MCHD Paramedic Podcast

Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of cooling directly correlates with mortality reduction. Learn how to implement CWI in your service. It's the...

MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some concrete solutions for the future.

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things...

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things...

As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are the potentially risky decisions? What should the MCHD field paramedics know about the process? Have a listen to better understand the true foundation of EMS clini...

The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehospital setting. What are the common mistakes? What tools can be implemented to improve patient outcomes? Why does geriatric care even matter? This episode is packe...

There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. This is part two of a two-part series. REFERENCES 1. Jarvis JL,...

Recently, some paramedics, obstetricians, and EMS medical directors were locked in a room and produced some fantastic collaborative prehospital guidelines for managing post-partum hemorrhage, eclampsia, and pre-eclampsia. Have a listen, take a look at the guidelines (links below), and we'll all take better care of our pregnant/post-partum patients. REFERENCES 1. https://naemsp.org/news/now-availab...

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

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

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

On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD. What device did you use? How did you train? What lessons have you learned? All these and more will be addressed and answered. REFERENCES: 1. Zhao, Y., Zang, B., & Wang, Q. (2024). The Effectiveness of Bougie Use on First-Attempt Success in Tracheal Intubations. Annals of eme...

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

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

We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank. REFERENCES 1. https://www.resuscitationacad...

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

On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence. What the...

We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to our daily care. REFERENCES 1. https://www.mchd-tx.org/media/podcasts/SITUS-Fig-1.pdf 2. https://www.mch...

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

MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES: Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour, R. B., Sims, S., Kellam, J. F., & Bosse, M. J. (2015). Type III open tibia fractures: immediate antibi...

We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild. REFERENCES: 1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Norep...

Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the positives that can come if we get past our egos and allow ourselves to have insight for future cases.

Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge. REFERENCES 1. https://www.emdocs.net/ecg-pointers-stemi-equivalents-from-the-american-college-of-cardiology/

We're working on a new series focusing on high-yield pharmacology reviews. Dr. Patrick starts us off with some background, mechanism of action discussion and common uses for magnesium sulfate. Mag is one of the true pharmacologic swiss army knives of emergency care. REFERENCES 1. Touyz RM, de Baaij JHF, Hoenderop JGJ. Magnesium Disorders. N Engl J Med. 2024 Jun 6;390(21):1998-2009. doi: 10.1056/NE...

One of the most fear-inducing procedures in all of emergency care is the surgical cricothyrotomy. Dr. Al Lulla from Dallas Fire joins the podcast to discuss our recent collaboration on a retrospective look at MCHD's surgical airway experience over the past decade. Can paramedics successfully perform cricothyrotomies? Who needs surgical airway placement in the field? What can we learn for our next...