Prehospital Paradigm Podcast

The crew welcomes back Dr. Greg Stefano and  Geoff Patty, RN from the interventional cardiology department.   If you're listening to this episode, head over to our YouTube channel to see the visuals of actual cases. An interesting discussion ensues about human and computer interpretations of various EKG strips.

As the panel discussion continues, the discussion of medical direction arises as well as how to handle the potential rotating staff and continuity of responder training including incident command training. If interested in starting or growing your campus-based EMS system, feel free to get in touch with the National Collegiate EMS Foundation .

The group continues to take questions from the audience regarding how to start a campus-based EMS system, funding, and how to impress upon the university/college administration members the importance of such a in-house response system at any level,

This episode was recorded at the National Collegiate EMS Foundation annual conference. NCEMSF is a group of campus-based EMS agencies that a part of the student organizations.   Some have vehicles. Some respond on foot and mainly are volunteering their time to do this during their college careers.   Let's learn more!   Joining the group is Eric Pohl and Zack Matuzsan.  

The crew gathered at Madison Fire to finish up their discussion of explosive ordnance disposal operations with Detective Brian Yenkevich of the Lake County Bomb Squad.  Thanks to the MFD for hosting us.

In part 3 of our discussion of explosive ordnance disposal operations with Detective Brian Yenkevich of the Lake County Bomb Squad. Oddly enough shooting water and water pellets is one of the main tools and constant research is part of how the team refines their methods between all bomb squads across the country. Finally, they discuss signs of what might be a questionable item on a scene that may...

The conversation with Lake County Bomb Squad team member, Brian Yenkevich continues. Part of the discussion reviews weapons of mass destruction including radiological and biological weapons and detection equipment.   We also discuss the types of old artillery and suspicious package types of calls and types of responses.

Lake County Bomb Squad team member, Brian Yenkevich joins Dr. Hill, Caleb and Scott for a different kind of discussion.  Explosive Ordnance Disposal Operations. In Part 1, Detective Yenkevich outlines how the team trains, operates and defines its mission.

In this engaging and surprisingly eye-opening episode, the crew sits down with Dr. Jordan Singer, an emergency medicine physician with unique experience providing in-flight medical command. Together, they explore the complexities of managing medical emergencies in one of the most austere environments imaginable—an airplane at cruising altitude. From physiology at altitude and cabin pressurization...

In Part 3 the crew addresses some loose ends including why the drop-down masks cannot be used for in flight medical emergencies, what patients should NOT get an a commercial airliner, specific emergencies such as seizures and treatment of and commercial airline diversion decisions.

Dr. Jordan Singer continues his in flight emergency discussion and includes the Aviation Medical Assistance Act which is similar to the Good Samaritan Laws is the discussion on this episode.   You are covered as a trained EMS professional as long it is within reasonable parameters of your typical skills.   There is an interesting caveat to this discussion as far as when flying nondomestic flights.

This episode, we are joined by Dr. Jordan Singer, an Assistant Professor and Core Faculty member in the EMS Fellowship at the University Hospitals of Cleveland.   Part of Dr. Singer's specialty, has become "in flight emergencies" on commercial airlines.   One in twenty flights, globally, experience some type of inflight emergency. In this episode, a general discussion ensues regarding cabin pressu...

As has been the routine in 2025, the Extra Monday Episodes are dedicated to interpreting EKG rhythms. This month, the crew discusses, wide complex bradycardias and tachycardias, the symptoms and the treatments.

In this episode of the Pre-Hospital Paradigm Podcast, Dr. Jon Hill and Scott Wildenheim are joined by Tony Crino, a registered respiratory therapist and paramedic. They continue the discussion of the growing role of advanced ventilator management in EMS. Tony Crino brings both respiratory therapy and paramedic perspectives, breaking down the essentials of ventilator physiology, modes, patient-vent...

As the crew starts to summarize their time with Tony, a few things are addressed: What if a department doesn't have the inclination to initiate advanced mechanical ventilation?   If they do, what kind of education needs to be commence and be continued. Also, what about mechanical ventilation in pediatric patients? Research shows that 93% of clinicians are improperly bagging patients.   Using mecha...

The crew continues to go through the basics of the respiratory system.... the anatomy, tidal volumes, pressure ventilation, the terminology, etc. As EMS professionals, we need to understand the basics of the respiratory system's operations in detail before mechanical ventilation can be applied. When you think of oxygenation, there are 2 ways to fix it, pharmacologically or with mechanical ventilat...

The crew is talking to Tony, a Respiratory Therapist educator and paramedic, about the portability and use of mechanical ventilators in the prehospital setting. Some EMS agencies have already purchased more advanced mechanical ventilators to move this concept forward. When they take this step, there needs to be a strong understanding of mechanical ventilation physiology.

In the LIVE version of this episode of the Pre-Hospital Paradigm Podcast, Dr. Jon Hill and Scott Wildenheim are joined by Ashley Rosser and Leisha Starkey of Thrive for Change, a Cleveland-based harm reduction nonprofit. They explore the real-life challenges and successes of harm reduction, tackling stigma, overdose response, safer use practices, and EMS integration. This episode bridges clinical...

  Dr. Hill and Scott wind up this discussion in Part 3 by addressing proper terminology to use when interacting with the patients and the public record availability of previous abuse with guests Ashley Rosser and Elisha Starkey from Thrive for Change.

Ashley Rosser and Elisha Starkey from Thrive for Change continue the discussion of drug abuse patients and the treatment of in this episode.   The challenge of stigmatizing of these patients is significant but the crew also finds out there is stigmatization that goes on within the drug use patient community.

Ashley Rosser and Elisha Starkey from Thrive for Change join the crew this month to talk about the stigma of drug use or opiate use disorders. According to the Thrive for Change website, their "vision is a world free from drug overdose fatalities, where people who use drugs have equal access to basic needs and are empowered to advocate for themselves." In episode 1, Ashley talks about her personal...

A question of Dopamine or Epinephrine initiates a discussion regarding what should/should not be in a drug box, how to have a good relationship with your pharmacy and the possible use of apps in the prehospital setting. The big question in this episode, when is it appropriate to downgrade a call from an ALS to a BLS?

Answering questions from the listeners as the grab bag episode continues.   Patient refusals, the use of Ketamine within in the seizure algorithm and sepsis are part of the discussion.

Some online questions have come in through the website.. time to clear out the email box. In this grab bag, chest pain assessment, the contraindications of epinephrine for anaphylaxis. EMS Education Podcast

As will be the routine in 2025, the Extra Monday Episodes are dedicated to interpreting EKG rhythms. This month, the crew discusses, bradycardias, tachycardias and wide and narrow rhythms.