Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

• Unlocking the Airway with Dr. Rich Levitan: Engineering Success in High-Stakes Medical Procedures

  Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance. Resources YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw The Resus Tailor - https://www.theresustailor.com/ Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Dr. Rich Levitan Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

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• The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use

  We dive into the latest emergency medicine research evaluating the complications following pre-hospital tourniquet use. Dr. Ben Li, an expert in emergency medicine literature reviews a 2023 study titled 'The Cost of Saving Lives: Complications Arising from Pre-Hospital Tourniquet Use,' exploring its implications for EMS providers. From infection to compartment syndrome, we discuss the potential downstream complications and we do so reviewing step by step guide on how to critically appraise current literature. Tune in to ensure your evidence-based care starts in the streets.   01:10 Introducing the Study 03:48 Understanding Study Design and Quality 06:19 Diving into the Study's Context and Background 09:04 Using Appraisal Checklists to Evaluate the Study 10:31 Cohort Study Design and Its Implications 15:31 Selection Bias and Generalizability 22:36 Measurement and Classification Bias 24:45 Understanding Confounding Variables 25:51 Evaluating Study Methods and Follow-Up 27:43 Analyzing Study Results 31:21 Complications and Their Implications 34:33 Multivariable Analysis Insights 36:49 Practical Applications and Future Research 46:24 Final Thoughts   Resources The Resus Tailor - https://www.theresustailor.com/  Critical Appraisal Checklists- https://casp-uk.net/casp-tools-checklists/  Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Books We Recommend The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Dr. Ben Li Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.co

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• Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It

  A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar? In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift. Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence. Key Concepts Covered: Crew Resource Management (CRM) Just Culture principles Aviation Safety Action Program (ASAP) Power distance in medical teams Human factors in emergency medicine Error prevention strategies Books Mentioned by Glen: Just Culture by Sidney Dekker - https://amzn.to/3Su0A9Y The Myth of Multitasking: How "doing it all" gets nothing done - https://amzn.to/4dAFa4E  Crew Resource Management Practice and Principles- https://amzn.to/3ZIjXzZ Threat & Error Management resources - https://skybrary.aero/articles/threat-and-error-management-tem Other Resources: The Resus Tailor - https://www.theresustailor.com/  This Episodes Blog Post- https://emspodcast.com/what-airplane-crashes-teach-us-about-saving-lives-in-ems-lessons-in-crew-resource-management-and-just-culture-from-the-aviation-industry/  Gear We Like: Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Other books we recommend: The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Glen Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

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• Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It

  A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar? In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift. Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence. Key Concepts Covered: Crew Resource Management (CRM) Just Culture principles Aviation Safety Action Program (ASAP) Power distance in medical teams Human factors in emergency medicine Error prevention strategies Books Mentioned by Glen: Just Culture by Sidney Dekker - https://amzn.to/3Su0A9Y The Myth of Multitasking: How "doing it all" gets nothing done - https://amzn.to/4dAFa4E  Crew Resource Management Practice and Principles- https://amzn.to/3ZIjXzZ Threat & Error Management resources - https://skybrary.aero/articles/threat-and-error-management-tem Other Resources: The Resus Tailor - https://www.theresustailor.com/  This Episodes Blog Post- https://emspodcast.com/what-airplane-crashes-teach-us-about-saving-lives-in-ems-lessons-in-crew-resource-management-and-just-culture-from-the-aviation-industry/  Gear We Like: Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Other books we recommend: The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information- Guest- Glen Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com

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• The Art of Managing Agitated Patients

  Effective agitated patient management requires a fundamental shift from viewing these encounters as behavioral problems to recognizing them as medical emergencies with underlying pathophysiological processes. By systematically addressing safety, identifying root causes, selecting appropriate pharmacological interventions, and maintaining rigorous post-sedation monitoring, EMS providers can dramatically improve outcomes for these challenging patients. Remember: you cannot talk someone out of a hypoglycemic crisis, hypoxic emergency, or sympathomimetic overdose. When verbal de-escalation fails, it's not your failure as a provider—it's an indication that medical intervention is required to address the underlying pathophysiology driving the patient's agitation. The goal isn't just to control behavior—it's to provide definitive medical care that addresses the root cause of the patient's distress while maintaining safety for everyone involved.   Our guest is Patrick Hendley, a practicing paramedic and an expert in agitated patient management. We'll explore the pathophysiology behind agitation and essential strategies for EMS providers faced with these calls. We'll also examine sedation choices, restraint use, and post-sedation care through a lens of real-world EMS principles. Join us as we look at more than just de-escalation, but understanding and acting effectively and ethically to safeguard everyone involved.   Don't forget to check out our sponsor, The Resus Tailor, for custom bag designs tailored to your EMS needs. Reach out to them at theresustailor.com.    00:00 Introduction to Loud and Clear EMS 00:27 Today's Topic: Managing the Agitated Patient 01:00 Guest Introduction: Patrick Henley 02:17 Sponsor Message: The Recess Tailor 03:01 Case Study: Agitated Patient Scenario 06:04 Understanding Agitation and Safety Principles 08:12 Sympathetic Nervous System and Agitation 10:00 Factors Contributing to Agitation 13:02 Drug Influence on Agitation 19:05 Safety Hierarchy in EMS 30:34 Transport Safety and Patient Management 33:07 Treating Underlying Causes of Agitation 39:08 Managing Patient Anxiety with Fentanyl and Oxygen 39:45 Using Ketamine for Pain Control and Sedation 40:25 Addressing Mixed Presentations: Schizophrenia and Substance Use 41:38 Treating Sympathomimetic Overdose and Psychosis 42:56 The Importance of Post-Sedation Monitoring 43:51 Verbal De-escalation and Benzodiazepines 45:00 Using Time as a Tool for Postictal Patients 46:11 Understanding Benzodiazepines and GABA Receptors 47:59 Antipsychotics and Ketamine: When Benzos Aren't Enough 59:17 The Role of Physical Restraints in Patient Management 01:08:43 Effective Handoff and Continuity of Care 01:18:11 Final Thoughts and Core Principles   Resources The Resus Tailor - https://www.theresustailor.com/ The Art of Managing Agitated Patients Supplemental Blog Post - https://emspodcast.com/the-art-of-managing-agitated-patients/ Gear We Like Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Guest/Cast/Crew information- Guest- Patrick Hendley Host- Ross Orpet, Will Berry  Catch up with us after the show Instagram- @emsloudandclear YouTube- https://www.youtube.com/@EMSLoudandClear Website- www.emspodcast.com  

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