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This episode features Dr. Dustin Calhoun, Scott Williams, Steve Lester and John Vance.

About our guest: 

Dr. Dustin J. Calhoun, MD, FAEMS is an Associate Professor of Emergency Medicine and Associate Director of the Division of Emergency Medical Services at the University of Cincinnati. A board-certified emergency physician and EMS physician, he practices at UC Medical Center and West Chester Hospital. Dr. Calhoun serves as the Medical Director for the Springdale Fire Department and the Cincinnati Fire Department and provides medical direction for numerous other fire, EMS, law enforcement, and special operations agencies throughout the Cincinnati region, including airport fire-rescue, SWAT teams, and multiple suburban fire departments. He is also a flight physician with Air Care and Mobile Care and serves as Medical Director for Emergency Management at UC Health. Nationally recognized for his expertise in prehospital emergency medicine, disaster preparedness, and tactical EMS, Dr. Calhoun is a frequent instructor and speaker on EMS leadership, special operations medicine, and emergency response. 

We break down how Cyanokit (hydroxycobalamin) fits into fireground care when smoke inhalation includes the toxic twin threat of hydrogen cyanide and carbon monoxide. We focus on patient selection, rapid delivery to the front yard, and the practical steps that help incident commanders, EMS crews, and hospitals work from the same playbook.
• what Cyanokit is and why older cyanide antidotes were risky with carbon monoxide exposure
• where hydrogen cyanide comes from in structure fires, smoldering, and overhaul plus dermal absorption risks
• why time to administration matters, especially for altered mental status and fireground cardiac arrest
• how departments deploy kits on district cars, battalion chiefs, engines, and ALS rescues to reduce delays
• real incidents and outcomes, including pediatric rescues and lessons when kits are limited
• IV and IO administration considerations, including push-pull delivery and flushing the line
• what the incident commander does to stage medical resources and get the kit to the patient fast
• what information helps the emergency department when there is no rapid cyanide test
• balanced use, costs, side effects, and why training should prevent wasting kits
• training approaches, trainer kits, and restock plans that keep programs sustainable

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