a patient taking their own nitroglycerin if they developed chest pain. I had to make sure they weren't on any phosphodiesterase inhibitors, grab a blood pressure, and make sure they took the right dose. We would obtain a 12 lead, but I had no clue what I was looking at, and my decision to give nitro was not based on any specific ECG finding. Fast-forward to paramedic school, and I am taught to ALWAYS perform a 12 lead before giving nitroglycerin. Why? Wellll If they had an inferior wall MI, nitroglycerin was a hard stop. Every time the student would give nitro before obtaining a 12 lead in simulation, their patients would code...Every. Time. I thought this was weird because patients were prescribed nitroglycerin if they developed chest pain at home. They were certainly not performing a 12 lead on themselves prior to doing this. So what was the fear? The Fear EMS is full of cautionary tales (as my buddy Brian Behn points out in this blog) . The fear of administering nitroglycerin to a patient with an inferior wall MI is the possibility of plummeting the blood pressure if there is right ventricular (RV) involvement. Because the RV is preload dependent, dropping preload with nitroglycerin could cause hypotension. This is probably a good place to say that the LV is preload dependent too, but the LV preload is dependent on the RV preload. So if you wipe out the RV, the LV follows. I believe the fear of nitro is probably healthy, but not for JUST inferior wall MIs. The benefit of sublingual nitro has yet to be proven (as Dr. Smith points out in the interview) and on top of that, a study published in Prehospital Emergency Care in 2015 found that h ypotension occurred post-NTG in 38/466 inferior STEMIs and 30/339 non-inferior STEMIs, 8.2% vs. 8.9%, p = 0.73. That means it makes literally no difference where the MI is.…

FOAMfrat Podcast

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Podcast 127 - Boyle's and Henry's Law! Gas Laws Explained 38:46

vor 4 years38:46

38:46

We've been exposed to gas laws our whole life, and we have intuition about what will happen to gas under certain conditions. For example, people notice that the pressure in their tires might become low on a very cold day. Or perhaps you've been at very high altitudes and you've been short of breath. And everyone knows that if you shake a carbonated beverage before opening it you'll be cleaning up a mess very shortly. Each of these observations has been classified into the laws, and we'll be splitting them up between this blog and the next. Stating the laws is one thing - anyone with google can copy and paste their definitions. However, we have a special interest in these laws as medical professionals because we deal with them on a different level. Sometimes we're manipulating these gas laws on purpose, and other times we're dealing with their side effects. Or perhaps we're just trying to pass our FP-C, CCP-C, or CFRN exam ;) Let's dive (pun intended) right in!…

FOAMfrat Podcast

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Podcast 126 - ECMO Physiology 36:34

vor 4 years36:34

36:34

The concept of taking blood out of the body, oxygenating it, removing the CO2, and then putting back in, fascinates me. A few years ago I admittedly knew very little about extracorporeal membrane oxygenation (ECMO) and its indications. I remember going to a class on ECMO at Life Link III and having questions like: Are we actually pumping blood backward through the body? What happens to the blood in the heart when using ECMO in cardiac arrest (ECPR)? What kind of vent settings should I use? I am by no means an expert on ECMO, in fact, I have only been on a handful of ECMO transports, but the concept fascinates me and I thought a blog breaking down a few concepts of ECMO physiology would be beneficial.…

FOAMfrat Podcast

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Podcast 125 - For Those Who Play With Fire 33:18

vor 4 years33:18

33:18

Before the July 4th weekend hits, I wanted to address two main questions whose answers may come in handy on a call you'll run very soon... Should EMS use a burn formula? What's the best way to manage pain for the burn patient? For a sense of a well-rounded blog on burns, I've included some quick facts about burn care at the end that are unrelated to these questions. Also, Erik Rima (CFRN and former burn center RN) left us his perspective at the end in a peer review. Be sure to check those out before you leave! Alright, on to question number one... should EMS even bother with a burn formula?…

FOAMfrat Podcast

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Podcast 124 - Arterial Line Placement in Critical Care Transport w/ Michael Lauria 50:29

vor 4 years50:29

50:29

Invasive arterial blood pressure (IABP) monitoring techniques have enjoyed a rich history of use throughout the mid-to-late 20th century in the peri-operative setting and are now a standard of care intensive care units. While there are a variety of IABP monitoring options, one of the most common techniques is percutaneous radial arterial catheterization. Although monitoring of radial arterial lines is a widely accepted skill in the critical care transport (CCT) world, placement by CCT providers is less common. Concerns over safety and logistical management have contributed to the perceived difficulty in arterial lines; however, this article aims to demonstrate that arterial lines can be placed safely and effectively in the pre-hospital setting. www.foamfrat.com…

FOAMfrat Podcast

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Podcast 123 - The Anion (figurative) Gap 22:50

vor 4 years22:50

22:50

Ok, here's the thing.. there really is no anion gap. We pretend there is because the things we routinely measure leave something to be desired on the anion side. Sam put out a killer blog and this is a follow-up conversation. Enjoy!

FOAMfrat Podcast

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Podcast 122 - Ultrasound-Guided Pacing w/ Leon Eydelman 48:42

vor 4 years48:42

48:42

Traditionally transcutaneous pacing involves a paramedic placing pads anterior/posterior (preferred), and turning up the milliamps until electrical capture is obtained. Electrical capture is obtained when a pacing spike is followed by a wide complex. The clinician will then try to palpate a pulse to confirm mechanical capture. Because the contractions of the pectoral muscles can tug on the muscles of the neck as well, AHA recommends palpating a femoral pulse versus a carotid (3) to avoid thinking you feel a pulse (false mechanical capture). Not only are events of false capture common, but there are even situations in which the paramedic swears they feel a pulse and observes the patient becoming more alert, and they never had mechanical capture. I believe most of us are using SPO2 pleth wave to confirm mechanical capture versus the subjectivity of palpating a pulse, but even patients with a pulse can have poor pleth wave readings. I believe ultrasound-guided pacing is ideal and should become mainstream. I typically find I can get a parasternal long view on ultrasound with the pads placed as illustrated below. However, there are other views if your pad sweet spot is obstructing where you wanna put the probe. This is nothing profound and is definitely not a new concept in emergency medicine. It is however a new concept for paramedics and another feather in the cap of prehospital ultrasound. This is a conversation between myself and Dr. Eydelman discussing this topic. Enjoy!…

FOAMfrat Podcast

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Podcast 121- The Curve & Airway Management 36:31

vor 4 years36:31

36:31

A few months ago Sam published a blog on the oxyhemoglobin dissociation curve. If you haven't checked it out I highly recommend reading that before listening to us discuss what this curve teaches us about airway management.

FOAMfrat Podcast

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Podcast 120 - The Mystery of Optimal PEEP 34:17

vor 4 years34:17

34:17

My buddy Bryan Winchell and I sit down and record a conversation about PEEP. We have way more questions than answers, but here's some shop talk on what we are currently doing to optimize PEEP. Check out the full blog and show notes at FOAMfrat.com

FOAMfrat Podcast

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Podcast 119 - Paramedic's Guide To Left Ventricular Function 32:03

vor 4 years32:03

32:03

If I give this patient a fluid bolus, will it increase cardiac output? What does wall tension have to do with myocardial oxygen demand? In this episode, we will give you a step-by-step guide into assessing LV function utilizing pulse pressure and ultrasound. FOAMfrat is an online library for EMS professionals who are looking to take their knowledge and skills to the next level. www.foamfrat.com…

FOAMfrat Podcast

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Podcast 118 - Obstetric Ultrasound w/ Cynthia Griffin 15:37

vor 4 years15:37

15:37

Anne keeps asking "is my baby ok?!" There may be some momentum to just break out the ultrasound and look for a fetal heart rate right now, but you know that taking care of mom means taking care of the baby. In this episode, Cynthia and I discuss the prehospital fetal assessment and how to communicate with mom what you see. www.foamfrat.com…

FOAMfrat Podcast

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Podcast 117 - Jumping The Gun - WPW and Adenosine? 25:38

vor 4 years25:38

25:38

WPW is an incredibly interesting disease process that can initially cause some trepidation on the part of the clinician due to the perceived nuance of treatment. However, we might just be psyching ourselves out a little bit. Check out Sam & Tyler as they break down the dos and don'ts of WPW management. www.foamfrat.com…

FOAMfrat Podcast

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Podcast 116 - Pulmonary Embolism (Clinical Signs) 35:22

vor 4 years35:22

35:22

In this episode, Sam and I break down the different clinical signs and diagnostics of the dreaded pulmonary embolism. Make sure you check out the show notes at foamfrat.com for references and videos mentioned throughout the episode!

FOAMfrat Podcast

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Podcast 115 - Prolonged Q-T Syndrome w/ Jake Good 39:06

vor 4 years39:06

39:06

Yesterday Sam released a blog on the various flavors of prolonged Q-T syndrome. As a complement to that blog, Sam and Jake sit down and tease out some of the nuances and treatments of this interesting pathology.

FOAMfrat Podcast

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Podcast 114 - Vent Strategies & Metabolic Acidosis w/ Bryan Winchell 33:10

vor 4 years33:10

33:10

Yesterday I posted the blog "Ventilation - Playing Defense." The blog addressed the reasons why we don't want to intubate a patient in metabolic acidosis, the correlation between VBG & ABG, and the importance of knowing your ETCO2 to PaCO2 gradient. In part two of this discussion (the podcast), Sam and I invite Bryan Winchell on to discuss the logistics of actually setting up the ventilator and settings that we think are helpful. 1. Optimize volume first and then take advantage of the "no-flow" zone to add in breaths. 2. The width of your flow waveform will tell you whether or not more inspiratory time will = more volume. 3.These patients typically don't need a ton of PEEP because they are spending such a short time exhaling (due to the fast rate). PEEP of zero is probably ok because the pressure will likely never truly get to zero. If a PEEP of zero gives you visceral pain, 3-5 mmHg is a good spot to start.…

FOAMfrat Podcast

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Podcast 113- DON'T stop the insulin! 43:36

vor 4 years43:36

43:36

We realized the other day that we have yet to do a podcast on diabetic ketoacidosis (DKA). In this episode, we spend a little bit of time talking about the pathophysiology, but the majority is focused on the logistics of running a DKA transfer. Here are the highlights: DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. The way you do this safely is by pre-planning! Ask for these things before you leave the hospital: IV Potassium Liter bag of D5W Bag of lactated ringers Three amps of sodium bicarbonate (if renal failure is suspected)…

FOAMfrat Podcast

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Podcast 112 - When Mental Models #FAIL w/ Tom Grawey & Bryan Selvage 49:41

vor 4 years49:41

49:41

So, my buddy, Bryan Selvage released a blog a few weeks ago called "The Curious Case of The Brain & The Octopus Trap." This case study caught me off guard because it did not match my mental model of a brain bleed patient. I called Bryan and had a great conversation regarding mental models and how they can either make us look like we have superhuman powers or trip us up. Bryan started working on a blog to address the perils of mental models at the same time my friend Tom Grawey was writing a piece for FOAMfrat on the "sick versus not sick" assessment. Both of the blogs complimented each other perfectly and I figured we could do a podcast and release both blogs as a package.…

FOAMfrat Podcast

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Podcast 111 - How We Peer Review w/ Eric Bauer & Chris Smetana 1:02:59

vor 5 years1:02:59

1:02:59

In this podcast, Sam and discuss the evolution of FOAMed peer review with Chris Smetana and Eric Bauer. Eric is the founder of FlightbridgeED which was one of the first EMS podcasts to surface and quickly became a hit. The FlightbridgeED brand now has grown into one of the industries household names when it comes to providing resources and training for flight clinicians all over the world. You can find their content at FlightbridgeED.com Chris Smetana is the CEO of IA Med and a known leader within the industry. The IA Med team prides itself on meeting the needs of the industry and collaborating to improve the EMS profession. You can find their content at IAMED.US. Topics discussed: What is the process from inception to publishing, when it comes to your brands content? Traditional and modified peer review techniques. The art of critique and feedback Reducing noise from social media posts.…

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