SMFR EMS Podcast

In this episode of the South Metro EMS Podcast the crew talk though a midnight call for difficulty breathing at a Chatfield campsite quickly turned into a peri-arrest, leaving the crew to manage severe anaphylaxis with no clear trigger and no known allergy history. Paramedic Will Martinez walks through the call firsthand, Dr. Jonathan Apfelbaum breaks down Alpha-Gal Syndrome, a tick-borne conditio...

In this episode of the South Metro EMS Podcast, the crew tackles something that doesn't get talked about enough, the gap between competence and confidence in paramedicine. Host EMS Captain Dusty King sits down with Medical Director Dr. Jonathan Apfelbaum and EMS Lt. Mikel Hogestad to explore what it actually looks like to move from knowing your protocols to trusting your judgment in the gray areas...

In this episode of the SMFR EMS Podcast, we sit down with our Medical Director Jonathan Apfelbaum, and Associate Medical Director of EMS of Children's Hospital Dr. Claire Gahm to review pediatric emergencies, a patient population we don't run often but one that can catch you off guard when we do. The conversation covers clinical assessment, why pediatric presentations can be deceptively subtle, an...

In this episode, Dusty King and Medical Director Jonathan Apfelbaum break down adenosine in a practical, field-ready way. They review how the medication works at the AV node, when it is appropriate for narrow-complex regular tachycardia, and why Wolff-Parkinson-White (WPW) does not automatically rule it out. The conversation also highlights patient preparation, what to expect after administration,...

In this episode of the South Metro EMS Podcast, “Blood on Board,” EMS Lieutenant Dusty King sits down with EMS Battalion Chief Glenn Maxson (Med 1) and Medical Director Dr. Jonathan Apfelbaum to break down SMFR’s prehospital blood program from the street level to the system impact. Using a recent trauma call as the anchor, they discuss how crews identify “blood calls,” why a brief on-scene delay c...

In this episode of Real Calls. Real Conversations. Real EMS., we take you into the cadaver lab at Link to Learn for a real-time look at managing difficult airways. We break down airway assessment, first-pass success, SALAD suction technique, bougie vs rigid stylet use, and how to adjust tools and approach based on patient anatomy, not provider comfort. The focus stays where it belongs: oxygenation...

This episode features Medical Director Dr. Jonathan Apfelbaum and EMS Lieutenant Dusty King as they unpack when epi helps, when it adds nothing, and when it can actually work against your patient. Using real cases, they revisit alpha and beta receptor effects, walk through why there is no evidence-based role for epi in classic traumatic arrest, and contrast that with scenarios like neurogenic shoc...

This episode takes a closer look at geriatric care, why “minor” complaints aren’t always minor, and how small misses can become big problems. Together with Dr. Jonathan Apfelbaum and EMS Lieutenant Dusty King, we review high-risk considerations in older adults, from bradycardia management, to low-speed trauma with hidden injuries, unwitnessed falls, and the “lift assist." Through real cases, we hi...

This episode takes a closer look at STEMI alerts—when they apply, when they don’t, and why accuracy matters. Together with Dr. Jonathan Apfelbaum and EMS Lieutenant Dusty King, reviews the four key criteria, discusses common pitfalls and mimics, and walks through real-world cases where judgment calls made all the difference. The conversation highlights both the fundamentals and the nuances, giving...

This episode dives into a real-world case of a patient found altered and seizing at Cherry Creek State Park during a string of heat-related calls. Paramedic Zach Hutchins recounts the challenges of navigating multiple simultaneous incidents, accessing the patient in a campsite, and recognizing the signs of heat stroke. Together with Dr. Jonathan Apfelbaum, the team breaks down key assessment point...

Join EMS Lieutenant Dusty King, EMS Lieutenant Scott Hipwell and Medical Director Dr. Jonathan Apfelbaum for part two of the "ECGs Unlocked: Crack the Code" series. In this episode, they apply their systematic approach to interpreting complex and challenging 12-lead ECGs. Covering rhythms such as first-degree AV block, second-degree type I and type II heart blocks, supraventricular tachycardia (SV...

In this episode, EMS Lieutenant Dusty King hosts EMS Lieutenant Scott Hipwell and Medical Director Dr. Jonathan Apfelbaum for a deep dive into systematically interpreting 12-lead ECGs. Whether you’re refreshing your knowledge or learning a consistent method for the first time, this practical discussion simplifies ECG interpretation through a clear, step-by-step approach.

Join host Dusty King, EMS Lieutenant, and Medical Director Jonathan Apfelbaum as they tackle one of the most important decisions in prehospital care: choosing the right destination for your patient. This episode breaks down the capabilities and limitations of free-standing emergency departments (FSEDs), who should (and shouldn’t) be transported there, and why good clinical judgment is critical. Th...

In this episode of the SMFR EMS podcast, EMS Lieutenant Dusty King, along with Paramedic Bob Rafferty and Medical Director Jonathan Apfelbaum, break down the essentials of safe patient transport in the field. This episode explores the latest protocols for securing adult and pediatric patients, provider restraint safety, and why proper use of seatbelts and restraint systems is critical for everyone...

In this episode of the SMFR EMS podcast, EMS Lieutenant Dusty King, along with Medical Director Jonathan Apfelbaum and Legal Counsel Allison Ulmer, explores key considerations when handling refusals, including when a patient has the capacity to refuse care and how to navigate the legal and ethical implications. The conversation covers real-world scenarios, offering practical advice for making thes...

In this episode of the SMFR EMS podcast, EMS Lieutenant Dusty King, along with Paramedic Austin Burrell and Medical Director Jonathan Apfelbaum, explores the evolving legal and ethical framework around patient refusals. The discussion covers key topics such as assessing a patient's capacity to refuse care, handling difficult or impaired patients, and the importance of effective communication and d...

Welcome back to Sound Decisions: Ultrasound's Role in EMS for Part 2 of our deep dive into ultrasound's transformative impact on pre-hospital care. Hosted by EMS Lieutenant, Dusty King, this episode features expert insights from Medical Director Dr. Jonathan Apfelbaum and Paramedic Zac Hutchins as they explore another interesting case study. In this episode, we discuss the life-saving power of ult...

Welcome to Sound Decisions: Ultrasound's Role in EMS, a podcast that dives deep into the evolving capabilities of ultrasound in the pre-hospital setting. Hosted by EMS Lieutenant Dusty King, this series features case studies and expert insights from Medical Director Dr. Jonathan Apfelbaum and Paramedic Zac Hutchins, exploring how ultrasound technology is transforming patient care in EMS. This epis...

In this episode of the EMS podcast, EMS Lieutenant Dusty King and Medical Director Apfelbaum break down a compelling pediatric cardiac arrest case from mid‑January. The discussion follows a high school athlete from Namibia who, during a school basketball event, suddenly collapsed in the stands. With bystanders initiating CPR and a school nurse alongside Parker PD swiftly applying an AED and delive...

In this dynamic EMS podcast episode, EMS Lieutenant Dusty King, Paramedic Rafferty, and Medical Director Apfelbaum break down a recent, high-stakes cardiac arrest case involving a 29‑year‑old male who collapsed on a basketball court. The crew details the life-saving chain of survival—from swift bystander CPR and proper AED pad placement to rapid on-scene role assignment, advanced airway management...

Shortness of breath is one of the most common and urgent EMS complaints, with causes ranging from minor to immediately life-threatening. In this episode, we use the B.R.E.A.TH. approach to break down five critical differentials: Bronchoconstriction (COPD/Asthma), Respiratory Infection (Pneumonia), Edema (Congestive Heart Failure), Acidosis (Diabetic Ketoacidosis), and THromboembolism (Pulmonary Em...

Trauma patients can deteriorate rapidly, making early recognition of life-threatening conditions essential. In this episode, we use the B.L.E.E.D. approach to break down five critical trauma differentials: Bleeding (Hemorrhagic Shock), Low Oxygen Levels (Hypoxia), Elevated Intrathoracic Pressure (Tension Pneumothorax/Pericardial Tamponade), Elevated Intracranial Pressure (Closed Head Injury), and...

Abdominal pain can be deceptive; ranging from benign to life-threatening in seconds. In this episode, we use the G.R.O.A.N. approach to break down five critical differentials: Gastrointestinal Perforation, Reproductive Organ Torsion (Testicular/Ovarian), Occlusive Ischemic Bowel/Infarction, Abdominal Aortic Aneurysm, and Nonviable Ectopic Pregnancy. We’ll discuss how to recognize red flags, differ...

When a patient presents with an altered mental status, the differential is broad, and every second counts. In this episode, we use the 5 S’s approach to identify the most critical causes: Seizure, Sepsis, Stroke, Sugar (Hyper/Hypoglycemia), and Severe Toxicology. We’ll break down key assessment clues and how to rule in or rule out life-threatening conditions.

Chest pain is one of the most high-risk complaints encountered in EMS, requiring quick thinking and decisive action. In this episode, we break down the C.H.E.S.T. approach to identifying life-threatening causes: Cardiac Tamponade, Heart Attack (MI), Embolism (Pulmonary), Simple/Tension Pneumothorax, and Thoracic Aortic Dissection. We’ll discuss key assessment findings, red flags, and field managem...