On this month’s episode, we’re joined by Dr. Steven Sanders to discuss heat related illnesses. 

During the episode, you’ll hear us cover:

Health impacts of temperature increase 

Physics/physiology of temperature vs heat

Spectrum of heat related illness

• heat rash
• heat cramps
• heat edema
• heat syncope
• heat exhaustion 
• heat stroke
• exertional vs classic

Comorbidities/confounders/risk factors

Temperature assessment

Disease management & treatment

On this month’s episode, we’re joined by Dr. Bonnie Snyder to discuss BVM as well her recently published paper in Resuscitation: Association of small adult ventilation bags with return of spontaneous circulation in out of hospital cardiac arrest. 

During the episode, you’ll hear us cover:

There is nothing basic about the BVM - it is not a benign intervention

Rate and volume based on the guidelines 

• Consequences of excessive rate/volume
• Consequences of under ventilation 

General airway management

• positioning 
• suction
• airway adjuncts
• mask seal
• C-E technique
• 2 person technique 
• waveform capnography and other real time feedback
• importance of proper volume
• importance of proper pressure 

BVM sizing 

Dr. Snyder’s study 

• research question/impetus
• P-I-C-O
• results
• feedback 
• next steps

On this month’s episode, we’re joined by Dr. Katie Lin to discuss TBI and the crashing brain. 

During the episode, you’ll hear us cover:

head injury differentials and history gathering 

ischemic vs hemorrhagic 

head injury etiology 

head injury pathophysiology 

assessment

3 step neuro exam 

pupil assessments 

signs/symptoms of herniation 

ECG changes

management 

• avoid/manage the H bombs (hypoxia, hypotension, hyperventilation)
• airway management 
• ICP management 
• other medications 
• seizure management 

paediatrics 

neuroprognostication 

On this month’s episode, we’re joined by Dr. Janice Tijssen to discuss pediatric cardiac arrest. During the episode, you’ll hear us cover:

The importance of our early interventions

What is cardiac arrest

• incidence/epidemiology
• etiology 
• risk factors/past medical history
• outcomes
• sociodemographics

Differences between adult and pediatric cardiac arrest

Simplifying our response

Symptomatic bradycardia

The importance of scene time

The importance of CPR/ventilation

IV vs IO, SGA vs ETT

Epinephrine  

PRIME study

Family presence during arrest 

Disposition

On this month’s episode, we’re joined by Dr. Louisa Marion-Bellemare to discuss Suboxone (buprenorphine/naloxone) and managing patients who use illicit and controlled drugs. During the episode, you’ll hear us cover:

• history of the drug crisis 
• lay of the land of the current drug crisis
• historical treatments
• opiate pharmacology 
• healthcare utilization 
• stigma 
• suboxone use 
• patient advocacy

On this month's episode, we chat with Matt Smith about wilderness medicine. 

As we shift from a high resource to a low resource setting, there are 3 main concepts to consider:

- Ideal to real

- High risk to low risk

- Stable to unstable

These concepts are important as we shift our practice and prepare ourselves. 

For this patient context, we need to focus on the things we can't replace, and learn to manage that.

Our approach to these patients need to be algorithmic, and focus on doing the basics well. Two mnemonics (H-E-M-P; A-B-C-D-E) are presented to help with our approach.

Lastly, hypothermia assessment and management is discussed.

On this month’s episode, we discuss acute coronary syndrome (ACS) with Dr. Jess McLaren

We define ACS, we cover pathophysiology, and some common causes. Importantly we discuss the assessment of this patient population - paying attending to both objective and subjectives signs and symptoms. We spend some time talking about electrocardiograms, and perhaps most importantly, we chat about the management of this patient. 

On this episode, we’re joined by Dr. James Gilbertson with the Ottawa Hospital, and Cst. Caroline Gallant with The Ottawa Police Marine, Dive and Trails (MDT) Unit.

We take a dive into drowning and cover:

• What drowning is
• The scale of the problem
• Drowning pathophysiology
• The medical management of drowning patients
• Prognostication

Lastly, we speak to drowning prevention 

In British Columbia 7 people per day are dying as a result of a highly contaminated toxic supply of drugs. Since the announcement of the public health crisis related to illicit drug toxicity deaths in 2016 over 12,000 people have lost their lives.

Despite previous misconceptions that the toxic drug crisis is confined to Vancouver’s lower mainland and the downtown east side, Jen is sounding the alarm that not a square inch of the province of BC has been unaffected by the crisis. Working on the frontlines of a provincial organization means every patient and every paramedic is being affected, and as a service provider the organization is burdened with the monumental task of meeting the demand for emergency health services in rural communities that otherwise have never required such a response.

Jen emphasizes the importance of the paramedic role given the frequency at which they interact with people who use drugs. She proffers that paramedics are uniquely positioned to offer alternative models of care that aim to reduce harm, but that the window of opportunity to offer these tools is narrowing.

In this episode Jen speaks to some of the things paramedics can be doing to reduce harm in their approach, and in pathways that their organizations can be offering to patients. You can learn more about what the literature is saying about the paramedic role in caring for people who use drugs in Jen’s scoping review.

You can contact Jen on twitter at @jlynnbolster or e-mail her directly at [email protected]