Podcasts

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May 20, 2024
In this 3rd part of our discussion of field termination of care and DOA situations, the crew and Dr. Spaner talk about the Do Not Resuscitation situations. DNR does NOT mean do NOTHING! Anything that gives the patient comfort can be utilized on a patient under a DNR order.

Click below to listen to our podcast on our audio player or click the image on the right to watch us on YouTube

May 13, 2024
The discussion of EMS field termination of care and DOA situations continues with Dr. Don Spaner. More actual cases are discussed as peer review including BLS termination of care. "When in doubt, start resuscitation." Also, part of the profession of being an EMS provider is learning how to discuss field termination of care with the family on scene.

Click below to listen to our podcast on our audio player or click the image on the right to watch us on YouTube

May 6, 2024
The team gathers with Dr. Donald Spaner joins for a discussion of field termination and DOA situations. This discussion includes a review of actual cases as a peer review. Part 1, what the medical control physician is looking to hear from the field provider's report.

Click below to listen to our podcast on our audio player or click the image on the right to watch us on YouTube

April 29, 2024
As you already know, in the months when we have a 5th Monday, we have an extra airway series episode. This month, the team is talking blind-insertion airways. Interesting note, even anesthesia prefer a supraglottic airway device over intubation in short cases. Be sure to head to our Prehospital Paradigm Podcast YouTube channel to see the team demonstrate each of the skills discussed on this extra episode.
April 23, 2024
The podcast is on the road at Kent Fire Department. Dr. Stephanie Gaines and Jennifer Moreland, RN and Sexual Assault Nurse Examiner (SANE), hit the road with us to go live!
April 15, 2024
As an EMS provider, what is the proper language with which to approach a possible domestic violence or sexual assault? The crew also discusses situations that may be 'hot" situations of active violence as the crew determines once on scene. The crew needs to have an excellent sense of intuition in these cases.
April 8, 2024
This part of the discussion reviews what happens when your intuition is telling you to suspect a domestic violence situation but the patient doesn't seem to want to participate in that conversation?
April 1, 2024
This month we are joined by Dr. Stephanie Gaines and Jennifer Moreland, RN and Sexual Assault Nurse Examiner (SANE), to overview sexual assault cases and the appropriate responses.
In 2021, Dr. Stephanie Gaines was appointed as the Inaugural Director of the Blair Dickey-White Sexual Assault Survivor Program, formally known as the Adult Sexual Assault Nurse Examiner (SANE) Program. This endowment was funded by our beloved attending Dr. Howard Dickey-White and his wife, Linda, in memory of their daughter Blair.
March 25, 2024
This is the final part of our "Psychiatric Emergencies" episode. We discuss psychiatric emergencies and even address physical vs. chemical restraint with Dr. Jordan Singer. We recorded live at the Richfield Fire Department.
March 18, 2024
When alcohol and substance abuse is involved, it can make the difficult to judge the patient's capacity to refuse treatment. By the way, dementia itself does not steal a patient's capacity to refuse treatment. When does the POA decision overrule the patient's decision? The crew also goes through a number of real-life scenarios to help bring this topic full circle.
March 11, 2024
The topic of soft restraints starts this episode with our guest Dr. Singer. No need to "MacGyver" some type of soft restraints. If you do any restraining, restrain all 4 points. A goal of restraining would be to minimize the patient's chance of injury but maximize proper ventilation.
March 4, 2024
This month, we talk about psychiatric emergencies. We even address physical vs. chemical restraint and actual cases with Dr. Jordan Singer who is back with us for the third time.
February 27, 2024
We were live from the Bainbridge Fire Department this month taking your calls and your questions to close out the STEMI review!
February 19, 2024
When you're making decisions with STEMI patients, in the lab, there are a number of considerations. The patient's previous cardiac history and current condition is taken into consideration. When you're making decisions on cath labs, there's also information you need... can the facility perform open heart surgery? By the way, visualizing the actual clogged artery with multi-view X-rays and contrast dye is extremely helpful in the treatment and diagnosis process.
February 12, 2024
Our two guests, Dr. Greg Stefano Interventional Cardiologist and Geoffrey Patty, Chest Pain Coordinator, with the UH Harrington Heart and Vascular Institute, are still with us talking about patients experiencing out-of-hospital STEMI situations. STEMIs can be confusing but, taking the assessment one step at a time and not being shy about activating a STEMI team is crucial.
February 5, 2024
Two special guests join us this month to talk about STEMI assessment, recognition, treatment and in-hospital treatment. Thanks to Dr. Greg Stefano Interventional Cardiologist and Geoffrey Patty, Chest Pain Coordinator, with the UH Harrington Heart and Vascular Institute, for joining us to talk about STEMI cases.
January 29, 2024
All of our Extra Monday Episodes in '24 are dedicated to airway and ventilation topics. Part 1, we talk about the basics, BVM, capnography, bougie and how prepared you are to use these tools. There are many tools.. back-ups to the back-ups but when is the last time, on your shift that you practiced each of them.
January 22, 2024
Dr. Jordan Singer rejoins the team to talk about CPR and ROSC care. In the pre-recorded parts we talked about refractory VF, subglottic airways vs. endotracheal intubation, being near a tertiary center vs. being in a rural setting, LVAD, pacemakers, traumas, and Lucas devices. New for this year we will be streaming from various EMS agencies under UH medical control and at a new later time. Thanks to Avon Fire Department for being the first to host the podcast.
January 15, 2024
It's ROSC rapid fire question time with Dr. Singer.. LVAD, pacemakers, traumas and Lucas devices. This part moves quickly!
January 8, 2024
The ROSC discussion continues and it's a mixed bag including a discussion of the use of Esmolol, refractory VF, and the use of subglottic airways vs. endotracheal intubation. Being near a tertiary center vs. being in a rural setting is also included.
January 1, 2024
Dr. Jordan Singer rejoins the team to talk about ROSC care. For part 1, the discussion focuses on good on-scene decisions and care that are the initial step to ROSC care.
December 18, 2023
Ray, Scott, Caleb and Dr. Hill continue the discussion of grab bag topics to end the year!
December 11, 2023
Ray, Scott, Caleb and Dr. Hill continue the discussion of analgesics, specifically Toradol, and then move on to the patient assessment considerations on administering pain control meds.
December 4, 2023
To end '23, we are answering your random questions. The gang is together literally pulling questions randomly and answering them. In Part 1, the question of RSI being a standard protocol is reviewed as well as a review of the various analgesic agents.
November 27, 2023
Dr. John Hill joins us to discuss Shock and all the different levels and types of shock. Anticipating shock helps to keep you ahead of the curve, but is it always done? "Patients don't suddenly deteriorate. Healthcare providers suddenly notice." Participants joined us live with their questions.
November 20, 2023
An epi pen owned by the patient may actually be helpful in the resuscitation of a patient experiencing anaphylactic shock. There's also a discussion around the thought, "Patients don't suddenly deteriorate. Healthcare providers suddenly notice." A cardiogenic shock discussion then winds up the episode.
November 13, 2023
Anticipating shock helps to keep you ahead of the curve. Sure, it sounds apparent but, is it truly done? Then we move into one of the rare types of shock, neurogenic and anaphylaxis.
November 6, 2023
Dr. Donald Spaner sits in with us for the month of November to talk all of the levels and types of shock. There's a lot to unpack in this episode! Assessment, prevention and treatment of:
  • Cardiogenic shock
  • Hypovolemic shock
  • Anaphylactic shock
  • Septic shock
  • Neurogenic shock
  • Distributive shock
October 31, 2023
Dr. Hill, Scott, Ray and Caleb gather together to talk about some random peds, protocol, drug administration and airway notes from the previous episodes. Heparin administration is the opening chat then we move into airway evaluation, using protocols and helpful items like Broselow tapes. We even through in some documentation for refusal tips!
October 24, 2023
Dr. Regina Yaskey joins us to discuss pediatric emergencies. Everyone knows that pediatric patients are not small adults. Dr Yaskey talks about the intricacies of assessing and treating pediatric patients. We talk about the pediatric assessment triangle, advanced airways, simple practices that have great impact, common and not-so-common calls, as well as red flags for abuse and weight-appropriate restraints for kids. Join us and ask us all your questions.
October 16, 2023
In part 3 of our pediatric discussion with Dr. Yaskey, we review various pediatric cases from which we can learn. The discussion includes pharmacology for airway issues, child protective services and how pediatric trauma is different from adult trauma.
October 9, 2023
The gang and Dr. Yaskey talk about a multitude of pediatrics skills, treatments and hacks! From anaphylaxis, to cuff or no-cuff on the endo tube to seizures and determining weight and drug dosages.
October 2, 2023
This month we meet Regina Yaskey, MD who has a specialty in pediatric emergency medicine as well as disaster medicine. In part 1, the talk is about the basics... the need for proper equipment and protocols as well as a state of mind.... confidence.
September 27, 2023
Jon Cameron, Paramedic / EMS Data Management Specialist joins us for a discussion on documentation and helping to tell the patient's story and report the care you provide. We discuss medical-legal issues, correct recording of treatments and medications, what to write in your narrative, when and how to call medical control, prehospital notifications, and bedside report. Join us and ask us all your questions.
September 18, 2023
When calling med control, making hospital notifications and at bedside, your communication needs to be effective.. succinct, informative and organized. Good documentation follows. What can be helpful in the future, is to stay at the E.D. and ask questions or, on a later call do follow-up. Remember, we're a team.
September 11, 2023
Jon Cameron, EMT-P / EMS Data Management Specialist are talking more about documentation. Remember this phrase from all documentation presentation's? It is soooooooooooo true! And, while we all have access to the latest technology... such as automated documentation and data transfer security for you ePCR.
September 4, 2023
As we start talking about documentation, let's get the correct mindset. Writing a great chart every time is how you tell your story. Sure, medicolegally, there are implications to charting but think of writing a great chart as how you're passing along your story.. your patient treatment so that those on the rest of the treatment continuum can plan and treat appropriately.
August 31, 2023
The panel takes your sports medicine questions live on Facebook and YouTube.
August 21, 2023
The First Response for Sports Trauma Course (FRST) is discussed. This is not a course about orthopedic injuries, etc. It is designed to provide first responders with the skills required to recognize, treat and transport athletes who become ill or suffer traumatic injury during sporting events, for conditions including cardiac arrest, heart arrhythmias, concussion, spinal injuries and heat-related illnesses.
What's discussed? The need for AEDs, coaches training to recognize when to call 911, the AED in 3 Challenge for high schools, access to emergency access plans, immobilization and more!
August 14, 2023
Dr. Robert Flannery from the UH Drusinsky Sports Medicine Institute is still with us. We discuss being on the same page with the team trainers and event medical team... especially when talking about hyperthermia in athletes. The decision point is, transport or stay-and-play.... in ICE!.
August 7, 2023
This episode, we are doing a deep dive into the concept of sport medicine, i.e. it is more than orthopedic issues. Dr. Robert Flannery from the UH Drusinsky Sports Medicine Institute is with us for this 4 part series.
July 31, 2023
Just like May, July has 5 Mondays which gives us a chance to offer up an extra episode of the Prehospital Paradigm Podcast. We're going over a few protocol updates, talking steroids and dextrose concentrations. It's a practical review of some drug box items.
July 24, 2023
This month Dr. Ross Campensa from Aultman Hospital joined us for a discussion on new innovations in resuscitation and a look at what Green City Fire Department is doing with Heads Up CPR.
July 17, 2023
The crew, still with Dr. Ross Campensa from Aultman Hospital, continues to reimagine CPR and resuscitation methods including re-thinking the equipment preparation and organization. So much of the re-thinking is “basic”.
July 10, 2023
Dr. Ross Campensa continues the discussion of re-thinking CPR techniques including the Lucas Device, rescue pumps, etc. The Aultman EMS crews actually did story boards regarding various CPR scenarios.
July 3, 2023
Dr. Ross Campensa from Aultman Hospital joined the crew. Aultman is part of designing a complete HDS, health delivery system with UH joint ventures. This episode, we discuss the evolution of heads up CPR and compression techniques.
June 26, 2023
Joe Schuerger and Brad Wilson joining Scott Wildenheim and Ray Pace for our live show discussing Tactical Medicine and answering your question. The group talks about Tactical Emergency Casualty Care (TECC) and how we teach and train with paramedics and law enforcement on SWAT teams with realistic role players and bleeding control trainers. Joe and Brad touch on counterfeit tourniquets and warn providers about these counterfeit products. Check out their website at https://www.prehospitalparadigm.com/tacmed
June 19, 2023
What wounds get packed? What wounds do not get packed? What about airway control on scene? We pull everything together in this episode including real-life "hacks" for patient treatment on scene.
June 12, 2023
The group continues the discussion of how tactical medicine, as a specialty, is different from everyday EMS. The discussion starts with the an updated rapid assessment mnemonic MARCH in place of ABCs.
June 5, 2023
Dr. Tony Daher and Joe Schuerger join Ray and Scott to discuss tactical medicine which has evolved over the years mainly due to the number of active shooter events.
May 29, 2023
May has 5 Mondays which gives us a chance to offer up an extra episode of the Prehospital Paradigm Podcast. We take this episode to talk about the types of strokes, treatment, decisions on transport to destination other appropriate in-field treatment as per protocol.
May 23, 2023
This month, Dr. Jordan Singer, from UH Elyria, joins us for a discussion on how to treat drug and cardiotoxic ingestions, excited delirium, and more about the drug box.
May 15, 2023
The thoughts behind the change of the protocol. The most important thought – simplification! Speaking of simplification, wave-form capnography simplifies intubation confirmation.
May 8, 2023
Now referred to hyperactive delirium with severe agitation, is part of the discussion. These patients are high risk for sudden cardiac emergencies but what can we do to “restrain” them?
May 1, 2023
This month, Dr. Jordan Singer, from Elyria, joins the group for a discussion about toxicology as it pertains to items that we carry in our EMS drug box.
April 25, 2023
This is part 4 of our discussion regarding the resuscitation of a Streetsboro Fire Department member.
April 17, 2023
Scott, Tyler, Dr. Hill and Chris all reflect on being a survivor of various injuries and sudden events. Thankfully, due to the resuscitation team and process, Chris has a chance to say “thank you” to all of those whom have reached out to him.
April 10, 2023
Ketamine makes it back into our podcast discussion. Our patient, Chris, reflects on his resuscitation while our hosts, Dr. Hill and Scott talk through the resuscitation process.
April 3, 2023
Early this year, one of our own suffered a sudden cardiac arrest and his peers had to respond. Thankfully, you will meet Chris Fredmonsky of the Streetsboro Fire Department, the survivor and hear his side of the resuscitation story.
March 28, 2023
Great questions and interaction with the live audience during this live recap of Ketamine. Dr. Don Spaner, Scott Wildenheim, Ray Pace, and Caleb Feronni chatted and took questions about Ketamine, Epinephrine, TXA and more!
March 20, 2023
Continuing the drug box discussion, the crew discussed the clinical math, preparation, and dosages of various drugs including Zofran, Epi, and Dilaudid. This is a great episode to watch on our YouTube channel. Med UPDATES: The new ADULT dosing is to mix 2 grams (2000 mg) in 100 ml of D5 and administer that dose over 10 minutes and Push Dose Epi can be given up to 50 mcg per dose prn.
March 13, 2023
A practical review of Ketamine. What’s in the protocol? Can we use it on patients that have serious medical or traumatic emergencies but also have excited emotional issues? The crew explains their practical knowledge of prepping Ketamine in the field.
March 6, 2023
Ketamine has received some “bad press”. Is it as volatile as it’s current reputation in the ED and the field? Why is it getting so much attention, how do we calm the discussion, and feel more comfortable with it's use?
January 30, 2023
This episode is the recap of our CPAP discussion. It's a practical discussion regarding the use of CPAP according to the UHEMS protocols. Thank you to all who participated as part of the live, virtual audience.
January 23, 2023
Using CPAP, what is the biggest risk? The risks are situationally dependent. What about usage with patients experiencing hypotension? The use of CPAP can be helpful to the patient's longterm care given that fact that there will be less complications from more extensive therapy such as intubation.
January 16, 2023
Using CPAP contraindications, running lights and sirens from a scene vs taking care of a patient in the appropriate manner. It's an EMT-level skill that can make a huge difference in the patient's longterm care.
January 9, 2023
How do we make people not afraid of the cpap machine? CPAP is easy to use and a great patient therapy. This episode is intended to help all feel more comfortable with its use.