In this thought-provoking episode of the FlightBridgeED Podcast: MDCAST, Dr. Mike Lauria is joined by Dr. Jeff Jarvis and Dr. Chris Stevens to tackle the critical and potentially controversial topic of airway management in hemodynamically unstable patients. The discussion dives into complex scenarios, decision-making challenges, and balancing the benefits of sedation with the risks of compromising a patient’s stability. From discussing medication-assisted intubation to exploring the concept of "crash airway" situations, the episode challenges conventional wisdom and encourages providers to think critically about their approach to airway management. This episode not only raises important questions but also provides valuable insights for both new and seasoned practitioners.

Some Takeaways to Listen For in this Episode:

• Balance Between Sedation and Hemodynamic Stability: It is important to understand how sedative agents like ketamine and etomidate affect blood pressure in critically ill patients. Over-sedation, especially in hemodynamically unstable patients, can lead to adverse outcomes. A nuanced approach to dosing is necessary.
• Awareness During Intubation: Awareness under paralysis can increase the risk of PTSD and depression. The conversation highlights the importance of avoiding awareness during airway management, especially using longer-lasting paralytics like rocuronium.
• Resuscitate Before Intubate: Emphasizes the need to stabilize patients, particularly their hemodynamics, before intubation. This can prevent worsening outcomes and cardiac arrest during emergency airway procedures.
• Decision-Making in Airway Management: Highlights that airway decisions are not black and white. Situational awareness, clinical judgment, and crew confidence are crucial, especially in determining whether to intubate pre-hospital or manage the airway in transit.
• Use of Supraglottic Airways: In emergencies where intubation is difficult or risky, supraglottic airways are recommended as a temporary measure to ensure oxygenation and ventilation until more definitive care is available.

In this engaging and insightful episode of the FlightBridgeED Podcast, Eric Bauer is joined by Dr. Michael Lauria as they delve into the intricacies of post-intubation care and the critical factors that impact patient outcomes during the first 10 minutes after intubation. Building on the well-established concepts of airway management and resuscitation, the discussion introduces the new acronym PHACTORS, which stands for Positive Pressure, Hypoxia, Acidemia, Cardiac Output, Transfer, Ongoing Pharmacology, Resuscitation, and Suction. Eric and Dr. Lauria explore how these elements play a pivotal role in the success or failure of post-intubation management, emphasizing the importance of maintaining vigilance during this critical phase. With practical tips, evidence-based insights, and real-world examples, this episode is a must-listen for anyone involved in pre-hospital critical care.

KEY TAKEAWAYS:

1. Prioritize Post-Intubation Monitoring: The first 10 minutes after intubation are critical. Continuously monitor for hypotension and hypoxia, even if the initial intubation appears successful.
2. Transition to Ventilator Early: Whenever possible, transition intubated patients from BVM to a mechanical ventilator as soon as possible to ensure consistent and controlled ventilation, which reduces the risk of over- or under-ventilation.
3. Use Head-Elevated Positioning: Intubate patients in a head-elevated position (30 degrees) whenever possible to maintain functional residual capacity and reduce the risk of derecruitment and hypoxia.
4. Suction Regularly: Proactively suction the ET tube and oral cavity to maintain airway patency. This helps prevent complications like ventilator-associated pneumonia and ensures optimal oxygenation.
5. Be Ready with Push-Dose Pressors: Have push-dose pressors ready during and after intubation, especially in trauma patients or those with borderline hemodynamics, to quickly address any sudden drops in blood pressure.
6. Assess and Manage Acidosis Individually: Not all acidosis requires aggressive ventilation. Consider the patient's overall condition, and tailor your ventilation strategy based on the specific type and cause of acidosis.
7. Regular Sedation and Analgesia Dosing: Avoid under-sedation, particularly with long-acting paralytics like rocuronium. Set regular intervals for administering sedation and analgesia to ensure patient comfort and avoid awareness of paralysis.
8. Proactively Manage Cardiac Output: In patients with compromised cardiac function, focus on optimizing preload, afterload, and contractility. Use fluids, inotropes, and vasopressors as needed to maintain stable hemodynamics.
9. Secure and Streamline Lines for Transport: Before transferring a patient, ensure all lines are secured and organized to prevent dislodgement or kinking during movement. Keep access points readily available for quick medication administration.
10. Understand the Impact of Positive Pressure: Transitioning from spontaneous breathing to mechanical ventilation can significantly impact venous return and cardiac output. Be prepared to manage these changes, especially in hemodynamically unstable patients.

Show Notes...

• A human, even when paying attention can deliver injurious tidal volume breaths that may go in "easy" but are probably injuring the lungs (Dafilou B, Schwester D, Ruhl N, Marques-Baptista A. It's in the bag: tidal volumes in adult and pediatric bag valve masks. West J Emerg Med. 2020;21(3):722–2021.)
• Not only are the volumes too big, but we likely WAY over breath for patients and that can be really, really bad especially after cardiac arrest or in TBI (common reasons patients get intubated...right?) (Dumont TM, Visioni AJ, Rughani AI, Tranmer BI, Crookes B. prehospital ventilation in severe traumatic brain injury increases in-hospital mortality. J Neurotrauma. 2010;27(7):1233–41.)
• More issues with BVM ventilation that shows it's not consistent
• Siegler J, Kroll M, Wojcik S, Moy HP. Can EMS providers provide appropriate tidal volumes in a simulated adult-sized patient with a pediatric-sized bag-valve-mask? Prehosp Emerg Care. 2017;21(1):74–8.
• Turki M, Young MP, Wagers SS, Bates JH. Peak pressures during manual ventilation. Respir Care. 2005;50(3):340–4.
• Kroll M, Das J, Siegler J. Can altering grip technique and bag size optimize volume delivered with bag-valve-mask by emergency medical service providers? Prehosp Emerg Care. 2019;23(2):210–4.
• Mechanical ventilation provides more consistency and automation of a simple task with monitoring parameters (alarms) that can make it safe and effective for paramedics to actually put their brain energy to important clinical decisions and complete other tasks (Weiss SJ, Ernst AA, Jones R, Ong M, Filbrun T, Augustin C, Barnum M, Nick TG. Automatic transport ventilator versus bag valve in the EMS setting: a prospective, randomized trial. South Med J. 2005;98(10):970–6.)
• Starting mechanical ventilation and safe ventilator settings in the prehospital setting seems to make ED providers more likley to put in the right settings and continue appropriate lung protective ventilation...at least in ARDS (Stephens RJ, Siegler JE, Fuller BM. Mechanical ventilation in the prehospital and emergency department environment. Respir Care. 2019;64 (5):595–603.)
• Here's a really solid position paper from NAEMSP on it that kind of summarizes everything including the specific clinical times when it may be more helpful like cardiac arrest, trauma, etc (Baez, A. A., Qasim, Z., Wilcox, S., Weir, W. B., Loeffler, P., Golden, B. M., … Levy, M. (2022). Prehospital Mechanical Ventilation: An NAEMSP Position Statement and Resource Document. Prehospital Emergency Care, 26(sup1), 88–95. https://doi.org/10.1080/10903127.2021.1994676)

In this episode of The FAST Archives, Ritu Sahni explores the essential topic of equity in emergency care. With a background that includes EMS Medical Director roles, emergency medicine, and air ambulance experience, Ritu provides a comprehensive look at what it means to care for entire communities.

In his talk, "Equity in Emergency Care: What Does That Even Mean?", Ritu unpacks the challenges of delivering equitable care in EMS and what it takes to make sure every individual gets the support they need. His insights, drawn from years of experience and his passion for public health, offer valuable guidance for EMS professionals committed to serving their communities.

Tune in to gain a deeper understanding of how we can achieve equity in emergency care and why it's so crucial in our roles as public health providers.

WOW! FAST19 was so amazing. So inspiring! If you missed FAST19.. Don't worry, FAST20 will be - May 18-20, 2020 in Murfreesboro, TN. This is the second of a few releases from FAST19. This was a moving talk by our own Daniel Mills from the 911 BuddyCheck Project. You don't want to miss this! Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this episode, we dive into the many emails I receive and attempt to answer hot-topic clinical questions. Join me in this dynamic episode as we discuss all things critical care. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this episode, we dive into another Nightmare Series Patient Case of the Undifferentiated Overdose. Join Ashley, Mike, and Eric during our recent visit to the National Teaching Institute Critical Care Nursing Conference. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

This is a plug and introduction to all the FBE listeners to our newest podcast. The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Mike Verkest and Dr. Jeff Jarvis as they shine the bright light of science on EMS practice in an informative and fun way as they look deep into the research on epi in cardiac arrest. Does it help? Are there better outcomes? How do patients do based on neurological outcomes? Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

WOW! FAST19 was so amazing. So inspiring! If you missed FAST19.. Don't worry, FAST20 will be - May 18-20, 2020 in Murfreesboro, TN. This is the first of a few releases from FAST19. This was a very popular talk by our own Bruce Hoffman as he perfectly goes through the case-based study called - RVAD vs. Air Embolus | A Lesson in CRM. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

FAST18 was Epic! If you missed FAST18... Don't worry, FAST19 is in three days - May 6-8, 2019 in Murfreesboro, TN. This is the fifth and final release of FAST18. Join the 2019 Keynote opening speaker, Ginger Locke for this thought-provoking talk - "When Things Get Wicked"! Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

We are back to the horrors associated with "The Nightmare Patient". The crew is tenuously attempting to rip the patient out of death’s mouth and bring him back from the roaring mouth of oblivion. Will the patient be saved? In this episode, we dive into the cardiac catastrophe. Take a journey as we discuss treatment pearls associated with atypical presentations, with a focus on Wellen's syndrome and papillary muscle rupture of the mitral valve and associated treatment PEARLS. Join me on the tough topic and take a journey with me as we explore our thinking methodology. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

The transition from a more rigid protocol into a more guideline-based thought process can be overwhelming. Many of us can be very black-and-white with our thinking. This can be dangerous! We all need to have the "Fifty Shades Of Gray" mindset. This podcast is meant to challenge the black-and-white thinking many of us struggle with. Join me on the tough topic and take a journey with me as we explore our thinking methodology. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this episode of The FlightBridgeED Podcast, Mike Verkest discusses the results of the Resuscitation Outcomes Consortium (ROC) TXA study in traumatic brain injuries. This was a double-blinded study that resulted from data derived from the Crash-2 and MATTERs studies on TXA in hemorrhage. Join Mike as he recaps the results. Hot off the press!! Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this episode, Eric is joined by Ashley Bauer as they look at the concept of the "Second Fracture". We can oftentimes become hyper-focused on a specific complaint, to then completely miss the true problem. Join us as we explore three different cases that highlight this concept. Don't miss this important lesson in medicine... The Second Fracture! Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this deeply impactful episode of The FAST Archives, we focus on the tragic events of the Parkland school shooting on February 14, 2018, through the lens of Peter Antevy, who served as the EMS Medical Director on the scene that day. With his vast expertise in pre-hospital pediatrics and emergency medicine, Peter offers a detailed and respectful reflection on that tragic day, shedding light on what unfolded, what could have been improved, and the critical importance of being prepared for such events.

The talk also pays tribute to the efforts of Max Schachter, whose son Alex was among the victims. Max has since dedicated himself to preventing future tragedies, and Peter highlights his efforts to make a difference in school safety.

In the show notes, you'll find resources mentioned in the talk and additional materials that have been provided to support responders and communities in preparing for and preventing similar tragedies.

We present this episode in memory of the 17 lives lost and in support of the families and communities affected by the Parkland shooting.

Show notes:
Safe Schools for Alex: https://www.safeschoolsforalex.org/
The Panic App/Rave Mobile Safety: https://www.ravemobilesafety.com/
Pulsara Wristbands: https://www.pulsara.com/why-wristbands/
"We all need to learn 'Stop the Bleed'" Article: https://www.ems1.com/mass-casualty-incidents-mci/articles/fla-medical-director-on-60-minutes-we-all-need-to-learn-stop-the-bleed-bLUgR7O0Lxa9J14S/

Life is like A Rollercoaster
A poem by Alex Schachter

Life is like a roller coaster
It has some ups and downs
Sometimes you can take it slow or very fast
It maybe hard to breath at times
But you have to push yourself and keep going
Your bar is your safety
It’s like your family and friends
You hold on tight and you don’t let go
But sometimes you might throw your hands up
Because your friends and family will always be with you
Just like that bar keeping you safe at all times
It maybe too much for you at times: the twists, the turns, the upside downs
But you get back up
You keep chugging along
Eventually it comes to a stop
You won’t know when or how
But you will know that’ll be time to get off and start anew
Life is like a roller coaster

In this episode of The FlightBridgeED Podcast, Eric breaks down atelectasis and physiologic shunting seen in the standard hypoxic patient. It is essential to understand the physiology and pathophysiology of these difficult patients. Join him in part 1 of 2 of this podcast series. Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this episode of The FlightBridgeED Podcast, Eric is joined by Mike Verkest to review the top 5 most downloaded podcasts from 2018. It was an incredible year, and 2019 is shining just as bright! Download, rate, and review wherever you get your podcasts. The FBE family of podcasts is now available on TuneIn! Get the app now and listen to your favorite podcast and more! Remember that reviews are key to helping keep us high on the charts where your friends and family can find us. We couldn’t make this podcast without you. Thanks for listening!

Diabetic ketoacidosis patients can be very sick and challenging. There are multiple diagnostic indicators used in diagnosing and treating DKA patients. One standard test used is the urine and/or serum ketone test. This can be inaccurate and does not always give the provider the true story when evaluating an improving or declining clinical picture. However, the earliest ketone body formed during fatty acid breakdown is beta-hydroxybutyrate. This isn't a new lab, but a lab that has become more available in the emergency department. Join me for this quick podcast on this great tool assisting in the overall diagnosis of the diabetic ketoacidosis patient. You don't want to miss this one! Last, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

Mechanical ventilation in the pediatric population brings forth different areas of concern. Couple this with an already stressful patient population and these types of calls can be highly stressful. Join us in part 2 of 2 as Tyler Christifulli hosts w/ guest Bryan Winchell, as they discuss the "Silent Killers related to pediatric mechanical ventilation, with an application to the Hamilton T1 ventilator. You don't want to miss this one! Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

Mechanical ventilation in the pediatric population brings forth different areas of concern. Couple this with an already stressful patient population and these types of calls can be highly stressful. Join us in the last podcast for 2018 where we dive into the "Silent Killer" in Pediatric mechanical ventilation. This will be part 1 of 2 podcasts on this highly requested topic. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

Join us at AMTC 2018 for a discussion that has been a hot topic around the United States for the past few years. Dr. Mike Hudson, medical director for Classic Air Medical in Utah, joins us. He is one of just a few medical directors in the United States taking a stance on this hot topic. Are we close to following in the footsteps of our brothers across the pond? Join us to find out more about "Soft Vs. Hard is the Question?" Lastly, we couldn’t make this podcast without you. Please rate and review wherever you download the podcast. Thanks for listening!

Using push dose pressors has become common practice in pre-hospital and critical care environments. We have seen many companies adopt protocols that guide the use of medications such as Epinephrine and Phenylephrine as the go-to medications in the setting of Rapid Sequence Intubation, with associated hemodynamic compromise. However, are these the best medications? We know that both Epinephrine and Phenylephrine come with many potential side effects. Is there a better option? Join us to find out more about "The New KID On The Block." Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

This is our second in a series of two unique podcasts that takes a look at the road to becoming a Flight Nurse. I'm joined with Kelly Miller, Regional Clinical Manager for the Midwest Region of Air Methods Corporation. We have received numerous podcast requests on the topic of: "What is the best way to achieve the position of "Flight Nurse". Kelly comes with a diverse experience level as a nurse in the ED, ICU and flight nurse in the HEMS industry, with his current role as a Regional Clinical Manager. Take a journey with us as we dive into the best way to obtain a flight position and be prepared for these challenging clinical positions. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

We have all sat back and thought about the worst scenarios possible. We train on different patient presentations and take great care in understanding our job as a whole. But...Do we take the same time and preparation in our crew resource management skills? How would you respond in different flight-related emergencies with your patient, partner, pilot, or aircraft? Sit back and get ready for the Nightmare Scenario - Managing The Unimaginable. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

What is the best tool we have? It is easy to get excited about intubation, chest tubes, or even surgical airways. What saves lives? What tool out of all our procedures and equipment is the best? In the episode, we discuss how to have optimal performance and ways to build on this amazing tool! We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

In this episode of The FAST Archives, William Heuser brings his extensive experience as a clinical critical care pharmacist, clinical toxicologist, and certified Flight Paramedic to demystify the controversial world of resuscitative medicine. In his dynamic talk, "Do Any of These Medications Work in Cardiac Arrest? Demystifying the Controversies!", Will examines the debate surrounding the administration of certain medications during cardiac arrest.

He discusses how these medications impact patient outcomes during resuscitation and offers a clear, evidence-based analysis of their risks and benefits. William’s unique blend of humor, energy, and knowledge makes this talk as entertaining as it is informative. Tune in to gain valuable insights into the evolving field of resuscitative medicine and explore the complexities of pharmacological interventions during cardiac arrest.

Don't forget to check out the other podcasts in the FAST Archives miniseries and join us at FAST24 for more talks like this one, including a brand-new one from Will! We hope to see you there! Enjoy the episode.

Join us for a special "hijacked episode" of the podcast. This is a much-needed topic of conversation. The "OODA Loop" process has been discussed in-depth concerning cognitive and performance psychology. However, we often find ourselves task-saturated, tunnel-visioned and stuck in a faulty loop of repetitive error. In the episode, we discuss five tips to train and prepare for optimal performance, troubleshooting, and the mental reset. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

If you didn't listen to the recent podcast put out by Tyler Christifulli and FOAMfrat called "Trigger Happy Transfusion Confusion" please download and listen via the FOAMfrat podcast feed. Tyler does a great job and provides out-of-the-box thinking on the hot topic of PRBC administration in the transport environment. This "Response" podcast is based on my commentary, overall thoughts on the topic, additional topic points to consider, and an overall review of the data related to PRBCs, FFP, and the recently published PAMPer trial. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

From the authors of David Olvera, FP-C, and Daniel Davis M.D. The abstract introduction: Rapid sequence intubation (RSI) is associated with several complications that can increase morbidity and mortality. Among RSI agents used to blunt awareness of the procedure and produce amnesia, ketamine is unique in its classification as a dissociative agent rather than a CNS depressant. Thus, ketamine should have a lower risk of peri-RSI hypotension due to the minimal sympatholysis as compared to other agents. The main goal of this analysis was to explore the incidence of hypotension and/or cardiopulmonary arrest in patients receiving ketamine versus other agents during RSI. We hypothesized that ketamine would be associated with a lower risk of hemodynamic complications, particularly after adjusting for co-variables reflecting patient acuity. In addition, we anticipated that an increased prevalence of ketamine use would be associated with a decreasing incidence of peri-RSI hypotension and/or arrest. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

FAST18 was Epic! If you missed FAST18... Don't worry, FAST19 is right around the corner - May 6-8, 2019 in Murfreesboro, TN. This is the fourth release of many FAST18 Rewinds that will be released throughout the next year, leading up to FAST19. This talk is a groundbreaking look into our mental ability to be ready for duty. This was one of my favorite talks and something everyone must hear! I promise you this will knock you down and pick you back up! Join James Boomhower a Flight Paramedic from Boston MedFlight with his talk "Fit For Duty"! We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

In this episode, Eric responds to the latest podcast by FOAMfrat and Tyler Christifulli, titled "Response Required"! This is a must-listen and a full Re..butt..AL based on the podcast we published a few weeks back called: "The 5 Hottest Questions In Mechanical Ventilation w/ Mike Herman". Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

In this episode, Eric discusses the continuing controversy surrounding the use of Ketamine in the TBI patient. Does Ketamine cause an increase in ICP after administration? Join us for a look at the available literature and review this controversial topic. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

In this episode, Eric is joined by his buddy Mike Herman for a down-and-dirty question-and-answer blitz on mechanical ventilation. We dive into the hottest subjects in mechanical ventilation, where I attempt to answer five questions that are common in pre-hospital critical care. You don't want to miss this episode!! Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

Download Advanced reperfusion strategies for patients with out-ofhospital cardiac arrest and refractory ventricular fibrillation
(ARREST): a phase 2, single centre, open-label, randomised controlled trial paper

Download The Minnesota mobile extracorporeal cardiopulmonary resuscitation consortium for treatment of out-of-hospital refractory ventricular fibrillation: Program description, performance, and outcomes

FAST18 was Epic! If you missed FAST18... Don't worry, FAST19 has been planned and booked for May 6-8, 2019 in Murfreesboro, TN. This is the third of many FAST18 Rewinds that will be released throughout the next year, leading up to FAST19. Don't miss this talk on the critical thinking involved in Traumatic Arrest. Join Sam Ireland from our FOAMfrat brothers and sista! Sam is a phenomenal speaker and will make you think differently about the Traumatic Arrest patient. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

High-dose nitro has become a hot topic as of late. In the podcast, I'm joined by Chris Meeks, a Flight Paramedic and the host of the Mind Body Medic Podcast.  Chris and I sit down and discuss the physiology of left systolic and diastolic ventricular failure and how to approach a patient who is in severe overload due to high systemic vascular resistance.  The newest literature is guiding high push dose nitro, with doses of 1-3mg IV push given every couple minutes. Join us for the discussion, and look into physiology and application in the pre-hospital ground and helicopter environments. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

This is a unique podcast that takes a look at the road to becoming a Flight Paramedic. I'm joined by the original co-founder of FlightBridgeED-Evan Claunch. We have received numerous podcast requests on the topic of: "What is the best way to achieve the position of Flight Paramedic". What better way to honor Evan as he moves into a new career and leaves the HEMS industry behind than to have this discussion with him? Evan and I discuss the best ways to achieve these tough-to-find positions. Take a journey with us as we dive into the best way to obtain a flight position and be prepared for these challenging clinical positions. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

Welcome back to The FAST Archives! In this episode, Ashley Liebig delivers a compelling talk, "Teaching, Trusting, and Teen Driving," where she explores the nuanced realities of learning, teaching, and belonging. Through her insights into psychological safety, cognitive learning theory, and feedback culture, Ashley opens up how the intricacies of how humans learn and interact... both the good stuff and the things we don't always have a great track record with as an industry. Maslow's hierarchy of needs emphasizes that our basic requirements must be met before we can focus on growth and learning. So grab yourself a snack and tune in to gain valuable knowledge from Ashley’s expertise, as she provides actionable advice that can enhance your approach to education and personal growth.

Hot Off the Press! In this podcast, we dive into the 2018 Surviving Sepsis Update and look at the new recommendations, evaluate the evidence, and take a look at how this does or does not fit with other high-level evidence. We dive into the fluid debate, with a focus on Normal Saline vs. Lactated Ringers, whether 30mL/kg is based on the best evidence, whether fluid should be given based on true body weight or ideal body weight, and lastly, the hot topic of EtCO2 guided fluid resuscitation when coupled with passive leg raising. This is always a hot topic! Take a journey with me on this often disagreed subject! Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

We are back to the horrors associated with "The Nightmare Patient". The flight crew is tenuously attempting to rip the patient out of death’s mouth and bring him back from the roaring mouth of oblivion. Will she be saved? How will her care be rendered? In this episode, Bruce Hoffman joins Eric for a look at the complexities associated with Tylenol toxicity. We look specifically at the physiology, associated labs, the four phases of toxicity, and associated treatment PEARLS. Don't miss this podcast. This is a highly tested subject on all advanced certification exams and can be a difficult patient to manage in general. Lastly, we couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

FAST18 was Epic! If you missed FAST18... Don't worry, FAST19 has been planned and booked for May 6-8, 2019 in Murfreesboro, TN. This is the second of many FAST18 Rewinds that will be released throughout the next year, leading up to FAST19. This talk is a groundbreaking look into pediatric resuscitation by a true visionary. Join Dr. Peter Antevy with his talk "A Paradigm Shift In Pediatrics. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

This podcast is going to dive into the topic of TIME CONSTANT. Have you ever wondered how we truly determine the exhalation time for our ventilator patients? Time Constant is the concept that guides our care and determines the time needed for proper alveolar filling or emptying. We couple this podcast with a downloadable worksheet for practice that can be found in the show notes on the FlightBridgeED website under this podcast. The worksheet gives calculation examples, practice questions, and answers to check your work. I promise this podcast will challenge you, bring insight into problems you've encountered in the transport environment, and ultimately give you new tools that will make you better as a clinician. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

This podcast is going to dive into the hot topic of ARDS or lack thereof. I’ve been so excited to review this article and was blown away by its depth and science-based discussion. In this amazing article by Pulmcrit and Josh Farkas, the topic of ARDS is examined with a focus on the Berlin Definition of ARDS, pathophysiology, iatrogenic injury, and the new theory called “pseudoARDS”. In this episode, we explore the old thought process in ARDS, with a focus on diagnosis, physiology, theory, and overall treatment approach. We then examine the science and take a look at the newer thoughts on “pseudoARDS”. We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks for listening!

FAST18 was Epic! If you missed FAST18... Don't worry, FAST19 has been planned and booked for May 6-8, 2019 in Murfreesboro, TN. This is the first of many FAST18 Rewinds that will be released throughout the next year, leading up to FAST19. This talk is my keynote talk that ended day 1. Join me in reflection and listen to "My Worst Day!"

In this episode of The FlightBridgeED Podcast, Eric invites Dr. Bryan C. Morse to discuss REBOA. REBOA is a minimally invasive procedure in which a balloon is inserted into the aorta to control bleeding. This buys time for the patient to receive the surgical care that they require and saves their life. Join us for this episode and share it with your colleagues! We couldn’t make this podcast without you. Please rate, and review wherever you download the podcast. Thanks so much for listening!

In this episode of The FlightBridgeED Podcast, we take a look at CVP and what it means to modern critical care practice. There are a lot of misconceptions about the correct ranges, what it tells us, and so much more. You won’t want to miss this incredibly informative podcast to get you on the road from Zero to Flow! If you love The FlightBridgeED Podcast, rate, and review wherever you get your podcasts. Thanks for listening!

FAST18 is almost here, and we couldn’t be more excited! As the clock counts down until the doors open, we are beginning to get a clear understanding of what an incredible gathering of brilliant educators and speakers is going to be in the same building at the same time. With that in mind, Eric has invited Ashley Liebig onto the show for a quick chat about what everyone can expect! If you haven’t made up your mind about attending, you still have a short window to purchase your tickets. This could be your chance to breathe new life into your career, or keep the fire burning! Hop in on this conversation and tap into the buzz surrounding this event! FlightBridgeED is dedicated to our community of friends and family from around the world! This is your chance to get connected, earn some continuing education hours, and learn from some of the most talented educators in the FOAMed community! Thanks for listening!

In this episode of The FlightBridgeED Podcast, Eric is joined by a curio collection of some of the most brilliant minds in the pre-hospital critical care industry to review the top 5 most downloaded podcasts from 2017. It was an incredible year and 2018 is shining just as bright! Download, rate, and review wherever you get your podcasts. The FBE family of podcasts is now available on TuneIn! Get the app now and listen to your favorite podcast and more! Remember that reviews are key to help keep us high on the charts where your friends, and family can find us. We couldn’t make this podcast without you. Thanks for listening!

In this compelling episode of the FlightBridgeED podcast, recorded at CCTMC24, we dive deep with Kevin Collopy, a distinguished figure in trauma care and awarded Best Research for his poster during the conference's Scientific Assembly. Kevin shares his groundbreaking work with just-in-time prehospital trauma training in Ukraine, a project that has garnered significant attention for its impact and innovation.

Amidst the backdrop of conflict, Kevin, along with a dedicated team of providers and organizations, developed and delivered seven different trauma courses, (including Pre-Hospital Trauma Fundamentals, which he and his team created specifically for this area of need) tailored for Ukrainian communities. These courses aim to mitigate civilian casualties and enhance patient outcomes amid wartime conditions especially when there are a limited number of responders and providers available and civilians are helping other civilians. Throughout the podcast, Kevin unpacks the process of creating these programs, their execution, and the potential future of just-in-time training in other conflict and disaster zones.

Kevin and host, Eric Bauer, also delve into a critical discussion on the undervalued importance of basic trauma skills (such as splinting, tourniquet and wound packing) which, as Kevin's research shows, play a vital role in managing war and disaster scenarios and are often overshadowed by more advanced skills. Tune in to this enlightening episode to understand the pivotal shifts in trauma training and how these lessons from the front lines can reshape our approach to emergency preparedness and response.

In this episode of The FlightBridgeED Podcast, Eric takes a few minutes to delve into an intriguing aspect of the paralytics we carry out on every flight. As the old quote goes, everything is a poison in the right amount, it is perhaps worth applying this, in a manner of speaking, to the pharmacokinetics of the paralytics we give our patients. Are some of these medications doing more harm than we realize? What are the potential problems with the tried-and-true medications we are comfortable with, and that have a long history with providers? Learn how you can bring the cutting edge of medicine to your paralytic toolbox in this episode! Download, rate, and review wherever you get your podcasts. The FBE family of podcasts is now available on TuneIn! Get the app now and listen to your favorite podcast and more! Remember that reviews are key to help keep us high on the charts where your friends, and family can find us. We couldn’t make this podcast without you. Thanks for listening!

Have you ever wondered what happens to that medicine you so easily flush down the IV line of your patient, or in that capsule your patient swallows? We so often take for granted that an incredibly complex, and amazing chain of processes must take place to move the medicine we give to the exact spot where it’s needed. Join Eric Bauer as he peels back the mysterious layers of medication absorption and distribution. As always, this really difficult subject gets broken down into easily understood analogies, and concepts that build knowledge on top of knowledge. The best part… it’s all free! Download, subscribe, rate, and review wherever you get your podcast from. Did you learn a lot from this podcast? Help us keep this podcast, and more high on the charts so your friends and colleagues can find us easily! Give us a quick review and let the world know how much you like our stuff! Thanks for listening!

In this episode of The FlightBridgED Podcast, Eric and Dave Olvera carve out some time while they are on the road to talk about airway management preparation strategies. Dave has invested many years of his professional career investigating, and researching, among other important projects, how to best optimize intubation success. For as long as I can remember, we have used difficult airway predictors in our field practice, such as LEMON(S), to help prepare for eventualities when placing an endotracheal tube. Dave and his colleagues have determined that those predictors are great, but may not be as applicable to field intubations. With mountains of research at hand the HEAVEN criteria was created, along with best-practice strategies for increasing intubation success in an ever-changing environment. Join us for this episode as Eric and Dave discuss HEAVEN criteria and more! Download, rate, and review wherever you get your podcast. Each review is so important to our success. Your reviews on iTunes, Google Play Music, Stitcher, or other platforms help to make us a recommended podcast so we are more visible, and easily discovered. If you believe in the value of what FlightBridgeED brings in this podcast, please take a few minutes and write a short review. We couldn’t make this podcast without you!