American Ambulance EMS Podcast: Recent Episodes
American Ambulance
Looking for some fun EMS education? Hosted by American Ambulance's Medical Director, Dr. Danielle Campagne, along with her UCSF-Fresno colleagues, Drs. Patil Armenian and Saajan Bhakta, they discuss practical, pertinent, and evidence-based topics that you can use today to take care of your community. They also bring in guests from all parts of the EMS world to highlight the heroes among us, and share their unique take on challenging situations. Join us, let’s learn together and thrive.
Today we take a break from drilling down into a specific policy or procedure and discuss an important topic that isn't so clinical but still extremely important in EMS: What makes a good leader? A big thanks to American Ambulance Paramedic Supervisor Robert Wankel for bringing his experience as a leader in the field to our discussion today.
Dr. Brian Lawton is a resident at UCSF Fresno and we were pleased to welcome him as a guest host for this episode.
Are you in EMS, wondering what it would take to be an EDPA (Emergency Department Physician Assistant)? Jordan Golding did it! He started his EMS career as an EMT with American Ambulance, and now works as an EDPA here in Fresno. Join us today as he answers our questions and shares his experience.
American Ambulance Paramedic Josh Garcia joins us again for this discussion as we prepare to introduce the pediatric i-gel into our local CCEMSA protocol.
It's not often that we are able to time a podcast to coincide exactly with the release of a new protocol, but today we did it! Dr. Scott Avey from UCSF Fresno joins us as a guest co-host, and we were pleased to have American Ambulance Paramedic Josh Garcia join as well to bring his experience and a story from the field.
in 2000, the CDC declared Measles eliminated but last year we saw a huge rise in cases and in 2026 the trend continues. Dr. Brian Lawton returns for the discussion today. Measles is no joke.
On today's podcast, we bid farewell to Ben Wiele and welcome Joey Ferreira to our usual panel of co-hosts. We were also pleased to have Dr. Brian Lawton join us to discuss the dangers of foraging for mushrooms.
American Ambulance Paramedic Elisa Bompadre joins the discussion today to share a story from the field. We were also happy to have Dr. Miranda Lewis join us again as a guest co-host.
A huge thanks to Jamie Charlston (special friend of the pod) for sitting down with us and bringing her experience and expertise to the conversation today.
This terrible scenario is rare, but can happen. Make sure you are confident in your knowledge of how to give these patients the best care possible, should you find yourself running this call.
What exactly are these tubes, and more importantly for EMS, what happens if one of these vital tubes becomes dislodged?
Join us for a breakdown of all the various viral illnesses circulating this time of year. All of these should be taken seriously.
We were very happy to have Dave Nicholas, a nurse at CRMC, join the team today to bring his cardiac expertise to the discussion.
This is a big topic, so we split it into two parts.
Our CCEMSA pediatric cardiac arrest specific protocol has been updated be more streamlined and comprehensive with an emphasis on incorporating high performance CPR, as well as quite a few other changes backed by the latest data on how to achieve the favorable outcomes we all are hoping for! Join us as we walk through this updated protocol with Dr. Miranda Lewis.
The first ten minutes of a cardiac arrest are the most critical. We have updated our cardia arrest protocol to incorporate high performance CPR, as well as quite a few other changes backed by the latest data on how to achieve the favorable outcomes we all are hoping for! Join us as we walk through this updated protocol with Dr. Miranda Lewis.
Hyperthermia has a high risk of mortality. A dangerously overheated body, usually in response to prolonged, hot, humid weather, is very important to look out for. Especially in these hot months of summer.
Backboards, cervical collars... first we used them, then we didn't, now we're bringing them back! Why, and how to use them is the subject of today's discussion.
Code 3 driving is a potentially risky part of the job. We are thrilled to have Ben Garcia, American Ambulance's Manager of Risk, Safety and Compliance joins us on the podcast today to discuss how to navigate Code 3 Driving as safely as possible.
Our system has recently added Ketamine to our pain management toolbox. How's it going? Find out!
American Ambulance's own Daniel Bernhardt joins us today to discuss the dangers of RMCT (Refusal of Medical Care and/or Transportation).
It's warming up, and that means the snakes are coming out! Join us for a deep dive into how to approach rattlers, fortunately the only venomous snakes we have in our service area of California.
Transtracheal Jet Insufflation (TTJI) is one of those rarely needed procedures that hopefully you will never even have to perform. But if and when you do, you need to be ready! So have a listen and brush up.
For today's discussion we are joined by two awesome guests: Paramedic Derek Ratzel, and Dr. Joe Mueller, both bringing their own expertise on the subject to the podcast!
The basics (BLS) are core to what we do, and vital to doing it well! Today we are pleased to welcome paramedic and field training officer Alex Diaz to discuss these important EMS fundamentals.
Today our team is pleased to have Kathy Cromwell from Hinds Hospice join us to discuss death and how to navigate this dreaded/avoided but inevitable scenario in the career of an EMS worker.
American Ambulance's own QA documentation specialist Daniel Bernhardt joins us for an exciting update on our newly implemented High Performance CPR Initiative.
Merry Christmas! On this episode we are discussing what it takes to be a CCT Paramedic and outlining the plans for a brand new course that will be rolling out early next year that will bring the training needed to become a CCT medic to California for the first time ever! A very big thanks to American Ambulance CCT Paramedic Clarissa Torralva for joining us for this episode for this exciting conversation.
On this episode we welcome back Dr. Miranda Lewis, the EMS Medical Director of our Central California EMS Agency to talk about Pain Management in EMS and the eminent changes in our local protocols here in the CCEMSA region.
Cardiac Pacing is one of those HALO (High Acuity Low Occurrence) skills that it never hurts to brush up on so that you're ready when the time comes!
A special thanks to American Ambulance Paramedics Ben Callahan and Lauren Cooper for sharing a case on this week's episode!
Ventricular fibrillation (VF) is the most important shockable cardiac arrest rhythm. Still, it's fatal unless good quality, high performance CPR is administered as soon as possible. Lets dive in and really get to understand this rhythm. A special thanks to American Ambulance Paramedic Megan Resendez for sharing a case from the field to get the conversation going.
Kids test everything, even how far that marble can fit up their nose...or worse! Join us as we discuss how to recognize these cases that are often hard or even impossible to easily diagnose. While usually not too serious, these cases can definitely be dangerous, even deadly.
In the central valley we are surrounded by agriculture where extremely poisonous pesticides are used on a daily basis. Today we familiarize ourselves with how to recognize and treat such exposures.
We're called to care, we're here to help, but sometimes a scene can turn and the patient who needs our help might be in crisis and not ready to accept our help. What do we do? Today our usual panel of hosts is joined by American Ambulance's own Ken Katz and Fresno PD Officer Robert Valdez who bring their expertise in de-escalation techniques.
Special thanks to Dr. Miranda Lewis for stopping by to discuss the plans for the inclusion of this drug in our Central California EMS Agency's first responder toolbox!
April 15-19 is Telecommunications Week, so today we're joined by representatives from our local Communications Center to talk us through what their shifts are like. So join us as we break down what life is like on the other end of the radio!
Special thanks to Communications Director Jamie Martin, Call Taker Eloy Robles and Radio Operator/Supervisor Amanda Wilson!
Dr. Patil Armenian couldn't join us for today's podcast, but we have a full panel of guests to talk about the incredibly important topic of scene safety in EMS.
Sergeant Mike Martin join us from the Fresno Police Department, Jamie Martin from the Fresno County Communications Center, Ben Wiele and Ken Katz from American Ambulance, and we have Paramedic Derek Ratzel join us once again to share a story from the field to get the conversation rolling!
Special thanks to American Ambulance's own Kurt Kindig for sharing his story from the field on this episode.
GRAPHIC WARNING for the story portion of this episode. Although this is a medical podcast, some things can still be triggering, especially when gore and suicide are discussed.
This is the first episode that Ben Wiele will be joining the discussion as a regular paramedic co-host. We are very excited to welcome him to our American Ambulance EMS Podcast team!
A special thanks to American Ambulance Critical Care Paramedic Robert Wankel for joining us for this podcast!
Possibly our most important episode ever? Share it with everyone you know, because when it comes to surviving cardiac arrest, speed is everything and technique helps a LOT. Bystander CPR absolutely saves lives, so spread the word!
Special thanks to Dr. Nathan Dreyfus for being a guest host on this episode.
Today, Dr. Miranda Lewis and Dr. Hana Choe bring their expertise to the podcast, and we are also pleased to have American Ambulance Paramedic Dan Bernhardt share a case from the field for us to discuss!
We could think of no better way to celebrate our 100th episode than to have four career paramedics come and share their stories and wisdom gained from their many years of experience in the field. A very special thank you to Lonnie Taylor, Rick Zavala, Mario Torralva, and Dan Ward!
Dr. Seema Policepatil joins us today from UCSF Fresno to share some of her expertise as we dive into the subject of Hypertension.
American Ambulance Paramedic Dan Ward brings a story of how he treated a patient with Blunt Orbital Trauma on today's podcast!
Dr. Lynn Keenan (Clinical Professor of Medicine, UCSF Program Director of Sleep Medicine Fellowship) joins us for a discussion on sleep. For something we spend a third of our lives doing, you might be surprised at how little you know about it and the effects it has on our waking hours.
We are pleased to have Dr. Geetha Sivasubramanian, interim chief of the division of infectious disease at UCSF Fresno, join us today for our discussion.
Welcome to another deep dive into an important drug. Today, our team is honored to be joined by Dr. Miranda Lewis, assistant medical director for SEMSA, and an emergency physician at CRMC.
Unfortunately, drug shortages affect us all. In this episode, our hosts mull over why they happen, and how best to mitigate the effects of these shortages.
Delivering a baby is one of the most amazing things that can happen in this job. But what happens if things don't go as we hope? A huge thanks to Paramedic Derek Ratzel for stopping in to the podcast studio once again and sharing his incredible case with us!
There are a lot of different viruses going around out there right now. Why that is and how best to navigate this surge is what we cover in today's episode.
American Ambulance's own Russ Richardson stops in to bring his experience to this topic's discussion today!
This is a particularly unpleasant subject, but our team breaks it down so that you can be prepared if/when responding to one of these unfortunate calls.
A special thanks to special guest Christian Valdez for bringing us some stories of using the IGel in the field.
Upper gastrointestinal (GI) bleeding is bleeding that can be happening anywhere in the esophagus, stomach, or the upper part of the small intestine. It is usually a symptom of an underlying disorder, and it can be very serious.
American Ambulance Paramedic Lano Tucay stops by the studio this week to share one of his stories about recognizing pulmonary embolism in the field. Thanks, Lano, always a pleasure!
Paramedic Stephan Rippee joins our podcast team today to share a trach story from his early days in EMS.
On this episode, our team is joined by Dr. Lawrence Sue, Clinical Professor of Surgery/Associate Chief of Trauma at Community Regional Medical Center to discuss how to manage prehospital bleeding. Dr. Sue also serves as a medic on Fresno's SWAT team and that experience in prehospital medicine is what makes him such a great guest for today's subject. Enjoy!
Kids are usually fine...until they're not. Respiratory infections can quickly become life threatening. Join our UCSF physician team and our very own Critical Care Paramedic Travis McSherry, as they discuss severe upper respiratory infections in the pediatric population.
Thank you to American Ambulance's own Mario Torralva for bringing your experience to our show this week!
Join us for a discussion on Anaphylaxis, a severe, potentially life-threatening allergic reaction. Today we are joined by Tiffany Rangel, a Paramedic Supervisor with American Ambulance who shares the story of an anaphylaxis call with us.
Involuntary contractions of muscles of the extremities, face, neck, eyes, abdomen, pelvis, or larynx in either sustained or intermittent patterns that lead to abnormal movements or postures.
QIs are not meant to be punitive. The goal of Continuing Quality Improvement is to find parts of the job, policies, and/or protocols that need help. We can't know what to fix without identifying how it's broken! Today we're joined by Kurt Kindig (American Ambulance's new Clinical Coordinator) and Amy Campbell (PLN for Fresno's Community Regional Medical Center) to discuss how the CQI process works and why it's so important to a healthy EMS system.
Dealing with agitated or combative patients is one of the most challenging aspects of the job. Today we are joined by special guest Dr. Matthew Lippi, an emergency medicine resident at UCSF Fresno, as we discuss situations where physical/chemical restraints might be required for the safety of all involved.
Planning a trip to the High Sierras, or working at altitude? Join us on this episode as we introduce another physician guest, Dr. William Frye, to discuss all things altitude.
What is that sixth sense that veteran first responders tend to have when facing difficult decisions in the field? Is it intuition, experience, some sort of spider sense... or could it be a combination of them all? Join us as we discuss EMS "Jedi" training, and what it takes to achieve the level of "Master".
Join us as Paramedic Garry Dhesi stops by the podcast to share a story of how this episode's subject became extremely personal for him and his family.
In this short episode we discuss dental emergencies, specifically fully avulsed teeth and how they can be saved. Tune in to find out what you can do if you encounter this situation in the field to give those teeth their best chance at reimplantation.
The chance to deliver a baby doesn't come around every day, but when it does, we want to be as prepared as possible! American Ambulance Paramedic Mindy Fisher joins us this time to share a story from the field and discuss this miraculous yet potentially terrifying topic.
Today we’re going to talk about ECMO/ECLS and how it intersects with prehospital medicine. ECMO is the acronym for extra-corporeal membrane oxygenation and ECLS is extra-corporeal life support. Please join the UCSF-Fresno team as they discuss this new and exciting topic with special guest Dr. Crystal Ives-Tallman.
Post Traumatic Stress Disorder (PTSD) is more common in first responders than the general population. Please join the UCSF-Fresno physician team as they interview and discuss PTSD with special guests, Ken Katz and Herman Barretto.
This week is EMS week, so we decided to record a special episode celebrating all of you incredible people that have dedicated your lives to caring for our communities. This week our podcast team chats with career Paramedics Noelle Reimers and Clark Sumner. We also sit down with American Ambulance owner Todd Valeri and Dan Lynch, the Fresno County EMS Division Manager, to hear stories of their early days in this field and what motivates them to keep making our EMS system the best it can be!
Stroke is one of the leading causes of death in America and around the world. Join us as we discuss the pathophysiology of strokes and how best to treat our stoke patients in the pre-hospital setting. Our team was pleased to be joined by paramedic Scott Davis for this episode as he stopped in to share a stroke case from the field!
Complaints of abdominal pain are extremely common in EMS, yet each case needs to be taken seriously as the cause can range from the most benign, like indigestion, to the immediately life-threatening such as a ruptured abdominal aortic aneurysm. Join us as we discuss this topic and hear a few stories from the field from our special guest, Paramedic Supervisor Chris Zaczek.
Join us for a lively discussion about pediatric fever. Listen and enjoy the discussion of the pathophysiology of fevers, why high temperatures are such a HUGE deal when a patient is less than 3 months old and how to treat pediatric shock.
Join us for our one-year anniversary podcast! This episode features questions we received from our listeners on a range of topics, from sleep and the challenges of shift work to what diagnosis scares our hosts the most.
Thank you so much to our growing listener base! Over the past year we have really enjoy these discussions and it has truly been an honor bringing you this information in what we hope is an educational but still fun and entertaining way. We have much more to cover, and we promise to continually deliver the best podcast we can!
If you appreciate what we do, don't forget to subscribe, leave us a review, and give us a rating on itunes (or wherever you get your podcasts). It helps so much in making our little podcast move up the search algorithms and appear to those who might be looking for exactly the sort of content we provide. You can also now follow us today on Instagram and Facebook so that you can easier reach out to us with any questions or suggestions of what you'd like to hear us cover in our second year of producing the American Ambulance EMS Podcast!
In acute respiratory distress, telling the difference in the prehospital setting between COPD and CHF can be a challenge. Please join the UCSF-Fresno doctors and special guest, Critical Care Paramedic, Scott Charlston as they discuss the astute differences between pulmonary edema and bronchoconstriction and help give tips and tricks to make sure you are on the correct protocol.
Join our UCSF physician team as they discuss the topic of traumatic amputations. Special guest co-host Dr. Steffani Campbell and Paramedic Ian Ashby join the podcast to discuss amputations and the importance of early tourniquet use. Hear the discussion of the evidence behind the use of tourniquets and hear a lively discussion on how to treat digit amputations.
We are joined this time by EMT Dillon Sacra and Paramedic Clarissa Torralva as they share their case of a bradycardic emergency patient. The podcast team will discuss the pathophysiology of symptomatic bradycardia, the different AV blocks you may encounter on EKG and treatment options like atropine and cardiac pacing.
Please join us with special guest, Paramedic Derek Ratzel as we discuss coronary ischemic chest pain. Hear how aspirin and nitroglycerin work on the body. Enjoy a fun "Fact vs Fiction" discussion about common misconceptions in the care of chest pain patients that help us all understand how the treatment provided in the field makes a difference in the patient's ultimate outcome.
Seeing tachycardia on the monitor can certainly be tachycardia inducing for EMS providers! Join our UCSF-Fresno docs and special guest, EMT Jordan Golding as the team discusses the the different fast rhythms that can present and the treatment options of stable and unstable patients.
Today, we will be answering lots of frequently asked questions about COVID vaccines. Join our UCSF- Fresno physician team to hear a fun, evidence based discussion.
Join us for our 25th episode of the podcast! Today, we will be discussing acute ingestion/poisoning cases and our UCSF Fresno physician team will be joined by senior Paramedic Hal Fielding. Hear a fast paced, evidence based discussion on current EMS treatment and why charcoal and ipecac are falling out of favor.
Interested in how cocaine and methamphetamine affect the heart? Tune in to this podcast to hear a lively discussion about these substances, the short term and long term effects they have on the heart and how stimulants can affect your chest pain patients.
Please join our Podcast team with special co-host Dr. Kayla Johnson and paramedic Kyle Van Mowrick as we discuss the epidemiology, pathophysiology and treatment of pediatric respiratory distress. You will hear a great discussion regarding asthma, brochiolitis, croup and foreign body obstruction. After listening, you will have a deeper understanding of upper and lower airway sounds including stridor and wheezing and how this assessment can impact treatment decisions.
A seizure is a sudden, uncontrolled electrical disturbance in the brain. Join is as we discuss the pathophysiology of seizures, how best to treat them, and hear a case from Paramedic Jordan Yost.
Burnout is real, and affects everyone at some point in their lives. In this episode, we talk to EMT Lashon Newsome about her experience with it and how it led to her career in paramedicine. We discuss burnout in depth, including what leads to it and ways to get yourself out of it with our American Ambulance social worker Ken Katz, In addition, our Human Resources adviser Victoria Pope joins us to explain all the wellness tools American Ambulance has available to its wonderful employees.
Asthma affects many children and adults around the country, and we have an especially high rate of asthma in the California Central Valley. This podcast discusses the pathophysiology of asthma, common triggers, and the mainstays of treatment. Hear Paramedic Jordan Yost’s asthma case and how quick interventions provided great patient care.
Join us on this podcast as we meet the owner and CEO of American Ambulance. Mr. Todd Valeri shares his inspirational story of how he got into paramedicine. He also discusses his vision for the agency and shares with us insight into his involvement in EMS at a regional and statewide level.
Dry drowning, wet drowning, near drowning…What really matters when you find someone who has been drowning? Is it necessary to always protect c-spine if it makes airway management difficult? Listen to the team’s conversation as they highlight the most important aspects of submersion injuries. Our guest this episode is Paramedic Tasha Mulvena. Thank you Tasha, for going above and beyond the call of duty and taking care of patients the way no one else can.
In today's episode, we discuss smoke inhalation, specifically the toxic gases carbon monoxide and cyanide. Cyanide is a toxic gas formed from the combustion of plastic and petroleum products, which is basically everything a modern home/building is made out of. We discuss the mainstays of prehospital treatment for smoke inhalation, Oxygen, as well as cyanide antidotes carried by prehospital personnel in some EMS agencies in the US and Europe.
References:
Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation.
Borron SW, Baud FJ, Barriot P, Imbert M, Bismuth C. Ann Emerg Med. 2007;49:794-801
Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning?
Alan H Hall 1, Richard Dart, Gregory Bogdan. Ann Emerg Med. 2007;49:806-813.
Much attention has been paid to opioid abuse in recent years; yet, in the Central Valley, we can trace many drug related accidents and illness to Methamphetamine. Co-host and resident Toxicologist Dr. Armenian has a wealth of knowledge to give you the tools you need, from history, to clinical presentation, to treatment. It may change how you care for your next patient. Our guest this episode is Derek Ratzel. Thank you Derek, for recognizing and treating some of the most unpredictable presentations.
Please join us and Special guest Mato Parker from the EMS Agency have an evidence based discussion surrounding the quality improvement initiatives for the Central California EMS Agency (CCEMSA).
SHOW NOTES:
Brown J, Rosengart M, et al. Not all prehospital time is equal, Influence of scene time on mortality
J Trauma Acute Care Surg. 2016 Jul; 81(1): 93–100.
Nasser A, Nederpelt C, et al. Every Minute Counts: The impact for pre hospital response time and scene time on mortality of penetrating trauma patients. American Journal of Surgery 2019, 220:1, 240-244.
Haroon C, Ratner D, Pozo M, et al. Prehospital delay and its impact on time to treatment in ST-elevation myocardial infarction. Am J Emerg Med. 2011;29(4):396–400.
McNally B, Stokes A, Crouch A, Kellermann AL; CARES Surveillance Group. CARES: Cardiac Arrest Registry to Enhance Survival. Ann Emerg Med. 2009;54(5):674-683.e2. doi:10.1016/j.annemergmed.2009.03.018
Non-accidental trauma is something no one wants to talk about, but it is something you should always be thinking about. In this episode, the team discusses specific findings that should make you suspicious, or at least think twice, while you are transporting a child. You can be the difference between a healthy child and a fatal case report. Thank you to our guest, Ben Garcia, American Ambulance's Operation Manager, for his contribution to this episode, his knowledge and insight provided the perfect complement to our hosts’ discussion.
Diabetic complications are a common complaints faced by EMS daily. Tune in to hear paramedic Chris Zaczek share his story and listen to an evidence based discussion of hypoglycemia and other diabetic emergencies.
The Central Valley gets hot. Really hot. One of the most dangerous conditions that we see all of the time, yet tend to look over, is heat illness. This can range from mild exhaustion to lethal heat stroke. What’s the fastest way to cool a patient in the back of an ambulance? Our guest this episode is Paramedic Lonnie Taylor. Thank you Lonnie, for your incredible dedication and hard work each and every day.
Trauma calls can be chaotic, and code situations can be the most stressful call EMS providers receive. What happens if a patient codes in the setting of trauma? What do you need to remember to do differently? What is going to save that person’s life? Our guest this episode is Paramedic Lonnie Taylor. Thank you Lonnie, for staying cool in the most tense situations and being someone we can aspire to be.
Lightning strikes are not common; however, about 30% of those struck by lightning die and up to 70% have permanent disabilities. Within one hour of injury, respiratory failure and arrhythmias can be lethal. The teams gives you the practical knowledge you can use if you are ever in this unique situation. Our guest this episode is John-Mark Bergen. Thank you John-Mark, for sharing your experiences so that we can all learn.
As the opioid epidemic evolves, there is a rise in synthetic opioid intoxication such as with fentanyl and use of naloxone in the prehospital setting. In this episode, we talk about the CCEMSA protocol along with assessment and management of these patients, with special attention paid to naloxone dosing.