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Critical Levels

Critical Levels

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Hosted by paramedic Zach Cantor, "Critical Levels" is a new podcast dedicated to having critical conversations in paramedicine. "Critical Levels" is a podcast for paramedics, by paramedics, with a Canadian and local bias. Please visit our website - http://www.criticallevels.ca - for more information Please email us at info@criticallevels.ca for any suggestions/feedback/comments Follow us on Twitter: @criticalevels
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How prepared do you feel to care for children and youth who have experienced abuse or assault? 1 in 10 Canadians (7.8%) over 15 report at least one instance of sexual abuse before age 15 (Stats Canada) Up to 88% of people being trafficked access health care (Polaris Project) - many don’t disclose they are being trafficked Highest rates of intimate …
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On this month’s episode, we dive deep into the world of military medicine with special forces paramedics, pulling back the veil of secrecy surrounding their vital work. Join us as we explore the unique challenges and high-stakes scenarios these elite medics faced on the front lines. From advanced trauma care in combat zones to the mental resilience…
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On this month’s episode, we’re joined by Dr. Justin Mausz to discuss violence against paramedics. During the episode, you’ll hear us cover: How often are we seeing violence against paramedics What is violence? Is it different from harassment? Does intent matter? Incident reporting How does it compare to other industries? What does violence against …
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On this month’s episode, we’re joined by Dr. Steven Sanders to discuss heat related illnesses. During the episode, you’ll hear us cover: Health impacts of temperature increase Physics/physiology of temperature vs heat Spectrum of heat related illness heat rash heat cramps heat edema heat syncope heat exhaustion heat stroke exertional vs classic Com…
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On this month’s episode, we’re joined by Dr. Bonnie Snyder to discuss BVM as well her recently published paper in Resuscitation: Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. During the episode, you’ll hear us cover: There is nothing basic about the BVM - it is not a benign int…
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On this month’s episode, we’re joined by Dr. Katie Lin to discuss TBI and the crashing brain. During the episode, you’ll hear us cover: head injury differentials and history gathering ischemic vs hemorrhagic head injury etiology head injury pathophysiology assessment 3 step neuro exam pupil assessments signs/symptoms of herniation ECG changes manag…
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On this month’s episode, we’re joined by Dr. Janice Tijssen to discuss pediatric cardiac arrest. During the episode, you’ll hear us cover: The importance of our early interventions What is cardiac arrest incidence/epidemiology etiology risk factors/past medical history outcomes sociodemographics Differences between adult and pediatric cardiac arres…
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On this month’s episode, we’re joined by Dr. Louisa Marion-Bellemare to discuss Suboxone (buprenorphine/naloxone) and managing patients who use illicit and controlled drugs. During the episode, you’ll hear us cover: history of the drug crisis lay of the land of the current drug crisis historical treatments opiate pharmacology healthcare utilization…
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On this month's episode, we chat with Matt Smith about wilderness medicine. As we shift from a high resource to a low resource setting, there are 3 main concepts to consider: - Ideal to real - High risk to low risk - Stable to unstable These concepts are important as we shift our practice and prepare ourselves. For this patient context, we need to …
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On this month’s episode, we discuss acute coronary syndrome (ACS) with Dr. Jess McLaren We define ACS, we cover pathophysiology, and some common causes. Importantly we discuss the assessment of this patient population - paying attending to both objective and subjectives signs and symptoms. We spend some time talking about electrocardiograms, and pe…
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On this episode, we’re joined by Dr. James Gilbertson with the Ottawa Hospital, and Cst. Caroline Gallant with The Ottawa Police Marine, Dive and Trails (MDT) Unit. We take a dive into drowning and cover: What drowning is The scale of the problem Drowning pathophysiology The medical management of drowning patients Prognostication Lastly, we speak t…
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In British Columbia 7 people per day are dying as a result of a highly contaminated toxic supply of drugs. Since the announcement of the public health crisis related to illicit drug toxicity deaths in 2016 over 12,000 people have lost their lives. Despite previous misconceptions that the toxic drug crisis is confined to Vancouver’s lower mainland a…
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“No statistical difference” On today’s episode of Critical Levels, we chat with Dr. Ken Milne of the Skeptics’ Guide to Emergency Medicine (https://thesgem.com; @thesgem). We start with a high-level discussion and literature and evidence, and then apply these concepts to ‘lyse’ and ‘bust’ some of the predominate prehospital myths. Find links to the…
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Paramedics receive little education on grief and bereavement. As paramedicine integrates palliative approaches to care, it has become very apparent paramedics are under-prepared for the crucial role they play in supporting patients and families in grief and recognizing and responding to their own grief reactions. In this episode we talk to Cheryl C…
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On today’s episode, we carry on last month’s conversation about cardiac arrest management and care. Recorded at the Paramedicine Across Canada Expo (PACE) Conference in Saskatoon in September 2022, we’re sitting down with Mike Humphrey and Adam Perrett of Lethbridge Fire and Emergency Services to talk about how they’ve revolutionized the care provi…
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On today's episode, we chat with Dr. Sheldon Cheskes, principal investigator of the landmark DOSE VF trial. In this study, published in the New England Journal of Medicine, Dr. Cheskes and his team wanted to evaluate DSED and VC defibrillation as compared with standard defibrillation in patients who remain in refractory ventricular fibrillation dur…
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Pain is a condition that we often see in the prehospital world, yet for a variety of reasons, we're bad at treating it. On today's episode with pain expert Dr. Samina Ali, we go through what pain is, pain assessment, barriers to providing analgesia, and then discuss how we actually treat pain, using both non-pharmacologic and pharmacologic interven…
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Join us this month as we chat with Dr. Simon Hatcher, psychiatrist at the Ottawa Hospital and Ottawa Inner City Health, about First Responder Mental Health Who gets PTSD, what’s the pathway/differences to mental health professionals, how do we heal, and how do we get people back to work are all topics we cover, plus more!…
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IVEGOTYOURBACK911 was started by paramedics Jill Foster & Shaun Taylor in 2014. The goal of the campaign is to spread social awareness worldwide in regards to First Responder mental health issues. On this month’s episode of Critical Levels, we sit down with Jill & Shaun to learn a little bit more about how and why they started the company, and some…
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On today’s episode, we chat with Dr. Brodie Nolan, an emergency physician and trauma team leader at St. Michael's Hospital (one of Canada’s largest trauma centres), and a transport medicine physician for ORNGE. We discuss what trauma is, and how we define hemorrhagic shock. We discuss that trauma triad of death, and why it’s important to get these …
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On today’s episode we sit down with Dr. Sonny Dhanani, Chief of the Pediatric Intensive Care Unit (PICU) at the Children’s Hospital of Eastern Ontario (CHEO). We discuss the approach and management of the critically ill child, with an in-depth discussion on the A-B-Cs. With respect to airway, we chat tips/tricks for airway management, as well as in…
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The United Nations (UN) defines human trafficking (HT) as “the recruitment, transport, transfer, harbouring, or receipt of a person by such means as threat or use of force or other forms of coercion, abduction, fraud, or deception for the purpose of exploitation“. What is human trafficking? How prevalent is it? What are the red flags? How can I use…
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After the War in Afghanistan, the Chief of Defence Staff of the Canadian Armed Forces decided to create a brand new forward aeromedical evacuation capability. This is where our episode’s guest comes in. We speak with Dr. Leilani Doyle, Lt. Col. with the Canadian Armed Forces about her role in the creation of CMERT - the Canadian Medical Emergency R…
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Not all paramedics respond to just 911 calls. On today’s episode, we’re chatting with Matt Cruchet and Sgt. Gregory Hudson Matt is a key member of the Country of Renfrew Paramedic Service’s Sierra Team – essentially their special operations arm. Sgt. Hudson is a Search and Rescue Technician (SAR Tech) with the 424 Transport and Rescue Squadron base…
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On today's episode with Dr. Kyeremanteng, we're covering all things ROSC: what is ROSC? How do we optimize our patient's physiology (the A-B-Cs) post-arrest? What happens next - what's TTM, how does neuroprognostication happen? Lastly, we cover what is the impact to the healthcare system at large. Thanks to Zoll Medical for sponsoring this episode!…
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Obstetrics. Arguably one of the scarier and uncomfortable things we do as paramedics, at least that’s what I think. If you’re looking for a way to make this tremendously stressful call just a little bit easier, then I think you’ve come to the right spot. On this engaging episode of Critical Levels, we’re talking with Dr. Glenn Posner about the preh…
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CVA are amongst the top 5 causes of death, and number 1 cause of disability in N.A. Given the associated morbidity and mortality, rapid recognition and aggressive management is of the utmost importance. The American Heart Association (AHA) and the American Stroke Association (ASA), characterizes stroke as a neurological deficit attributed to an acu…
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Join us as we sit down with Critical Care Paramedic Natalie Lavergne with ORNGE - to discuss exactly that: critical care paramedicine and ORNGE, the Ontario air ambulance service. In this episode, we cover: What is a critical care paramedic and how are they different? What type of training/continuing education do they receive? What is ORNGE? What t…
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On June 8th 2021, The Honourable Mr. Justice H.S. Arrell gave his judgment finding 2 Hamilton paramedics, Christopher Marchant & Steven Snively, guilty of failing to provide the necessaries of life to Yosif Al-Hasnawi (19), who died on December 2 2017. In this episode, we chat with former paramedic and current lawyer Christopher Robertson, where we…
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Is it an accident or is it abuse? Tune in with Dr. Michelle Ward, Division Head of Child and Youth Protection at the Children's Hospital of Eastern Ontario, as we discuss what paramedics need to know about child & youth maltreatment
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In this episode, we sit down with Dr. Louis McNaughton-Filion, Regional Supervision Coroner for Eastern Ontario. We cover death investigations, what paramedics need to be aware of on suspicious scenes, and some of the pathophysiology/body changes after death.
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Listen to part 1 of our conversation with Will Johnston about Calming the Chaos. In this episode, we cover some of the physiological responses to stress and it's the impact on team performance as well as individual performance, as well as how to mitigate that response. We also covered what makes up highly competent teams. Tune in soon for part 2 to…
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