Critical Levels

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 and the downtown east side, Jen is sounding the ala...

"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 primary literature on our website. We examine:...

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 Cameron and Tyne Lunn about how paramedicine is evo...

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 provided to the citizens of Lethbridge, Alberta.   ...

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 during out-of-hospital cardiac arrest. In this episo...

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 interventions

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!

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 of the amazing work that they're doing to help fi...

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 patients to a lead trauma centre. These patients u...

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 intubation. On the topic of breathing, we chat about...

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 the history and assessment to raise my index of s...

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 Response Team. Not only are we going to cover the d...

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 based out of CFB Trenton. Covering more than 10 millio...

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!

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 prehospital OB assessment, the uncomplicated birth, a...

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 acute focal injury of the central nervous system (CN...

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 types of calls do they attend? How do they atte...

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 cover the background, the legal analysis, and wha...

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

Tune in with Jon Lee, formerly from the ORNGE Pediatric Critical Care Transport Team as he discusses his approach to the critically ill child

Continue our conversation with Dr. Drennan about cardiac arrest care. We've reached the end of our algorithms - what can we do next? 

We claim to practice evidence-based medicine, but what does the evidence actually say about how we manage our cardiac arrests? Tune in to our discussion to find out

Tactical paramedicine, rescue task force, tourniquets, and massive life-threatening hemorrhage. Tune in to our conversation about these topics with Ben Jolicoeur of the Ottawa Paramedic Service Paramedic Tactical Unit 

How do we make decisions? How does our bias impact patient care? Listen in to our conversation with Dr. Vanessa Bohn as we discuss cognitive errors, metacognition, and cognitive bias 

Join us as we chat with Jason Buick, the lead author of the recent article published in the Canadian Journal of Emergency Medicine (CJEM) - COVID 19: What Paramedics Need to Know!