Keywords: prehospital care, stroke management, blood pressure control, INTERACT4, emergency medicine, ischemic stroke, hemorrhagic stroke, clinical research, medical literature, EMS

Summary: In this conversation, Mustafa Sidik and James Brady discuss the INTERACT4 trial, which investigates blood pressure management in pre-hospital settings for stroke patients. They explore the trial's methodology, results, and implications for clinical practice, emphasizing the need for ongoing research and the importance of understanding the differences between ischemic and hemorrhagic strokes. The discussion also highlights the strengths and weaknesses of the study, the significance of negative findings, and the necessity for better diagnostic tools in emergency medicine.takeaways

• Pre-hospital providers need to stay updated on current literature.
• The INTERACT4 trial focused on blood pressure control in stroke patients.
• No significant difference was found in outcomes between treatment groups.
• The odds ratio of 1.0 indicates no effect of the intervention.
• Blood pressure management varies significantly between ischemic and hemorrhagic strokes.
• Negative research findings can provide valuable insights.
• Generalizability of research is crucial for clinical application.
• The study's high percentage of hemorrhagic strokes raises questions about its applicability in other regions.
• Future research should focus on improving diagnostic tools for stroke.
• Effective blood pressure management is essential for optimizing patient outcomes.

In this conversation, Mustafa Sidik interviews Dr. Andrew Stolbach, an emergency physician and medical toxicologist, to discuss the fundamentals of toxicology, including definitions, toxidromes, and management strategies for various overdoses. They explore the mechanisms of common antidotes like naloxone, sodium bicarbonate, and glucagon, emphasizing the importance of treating the patient rather than just the poison. The discussion highlights the complexities of toxicology in emergency medicine and the critical role of understanding symptoms and treatment protocols.

Takeaways

Toxicology focuses on treating poisonings and overdoses.

The dose of a substance determines its toxicity.

Toxidromes are key in identifying specific overdoses.

Cholinergic and anticholinergic toxidromes present opposite symptoms.

Sympathomimetic toxidromes are often caused by stimulants like cocaine.

Benzodiazepines are crucial in managing sympathomimetic overdoses.

Opioid overdoses can lead to respiratory failure.

Naloxone is an effective antidote for opioid overdoses.

Sodium bicarbonate is used in TCA overdoses to normalize EKG findings.

Glucagon can be used in beta blocker overdoses to bypass receptor blockage.

Keywords

toxicology, toxidromes, overdose management, medical toxicology, emergency medicine, naloxone, sedative hypnotics, opioid epidemic, glucagon, sodium bicarbonate

Link to Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California: ⁠https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822449

Summary: In this episode of the Alert Medic One podcast, Josh and Cody discuss the complexities of progression in Emergency Medical Services (EMS). They explore the balance between being early adopters of new evidence-based practices and the risks of jumping on trends without sufficient backing. The conversation delves into specific topics such as the use of calcium in trauma care and the implications of chest compressions in trauma situations. They emphasize the importance of effective change management within agencies, the need for proper training and rollout strategies for new tools and medications, and the ultimate goal of improving patient care.

Takeaways:

• Progression in EMS requires careful consideration of new evidence-based practices.
• Being an early adopter can be beneficial, but it carries risks.
• The implementation of new practices should be patient-centered.
• Change management is crucial for successful adoption of new protocols.
• Training and education must keep pace with new tools and medications.
• Effective rollouts involve clinician buy-in and feedback.
• Organizations should avoid chasing trends without evidence.
• The right tools and timing are essential for successful implementation.
• Communication and transparency are key during transitions.
• Continuous improvement in EMS practices is vital for patient outcomes.

• The Role of Training in EMS Progression
• Creating a Culture of Excellence in EMS

• "Are you too slow to get on?"

Keywords: EMS, progression, evidence-based medicine, change management, patient care, protocols, training, implementation, medical director, clinical practice

Summary: In this conversation, Dr. Paul Singh discusses the advancements in stroke treatment, particularly focusing on thrombectomy. He shares his journey into medicine, the significance of timely intervention in stroke cases, and the evolution of treatment protocols. The discussion covers the types of strokes, the criteria for thrombectomy candidates, and the procedure itself. Emphasis is placed on the importance of time in stroke care, the role of AI in improving outcomes, and the future directions in stroke prevention and treatment.

Keywords: thrombectomy, stroke treatment, ischemic stroke, emergency medicine, neuroendovascular surgery, patient outcomes, AI in healthcare, stroke awareness, EMS protocols, healthcare innovation

Takeaways

• Thrombectomy can significantly improve patient outcomes with a low number needed to treat.
• Understanding the types of strokes is crucial for effective treatment.
• Time is critical in stroke care; every minute counts.
• AI technology is enhancing the speed and accuracy of stroke diagnosis.
• Community awareness of stroke symptoms can lead to quicker treatment.
• The thrombectomy procedure is similar to cardiac catheterization.
• Patient outcomes have improved due to advancements in technology and techniques.
• Preventative care and awareness are essential in reducing stroke incidence.
• The landscape of stroke care is continuously evolving with new research and innovations.
• Access to thrombectomy centers is vital for rural areas.

• AI and the Future of Stroke Treatment
• Innovations in Stroke Care: What’s Next?

• "I wanted to work in something where I wouldn't feel like it was a job."
• "You only have to treat two to four patients to get a meaningful outcome."
• "Time is brain."

Summary

In this episode, Josh and Cody discuss common mistakes in airway training for paramedics, emphasizing the need for updated techniques and realistic training scenarios. They highlight the importance of teaching airway management as a comprehensive system rather than focusing solely on intubation. The conversation also covers the significance of proper airway assessment and the dangers of allowing successful poor techniques in training. The hosts provide actionable takeaways for improving airway training programs.

Keywords

airway training, paramedic education, airway management, teaching techniques, simulation training, medical training, emergency medicine, intubation, airway assessment, training mistakes

Takeaways

• Poor teaching habits are prevalent in airway management training.
• Training should evolve to incorporate current best practices.
• High fidelity training is not always necessary for effective learning.
• Successful poor technique can lead to dangerous outcomes in airway management.
• Airway management should be taught as a comprehensive system.
• Realistic training scenarios are crucial for effective learning.
• Airway assessment must include BVM and supraglottic considerations.
• Training should reflect real-life scenarios encountered in the field.
• Success in airway management is built over time through proper training.
• Look to high-performing agencies for best practices in airway training.

Sound Bites

"Poor teaching habits are a major issue."

"We need to evolve our training methods."

"High fidelity training isn't always necessary."

Chapters

1. 00:00 Introduction to Airway Training Mistakes
2. 02:47 Common Teaching Mistakes in Airway Management
3. 11:12 The Importance of Updated Techniques
4. 20:02 Focus on Airway Management as a System
5. 33:40 The Need for Realistic Training Scenarios
6. 49:36 Key Takeaways for Effective Airway Training

Summary

This conversation delves into the critical role of EMS in stroke care, highlighting the importance of timely assessment and treatment. Experts Kenny Barajas and Lindsay Goff discuss the definitions, types, and symptoms of strokes, emphasizing the need for EMS providers to recognize and act swiftly. They explore the impact of stroke on patients and their families, the differences between ischemic and hemorrhagic strokes, and the protocols for EMS management. The discussion also addresses the importance of communication with hospital partners and the need for ongoing education in stroke awareness and care.

Takeaways

Stroke is a disruption in blood flow to the brain.

The BFAST algorithm is crucial for identifying stroke symptoms.

Approximately one-third of stroke patients die within a year.

Ischemic strokes account for 88% of all strokes.

Hypertension and diabetes are significant risk factors for stroke.

Every 40 seconds, someone in the US has a stroke.

Time is critical; every minute counts in stroke treatment.

Patients can have both vertigo and a stroke simultaneously.

EMS providers must advocate for their patients effectively.

Education and training are essential for EMS providers in stroke care.

Titles

The Critical Role of EMS in Stroke Care

The Impact of Stroke on Patients and Families

Sound Bites

"Stroke is the number one cause of long-term disability."

"Every 40 seconds, someone in the US has a stroke."

"Time is brain; the sooner we get treatment, the better."

Chapters

00:00

Introduction to Stroke Care in EMS

03:35

Understanding Stroke: Definition and Symptoms

07:13

Morbidity, Mortality, and Risk Factors of Stroke

11:18

Types of Stroke: Ischemic vs Hemorrhagic

25:16

EMS Management of Stroke: Assessment and Protocols

40:27

The Role of Education and Training in Stroke Recognition

55:34

Closing Thoughts on Stroke Care and Patient Advocacy

Keywords

stroke, EMS, ischemic stroke, hemorrhagic stroke, stroke symptoms, stroke care, emergency medical services, stroke assessment, stroke management, patient advocacy

The Alert Medic 1 team sits down with their medical director, Dr. Ben Lawner, to discuss various topics related to EMS medicine.

Keywords: Sudden Ambulance Death Syndrome, EMS, patient transport, clinical decision-making, emergency medicine, treatment protocols, communication, high-stress situations, continuous learning

Summary: In this episode, the hosts discuss the concept of Sudden Ambulance Death Syndrome, exploring its implications for emergency medical services (EMS) and patient care. They delve into the cultural perspectives surrounding patient transport, the nuances of treatment decisions, and the importance of communication in high-stress situations. Through case studies, they highlight the significance of treatment before transport and the need for continuous learning and adaptation in the field. The conversation emphasizes the critical role of protocols and the management of emotions during emergencies, ultimately advocating for a patient-centered approach in EMS.

Takeaways

• Transport is a treatment, and timing is crucial.
• Cultural perspectives influence how EMS professionals approach patient care.
• There is a need for a balanced approach between staying on scene and rapid transport.
• Understanding the nuances of treatment decisions can improve patient outcomes.
• Communication is key in high-stress situations to ensure effective care.
• Protocols should encourage critical thinking rather than rigid adherence to algorithms.
• Managing emotions is essential for effective decision-making in emergencies.
• Continuous learning and adaptation are vital for EMS professionals.
• The importance of treating through the doors cannot be overstated.
• Patient-centered care should guide all decisions in EMS.

• Learning from Case Studies in EMS
• Cultural Influences on EMS Practices

• "Transport is a treatment, right?"
• "We can't think in extremes."
• "Treat through the doors."

Chapters

00:00 Introduction and Overview

02:41 Transport as a Treatment

06:04 Thinking in Extremes

09:31 Treating Through the Doors

15:46 Working the Arrest in the Back of the Unit

18:14 The Hospital as Definitive Care

36:10 The Importance of Critical Thinking and Education 38:30 Immediate Life-Saving Treatments

41:35 Addressing Critical Life Threats

46:10 Managing Emotions and Maintaining a Calm Mindset

49:07Effective Communication and Teamwork

The Alert Medic 1 team sits down with Dr. Jim Brady to discuss the fundamentals of Serotonin Syndrome.

The AM1 team sat down to discuss "four-walled calls."

Cody and Mustafa sit down to discuss various topics related to EMS education.

The AM1 team sits down to discuss a case study where they utilized the Dual Sequential Defibrillation technique on a patient in persistent cardiac arrest.