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EMSconnect On Shift Host Shaun Pitts engages in a compelling conversation with author David Givot, delving into his transformative book, "Sirens, Lights, and Lawyers." David Givot, a seasoned EMS Defense lawyer with a background as a paramedic, offers an enlightening and refreshingly candid perspective for EMS providers at all career levels. "Sirens, Lights, and Lawyers" serves as a practical guide, unraveling the complexities of the law, demystifying legal processes, and addressing the inherent risks encountered in emergency medical services. This invaluable resource empowers readers with the necessary knowledge and insight to effectively navigate both the legal intricacies and personal challenges inherent in their daily responsibilities. Listen to this episode and get the book before writing another narrative!!! 

Find the book here: https://www.amazon.com/Sirens-Lights-Lawyers-Important-Providers-ebook/dp/B0C4WGP61G

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Dr. Dierks sit down and breaks up the clogs about CHF management, and what EMS providers can do to help these patients. Also on this episode, he navigates the twist, turns, and blockages with encountering LVAD devices in the field! 

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Get ready to dive into the world of obstetric and gynecological emergencies with a healthy dose of humor! This course is designed to equip EMS professionals with the knowledge and skills needed to handle situations where storks are nowhere to be found. From unexpected meconium mishaps to surprise labor parties, we've got you covered!

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So, this may be a first! Shaun sits down with the fire educators of EMSconnect and their WIVES! So what does that mean for you? Grab your spouse, and listen to this one together. This is not therapy, but I hear from two great couples who have lived through what this job does to families and made it work!  

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We've all heard the saying, "If it's icky, sticky, brown, and not yours, don't touch it." But let's face reality, in EMS, we often don't have the luxury of choice. Patients deteriorate, wound dressings must be changed, and sick individuals call 9-1-1. We administer airway adjuncts and medications that increase our exposure to aerosolized particles—particles that seem to have an uncanny ability to travel impressive distances and head straight for our faces at the speed of a sneeze. So, how can we prioritize safety? What precautions should we be taking, and what gear is essential? We've got just the expert to shed light on all of this. Join us as Dr. Stanton delves into the realm of infectious diseases. 

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In this episode of "Are you Altered? Hypothermia Has Become Cool, Right?" we dive deep into the critical topic of hypothermia management within the realm of EMS. Join us as we explore the intricacies of identifying, assessing, and treating hypothermic patients in the field.

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Well, this one sure caught our attention. Shaun Pitts and Dr. Travis Dierks dive into the recent article published in The New Yorker: "The Hidden Harms of CPR" by Sunita Puri.
This raises the ethical question, should EMS be doing CPR on patients that are VERY unlikely to survive? We know that all patients have the right to refuse care, and on the flip side, have the right to demand care, and EMS is caught right in the middle of a legal and more often ethical grey area. 

Link to  article: https://www.newyorker.com/news/the-weekend-essay/the-hidden-harms-of-cpr?fbclid=IwAR2EoZ1S4DNbDk5xXILzC4PThVo_LyUH51mEVUEC-CRXf0sWXRySkpCcaAI

Link to Dr Dierks reference: https://www.bmj.com/company/newsroom/patients-overestimate-the-success-of-cpr/#:~:text=Patients%20and%20the%20general%20public,online%20in%20Emergency%20Medicine%20Journal.

Links to studies found on damage from CPR: 

1. Ouellette l, Puro A, Weatherhead j, Chassee T, Whalen D, Jones J. Public knowledge and perceptions about cardiopulmonary resuscitation (CPR): Results of a multicenter survey. American Journal of Emergency Medicine 2018;36(10): P1900-1901. Available at: https://www.ajemjournal.com/article/S0735-6757(18)30117-7/fulltext.
2. Peberdy MA, Kaye W, Ornato JP, Larkin GL, Nadkarni V, Mancini ME, et al. Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation. Resuscitation 2003;58;297-308. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12969608. 
3. Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz. Trends in survival after in-hospital cardiac arrest. New England Journal of Medicine 2012 Nov 15;367(20):1912-20. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517894/
4. van Gijn MS, Frijns D, van de Glind EMM, van Munster BC, Hamaker ME. The chance of survival and the functional outcome after in-hospital cardiopulmonary resuscitation in older people: a systematic review. Age and Ageing 2014;43(4): 456-463. Available at: https://academic.oup.com/ageing/article/43/4/456/2812217. 
5. Sehatzadeh S. Cardiopulmonary Resuscitation in Patients With Terminal Illness: An Evidence-Based Analysis.Ontario Health Technology Assessment Series 2014; 14(15): 1–38. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552960/. 
6. Scholz KH, Tebbe U, Herrmann C, Wojcik J, Lingen R, Chemnitius JM, et al. Frequency of complications of cardiopulmonary resuscitation after thrombolysis during acute myocardial infarction [see comments]. Am J Cardiol.1992; 69:724–728.Available at: https://www.ajconline.org/article/0002-9149(92)90494-J/pdf. 
7. Kralja E, Podbregarb M, Kejžarc N, Balažica J. Frequency and number of resuscitation related rib and sternum fractures are higher than generally considered. Resuscitation. Aug 2015. 93:136-141. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404201/.

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Drop the Narcan! Are you sure this is the right medication and the right time? And let's get real, not every overdose gets Narcan. Join Dr. Dierks talking about ALL kinds of overdoses, poisonings, and toxicological emergencies! 

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Thought biases, also known as cognitive biases, refer to systematic errors in thinking that can influence our decision-making processes and judgments. Understanding these biases is essential for EMS professionals as it helps in recognizing and mitigating potential errors in critical situations. Understanding these biases can help EMS professionals be more aware of their own thinking processes and make more informed decisions. By continuously learning about thought biases and engaging in critical thinking exercises, EMS professionals can develop strategies to mitigate the impact of biases and improve patient care.

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"Train like your life depends on it. You don't rise to the occasion, you fall to the level of your training. Muscle memory. Slow is smooth and smooth is fast." I am sure we all have heard these things yelled across the drill ground, said in an AAR after a critical call, or even muttered by our mentors. So what does it mean? Is it a mindset, or science? Ryan and I do our best at talking about both the mindset and the science of training how and why we should train in certain ways. If you are a training officer, instructor, FTO, or want to step up your training game, take notes on this one, Ryan is full of information! 

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