MCHD Paramedic Podcast – Détails, épisodes et analyse

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MCHD Paramedic Podcast

Montgomery County Hospital District

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Fréquence : 1 épisode/14j. Total Éps: 177

The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Director Dr. Casey Patrick invites you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

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Données mises à jour le 04/07/2026

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http://www.nejm.org/doi/full/10.1056/NEJMoa1706442
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http://www.nejm.org/doi/full/10.1056/NEJMoa1713973
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Episode 182 - Traumatic Arrest With The Prehospitalist

lundi 16 juin 2025 • Durée 40:27

Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case, asked some hard questions, and will provide solid answers—our favorite recipe for a jam-packed educational session. REFERENCES 1. Witt, C. E., Shatz, D. V., Robinson, B. R. H., Campion, E. M., Shapiro, M. L., Bui, E. H., Meizoso, J. P., & Dorlac, W. C. (2025). Epinephrine in Prehospital Traumatic Cardiac Arrest-Life Saving or False Hope?. Prehospital emergency care, 1–9. 2. Breyre, A. M., George, N., Nelson, A. R., Ingram, C. J., Lardaro, T., Vanderkolk, W., & Lyng, J. W. (2025). Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest - A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP. Prehospital emergency care, 1–15. 3. https://www.anzcor.org/assets/anzcor-guidelines/guideline-11-10-1-management-of-cardiac-arrest-due-to-trauma-253.pdf

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Episode 181 - Why You Should Attend The Resuscitation Academy

lundi 19 mai 2025 • Durée 37:16

We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank. REFERENCES 1. https://www.resuscitationacademy.org

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Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?

lundi 21 avril 2025 • Durée 20:18

Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in EMS? Could standing a patient to check their heart rate actually be harmful? Join the podcast crew as they address these questions and more. REFERENCES 1. White, JL, Hollander, JE, Chang, AM, et al. (2019). Orthostatic vital signs do not predict 30-day serious outcomes in older emergency department patients with syncope: A multicenter observational study. The American journal of emergency medicine, 37(12), 2215–2223. 2. Shen W, Sheldon R, Yancy C, et al. 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of The American College Of Cardiology. August 1, 2017;70(5):e39-e110. Available from: MEDLINE, Ipswich, MA. Accessed May 1, 2018. 3. Cohen E, Grossman E, Sapoznikov B, et al. Assessment of orthostatic hypotension in the emergency room. Blood Press. 2006;15(5):263-267. 4. Aronow WS, Lee NH, Sales FF, Etienne F. Prevalence of postural hypotension in elderly patients in a long-term health care facility. Am J Cardiol. 1988;62(4):336. 5. Ooi WL, Barrett S, Hossain M, et al. Patterns of orthostatic blood pressure change and their clinical correlates in a frail, elderly population. JAMA. 1997;277(16):1299-1304.

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Episode 179 - Transcutaneous Pacing Pearls and Pitfalls

mercredi 19 mars 2025 • Durée 38:18

On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence. What they found should motivate us all to be skeptical when it comes to determining if TCP is actually working. REFERENCES 1. https://www.mchd-tx.org/wp-content/uploads/2025/03/TCP-Podcast-Figures.pdf 2. Kimbrell, J., Kreinbrook, J., Poke, D., Kalosza, B., Geldner, J., Shekhar, A. C., Miele, A., Bouthillet, T., & Vega, J. (2024). False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series. Prehospital emergency care, 28(7), 928–936. 3. https://www.ems12lead.com/post/tcp-in-transit-part-i 4. https://www.ems12lead.com/post/transcutaneous-pacing-part-2 5. https://www.ems12lead.com/post/transcutaneous-pacing-part-3

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Episode 178 - A STEMI Unlike Any Other

mardi 18 février 2025 • Durée 21:23

We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to our daily care. REFERENCES 1. https://www.mchd-tx.org/wp-content/uploads/2025/02/SITUS-Fig-1.pdf 2. https://www.mchd-tx.org/wp-content/uploads/2025/02/SITUS-Fig-2.pdf 3. https://montgomerycountypolicereporter.com/mchd-celebrates-survival-of-one-in-a-million-patient-first-responders-please-read/ 4. https://pubmed.ncbi.nlm.nih.gov/34317454/

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Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration

mercredi 22 janvier 2025 • Durée 01:20:12

This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release. This episode has been out in the world on Medic Mindset for a couple of months, but we wanted to offer it to our MCHD Paramedic Podcast listeners as well. Also, like, subscribe to and follow Medic Mindset wherever you listen to podcasts. REFERENCES 1. https://medicmindset.com 2. Elam, K., & Bolar-Softich, K. L. (1997). Dilemmas in the acute pharmacologic treatment of uncontrolled atrial fibrillation. The American journal of emergency medicine, 15(4), 418–419. 3. Abarbanell, N. R., & Marcotte, M. A. (1997). Prehospital use of intravenous diltiazem (cardizem Lyo-Ject) in the treatment of rapid atrial fibrillation. The American journal of emergency medicine, 15(6), 618–619. 4. Abarbanell, N. R., Marcotte, M. A., Schaible, B. A., & Aldinger, G. E. (2001). Prehospital management of rapid atrial fibrillation: recommendations for treatment protocols. The American journal of emergency medicine, 19(1), 6–9. 5. Wang, H. E., O'connor, R. E., Megargel, R. E., Schnyder, M. E., Morrison, D. M., Barnes, T. A., & Fitzkee, A. (2001). The use of diltiazem for treating rapid atrial fibrillation in the out-of-hospital setting. Annals of emergency medicine, 37(1), 38–45. 6. Luk, J. H., Walsh, B., & Yasbin, P. (2013). Safety and efficacy of prehospital diltiazem. The western journal of emergency medicine, 14(3), 296–300. 7. Rodriguez, A., Hunter, C. L., Premuroso, C., Silvestri, S., Stone, A., Miller, S., Zuver, C., & Papa, L. (2019). Safety and Efficacy of Prehospital Diltiazem for Atrial Fibrillation with Rapid Ventricular Response. Prehospital and disaster medicine, 34(3), 297–302. 8. Fornage, L. B., O'Neil, C., Dowker, S. R., Wanta, E. R., Lewis, R. S., & Brown, L. H. (2024). Prehospital Intervention Improves Outcomes for Patients Presenting in Atrial Fibrillation with Rapid Ventricular Response. Prehospital emergency care, 28(7), 910–919.

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Episode 176 - Antibiotics & Open Fractures

samedi 28 décembre 2024 • Durée 20:47

MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES: Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour, R. B., Sims, S., Kellam, J. F., & Bosse, M. J. (2015). Type III open tibia fractures: immediate antibiotic prophylaxis minimizes infection. Journal of orthopaedic trauma, 29(1), 1–6. Johnson, J. P., Oliphant, B. W., Dodd, J., Duckworth, R. L., Goodloe, J. M., Lyng, J. W., Sagraves, S. G., & Fischer, P. E. (2024). Prehospital Antibiotic Administration for Suspected Open Fractures: Joint COT/OTA/ACEP/NAEMSP/NAEMT Position Statement. Prehospital emergency care, 28(8), 1063–1067. Muniz, A. D., Gregorio, D. J., Studebaker, S. A., Peth, A. M., Camacho, C. G., Williams, B., Kupas, D. F., & Brown, L. H. (2024). Time Savings and Safety of EMS Administration of Antibiotics for Open Fractures. Prehospital emergency care, 28(8), 1046–1052.

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Episode 174 - Push Dose Norepinephrine

samedi 2 novembre 2024 • Durée 25:27

We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild. REFERENCES: 1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Norepinephrine a Better Choice? The western journal of emergency medicine, 25(5), 708–714. 2. Permpikul, C., Tongyoo, S., Viarasilpa, T., Trainarongsakul, T., Chakorn, T., & Udompanturak, S. (2019). Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial. American journal of respiratory and critical care medicine, 199(9), 1097–1105.

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Episode 175 - The Rear View Mirror - Tunnel Vision

mardi 29 octobre 2024 • Durée 31:09

Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the positives that can come if we get past our egos and allow ourselves to have insight for future cases.

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Episode 172 - The MCHD EKG Manifesto - Part 3

vendredi 27 septembre 2024 • Durée 27:12

Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge. REFERENCES 1. https://www.emdocs.net/ecg-pointers-stemi-equivalents-from-the-american-college-of-cardiology/

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