Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Ross Orpet, Paramedic turned EMS Physician

Latest episode
129 episodes
- Trust is the architecture behind every patient interaction you run.
Dr. Cory Scheer, author of Closing the Trust Gap, has identified three evidence-based building blocks of trust: competency, problem-solving, and care for others. It turns out EMS providers already use all three the moment they step on scene.
In this episode, we unpack the gap between senior leaders and frontline EMS workers, what your "trust signature" reveals about how you naturally lead, and why imposter syndrome might be a signal worth listening to instead of pushing through.
Book a Free Coaching Call · Sign up for the weekly newsletter · Check out The Loud & Clear Fellowship program. - The hardest part of a bad call is rarely the algorithm. In two different interviews I explore some human traps of running an EMS call. I talk with Danny and Rance from DNR Prehospital Education about a choking arrest, a difficult field intubation, and the trainer-trainee dynamic that made the call more complicated than the procedure itself. Then Bobby breaks down the CAFE pneumonic of heuristic traps: commitment, acceptance, familiarity, and expert halo. This episode moves from the protocol and algorithm to the human challenges of running.
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Interested in ABLS Now? Our listeners get 10% off and a chance to win a free subscription (giveaway on July 1st, 2026). - A postpartum patient does not need to look dramatic to be in real danger. In this episode from FAST 26, Ross talks with Amy Loucks about pregnancy-related deaths, maternal care deserts, postpartum warning signs, hypertension, cardiomyopathy, infection, and the calls EMS can easily miss. Then Elizabeth Garchar walks through amniotic fluid embolism, now often framed as an anaphylactoid reaction of pregnancy: sudden cardiovascular collapse, right heart failure, DIC, TXA, whole blood, AOK, and the principle that matters most when everything goes bad: treat mom first.
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Episode Resources-
CDC: Preventing pregnancy-related deaths — https://www.cdc.gov/maternal-mortality/preventing-pregnancy-related-deaths/index.html
Amniotic fluid embolism overview — https://my.clevelandclinic.org/health/diseases/15463-amniotic-fluid-embolism
AOK regimen for amniotic fluid embolism — https://pmc.ncbi.nlm.nih.gov/articles/PMC9477128/
https://www.marchofdimes.org/peristats/
https://www.marchofdimes.org/research/maternity-care-deserts-report.aspx
https://saferbirth.org/
https://www.nmperinatalcollaborative.com/ Pressure Matters: Oxygenation vs. Ventilation in Pre-Oxygenation with Scott Weingart
07/06/2026 | 30 mins.Pre-Oxygenation is not just putting oxygen on the patient and hoping the sat buys you enough time. In this episode, Ross talks with Scott Weingart after his FAST26 talk on preventing peri-intubation arrest.
They get into why many peri-intubation arrests are predictable and preventable, why shunt physiology requires pressure and not just FiO2, and how EMS clinicians can build a field-ready setup with a nasal cannula, BVM mask, PEEP valve, and continuous pressure. Scott also walks through low-, moderate-, and high-risk patients, why high-risk oxygenation patients may not be good RSI candidates, and what changes for asthma, aspiration risk, and morbid obesity.
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American Burn Association ABLS Now giveaway and 10% listener discount
PREOXI trial: Noninvasive Ventilation for Preoxygenation during Emergency Intubation
PreVent trial: Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults
EMS World Live + FAST 26 conference coverage
Guest: Scott Weingart / EMCrit — https://emcrit.org/Your Checklist Is Making You Worse: Why Pilots Use Checklists and Paramedics Don't
31/05/2026 | 1h 6 mins.A checklist should reduce cognitive load. So why does yours make things worse? Airline pilot and safety officer Glenn Fisher breaks down how aviation refined checklists over decades of crash data and human factors research — from verification-only flows to abnormal read-and-do procedures to defining the criteria for what should actually earn a spot on the card.
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NASA papers on checklist design-
Human Factors of Flight-Deck Checklists: The Normal Checklist
COCKPIT CHECKLISTS: CONCEPTS, DESIGN, AND USE
Design Guidance for Emergency and Abnormal Checklists in Aviation
American Burn Association / ABLS: Enter the ABLS giveaway by June 30, 2026; the winner will be selected July 1, 2026. Loud & Clear listeners also get 10% off ABLS Now through August 31, 2026. Details: https://bit.ly/aba-loud-clear
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About Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters.Loud & Clear: EMS Guiding Principles is an EMS Cast LLC production
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