Heavy Lies the Helmet: Recent Episodes
Mike & Bryan Boone
"Heavy lies the crown" is a common misquote of "uneasy lies the head that wears a crown" from Shakespeare's Henry IV, Part 2. It refers to the responsibility and insecurity of governing an entire kingdom. Likewise, "heavy lies the helmet" refers to the responsibility we face as critical care transport providers working in an autonomous and often unpredictable environment. Our minds are eased with education that better prepares us for any situation that we may encounter. That is exactly what Heavy Lies the Helmet provides.
Founded by two brothers, Heavy Lies the Helmet is comprised of industry leaders working in the fields of pre-hospital and inter-hospital critical care and emergency services. We are an accredited podcast, blog, and conference that openly discusses the world of resuscitation and aviation. We highlight caring for critically ill and injured patients in addition to the controversies surrounding their management. Though tailored to the transport environment, our information is applicable to any discipline working in an emergency and/or intensive care setting. We utilize the most recent evidence to provide applicable and accurate education that can assist in improving individual clinical practice and overall program operations.
We offer continuing education units to any listener and/or reader interested in obtaining credit for their progressive learning experience. Please visit heavyliesthehelmet.com/ce for more information.
FOAMed has revolutionized medical education, but has it also made it easier for bad information to spread?
In this podcast episode, we explore the difference between evidence and opinion, what actually defines an expert, and why a large following doesn't necessarily mean someone is right. We'll discuss where expert opinion fits within evidence-based medicine, the role of medical direction and provider oversight, and how cognitive bias and social media can turn repetition into perceived truth. Join us as we discuss how to become a more discerning consumer of medical education and why the most important skill you can develop isn't finding the loudest voice but knowing how to evaluate what you hear.
FOAMed isn't the problem. Uncritical consumption is.
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Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Seizures demand fast decisions, but the best answers aren't always simple. In this episode, we sit down with Skyee Edwards, a pharmacist, to break down seizure cessation and prophylaxis in real-world emergencies.
We go beyond traditional benzodiazepine-first thinking and explore how current evidence guides escalation to agents like levetiracetam, valproate, and fosphenytoin. Then we step into the evolving edge of care: where ketamine and lacosamide fits in refractory status epilepticus, and when propofol becomes a tool instead of a last resort. We also dig into common pitfalls such as delayed escalation, under-dosing, and not appreciating non-convulsive status.
If you manage seizures in any high-acuity environment, this conversation will sharpen your approach from first contact through definitive control.
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Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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In this podcast episode, we dive into the clinical chaos of Infective Endocarditis. It's a disease that can quietly destroy valves before showing its hand. We discuss how it presents, why it matters in transport and critical care environments, and how it can spiral into life-threatening complications like Cardiogenic Shock.
Along the way, we touch on early antibiotic considerations and talk through hemodynamic support strategies such as push-dose Epinephrine when things start to fall apart. As always, the goal is connecting physiology to practical decision-making for clinicians who manage sick patients in dynamic environments.
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Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Airway management gets dangerous.
In this episode of the podcast, we explore prehospital bronchoscopy—a true bleeding-edge concept—and where it fits in managing airway obstruction before the hospital. We talk mucous plugs, massive hemoptysis, refractory hypoxia, how to address obstructions you can't fix with pressure or bronchodilators, and what to do when bronchoscopy is likely unavailable. This isn't about chasing new tools—it's about physiology, pattern recognition, and knowing when innovation may help.
When it comes to considering prehospital bronchoscopy in your system, ask yourself the following:
- Is this something we need?
- Can we do the training to support it?
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Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, clean decision-making, and an approach that works whether you're in the back of a helicopter, a tight ambulance box, or a chaotic ED bay.
We walk through the foundational concepts and the "why" behind each knob you touch. Then we zoom in on the Hamilton T1, the vent many of us love, hate, and still rely on every single shift. We cover what the T1 gets right, where people get tripped up, and how to let the machine work with you instead of against you.
If you've ever wished mechanical ventilation felt less like memorizing settings and more like understanding physiology in motion, this episode will tighten up your practice and give you tools you can use on your very next flight or transport.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, clean decision-making, and an approach that works whether you're in the back of a helicopter, a tight ambulance box, or a chaotic ED bay.
We walk through the foundational concepts and the "why" behind each knob you touch. Then we zoom in on the Hamilton T1, the vent many of us love, hate, and still rely on every single shift. We cover what the T1 gets right, where people get tripped up, and how to let the machine work with you instead of against you.
If you've ever wished mechanical ventilation felt less like memorizing settings and more like understanding physiology in motion, this episode will tighten up your practice and give you tools you can use on your very next flight or transport.
Get CE hours for our podcast episodes HERE!
Twitter @heavyhelmet
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Website heavyliesthehelmet.com
Email contact@heavyliesthehelmet.com
Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Tracheostomies are increasingly common in both prehospital and critical care transport settings, but they come with unique challenges. In this podcast episode, we break down short-term and long-term complications you may encounter, and how to troubleshoot them in high-stakes environments. From occlusions and dislodgements to bleeding, we’ll cover practical strategies to keep these vulnerable patients safe. Whether you’re new to airway management or a seasoned clinician, this discussion will sharpen your approach to one of the most intimidating airways you’ll encounter.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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What happens when resources are limited, transport is delayed, or you’re forced to manage a critically ill patient far beyond the typical flight window? In this podcast episode, Dr. Tim Hurtado and Brett Weiner help us dive into the challenges and realities of prolonged field care in air medical transport. We’ll explore clinical considerations, crew dynamics, and decision-making strategies that can help you maintain high-quality care when time isn’t on your side.
We’re also excited to announce our new in-person course. This immersive training opportunity is designed to push you beyond the textbook and prepare you for the complexities of prolonged care in austere or transport environments.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Tranexamic Acid (TXA) is a lot like hot sauce: People put it on everything — especially for apparent or suspected acute blood loss. In this podcast episode, we dive into a drug that’s been both praised and questioned in trauma and prehospital care. We break down what TXA is, how it works, and the evidence behind its use. From CRASH-2 to CRASH-3, we explore the key studies, the controversies, and the real-world implications. Whether you’re administering TXA in the back of a rig or evaluating its role in your protocols, this episode helps you make sense of when, why, and how TXA might—or might not—stop the bleeding.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Though evidence dictates much of what we do as emergency medical providers, some areas remain open to debate: How are we justifying stroke ambulances, CCT speciality teams, AHA guidelines, and our choice of crystalloids? How are we justifying what professionals are allowed to post on social media? And do we agree with the currently accepted norms?
Who better to join us in this discussion than Mike Carunchio of The World's Okayest Medic Podcast. Diving into these and other controversial topics, we see if our two platforms can come to a consensus in a randomized, uncontrolled conversation.
*Strong opinions were involved in this production. If something challenges your perspective, good—that's the point.
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Wet or dry. Air in or out. Reactive or obstructive. The possibilities may seem endless when treating the pediatric patient with undifferentiated respiratory distress. It is confounded by the fact that pediatrics are outside the comfort zone of many novice critical care transport providers. In this podcast episode, neonatal/pediatric specialist Nate Brown eases your worries with concise and effective means of diagnostics and intervention. Primarily, we cover croup, bronchiolitis, and asthma disease processes.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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'Tis the season for trauma. (If there truly is a season.) Chest trauma, specifically, can vary in subtlety and severity, primarily due to the presence of multiple vital organs and vessels. In this podcast, we discuss these potentials while focusing on those injuries that are associated with the highest mortality rate. We also discuss why you should think twice before intervening.
Get CE hours for our podcast episodes HERE!
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Disclaimer: Heavy Lies the Helmet’s content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates.
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Does your patient have high blood pressure? Are they seizing or showing other signs of a neurological disorder? It could be PRES! Unfortunately, Posterior Reversible Encephalopathy Syndrome (PRES) is difficult to diagnose unless you are aware of its existence. In this podcast episode, we discuss this infrequent condition and how can you appropriately diagnose and treat it.
Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How much value should we on that piece of paper? And, regardless, how do we work towards obtaining and maintaining qualifications? In this podcast episode, we discuss it all including Dunning-Kruger Effect and Hierachy of Competence. We also delve into teaching strategies that can help newcomers gain their confidence after achieving whatever got them there in the first place.
Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Previously, we recorded a podcast episode about the utility surrounding Point of Care Ultrasound (POCUS). In this episode, we apply that knowledge to specific case scenarios as a continuation of our "Breaking the Case" series. We also ask the question, is POCUS really all it's cracked up to be, or should we be re-thinking our approach, particularly in the prehospital setting?
Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Humans are easy. That's why we are able to do what we do as prehospital providers. But what happens when your patient is a canine? These working dogs are highly regarded by their handlers and require care just like anyone else that may be ill or injured. Considering that, are you equipped to care for them? If not, how can you successfully start and maintain a K9 program at your agency?
Tune in to another podcast to discuss this unique topic, but this time, we are joined by HLTH team member Rick Maricle and his colleague George Tarver III.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than focusing on the patient in front of them. Asymptomatic hypertension, in particular, is often benign. In fact, treating asymptomatic hypertension in a patient who a primary medical history of hypertension can harm them.
In this podcast, we discuss these adverse effects related to blood pressure physiology, acute versus chronic hypertension, and how you can determine whether anti-hypertensives or other forms of therapy are indicated.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI).
In the PREOXI Trial, the authors pushed this concept further, questioning whether non-invasive positive pressure ventilation (NIPPV) might be more effective than these formally mentioned adjuncts. In this podcast, we dive into the strengths and weaknesses of the trial and explore whether its findings are truly practice-changing. We might even disagree along the way…
(We also provide a rebuttal to some of the feedback we received on our previous podcast episode.)
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailored interventions beyond "blanket" protocol and ACLS/PALS algorithms. When refractory to conventional therapy, the pulseless V-Tach/V-Fib patient, in particular, requires critical thinking "outside the box" in order to gain ROSC (Return of Spontaneous Circulation) and preserve neurological outcomes. What are some of the measures we can consider when presented with these refractory patients? We answer that question in this podcast episode.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformation or a lack of advocacy by the transport agency, these transfers can result in unnecessary risk for crew members and patients. Specifically, weather conditions, time of day, crew fatigue, and other important factors are not always considered when blindly accepting these transfers. As the transport specialists, how can we ensure that we are accepting and performing these transports safely?
In this episode, Austin Wingate provides a holistic method that you, too, can integrate into your own region.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Antidiuretic hormone (ADH) plays an essential part in the body's osmotic/fluid balance, sodium homeostasis, and blood pressure regulation. This hormone is synthesized in the hypothalamus and released from the posterior pituitary gland. In conditions such as Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH), there is a lack of synthesis or over-production of this hormone which results in negative downstream effects.
At the request of a podcast listener, we have decided to cover these conditions in this episode. Tune in as we discuss DI (central and nephrogenic), SIADH, and hypo/hypernatremia.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Angioedema is defined by upper airway swelling secondary to an immune response. The trigger and subsequent physiological response are how we categorize it. In this podcast, we discuss how to diagnose and treat both types: IgE/Histamine-mediated and Bradykinin-mediated. We also touch on how to address the difficult airway that may or may not lead to intubation. All in all, do not fear angioedema but respect it.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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When discussing methylene blue, management and treatment of methaemoglobinaemia is usually the first indication mentioned. But in this podcast, we challenge you to increase the size of your lense and focus on its benefits in other states (e.g., septic shock). Of course, we could not do this alone, so we invited a Flight Paramedic, Pharmacist, Toxicologist, and Professor to join us. And fortunately for us, they are all the same person.
Tune in as Will Heuser helps us discuss the pathophysiology of distributive shock, the pharmacodynamics and pharmacokinetics of methylene blue related to its effects on endothelial relaxation, and how this simple dye goes beyond that of salvage therapy when a patient has high vasopressor requirements.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Though we have delved into foreign HEMS systems in the past (See Episode 61 – Down Under Dynamics w/Dr. Cliff Reid), we have not dedicated an entire series to it. Having now rubbed shoulders with many clinicians and operators around the world, it is evident that these conversations need to take place on a regular basis. Why? Because operating in a vacuum can lead to bad decision making. Our new "Around the World" series attempts to mitigate this by interviewing prehospital and intrahospital disciplines from around the world and finding out how they do things, whether for better or for worse when compared to the United States.
We begin our series with our neighbors to the south, Mexico. Daniel Peñaflor, Flight Paramedic, joins us to discuss prehospital operations in Guanajuato City. Interestingly enough, you will find out that they are not too dissimilar from us.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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"Self-loading baggage" is a derogatory term often used by pilots to describe lazy or disengaged medical crew members in the air medical industry. Whether intentional or not, this behavior sets a bad precedent for those of us that want to embrace aviation cross-training and be able to assist the pilot effectively.
In this podcast episode, we are joined by pilots Miles Dunagan and Brett Reeder to discuss how pilots and clinicians alike can be a cohesive team before, during, and after the flight. We touch on complacency, Crew Resource Management (CRM), and specific skills required of an effective air crew.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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The Russo-Ukrainian War is an ongoing international conflict between Russia and Ukraine. At times such as these, medical training is essential and sometimes required of laypersons. International Medical Corps partnered with the Harvard Humanitarian Initiative (HHI) to provide comprehensive emergency and trauma care training to healthcare workers, public safety professionals, and the Ukrainian community. Course Coordinator Kevin Collopy and Instructor Brock Jenkins, live from AMTC23, join us for an eye-opening podcast episode where we discuss their role in this mission and the personal experiences motivating them to continue their efforts.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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B.R.A.S.H. Syndrome is a phenomenon with a constellation of Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia requiring identification and management in the prehospital and transport setting. In this podcast episode, live from AMTC23, we discuss the pathophysiology of BRASH Syndrome, highlighting the synergy between its components, as well as relevant pharmacotherapy and treatment considerations.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Dan presented the talk “Metabolic Acidosis: The Eye Can Only See What the Mind Can Comprehend” at AMTC23. In this recording, he teaches you how to identify the prevalence of acid-base disorders including triple disturbances, how to calculate anion gap and determine the etiology of the gap, and how to identify adequacy of compensation for a primary metabolic acidosis.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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As a critical care clinician, do you consider yourself well-versed in comfort care? Do you consider yourself well-rehearsed in having the discussions leading up to the patient's or family's decision to implement it? This concept may be outside your comfort zone, especially if you work in emergency medicine. But the fact of the matter is, from the prehospital environment all the way to the ICU, we are provided many opportunities for implementation of this type of care plan. Join us for a discussion with an ICU charge nurse where we tell you how to do so effectively and tactfully.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Atrial fibrillation, particularly A-Fib with RVR (Rapid Ventricular Response), is often an emergency requiring emergent intervention beyond ACLS and its associated algorithms. Identification of A-Fib can be challenging in itself, much less trying to determine what intervention(s) are indicated. This includes chemical and/or electrical cardioversion. So where do we start? And where should we end up? Dan and Mike will let you know in this podcast episode.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Continuing our "10 Things" series, we focus our attention on gastroenterology. GE/GI goes well beyond colorectal. From bleeding esophageal varices to pancreatitis to liver failure, these patients require specific diagnostics and interventions to improve their mortality and morbidity. Join us for a "pearl packed" episode where we discuss practical steps you can take to improve your care of this specialized patient population.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Pediatric Emergency Medicine (PEM) is a sub-speciality that many clinicians find intimidating. Are pediatric patients truly unique or are they simply "little adults"? In this podcast episode, we are joined by Dr. Dominique Diggs, board certified PEM physician, to demystify pediatric emergency care with 10 tips that will help you the next time you care for this patient population.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Vascular emergencies refer to any time-sensitive condition where perfusion is prevented secondary to bleeding or occlusion of a vessel. These can include, but is not limited to, the superior mesenteric artery (SMA) and aorta. And depending on the severity of the aneurysm or embolism/thrombus, downstream ischemia can significantly impact a patient's quality of life. How do we identify these conditions? When are they classified as a true emergency? And how do we treat patients with the notion that strict hemodynamic parameters are indicated?
Join us for a clinical heavy podcast episode where we focus on ischemic leg, SMA ischemia/dead gut, and thoracic/AAA.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Reviewing case studies with trusted colleagues can be extremely beneficial. Not only does it provide a moment of reflection on actions taken, but it also provides different approaches that may be applicable to future scenarios.
Occasionally we like to challenge each other, and this episode is no exception. Tune in as Amanda, Dan, and Mike present three real case studies and see if they would approach the same patient differently. We start from "bread and butter" to the complex critically ill.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Have you ever handed off to an ER doctor, and you felt they were displeased with your care? Have you ever received an order from an ER doctor, and you didn't quite understand why? In this podcast episode, we continue our "10 Things" series with a focus on the emergency department. Our very own Dr. Amanda Humphries, Emergency Physician and Assistant Professor of Emergency Medicine and Emergency Medical Services, leads the discussion.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Myocardial infarctions can present in a variety of ways depending on vessel involvement, timing of pathology, and interpretation of diagnostics (e.g., 12-lead EKG). Unfortunately, not every patient with a myocardial infarction will fit STEMI criteria's paradigm, which has lead to the adoption of a new term: OMI (Occlusion Myocardial Infarction). In this podcast episode, we are joined by our very own Nick Zuber to discuss his recent OMI and why he's able to sit down and talk with us today.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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No matter what level of scope, management of medical and traumatic cardiac arrests is the focus of many clinicians. But what happens after return of spontaneous circulation (ROSC) is achieved? Many do not appreciate the fact that the likeliness of re-arrest is high. How can we avoid return of spontaneous arrest (our coined phrase) by appropriately treating the patient during the peri-arrest phase and subsequently improving quality of life? Tune in to another nugget-filled podcast episode where the team discusses everything from etiology identification to treatment methods beyond the scope of PALS and ACLS.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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The medical industry puts great emphasis on formal education via university and other training programs. Due to financial incentive, these institutions often discourage independent learning despite it usually having a greater impact on patient care quality. For example, paramedics are often non-degree holders, yet they effectively practice medicine on a daily basis as a result of learning via unconventional methods (e.g., podcasts).
How much actual value is in formal education? Do we need a practitioner track for prehospital providers on the university level? And regardless of degree, how can we teach with the goal of long-term retention of information as opposed to simply passing an exam? Tune in to this podcast where we are joined by a pioneer in critical care transport education, Will Wingfield, to discuss.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Whether it's antibiotic-resistant "super bugs" or administration prior to acquiring blood cultures, empirical use of antibiotics is controversial. Should we be administering antibiotics in the prehospital environment for open long bone fractures and/or sepsis? When are antibiotics truly indicated? And is that more important than the timing of the antibiotic itself? This podcast is not only "Antibiotics 101", but we also address these important issues.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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It's not clinical. It's not non-clinical, really. Celebrating our 100th full podcast episode, Bryan and Mike sit down in a Mystery Science Theater 3000 format and make fun of our 1st episodes ever. If you're looking for some light-hearted entertainment including a reflection of how far the platform as come, this is the podcast for you.
And one last thing...
THANK YOU FOR 5 YEARS! Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Based on the Crash and Learn 2022 special feature presentation, we sit down with Jonathan Godfrey and Chris Stevenson to discuss the EMS helicopter crash that had a dramatic effect on both of their lives. Jonathan is the sole survivor of a 3-person crew, and Chris was part of his leadership team at the time of the incident. We carefully examine both perspectives and how the rest of us can learn from their experiences.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Whether it is upper or lower, gastrointestinal hemorrhages can present in a variety of ways from a variety of sources. Bleeding esophageal varices, in particular, can be life-threatening. How do we manage these patients? When is it appropriate to establish an advanced airway? Are gastrointestinal tubes contraindicated even though the patient is vomiting? And what do we do when an esophageal tamponade device is indicated or already in place? Tune in to another podcast episode where we discuss GI bleeds.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Whether it's radio or bedside reporting, communication is a requirement of safely handing off patients. How do we build confidence in our ability to communicate about our patients? How do we develop qualities such as professionalism, accuracy, and conciseness that are essential to our reports? And if we experience interpersonal conflict, how do we resolve it? Tune in to this podcast episode where we discuss how to effectively communicate with other medical providers.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Having an appropriate mindset is crucial when it comes to airway management, particularly in a prehospital and/or emergency setting. Whether it's team dynamics or the tools at our disposal, we need to have a different outlook when it comes to addressing the A in ABC's.
If you are looking for a comprehensive guide on how to RSI, this is not the episode for you. This is simply a table discussion about appropriate perspective.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Traumatic Brain Injury (TBI) is always in the back of our mind when treating polytrauma patients. Unfortunately, the evidence has a controversial history. More and more, we are reminded of how a basic approach is much more important than other therapies that have little evidence to support their effectiveness. In fact, some may even cause harm.
Tune in to a podcast where we debunk these common TBI myths. Also, this is the debut episode of Dr. Amanda Humphries-Ventura as an official HLTH team member.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Heat illness is prevalent around this time of year. And compared to hypothermia, hyperthermia has a lower threshold for danger. From heat cramps to heat stroke, clinicians need to know how to identify and treat each stage appropriately. But what contributes to severe heat illness? How do we treat each stage of illness? And how much time do we have before it becomes fatal? From Texan turned Aussie, we are joined by Dr. Justin Hensley, Flight Physician, to discuss.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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It's no secret that we as emergency and critical care professionals are expected to perform highly in high pressure situations. Unfortunately, none of us are immune to limited cognitive capacity, task saturation/fixation, time pressure, negative team dynamics, and poor communication. How can we mitigate these variables, so that we can continue to effectively operate in our respective fields? Join us for an insightful podcast episode where Dr. Stephen Hearns explains how.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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What should you carry in your flight suit as an American-based HEMS provider? In our opinion, no one can definitively tell you that. But we can attempt to share some ideas based on our personal experiences and training. In this vodcast, Mike shares what he currently carries in his flight suit; from survival gear to medical equipment.
Watch the vodcast on our YouTube channel at /heavyliesthehelmet.
Brands include:
One Shear
ER Life
Benchmade
Foursevens
Fisher Space Pen
Littmann
Nite Ize
Doug Fitter
Tactical Notepad Covers
Sharpie
Bic
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Mores lies! But this time, we focus on empirical use of spinal immobilization devices and the harm associated with them. The dogma surrounding this topic is staggering, to say the least. From EMS agencies to Level 1 tertiary centers, cervical collars and long spine boards (LSB) remain a "standard" predicated on a lack of evidence. What evidence DO we have regarding spinal immobilization? And how should we restrict spinal movement of polytrauma patients based on that evidence? Tune in to another eye-opening podcast episode where we are joined by air medical director, Dr. Mike Hudson, who has been leading the way in U.S. spinal motion restriction (SMR) techniques.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Diabetic Ketoacidosis (DKA) is a common metabolic disorder, particularly in the pediatric population. If treated inappropriately, these patients can quickly decompensate to the point of hypovolemic shock, acute respiratory failure, and even cerebral herniation. What are the physiological differences behind DKA verses HHS (Hyperglycemic Hyperosmolar Syndrome)? What are some simple methods to identify DKA in the field? How do we effectively treat DKA? And how should we monitor our interventions? Tune in to a bittersweet podcast episode where we discuss this derangement in its entirety. Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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There are a lot of "lies"/misunderstandings surrounding appropriate use of paralytics AKA neuromuscular blocking agents (NMBAs). When are these medications truly indicated? How do we appropriately administer them? How do we accurately monitor these patients? And how do we reverse the effects of NMBAs? Tune in to another pharmacologically driven podcast where we draft our EM pharmacist friend, Chase Turner, to discuss.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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The clotting cascade, particularly in the context of anti-coagulation reversal can be complex to understand. Unfortunately, many of our patients are on anti-coagulation agents that require reversal in the presence of life-threatening hemorrhage. How do we choose the most appropriate agent based on which step of the coagulation cascade that it antagonizes? And when is it time to pull the trigger on doing so? In this podcast episode, we discuss this intense topic.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Which is the lesser evil, opioid or naloxone overdose? To avoid adverse effects, how should we be administering naloxone in the presence of opioid overdose? In this podcast episode, we are joined by Dr. Arne Skulberg, anesthesiologist and lead author, to discuss his recently published RCT comparing intranasal with intramuscular naloxone. We highlight naloxone dose discrepancies and the pitfalls surrounding intravenous administration of it.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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An incapacitated pilot scenario is an unfortunate but potential reality of working in rotor and fixed wing EMS. What do you do as medical crew members if your pilot becomes incapacitated? What training and capabilities do you have to revive the pilot and/or get the aircraft on the ground? Do some Controlled Flight Into Terrain (CFIT) incidents actually involve an incapacitated pilot?
In this podcast episode, we are joined by Pilot Wade Dunford and Flight Paramedic Scott Davis to discuss their Incapacitated Pilot Working Group (IPWG) and how they have taken steps to address this issue in their region. We cover the crawl, walk, and run phases, and how you can stabilize an aircraft using a 3-axis autopilot system.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) devices are recommended to reduce risk and maintain chest compression quality. However, such transports have inherent pitfalls to both patient and provider safety. This is a poorly studied field of our practice and no clear consensus for how this should be done exists. In this podcast episode, we are joined by Dr. Per Olav Berve to discuss the practical challenges of these missions, CPR physiology, hemodynamics, and hopefully some hard-earned advice on how to get a patient in cardiac arrest to hospital in a survivable physiologic state.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Ventricular Assist Devices (VAD) come in many shapes and sizes. From right to left, extracorporeal to intracorporeal, pulsatile to continuous - It can be confusing. Join us for a podcast episode where Allen Wolfe clarifies the confusion and gives us the maximum amount of knowledge we need to succeed while taking care of these patients.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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If "you can't handle the truth", you can't handle a mentor. Mentors come in the form of leaders, educators, guides, and advisors to help you with honest self-reflection in order to improve yourself and your practice. Join us from AMTC21 where we discuss the importance of this arrangement with our close friends and fellow mentors, Adam Tresidder and Shane Turner.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a patient who is refractory to conventional therapy? Joined by EM pharmacist, Chase Turner, we discuss all things hyperthyroidism in this podcast episode.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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"Kung" means "skillful work" and "Fu" means "time spent". "Resus Kung Fu" refers to the resuscitation skills we acquire over time to become a true master. But how do we achieve mastery of these cognitive abilities and technical skills? And what role does stress inoculation play in training? Join us and Dr. Michael Lauria in this podcast episode where we answer these questions.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Have you ever been hiking in the woods and wondered what emergency medical services are available in case you got injured? The level of scope varies greatly across the country for wilderness emergency medical and SAR technicians. From first aid to critical care, in this podcast episode, we discuss who is coming, what their capabilities are, and how David Fifer is trying to change that model.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Sometimes, we're wrong. And when it comes to normal saline, we might be.
Tune in to a breaking news podcast of sorts where we discuss the recently published BaSICS Randomized Clinical Trial, and how it affects our practice in regard to balanced fluid resuscitation.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Though the incidents of crush injuries may be low in frequency, major crush injury syndrome is associated with a high mortality rate. In this podcast episode, we sit down with regular guest, Chris Stevenson, to discuss the "why". We highlight the pathophysiology behind re-perfusion injury and pre- and post-treatment options.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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How do you decide between non-invasive and invasive ventilation? If you decide on non-invasive ventilation (NIV), how do you choose between heated high flow nasal cannula (HFNC), C-pap, or Bipap? And what critical decision-making tools do you utilize when escalating to intubation? In this podcast episode, we are joined by Flight Respiratory Therapist, Jon Inkrott, to answer those questions and more.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Managing Acute Myocardial Infarction (AMI) patients is a concept that many of us learn early on in our careers. Because of that, we can potentially underestimate the importance of our interventions.
In this podcast episode, we are joined by Dr. Gottula and Dr. Skrobut to discuss timely management of AMI's, when coronary intervention (PCI) is indicated, and what medications we should consider to achieve maximal medical management of a patient suffering an AMI in 2021.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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There are a lot of misconceptions surrounding the meaning of certain lab values and what a positive truly is. Are these numbers as black and white as they are perceived? In this podcast episode, we discuss sensitivity versus specificity, define some of the most common labs and how to avoid tunnel vision when it comes to your clinical interpretation.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Taking care of the High Risk OB patient is outside the comfort zone of many of us. The third trimester, specifically, presents unique challenges both pregnancy-related and otherwise. Why are normal physiologic changes related to pregnancy ABNORMAL in the third trimester? How do we determine if the pregnant patient is sick or not sick? And how do you change your treatment based on these findings?
Tune in as we sit down with Dr. Zaf Qasim to address these important questions. We also touch on peri-mortem cesarean sections at the end.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Has administration ever made a decision that you didn't agree with and/or understand? Of course! As much as we don't like to admit it, the medical industry is a business. For that reason, finances play a significant factor in decision-making. How do we maintain balance between profit and patient care? How do we bridge the gap between leadership and staff members?
Tune in to this brutally honest episode where we sit down with Chris Smetana, former Flight Medic and CEO of IA MED, and our very own Bryan Boone, ED Director, to discuss this very important topic that affects ALL OF US.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may encounter.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may encounter.
Get CE hours for our podcast episodes HERE!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an advanced airway, some clinicians may not be mindful of cerebral perfusion pressure and how to optimize it effectively.
In this podcast episode, we provide you with the recording of Bryan's presentation from ICON (IA MED Conference Online) 2021. After introducing a case study, he breaks down the various neuro assessment techniques that can be used when assessing comatose patients and how to best control their ICP when interventions are indicated.
*This recording is intended as an introduction to our next podcast episode, so stay tuned!
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But are the studies skewed by inappropriate management and our resistance to act? When do we intervene, and when do we not? And how can we help improve these poor mortality rates?
Join us as we discuss this important topic with Dr. Amanda Humphries, Flight Physician and EMS Fellow. We touch on determining medical versus traumatic arrest, prioritization of interventions, and special patient populations.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic.
*Reference the show notes for this episode at heavyliesthehelmet.com/068 for the x-ray images we discuss.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic.
Get CE hours for our podcast episodes HERE!
Twitter @heavyhelmet
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this podcast episode where we discuss the SAR and relief work he was a part of during that dire time. We highlight mission preparation, prioritization of victims, and several high risk incidents that will help you be a safer crew person.
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Disclaimer: The views, information, or opinions expressed on the Heavy Lies the Helmet podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information available for listening on this platform. The primary purpose of this series is to educate and inform, but it is not a substitute for your local laws, medical direction, or sound judgment.
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Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altered mental status is usually the only notable deficit, so it's important to know how to identify and treat this life-threatening disorder. Tune in to find out how through a casual discussion and real-life example.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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Acquiring a job in flight medicine is only the beginning. In this presentation to the 2020 Flight Crew Academy graduating class, Mike discusses three archetypes of new hires. He highlights positive and negative behaviors, systematically addressing incompetence, and how to ultimately get off orientation successfully.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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With the upcoming respiratory season, many of us will be caring for an increased number of pediatric and adult patients with pulmonary disease processes. Obstructive physiology, specifically, can result in an increased strain of resources to effectively care for this critically ill population.
In this webinar, Mike, Bryan, and Jordan focus on status asthmaticus and COPD exacerbation. They discuss etiology, diagnostic criteria, and the latest evidence-based treatment ranging from medication administration to mechanical ventilator management.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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Chris Stevenson is back for a third go-round, so I think that makes him a regular guest on the show. This time, he came at us with a non-clinical topic that peeked our interest...
Likely over the years, we find ourselves giving or receiving advice related to flight medicine. As our years of experience have accumulated, so has the length of our rules and mantras related to flying. From military to mentors to pop culture, these are our 'Rules for Surviving Flight Medicine'.
*We take no credit for this list. It is only a compilation guide for new crew members.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a discussion based on what-would-have-been our Yacht Club presentation.
Everyone carries a card that says they know how to manage tachydysrhythmias. But what happens when your interventions don’t work? In this podcast episode, we focus on recent evidence suggesting alternate means of management when the patient remains refractory to conventional therapy. Though controversial, we will NOT be spewing ACLS algorithms. It’s time to live your life a quarter of a milligram at a time.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the privilege of welcoming the infamous Dr. Cliff Reid to the show to discuss his and Sydney HEMS' approach to all of these areas. Tune in and learn how to be a high level transport provider from one of the best in our industry.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in this podcast. The primary purpose of this podcast is to educate and inform. This podcast is not a substitute for critical thinking and good judgment. Always follow your local laws and Medical Direction.
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This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry.
What is the opposite of complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the chain, and ultimately save your life.
The discussion was so in-depth, that we decided to separate it into two parts. This is Part 2.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry.
What is complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the chain, and ultimately save your life.
The discussion was so in-depth, that we decided to separate it into two parts. This is Part 1.
Get CE hours for our podcast episodes HERE!
Twitter @heavyhelmet
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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High flow nasal cannula is an increasingly popular modality for Acute Respiratory Distress and Failure. Previously, we saw it used mostly in the pediatric population. But as time has went on, especially with the COVID-19 outbreak, this has become an effective means of O2 delivery in all patient groups. With its increased frequency of use, it is only natural that we as transport providers will adopt this therapy.
Tune in to Mike's ICON 2020 presentation regarding this topic.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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How do you calculate your drug dosages? What do you base it on? In this podcast episode, we are joined by Lynn Lamkin, EM pharmacist, to discuss weight based versus non-weight based drug dosages. We also breakdown when true body weight (TBW), ideal body weight (IBW), lean body weight (LBW) or adjusted body weight (ABW) is a more appropriate option.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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You asked. We answered. In a follow-up to our burn resuscitation podcast episode, we are joined by Chris Stevenson and his burn center Medical Director, Dr. Mike Feldman, to discuss inhalation injuries. Tune in as we discuss the mechanism surrounding inhalation injuries and how to treat them affectively based on anatomical location and poison type.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Titrating intravenous drips is a source of contention for many providers. This is, in part, due to a wide range of approaches depending on the patient's condition. Further attribution is based on each individual's comfort level and respective professional background (e.g. ICU versus EMS). But what does the literature say regarding this topic?
In this podcast episode, we are joined by our CMO and After the Call host, Jordan White, to discuss appropriate titration of vasopressors, inotropes, and chronotropes from a first-line perspective.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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With the rising number of COVID-19 patients, many of our listeners have requested additional information regarding transporting patients in the prone position. Despite refractory hypoxemia, many of these patients are benefiting from the prone position.
Based on Episode 17 of the podcast, we updated our information in presentation-form. The following is a live recording of our talk being given at AMTC19.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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'Stranger Things' Theme Song by Kyle Dixon and Michael Stein | Remix from 'Beyond Stranger Things' as seen on Netflix
Recently, Bryan was asked to present at a local EMS conference. The majority of the audience was ground personnel and student nurses, so he decided to present the why and how of measuring waveform capnography. EtCO2 truly should be the 5th vital sign, so we hope you appreciate this recording.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Due to a recent outbreak, influenza and COVID-19 have been in the forefront of people's minds. Influenza, in particular, continues to affect all age groups despite it being late in the typical season. In this podcast episode, we discuss the entire course of this disease process; from positive nasopharyngeal swab to downstream ARDS and the complex ventilator management associated with refractory hypoxemia.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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In this podcast episode, we are joined by Dr. Deep Sharma, Interventional Pulmonologist, to answer listener questions in a rapid fire format. We cover everything from modes of ventilation to respiratory decompensation to snorting sugar dust.
You asked. He answers.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Proper fluid management in burns is critical to survival. But what happens when we administer too little or too much fluid therapy? In this podcast episode, we are joined by Chris Stevenson to discuss epidemiology and appropriate resuscitation for the prehospital provider. Our discussion includes an assessment of past and current formularies and what you should be using.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to discuss this technique and his most recent Air Medical Journal study aimed at investigating its usefulness in training prehospital emergency providers to improve their ability to intubate a contaminated airway.
Video of Matt's colleague Will Hicks performing the SALAD technique with the screen split between external and internal views: https://drive.google.com/file/d/1SKgwcp3Up1YuKKNRV7FpbBehzeqK_3mI/view?usp=sharing
YouTube video of Du Canto demonstrating SALAD: https://www.youtube.com/watch?v=PztChpfur4g
YouTube video showing the inside-mouth view of the technique: https://www.youtube.com/watch?v=57a39GCvWL8
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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The Annual Sim Cup at the Air Medical Transport Conference (AMTC) is a prestigious event that gathers flight clinicians from all over the world to compete. Jason Peng (ED and Flight NP) and Ellen Parsley (Flight Nurse) of University of Cincinnati Air Care joined forces and took home the 1st place trophy at AMTC19. We use this opportunity to sit down with them and discuss their experience, the preparation leading up to their participation, and their approach to the various scenarios that ultimately lead to success.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medical management and aircraft safety considerations surrounding the patient with acute agitation, excited delirium, and/or drug-induced psychosis. We also touch on Droperidol; an old drug that is finding its way back into the Pyxis and hearts of emergency providers everywhere.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Making her second debut on the podcast, Dr. Cynthia Griffin joins us at AMTC19 to discuss the utility of ultrasound/POCUS. Cynthia presented on this topic and highlighted its indication when following your XABC's (Hemorrhage, Airway, Breathing, Circulation) exam. Are you currently using ultrasound in your practice? If not, are you actively trying to convince your medical director to implement it? If so, you don't want to miss this episode!
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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As an air medical provider, our bread and butter is interfacility transports. Whether at the referring or receiving facility, we deal with Intensivists on a regular basis. What are their expectations? How can we provide the best care for our ICU level patients while simultaneously pleasing the facility staff? Our resident nocturnal Intensivist, Dan Rauh, leads a discussion in this podcast episode regarding 10 random things that your Intensivist wants you to know when caring for their patients. Consider this a tasting menu for potential future episodes.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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The title says it all. We hope you will join us.
*Standby for more information regarding this unique opportunity to expand your knowledge.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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In our final Guatemala Educational Aircrew Retreat (GEAR) 2019 podcast episode, we summarize the overall experience. G.E.A.R. was memorable, to say the least. It resulted in currency, competency, and confidence through camaraderie and collaboration. But what do Black Wolf Special Helicopter Operations, RED MED, and HeliSOS Servicios Medicos mean? Where do Chris Sharpe and Chris Gibson come from? What is their motivation behind this training? And how can you experience firsthand what we've been through? Through blood, sweat, and tears. Take a listen.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Part 1 is on our other podcast platform, After the Call.
In this podcast episode, we are again joined by survival experts Chris “Gibbo” Gibson and Jimmy “Jungle” McSparron to discuss the concept of tacticool. This common expression is regularly featured on social media when individuals inquire about various gear options for one’s person. We discuss the dangerous mindset surrounding this toxic ideal, highlighting the importance of factual preparedness. If you’re new or old to the industry, this episode is our reply.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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With kick off our Guatemala Educational Aircrew Retreat (GEAR 2019) series with an open forum. Located at Guatemala's aviation training center, we sat in a mock airplane, pulled out the lapel mics, and decided to discuss the broad topic of survival. The morning after our jungle excursion inspired a multitude of discussions ranging from fire to survival gear to everything in between.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models in HEMS. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to cheat your experience, so we split the podcast episode into two separate parts.
This second part focuses on the big picture. We talk about the Airline Disregulation Act (ADA), HEMS bureaucracy, over-saturation, and billing practices. We touch on the need for advanced practice models in our current climate and the importance of generally doing the right thing.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Is the Registered Nurse/Paramedic crew configuration optimal for HEMS? In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to cheat your experience, so we split the podcast episode into two separate parts.
This first part focuses primarily on Bill's experience as an EM physician, flight physician, and medical director for University of Cinncinatti Health's Air Care and Mobile Care. We talk about the pitfalls and successes of advanced practice versus standard crew configurations. We touch on specific models involving nurse practitioners, resident-level physicians, and attending-level physicians which leads into a discussion regarding the current state of American HEMS. You don't want to miss it!
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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In this podcast episode, we are joined by Flight Physician Mike Abernethy to discuss the importance of high fidelity, simulation training. We discuss common pitfalls of simulation learning, EMS education, and highlight tips and tricks for building successful moulage; the art of applying mock injuries for the purpose of training emergency response teams and other medical and military personnel. Also, Mike advocates for a specific trauma course that seems to be doing things right across the pond.
Summary: CREATE THE ENVIRONMENT!
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Armchair Air is at it again with this is the second installment of the "Breaking the Case" series where we discuss case studies related to previously covered topics. Even though some content from Episode 33 - P.E. MERGENCY is reviewed, we recommend listening to it before proceeding. It will provide the foundation needed to understand the concepts that we base our decision-making on.
With that being said, this episode discusses three patient scenarios where pulmonary embolism plays a factor in their presentations. We discuss diagnostics and treatment methods based on the severity of each case. We also highlight the challenges surrounding the P.E. patient when resources are limited.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Earlier this year, we were asked to present at a local critical care conference. Due to the recent release of the 1-hour bundle, this was a timely discussion regarding pre-hospital sepsis. We touched on various definitions, diagnostics, treatments, and the ongoing controversy surrounding the Surviving Sepsis Campaign.
Since we try to record most of our talks, we decided to share this particular presentation with you on the podcast. We hope you enjoy this format for a change of pace.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Ladies and gentlemen, welcome to the main event. This long awaited, highly anticipated match-up is finally here.
Dan received feedback, after giving a recent talk, that we wanted to address in a fun way. What causes peri-intubation hypotension and death? Is positive pressure ventilation (PPV) or induction agents the primary contributing factor? Tune in to this special podcast episode where our own Dan "Macho Man" Rauh and Bryan Boone "The Doom" debate this heated topic. (Refereed by yours truly, Mike Boone.) We detail various sympatholytics used for induction, thoracic pressure consequences of PPV, and our ultimate concerns regarding the Rapid Sequence Intubation (RSI) procedure.
This no holds barred, cage match is brought exclusively to you live from Dan's farm aka The Thunderdome. Buckle your 5-point harnesses, because you're in for a wild ride.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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How do you become an asset rather than a lability at work? In this podcast episode, we are joined by multi-keynote speaker Shane Turner to discuss the difference between an employee and a professional. We highlight topics such as work ethic and personal drive. We also bring out how to stay engaged, using past mistakes as present motivators, and how to fight negativity at the base level. We also give tips on how to bring up uncomfortable topics to infect others with positive change as 'provider zero'.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
The Endovascular Balloon Occlusion of the Aorta (REBOA) of 2015 is drastically different than the REBOA of 2019. In order to understand new techniques such as 'partial REBOA', expert Liam Madigan joins us all the way from Scotland to discuss procedure indications, complications, and clarifications regarding recent studies. We touch on his progress with an upcoming United Kingdom RCT versus the recent retrospective analysis performed in the United States.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this podcast episode, we discuss massive, sub-massive, and non-massive pulmonary embolism. This common diagnosis is often misunderstood and mismanaged. To remedy that, we highlight categories of severity, pregnancy-related complications, effective and ineffective diagnostic tools, and definitive treatment options you should and should not consider.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Esophageal perforation/rupture is a rare, but life-threatening condition that requires immediate intervention. Late identification can result in pneumothorax, pneumomediastinum, subcutaneous emphysema, Sepsis, Acute Respiratory Distress Syndrome (ARDS), and ultimately multiple organ failure (MOF) and death.
Based on personal experience, Flight Paramedic and Educator Brian King joins us in a discussion regarding the various causes, signs/symptoms, and treatment based on our care environment. We also touch on controversies surrounding gastric tube insertion.
See our GT podcast episode here.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Especially with recent events, safety is at the forefront of every flight clinician’s mind. How do we work together to make sure everyone goes home after every shift? Chris, our resident safety expert, joins us in a special podcast episode where we discuss a team approach to flight safety in addition to other timely concepts we should consider before, during, and after every transport.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
We are introducing a new podcast series that focuses purely on case studies. In this episode, Dan helps us analyze three examples of nephrology emergencies that we might encounter as emergency providers. They are reviewed sequentially based on level of complexity. Please let us know, if you enjoyed this new format, or how we can make it better for future episodes. For a PowerPoint copy of the case studies including lab values, go to the episode's web page. Also, listen until the very end for a special feature!
*We are still working on improving Dan's recording setup. Until that time, we apologize for the poor audio quality.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Though similar presentations, beta blocker (BB) and calcium channel blocker (CCB) overdoses can affect your patients in very different ways. In this episode, we are joined by Dr. Dan Rusyniak (Toxicologist) of the Dantastic Mr. Tox & Howard Show and The Tox & The Hound (EMCrit). Tune in as we discuss BB toxicity, CCB toxicity, and a differential you can perform to treat your patients effectively.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is a trailer we created for fun to promote the website on iTunes and other trailer compatible podcast platforms. Enjoy!
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
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Music by Minutemen (Corona)
Acute Kidney Injury (AKI), formally Acute Renal Failure (ARF), is a prevalent disease process that affects over 50% of ICU admissions. AKI is not only caused by a variety of etiologies, but it can be hard to clearly define depending on your diagnostic capabilities. Tune in to this next podcast episode where we are joined by Dan "Analogy King" Rauh for a general discussion of AKI. We touch on fractional excretion of sodium (FENa) versus BUN/Creatinine ratio, mixed venous oxygenation saturation (SvO2), and when they matter. Still administering "renal dose" Dopamine? Make sure you listen until the end of the episode!
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
We wrap up AMTC18 in style with our exhibit hall neighbors and fellow podcasters Eric Bauer & Mike Verkest of FlightBridgeEDand SecondShift. Tune in as we discuss Podcast Row, FOAMed, and tips for new and old podcasters alike. We also touch on the history of HLTH, and how it all got started.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Protect your head! In this next AMTC18 Podcast Row episode, we are joined at our booth by Carlos Andino, Market Development Director at Paraclete Aviation Life Support. Tune in as we continue our discussion of helmet safety with an industry expert. We touch on commonly used materials, defining Military Standard (MIL-SPEC), Department of Defense (DoD) versus civilian testing, and other safety expectations that should be met...and aren't being met.
For additional information on this topic, reference Episode 11 - Gearing Up for Transport w/Todd Hope and our "Skids Up" blog series authored by Chris Sharpe.
*Disclosure: Carlos was technically representing a company at AMTC, but we worked hard to make this episode unbiased. This is NOT a paid sponsorship.
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Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Live from Podcast Row, we continue our AMTC18 series with a brief, “Short Final”. It is no secret that signs and other physical phenomenon are numerous. Sometimes, it is difficult to remember all of these when performing our head-to-toe assessments. In this episode, we take the time to consider one sign in particular; a sign especially common in the pediatric population. Tune in as we discuss sunset eyes phenomenon, when it’s benign, and when it matters. We also touch on Parinaud's Syndrome and its conjunction with this finding.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Kicking off our AMTC18 series, we are joined at our Podcast Row booth by the beloved Dr. Cynthia Griffin. Cynthia is an Emergency and Flight Physician for University of Wisconsin, and a member of the FOAMfrat team. After many pleasantries, we begin our discussion with the challenges surrounding flight medicine, the rarity of available positions, and team dynamics when a doctor is present on the transport team. We quickly transition to finger thoracostomy; a clinical topic and passion project for Cynthia. She highlights the common, yet ineffective nature of needle techniques in the presence of tension physiology, and the benefits finger utilization can provide. We complete that discussion with Cynthia's AMTC presentation topic: front-of-neck access. We discuss logistics, complications, and the horrors surrounding the pediatric patient with an obstructive airway. Tune in for an educational and fun-filled conversation full of sweater vests and patient zero.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this informal podcast episode, we are joined by Brad Garmon; Flight Medic, Educator, and overall good dude. Brad was our fellow "Sick Lung" clinical category presenter at the 2018 Every Coast Helicopter Operations (ECHO) annual conference. After the last day, we decided to grab dinner, a few beers, and chit chat about our overall impression of the conference. We touch on our individual presentations with an occasional tangent to finish up a weekend full of education, networking, and fish.
Topics of Discussion:
Conferences in Comparison
Upper GIB’s and Minnesota tubes
Coagulopathies and PCC’s
Critical Care Panel and MD Discretion
Ventilating the Obstructed Pt
Transporting Prone
...and everything in between!
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this special podcast episode, we are joined by a third person: Flight NP and PT Intensivist, Dan Rauh. Dan joins us at the 2018 Every Coast Helicopter Operations (ECHO) annual conference as a fellow clinical track speaker and critical care panel participant. Tune in as we discuss three, in-depth topics including Nurse Practitioner autonomy, advanced acid/base interpretation, and coagulopathy reversal. Dan also provides an easy way to calculate triple acid/base disorders including anion gap and osmolality analysis.
Time Stamps:
02:25- NP vs. PA and autonomy
05:28- Acid/base including triple disorders
26:12- Coagulopathy and TEG
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Magnesium is a co-factor in more than 300 enzyme systems that are responsible for biochemical reactions in the body. This includes protein synthesis, muscle/nerve function, blood glucose control, and blood pressure regulation. In this podcast episode, we continue our popular electrolyte series by discussing this important electrolyte. As usual, we touch on hyper and hypo states, supplementation, and other reasons to administer magnesium sulfate aside from hypomagnesemia replacement.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the video that accompanies Episode 21 where we demonstrate how to introduce an OG tube when inserting by conventional methods is difficult.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Gastric tubes are commonly used in both the pre-hospital and hospital environment for a variety of reasons. Depending on the patient and/or provider, these range from orogastric to nasogastric in nature. In this podcast episode, we raise the question, "Does it matter which one we choose?" Tune in as we discuss gastric tubes in general, indications, contraindications, and why you should choose OG over NG whenever possible. We also feature a video demonstrating how to introduce an OG tube when inserting by conventional methods is difficult.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
The vast majority of endotracheal tubes (ETT) are now cuffed. In general practice, appropriate cuff pressures are assessed by external palpation or cession of an audible leak. But is this conventional method safe? In this podcast episode, we discuss hyper and hypo-inflation, frequency of their occurrence, and how to accurately measure cuff pressures to ensure appropriate inflation.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In America, many of our patients do not speak English. This presents a challenge for us as healthcare providers when trying to communicate or acquire pertinent information regarding their illness or injury. Deaf persons who communicate via American Sign Language (ASL) can compound this issue, if we are not educated appropriately. In this video, Bryan teaches you how to sign common medical questions and responses, so that you can better communicate with your deaf patients.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Helicopter ditching is a harsh reality of the HEMS industry that can affect any crew flying near bodies of water; large or small. In this podcast episode, we are joined by Chris Sharpe who, among other things, is an expert educator in Helicopter Underwater Egress Training (HUET). Tune in as Chris describes his personal experiences as a multiple helicopter ditching survivor, common misconceptions surrounding dunk training/HUET, and his recommendations for preparing for such an incident.
*This is a remote interview since Chris is based in Guatemala. Sound quality reflects that.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Base deficit and excess are reliable biomarkers in determining the severity of our patients’ conditions. But is a deficit an automatic indicator for fluid resuscitation, as some may believe? Tune in as we discuss acid/base balance and what you should base fluid resuscitation on. We also include an updated mnemonic that will help you remember the causes of metabolic acidosis.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Dilution of intravenous medications is a common practice in most healthcare settings. Often times, this stems from ease of administration and other variables based on the provider's comfort level and past experience. But is this practice supported by evidence? Most organizational policies/protocols do not address this specific method of medication handling. In this episode, we are. Tune in as we discuss evidence based practice, medication errors, and how you should approach your next IV medication administration. We also recommend two apps to help you along in your endeavors.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the video that accompanies Episode 17. Watch as we demonstrate how to prepare your cot for a patient in the prone position, and how to turn your patient in the event of cardiac arrest.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Prone positioning in the presence of Acute Respiratory Distress Syndrome (ARDS) has been a controversial topic over the years due to variable results. Recent studies, however, have shown a significant decrease in mortality rates. These findings suggest that prone positioning has beneficial effects, and should therefore be performed in most critical care settings. Increased frequency of this therapy has led to providers being called to transport these patients; often times for ECMO support at the receiving facility. Can transport providers safely transport these patients in the prone position? In this episode, we review ARDS, the specific benefits of prone positioning, and how we can effectively perform these transfers.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the video that accompanies Episode 16. Watch as we demonstrate how to safely and effectively tape a pediatric endotracheal tube.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we discuss the logistics of securing pediatric endotracheal tubes and its relation to the pre-hospital environment. Tune in as we touch on the pro's and con's of commercial devices versus adhesive tape. We also provide a step-by-step tutorial on how to safely and effectively secure an ETT that is 4.5mm or smaller in diameter.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we discuss Multivalvular Disease. Multivalvular Disease is a fluid and complex disease process that requires expert evaluation on the part of the emergency and/or critical care clinician. Tune in as we review the cardiac cycle, systolic and diastolic heart failure, single valve dysfunction, and Multivalvular Disease’s various manifestations depending on the combination of valve lesions that your patient may present with.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the video that accompanies Episode 14. Watch as Tyler Christifulli of FOAMfrat and FlightBridgeEd tests how 3 popular nasal cannula devices perform during apneic oxygenation.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we are joined by Tyler Christifulli of the FOAMfrat blog and podcast (formally Lifestar Podcast), and FlightBridgeEd. Apneic oxygenation has been recently popularized for use during RSI in an attempt to decrease desaturation time during the apneic period of induction. Inspired by a discussion between Tyler and Dr. Jeff Jarvis, we decided to collaborate in testing the inspired O2 capabilities of several commonly used nasal cannulas with this purpose in mind. You may be surprised by our results. Tune in as we briefly discuss the physiological process of apneic oxygenation, and the equipment you should and should not be using for supplementation.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Most of us carry and commonly administer medications that affect the neurotransmitter serotonin (e.g. Fentanyl). Additionally, most of our patients with a history of depression and/or anxiety are prescribed selective serotonin reuptake inhibitors (SSRI's). In this episode, we discuss Serotonin Syndrome: a dangerous condition precipitated by the combined use of these commonly administered serotonergic drugs. Tune in as we discuss various drug combinations, the mechanism driving the resulting signs/symptoms, and the treatment course we should take to reverse these adverse effects.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we continue our electrolyte series by focusing on one of the most abundant minerals in our body: calcium. Calcium is an ion that plays a number of roles in maintaining homeostasis, and it is readily available for administration for most of us in both the pre-hospital and hospital setting. Tune in as we discuss total calcium and its affects on our critically ill patients; primarily focusing on the measurement of ionized calcium (iCa) levels, and the appropriate treatments of both hypo and hyper states.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Are you new to transport medicine and are looking for your first set of personal gear? Or, are you a seasoned critical care transport provider looking to change your current setup and upgrade to a more quality system? Or, are you a member of leadership at a HEMS program that is looking to change the equipment currently being assigned to your staff members? If so, this is the podcast for you. In this episode, we discuss specific gear options with a seasoned Flight Medic and gear guru, Todd Hope.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we continue our discussion of AMTC 17. Tune in as we touch on key points from the AMTC talks that we attended that will provide you with several clinical pearls that may apply to your practice. Due to the large amount of discussion, this podcast is split into 3 episodes; 1 for each day of the conference. This is the 3rd and final day.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we continue our discussion of AMTC 17. Tune in as we touch on key points from the AMTC talks that we personally attended. Due to the large amount of discussion, this podcast is split into 3 episodes; 1 for each day of the conference. This is day 2.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Were you unable to attend AMTC? If you were, were you able to attend every talk that you wanted to? Or, are you wondering if you missed a key point during a talk that you were able to attend? Tune in as we discuss key points from the AMTC talks that we personally attended in addition to our overall impression of the conference. Due to the large amount of discussion, we are splitting this particular podcast into 3 episodes; 1 for each day of the conference. In this particular episode, we discuss day 1.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we continue our electrolyte series by discussing one of the most infamous electrolytes: potassium. Tune in as we cover hypo and hyper states, including their effects on our bodies' electrophysiology. We also provide an acronym that we created to help you memorize the causes of hyperkalemia, specifically.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we discuss one of the most dangerous secondary complications seen in the critically ill: Disseminated Intravascular Coagulation (DIC). Tune in as we cover the clotting cascade and how opposing treatment regimens may be indicated for your patients depending on the stage of the disease's progression.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the next installment of our "Short Final" series. In this particular episode, we discuss a controversial topic regarding nurses' qualification to intubate in the pre-hospital environment. We also discuss maintaining competency for all disciplines, and whether your program's minimum requirements are enough to remain proficient.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In Part 1, we discussed chloride and touched on its close relationship with sodium. In this episode, we continue our multi-part series focusing specifically on sodium. Tune in as we discuss one of the highest regarded electrolytes, and how our treatment regimen can improve or worsen our patients' conditions. We also recommend a specific phone app to assist your resuscitation.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we interview Dr. Robert McKnight; an emergency physician who specializes in tactical medicine. Active shooter scenarios are increasingly common and require specialized training for pre-hospital medical personnel. Listen closely as Dr. McKnight relays invaluable information on how we as transport crew members can do our part in assisting law enforcement during these critical situations.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we begin a multi-part series regarding electrolytes. Listen in as we discuss hypo and hyper states, and the obscure changes that will drastically change your plan of attack in the patient with dyschloremia. We also briefly touch on acid-base balance and the limitations of anion gap.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
This is the first episode of our "Short Final" series where we discuss topics that do not necessitate a full length episode. That includes, but is not limited to, non-clinical content. In this particular episode, we offer advice on how to acquire a job in HEMS/critical care transport. Though this topic has been addressed by many others, it remains one of the most frequently asked questions by listeners. We hope that our share of knowledge will contribute to your professional success in this particular field of medicine.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
Most of us are familiar with resuscitation of the standard sick person. But how do we change our course of treatment when caring for the patient with Sickle Cell Disease (SCD)? In this episode, we bring out a case study and discuss variances in managing a sick SCD patient.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we discuss potential bradycardia in traumatic injuries. We touch on main differential diagnoses and their treatment options; primarily focusing on neurological injuries and how we can maximize our effectiveness.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.
In this episode, we introduce ourselves and explain the intent of our podcast. We are extremely excited to begin this journey and hope to contribute valuable information to the critical care transport industry.
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Disclaimer: The views, information, or opinions expressed during the HLTH podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. HLTH is not responsible for the accuracy of any information contained in the podcast series available for listening or reading on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute other professional advice or services.