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

In this episode, Dr. Andrew Petrosoniak, an emergency and trauma doctor at St. Michael's Hospital in Toronto and Medical Director at Unity Health, shares his expertise in optimizing team performance in high-stress situations. He discusses the importance of designing systems that promote correct actions, the lessons learned from his work in simulation and design, and the value of borrowing strategies from other industries like aviation and athletics. Dr. Petrosoniak highlights the significance of interprofessional training, team coordination, and iterative feedback in improving clinical outcomes.

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 Introduction to Effective Training and Design

00:37 Guest Introduction and Background

02:12 Journey into Simulation and Performance Optimization

05:04 Lessons from Aviation and Other Industries

11:56 Importance of Environment and Iteration

19:10 Interprofessional Training and Team Dynamics

23:28 Frameworks for Effective Team Coordination

26:19 Conclusion and Final Thoughts

#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]

LinkedIn: https://www.linkedin.com/in/ryan-cichowski-787b99274/

https://www.linkedin.com/in/jakob-rodger-b60571141/

Justin is an Advanced Care Paramedic and researcher with Peel Regional Paramedic Services, a member of the Department of Family and Community Medicine at the University of Toronto, and a Scientist with the McNally Project for Paramedicine Research. His work focuses on psychological health and safety among paramedics. Justin is the research lead of the External Violence Against Paramedics (EVAP) program and co-leads the Violence Against Paramedics project with Dr. Donnelly. Connect with Justin on LinkedIn, follow him on Twitter, or see more of his work on ResearchGate.

LinkedIn: https://www.linkedin.com/in/justinmausz/Twitter:

https://x.com/i/flow/login?redirect_after_login=%2Fi%2Fflow%2FloginViolence Against Paramedics: https://www.protectparamedics.com/

Part 2:

In this insightful episode, we delve into the importance of having a sense of self, purpose, and the role of diversified sources of fulfillment in protecting psychological health and wellbeing, especially in high-stress professions like being a paramedic. The discussion touches on generational differences in values regarding work-life balance, the potential for early career mental health screenings, and the impact of occupational trauma. The conversation also addresses the types of violence paramedics face, the role of mental health and substance use in these incidents, and strategies to improve safety for both paramedics and patients. Join us as we explore how to support and sustain the mental health and safety of our essential emergency responders.

References:

https://peelregion.ca/sites/default/files/2024-03/paramedic-experiences-with-workplace-violence.pdfhttps://pubmed.ncbi.nlm.nih.gov/24830544/https://pubmed.

ncbi.nlm.nih.gov/35206301/https://www.researchgate.net/profile/Paige-Masonhttps://www.protectparamedics.com/the-teamhttps://www.insighthealthsolutions.com/launch-of-peel-region-paramedic-services-partnership-with-thp-for-mental-health-services/https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2019-ctn-pln-ptsi/index-en.aspx?wbdisable=true

Chapters:

00:00 Introduction: The Importance of Purpose and Meaning

00:19 Generational Shifts in Work-Life Balance

01:00 Early Career Mental Health Screening

01:30 Challenges in Psychological Assessments

03:33 The Role of Resilience in Mental Health

05:23 Personal Struggles and Professional Challenges

09:10 Violence Against Paramedics: A Growing Concern

15:20 Addressing Mental Health Crises in the Field

17:36 Legal and Ethical Considerations

19:47 Conclusion: Ensuring Safety for All

Get in Touch Here or in the Comments:[email protected]

LinkedIn: https://www.linkedin.com/in/ryan-cichowski-787b99274/

https://www.linkedin.com/in/jakob-rodger-b60571141/

"1 in 4 Paramedics Screened Positive For Symptoms of a Mental Health Disorder."

This episode dives into the real impact of the job.

Join us as we break the silence and explore the support paramedics actually need.

🔊 Listen now

About Justin:

Justin is an Advanced Care Paramedic and researcher with Peel Regional Paramedic Services, a member of the Department of Family and Community Medicine at the University of Toronto, and a Scientist with the McNally Project for Paramedicine Research. His work focuses on psychological health and safety among paramedics. Justin is the research lead of the External Violence Against Paramedics (EVAP) program and co-leads the Violence Against Paramedics project with Dr. Donnelly. Connect with Justin on LinkedIn, follow him on Twitter, or see more of his work on ResearchGate.In this episode, we discuss the unacceptable nature of violence against paramedics and shed light on how it affects their mental health and job performance. The conversation explores the efforts made by paramedics like Mandy Johnston and researchers to gather data, understand the prevalence of violence, and implement effective risk mitigation strategies. The program delves into the impact of reporting violence, changes in organizational culture, and the importance of mental health resources. Hear about the personal experiences that led to this crucial research, the training initiatives to de-escalate violent situations, and the ultimate goal of creating a safer and more supportive environment for paramedics.

Support Justin:

https://www.protectparamedics.com/the-team

Chapters:

00:00 Introduction: Addressing Violence Against Paramedics

01:01 Personal Motivations and Research Beginnings

02:16 Documenting and Measuring Violence

03:12 Barriers to Reporting and Cultural Change

04:57 Impact of Reporting and Training

06:52 Mental Health Studies and Personal Stories

09:45 Challenges in Paramedic Mental Health

14:31 Systemic Issues and Resource Allocation

24:03 Historical Context and Physical Injuries

25:38 The Reality of Early Career Paramedics

26:10 Role Identity and Paramedic Identity Mismatch

26:54 Building Resilience: Individual and Organizational Strategies

28:34 The Swiss Cheese Model and Mental Health Screening

References:https://pubmed.ncbi.nlm.nih.gov/24830544/https://pubmed.ncbi.nlm.nih.gov/35206301/https://www.researchgate.net/profile/Paige-Masonhttps://www.protectparamedics.com/the-teamhttps://www.insighthealthsolutions.com/launch-of-peel-region-paramedic-services-partnership-with-thp-for-mental-health-services/https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2019-ctn-pln-ptsi/index-en.aspx?wbdisable=true#ems #science #paramedic #emergencymedicine #prehospitalcare

#paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​

In this episode, we delve into the best practices for intubation and the administration of epinephrine during emergency scenarios. Our discussion focuses on avoiding the use of epinephrine through the ETT, the importance of IV and IO routes, the benefits of video laryngoscopy, and the significance of preparation and teamwork. We also touch on airway management challenges, especially in cases with potential C-spine injuries, and emphasize the importance of setting up a systematic and well-coordinated approach to maximize patient outcomes.

Chapters:

00:00 Introduction: Epinephrine Administration Dilemma

00:45 Optimizing Intubation Success

01:51 Video Laryngoscopy and Airway Management

04:07 Preparation and Team Approach

09:21 Debriefing and Continuous Learning

20:47 Conclusion and Final Thoughts

#ems #science #paramedic #emergencymedicine #pediatriccare #prehospitalcare #cardiacarrest #pediatricmedicine #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #ROSC #post-arrest #resuscitation #resuscitationsReferences:https://www.ahajournals.org/doi/10.1161/CIR.0000000000001194https://www.ilcor.org/publicationshttps://pmc.ncbi.nlm.nih.gov/articles/PMC8951653/https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf

In this podcast episode, we dive deep into pre-hospital management strategies for drowning incidents, focused on both adult and pediatric patients. We explore the critical differences between drowning in cold and warm water, the impact of these factors on patient outcomes, and key considerations for initial resuscitation. The discussion covers scene safety, airway management, the effectiveness of PEEP and CPAP in treating pulmonary edema, and the role of epinephrine in these emergencies. The hosts also share best practice guidelines, evidence-based approaches, and practical tips to optimize patient care and improve outcomes.

Chapters:

00:00 Introduction and Overview

00:56 Understanding Drowning: Cold vs Warm Water

01:22 Pediatric Drowning: Unique Considerations

05:10 Initial Resuscitation Steps

06:27 Airway Management Techniques

11:33 The Role of PEEP and CPAP

20:00 Hemodynamic Resuscitation

#ems #science #paramedic #emergencymedicine #pediatriccare #prehospitalcare #cardiacarrest #pediatricmedicine #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #ROSC #post-arrest #resuscitation #resuscitations

References:

2024 American Heart Association and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | Circulation - American Heart Association Journals, accessed April 4, 2025, https://www.ahajournals.org/doi/10.1161/CIR.0000000000001274Prehospital Cross-Sectional Study of Drowning Patients Across the United States - PMC, accessed April 4, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9052871/2024 American Heart Association and American Academy of Pediatrics Focused Update on Special Circumstances: Resuscitation Following Drowning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care | Pediatrics, accessed April 4, 2025, https://publications.aap.org/pediatrics/article/154/6/e2024068444/199870/2024-American-Heart-Association-and-AmericanDrowning resuscitation Special considerations for prehospital management - ResearchGate, accessed April 4, 2025, https://www.researchgate.net/publication/374738312_Drowning_resuscitation_Special_considerations_for_prehospital_managementhttps://www.anzcor.org/home/new-guideline-page-3/guideline-9-3-2-resuscitation-in-drowning/downloadpdfHighlights of the 2020 ILCOR Guidelines Update - SaveaLife.com, accessed April 4, 2025, https://nhcps.com/highlights-of-the-2020-ilcor-guidelines-update/European Resuscitation Council Guidelines 2021: Systems saving lives, accessed April 4, 2025, https://www.erc.edu/assets/documents/RESUS-8901-SSL.pdfA systematic review of interventions for resuscitation following drowning - ResearchOnline@JCU, accessed April 4, 2025, https://researchonline.jcu.edu.au/79100/1/79100.pdfA systematic review of interventions for resuscitation following drowning - PMC, accessed April 4, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC10323217/https://journals.physiology.org/doi/full/10.1152/physiol.00002.2015https://www.anzcor.org/assets/anzcor-guidelines/guideline-9-3-2-resuscitation-in-drowning-275.pdfhttps://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2020.00524/fullhttps://journals.sagepub.com/doi/abs/10.1177/0883073811415269

In this comprehensive episode, we delve into the nuances of post-arrest care, focusing on the role of epinephrine, the importance of 12-lead ECG timing, and understanding false positives. The discussion covers essential post-resuscitation strategies, optimizing patient outcomes, and effective communication during patient handover. We also explore the ongoing changes in post-arrest care, including recommendations for paramedics to improve patient safety and outcomes. Key takeaways include the importance of slowing down after ROSC, thorough assessment, and detailed reporting to receiving hospitals.

Chapters:00:00 Introduction and Anecdotes

00:37 Medication Strategies Post-ROSC

00:51 Importance of 12-Lead ECG

02:19 Study on False Positives in ECG

06:18 Neurological Outcomes Post-Arrest

12:04 Patient Handover Best Practices

16:32 Evolving Field of Post-Arrest Care

References:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10455131/https://www.sciencedirect.com/science/article/pii/S1755599X21000355file:///Users/ryancichowski/Downloads/AmbulancetoEDstaffhandover-Pre-publicationfinalversion.pdfhttps://academic.oup.com/eurheartj/article/41/Supplement_2/ehaa946.1851/6005196#google_vignette https://www.ahajournals.org/doi/10.1161/CIR.0000000000001163https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001163?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org

#ems #science #paramedic #emergencymedicine #pediatriccare #prehospitalcare #cardiacarrest #pediatricmedicine #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #ROSC #post-arrest #resuscitation #resuscitations

In this episode, Jakob and I dive into the complexities of managing post-arrest patients. We discuss the critical shift in mindset required once a pulse is regained and emphasize the importance of preventing secondary injuries before transport. Key topics include the priorities in post-arrest care, the role of vital signs, the use of dopamine for treating hypotension, and the ideal oxygen saturation and end-tidal CO2 levels for optimizing patient outcomes. We also explore the challenges of pre-hospital care and share practical tips for ensuring the best possible results for post-arrest patients.

Chapters:00:00 Introduction and Initial Thoughts

00:38 Post-Arrest Patient Management

01:11 Prioritizing Patient Stabilization

05:49 Addressing Hypotension and Fluid Responsiveness

08:51 Dopamine Use and Considerations

18:06 Oxygenation and Ventilation Strategies

20:23 End-Tidal CO2 Monitoring

25:08 Conclusion and Final Thoughts

References:

https://www.bmj.com/content/384/bmj-2023-076019https://pmc.ncbi.nlm.nih.gov/articles/PMC8152988/https://pmc.ncbi.nlm.nih.gov/articles/PMC7703417/https://pubmed.ncbi.nlm.nih.gov/32286900/https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00152-3/fulltexthttps://www.ahajournals.org/doi/10.1161/CIR.0000000000001163https://cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-and-European-Societ.pdf

#ems #science #paramedic #emergencymedicine #pediatriccare #prehospitalcare #cardiacarrest #pediatricmedicine #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​ #ROSC #post-arrest #resuscitation #resuscitations

In this episode, Jakob and I discuss handling pediatric patients in shockable rhythms, including calculating defibrillation dosages—2 joules per kilogram for the first shock and 4 joules per kilogram for subsequent shocks. We delve into antiarrhythmic medications, highlighting that amiodarone and lidocaine are considered equivalent and outlining their dosages. The importance of family presence and communication during resuscitation efforts is stressed, with evidence suggesting it aids in their recovery from traumatic events. A recent trial on standardized intramuscular epinephrine injections to mitigate delays in administration is also explored. Lastly, the episode touches on the impact of socioeconomic factors on pediatric cardiac arrests and emphasizes the role of community paramedicine.

Chapters:

00:00 Introduction to Shockable Rhythms

00:05 Dosage Calculations for Defibrillation

00:56 Antiarrhythmic Medications

02:17 Family Involvement During Resuscitation

04:12 The PRIME Trial

05:55 Pediatric Cardiac Arrest Statistics

07:10 Key Takeaways

References:https://pubmed.ncbi.nlm.nih.gov/28009655/https://caep.ca/periodicals/Volume_16_Issue_6/Vol_16_Issue_6_Page_497_-_501_Motillo.pdfhttps://media.emscimprovement.center/documents/familypresencecpg3eaabb7cf0414584ac2291feba3be481_36JegLp.pdfhttps://www.thrasherresearch.org/grant/01695?lang=enghttps://pmc.ncbi.nlm.nih.gov/articles/PMC10423885/

#ems #science #paramedic #emergencymedicine #pediatriccare #prehospitalcare #cardiacarrest #pediatricmedicine #paramedic​ #emt​ #firefighter​#ambulance​ #medic​ #emergency​ #rescue​#firstresponders​ #emtlife​