The EMS Lighthouse Project

Ketamine is a wonder drug. Ketamine is a tool of systemic racism. Ketamine is impossible to overdose. Ketamine is an inappropriate drug used for inappropriate purposes. So much controversy. What should we believe? When in doubt, follow the data. Dr. Jeff Jarvis reviews a very timely paper just released in Annals of Emergency Medicine using the 2019 Data Collaborative data set that aims to describe the characteristics of patients getting ketamine as well as the potential deaths associated with it. As a bonus, Drs. Remle Crowe and Brent Myers join Dr. Jarvis for an interview about their paper and the controversies surrounding ketamine use.

What is the impact of on-scene resuscitation vs intra-arrest transport on outcomes? Could the differences in first-pass success between ETI and King LT have accounted for the differences in outcome in the PART trial? How about differences in compression interruptions? In this episode recorded on the road in Bend, Oregon, Dr. Jarvis reviews three new papers addressing these questions. He then interviewed Petar and Amber Hossick about how Bend Fire Rescue has implemented tenets of improvement science to impact survival in their community.

We saw the amazing performance of Pfizer and Moderna's two mRNA COVID vaccines in their RCTs. As encouraging as trial performance is, we always want to know how those numbers hold up under large-scale, real-world pragmatic conditions. Well, we now have three new pieces of information on that. And, for the cherry on top, we get evidence of performance against asymptomatic infection! Dr. Jarvis does a quick review of the latest evidence on vaccine performance.

December 4, 2001. A bad day, indeed. That’s the day the FDA issued a black box warning for droperidol, citing evidence of QT prolongation, Torsades de Pointes, and death. This was a surprise warning because droperidol had been extensively used by emergency medicine and anesthesiology for decades without apparent problems. Since this bad day, we’ve essentially been without droperidol. Fortunately, it’s back! Before we use it again, we should look at what got this drug on the FDA’s radar. Dr. Jarvis reviews the literature about the “evidence” behind the warning and describes how his systems will be bringing droperidol back into practice.

The FDA just granted EUA for the Johnson and Johnson vaccine against COVID. This is a big deal because it is a one-shot vaccination that is much more stable than the two mRNA vaccines. Dr. Jarvis provides a quick overview of the data submitted to the FDA for approval.

LIVE from a virtual Texas EMS Conference; we bring you a session moderated by Mike featuring Drs. Jeff Jarvis, Jason Pickett, and Heidi Abraham. This is the highly anticipated Part Deux of a session we all did at the Texas EMS Conference in Fort Worth in 2019… back before “the situation” when we could all meet in person like civilized humans. We discussed various topics, including the new DEA rules about controlled substances, the latest AHA guidelines, and many other goodies. But mostly, we just had fun.

Ketamine-only intubation has been promoted by some as a safe approach to airway management in patients with anatomically or physiologically difficult airways. It turns out Dr. Jarvis has some thoughts on the subject. He uses a 2020 paper by Dr. Driver entitled “Success and Complications of the Ketamine-Only Intubation Method in the Emergency Department” to discuss this concept. 

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As always, we want to hear your feedback and questions/comments. You can reach us at @DrJeffJarvis or [email protected]. 

Thanks y’all!

Children are often considered to be just small adults, much to the dismay of pediatricians everywhere. But when it comes to peri-intubation cardiac arrest, is it true? We know that, in adults, peri-intubation hypoxia is a strong predictor of cardiac arrest. Is this true in pediatric patients?

This episode features another oral board case with Dr. Erin Lincoln (@ErinTWL) and a live discussion with Mike (@MikeVerkest), Jeff (@DrJeffJarvis), and special guest Dr. Peter Antevy (@HandtevyMD). Our live segment had lots of great listener questions, which led Peter and Jeff to explore safe intubation practices in depth. 

If you like what you hear, please give us a 5-star rating wherever you get your podcasts and tell your friends to subscribe. All of our podcasts are now also released in video format on the FlightbridgeED YouTube channel. Take a look, subscribe, and give us a ‘thumbs up.’ 

As always, we want to hear your feedback and questions/comments. You can reach us at @DrJeffJarvis or [email protected].

Dr. Jarvis and Mike Verkest are joined by a trio of guests to discuss the literature surrounding the Pfizer BionTech and Moderna Vaccines. Dr. Ritu Sahni, Dr. Veer Vithilani, and Dr. Remle Crowe round out the panel. This episode is nearly two hours in length, and we hope we answered any questions you might have in a non-biased way. Feel free to share this episode or any of the mRNA series of podcasts and live broadcasts we have done this month. We appreciate you listening.

This episode was a LIVE media broadcast discussing a double-blind trial of IM Droperidol, Ziprasidone, and Lorazepam for acute undifferentiated agitation in the emergency department. Join Mike and Jeff as they discuss the paper, take viewers' questions, and tease the newly released Standard of Care Podcast! Thank you for listening, sharing, rating, and reviewing all the FlightBridgeED podcasts! We appreciate you being on this journey with us!