Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of cooling directly correlates with mortality reduction. Learn how to implement CWI in your service. It's the best of all worlds: inexpensive, impactful, and applies to all EMS clinician levels.

REFERENCES

1. Comp G, Finch C, Kupanoff K, Sandoval M, Lloyd M, Aldaco N, Kirk D, Pugsley P, Nordstrom L, Koenig BW, Narang A, Snow J, Kamer M, Foster A, Patel G, Stowell JR. Fighting Fire with Ice: A Multisite Collaboration to Evaluate the Impact of Prehospital Cold Water Immersion on Heat Stroke Patients. Prehosp Emerg Care. 2026 Mar 13:1-11.

MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some concrete solutions for the future.

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. This is the second episode of our two-part series!

REFERENCES

1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. The episode went so well, we had to create a two-part series!

REFERENCES

1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.

As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are the potentially risky decisions? What should the MCHD field paramedics know about the process? Have a listen to better understand the true foundation of EMS clinical practice.

The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehospital setting. What are the common mistakes? What tools can be implemented to improve patient outcomes? Why does geriatric care even matter? This episode is packed with high-yield information that will make all of us better clinicians.

REFERENCES

1. Dorsett M, Allen H, Garbacz H, Sensenbach B, Kumar S, Jones CMC, Cushman JT. Timeline for Repeat EMS Encounters Resulting in Transport Following "Lift Assist" in a Suburban EMS System. Prehosp Emerg Care. 2025 May 29:1-6.

2. Haussner WK, Breyre AM, Bascombe K, Barrett WJ, Camacho MA, Overton-Harris P, Williams S, Lyng JW, Martin-Gill C, Colwell C. Prehospital Trauma Compendium: Management of Geriatric Trauma Patients - A Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. 2025 Sep 25:1-10.

There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. This is part two of a two-part series.

REFERENCES

1. Jarvis JL, Jarvis SE, Kennel J. The Association Between Out-of-Hospital Drug-Assisted Airway Management Approach and Intubation First-Pass Success. Ann Emerg Med. 2025 Nov;86(5):521-530.

2. Spigner MF, Wang HE, Carlson JN. One and Done? Rethinking "First-Pass Success" in Out-of-Hospital Airway Management. Ann Emerg Med. 2025 Nov;86(5):531-532.

3. Maia IWA, Besen BAMP, Silva LOJE, et al; BARCO group. Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study. Crit Care. 2025 Apr 17;29(1):155.

Recently, some paramedics, obstetricians, and EMS medical directors were locked in a room and produced some fantastic collaborative prehospital guidelines for managing post-partum hemorrhage, eclampsia, and pre-eclampsia. Have a listen, take a look at the guidelines (links below), and we'll all take better care of our pregnant/post-partum patients.

REFERENCES

1. https://naemsp.org/news/now-available-new-ems-obstetric-emergency-guidelines/

There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why don't we intubate our cardiac arrest patients like we used to?" "MCHD has been hyper-focused on recording video laryngoscopy over the past year. Why?" Join the podcast crew to discuss recent EMS airway literature that helps us answer these questions and provides invaluable tips. This is part one of a two-part series.

REFERENCES

1. Galinski, M., Tazi, G., Wrobel, M., Boyer, R., Reuter, P. G., Ruscev, M., Debaty, G., Bagou, G., Dehours, E., Bosc, J., Lorendeau, J. P., Goddet, S., Marouf, K., Simonnet, B., & Gil-Jardiné, C. (2025). Risk factors for failure of the first intubation attempt during cardiopulmonary resuscitation in out-of-hospital emergency settings: What about chest compression?. Resuscitation, 214, 110623.

2. Brenne, N., Brünjes, N., Rupp, D., Sassen, M. C., Jerrentrup, A., Wulf, H., Heuser, N., & Volberg, C. (2025). Success of airway management in out-of-hospital cardiac arrest using different devices - a prospective, single-center, observational study comparing professions. Scandinavian journal of trauma, resuscitation and emergency medicine, 33(1), 109.

3. Bryan, A., Feltes, J., Sweetser, P. W., Winsten, S., Hunter, I., & Yamane, D. (2025). Hyperangulated video laryngoscopy in the emergency department: An analysis of errors and factors leading to prolonged apnea time. The American journal of emergency medicine, 95, 153–158.

We're lucky to have a special guest on this podcast episode to discuss a topic that, unfortunately, all of us in emergency care encounter all too frequently: the opiate epidemic. Peter Canning is a paramedic who has lived through the epidemic while working on the ambulance in the New England epicenter. This discussion navigates Peter's progression through newer terminology like stigma and harm reduction in an effort to provide compassionate and best-practice care for our OUD patients.

REFERENCES

1. https://www.press.jhu.edu/books/title/12438/killing-season?srsltid=AfmBOopOX3Wpf9blJDuiJbwOCKyNCACoxU2IixIMtLg1N1a-wYTGeEmr

2. https://www.press.jhu.edu/books/title/53796/friends-and-family-guide-opioid-overdose-epidemic