The Inflection Point: Conversations in Care, Culture and Change. Designed for Paramedics.

In this video, we delve into the challenges and best practices for treating COPD patients in pre-hospital settings. We discuss the daily struggles of COPD patients, the use of medications like Salbutamol and Dexamethasone, and the importance of early steroid administration to reduce hospitalizations and improve outcomes. The video also addresses the myths and realities of oxygen therapy, the significance of accurately targeting oxygen saturation levels, and the use of CPAP to prevent the need for intubation. Additionally, we highlight the critical role of chronic management, including vaccinations and home oxygen therapy, for preventing severe exacerbations and improving patient quality of life.Chapters:00:00 Understanding COPD Patient Challenges00:25 Addressing Airway Reactivity with Medications00:48 The Importance of Steroids in Pre-Hospital Care03:30 Oxygen Therapy: Myths and Realities16:13 Managing COPD at Home and Preventive Measures17:56 Monitoring CO2 Levels in COPD Patients#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse #COPD #ParamedicPodcast #Emphysema #EMS #PrehospitalCare #Bronchitis #RespiratoryCare #AirwayManagement #PathophysiologyPeer-Reviewed References Featured in This Video:Target oxygen saturation in acute COPD exacerbations – BMJ EMJ (2021)The Canadian Lung Association – Oxygen Therapy in COPDHigh-flow oxygen harms in COPD – Critical Care Journal (2021)Chronic Obstructive Pulmonary Disease Across Three Decades – FrontiersGlobal Initiative for Chronic Obstructive Lung Disease 2023 Report – PMCEffect of High-Flow Oxygen on Mortality in Prehospital COPD – BMJPulmonary Rehabilitation and Physical Interventions – European Respiratory SocietyEfficacy and Safety of Triple Fixed-Dose Combinations in COPD – MDPIGet in Touch Here or in The Comments:LinkedIn: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/Disclaimer:This video is for educational purposes only and does not constitute medical advice. Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

In this video, we dive deep into Chronic Obstructive Pulmonary Disease (COPD), exploring its pathophysiology, prevalence, and management, particularly for paramedics. The conversation covers the factors contributing to COPD, including smoking and inflammatory responses, as well as the differentiation between chronic bronchitis and emphysema. We discuss the significance of early smoking cessation and the tools available to help patients quit. The video also examines the role of paramedics in managing acute exacerbations, emphasizing the use of bronchodilators, steroids, oxygen therapy, and CPAP. Additionally, we touch on chronic care, patient education, and the importance of vaccinations to prevent exacerbations. Join us for an in-depth analysis aimed at enhancing the knowledge and skills of healthcare providers dealing with COPD in various settings.

Chapters:

00:00 Introduction to COPD

00:18 Smoking and Its Impact on COPD

01:06 Pathophysiology of COPD

04:09 Chronic Bronchitis and Emphysema

06:56 Inflammatory Response and Immune System

12:51 Clinical Manifestations and Diagnosis

15:33 Treatment and Medications

#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse #COPD #ParamedicPodcast #Emphysema #EMS #PrehospitalCare #Bronchitis #RespiratoryCare #AirwayManagement #PathophysiologyPeer-Reviewed References Featured in This Video:Chronic Obstructive Pulmonary Disease Across Three Decades – FrontiersGlobal Initiative for Chronic Obstructive Lung Disease 2023 Report – PMCEffect of High-Flow Oxygen on Mortality in Prehospital COPD – BMJPulmonary Rehabilitation and Physical Interventions – European Respiratory SocietyEfficacy and Safety of Triple Fixed-Dose Combinations in COPD – MDPIGet in Touch Here or in The Comments:LinkedIn: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/

Disclaimer:

This video is for educational purposes only and does not constitute medical advice. Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

In this episode, we dive into the intricacies of managing status epilepticus in prehospital settings. We discuss the significant risks associated with delayed or underdosed benzodiazepines, and the evolving guidelines that now define status epilepticus as a seizure lasting more than 5 minutes or multiple seizures without full recovery. Experts explore the pros and cons of ketamine as an adjunctive treatment, emphasizing the need for robust clinical trials to establish its efficacy. The episode also highlights the importance of a randomized controlled trial to determine safe and effective protocols for seizure management. Additionally, the conversation extends to pediatric considerations and the new 'treat and discharge' pathways, which allow certain patients to stay home, effectively unburdening the healthcare system. We also address the common pitfalls and misconceptions paramedics encounter, stressing the importance of taking informed action. This episode provides crucial insights for healthcare professionals aiming to improve patient outcomes in emergency care scenarios.Chapters:00:00 Understanding Status Epilepticus00:44 Pre-Hospital Management of Seizures02:26 Challenges with Benzodiazepines02:50 Exploring Alternative Treatments03:44 The Need for Rigorous Studies10:40 Managing Seizures in Pediatric Patients15:57 Common Pitfalls in Seizure Management18:08 Treat and Refer Pathway for Epilepsy📚 References:PMID: 39058382PMID: 37276174PMC: 11627481PMC: 9396974 #ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse Get in Touch Here or in The Comments:LinkedIn: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/Disclaimer:This video is for educational purposes only and does not constitute medical advice. Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

In this episode, we delve into seizure management for pre-hospital settings, beginning with a detailed case study of a 67-year-old male experiencing his first seizure. The discussion covers differential diagnoses, including the use of the 'VITAMINS' acronym to identify potential causes, ranging from infections to metabolic issues. Key seizure management strategies are outlined, emphasizing the importance of immediate intervention and medication administration. Differences between focal, generalized, and unclassified seizures are explained, along with a breakdown of seizure phases and treatments. The conversation also touches on the role of Midazolam, its effects, and the necessary approach to managing a seizing patient effectively in the field. The episode aims to equip EMS professionals with essential knowledge and procedures to optimize patient outcomes.Chapters:00:00 Introduction to Seizure Management00:21 Case Study: First-Time Seizure01:40 Differential Diagnosis and Initial Assessment05:08 Seizure Management Protocols07:16 Pathophysiology of Seizures16:06 Operational Treatment of Seizures📚Referenced Studies & Further Reading:Best practices for seizure management in EMS: PMID: 39531982Improving prehospital seizure outcomes: PMC: PMC8977974Integrated care frameworks in seizure response: IJIC: https://ijic.org/articles/10.5334/ijic.5598Prehospital seizure care gaps: PMID: 33485168Innovations in seizure care delivery: PMC: PMC9650192Paramedic decision-making in neurologic emergencies: PMID: 31722820#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse Get in Touch Here or in The Comments:[email protected]: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/Disclaimer:This video is for educational purposes only and does not constitute medical advice. Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

About Dr. Callum:https://research.sunnybrook.ca/researchers/jeannie-callum/https://pathology.queensu.ca/faculty-staff/jeannie-callumhttps://www.researchgate.net/profile/Jeannie-Callumhttps://www.youtube.com/watch?v=paAvUuXDChU&t=962s In this insightful part 2 episode, we explore the critical importance of temperature management and the timely administration of Tranexamic Acid (TXA) for trauma patients in pre-hospital settings. The discussion covers the mechanics and benefits of TXA administration, including its proven effects on reducing mortality in trauma and obstetric hemorrhage cases, as well as its applications in various surgical procedures. We examine the evidence from key trials like Crash-2 and the WOMAN trial, and highlight practical aspects such as storage and dosage. Additionally, the episode addresses the importance of maintaining a patient's body temperature and presents initiatives to improve the efficacy of pre-hospital care, including potential research opportunities and strategies to make workflows more efficient for healthcare professionals.Chapters00:00 Introduction to Pre-Hospital Temperature Management00:46 Understanding TXA Administration Timelines02:08 Case Studies and Anecdotal Evidence03:01 Dosage and Safety of TXA07:02 Storage and Temperature Considerations for TXA09:14 TXA in Various Medical Scenarios22:33 Research and Future Directions for TXA31:48 Conclusion and Key TakeawaysReferences:Ontario Transfusion Quality Improvement Plan.Massive Hemorrhage Protocol Toolkit – Version 1 (October 2021).Available at: https://transfusionontario.org/wp-content/uploads/2021/10/MHP_Toolkit_v1_Oct2021.pdfCallum JL, Karkouti K, Lin Y, et al.The Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. JAMA Surg. 2020;155(9):e202243.Available at: https://jamanetwork.com/journals/jamasurgery/fullarticle/2771225Gayet-Ageron A, Prieto-Merino D, Ker K, et al.Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: A meta-analysis. Lancet. 2023;401(10378):1344-1353.Available at: https://pubmed.ncbi.nlm.nih.gov/32897344/Yee DA, Knudson MM, Cohen MJ, et al.Prehospital tranexamic acid is associated with improved survival in severely injured patients with major hemorrhage. J Trauma Acute Care Surg. 2023 Nov;95(5):665–671.Available at: https://pubmed.ncbi.nlm.nih.gov/37928456/Roberts I, Shakur H, Coats T, et al.The CRASH-2 trial: A randomized controlled trial and economic evaluation of the effect of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013;17(10):1–79.Available at: https://pubmed.ncbi.nlm.nih.gov/23477634/CRASH-3 trial collaborators.Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): A randomized, placebo-controlled trial. Lancet. 2019;394(10210):1713–1723.Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltextShariff ZA, Joshi N, Reardon PM, et al.Implementation of prehospital tranexamic acid (TXA) in Ontario: A provincial, prospective, collaborative approach. BMC Emerg Med. 2024;24(1):14.Available at: https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01119-2Sperry JL, Guyette FX, Rosario-Rivera BL, et al.Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial. Ann Surg. 2024 Aug 1;280(2):212-221.Available at: https://pubmed.ncbi.nlm.nih.gov/38708880/Relke N, Chornenki NLJ, Sholzberg M.Tranexamic acid evidence and controversies: An illustrated review. Res Pract Thromb Haemost. 2021;5(5):e12546.Available at: https://pubmed.ncbi.nlm.nih.gov/34278187/Disclaimer:Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

Dr. Jeannie Callum: The Architect of Prehospital TXA in OntarioWhat does it take to change an entire province’s approach to trauma care? For Dr. Jeannie Callum—hematologist, transfusion medicine specialist, and researcher—it took relentless advocacy, bold data, and a vision for saving lives before patients even reach the hospital. Known internationally for her expertise in bleeding disorders and transfusion science, Dr. Callum played a pivotal role in bringing tranexamic acid (TXA) out of the hospital and into the hands of Ontario paramedics.About Dr. Callum:https://research.sunnybrook.ca/researchers/jeannie-callum/https://pathology.queensu.ca/faculty-staff/jeannie-callumhttps://www.researchgate.net/profile/Jeannie-Callumhttps://www.youtube.com/watch?v=paAvUuXDChU&t=962s Join us as we delve into the critical topic of TXA in trauma treatment with one of the leading specialists in the field. Our guest, a renowned hematologist and transfusion medicine expert, shares her journey, expertise, and the importance of TXA in improving patient outcomes. Discover the intricacies of traumatic coagulopathy, the significance of timely TXA administration, and its application from pre-hospital to in-hospital settings. Chapters:00:00 Introduction to TXA and Trauma00:26 Expert Background and Journey02:58 The Importance of Early TXA Administration07:36 Mechanism and Benefits of TXA11:43 Addressing Concerns and Misconceptions16:53 Pre-Hospital and In-Hospital TXA Protocols25:33 Pediatric Considerations and Future Research30:00 Conclusion and Final ThoughtsReferences:Ontario Transfusion Quality Improvement Plan.Massive Hemorrhage Protocol Toolkit – Version 1 (October 2021).Available at: https://transfusionontario.org/wp-content/uploads/2021/10/MHP_Toolkit_v1_Oct2021.pdfCallum JL, Karkouti K, Lin Y, et al.The Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. JAMA Surg. 2020;155(9):e202243.Available at: https://jamanetwork.com/journals/jamasurgery/fullarticle/2771225Gayet-Ageron A, Prieto-Merino D, Ker K, et al.Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: A meta-analysis. Lancet. 2023;401(10378):1344-1353.Available at: https://pubmed.ncbi.nlm.nih.gov/32897344/Yee DA, Knudson MM, Cohen MJ, et al.Prehospital tranexamic acid is associated with improved survival in severely injured patients with major hemorrhage. J Trauma Acute Care Surg. 2023 Nov;95(5):665–671.Available at: https://pubmed.ncbi.nlm.nih.gov/37928456/Roberts I, Shakur H, Coats T, et al.The CRASH-2 trial: A randomized controlled trial and economic evaluation of the effect of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013;17(10):1–79.Available at: https://pubmed.ncbi.nlm.nih.gov/23477634/CRASH-3 trial collaborators.Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): A randomized, placebo-controlled trial. Lancet. 2019;394(10210):1713–1723.Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltextShariff ZA, Joshi N, Reardon PM, et al.Implementation of prehospital tranexamic acid (TXA) in Ontario: A provincial, prospective, collaborative approach. BMC Emerg Med. 2024;24(1):14.Available at: https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01119-2Sperry JL, Guyette FX, Rosario-Rivera BL, et al.Early Cold Stored Platelet Transfusion Following Severe Injury: A Randomized Clinical Trial. Ann Surg. 2024 Aug 1;280(2):212-221.Available at: https://pubmed.ncbi.nlm.nih.gov/38708880/Relke N, Chornenki NLJ, Sholzberg M.Tranexamic acid evidence and controversies: An illustrated review. Res Pract Thromb Haemost. 2021;5(5):e12546.Available at: https://pubmed.ncbi.nlm.nih.gov/34278187/

In this second episode, we delve into the crucial role of psychological safety within medical teams, particularly in high-stress environments like trauma care. The discussion highlights the importance of the phrase 'What else am I missing?' as a tool for team leads to flatten hierarchies and encourage open communication. Case studies, such as Elaine Bromley's tragic story, are explored to underline the significance of teamwork and decision-making. The episode further discusses techniques like pre-briefings, signposting decisions, and setting clear objectives to ensure optimal team performance and patient safety. Practical advice and strategies are shared for both current and aspiring medical professionals to implement in their practices.

Learn more about Dr. Petrosoniak's work: https://research.unityhealth.to/profiles/andrew-petrosoniak/ https://t.co/XYAzUMg9xz.https://advancedperformance.ca/

Learn more about Dr. Hicks' work:

https://scientific.acoep.org/speakers/chris-hicks-md/

Chapters:

00:00 The Power of Asking 'What Else Am I Missing?'

00:42 Overcoming Hierarchical Barriers in Healthcare

01:17 The Importance of Psychological Safety

03:06 The Tragic Story of Elaine Bromley

06:29 Understanding the Sunk Cost Fallacy in Medical Decisions

09:05 Signposting Decisions to Mitigate Errors

14:43 Pre-Briefing and Shared Mental Models in Trauma Care

23:01 Final Thoughts and Reflections on Success

References:

• Airway Management & Human Factors
  FutureLearn – “Airway Matters” course:
  A free online course exploring the human and system factors behind airway complications and how to prevent them.
  👉 Access the course

• Barriers to Speaking Up in Healthcare
  BMC Health Services Research (2020):
  A peer-reviewed study on why healthcare workers hesitate to speak up about patient safety concerns—and how culture and hierarchy influence this behaviour.
  👉 Read the article

• Creating Psychological Safety in Healthcare
  Healthcare Excellence Canada:
  A practical toolkit and guidance on building safe environments where healthcare workers feel comfortable seeking and offering peer support.
  👉 View the resource

• Psychological Safety for Patients
  ISMP Canada Bulletin:
  Highlights how psychological safety extends to patients, and why it's essential for preventing medication and communication errors.
  👉 Read the bulletin

#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse

Get in Touch Here or in The Comments:[email protected]: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/

In this episode, we delve into the PACKMaN trial, a recent study comparing ketamine and morphine for the treatment of traumatic pain. The discussion covers critical appraisal methods, study methodologies, sample size considerations, and the implications of the study's findings for paramedic practice in Ontario. We also explore the side effects, patient populations, and operational contexts in which ketamine and morphine might be chosen. This educational content is aimed at providing paramedics with evidence-based insights and supplemental knowledge for their practice.Chapters:00:00 Introduction to Ketamine vs. Morphine00:44 Overview of the Pac-Man Trial01:12 Critical Appraisal of the Study01:19 Understanding Critical Appraisal02:17 Research Question and Methodology02:58 Study Protocol and Applicability04:55 Blinding and Ethics in Research07:14 Sample Size and Statistical Significance12:03 Primary and Secondary Outcomes14:57 Operational Implications and Pain Management18:19 Understanding Dosage Nuances19:20 Ketamine's Safety and Side Effects20:23 Combining Opiates and Ketamine21:09 Contextual Considerations in Pain Management22:33 Operational Insights and Practical Tips27:25 Mechanisms and Effects of Ketamine30:43 Concluding Thoughts and RecommendationsReferences:https://warwick.ac.uk/fac/sci/med/research/ctu/trials/packman/overview/https://pubmed.ncbi.nlm.nih.gov/38001541/https://pmc.ncbi.nlm.nih.gov/articles/PMC9621014/https://www.tandfonline.com/doi/full/10.1080/10903127.2021.2018073https://pmc.ncbi.nlm.nih.gov/articles/PMC7223585/https://pubmed.ncbi.nlm.nih.gov/32328972/https://pmc.ncbi.nlm.nih.gov/articles/PMC7689093/#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse Get in Touch Here or in The Comments:[email protected]: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/Disclaimer:This video is for educational purposes only and does not constitute medical advice. Always follow your local medical directives, protocols, and the guidance of your medical director or regulatory authority.

In this episode, we dive deep into the life-saving benefits of Tranexamic Acid (TXA) for trauma patients. We discuss what TXA is, how it works, and why it is considered one of the safest and most effective drugs in critical care. Join us as we explore the evidence supporting its use, common concerns, contraindications, and the importance of timely administration. Whether administered intravenously or intramuscularly, TXA has been proven to significantly reduce morbidity and mortality in trauma cases. Learn about its application in various scenarios, from pre-hospital care to emergency departments, and understand why TXA is a game-changer in modern medicine.

Chapters:

00:00 Introduction and Overview

00:36 What is TXA?

02:03 TXA in Trauma Care

05:43 TXA for Other Conditions

07:22 Administration Guidelines

10:52 Contraindications and Special Cases

17:30 Conclusion and Future Directions

References:

https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01119-2#data-availability

https://pmc.ncbi.nlm.nih.gov/articles/PMC10455131/#sec19

https://pmc.ncbi.nlm.nih.gov/articles/PMC11642692/

https://pmc.ncbi.nlm.nih.gov/articles/PMC10455131/#sec19

https://pubmed.ncbi.nlm.nih.gov/23477634/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltexthttps://pubmed.ncbi.nlm.nih.gov/37928456/

https://pubmed.ncbi.nlm.nih.gov/33605702/https://journals.sagepub.com/doi/10.1177/14604086221145317?icid=int.sj-abstract.similar-articles.4

https://www.ontario.ca/files/2025-04/moh-advanced-life-support-als-patient-care-standards-pcs-5.4-en-2025-04-23.pdf

#ems #science #paramedic #emergencymedicine #prehospitalcare #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #health #healthcare #healthcareheros #simulation #humanfactors #medicine #science #healthcare #healthquality #healthsafetycourse

Get in Touch Here or in The Comments:[email protected]: https://www.linkedin.com/in/ryan-cichowski-787b99274/https://www.linkedin.com/in/jakob-rodger-b60571141/

Disclaimer:
This video is for educational purposes only and does not constitute medical advice. Always follow your local Medical Directives, protocols, and the guidance of your medical director or regulatory authority.

This is a clip from our first podcast episode. In this powerful episode, Dr. Andrew Petrosoniak shares what it takes for trauma teams to perform under extreme pressure. From human factors to psychological safety, this conversation dives deep into how elite medical teams make decisions, stay focused, and save lives—even in total chaos.🎯 Topics covered:High-stakes decision-making in trauma careBuilding psychological safety in medical teamsLessons from simulation and real-world casesFlattening hierarchies to improve outcomesThe question every team leader should ask: "What else am I missing?"🎙 Hosted by Jakob Rodger and Ryan Cichowski – Paramedic Educators & Podcast Hosts🔗 Subscribe for more insights on prehospital care, leadership, and performance👍 Like, comment, and share if this resonated with you!#TraumaCare #EmergencyMedicine #HumanFactors #MedicalLeadership #PsychologicalSafety #AndrewPetrosoniak #ParamedicPodcast #MedicalPodcast #PrehospitalCare #paramedic #paramediceducation