The EMS Lighthouse Project: Recent Episodes
FlightBridgeED, LLC.
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Mike Verkest and Dr. Jeff Jarvis as they shine the bright light of science on EMS practice in an informative and fun way.
Y’all know I have thoughts on epinephrine in cardiac arrest. And perhaps might have heard me say epinephrine “saves the heart at the expense of the brain”. I’ve also said I don’t have an issue with any epinephrine in arrest, just how we give it currently and have wondered if less epi might do the trick. We review the One and Done paper recently published from North Carolina that looks at this question.
Citations
1. Ashburn NP, Beaver BP, Snavely AC, Nazir N, Winslow JT, Nelson RD, Mahler SA, Stopyra JP: One and Done Epinephrine in Out-of-Hospital Cardiac Arrest? Outcomes in a Multiagency United States Study. Prehospital Emergency Care. 2022;September 26;27(6):751–7.
2. Fernando SM, Mathew R, Sadeghirad B, Rochwerg B, Hibbert B, Munshi L, Fan E, Brodie D, Di Santo P, Tran A, et al.: Epinephrine in Out-of-Hospital Cardiac Arrest. Chest. 2023;August;164(2):381–93.
We’ve spoken a lot recently about intubation First Pass Success, including what the definition is. We’ve also discussed different papers about the impact the type of laryngoscope, video or direct, has on first pass success. There’s a new paper out that directly compares video vs direct laryngoscopy. Join us to discuss the DEVICE trial.
Citations Prekker ME, Driver BE, Trent SA, et al. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. Published online June 16, 2023 Jarvis JL, McClure SF, Johns D. EMS Intubation Improves with King Vision Video Laryngoscopy. Prehosp Emerg Care. 2015 Ducharme S, Kramer B, Gelbart D, Colleran C, Risavi B, Carlson JN. A pilot, prospective, randomized trial of video versus direct laryngoscopy for paramedic endotracheal intubation. Resuscitation. 2017 Pourmand A, Terrebonne E, Gerber S, Shipley J, Tran QK. Efficacy of Video Laryngoscopy versus Direct Laryngoscopy in the Prehospital Setting: A Systematic Review and Meta-Analysis. Prehosp Disaster Med. 2023 Brown CA, Kaji AH, Fantegrossi A, et al. Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study. Acad Emerg Med. 2020 Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation: a Cochrane systematic review and meta-analysis update. British Journal of Anaesthesia. 2022
See omnystudio.com/listener for privacy information.
What even IS FPS? There's been a long running argument about the definition of FPS. And by argument, I mean mostly established in the literature with some people just not liking it. FPS is successful ET passage through the cords within 1 attempt at laryngoscopy or when the blade passes the teeth.
That definition worked well when we were using direct laryngoscopy where the hard part of intubation was visualization and the easy part of tube passage. But does it still hold in an age of VL where visualization is easy and tube passage is the hard part.
We discuss a paper on this episode that proposes a new definition, perhaps better meeting the needs of the VL era.
Citation:
Trent SA, Driver BE, Prekker ME, et al. Defining Successful Intubation on the First Attempt Using Both Laryngoscope and Endotracheal Tube Insertions: A Secondary Analysis of Clinical Trial Data. Annals of Emergency Medicine. Published online April 2023:S0196064423002135. doi:10.1016/j.annemergmed.2023.03.021
See omnystudio.com/listener for privacy information.
A new study came out describing the utility of post-mortem CT panscans in patients who died either in the field or in the ED to identify mortal and potentially mortal injuries. This paper has a couple of surprise findings that can help EMS focus our efforts on the care of these patients.
Citations:
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Levin JH, Pecoraro A, Ochs V, Meagher A, Steenburg SD, Hammer PM. Characterization of fatal blunt injuries using post-mortem computed tomography. J Trauma Acute Care Surg. 2023;Publish Ahead of Print.
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Sakles JC, Ross C, Kovacs G. Preventing unrecognized esophageal intubation in the emergency department. JACEP Open. 2023;4(3):e12951.
- Chrimes N, Higgs A, Hagberg CA, et al. Preventing unrecognised oesophageal intubation: a consensus guideline from the Project for Universal Management of Airways and international airway societies*. Anaesthesia. 2022;77(12):1395-1415.See omnystudio.com/listener for privacy information.
DSI (delayed sequence intubation) has been proposed as an alternative to RSI (rapid sequence intubation) for patients who can't tolerate interventions needed to properly pre oxygenate patients. But does it work? There have been several observational studies (blantant bias acknowledgement: I wrote one of them!) suggesting it is safe and effective but no randomized trials. Well, now we have one. Join Dr. Jarvis as he describes this RCT of DSI vs RSI in adult trauma patients presenting to an Indian ED.
Citation:1. Bandyopadhyay A, Kumar P, Jafra A, Thakur H, Yaddanapudi LN, Jain K. Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial. Anesthesia & Analgesia. 2023;136(5):913-919.See omnystudio.com/listener for privacy information.
We interviewed Tanner Smida in episode 69 about his very interesting paper using the ESO dataset looking at the association between survival from out of hospital cardiac arrest and type of SGA used (iGel vs KingLT). He found 36% higher odds of survival with iGel.
The ink was barely dry on that paper before he published a follow up paper looking at the same association but with a different dataset, this time CARES, and national US registry of OHCA. Citations:1. Smida T, Menegazzi J, Scheidler J, Martin PS, Salcido D, Bardes J. A retrospective comparison of the King Laryngeal Tube and iGel supraglottic airway devices: a study for the CARES surveillance group. Resuscitation. Published online April 2023:109812. doi:10.1016/j.resuscitation.2023.1098122. Smida T, Menegazzi J, Crowe R, Scheidler J, Salcido D, Bardes J. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care. Published online January 18, 2023:1-13. doi:10.1080/10903127.2023.2169422See omnystudio.com/listener for privacy information.
Man, did we have fun recording this one. I found myself in a hotel room in Ashland, Oregon with Drs. Ed Racht, Maia Dorsett, and Ritu Sahni talking about Sepsis. We decided this would make for a great crossover episode with The EMS Show, minus our buddy Mikey V. Anytime I get together with this group of friends, I always have fun. We discuss a new sepsis trial but also discuss the OG sepsis paper, Dr. River's Early Goal Direct Therapy and discuss the cautionary tale of performance measures gone awry. We also hit on using EtCO2 as a surrogate for lactate in sepsis and collectively decide Dr. Dorsett is a rockstar.
Citation: The National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023;388(6):499-510. doi:10.1056/NEJMoa2212663
See omnystudio.com/listener for privacy information.
The cage match you've all been waiting for! iGel vs King LT in cardiac arrest. Which is associated with higher survival?
Airways-2 was an RCT of iGel vs ETI in OHCA and found no difference.PART was an RCT of King LT vs ETI in OHCA and found a slight difference favoring King LT.How about in those patients just getting a SGA... how does the iGel compare to King LT? Dr. Jarvis interviews the amazing young researcher and medical student Tanner Smida about his new paper using the ESO dataset to answer just this question. Citation: 1. Smida T, Menegazzi J, Crowe R, Scheidler J, Salcido D, Bardes J. A Retrospective Nationwide Comparison of the iGel and King Laryngeal Tube Supraglottic Airways for Out-of-Hospital Cardiac Arrest Resuscitation. Prehospital Emergency Care. Published online January 18, 2023:1-13.See omnystudio.com/listener for privacy information.
Remember AIRWAYS-2, the British RCT comparing iGel to ETI in adults with cardiac arrest? Have you wondered if those results would hold up in a different prehospital population?
Wonder no more. Dr. Jarvis reviews the SAVE Trial, another RCT of adult, non-traumatic cardiac arrest comparing iGel to ETI in Taiwan. Citation: 1. Lee AF, Chien YC, Lee BC, et al. Effect of Placement of a Supraglottic Airway Device vs Endotracheal Intubation on Return of Spontaneous Circulation in Adults With Out-of-Hospital Cardiac Arrest in Taipei, Taiwan: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2022;5(2):e2148871. doi:10.1001/jamanetworkopen.2021.48871See omnystudio.com/listener for privacy information.
If one is good, two must be better, right? If it applies to cookies and ice cream, why not defibrillators? That’s the question the DOSED-VF trial set out to answer. We’ve covered this topic in episodes 12 and 27, including going over the pilot trial of DOSED-VF. But now the full meal deal is available. And you may have heard it was stopped early because… well, you’d best listen to find out.
And, as a special bonus, Dr. Jarvis explains the difference between odds and risk after he fell off into the statistical rabbit hole. Remember, this podcast also has a YouTube version complete with graphs and charts (oh, my!): https://www.youtube.com/@FlightbridgeedHEMS/playlistsCitation:1. Cheskes S, Verbeek PR, Drennan IR, et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022;387(21):1947-1956. doi:10.1056/NEJMoa2207304Other papers discussed in this episode:2. Mapp JG, Hans AJ, Darrington AM, et al. Prehospital Double Sequential Defibrillation: A Matched Case–Control Study. Braithwaite SA, ed. Academic Emergency Medicine. 2019;26(9):994-1001. doi:10.1111/acem.136723. Beck LR, Ostermayer DG, Ponce JN, Srinivasan S, Wang HE. Effectiveness of Prehospital Dual Sequential Defibrillation for Refractory Ventricular Fibrillation and Ventricular Tachycardia Cardiac Arrest. Prehosp Emerg Care. 2019;23(5):597-602. doi:10.1080/10903127.2019.15842564.Cabanas JG, Myers JB, Williams JG, De Maio VJ, Bachman MW. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015;19(1):126-130. doi:10.3109/10903127.2014.9424765. Cheskes S, Dorian P, Feldman M, et al. Double sequential external defibrillation for refractory ventricular fibrillation: The DOSE VF pilot randomized controlled trial. Resuscitation. 2020;150:178-184. doi:10.1016/j.resuscitation.2020.02.0106. Ranganathan P, Aggarwal R, Pramesh C. Common pitfalls in statistical analysis: Odds versus risk. Perspect Clin Res. 2015;6(4):222. doi:10.4103/2229-3485.167092See omnystudio.com/listener for privacy information.
Dr. Crowe returns to the EMS Lighthouse Project Podcast from our “vacation” in Mexico to discuss the impact of variations between pulse oximetry and blood gas values across races.
Citation:
- Sudat SEK, Wesson P, Rhoads KF, et al. Racial Disparities in Pulse Oximeter Device Inaccuracy and Estimated Clinical Impact on COVID-19 Treatment Course. Am J Epidemiol. Published online September 2022:kwac164. doi:10.1093/aje/kwac164
- Fawzy A, Wu TD, Wang K, et al. Racial and Ethnic Discrepancy in Pulse Oximetry and Delayed Identification of Treatment Eligibility Among Patients With COVID-19. JAMA Intern Med. 2022;182(7):730. doi:10.1001/jamainternmed.2022.1906
See omnystudio.com/listener for privacy information.
National guidelines for the management of seizures recommend midazolam 10 mg IM as first line therapy. The big question is how often EMS follows this guideline or how well that guideline matches up to real world use. Dr. Jarvis makes a road trip to ESO headquarters to discuss this paper using the ESO research dataset with newly minted Texan Mike Verkest and special guest Dr Remle Crowe. We go deep on the very interesting methodology used in this paper as we get our nerd on!
Citation: Guterman EL, Sporer KA, Newman TB, et al. Real-World Midazolam Use and Outcomes With Out-of-Hospital Treatment of Status Epilepticus in the United States. Annals of Emergency Medicine. Published online August 2022.
doi:10.1016/j.annemergmed.2022.05.024See omnystudio.com/listener for privacy information.
National guidelines for the management of seizures recommend midazolam 10 mg IM as first line therapy. The big question is how often EMS follows this guideline or how well that guideline matches up to real world use. Dr. Jarvis makes a road trip to ESO headquarters to discuss this paper using the ESO research dataset with newly minted Texan Mike Verkest and special guest Dr Remle Crowe. We go deep on the very interesting methodology used in this paper as we get our nerd on!
Citation: Guterman EL, Sporer KA, Newman TB, et al. Real-World Midazolam Use and Outcomes With Out-of-Hospital Treatment of Status Epilepticus in the United States. Annals of Emergency Medicine. Published online August 2022.
doi:10.1016/j.annemergmed.2022.05.024See omnystudio.com/listener for privacy information.
First, there was Episode 31: TXA for Epistaxis (the Zahed RCT from Tehran), then there was Episode 40: TXA for Epistaxis, Part Deux (the NoPAC trial), now there's Episode 64: TXA for Epistaxis, Part Trois, another Iranian RCT.
So... we have conflicted evidence, all from RCTs, about whether TXA works for epistaxis. Dr. Jarvis goes through the prior trials and then gives a more detailed look at the new evidence. He closes by talking about how he handles conflicting evidence.
Citation: Hosseinialhashemi M, Jahangiri R, Faramarzi A, et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Annals of Emergency Medicine. 2022;80(3):182-188. doi:10.1016/j.annemergmed.2022.04.010See omnystudio.com/listener for privacy information.
First, there was Episode 31: TXA for Epistaxis (the Zahed RCT from Tehran), then there was Episode 40: TXA for Epistaxis, Part Deux (the NoPAC trial), now there's Episode 64: TXA for Epistaxis, Part Trois, another Iranian RCT.
So... we have conflicted evidence, all from RCTs, about whether TXA works for epistaxis. Dr. Jarvis goes through the prior trials and then gives a more detailed look at the new evidence. He closes by talking about how he handles conflicting evidence.
Citation: Hosseinialhashemi M, Jahangiri R, Faramarzi A, et al. Intranasal Topical Application of Tranexamic Acid in Atraumatic Anterior Epistaxis: A Double-Blind Randomized Clinical Trial. Annals of Emergency Medicine. 2022;80(3):182-188. doi:10.1016/j.annemergmed.2022.04.010See omnystudio.com/listener for privacy information.
Description: COVID sucks, no doubt about it. Vaccination has been a game changer for how we live through the pandemic, but we still need therapeutics for those breakthrough cases and the unvaccinated amongst us. Paxlovid is a novel anti-viral agent that showed promise in an initial industry-sponsored trial among unvaccinated patients with the delta strain. But does it hold up in the real world where vaccination is common, and omicron has pushed delta to the wayside? Dr. Jarvis reviews the initial RCT and a recent Israeli observational trial where more than 75% of patients were vaccinated. He also covers the contraindications for its use. Finally, he’ll no doubt massacre the almost impossible-to pronounce generic names for the drugs in Paxlovid.
Citations.
- Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in Reducing Severe Coronavirus Disease 2019 and Mortality in High-Risk Patients. Clinical Infectious Diseases. Published online June 2, 2022:ciac443. doi:10.1093/cid/ciac443 2.Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022;386(15):1397-1408. doi:10.1056/NEJMoa2118542See omnystudio.com/listener for privacy information.
Description: COVID sucks, no doubt about it. Vaccination has been a game changer for how we live through the pandemic, but we still need therapeutics for those breakthrough cases and the unvaccinated amongst us. Paxlovid is a novel anti-viral agent that showed promise in an initial industry-sponsored trial among unvaccinated patients with the delta strain. But does it hold up in the real world where vaccination is common, and omicron has pushed delta to the wayside? Dr. Jarvis reviews the initial RCT and a recent Israeli observational trial where more than 75% of patients were vaccinated. He also covers the contraindications for its use. Finally, he’ll no doubt massacre the almost impossible-to pronounce generic names for the drugs in Paxlovid.
Citations.
- Najjar-Debbiny R, Gronich N, Weber G, et al. Effectiveness of Paxlovid in Reducing Severe Coronavirus Disease 2019 and Mortality in High-Risk Patients. Clinical Infectious Diseases. Published online June 2, 2022:ciac443. doi:10.1093/cid/ciac443 2.Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. N Engl J Med. 2022;386(15):1397-1408. doi:10.1056/NEJMoa2118542See omnystudio.com/listener for privacy information.
Our good friends at Montgomery County Hospital District EMS in suburban Houston brings us a nice feasibility study about the use of esmolol for refractory v-fib. Dr. Jarvis discusses why this is a helpful study.
If you like the show, please give us a 5-star rating wherever you get your podcasts. Did you know our podcast is on YouTube, too? Check us out and subscribe on the FlightBridgeED channel. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvis
See omnystudio.com/listener for privacy information.
Our good friends at Montgomery County Hospital District EMS in suburban Houston brings us a nice feasibility study about the use of esmolol for refractory v-fib. Dr. Jarvis discusses why this is a helpful study.
If you like the show, please give us a 5-star rating wherever you get your podcasts. Did you know our podcast is on YouTube, too? Check us out and subscribe on the FlightBridgeED channel. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvis
See omnystudio.com/listener for privacy information.
Dr. Jarvis interviews several EMS industry leaders discussing why we should use Red Lights & Sirens as a clinical intervention and only as indicated. This podcast is part of the first-ever national EMS quality improvement effort led by NEMSQA (https://www.nemsqa.org/lights-and-siren)
Join us for interviews with Drs. Doug Kupas, Lawrence Brown, Michael Redlenner, and Mike Taigman to hear about The Case Against Lights & Sirens. Did you know all of our podcasts are also available as in video versions? Check them out on the FlightbridgeED YouTube channel.
See omnystudio.com/listener for privacy information.
Dr. Jarvis interviews several EMS industry leaders discussing why we should use Red Lights & Sirens as a clinical intervention and only as indicated. This podcast is part of the first-ever national EMS quality improvement effort led by NEMSQA (https://www.nemsqa.org/lights-and-siren)
Join us for interviews with Drs. Doug Kupas, Lawrence Brown, Michael Redlenner, and Mike Taigman to hear about The Case Against Lights & Sirens. Did you know all of our podcasts are also available as in video versions? Check them out on the FlightbridgeED YouTube channel.
See omnystudio.com/listener for privacy information.
I got a great question during my FAST22 talk about what to make of two different papers, seemingly on the same topic, that give different results. In this case, it was about the Prague study Mike and I spoke about on the last episode (E59) and the one from Minneapolis (The ARREST trial). It was a great question that’ll I’ll discuss in this episode. I’ll also talk more about the ARREST trial.
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvisSee omnystudio.com/listener for privacy information.
I got a great question during my FAST22 talk about what to make of two different papers, seemingly on the same topic, that give different results. In this case, it was about the Prague study Mike and I spoke about on the last episode (E59) and the one from Minneapolis (The ARREST trial). It was a great question that’ll I’ll discuss in this episode. I’ll also talk more about the ARREST trial.
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvisSee omnystudio.com/listener for privacy information.
Mikey V and Dr. Jarvis get together again, “live” from Planet Hollywood at Las Vegas for FAST22! We took the opportunity to sit down and discuss two papers on cardiac arrest. Should we stay and play or should we load and go? In other words, should we work our arrests to conclusion where we find them or rapidly transport them? In a paper from Prague, we discuss whether early transport with LUCAS direct to cath lab for ECMO and PCI improves survival.
As a foretaste of a pod to come, we’ll discuss the apparent contrasting results between the Prague ECMO study and one from Minneapolis (The ARREST trial) in a future episode. If you like the show, please give us a 5-star rating wherever you get your podcasts. Did you know our podcast is on YouTube, too? Check us out and subscribe on the FlightBridgeED channel. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvis
See omnystudio.com/listener for privacy information.
Mikey V and Dr. Jarvis get together again, “live” from Planet Hollywood at Las Vegas for FAST22! We took the opportunity to sit down and discuss two papers on cardiac arrest. Should we stay and play or should we load and go? In other words, should we work our arrests to conclusion where we find them or rapidly transport them? In a paper from Prague, we discuss whether early transport with LUCAS direct to cath lab for ECMO and PCI improves survival.
As a foretaste of a pod to come, we’ll discuss the apparent contrasting results between the Prague ECMO study and one from Minneapolis (The ARREST trial) in a future episode. If you like the show, please give us a 5-star rating wherever you get your podcasts. Did you know our podcast is on YouTube, too? Check us out and subscribe on the FlightBridgeED channel. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com @DrJeffJarvis
See omnystudio.com/listener for privacy information.
Y’all have had lots of questions about using sodium bicarbonate in cardiac arrest after we ran an interview with Dr. Menegazzi talking about an abstract he presented showing benefit with bicarb. You wanted more so here it is! Dr. Jarvis reviews a paper from British Columbia from 2017 that looks at just this thing!
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the
Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at:
Jeff.jarvis@flightbridgeed.com
@DrJeffJarvis
Citations:
1. Kawano T, Grunau B, Scheuermeyer FX, et al. Prehospital sodium bicarbonate use could worsen long term survival with favorable neurological recovery among patients with out-ofhospital cardiac arrest. Resuscitation. 2017;119:63-69. doi:10.1016/j.resuscitation.2017.08.008
See omnystudio.com/listener for privacy information.
Y’all have had lots of questions about using sodium bicarbonate in cardiac arrest after we ran an interview with Dr. Menegazzi talking about an abstract he presented showing benefit with bicarb. You wanted more so here it is! Dr. Jarvis reviews a paper from British Columbia from 2017 that looks at just this thing!
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the
Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at:
Jeff.jarvis@flightbridgeed.com
@DrJeffJarvis
Citations:
1. Kawano T, Grunau B, Scheuermeyer FX, et al. Prehospital sodium bicarbonate use could worsen long term survival with favorable neurological recovery among patients with out-ofhospital cardiac arrest. Resuscitation. 2017;119:63-69. doi:10.1016/j.resuscitation.2017.08.008
See omnystudio.com/listener for privacy information.
Join us for a joint release of the first episode of The Pediatric EMS Podcast. We collaborate with the great folks from the PEC podcast, and MedicMindset to introduce this new podcast. We discuss assessment and management of pediatric pain.See omnystudio.com/listener for privacy information.
Join us for a joint release of the first episode of The Pediatric EMS Podcast. We collaborate with the great folks from the PEC podcast, and MedicMindset to introduce this new podcast. We discuss assessment and management of pediatric pain.See omnystudio.com/listener for privacy information.
Do y'all treat a-fib? Have you wondered what the best method of rate control is? Should you use diltiazem or metoprolol? How about the best pad placement for electrical Cardioversion? Should you go anterior posterior or anterior lateral? Great questions! Dr. Jarvis reviews two recent papers to help shed the bright light of science on these two questions.See omnystudio.com/listener for privacy information.
Do y'all treat a-fib? Have you wondered what the best method of rate control is? Should you use diltiazem or metoprolol? How about the best pad placement for electrical Cardioversion? Should you go anterior posterior or anterior lateral? Great questions! Dr. Jarvis reviews two recent papers to help shed the bright light of science on these two questions.See omnystudio.com/listener for privacy information.
We’re back with the second part of our interviews with researchers from NAEMSP 2022 conference in San Diego. In this episode, Dr. Jarvis interviews Dr. Brian Miller from Fort Worth, Texas about his work on “MCD Walk”, ie the case of the migratory Lucas device, Dr. Sarah Frances McClure from UT San Antonio about the impact of EMS leadership engagement on a medic’s decision to get vaccinated against COVID-19, and finally Dr. Jim Menegazzi from Pitt about sodium bicarb in EMS Witnessed cardiac arrest.
Abstracts:
“MCD Walk” – Mechanical Compression Device Migration Leading to Inadequate Compression Depth.
Kerby Johnson, BS, NRP
William Gleason, BS, LP
Brian Miller, MD, FACEP, FAEMS
Veer Vithalani, MD, FACEP, FAEMS
Office of the Medical Director, Metropolitan Area EMS Authority, Fort Worth, Texas
EMS Leadership Presence Positively Influences EMS Provider’s Decision to Receive the COVID-19 Vaccine
Sarah Frances McClure, DO, FAWM, NRP
Bryan Everitt, MD, NRP
Mark Sparkman, MD
David Wampler, PhD, LP
Courtney Wenzell, EMT-P
University of Texas Health Science Center at San Antonio, Dept of Emergency Medicine & San Antonio FD
Sodium Bicarbonate Use in EMS-Witnessed Out-of-Hospital Cardiac Arrest
Sara M. Niederberger
Remle Crowe, PhD, EMT
David D. Salcido, PhD
James J. Menegazzi, PhD
University of Pittsburgh School of Medicine, Dept of Emergency Medicine, & ESO
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at:
Jeff.jarvis@flightbridgeed.com
@DrJeffJarvis
See omnystudio.com/listener for privacy information.
We’re back with the second part of our interviews with researchers from NAEMSP 2022 conference in San Diego. In this episode, Dr. Jarvis interviews Dr. Brian Miller from Fort Worth, Texas about his work on “MCD Walk”, ie the case of the migratory Lucas device, Dr. Sarah Frances McClure from UT San Antonio about the impact of EMS leadership engagement on a medic’s decision to get vaccinated against COVID-19, and finally Dr. Jim Menegazzi from Pitt about sodium bicarb in EMS Witnessed cardiac arrest.
Abstracts:
“MCD Walk” – Mechanical Compression Device Migration Leading to Inadequate Compression Depth.
Kerby Johnson, BS, NRP
William Gleason, BS, LP
Brian Miller, MD, FACEP, FAEMS
Veer Vithalani, MD, FACEP, FAEMS
Office of the Medical Director, Metropolitan Area EMS Authority, Fort Worth, Texas
EMS Leadership Presence Positively Influences EMS Provider’s Decision to Receive the COVID-19 Vaccine
Sarah Frances McClure, DO, FAWM, NRP
Bryan Everitt, MD, NRP
Mark Sparkman, MD
David Wampler, PhD, LP
Courtney Wenzell, EMT-P
University of Texas Health Science Center at San Antonio, Dept of Emergency Medicine & San Antonio FD
Sodium Bicarbonate Use in EMS-Witnessed Out-of-Hospital Cardiac Arrest
Sara M. Niederberger
Remle Crowe, PhD, EMT
David D. Salcido, PhD
James J. Menegazzi, PhD
University of Pittsburgh School of Medicine, Dept of Emergency Medicine, & ESO
If you like the show, please give us a 5-star rating wherever you get your podcasts.
Did you know our podcast is on YouTube, too? Check us out and subscribe on the Flightbridgeed channel.
Drop us questions/comments/suggestion for future pods at:
Jeff.jarvis@flightbridgeed.com
@DrJeffJarvis
See omnystudio.com/listener for privacy information.
NAEMSP in Sunny San Diego… Just. SO. MUCH. GREAT. RESEARCH. Dr. Jarvis interviewed a small sample of the great work presented. There was so much we broke it into two parts. This episode features interviews with Dr. Amber Rice from Tucson, Arizona discussing a secondary analysis of the EPIC trial looking further into the impact of hypotension on TBI, Dr. Veer Vithalani from MedStar in Fort Worth, TX discussing how he used his CAD and ePCR data to determine which calls could safely get a BLS response, Dr. Erin Lincoln from Austin discussing her work on disparities in analgesia, and Dr. Henry Wang on his latest secondary analysis of the PART trial, this one looking at the impact of airway type (LT or ET) on ventilatory rates.
Are you still giving Calcium in undifferentiated cardiac arrests? Not those with hyperkalemia or hypocalcemia… you know, when it’s actually indicated. Be honest, now… Nobody’s looking. If you are, join us for this episode where we review a randomized, double blind, placebocontrolled clinical trial of calcium vs placebo in out of hospital cardiac arrest.
Do you even bougie, bro? Do you use the bougie on every intubation? If so, why? Do you think it improves first pass success? Well, I certainly did. At least before this trial was released. Join me to discuss this randomized controlled trial of bougie vs no bougie for intubation. I suspect the results will surprise you!
Dr. Jarvis and Mike Verkest return for part 2 of our interviews with some of the great researchers at the Prehospital Care Research Forum at EMS Expo in Atlanta. In this episode, we interview: Kevin Collopy on his RCT comparing ketamine and etomidate for RSI, Sean McAllister on Sepsis using the ESO dataset, and David Page about PCRF and his work on comparing Mexican and American EMT training. If you like the show, please give us a like on YouTube and a 5-star rating wherever you get your podcasts.
Dr. Jarvis and Mike Verkest were at EMS Expo in Atlanta. We recorded some interviews from the FlightbridgeED booth on the exhibit floor and then discussed them when Mike stopped by the Casa Jarvis in Austin a bit later. There was so much goodness, we broke it up into two different episodes to keep these at a reasonable length.
Ketamine has been getting a lot of attention recently in the media. Its probably safe to say it’s had a bad year. We like ketamine. We felt bad it’s been having a rough year so we wanted to do something that would lift its spirits. Fortunately, Dr. David Barbic and his colleagues from Vancouver, BC published a wonderful, randomized trial comparing ketamine to a combination of haloperidol plus midazolam for undifferentiated agitation in the ED. This was the amazingly titled RACKED trial (Rapid Agitation Control with Ketamine in the ED). It has direct and important implications for EMS and is something all emergency providers should know about. Dr. Jarvis reviews the trial and then invites Dr. Barbic himself on the show to discuss this study. If you like the show, please give us a like on YouTube and a 5-star rating wherever you get your podcasts.
Mike and Jeff get together to discuss some airway papers from the National Emergency Airway Registry (NEAR) and float an idea for some merch.If you like the show, please give us a like on YouTube and a 5-star rating wherever you get your podcasts. Drop us questions/comments/suggestion for future pods at: Jeff.jarvis@flightbridgeed.com, @DrJeffJarvis, or Mike.Verkest@flightbridgeed.com, @MikeVerkest
In this episode, Dr. Jarvis discusses a paper that is hot off the presses and that he’s super excited to talk about. The good folks up in Seattle, WA and the Seattle FD looked at their cardiac arrest survival rates as a function of the number of intubation attempts needed to secure the airway. Results from this trial might help explain the 2.9% improved survival with King LT vs ETI that we saw in the PART trial. Join us to hear all the juicy details. As always, if you like the pod, give us a 5-star rating wherever you get your pods. If you have any questions, drop us a note: jeff.jarvis@flightbridgeed.com or @DrJeffJarvis and mike.verkest@flightbridgeed.com or @MikeVerkest. You can also follow the pod on Twitter at @EMSLighthouseProject.
Every other year board certified EMS physicians must take an open book quiz over 20-25 papers felt by the American Board of Emergency Medicine (ABEM) to be something all EMS physicians should know. Dr. Jarvis and Dr. Casey Patrick (@cpatrick_89) from Montgomery County Health District EMS gave a lecture reviewing the 2020 ABEM EMS LLSA articles at the recent meeting of the Texas Chapter of NAEMSP. We got together right after our lecture to record this podcast going over these articles. Join us from the Cavalier Room at the Historic Menger Hotel (@mengerhotel) in downtown San Antonio, literally next door to the Alamo.
Ketamine is a wonder drug. Ketamine is a tool of systemic racism. Ketamine is impossible to overdose. Ketamine is an inappropriate drug used for inappropriate purposes. So much controversy. What should we believe? When in doubt, follow the data. Dr. Jeff Jarvis reviews a very timely paper just released in Annals of Emergency Medicine using the 2019 Data Collaborative data set that aims to describe the characteristics of patients getting ketamine as well as the potential deaths associated with it. As an added bonus, Drs. Remle Crowe and Brent Myers join Dr. Jarvis for an interview about their paper and the controversies surrounding ketamine use.
What is the impact of on-scene resuscitation vs intra-arrest transport on outcomes? Could the differences in first pass success between ETI and King LT have accounted for the differences in outcome in the PART trial? How about differences in compression interruptions? In this episode recorded on the road in Bend, Oregon, Dr. Jarvis reviews three new papers that address just these questions. He then has an interview and Petar and Amber Hossick about how Bend Fire Rescue has implemented tenets of improvement science to impact survival in their community.
We saw the amazing performance of the two mRNA COVID vaccines from Pfizer and Moderna in their RCTs. As encouraging as trial performance is, we always want to see how those numbers hold up under large-scale, real-world pragmatic conditions. Well, we now have three new pieces of information on that. And, for the cherry on top, we get evidence of performance against asymptomatic infection! Dr. Jarvis does a quick review of the latest evidence on vaccine performance.
December 4, 2001. A bad day, indeed. That’s the day the FDA issued a black box warning for droperidol, citing evidence of QT prolongation, Torsades de Pointes, and death. This was a surprise warning because droperidol had been extensively used by emergency medicine and anesthesiology for decades without apparent problems. Since this bad day, we’ve essentially been without droperidol. Fortunately, it’s back! Before we start using it again, we should take a look at what got this drug on the FDA’s radar. Dr. Jarvis reviews the literature about the “evidence” behind the warning and describes how his systems will be bringing droperidol back into practice.
The FDA just granted EUA for the Johnson and Johnson vaccine against COVID. This is a big deal because it is a one-shot vaccination that is much more stable than the two mRNA vaccines. Dr. Jarvis does a quick overview of the data submitted to the FDA for their approval.
LIVE from a virtual Texas EMS Conference, we bring you a session moderated by Mike featuring Drs. Jeff Jarvis, Jason Pickett, and Heidi Abraham. This is the highly anticipated Part Deux of a session we all did at the Texas EMS Conference in Fort Worth 2019… back before “the situation” when we could all meet in person like civilized humans. We discussed a variety of topics including the new DEA rules about controlled substances, the new AHA guidelines, and lots of other goodies. But mostly, we just had fun.
Ketamine only intubation has been promoted by some as a safe approach to airway management in patients with anatomically or physiologically difficult airways. It turns out Dr. Jarvis has some thoughts on the subject. He uses a 2020 paper by Dr. Driver entitled “Success and Complications of the Ketamine-Only Intubation Method in the Emergency Department” to discuss this concept.
If you like what you hear, please give us a 5-star rating wherever you get your podcasts and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all). All of our podcasts are now also released in video format on the FlightbridgeED YouTube channel. Take a look, subscribe, and give us a ‘thumbs up’.
As always, we want to hear your feedback and questions/comments. You can reach us at @DrJeffJarvis, jeff.jarvis@flightbridgeed.com and @MikeVerkest, mike.verkest@flightbridgeed.com.
Thanks y’all!
Children are often considered to be just small adults, much to the dismay of pediatricians everywhere. But when it comes to peri-intubation cardiac arrest, is it true? We know that, in adults, peri-intubation hypoxia is a strong predictor of cardiac arrest. Is this true in pediatric patients?
This episode features another oral board case with Dr. Erin Lincoln (@ErinTWL) and live discussion with Mike (@MikeVerkest), Jeff (@DrJeffJarvis) and special guest Dr. Peter Antevy (@HandtevyMD). Our live segment had lots of great listener questions which led Peter and Jeff to go deep down the rabbit hole of safe intubation practices.
If you like what you hear, please give us a 5-star rating wherever you get your podcasts and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all). All of our podcasts are now also released in video format on the FlightbridgeED YouTube channel. Take a look, subscribe, and give us a ‘thumbs up’.
As always, we want to hear your feedback and questions/comments. You can reach us at @DrJeffJarvis, jeff.jarvis@flightbridgeed.com and @MikeVerkest, mike.verkest@flightbridgeed.com.
Dr. Jarvis and Mike Verkest are joined by a trio of guests to discuss the literature surrounding both the Pfizer BionTech and Moderna Vaccines. Dr. Ritu Sahni, Dr Veer Vithilani and Dr. Remle Crowe round out the panel. This episode is nearly 2 hours in length, and we hope we answered any questions you might have in a non-bias way. Feel free to share this episode or any of the mRNA series of podcasts and live broadcasts we have done this month. We appreciate you listening.
This episode was a LIVE media broadcast discussing a double-blind trial of IM Droperidol, Ziprasidone and Lorazepam for acute undifferentiated agitation in the emergency department. Join Mike and Jeff as they discuss the paper, take questions from the viewers and tease the newly released Standard of Care Podcast! Thank you for listening, sharing, rating and reviewing all the FlightBridgeED podcasts! We appreciate you being on this journey with us!
Part pre-recorded, part LIVE! Dr. Jeff Jarvis, Dr. Jason Pickett, and Mike Verkest discuss the results of the Resuscitation Outcomes Consortium TXA in TBI Trial. Thanks for coming to the channel! Be sure to subscribe here and wherever you listen to podcasts!
Have you had patients recently with repeat EMS calls and lots of ED visits for nausea and vomiting? They say the only thing th works for them is scalding hot showers and that drug that starts with a "D". Did they just happen to smoke a lot of weed? In this episode, Dr. Jarvis discusses cannabinoid hyperemesis syndrome and reviews an RCT comparing topical capsaicin cream (yes... the stuff of pepper spray fame) vs placebo.
Mike and Dr. Jarvis are joined by Drs. David Wampler and Emily Kidd to discuss their study on the performance characteristics of the VAN score for detecting large vessel strokes. Drs. Jarvis and Kidd run through a case of a patient with stroke to discuss the thought process of an emergency physician.
We talk headaches in this episode, specifically an RCT comparing haloperidol to placebo for benign headache. Joining us for this episode is special guest Dr. Erin Lincoln (@ErinTWL), EM resident and paramedic. Drs Jarvis and Lincoln will go through an oral boards-type case of a 45-year-old woman with a headache. We’ll include a review of the literature on headache treatments, hit on why opioids aren’t recommended, and discuss the differential diagnosis of headaches and the red flags that will help find those “can’t miss” diagnoses. This is a new format for us. We really, really want your feedback. Do you like the oral boards-style interview? Drop us a note on Twitter: @MikeVerkest, @DrJeffJarvis, or an email mike.verkest@flightbridgeed.com or jeff.jarvis@flightbridgeed.com. And don’t forget to give us a review on Apple Podcasts to help other likeminded clinicians find our show.
VL vs Augmented DL with Special Guest: Dr. George Kovacs. We’re starting a new format with this episode. We kick things off with a review of a paper: Brown CA, et al. Video Laryngoscopy Compared to Augmented Direct Laryngoscopy in Adult Emergency Department Tracheal Intubations: A National Emergency Airway Registry (NEAR) Study. Acad Emerg Med. 2020; 27: 100-108. After discussing the paper, we have an amazing interview with Dr. George Kovacs (@kovacsgj) to discuss the differences between types of VL devices. He drops some great pearls on some tips for intubation success. Then Mike joins us for a discussion of the paper and interview. We hope you like the new format. Please drop us a line and let us know what you think! As always, please subscribe and give us a 5-star rating on Apple Podcasts. We’d love to hear your thoughts, questions, and suggestions. Join us on Twitter: @MikeVerkest, @DrJeffJarvis, @EMSLighthouse
There has been a lot of talk about the benefits of TXA in major trauma with small differences in outcomes. If you’re looking for a big treatment benefit for TXA, look no further than the very sexy nose bleeds. This is an easy and safe intervention that EMS can provide that makes a real difference in a growing number of patients. If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all).
Are you worried about what might happen in your jurisdiction if COVID breaks out in your nursing homes? You should be. Dr. Jarvis reviews a NEJM paper in this episode: Presymptomatic SARS-CoV-2 Infections and Transmission in a Skilled Nursing Facility. Afterward, he’s joined by a special guest, Dr. Jason Pickett. Dr. Pickett is the deputy medical director for Austin-Travis County EMS, assistant local health authority for Austin Public Health, and the host of the EMS podcast with the longest name ever. As always, please subscribe and give us a 5-star rating on Apple Podcasts. We’d love to hear your thoughts, questions, and suggestions. Join us on Twitter: @MikeVerkest, @DrJeffJarvis, @EMSLighthouse.
We are living, in a COVID world. And I am a COVID doc. This is a special episode of the EMS Lighthouse Project Podcast. Since the entire Jarvis household is quarantined in our bunker in Central Texas, I brought the family together to discuss how this such a short little piece of RNA has changed our world. Oh, and we talk about the MMWR report from Singapore that, apparently, got the CDC to change its stance on the use of public face masks. If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe. Most importantly, stay safe out there. Thank you for stepping up and caring for others in these difficult times. We appreciate each one of you. I’ve never been prouder to be in EMS.
Remember our podcast where we talked about amiodarone and lidocaine improving survival from arrest when given IV but not IO? Wait! There’s more. Another paper dropped looking at the same thing but with epinephrine instead of anti-dysrhythmics. Does this paper show the same thing? Is there really something to this IV superiority thing? Dr. Jarvis breaks this new paper down. As always, please subscribe and give us a 5-star rating on Apple Podcasts. We’d love to hear your thoughts, questions, and suggestions. Join us on Twitter: @MikeVerkest, @DrJeffJarvis, @EMSLighthouse
Remember Episode 12 where we reviewed a Houston paper on DSD showing worse outcomes with DSD? At the end of that pod, I spoke about an ongoing RCT trial comparing DSD to standard therapy AND vector change defibrillation. Well, the pilot phase of that trial is over and has JUST been published. It has some surprising preliminary results. Join us and find out how that study is going. If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all).
Have you ever given adenosine to a patient in SVT? Yeah? Did they like it? I didn’t think so. You’ve probably also given up trying to use the Valsalva maneuver because you’ve found it doesn’t work very often. Wouldn’t it be great if there were a way to make the Valsalva more effective and, perhaps, avoid kicking the patient in the chest with adenosine? Dr. Jarvis reviews a paper in this episode that may offer just this. If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all).
The final part of our coverage of some of the research from NAEMSP2020 in San Diego. If you missed any of the first three episodes, be sure to download them and take a listen. They were great! In this episode, we wrap up the series with outstanding discussions. We discuss the epidemiology of pediatric trauma activations with San Antonio’s Dr. Craig Cooley and finish up with a discussion with Dr. Henry Wang. Dr. Wang talks to us through an oral abstract he presented here on a secondary analysis looking at the impact of FPS in the PART trial comparing ET and King LT in cardiac arrest. As a bonus, he talks us through the original PART trial for which he was the principal investigator. As always, we want to hear your feedback. Let us know what you think: @MikeVerkest, @DrJeffJarvis, and @EMSLigthouse. Subscribe and give us a great rating on Apple Podcast.
And…we are back for part 3 of our coverage of some of the research from NAEMSP2020 in San Diego. If you missed parts 1 or 2, be sure to download them and take a listen. They were great! In this episode, we have two great interviews. We talk with Dr. Veer Vithalani of MedStar in Fort Worth, TX about his work using EtCO2 to detect unrecognized BVM ventilation failures. We also chat with Drs. Casey Patrick and Rob Dickson from Montgomery County Hospital District EMS in Conroe, Tx about push-dose drugs including epinephrine and nitroglycerin.
What if we told you that neither amiodarone nor lidocaine did any better in cardiac arrest when given by IO? What if we told you neither one improved survival when given by IV? Would you think I was smoking crack? Yeah, I would have thought that too until last week. I’m going to give a quick recap of this important secondary analysis of the ALPS trial, but only as a precursor to get y’all warmed up for the main event on Facebook Live Wednesday, January 29th at 8:30 CST. Listen to this podcast, and then join me, Mikey V, Eric Bauer, and Ritu Sahni as we talk about what we should make of this interesting trial. Most importantly, what we should do (or not do) in our clinical practice. As always, please subscribe and give us a 5-star rating on Apple Podcasts. We’d love to hear your thoughts, questions, and suggestions. Join us on Twitter: @MikeVerkest, @DrJeffJarvis, @EMSLighthouse @FlightBridgeED
And we’re back for part 2 of our coverage of some of the research from NAEMSP2020 in San Diego. If you missed part 1, be sure to download it and take a listen. It was great! As always, we want to hear your feedback. Let us know what you think: @MikeVerkest, @DrJeffJarvis and @EMSLightouse. Subscribe and give us a great rating on Apple Podcast.
Did y’all make it to NAEMSP 2020 in San Diego? If not, I’m sorry. It was awesome! If you did, you probably had a great time but still missed a lot. There’s just too much going on. Being the research nerds we are, we focused our time on the oral and poster presentations. We interviewed as many investigators as we could. In fact, we recorded more audio than we could fit in one episode. So… we’re cutting them into smaller chunks and will get them out faster than our normal q2 weeks release schedule. Join us as we sit down (or stand up as the case may be) for some great interviews from NAEMSP. As always, we want to hear your feedback. Let us know what you think: @MikeVerkest, @DrJeffJarvis and @EMSLightouse. Subscribe and give us a great rating on Apple Podcast.
HAPPY NEW YEARS! We hope you are celebrating 2020 at the NAEMSP National Conference in San Diego. If you're around, stop by and say hi to the PEC podcast team! This year, we teamed up with our brand new podcast partners Mike Verkest (@MikeVerkest)and Dr. Ritu Sahni (@MD59) of the Second Shift Podcast and Dr. Jeffrey Jarvis (@DrJeffJarvis) of the EMS Lighthouse Project for the VERY first bi-annual EMS Collaborative podcast. In this special episode of the EMS Collaborative, we talk about the wonderful world of Mobile Integrated Health (MIH) and ET3. It's a fascinating conversation filled with MIH history, MIH research, editorials, and, of course, checking to see if Dr. Sahni can qualify for medicare. Check out this fun, entertaining, and witty podcast today! As always THANK YOU for listening! Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston), Jeremiah Escajeda MD, MPH (@jerescajeda), Joelle Donofrio-Odmann DO (@PEMems), Mike Verkest (@MikeVerkest), Ritu Sahni MD (@MD59), Jeffrey Jarvis MD (@DrJeffJarvis), and @FlightBridgeED!
Dr. Jarvis had an opportunity to sit with Dr. Ben Bobrow at the Texas EMS Conference. Dr. Bobrow is the chair of Emergency Medicine at UT Houston. During his time in Arizona, Dr. Bobrow was instrumental in the studies of Traumatic Brain Injury and approaches to improved outcomes in cardiac arrest. If you know about the dangers of hypoxia and hypotension in TBI or the importance of minimally interrupted chest compressions and passive oxygenation in cardiac arrest, you should hear this interview. If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe (or download each episode several times… we’ve gotta beat Second Shift after all).
The debate has raged. In this corner, we have our established champion succinylcholine, or, as the oldsters call it, “because we’ve always done it this way”. In that other corner over there, we have the brash newcomer, rocuronium, or, as the youngsters call it, “OMG… what about the hyperK!.” Wouldn’t you just like an answer? Which is better? SAMU to the (potential) rescue. Our French colleagues published a Randomized Clinical Trial comparing FPS among prehospital patients undergoing intubation between succinylcholine and rocuronium. What did they find? Join Dr. Jarvis for a hot-off-the-presses podcast that will give you the down and dirty about this trial ON THE DAY IT WAS PUBLISHED! Take THAT Second Shift! If you like what you hear, please give us a 5-star rating on Apple Podcasts and tell your friends to subscribe. As always, we want to hear your feedback. You can reach us on Twitter at @EMSLighthouse, @MikeVerkest, and @DrJeffJarvis.
Should we chill out with the non-shockable cardiac arrests? Another look at targeted temperature management. First, we knew early hypothermia after ROSC saved brains. Then, we learned that doing it in the field didn’t make a difference and that there was no difference between 33C and 36C. This month, the NEJM published the HYPERION trial of non-shockable arrests randomized to hypothermia (33C) or normothermia (37C). If you like what you hear, please give us a 5-star rating on Apple Podcasts and other premier podcast purveyors and tell your friends to subscribe (or download each episode several times… we’ve gotta beat SecondShift after all).
As a special Thanksgiving treat we bring a “Live” panel discussion featuring Drs. Jeff Jarvis, Jason Pickett, Heidi Abraham, and Taylor Ratcliff. Skillfully (and tactfully) moderated by the awesome Ginger Locke. Recorded 11/26/19 at the Texas EMS Conference in Fort Worth, Texas. Topics include epinephrine and advanced airways in cardiac arrest, paramedic degrees, intubation with paralytics vs “sedation assisted intubation”, whole blood, IV push nitroglycerine for CHF, POCUS, and discussing clinical errors. This was a ton of fun to record. We hope you enjoy it as much as we did. Happy Thanksgiving! If you like what you hear, please give us a 5-star rating on Apple Podcasts and tell your friends to subscribe (or download each episode several times... we’ve gotta beat Second Shift after all). You can reach us on Twitter at @EMSLighthouse, @MikeVerkest, and @DrJeffJarvis.
You’ve all seen it. Most of you have probably taken (or fired) a round or two in it. It’s the Great Twitter "VL vs DL War". Everyone has their opinion. I certainly did. But now I’ve found peace by retreating from the madness. Ultimately, it’s WAY more about the training than the particular device being used. Dr. Jarvis reviews a randomized trial comparing AP Advance, CMAC, and King Vision to make his point. If you like hearing about the latest in EMS research, subscribe to our podcast. If you like what you hear, please give us a 5-star rating on Apple Podcasts to help others discover the EMS LightHouse Project Podcast!. As always, we want to hear your feedback. You can reach us on Twitter at @EMSLighthouse, @MikeVerkest, and @DrJeffJarvis.
More and more EMS research is being presented at the PCRF research forum at EMS Expo. Dr. Jarvis sat down with Dr. David Wampler at EMS Expo 2019 in New Orleans. Dr. Wampler won the award for best research at EMS Expo 2019 for his research comparing inhaled isopropyl alcohol to oral ondansetron for nausea. He also discusses his other two posters. If you like hearing about the latest in EMS research, subscribe to our podcast. If you like what you hear, please give us a 5-star rating on Apple Podcasts to help others discover the EMS LightHouse Project Podcast!. As always, we want to hear your feedback. You can reach us on Twitter at @EMSLighthouse, @MikeVerkest, and @DrJeffJarvis.
A variety of papers, including CRASH-2, suggest that TXA can decrease mortality if given early for patients at risk of significant hemorrhage but exclude patients with TBI. CRASH-3 was a large, multi-national placebo-controlled randomized trial comparing TXA, 1 gm over 10 minutes, followed by a subsequent 1 gm infusion over the next 8 hours. So… what do we think of the paper’s results, and do we believe TXA should be given in TBI patients? The EMS Lighthouse Project Podcast is the newest show on the FlightBridgeED clinical podcast network! Your feedback has been fantastic, and we appreciate the support! If you haven’t, please leave feedback and give is a rating on your favorite podcast app!
DSD is the current bright and skinny object. Many agencies (including mine) adopted it based on a few case series. Dr. Jarvis discusses a brand new paper looking at Houston Fire/EMS’ experience with DSD. Should we change our practice? Listen and find out. Thank you for the comments, reviews and emails! If you haven’t, please go to your favorite podcast app and leave a rating and review! We appreciate it!
Mike and Ritu bring Dr. Jarvis in the mix for the "cross over episode of the century"…um, described by Mike as a ménage a trois…it's not like that…he just meant it’s a 3 for one…even that doesn't sound right. He is simply saying how often do you get 2 AMAZING EMS Physicians on the same pod at the same time!? We tackle DROPERIDOL!! Remember that medication? It's was an amazing drug that lost its way. WE talk about why and how it's making a comeback. Still considered one of the top 10 in the industry, we couldn’t do it without your support! Thank you for the comments, reviews and emails! If you haven’t, please go to your favorite podcast app and leave a rating and review! We appreciate it!
This episode was recorded LIVE on Facebook with a ton of fun interaction. Dr. Jeff Jarvis and Mike Verkest look at a recent paper that described stroke patients who underwent RSI had worse outcomes than their non-RSI counterparts! …do the benefits outweigh the risks? Tune in to find out! The EMS Lighthouse Project Podcast is the newest show on the FlightBridgeED clinical podcast network! Your feedback has been amazing, and we appreciate the support! If you haven’t, please leave feedback and give is a rating on your favorite podcast app!
In this episode of the EMS LHP Podcast, Dr. Jarvis and Mike Verkest take a look at the data regarding responding to and from calls with lights and sirens…you may be surprised and the risks we are taking…do the benefits outweigh the risks? Tune in to find out! The EMS Lighthouse Project Podcast is the newest show on the FlightBridgeED clinical podcast network! Your feedback has been amazing, and we appreciate the support! If you haven’t, please leave feedback and give is a rating on your favorite podcast app!
In this episode of the EMS LHP Podcast, Dr. Jarvis goes solo and discusses an important paper regarding Airway and TBI. The Excellence in Prehospital Injury Care study (EPIC) published in May of 2019 in JAMA definitely sheds the bright light of science on current EMS Practice. Take a listen and tell us your thoughts! The EMS Lighthouse Project Podcast is the newest show on the FlightBridgeED clinical podcast network! Your feedback has been amazing, and we appreciate the support! If you haven’t, please leave feedback and give is a rating on your favorite podcast app!
In this episode of the EMS LHP Podcast, Dr. Jarvis and Mike Verkest are joined by David Olvera to see what the literature says about ketamine for pain. Is it safer? Does it take care of pain any better? Tune in to find out! The EMS Lighthouse Project Podcast is the newest show on the FlightBridgeED clinical podcast network! Your feedback has been amazing, and we appreciate the support! If you haven’t, please leave feedback and give is a rating on your favorite podcast app! We appreciate the subscriptions, comments, and ratings. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
In this episode, Dr Jarvis looks at the first secondary analysis from the PART trial of advanced airway management in cardiac arrest (King LT vs. ETI). The analysis looks at the impact of airway type and time to first epinephrine, with an expanded look at outcomes as a function of time to epi. We appreciate the subscriptions, comments, and ratings. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
In this episode, we continue from part 1 and look at 3 papers that try to answer the question about airway in the adult cardiac arrest. Thank you for supporting the FlightBridgeED network of podcasts. We appreciate the subscriptions, comments, and ratings. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
In this episode, we look at 3 papers that try to answer the question about airway in the adult cardiac arrest. Put your seat belt on, this episode is nearly 2 hours so we broke it into 2 parts! We are joined By Eric Bauer from the FlightBridgeED podcast for a quick case review to start things off. Thank you for supporting the FlightBridgeED network of podcasts. We appreciate the subscriptions, comments, and ratings. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Mike Verkest and Dr. Jeff Jarvis as they shine the bright light of science on EMS practice in an informative and fun way as they look deep into the research on epi in cardiac arrest. Does it help? Are there better outcomes? How do patients do based on neurological outcomes? Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!
The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Mike Verkest and Dr. Jeff Jarvis as they shine the bright light of science on EMS practice in an informative and fun way. Remember that reviews are key to help keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!