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

What if the mistake wasn't your fault... but it's still your responsibility?

That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurse and educator. At FAST 25, she gave one of the sharpest talks of the conference — not on a procedure or a drug, but on the science of why humans make mistakes and what we can actually do about it.

WHAT YOU'LL LEARN:

Task Brackets — Your brain bundles repetitive actions into smooth automated sequences.

The First Habit Rule — The first habit is permanently ingrained. Old habits lurk underneath new ones and surface under stress. Get it right the first time.

Goal-Oriented Stimulus — Don't ask "Do I have everything?" Ask "Where are the things I need?" and physically point to them.

The Preceptor Problem — Most preceptors feel unprepared. The goal isn't to make "mini me", it's to create independent critical thinkers.

Shift Fatigue — Cognitive function degrades meaningfully at 16 hours.

Just Culture — Human error is inevitable. Punishment doesn't fix the system. The guilty already feel terrible. They need peer support and system redesign.

 

RESOURCES:

Join our Paramedic Confidence Builder 

 

CONNECT WITH US:

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com 

 

CONNECT WITH SHEA:

- TikTok: @flightnurseshay

- Instagram: @flightnurseshay

Miss your first intubation attempt and your patient's risk of adverse events jumps sevenfold. By the third attempt? Nearly guaranteed complications. This isn't about your anatomical knowledge or practice hours—expert clinicians fail too. David Olvera, who led national research on intubation checklists, reveals why your brain predictably fails under pressure and what systems actually prevent it. You'll learn the challenge-response checklist protocol that speeds up your intubation time (not slows it down), the HEAVEN criteria's six specific warning signs that predict difficult airways before you attempt, and why dump kits create muscle memory that works in the dark. David shares the story that started his human factors obsession and proves that expertise doesn't protect you from error—systems do. This is operational excellence: building checklists that think for you when tunnel vision sets in.

 

Resources  

Paramedic Confidence Builder - emspodcast.com/program 

To see the actual checklist - https://www.airmedandrescue.com/latest/long-read/medical-insight-latest-tools-ensure-successful-first-pass-intubation 

 

Guest/Cast/Crew information-

Guest- David Olvera

Host- Ross Orpet, Will Berry 

 

Catch up with us after the show

- Instagram- @emsloudandclear

- YouTube- https://www.youtube.com/@EMSLoudandClear

- Website- www.emspodcast.com

 

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

 

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

Behind the curve. We've all heard it. Most of us have lived it. That sinking feeling when you're mentally three steps behind where the call actually is. The concept of the Power Curve comes from aviation—pilots need to understand the phases of flight and how the plane will react differently and require different inputs during each of these phases. The same principle applies to your 911 calls. This episode breaks down the exact framework to chunk calls into five critical phases. When you understand phases you understand what is needed during each point of the call and how to stay ahead. How to build if-then statements that eliminate decision fatigue. The psychological safety that lets you reset after screwing up in the apartment. And why 80% of medical errors tie back to the one phase—the hospital handoff. Stop reverting to chaos. Build the system that keeps you ahead.

Guest/Cast/Crew information-

Guest- Moose and Josh from Alert Medic 1 podcast

Host- Ross Orpet, Will Berry 

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear  

Website- www.emspodcast.com

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

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

You're not making mistakes because you're dumb. You're making mistakes because of seven predictable factors—and once you know them, you can control them.

Kris Kaull delivered a masterclass at FASTCAN on the hidden forces that cause even experienced paramedics to miss critical information when it matters most. This isn't about memorizing more protocols—it's about understanding the cognitive science behind high-stakes decision-making in emergency medicine.  

Guest/Cast/Crew information-

Guest- Kris Kaull, FP-C

Host- Ross Orpet

Catch up with us after the show -

Instagram- @emsloudandclear 

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

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

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

This episode tells the tragic story of Max McKenzie, a teenager with asthma who died from anaphylaxis despite receiving "standard care." His death led his father, Dr. Ben McKenzie, to develop the AMAX4 algorithm. Educator and critical care transport nurse/paramedic Bruce Hoffman breaks down the algorithm and explains why the combination of anaphylaxis and asthma can be lethal, why IM epinephrine may not be enough, and why this is the time to be aggressive.

But this isn't simply about memorizing another algorithm. It's about developing the operational confidence to recognize when standard approaches may fail and override your impulse to "try the book answer one more time." You'll learn to identify time-critical scenarios, build red-flag combination awareness, and make high-stakes decisions without second-guessing yourself. 

Want to systematically build this decision-making confidence? Discover the Paramedic Confidence Builder at emspodcast.com/program —where we teach the operational skills your school didn't.

 

Guest/Cast/Crew information-
Guest- Bruce Hoffman, Associate Professor, Critical Care RN and Paramedic
Host- Ross Orpet, Will Berry 

Catch up with us after the show

Instagram- @emsloudandclear

YouTube- https://www.youtube.com/@EMSLoudandClear

Website- www.emspodcast.com

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

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