In this compelling episode of the FlightBridgeED Podcast, Eric Bauer is joined by Kari Young, Advanced Practice Paramedic and educator, for another installment of The Nightmare Series. Together, they dissect a complex critical care case where the obvious diagnosis was only the beginning. What initially appeared to be a straightforward presentation quickly evolved into a diagnostic minefield involving diabetic ketoacidosis (DKA), end-stage renal disease (ESRD), pneumonia, sepsis, acute respiratory failure, hypoxemia, and acute encephalopathy. 
 
Throughout the discussion, Eric and Kari walk listeners through the clinical presentation, differential diagnosis, decision-making process, and the cognitive biases that can lead providers to anchor on a single diagnosis while overlooking other life-threatening conditions. Filled with practical teaching points, evidence-based discussion, and real-world lessons, this episode challenges clinicians to think beyond the first diagnosis and embrace a more comprehensive approach to critically ill patients. 
 
Whether you're an EMT, paramedic, flight clinician, nurse, or physician, The Nightmare Series: The Diagnostic Minefield will sharpen your clinical reasoning and remind you that sometimes the sickest patients aren't suffering from one disease, but several, all at once.

In this compelling episode of the FlightBridgeED Podcast, Eric Bauer is joined by Kari Young, Advanced Practice Paramedic and educator, for another installment of The Nightmare Series. Together, they dissect a complex critical care case where the obvious diagnosis was only the beginning. What initially appeared to be a straightforward presentation quickly evolved into a diagnostic minefield involving diabetic ketoacidosis (DKA), end-stage renal disease (ESRD), pneumonia, sepsis, acute respiratory failure, hypoxemia, and acute encephalopathy. Throughout the discussion, Eric and Kari walk listeners through the clinical presentation, differential diagnosis, decision-making process, and the cognitive biases that can lead providers to anchor on a single diagnosis while overlooking other life-threatening conditions. Filled with practical teaching points, evidence-based discussion, and real-world lessons, this episode challenges clinicians to think beyond the first diagnosis and embrace a more comprehensive approach to critically ill patients. Whether you're an EMT, paramedic, flight clinician, nurse, or physician, The Nightmare Series: The Diagnostic Minefield will sharpen your clinical reasoning and remind you that sometimes the sickest patients aren't suffering from one disease, but several, all at once.

In this compelling episode of the FlightBridgeED Podcast, Eric Bauer is joined by Kari Young, Advanced Practice Paramedic and educator, for another installment of The Nightmare Series. Together, they dissect a complex critical care case where the obvious diagnosis was only the beginning. What initially appeared to be a straightforward presentation quickly evolved into a diagnostic minefield involving diabetic ketoacidosis (DKA), end-stage renal disease (ESRD), pneumonia, sepsis, acute respiratory failure, hypoxemia, and acute encephalopathy. 
 
Throughout the discussion, Eric and Kari walk listeners through the clinical presentation, differential diagnosis, decision-making process, and the cognitive biases that can lead providers to anchor on a single diagnosis while overlooking other life-threatening conditions. Filled with practical teaching points, evidence-based discussion, and real-world lessons, this episode challenges clinicians to think beyond the first diagnosis and embrace a more comprehensive approach to critically ill patients. 
 
Whether you're an EMT, paramedic, flight clinician, nurse, or physician, The Nightmare Series: The Diagnostic Minefield will sharpen your clinical reasoning and remind you that sometimes the sickest patients aren't suffering from one disease, but several, all at once.

The Nightmare Series Case: The Diagnostic Mindfield

Welcome to another essential episode of the FlightBridgeED Podcast: MDCAST, where we dive deep into the complexities of critical care and continue our high-risk OB transport conversation. This episode focuses on the often overlooked yet rapidly increasing crisis of hypertensive disorders in pregnancy. Host Dr. Mike Lauria and maternal-fetal medicine specialist Dr. Elizabeth Garchar discuss the full spectrum of hypertensive disorders—from gestational hypertension to the life-threatening condition of eclampsia—and share practical insights on managing these critical patients in prehospital and transport settings. 
 
Starting with foundational definitions of specific disorders like pre-eclampsia vs. eclampsia and HELLP syndrome, they explore the physiological mechanisms driving preeclampsia, the increased mortality rates, and why transport providers are seeing more cases in rural or under-resourced facilities. Learn how to distinguish between different diagnoses, manage acute cases in transit, and navigate treatment protocols with a detailed look at magnesium sulfate's role and the right blood pressure control strategies. This episode brings expert-level insight to providers of all backgrounds, from the basics to the most advanced interventions. 
 
Listen to The FlightBridgeED Podcast anywhere you enjoy podcasts, or find this episode and more podcasts at https://flightbridgeed.com/explore. While there, explore our award-winning courses that empower pre-hospital and critical care transport medicine professionals to build their critical care expertise. 
 
Key Takeaways: 
 
• Pathophysiology of Preeclampsia: This condition often arises from placental abnormalities that lead to widespread vascular issues, impacting both the mother and fetus. 
 
• Magnesium Sulfate in Management: Magnesium sulfate is vital for preventing eclampsia and should be monitored for toxicity, especially in patients with reduced kidney function. 
 
• Identification of Hypertensive Disorders: A blood pressure reading of 160/110 mmHg or greater post-20 weeks' gestation is a significant indicator of hypertensive disorders, warranting immediate medical attention. 
 
References 
 
• Sperling JD, Dahlke JS, Huber WJ, Sibai BM.  The role of Headache in the classification and management of hypertensive disorders in pregnancy.  Obstetrics and Gynecology. 2015; 126:297-302.  
 
• Sabai BM.  The HELLP syndrome (hemolysis, elevated liver enzymes and low platelets): much ado about nothing? Am J of Obstetrics and Gynecology. 1990; 162:311-6. 
 
• Steegers EA, von Daselszen P, Duvekot JJ, Pijnenborg R.  Pre-Eclampsia.  Lancet. 2010; 376:631-44. 
 
• Redman CW, Sargent IL.  Latest advances in understanding preeclampsia.  Science. 2005; 308:1592-4 
 
• von Dadelszen P, Magee LA, Roberts JM. Subclassification of preeclampsia.  Hypertens Pregnancy. 2003; 22:143-8 
 
• Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts.  Am J Obstet Gynecol. 1998; 179; 1359-75.  
 
• Gillon TE, Pels A, von Dadelszen P, MacDonell K, Magee LA. Hypertensive disorders of pregnancy: a systematic review of international clinical practice guidelines. PloS one. 2014; 9(12): e113715. 
 
• Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260.

Welcome to another essential episode of the FlightBridgeED Podcast: MDCAST, where we dive deep into the complexities of critical care and continue our high-risk OB transport conversation. This episode focuses on the often overlooked yet rapidly increasing crisis of hypertensive disorders in pregnancy. Host Dr. Mike Lauria and maternal-fetal medicine specialist Dr. Elizabeth Garchar discuss the full spectrum of hypertensive disorders—from gestational hypertension to the life-threatening condition of eclampsia—and share practical insights on managing these critical patients in prehospital and transport settings. Starting with foundational definitions of specific disorders like pre-eclampsia vs. eclampsia and HELLP syndrome, they explore the physiological mechanisms driving preeclampsia, the increased mortality rates, and why transport providers are seeing more cases in rural or under-resourced facilities. Learn how to distinguish between different diagnoses, manage acute cases in transit, and navigate treatment protocols with a detailed look at magnesium sulfate's role and the right blood pressure control strategies. This episode brings expert-level insight to providers of all backgrounds, from the basics to the most advanced interventions. Listen to The FlightBridgeED Podcast anywhere you enjoy podcasts, or find this episode and more podcasts at https://flightbridgeed.com/explore. While there, explore our award-winning courses that empower pre-hospital and critical care transport medicine professionals to build their critical care expertise. Key Takeaways: • Pathophysiology of Preeclampsia: This condition often arises from placental abnormalities that lead to widespread vascular issues, impacting both the mother and fetus. • Magnesium Sulfate in Management: Magnesium sulfate is vital for preventing eclampsia and should be monitored for toxicity, especially in patients with reduced kidney function. • Identification of Hypertensive Disorders: A blood pressure reading of 160/110 mmHg or greater post-20 weeks' gestation is a significant indicator of hypertensive disorders, warranting immediate medical attention. References • Sperling JD, Dahlke JS, Huber WJ, Sibai BM. The role of Headache in the classification and management of hypertensive disorders in pregnancy. Obstetrics and Gynecology. 2015; 126:297-302. • Sabai BM. The HELLP syndrome (hemolysis, elevated liver enzymes and low platelets): much ado about nothing? Am J of Obstetrics and Gynecology. 1990; 162:311-6. • Steegers EA, von Daselszen P, Duvekot JJ, Pijnenborg R. Pre-Eclampsia. Lancet. 2010; 376:631-44. • Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005; 308:1592-4 • von Dadelszen P, Magee LA, Roberts JM. Subclassification of preeclampsia. Hypertens Pregnancy. 2003; 22:143-8 • Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998; 179; 1359-75. • Gillon TE, Pels A, von Dadelszen P, MacDonell K, Magee LA. Hypertensive disorders of pregnancy: a systematic review of international clinical practice guidelines. PloS one. 2014; 9(12): e113715. • Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260.

Welcome to another essential episode of the FlightBridgeED Podcast: MDCAST, where we dive deep into the complexities of critical care and continue our high-risk OB transport conversation. This episode focuses on the often overlooked yet rapidly increasing crisis of hypertensive disorders in pregnancy. Host Dr. Mike Lauria and maternal-fetal medicine specialist Dr. Elizabeth Garchar discuss the full spectrum of hypertensive disorders—from gestational hypertension to the life-threatening condition of eclampsia—and share practical insights on managing these critical patients in prehospital and transport settings. 
 
Starting with foundational definitions of specific disorders like pre-eclampsia vs. eclampsia and HELLP syndrome, they explore the physiological mechanisms driving preeclampsia, the increased mortality rates, and why transport providers are seeing more cases in rural or under-resourced facilities. Learn how to distinguish between different diagnoses, manage acute cases in transit, and navigate treatment protocols with a detailed look at magnesium sulfate's role and the right blood pressure control strategies. This episode brings expert-level insight to providers of all backgrounds, from the basics to the most advanced interventions. 
 
Listen to The FlightBridgeED Podcast anywhere you enjoy podcasts, or find this episode and more podcasts at https://flightbridgeed.com/explore. While there, explore our award-winning courses that empower pre-hospital and critical care transport medicine professionals to build their critical care expertise. 
 
Key Takeaways: 
 
• Pathophysiology of Preeclampsia: This condition often arises from placental abnormalities that lead to widespread vascular issues, impacting both the mother and fetus. 
 
• Magnesium Sulfate in Management: Magnesium sulfate is vital for preventing eclampsia and should be monitored for toxicity, especially in patients with reduced kidney function. 
 
• Identification of Hypertensive Disorders: A blood pressure reading of 160/110 mmHg or greater post-20 weeks' gestation is a significant indicator of hypertensive disorders, warranting immediate medical attention. 
 
References 
 
• Sperling JD, Dahlke JS, Huber WJ, Sibai BM.&nbsp; The role of Headache in the classification and management of hypertensive disorders in pregnancy.&nbsp; Obstetrics and Gynecology. 2015; 126:297-302.&nbsp; 
 
• Sabai BM.&nbsp; The HELLP syndrome (hemolysis, elevated liver enzymes and low platelets): much ado about nothing? Am J of Obstetrics and Gynecology. 1990; 162:311-6. 
 
• Steegers EA, von Daselszen P, Duvekot JJ, Pijnenborg R.&nbsp; Pre-Eclampsia.&nbsp; Lancet. 2010; 376:631-44. 
 
• Redman CW, Sargent IL.&nbsp; Latest advances in understanding preeclampsia.&nbsp; Science. 2005; 308:1592-4 
 
• von Dadelszen P, Magee LA, Roberts JM. Subclassification of preeclampsia.&nbsp; Hypertens Pregnancy. 2003; 22:143-8 
 
• Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts.&nbsp; Am J Obstet Gynecol. 1998; 179; 1359-75.&nbsp; 
 
• Gillon TE, Pels A, von Dadelszen P, MacDonell K, Magee LA. Hypertensive disorders of pregnancy: a systematic review of international clinical practice guidelines. PloS one. 2014; 9(12): e113715. 
 
• Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260.

Hypertensive Disorders in Pregnancy

The "Pandemic Immunity Gap" is likely behind the massive surge in respiratory syncytial virus (RSV), with current CDC data showing a 275% increase from 2020-2021 to 2022-2023. The most vulnerable population is between 0-6 months old, which often raises the stress level for providers across all spectrums. Join Eric for a deep dive into a case study involving a 4-month-old male in acute respiratory compromise. We break down the progression of RSV and its association with bronchiolitis. Dive deep into the current evidence on fluid management, bronchodilators, corticosteroids, NS 0.9%, Hypertonic 3%, racemic epinephrine, HFNC, NiPPV, intubation, and much more.  
 
Recommended flow settings and cannula sizes for high-flow nasal cannula therapy in pediatric patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027347/table/t1-kjp-2019-00626/?report=objectonly 
 
Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma: Hosp Pediatr (2017) 7 (7): 403–409. https://doi.org/10.1542/hpeds.2016-0211 
 
Efficacy of 3% hypertonic saline in bronchiolitis: A meta‑analysis,  Received May 10, 2018; Accepted August 22, 2018. DOI: 10.3892/etm.2019.7684 
 
Respiratory syncytial virus: diagnosis, prevention and management: Ther Adv Infectious Dis 2019, Vol. 6: 1–9 DOI: 10.1177/2049936119865798 
 
https://journals.sagepub.com/doi/epdf/10.1177/2049936119865798 
 
Gadomski AM, Brower M. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev. 2010;12CD001266. 
 
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001266.pub4/full 
 
Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis 
 
https://www.bmj.com/content/342/bmj.d1714 
 
High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. 
 
Ermers MJ, Rovers MM, van Woensel JB, Kimpen JL, Bont LJ; RSV Corticosteroid Study Group. High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. BMJ. 2009;338:b897. 
 
Heliox inhalation therapy for bronchiolitis in infants 
 
Liet JM, Ducruet T, Gupta V, Cambonie G. Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev. 2010;4:CD006915.

The "Pandemic Immunity Gap" is likely behind the massive surge in respiratory syncytial virus (RSV), with current CDC data showing a 275% increase from 2020-2021 to 2022-2023. The most vulnerable population is between 0-6 months old, which often raises the stress level for providers across all spectrums. Join Eric for a deep dive into a case study involving a 4-month-old male in acute respiratory compromise. We break down the progression of RSV and its association with bronchiolitis. Dive deep into the current evidence on fluid management, bronchodilators, corticosteroids, NS 0.9%, Hypertonic 3%, racemic epinephrine, HFNC, NiPPV, intubation, and much more. Recommended flow settings and cannula sizes for high-flow nasal cannula therapy in pediatric patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027347/table/t1-kjp-2019-00626/?report=objectonly Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma: Hosp Pediatr (2017) 7 (7): 403–409. https://doi.org/10.1542/hpeds.2016-0211 Efficacy of 3% hypertonic saline in bronchiolitis: A meta‑analysis, Received May 10, 2018; Accepted August 22, 2018. DOI: 10.3892/etm.2019.7684 Respiratory syncytial virus: diagnosis, prevention and management: Ther Adv Infectious Dis 2019, Vol. 6: 1–9 DOI: 10.1177/2049936119865798 https://journals.sagepub.com/doi/epdf/10.1177/2049936119865798 Gadomski AM, Brower M. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev. 2010;12CD001266. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001266.pub4/full Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis https://www.bmj.com/content/342/bmj.d1714 High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. Ermers MJ, Rovers MM, van Woensel JB, Kimpen JL, Bont LJ; RSV Corticosteroid Study Group. High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. BMJ. 2009;338:b897. Heliox inhalation therapy for bronchiolitis in infants Liet JM, Ducruet T, Gupta V, Cambonie G. Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev. 2010;4:CD006915.

The "Pandemic Immunity Gap" is likely behind the massive surge in respiratory syncytial virus (RSV), with current CDC data showing a 275% increase from 2020-2021 to 2022-2023. The most vulnerable population is between 0-6 months old, which often raises the stress level for providers across all spectrums. Join Eric for a deep dive into a case study involving a 4-month-old male in acute respiratory compromise. We break down the progression of RSV and its association with bronchiolitis. Dive deep into the current evidence on fluid management, bronchodilators, corticosteroids, NS 0.9%, Hypertonic 3%, racemic epinephrine, HFNC, NiPPV, intubation, and much more.&nbsp; 
 
Recommended flow settings and cannula sizes for high-flow nasal cannula therapy in pediatric patients https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027347/table/t1-kjp-2019-00626/?report=objectonly 
 
Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma: Hosp Pediatr (2017) 7 (7): 403–409. https://doi.org/10.1542/hpeds.2016-0211 
 
Efficacy of 3% hypertonic saline in bronchiolitis: A meta‑analysis,&nbsp; Received May 10, 2018; Accepted August 22, 2018. DOI: 10.3892/etm.2019.7684 
 
Respiratory syncytial virus: diagnosis, prevention and management: Ther Adv Infectious Dis 2019, Vol. 6: 1–9 DOI: 10.1177/2049936119865798 
 
https://journals.sagepub.com/doi/epdf/10.1177/2049936119865798 
 
Gadomski AM, Brower M. Bronchodilators for bronchiolitis. Cochrane Database Syst Rev. 2010;12CD001266. 
 
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001266.pub4/full 
 
Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis 
 
https://www.bmj.com/content/342/bmj.d1714 
 
High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. 
 
Ermers MJ, Rovers MM, van Woensel JB, Kimpen JL, Bont LJ; RSV Corticosteroid Study Group. High-dose inhaled corticosteroids’ effect on wheezing in infants after respiratory syncytial virus infection: a randomized, double-blind placebo-controlled trial. BMJ. 2009;338:b897. 
 
Heliox inhalation therapy for bronchiolitis in infants 
 
Liet JM, Ducruet T, Gupta V, Cambonie G. Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev. 2010;4:CD006915.

E222: “Pandemic Immunity Gap?” - Managing Acute Respiratory Compromise in RSV

This is part 1 of a 2-part series covering 12-lead ECG fundamentals.

This is part 1 of a 2-part series covering 12-lead ECG fundamentals.

E9: 12-Lead: A Fundamental Approach

Eric Bauer discusses the importance of the first "Platinum 10" minutes and its key relationship to the "Golden Hour."

Eric Bauer discusses the importance of the first "Platinum 10" minutes and its key relationship to the "Golden Hour."

E8: The Platinum 10

In this three-part education series, Eric presents ventilator management approaches and strategies for different patient presentations. We also apply the pathophysiology we learned in parts 1 and 2, bringing it all together to form an easy-to-understand strategy for ventilator management.

In this three-part education series, Eric presents ventilator management approaches and strategies for different patient presentations. We also apply the pathophysiology we learned in parts 1 and 2, bringing it all together to form an easy-to-understand strategy for ventilator management.

E7: Ventilator Management In The EMS World - Part 3

In this 3 part education series, Eric Bauer discusses ventilator management in the critical care environment and the different ventilation modes.

In this 3 part education series, Eric Bauer discusses ventilator management in the critical care environment and the different ventilation modes.

E6: Ventilator Management In The EMS World - Part 2

In this three-part education series, Eric Bauer discusses ventilator management in the critical care environment. We look closely at cellular respiration and the different terminology related to ventilator management.

In this three-part education series, Eric Bauer discusses ventilator management in the critical care environment. We look closely at cellular respiration and the different terminology related to ventilator management.

E5: Ventilator Management In The EMS World - Part 1

In this two-part series, Eric discusses RSI and all aspects of related drug pharmacology, providing insight into implementation in the critical care setting.

In this two-part series, Eric discusses RSI and all aspects of related drug pharmacology, providing insight into implementation in the critical care setting.

E4: RSI: Doing It Right! - Part 2

E3: RSI: Doing It Right! - Part 1

Eric Bauer explains everything about oxygenation. We examine cellular respiration and diffusion, ventilation/perfusion, shunt, VQ mismatches, and the Fick principle.

Eric Bauer explains everything about oxygenation. We examine cellular respiration and diffusion, ventilation/perfusion, shunt, VQ mismatches, and the Fick principle.

E2: Cellular Respiration

Eric Bauer introduces himself and The FlightBridgeED Podcast. In this first episode, he briefly describes this educational podcast series and the origins of FlightBridgeED.

Eric Bauer introduces himself and The FlightBridgeED Podcast. In this first episode, he briefly describes this educational podcast series and the origins of FlightBridgeED.

E1: Introduction

The FlightBridgeED Podcast provides convenient, easy-to-understand critical care medical education and current topics related to the air medical industry. Each topic builds on another and weaves together a solid foundation of emergency, critical care, and prehospital medicine.

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