The Inflection Point: Conversations in Care, Culture and Change. Designed for Paramedics.

Podcast Clip — from The Inflection Point Changing culture in paramedicine isn’t about policies or slogans. In this clip, Mandy Johnston explains what actually drives culture change in paramedic services—based on real-world experience leading the EVAP program and training frontline paramedics across an entire service. She shares: Why fence-sitters , not critics, determine whether change succeeds Ho...

What actually keeps paramedics safe during violent encounters isn’t toughness — it’s training, leadership, and culture . In this clip from The Inflection Point , we explore how empowering paramedics with knowledge, skills, and decision-making authority fundamentally changes outcomes in high-stress, high-risk situations. This conversation examines: Why empowerment matters more than resilience alone...

Violence against paramedics didn’t just affect work — it followed people home. In this clip, Mandy Johnston shares the most overwhelming insight from frontline survey data: when paramedics were asked how violence impacted their work life , they didn’t talk about work at all. They talked about their personal lives, their morale, and their desire to return to the job. One line stood out: “It makes y...

Violence against paramedics is rising across Canada and internationally, placing frontline clinicians among the most at-risk professionals in healthcare. Addressing this crisis requires far more than resilience training or individual coping strategies—it demands leadership, cultural change, and system-level accountability. In this episode of The Inflection Point , we sit down with Mandy Johnston ,...

In this Best of 2025 episode of The Inflection Point , Dr. Andrew Petrosoniak examines one of the most powerful—and often invisible—drivers of patient safety in healthcare: psychological safety . The conversation explores how rigid hierarchies in medicine and EMS can silence clinicians, even when they recognize escalating risk or imminent harm. Drawing on the foundational research of Dr. Amy Edmon...

In this Best of 2025 episode of The Inflection Point , we revisit a high-impact conversation on prehospital cardiogenic shock management with Dr. Aws Almufleh . This episode is designed for Advanced Care Paramedics, critical care clinicians, and prehospital providers navigating complex shock states in the field. The discussion breaks down the core physiology of cardiogenic shock and applies it dir...

In this Best of 2025 episode of The Inflection Point , we revisit a critical discussion on the real-world challenges of remote medical evacuations with Matt Cruchet, focusing on both helicopter operations and ground-based extrications in austere and high-risk environments. Drawing on Matt Cruchet’s extensive experience in remote rescue and evacuation operations, this episode explores the logistica...

In this episode of The Inflection Point , Dr. Kimmo Murto and Dr. Jeannie Callum examine the leading causes of death in pediatric trauma, with a focus on early hemorrhagic mortality and its relationship to traumatic brain injury. The discussion highlights why children are uniquely vulnerable after severe trauma and why the first six hours after injury represent a critical window for intervention....

In this Best of 2025 episode of The Inflection Point , we revisit one of the most critical—and frequently misunderstood—topics in prehospital medicine: airway management . This conversation challenges the reflex to intubate and reframes airway decision-making around what truly drives outcomes in critically ill and brain-injured patients: oxygenation and physiology . Drawing from major airway trial...

In this episode of The Inflection Point , Dr. Dick Zoutman returns to unpack the science behind respiratory viruses, immune function, airborne transmission, and the ongoing impact of long COVID on individuals, health systems, and the global economy. We break down how viruses mutate, why RSV and influenza remain so difficult to control, and why the air around us is a major—yet underestimated—driver...

In this episode of The Inflection Point, we sit down with Dr. Dick Zoutman, a professor at Queen’s University, Faculty of Health Sciences, to unpack the science behind N95 masks, airborne transmission, and respiratory protection. Dr. Zoutman explains how N95 respirators, originally designed for heavy-industry applications, became essential tools in preventing airborne disease transmission. We expl...

In this solo episode, we explore dopamine and vasopressor use in the prehospital setting, focusing on how evidence, safety, and clinical reasoning intersect in Ontario’s current practice. You’ll learn why dopamine was historically chosen, its mechanism of action, dose-dependent effects, and the clinical risks associated with its use in critically ill patients. We also compare dopamine and norepine...

In this episode of The Inflection Point , Dr. Jeannie Callum and Dr. Kimmo Murto dive into the realities of pediatric trauma —a leading cause of childhood death and disability worldwide. Together, they explore why injured children demand unique approaches from paramedics, emergency clinicians, and trauma systems alike. From TXA use and massive hemorrhage protocols to traumatic brain injury (TBI) a...

About The Inflection Point Podcast The Inflection Point is a Canadian paramedic podcast advancing EMS education, prehospital care, and healthcare leadership. Hosted by Jakob Rodger and Ryan Cichowski , the show brings evidence-based discussions on pathophysiology, pharmacology, trauma, cardiac care, human factors, and clinical decision-making — designed to bridge the gap between frontline care and...

In this episode, we sit down with Dr. Aws Almufleh , Cardiologist and Assistant Professor at Queen’s University , to explore cutting-edge strategies in heart failure management . With advanced training in heart transplantation, mechanical circulatory support, echocardiography, and cardiovascular imaging , Dr. Almufleh brings a remarkable blend of global experience, research expertise, and authenti...

In this episode of The Inflection Point , Jakob and Ryan take a focused dive into pulmonary embolism (PE) —exploring its pathophysiology, risk factors, diagnostic challenges, and treatment strategies across both prehospital and hospital settings. Timed with World Patient Safety Day , the discussion emphasizes how human factors, system-level improvements, and safety principles can reduce errors and...

Episode Description In this episode of The Inflection Point , we continue our conversation with Matt Cruchet , a dedicated ambassador for the paramedic profession with a Master’s in Health Education. Matt works with one of Canada’s most progressive paramedic services, renowned for adapting to the unique challenges of Renfrew County’s rugged geography. Together, we go behind the scenes of remote an...

In this episode of The Inflection Point , we sit down with Matt Cruchet to explore the world of Renfrew County Paramedics and their elite Sierra Team —a specialized unit delivering lifesaving care across Ontario’s most remote and challenging regions. Matt shares what it takes to succeed in these high-stakes environments, including: The unique challenges of rural and wilderness paramedicine How the...

In this episode, we dive into the realities of shift work, nutrition, and wellness with Carly Ring, a former paramedic who is now a Registered Psychotherapist in Ottawa. Carly draws on her lived frontline experience and clinical practice to share both personal stories and professional strategies for maintaining health and balance while working unpredictable hours. From the importance of fitness an...

In this episode, we sit down with Carly Ring, a former paramedic who is now a Registered Psychotherapist based in Ottawa. Carly shares her inspiring journey from hospitality to paramedicine, and now into psychotherapy, where she helps clients navigate trauma, PTSD, operational stress injuries (OSI), depression, and the unique challenges faced by first responders. Carly speaks with honesty and auth...

About Dr. Baranchuk: Dr. Adrian Baranchuk is a Professor of Medicine at Queen’s University (Kingston, Canada), and a cardiac electrophysiologist. He founded Queen’s Electrophysiology Training Program and serves as Editor-in-Chief of the Journal of Electrocardiology. His scholarship spans cardiac arrhythmias, electrophysiology, and the cardiovascular effects of alcohol. https://deptmed.queensu.ca/p...

Dr. Adrian Baranchuk is a Professor of Medicine at Queen’s University (Kingston, Canada) and a cardiac electrophysiologist. He founded Queen’s Electrophysiology Training Program and serves as Editor-in-Chief of the Journal of Electrocardiology. His scholarship spans cardiac arrhythmias, electrophysiology, and the cardiovascular effects of alcohol. https://deptmed.queensu.ca/people/adrian-baranchuk...

About Dr. Brodie Nolan:Today’s guest is Dr. Nolan — an emergency physician and trauma team leader at St. Michael’s Hospital, a transport medicine physician with Ornge, and an assistant professor in the Department of Medicine at the University of Toronto. With a Master of Science in Clinical Epidemiology and Health Care Research, Dr. Nolan’s work zeroes in on improving trauma systems, reducing dela...

About Dr. Brodie Nolan: Today’s guest is Dr. Nolan — an emergency physician and trauma team leader at St. Michael’s Hospital, a transport medicine physician with Ornge, and an assistant professor in the Department of Medicine at the University of Toronto. With a Master of Science in Clinical Epidemiology and Health Care Research, Dr. Nolan’s work zeroes in on improving trauma systems, reducing del...

In this special episode, we sit down with Marc Goudie, the Chief of Frontenac Paramedics. About Chief Marc Goudie:Chief Goudie holds multiple graduate degrees, including a Master of Health Management from McMaster University and a Master of Arts in Disaster and Emergency Management from Royal Roads University. He brings a wealth of clinical, academic, and strategic leadership experience to his new...