最高の Flightnurse ポッドキャスト (2024)

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Episode 123 - To Treat or Not to Treat: Hypertension 1:00:03

9d ago1:00:03

1:00:03

It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than focusing on the patient in front of them. Asymptomatic hypertension, in particular, is often benign. In fact, treating asymptomatic hypertension in a patient who a primary medical history of hypertens…

1
Episode 122 - Stay Positive When Preoxygenating (PREOXI Trial) 1:01:23

1M ago1:01:23

1:01:23

The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI). In the PREOXI Trial, the authors pushe…

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Episode 121 - Outside the Box: Cardiac Arrest Management 46:51

2M ago46:51

46:51

Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailored interventions beyond "blanket" protocol and ACLS/PALS algorithms. When refractory to conventional therapy, the pulseless V-Tach/V-Fib patient, in particular, requires critical thinking "outside the …

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Episode 120 - Sorry, We Are Closed: Interfacility Transfers w/Austin Wingate 1:04:17

4M ago1:04:17

1:04:17

Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformation or a lack of advocacy by the transport agency, these transfers can result in unnecessary risk for crew members and patients. Specifically, weather conditions, time of day, crew fatigue, and other i…

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Episode 119 - Losses and Gains: Antidiuretic Hormone 43:50

6M ago43:50

43:50

Antidiuretic hormone (ADH) plays an essential part in the body's osmotic/fluid balance, sodium homeostasis, and blood pressure regulation. This hormone is synthesized in the hypothalamus and released from the posterior pituitary gland. In conditions such as Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH), there is a lack of synthe…

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Episode 118 - Trigger Warning: Angioedema 46:54

7M ago46:54

46:54

Angioedema is defined by upper airway swelling secondary to an immune response. The trigger and subsequent physiological response are how we categorize it. In this podcast, we discuss how to diagnose and treat both types: IgE/Histamine-mediated and Bradykinin-mediated. We also touch on how to address the difficult airway that may or may not lead to…

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Episode 117 - Dye or Die: Methylene Blue w/Will Heuser 50:56

8M ago50:56

50:56

When discussing methylene blue, management and treatment of methaemoglobinaemia is usually the first indication mentioned. But in this podcast, we challenge you to increase the size of your lense and focus on its benefits in other states (e.g., septic shock). Of course, we could not do this alone, so we invited a Flight Paramedic, Pharmacist, Toxic…

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Episode 116 - Around the World: HEMS in México w/Daniel Peñaflor 58:23

9M ago58:23

58:23

Though we have delved into foreign HEMS systems in the past (See Episode 61 – Down Under Dynamics w/Dr. Cliff Reid), we have not dedicated an entire series to it. Having now rubbed shoulders with many clinicians and operators around the world, it is evident that these conversations need to take place on a regular basis. Why? Because operating in a …

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Episode 115 - Me, My Self-Loading Baggage, and I w/Miles Dunagan and Brett Reeder 1:06:59

11M ago1:06:59

1:06:59

"Self-loading baggage" is a derogatory term often used by pilots to describe lazy or disengaged medical crew members in the air medical industry. Whether intentional or not, this behavior sets a bad precedent for those of us that want to embrace aviation cross-training and be able to assist the pilot effectively. In this podcast episode, we are joi…

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Episode 114 - You Train Ukraine w/Kevin Collopy and Brock Jenkins 37:09

11M ago37:09

37:09

The Russo-Ukrainian War is an ongoing international conflict between Russia and Ukraine. At times such as these, medical training is essential and sometimes required of laypersons. International Medical Corps partnered with the Harvard Humanitarian Initiative (HHI) to provide comprehensive emergency and trauma care training to healthcare workers, p…

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Episode 113 - Being B.R.A.S.H. When Treating Bradycardia w/Dr. Kate Connelly and Jake Miller 30:45

12M ago30:45

30:45

B.R.A.S.H. Syndrome is a phenomenon with a constellation of Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia requiring identification and management in the prehospital and transport setting. In this podcast episode, live from AMTC23, we discuss the pathophysiology of BRASH Syndrome, highlighting the synergy between its compone…

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Episode 112 – Acid Base Trifecta (Presentation) 56:03

1y ago56:03

56:03

Dan presented the talk “Metabolic Acidosis: The Eye Can Only See What the Mind Can Comprehend” at AMTC23. In this recording, he teaches you how to identify the prevalence of acid-base disorders including triple disturbances, how to calculate anion gap and determine the etiology of the gap, and how to identify adequacy of compensation for a primary …

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Episode 111 - Critical Comfort Care w/Brianna Fields 47:52

1y ago47:52

47:52

As a critical care clinician, do you consider yourself well-versed in comfort care? Do you consider yourself well-rehearsed in having the discussions leading up to the patient's or family's decision to implement it? This concept may be outside your comfort zone, especially if you work in emergency medicine. But the fact of the matter is, from the p…

1
Episode 110 - The Truth About A-Fib 43:49

1y ago43:49

43:49

Atrial fibrillation, particularly A-Fib with RVR (Rapid Ventricular Response), is often an emergency requiring emergent intervention beyond ACLS and its associated algorithms. Identification of A-Fib can be challenging in itself, much less trying to determine what intervention(s) are indicated. This includes chemical and/or electrical cardioversion…

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Episode 109 - 10 Things Your Gastroenterologist Wants You to Know w/Dr. Josh Peck 46:55

1y ago46:55

46:55

Continuing our "10 Things" series, we focus our attention on gastroenterology. GE/GI goes well beyond colorectal. From bleeding esophageal varices to pancreatitis to liver failure, these patients require specific diagnostics and interventions to improve their mortality and morbidity. Join us for a "pearl packed" episode where we discuss practical s…

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Episode 108 - 10 Things Your PEM Physician Wants You to Know w/Dr. Dominique Diggs 1:19:00

1+ y ago1:19:00

1:19:00

Pediatric Emergency Medicine (PEM) is a sub-speciality that many clinicians find intimidating. Are pediatric patients truly unique or are they simply "little adults"? In this podcast episode, we are joined by Dr. Dominique Diggs, board certified PEM physician, to demystify pediatric emergency care with 10 tips that will help you the next time you c…

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Episode 107 - Vascular Disaster 1:01:50

1+ y ago1:01:50

1:01:50

Vascular emergencies refer to any time-sensitive condition where perfusion is prevented secondary to bleeding or occlusion of a vessel. These can include, but is not limited to, the superior mesenteric artery (SMA) and aorta. And depending on the severity of the aneurysm or embolism/thrombus, downstream ischemia can significantly impact a patient's…

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Episode 106 - Breaking the Case (Pt. 2) 45:39

1+ y ago45:39

45:39

Reviewing case studies with trusted colleagues can be extremely beneficial. Not only does it provide a moment of reflection on actions taken, but it also provides different approaches that may be applicable to future scenarios. Occasionally we like to challenge each other, and this episode is no exception. Tune in as Amanda, Dan, and Mike present t…

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Episode 105 - 10 Things Your Emergency Physician Wants You to Know 1:02:54

1+ y ago1:02:54

1:02:54

Have you ever handed off to an ER doctor, and you felt they were displeased with your care? Have you ever received an order from an ER doctor, and you didn't quite understand why? In this podcast episode, we continue our "10 Things" series with a focus on the emergency department. Our very own Dr. Amanda Humphries, Emergency Physician and Assistant…

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Episode 104 - OMI, I Almost Died 37:55

1+ y ago37:55

37:55

Myocardial infarctions can present in a variety of ways depending on vessel involvement, timing of pathology, and interpretation of diagnostics (e.g., 12-lead EKG). Unfortunately, not every patient with a myocardial infarction will fit STEMI criteria's paradigm, which has lead to the adoption of a new term: OMI (Occlusion Myocardial Infarction). In…

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Episode 103 - Arrest, ROSC, Repeat 52:49

1+ y ago52:49

52:49

No matter what level of scope, management of medical and traumatic cardiac arrests is the focus of many clinicians. But what happens after return of spontaneous circulation (ROSC) is achieved? Many do not appreciate the fact that the likeliness of re-arrest is high. How can we avoid return of spontaneous arrest by appropriately treating the patient…

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Episode 102 - Long and Short of Learning w/Will Wingfield 56:01

2y ago56:01

56:01

The medical industry puts great emphasis on formal education via university and other training programs. Due to financial incentive, these institutions often discourage independent learning despite it usually having a greater impact on patient care quality. For example, paramedics are often non-degree holders, yet they effectively practice medicine…

1
Episode 101 - Anti-Antibiotics 36:23

2y ago36:23

36:23

Whether it's antibiotic-resistant "super bugs" or administration prior to acquiring blood cultures, empirical use of antibiotics is controversial. Should we be administering antibiotics in the prehospital environment for open long bone fractures and/or sepsis? When are antibiotics truly indicated? And is that more important than the timing of the a…

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Episode 100 - Medical Science Theater 100 55:49

2y ago55:49

55:49

It's not clinical. It's not non-clinical, really. Celebrating our 100th full podcast episode, Bryan and Mike sit down in a Mystery Science Theater 3000 format and make fun of our 1st episodes ever. If you're looking for some light-hearted entertainment including a reflection of how far the platform as come, this is the podcast for you. And one last…

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Episode 99 - A Survivor's Story w/Jonathan Godfrey and Chris Stevenson 1:03:45

2y ago1:03:45

1:03:45

Based on the Crash and Learn 2022 special feature presentation, we sit down with Jonathan Godfrey and Chris Stevenson to discuss the EMS helicopter crash that had a dramatic effect on both of their lives. Jonathan is the sole survivor of a 3-person crew, and Chris was part of his leadership team at the time of the incident. We carefully examine bot…

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Episode 98 - Ups and Lows of GI Bleeds 44:33

2y ago44:33

44:33

Gastrointestinal hemorrhages can present in a variety of ways from a variety of sources. Bleeding esophageal varices, in particular, can be life-threatening. How do we manage these patients? When is it appropriate to establish an advanced airway? Are gastrointestinal tubes contraindicated even though the patient is vomiting? And what do we do when …

1
Episode 97 - How Do You Copy 1:14:35

2y ago1:14:35

1:14:35

Whether it's radio or bedside reporting, communication is a requirement of safely handing off patients. How do we build confidence in our ability to communicate about our patients? How do we develop qualities such as professionalism, accuracy, and conciseness that are essential to our reports? And if we experience interpersonal conflict, how do we …

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Episode 96 - Airway Management for Airheads w/Dr. Mario Rugna 49:42

2y ago49:42

49:42

Having an appropriate mindset is crucial when it comes to airway management, particularly in a prehospital and/or emergency setting. Whether it's team dynamics or the tools at our disposal, we need to have a different outlook when it comes to addressing the A in ABC's. If you are looking for a comprehensive guide on how to RSI, this is not the epis…

1
Episode 95 - Busted Skulls and Myths 1:02:12

2y ago1:02:12

1:02:12

Traumatic Brain Injury (TBI) is always in the back of our minds when treating polytrauma patients. Unfortunately, the evidence has a controversial history. More and more, we are reminded of how a basic approach is much more important than other therapies that have little evidence to support their effectiveness. In fact, some may even cause harm. Tu…

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Episode 94 - Treat the Heat w/Dr. Justin Hensley 1:13:10

2+ y ago1:13:10

1:13:10

Heat illness is prevalent around this time of year. And compared to hypothermia, hyperthermia has a lower threshold for danger. From heat cramps to heat stroke, clinicians need to know how to identify and treat each stage appropriately. But what contributes to severe heat illness? How do we treat each stage of illness? And how much time do we have …

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Episode 93 - Performing Under Pressure w/Dr. Stephen Hearns 49:54

2+ y ago49:54

49:54

It's no secret that we as emergency and critical care professionals are expected to perform highly in high pressure situations. Unfortunately, none of us are immune to limited cognitive capacity, task saturation/fixation, time pressure, negative team dynamics, and poor communication. How can we mitigate these variables, so that we can continue to e…

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Episode 92 - Flight Suit Pat Down (Audio Only) 33:25

2+ y ago33:25

33:25

What should you carry in your flight suit as an American-based HEMS provider? In our opinion, no one can definitively tell you that. But we can attempt to share some ideas based on our personal experiences and training. In this vodcast, Mike shares what he currently carries in his flight suit; from survival gear to medical equipment. Watch the vodc…

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Episode 91 - Immobi-Lies w/Dr. Mike Hudson 38:40

2+ y ago38:40

38:40

Mores lies! But this time, we focus on empirical use of spinal immobilization devices and the harm associated with them. The dogma surrounding this topic is staggering, to say the least. From EMS agencies to Level 1 tertiary centers, cervical collars and long spine boards (LSB) remain a "standard" predicated on a lack of evidence. What evidence DO …

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Episode 90 - The Key to Ketoacidosis 41:15

2+ y ago41:15

41:15

Diabetic Ketoacidosis (DKA) is a common metabolic disorder, particularly in the pediatric population. If treated inappropriately, these patients can quickly decompensate to the point of hypovolemic shock, acute respiratory failure, and even cerebral herniation. What are the physiological differences behind DKA verses HHS (Hyperglycemic Hyperosmolar…

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Episode 89 - Para-Lies 53:04

2+ y ago53:04

53:04

There are a lot of "lies"/misunderstandings surrounding appropriate use of paralytics AKA neuromuscular blocking agents (NMBAs). When are these medications truly indicated? How do we appropriately administer them? How do we accurately monitor these patients? And how do we reverse the effects of NMBAs? Tune in to another pharmacologically driven pod…

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Episode 88 - Closing the Blood Gates 59:23

2+ y ago59:23

59:23

The clotting cascade, particularly in the context of anti-coagulation reversal can be complex to understand. Unfortunately, many of our patients are on anti-coagulation agents that require reversal in the presence of life-threatening hemorrhage. How do we choose the most appropriate agent based on which step of the coagulation cascade that it antag…

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Episode 87 - The Lesser Evil Overdose w/Dr. Arne Skulberg 50:52

2+ y ago50:52

50:52

Which is the lesser evil, opioid or naloxone overdose? To avoid adverse effects, how should we be administering naloxone in the presence of opioid overdose? In this podcast episode, we are joined by Dr. Arne Skulberg, anesthesiologist and lead author, to discuss his recently published RCT comparing intranasal with intramuscular naloxone. We highlig…

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Episode 86 - Pilot Down But Not Out w/Wade Dunford & Scott Davis 1:16:00

2+ y ago1:16:00

1:16:00

An incapacitated pilot scenario is an unfortunate but potential reality of working in rotor and fixed wing EMS. What do you do as medical crew members if your pilot becomes incapacitated? What training and capabilities do you have to revive the pilot and/or get the aircraft on the ground? Do some Controlled Flight Into Terrain (CFIT) incidents actu…

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Episode 85 - A Great First Compression w/Dr. Per Olav Berve 53:37

3y ago53:37

53:37

Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) devices are recommended to reduce risk and maintain chest compression quality. However, such transports have inherent pitfalls to both patient and provider safety. This is a poorly studied field of our…

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Episode 84 - VAD Max w/Allen Wolfe 56:38

3y ago56:38

56:38

Ventricular Assist Devices (VAD) come in many shapes and sizes. From right to left, extracorporeal to intracorporeal, pulsatile to continuous - It can be confusing. Join us for a podcast episode where Allen Wolfe clarifies the confusion and gives us the maximum amount of knowledge we need to succeed while taking care of these patients. Get CE hours…

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Episode 83 - A Few Good Mentors w/Adam Tresidder & Shane Turner 45:00

3y ago45:00

45:00

If "you can't handle the truth", you can't handle a mentor. Mentors come in the form of leaders, educators, guides, and advisors to help you with honest self-reflection in order to improve yourself and your practice. Join us from AMTC21 where we discuss the importance of this arrangement with our close friends and fellow mentors, Adam Tresidder and…

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Episode 81 - Thyroid Storm Chaser w/Chase Turner 43:51

3y ago43:51

43:51

Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a patient who is refractory to conventional therapy? Joined by EM pharmacist, Chase Turner, we discuss all things hyperthyroidism in this…

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Episode 80 - Resus Kung Fu w/Dr. Michael Lauria 54:40

3y ago54:40

54:40

"Kung" means "skillful work" and "Fu" means "time spent". "Resus Kung Fu" refers to the resuscitation skills we acquire over time to become a true master. But how do we achieve mastery of these cognitive abilities and technical skills? And what role does stress inoculation play in training? Join us and Dr. Michael Lauria in this podcast episode whe…

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Episode 79 - Medicine in the Wild w/David Fifer 1:06:31

3y ago1:06:31

1:06:31

Have you ever been hiking in the woods and wondered what emergency medical services are available in case you got injured? The level of scope varies greatly across the country for wilderness emergency medical and SAR technicians. From first aid to critical care, in this podcast episode, we discuss who is coming, what their capabilities are, and how…

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Episode 78 - Eating Our Humble Pie (BaSICS Trial) 25:26

3y ago25:26

25:26

Sometimes, we're wrong. And when it comes to normal saline, we might be. Tune in to a breaking news podcast of sorts where we discuss the recently published BaSICS Randomized Clinical Trial, and how it affects our practice in regard to balanced fluid resuscitation. Get CE hours for our podcast episodes HERE! ----------------------------------------…

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Episode 77 - My First Crush w/Chris Stevenson 44:39

3y ago44:39

44:39

Though the incidents of crush injuries may be low in frequency, major crush injury syndrome is associated with a high mortality rate. In this podcast episode, we sit down with regular guest, Chris Stevenson, to discuss the "why". We highlight the pathophysiology behind re-perfusion injury and pre- and post-treatment options. Get CE hours for our po…

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Episode 76 - Pressure to Intubate w/Jon Inkrott 48:43

3+ y ago48:43

48:43

How do you decide between non-invasive and invasive ventilation? If you decide on non-invasive ventilation (NIV), how do you choose between heated high flow nasal cannula (HFNC), C-pap, or Bipap? And what critical decision-making tools do you utilize when escalating to intubation? In this podcast episode, we are joined by Flight Respiratory Therapi…

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Episode 75 - Door to Balloon and in Between w/Dr. Adam Gottula & Dr. Trevor Skrobut 1:04:37

3+ y ago1:04:37

1:04:37

Managing Acute Myocardial Infarction (AMI) patients is a concept that many of us learn early on in our careers. Because of that, we can potentially underestimate the importance of our interventions. In this podcast episode, we are joined by Dr. Gottula and Dr. Skrobut to discuss timely management of AMI's, when coronary intervention (PCI) is indica…

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Episode 74 - These Aren't the Labs You're Looking For 41:55

3+ y ago41:55

41:55

There are a lot of misconceptions surrounding the meaning of certain lab values and what a positive truly is. Are these numbers as black and white as they are perceived? In this podcast episode, we discuss sensitivity versus specificity, define some of the most common labs and how to avoid tunnel vision when it comes to your clinical interpretation…

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Episode 73 - Coming in Third w/Dr. Zaf Qasim 57:35

3+ y ago57:35

57:35

Taking care of the High Risk OB patient is outside the comfort zone of many of us. The third trimester, specifically, presents unique challenges both pregnancy-related and otherwise. Why are normal physiologic changes related to pregnancy ABNORMAL in the third trimester? How do we determine if the pregnant patient is sick or not sick? And how do yo…

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