Summary

In this episode of the Overrun Podcast, hosts Ed Bauter and Dan Schwester engage with Scott Weingart to discuss critical topics in emergency medical services (EMS). The conversation covers the importance of whole blood in prehospital care, the logistical challenges of blood supply, and strategies for overcoming resistance to change within EMS systems. They also delve into advancements in defibrillation techniques, the use of pressors, and the significance of addressing burnout among EMS professionals. The episode concludes with a discussion on the potential role of ultrasound in EMS, emphasizing the need for effective tools in critical care settings.

Keywords

EMS, whole blood, defibrillation, push dose pressors, burnout, ultrasound, blood supply, logistics, critical care, emergency medicine

Takeaways

Whole blood is essential for critically ill trauma patients in the field.
Logistical challenges hinder the effective use of blood in EMS.
Evidence-based practice is crucial for implementing changes in EMS.
Dual sequential defibrillation shows promise in resuscitation efforts.
Dopamine should be phased out in favor of norepinephrine.
Push dose pressors should be used judiciously and not repeatedly.
Burnout is a significant issue in EMS that needs addressing.
Self-care and mental health are vital for EMS professionals.
Compassionate care can help combat cynicism in the field.
Ultrasound technology has potential benefits for EMS, especially in IV access.

Sound bites

“Whole blood is just the ideal product.”
“Stop using dopamine in EMS.”
“Ultrasound should be on the buses.”

Chapters

00:00 Introduction to the Overrun Podcast
03:03 The Importance of Whole Blood in EMS
07:42 Logistical Challenges in Blood Supply
08:35 Overcoming Resistance to Change in EMS
12:13 Advancements in Defibrillation Techniques
19:32 Pressors in EMS: What Works Best?
25:33 The Role of Push Dose Pressors
30:47 Addressing Burnout in EMS
36:53 The Future of Ultrasound in EMS

www.overrunems.com

www.emcrit.org

Summary

In this episode of the Overrun Podcast, Ed Bauter and Dan Schwester welcome Anthony Christian, known as Badge502, to discuss the impact of social media on EMS and medicine. They explore Badge502’s journey from EMT to social media influencer, the importance of humor and mental health in the EMS community, and the challenges of navigating social media policies. The conversation also touches on the balance between humor and professionalism, the significance of anonymization in social media posts, and the positive influence of social media on aspiring EMS professionals. Additionally, they address the issue of misinformation in the field and the phenomenon of shadow banning on social media platforms.

Keywords

social media, EMS, mental health, humor, influencer, education, policies, misinformation, shadow banning, community engagement

Takeaways

Social media has a significant impact on EMS and medicine.
Humor can be a vital tool for mental health in high-stress environments.
It’s essential to be mindful of social media policies in EMS.
Anonymization is crucial when sharing content related to patient care.
Social media can inspire new generations to pursue careers in EMS.
Misinformation can spread easily on social media, requiring vigilance.
Shadow banning can affect content visibility on social media platforms.
Using social media for good can enhance community engagement.
Balancing humor and professionalism is key in EMS content creation.
It’s important to foster a supportive and positive online community.

Chapters

00:00 Introduction to Social Media in EMS
01:07 The Journey of Content Creation
03:30 The Impact of Humor on Mental Health
08:05 Navigating Social Media Policies
11:33 The Balance of Humor and Professionalism
16:07 Anonymization and Ethical Considerations
20:07 The Importance of Education in Emergency Response
22:59 The Role of Social Media in EMS Education
25:00 The Impact of Content Creation on Future Generations
26:39 Navigating Misinformation in the EMS Community
30:36 The Challenges of Shadow Banning and Social Media Algorithms
31:43 Agency Mandated Training and Its Necessity
33:07 Respecting Patient Privacy in the Digital Age
36:12 Understanding Shadow Banning in Social Media

OverrunEMS.com

Summary

In this episode of the Overrun Podcast, Dr. Andrew Fisher discusses the implications of using whole blood in emergency medical services (EMS), particularly in relation to trauma care and sepsis. The conversation explores the benefits and complications of whole blood transfusions, the financial challenges faced by EMS systems, and the importance of community engagement in supporting these programs. Dr. Fisher emphasizes the need for ongoing research and adaptation in EMS practices to improve patient outcomes, including the potential role of freeze-dried plasma as an alternative to whole blood.

Keywords

whole blood, EMS, sepsis, trauma care, hemorrhagic injury, freeze-dried plasma, blood transfusion, emergency medicine, patient outcomes, community engagement

Takeaways

Whole blood is a significant advancement in trauma care.
There is a 4% increase in sepsis risk with each unit of whole blood.
EMS should focus on treating immediate patient needs.
Financial sustainability is a major concern for whole blood programs.
Community support is essential for the success of EMS initiatives.
Freeze-dried plasma may revolutionize pre-hospital care.
EMS must take ownership of hemorrhagic control practices.
Research should guide changes in EMS protocols.
The cost of blood products can impact patient care decisions.
Ongoing education and adaptation are crucial for EMS professionals.

Titles

The Future of Whole Blood in EMS
Sepsis Risks and Whole Blood: What You Need to Know

Sound bites

“We have to lobby for better EMS funding.”
“Freeze-dried plasma could be a game changer.”
“The evolution of EMS practices is ongoing.”

Chapters

00:00 Introduction to Whole Blood in EMS
02:52 Understanding Sepsis and Whole Blood Complications
05:43 The Role of Whole Blood in Trauma Care
08:28 Financial Implications of Whole Blood Use
11:12 Alternatives to Whole Blood in Emergency Care
13:37 Future of Hemorrhagic Trauma Treatment
16:10 Community Engagement and Support for EMS
19:01 Conclusion and Future Directions

Summary

In this episode, Dr. Peter Antevy discusses the critical role of EMS in the early treatment of sepsis, challenging the traditional view that sepsis is solely a hospital issue. He emphasizes the importance of data-driven approaches, early intervention, and the need for EMS to adopt effective treatment protocols. The conversation highlights the potential for EMS to significantly impact patient outcomes and reduce hospital burdens by providing timely care in the field. In this conversation, Peter Antevy discusses the innovative treatment of sepsis using spray-dried plasma, emphasizing its potential to improve patient outcomes. The dialogue explores the importance of data collection in recognizing and treating sepsis, the challenges faced in implementing evidence-based practices in EMS, and the need for transparency in healthcare data. Antevy highlights the role of clinicians in bridging the gap between research and practice, advocating for progressive protocols in EMS, and the necessity of adapting to the evolving landscape of healthcare.

Takeaways

Sepsis is often misunderstood as a hospital-only issue.
EMS can and should be involved in sepsis treatment.
Data is crucial for demonstrating the effectiveness of EMS interventions.
Early treatment of sepsis can drastically improve patient outcomes.
Protocols for sepsis management in EMS are essential.
The healthcare system needs to recognize the value of EMS.
Fluid resuscitation and antibiotics are critical in the field.
The role of EMS can alleviate pressure on emergency departments.
Understanding the business side of healthcare is important for EMS.
Future advancements in EMS will include more comprehensive treatment options. Spray-dried plasma could revolutionize sepsis treatment.
Data collection is crucial for recognizing and treating sepsis.
There is a gap between clinical practice and research.
RCTs are essential for validating new treatments.
High-performance CPR is a cost-effective improvement.
EMS must adapt to changes in healthcare delivery.
Data transparency can drive improvements in EMS.
Innovative treatments require rigorous research and validation.
Small agencies can implement progressive protocols without high costs.
The future of EMS lies in proactive patient care beyond 911 calls.

Chapters

00:00 Introduction to Sepsis and EMS
03:11 The Role of EMS in Sepsis Treatment
05:47 Data-Driven Approaches to Sepsis
09:05 The Importance of Early Intervention
12:00 Protocols and Practices in Sepsis Management
14:54 The Future of EMS in Sepsis Care
26:29 Innovations in Plasma Treatment for Sepsis
28:08 The Importance of Data in Recognizing and Treating Sepsis
30:21 Bridging Clinical Practice and Research
33:20 The Future of EMS Research and Data Collection
39:06 Challenges in Implementing Evidence-Based Practices
43:18 Navigating Resources in EMS for Progressive Protocols
46:55 The Need for Data Transparency in EMS

Summary

In this episode of the Overrun Podcast, Ed Bauter speaks with Greg Clopp, a former paramedic turned nurse anesthetist, about the evolution and nuances of Rapid Sequence Intubation (RSI) in emergency medicine. They discuss the importance of understanding patient needs, the role of various medications, and the shift towards Delayed Sequence Intubation (DSI) as an alternative to RSI. The conversation also touches on the challenges faced by EMS professionals, the importance of patient assessment, and the potential for career growth within the industry. Greg shares insights on how to navigate the EMS landscape and the importance of having diverse options in medication protocols.

Takeaways

RSI is taken more seriously in modern practice.
One size doesn’t fit all in patient care.
Aggressive treatment is necessary in emergency settings.
Career opportunities in EMS are limited on the East Coast.
Understanding patient needs is crucial for effective treatment.
Video laryngoscopy has its limitations, especially with cervical spine injuries.
Push dose pressors can be beneficial in fragile patients.
Diverse medication options are essential for effective care.
Patient assessment should guide treatment decisions.
Career pathways in EMS can lead to advanced practice roles.

Chapters

00:00 Introduction to RSI and Its Evolution
03:09 The Nuances of RSI in Practice
05:59 Exploring Alternatives: DSI vs. RSI
09:01 The Role of Medications in RSI
11:56 The Disconnect Between Field and Hospital Practices
14:59 Video Laryngoscopy: Benefits and Risks
18:10 Career Pathways in EMS and Nursing
20:58 Final Thoughts on EMS and Career Growth

Summary

In this episode of the Overrun Podcast, Ed and Dan welcome intensivist Eddie Joe Gutierrez to discuss the use of vasopressors in emergency medical services (EMS). The conversation covers the challenges of peripheral IV access, the importance of early vasopressor administration in hypotensive patients, and the evolving understanding of fluid resuscitation in sepsis. Eddie emphasizes the significance of norepinephrine as a first-line vasopressor and compares it to phenylephrine, while also addressing the complexities of managing cardiogenic shock in the pre-hospital setting. In this conversation, Eddy Joe Gutierrez discusses critical aspects of managing shock and trauma in pre-hospital settings. He emphasizes the importance of understanding different types of shock, the role of vasopressors, and the challenges pre-hospital teams face. The discussion also covers the use of whole blood in trauma care and the growing interest in point-of-care ultrasound. Ultimately, the key takeaway is the urgency of restoring perfusion to patients as quickly as possible, with norepinephrine being the preferred vasopressor in many situations.

Takeaways

Chapters

00:00 Introduction to Vasopressors in EMS
02:49 Peripheral IV Access and Vasopressors
05:54 Early Use of Vasopressors in Hypotensive Patients
09:04 Fluid Resuscitation vs. Vasopressors in Sepsis
12:00 Understanding Norepinephrine and Its Mechanism
14:58 Comparing Vasopressors: Norepinephrine vs. Phenylephrine
17:57 Cardiogenic Shock and Its Management
20:21 Understanding Shock: A Clinical Perspective
24:07 Trauma Management and Whole Blood Administration
26:56 Point-of-Care Ultrasound in Pre-Hospital Settings
29:13 Vasopressors: Choosing the Right Agent
36:52 Restoring Perfusion: The Key Takeaway

Eddy Joe’s work can be found on Instagram @eddyjoemd

Buy his book here

Summary

In this episode of the Overrun Podcast, Ed Bauter and Dan Schwester engage with immigration attorney Matthew Hartnett to discuss the complex interactions between EMS professionals and ICE agents. The conversation delves into the rights of EMS workers and patients, the legal boundaries of ICE’s jurisdiction, and the importance of maintaining patient privacy under HIPAA during emergencies. Hartnett emphasizes the need for EMS workers to understand their rights and responsibilities when encountering ICE, especially in sensitive environments where medical care is provided. The discussion highlights the evolving landscape of immigration enforcement and its implications for public safety and patient care.

Takeaways

EMS workers have specific rights when interacting with ICE agents.
The right to privacy under the Fourth Amendment is crucial for patients.
ICE cannot enter a home without a judicial warrant.
Public spaces have different privacy expectations compared to private spaces.
Emergency medical situations require a delicate balance of rights and responsibilities.
HIPAA regulations must be upheld even in the presence of ICE.
Communication with ICE should focus on patient care and privacy.
Understanding the legal framework surrounding ICE is essential for EMS professionals.
The landscape of immigration enforcement is changing and may impact EMS operations.
Maintaining patient confidentiality is paramount in all interactions.

Chapters

00:00 Understanding the Intersection of EMS and ICE
18:02 Navigating Rights and Responsibilities in Emergency Situations

Summary

In this episode of the Overrun Podcast, Ed and Dan engage with Judyth Brown, an experienced instructional designer, to discuss the challenges and opportunities in EMS education. They explore the differences between instructing and educating, the importance of effective instructor training, and the need for a focus on entry-level competence. Judyth emphasizes the significance of integrating real-life experiences into teaching and the detrimental effects of standardized testing on education quality. The conversation also highlights the critical need for documentation training and the role of social-emotional learning in preparing EMS professionals for the field. This conversation delves into the challenges and opportunities in EMS education, focusing on the importance of social-emotional learning, the application of Bloom’s Taxonomy, and the need for a shift towards quality education over quantity. The speakers discuss the role of instructors in fostering a supportive learning environment and the necessity of adapting teaching methods to better prepare students for real-world challenges in emergency medical services.

Keywords

EMS education, instructional design, adult learning, teaching methods, entry-level competence, standardized testing, documentation training, social-emotional learning, instructor training, critical thinking, education, social-emotional learning, Bloom’s taxonomy, EMS training, instructor development, emotional intelligence, teaching methods, professional values, effective learning, instructor ego

Chapters

00:00 Introduction to EMS Education Challenges

03:03 The Role of Experience in Teaching

05:52 Identifying Effective Instructors

09:10 Defining Entry-Level Competence

12:07 The Impact of Standardized Testing

14:57 The Importance of Documentation Training

17:57 Addressing the Dumbing Down of EMS Education

21:02 Social-Emotional Learning in EMS

24:00 Conclusion and Future Directions

24:24 Overcoming Fear in Education

29:18 The Importance of Social-Emotional Learning

35:07 Understanding Bloom’s Taxonomy

43:10 Quality Over Quantity in Education

49:15 The Need for Change in EMS Education

Takeaways

The difference between instructing and educating is crucial in EMS. Instructors often lack training on how to teach effectively. Real-life experiences should be integrated into EMS education. Standardized testing can detract from meaningful learning. Entry-level competence should focus on practical skills and critical thinking. Documentation is a vital skill that is often overlooked in training. Social-emotional learning is essential for effective patient interactions. Instructors should define what they want to see in graduates. The EMS education system needs to evolve beyond outdated practices. Investing in instructor training is key to improving EMS education. Lowering the effective filter in education enhances learning. Gamification and challenging scenarios can improve engagement. Instructors must overcome their ego to facilitate learning. Social-emotional learning is crucial for professional development. Teaching values is essential for ethical decision-making in EMS. Bloom’s Taxonomy helps structure the learning process effectively. Rote memorization is insufficient for real-world application. Quality of education should be prioritized over duration. Instructors need to be aware of their own shortcomings. Change in EMS education is necessary for better outcomes.

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Summary

In this episode of the Overrun Podcast, Ed Bauter, Dan Schwester, and Dr. Michael DeFilippo discuss the recent advancements in dual sequential defibrillation for refractory ventricular fibrillation (VFib). They explore the importance of understanding the nuances between refractory and recurrent VFib, the significance of patient history in cardiac arrest situations, and the latest findings from the DOSE-VF trial. The conversation emphasizes the need for operational readiness, effective communication among medical teams, and the physics behind defibrillation techniques. The episode concludes with a discussion on the protocols for terminating resuscitation efforts and addressing concerns about equipment damage during advanced life support procedures.

Takeaways

Chapters

00:00 Introduction to Dual Sequential Defibrillation

02:36 Understanding Refractory VFib and Its Treatment

05:21 The Importance of Defibrillation Techniques

07:59 Literature Review on Defibrillation Strategies

11:01 Key Findings from Recent Studies

13:50 Implications for Practice and Future Research

20:00 Understanding Defibrillation Mechanics

25:19 Optimizing Cardiac Arrest Response

34:49 Determining Resuscitation Termination

Keywords

Dual Sequential Defibrillation, Refractory VFib, Cardiac Arrest, Resuscitation Science, Defibrillation Strategies, DOZ-VF Trial, Emergency Medicine, Pre-Hospital Care, Medical Protocols, Patient Outcomes

Paper available at: https://www.airmedicaljournal.com/article/S1067-991X(25)00002-1/fulltext

OverrunEMS.com

TT: The Overrun

FB/IG: Overrun Productions

Summary

In this year-end special episode of The Overrun podcast, Ed Bauter, Dr. Mike DeFilippo, and Dr. Michael Stone discuss five significant papers from the year that impact emergency medical services (EMS). The conversation covers non-invasive ventilation for pre-oxygenation during intubation, the early administration of adrenaline in out-of-hospital cardiac arrest, and the effectiveness of different routes of drug administration in cardiac arrest scenarios. The discussion emphasizes the importance of adapting practices based on new research findings and the need for further studies to validate these practices in various EMS settings. In this conversation, the speakers discuss multiple aspects of EMS practices, focusing on cultural differences in emergency medical services, the debate between IV and IO access during cardiac arrest, the cost-effectiveness of whole blood in trauma care, and strategies to improve cardiac arrest survival rates through training and system-level changes. They emphasize the importance of evidence-based practices and the need for ongoing education and adaptation in EMS protocols.

Takeaways

Non-invasive ventilation can reduce hypoxemia during intubation.

Practice changes in EMS can take time to implement.

Patient selection is crucial in emergency medicine.

The route of drug administration can impact survival rates.

Bundled care approaches may improve cardiac arrest outcomes.

Research findings should be adapted to local EMS practices.

Timely access to medications is critical in cardiac arrest.

Epinephrine’s role in cardiac arrest management is still debated.

Innovative studies can lead to significant changes in practice.

Cognitive aids can help guide emergency medical procedures. Cultural differences in EMS practices can impact patient outcomes.

The debate between IV and IO access in cardiac arrest is ongoing and complex.

Whole blood may offer significant cost savings and improved patient outcomes in trauma care.

Training and simulation are crucial for improving cardiac arrest survival rates.

Collaboration among different emergency services can enhance training effectiveness.

Cost-effectiveness is a key factor in implementing new EMS protocols.

Regular CPR skills assessments can lead to better patient outcomes.

Data-driven decisions are essential for EMS protocol development.

Engaging administrators with financial data can facilitate changes in EMS practices.

Continuous education and adaptation are necessary for improving EMS effectiveness.

Chapters

00:00 Introduction to Year-End Review

01:09 Non-Invasive Ventilation and Pre-Oxygenation

09:32 Early Administration of Adrenaline in Cardiac Arrest

20:24 Routes of Drug Administration in Cardiac Arrest

23:48 Cultural Differences in EMS Practices

27:41 The Debate: IV vs. IO in Cardiac Arrest

28:32 Cost-Effectiveness of Whole Blood in Trauma Care

38:57 Improving Cardiac Arrest Survival Rates

47:29 Conclusion and Future Directions

Keywords

EMS, non-invasive ventilation, pre-oxygenation, cardiac arrest, adrenaline administration, drug routes, medical research, practice change, emergency medicine, EMS, cardiac arrest, IV, IO, whole blood, trauma care, survival rates, cost-effectiveness, training, CPR

Papers: 

PREOXI: https://pubmed.ncbi.nlm.nih.gov/38869091/

Route of Administration: https://pmc.ncbi.nlm.nih.gov/articles/PMC7616768/

Cardiac Arrest Survival with Practice: https://pubmed.ncbi.nlm.nih.gov/38837166/

Cost Savings- Whole Blood: https://pubmed.ncbi.nlm.nih.gov/38591174/#full-view-affiliation-1

IM Epinephrine: https://pubmed.ncbi.nlm.nih.gov/38857847/

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