Heavy Lies the Helmet

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 podcast where we draft our EM pharmacist friend, Chas...

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 antagonizes? And when is it time to pull the trigger on...

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 highlight naloxone dose discrepancies and the pitfalls su...

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 actually involve an incapacitated pilot? In this podca...

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 practice and no clear consensus for how this shou...

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 for our podcast episodes HERE ! -----------------...

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 Shane Turner. Get CE hours for our podcast episod...

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 podcast episode. Get CE hours for our podcast epi...

"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 where we answer these questions. Get CE hours for our...

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 David Fifer is trying to change that model. Get C...

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 ! -------------------------------------------- Twitter @ heavyhelmet Facebook @ heavyliesth...

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 podcast episodes HERE ! ----------------------------...

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 Therapist, Jon Inkrott, to answer those questions and mor...

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 indicated, and what medications we should consider to ac...

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. Get CE hours for our podcast episodes HERE ! ---...

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 you change your treatment based on these findings? T...

Has administration ever made a decision that you didn't agree with and/or understand? Of course! As much as we don't like to admit it, the medical industry is a business. For that reason, finances play a significant factor in decision-making. How do we maintain balance between profit and patient care? How do we bridge the gap between leadership and staff members? Tune in to this brutally honest ep...

Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily i...

Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily i...

Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an advanced airway, some clinicians may not be mindful of cerebral perfusion pressure and how to optimize it effectively. In this podcast episode, we provide you with the recording of Bryan's presentation from ICON (IA MED Conference Online) 2021. After in...

Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But are the studies skewed by inappropriate management and our resistance to act? When do we intervene, and when do we not? And how can we help improve these poor mortality rates? Join us as we discuss this important topic with Dr. Amanda Humphries, Fligh...

Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. *Reference the show notes for this e...

Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. Get CE hours for our podcast episode...

Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this podcast episode where we discuss the SAR and relief work he was a part of during that dire time. We highlight mission preparation, prioritization of victims, and several high risk in...

Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altered mental status is usually the only notable deficit, so it's important to know how to identify and treat this life-threatening disorder. Tune in to find out how through a casual discussion and real-life example. Get CE hours for our podcast episodes...