Heavy Lies the Helmet

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, public safety professionals, and the Ukrainian comm...

B.R.A.S.H. Syndrome is a phenomenon with a constellation of B radycardia, R enal failure, A V nodal blockade, S hock, and H yperkalemia 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 components, as well as relevant pharmacotherapy and...

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 metabolic acidosis. Get CE hours for our podcast e...

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 prehospital environment all the way to the ICU, we...

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. So where do we start? And where should we end up...

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 steps you can take to improve your care of this spe...

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 care for this patient population. Get CE hours for...

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 quality of life. How do we identify these conditi...

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 three real case studies and see if they would appro...

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 Professor of Emergency Medicine and Emergency Med...

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 this podcast episode, we are joined by our very o...

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 during the peri-arrest phase and subsequently imp...

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 on a daily basis as a result of learning via unco...

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 antibiotic itself? This podcast is not only "Antibi...

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 thing... THANK YOU FOR 5 YEARS! Get CE hours for...

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 both perspectives and how the rest of us can learn fr...

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 an esophageal tamponade device is indicated or alr...

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 resolve it? Tune in to this podcast episode where...

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 episode for you. This is simply a table discussion abo...

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. Tune in to a podcast where we debunk these common TB...

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 before it becomes fatal? From Texan turned Aussie,...

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 effectively operate in our respective fields? Join...

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 vodcast on our YouTube channel at / heavyliesthehelmet...

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 we have regarding spinal immobilization? And how s...

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 Syndrome)? What are some simple methods to identi...