Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

By Ross Orpet, Paramedic turned EMS PhysicianEducation
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Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers episodes

  • How to Fail Better in EMS: A Framework for Growth

    Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it.

    In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus is a warning, not a role model. Why the best clinicians you'll ever work with have made bigger mistakes than you have. Why high-functioning organizations report mistakes ten times more often than average ones. Why self-identified perfectionists only ever climb to "moderately successful." 

    Book Your Free Coaching Call at emspodcast.com/free-coaching-call

    Sign up for the weekly newsletter - emspodcast.com/newsletter 

    American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

    17 min
  • The Call Nobody Trained You For — Jim Schmidt on Domestic Violence Recognition

    Most medics walk onto a domestic violence scene armed with instinct and not much else. Jim Schmidt thought 20 years in the fire service had prepared him for anything — until he had to identify his stepdaughter Gabby Petito's body in 2021. In the months and years after he realized how little EMS is prepared to recognize and treat domestic violence victims. What he's learned since has rewritten what first responders should be doing on these calls. Jim walks us through the red flags, why strangulation may leave no external marks but signals a 750% jump in homicide risk, how to document, how to treat and talk to the patient, and what patterns we can recognize.


    Resources

    • DomesticShelters.org — find local DV/SA orgs by address
    • National DV Hotline — 1-800-799-SAFE · text START to 88788
    • JEMS article by Jim Schmidt on educating first responders to recognize domestic violence: https://www.jems.com/ems-training/domestic-violence-educating-first-responders/ 
    • Jim Hopper, PHD on the neurobiology of trauma and sexual assault: https://www.youtube.com/@JimHopperPhD 
    • Want to go deeper?

      Book a Free Coaching Call at emspodcast.com/free-coaching-call Sign up for the weekly newsletter: emspodcast.com/newsletter

       

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      1 hr 13 min
    • Great Mentors Shape Better Clinicians

      Don't Be A Field Training Officer Be A Field Training Mentor.

      Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down with Ben Tacy onsite at FASTCAN to talk about the origins of field training and why Ben prefers the language of mentorship over “field training officer”.

      If you care about leadership, education, workplace culture, or building better medics, this conversation is worth your time.

      If you want deeper discussions on topics just like this subscribe to our weekly newsletter - emspodcast.com/newsletter 

      Want some individualized mentorship? Book a free coaching call with us - emspodcast.com/free-coaching-call 

      Interested in The Loud & Clear Fellowship? Book a free coaching call with us: emspodcast.com/free-coaching-call

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      20 min
    • Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite

      Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the Colorado Rockies, to break down frostbite from the prehospital perspective.

      Greg walks through field assessment, when to rewarm vs. when to leave it alone, pain management, and when to bypass your local ED for a tertiary care center.

      Whether you’re running urban calls or wilderness rescues, you may see this and this episode will help inform how you approach cold injury.

       

      Want more?

      Subscribe to The Confidence Dispatch, our free weekly newsletter for paramedics who want to get 1% better every shift: →  https://loudandclear.kit.com/d45b012fae

       

      Want to go even further?

      The Loud & Clear Fellowship is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands.

      Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance. The stuff nobody teaches you in school.

      If that sounds like what you've been looking for, book a free 30-minute coaching call and we'll talk about whether it's the right fit. Even if it’s not we’ll give you actionable advice on the call so that you still walk away with something valuable: →  emspodcast.com/free-coaching-call

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      1 hr 1 min
    • Suction First: Dr. DuCanto on the SALAD Technique for the Contaminated Airway and What Comes Next

      The contaminated airway is one of the most unforgiving calls in prehospital medicine. Blood, vomit, debris — your laryngoscope goes in and you're blind. For decades, paramedics managed this with tools designed for a clean OR and training that never got close to the real thing.

      Dr. Jim DuCanto decided that was unacceptable. He's the anesthesiologist who invented the DuCanto catheter and SALAD (Suction Assisted Laryngoscopy and Airway Decontamination). Will Berry sat down with Dr. DuCanto at the FASTCAN conference for a conversation.

      In this episode we cover:

      - The SALAD technique, step by step

      - Why paramedic OR training should default to video laryngoscopy

      - The downsides of SALAD that Dr. DuCanto himself will tell you about

      - What a new portable suction device does differently

      Guest: Dr. Jim DuCanto anesthesiologist, inventor of the DuCanto catheter and the SALAD technique

       

      Want more?

      Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

       

      Want to go even further?

      The Loud & Clear Fellowship is a year-long course and coaching community for medics who want to close the gap between what school taught them and what the job actually demands. 

      Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

      If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → emspodcast.com/free-coaching-call

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      30 min
    • Wired to Fail: The Science of Human Error in EMS

      What if the mistake wasn't your fault... but it's still your responsibility?

      That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actually do about it.

      WHAT YOU'LL LEARN:

      Task Brackets — Your brain bundles repetitive actions into smooth automated sequences.

      The First Habit Rule — The first habit is permanently ingrained. Old habits lurk underneath new ones and surface under stress. Get it right the first time.

      Goal-Oriented Stimulus — Don't ask "Do I have everything?" Ask "Where are the things I need?" and physically point to them.

      The Preceptor Problem — Most preceptors feel unprepared. The goal isn't to make "mini me", it's to create independent critical thinkers.

      Shift Fatigue — Cognitive function degrades meaningfully at 16 hours.

      Just Culture — Human error is inevitable. Punishment doesn't fix the system. The guilty already feel terrible. They need peer support and system redesign.

       

      RESOURCES:

      Join The Loud & Clear Fellowship 

       

      CONNECT WITH US:

      - Instagram- @emsloudandclear

      - YouTube- https://www.youtube.com/@EMSLoudandClear

      - Website- www.emspodcast.com 

       

      CONNECT WITH SHEA:

      - TikTok: @flightnurseshay

      - Instagram: @flightnurseshay

      Interested in The Loud & Clear Fellowship? Book a free coaching call with us: emspodcast.com/free-coaching-call

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      12 min
    • Dump Kits and Checklists: Why Expert Paramedics Still Crash

      Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. You'll learn the challenge-response checklist protocol that speeds up your intubation time (not slows it down), the HEAVEN criteria's six specific warning signs that predict difficult airways before you attempt, and why dump kits create muscle memory that works in the dark. David shares the story that started his human factors obsession and proves that expertise doesn't protect you from error—systems do. This is operational excellence: building checklists that think for you when tunnel vision sets in.

       

      Want more? Also subscribe to The Confidence Dispatch — Our free weekly newsletter for paramedics who want to get 1% better every shift: → https://loudandclear.kit.com/d45b012fae

      Want to go even further?

      The Loud & Clear Fellowship is a year-long course and coaching community for new medics who want to close the gap between what school taught them and what the job actually demands. Built by an ER doc who runs medical direction for 5 rural Colorado agencies and has talked with hundreds of paramedics about exactly where that gap shows up.

      Not a lecture series. Not another CE you'll forget by your next shift. Real frameworks for clinical reasoning and mental performance — the stuff nobody teaches you in school.

      If that sounds like what you've been looking for, book a free 30-minute call and we'll talk about whether it's the right fit: → emspodcast.com/free-coaching-call

      Resources  

      The Loud & Clear Fellowship - emspodcast.com/program 

      To see the actual checklist - https://www.airmedandrescue.com/latest/long-read/medical-insight-latest-tools-ensure-successful-first-pass-intubation 

       

      Guest/Cast/Crew information-

      Guest- David Olvera

      Host- Ross Orpet, Will Berry 

       

      Catch up with us after the show

      - Instagram- @emsloudandclear

      - YouTube- https://www.youtube.com/@EMSLoudandClear

      - Website- www.emspodcast.com

       

      Books we recommend

      - The Dichotomy of Leadership - https://amzn.to/4fiCAjN

      - Extreme Ownership - https://amzn.to/3O1FWfa

      -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

      - Thinking Fast and Slow - https://amzn.to/4fiJG85

       

      Gear We Like

      - Good Stethoscope - https://amzn.to/3YJJrf2

      - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 

      - Notepad for taking notes on calls - https://amzn.to/3Z1X21J

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      19 min
    • Feeling Behind the Curve? Understanding the EMS Power Curve Will Help You Stay Ahead

      Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This episode breaks down the exact framework to chunk calls into five critical phases. When you understand phases you understand what is needed during each point of the call and how to stay ahead. How to build if-then statements that eliminate decision fatigue. The psychological safety that lets you reset after screwing up in the apartment. And why 80% of medical errors tie back to the one phase—the hospital handoff. Stop reverting to chaos. Build the system that keeps you ahead.



      Guest/Cast/Crew information-

      Guest- Moose and Josh from Alert Medic 1 podcast

      Host- Ross Orpet, Will Berry 

      Catch up with us after the show -

      Instagram- @emsloudandclear 

      YouTube- https://www.youtube.com/@EMSLoudandClear  

      Website- www.emspodcast.com

       

      Books we recommend

      - The Dichotomy of Leadership - https://amzn.to/4fiCAjN

      - Extreme Ownership - https://amzn.to/3O1FWfa

      -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

      - Thinking Fast and Slow - https://amzn.to/4fiJG85

      Gear We Like

      - Good Stethoscope - https://amzn.to/3YJJrf2

      - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn   

      - Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

       

      Want to stay ahead of the top 1% in EMS and build real confidence in the field?

      👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: emspodcast.com/free-coaching-call
      📰 Join our bi-weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      1 hr 17 min
    • Stupidity in EMS: The causes and remedies

      You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them.

      Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science behind high-stakes decision-making in emergency medicine.  

      Guest/Cast/Crew information-

      Guest- Kris Kaull, FP-C

      Host- Ross Orpet

      Catch up with us after the show -

      Instagram- @emsloudandclear 

      YouTube- https://www.youtube.com/@EMSLoudandClear

      Website- www.emspodcast.com

      Books we recommend

      - The Dichotomy of Leadership - https://amzn.to/4fiCAjN

      - Extreme Ownership - https://amzn.to/3O1FWfa

      -  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf

      - Thinking Fast and Slow - https://amzn.to/4fiJG85

      Gear We Like

      - Good Stethoscope - https://amzn.to/3YJJrf2

      - Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  

      - Notepad for taking notes on calls - https://amzn.to/3Z1X21J 

       

      Want to stay ahead of the top 1% in EMS and build real confidence in the field?

      👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: emspodcast.com/free-coaching-call
      📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

      American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

      24 min
    • Anaphylaxis + Asthma: When Standard Anaphylaxis Treatment May Not Be Enough (AMAX4 Explained)

      This episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine may not be enough, and why this is the time to be aggressive.

      But this isn't simply about memorizing another algorithm. It's about developing the operational confidence to recognize when standard approaches may fail and override your impulse to "try the book answer one more time." You'll learn to identify time-critical scenarios, build red-flag combination awareness, and make high-stakes decisions without second-guessing yourself. 

      Want to systematically build this decision-making confidence? Discover The Loud & Clear Fellowship at emspodcast.com/program —where we teach the operational skills your school didn't.

       

      Guest/Cast/Crew information-

      Guest- Bruce Hoffman, Associate Professor, Critical Care RN and Paramedic
      Host- Ross Orpet, Will Berry 

      Catch up with us after the show

      • Instagram- @emsloudandclear
      • YouTube- https://www.youtube.com/@EMSLoudandClear
      • Website- www.emspodcast.com
      • Books we recommend

        • The Dichotomy of Leadership - https://amzn.to/4fiCAjN
        • Extreme Ownership - https://amzn.to/3O1FWfa
          •  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf
          • Thinking Fast and Slow - https://amzn.to/4fiJG85
              • A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2
              • Gear We Like

                • Good Stethoscope - https://amzn.to/3YJJrf2
                • Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn 
                • Notepad for taking notes on calls - https://amzn.to/3Z1X21J
                •  

                  Want to stay ahead of the top 1% in EMS and build real confidence in the field?

                  👉 Book a call to get personalized guidance, improve decision-making under pressure, and grow your skills as a paramedic: emspodcast.com/free-coaching-call
                  📰 Join our weekly newsletter for exclusive EMS insights, leadership strategies, real-life scenarios, and tools designed to help you stay sharp, confident, and ahead of the curve: https://loudandclear.kit.com/d45b012fae

                  American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear

                  20 min

                About Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

                From the publisher's feed

                Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if…

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