Cypress Creek EMS Podcast

In this episode, Steven and Samuel sit down with Dr. Jason Ausman, the current EMS fellow, to discuss COVID-19. Topics covered include: What's changed with COVID-19, including the new UK and South African virus variants. Long term effects of COVID-19. How we can reduce the spread of this disease. COVID-19 vaccinations. Resources mentioned in this episode: New England Journal of Medicine COVID-19 Vaccine FAQs: https://www.nejm.org/covid-vaccine/faq Inside the B.1.1.7 Coranavirus Variant https://www.nytimes.com/interactive/2021/health/coronavirus-mutations-B117-variant.html

Death and Dying Part 1 A topic that is not often discussed, death and dying are an inherent reality for the EMS provider. This conversation between Lynne, Samuel and Steven addresses how to deal with grief. There's a huge expectation that first responders should intrinsically understand how to move through the sadness and difficulty of losing a patient, whatever that may look like. This podcast looks at the stages of grief and how they relate to first responders; it is important to be healthy in processing the death of patients, especially when it is traumatic or sudden. Our increased exposure to the end of life means that we should be aware of the emotions associated with it so that we can move through them and continue…the best job in the world. The Kubler-Ross Grief Model: https://www.psycom.net/depression.central.grief.html Acceptance in Grief https://jamanetwork.com/journals/jama/fullarticle/205661

These changes go into effect on July 4th, 2020 at 7am. In this episode, we are joined by our medical director, Dr. Levon Vartanian, along with our assistant medical director Dr. Ziherl and discuss protocols to reduce ED overcrowding during this pandemic. We talk about Paramedic Initiated Referral, COVID-19 Non-Transport, and transport to freestanding EDs. Download our protocol app or visit Creekshare.org to download copies of these protocols and the patient handout brochures that go along with them. ———————— General PIR: Purpose What kinds of patients can be referred Who cannot be Why a consult is required Prehospital discharge instructions COVID-19 non-transport Purpose Criteria Process Handout Scripting Recommendations for testing/treatment at home/etc. Freestanding ED What they are What they have What kinds of patients should go there What kinds of patients should not

Following the ESD 11 meeting on June 9th, ICPs Chris Conn and Megan Spearman sit down with UO Steven Beesley to articulate their thoughts. These field staff providers share their perspective about the latest development in the CCEMS/ESD relationship. This format is being tested for bringing information to the field staff…please let us know what you think! One note about recent "news"; be mindful that CCEMS is your best source of information. While you may find opinions and statements elsewhere online, sensationalism and propaganda is widespread. Please allow us the chance to provide information before spreading something that you "heard". We are so thankful for your loyalty to CCEMS and in turn, we are committed to keeping you informed. Stay tuned for a question and answer session with Wren Nealy releasing next week on the CCEMS podcast!

In this episode, we discuss airways with Dr. Rachel Ely, who is doing a rotation with CCEMS as an Assistant Medical Director as part of the military's EMS and Disaster Medicine Fellowship based at Brooke Army Medical Center in San Antonio. Dr. Ely has a background in EMS and actively worked as a paramedic for a few years before and during medical school. Passionate about all things "airway", Dr. Ely outlines some of her "must-dos" for a successful advanced airway while providing insight from her years of experience. Before the call: Visualization and mental rehearsal Physical rehearsal: have a plan, and a backup, and a backup, and practice all of them Location of equipment is key Airway preparation During the call: Pre-oxygenate early. Once you decide they need an advanced airway, give all the oxygen. Resuscitate before you intubate, Laryngoscope as a Murder Weapon (Scott Weingart) Hypotension O2/Hypoxemia pH/acidosis. The apneic period can be deadly in certain patients. Recognizing this is trickier in EMS because you don't have all the data (like blood gases). Fear this in the DKA patient, the septic shock patient, any metabolic acidosis Position the patient: it is worth your time to try do this right. The donut works, sometimes towels/pillows are needed, but just having a FF lift the head off of the floor will give you a 100% better view. Head off stretcher works for some, but may actually make things worse as the angle of oropharynx to glottis becomes more steep (glottis more anterior). Neck flexed, head extended gives optimal alignment

In this episode, Steven Beesley, Christy Stermer, Alex Moore, and Samuel Kordik sat down to discuss aerosol-generating procedures, PPE requirements, and how to find answers to your questions during COVID-19. If you have questions, needs, or just would like someone to talk to, here's a list you can start with. Everyone on here cares deeply about you and would be happy to help: Samuel Kordik Elizabeth Breaux Casey Pile Zach Dunlap Lynne Singleton Ryan Jones References: K., T., K., C., M., S., C., P.-S., & J., C. (2011). Aerosol generating procedures (AGP) and risk of transmission of acute respiratory diseases (ARD): A systematic review. BMC Proceedings. Heinzerling, A., Stuckey, M. J., Scheuer, T., Xu, K., Perkins, K. M., Resseger, H., Magill, S., Verani, J. R., Jain, S., Acosta, M., & Epson, E. (2020). Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient - Solano County, California, February 2020. MMWR. Morbidity and Mortality Weekly Report, 69(15), 472–476. https://doi.org/10.15585/mmwr.mm6915e5 Loeb, M., McGeer, A., Henry, B., Ofner, M., Rose, D., Hlywka, T., … Walter, S. D. (2004). SARS among Critical Care Nurses, Toronto. Emerging Infectious Diseases, 10(2), 251–255. https://doi.org/10.3201/eid1002.030838 Orman, R., & Weingart, S. (2020). COVID-19: Weingart Q & A on Airway, Vents, Tubes, Lungs, ECMO, and CPAP. Retrieved from https://ercast.libsyn.com/covid-19-weingart-q-a-on-airway-vents-tubes-lungs-ecmo-and-cpap Raboud, J., Shigayeva, A., McGeer, A., Bontovics, E., Chapman, M., Gravel, D., … Green, K. (2010). Risk factors for SARS transmission from patients requiring intubation: A multicentre investigation in Toronto, Canada. PLoS ONE, 5(5). https://doi.org/10.1371/journal.pone.0010717 Teleman, M. D., Boudville, I. C., Heng, B. H., Zhu, D., & Leo, Y. S. (2004). Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore. Epidemiology and Infection, 132(5), 797–803. https://doi.org/10.1017/S0950268804002766 Links to Help with mental stress https://pca.st/nini28vt The Boiling Point of Stress - Stimulus (FOAM education) https://medicmindset.com/2019/11/28/antifragile/ Antifragile - Medic Mindset https://www.artofmanliness.com/articles/beyond-sissy-resilience-on-becoming-antifragile/ Blog post explaining the antifragile concept. https://disasterassets.org/events/ Zoom meetings (Healthcare workers - free)

In this episode, we answer questions submitted from field staff. Discussion of PTO, assigned roles at Admin, self-monitoring, quarantine criteria and COVID-19 documentation are all addressed...and a few more. If you have questions for the administrative staff during the response to COVID-19, submit a question on creekshare.org. Stay safe!

In this podcast episode, we discuss why EMS in stressful times requires a focused response. EMS providers carry an additional burden during times of disaster (or pandemic) and are more likely to experience stress and burnout. What does that look like and how can we mitigate it? We talk about how to recognize that you are hitting a breaking point, what you can do, and what is beyond resilience: becoming antifragile. Emergency Responder Crisis Text Line (text BADGE to 741741, trained crisis counselors who can help, available 24/7) Disaster Response Assets Network (free Zoom meetings daily with other healthcare professionals and first responders) Heroes Helpline - 833-367-4689 (identify treatment options, referrals to in-person therapy or social services) Refuge PTSD Group "Converge" - Monday evenings 6-7pm (in-person in Conroe, TX) Resources: https://pca.st/nini28vt The Boiling Point of Stress - Stimulus (FOAM education) https://medicmindset.com/2019/11/28/antifragile/ Antifragile - Medic Mindset https://www.artofmanliness.com/articles/beyond-sissy-resilience-on-becoming-antifragile/ Blog post explaining the antifragile concept. https://disasterassets.org/events/ Zoom meetings (Healthcare workers - free)

SHOW NOTES There's a lot of confusion around how masks protect you from getting COVID-19, how the virus is transmitted, and what PPE to wear when. We break down transmission mechanisms and how masks and PPE work in this episode. Links: Twitter thread about SARS-CoV-2 Transmission They Say Coronavirus Isn't Airborne—but It's Definitely Borne by Air (Wired) Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19 (JAMA Insights) (great videos and photos of gas clouds from sneezes, breathing, coughs, etc) How Diseases and Epidemics Move Through a Breath of Air (TED talk) Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review Videos showing Droplet Spread using Glo-Germ

In this episode, we sit down with Dr. Rachel Ely, who is a United States Air Force Emergency Medicine physician. Dr. Ely is doing a rotation with CCEMS as an assistant medical director as part of the military's EMS and Disaster Medicine fellowship based at Brooke Army Medical Center in San Antonio. Dr. Ely became an EMT and then a paramedic before going on to medical school and residency. We discuss her background in EMS, why she went to medical school, what medical school and residency was like, as well as glean some valuable insights into critical thinking, "paramagic", airway management, and a few pearls on COVID-19.

In this episode, Steven Beesley, Brian Cooper and Caitlyn Stoner of Athlete Training and Health discuss what you can do at home to stay healthy during the COVID-19 Pandemic. ATH North Houston ATH Facebook ATH Twitter

In this episode, we continue our discussion about evaluating misinformation and specifically address how to evaluate medical claims. Along the way, we answer several frequently asked questions. Links mentioned in episode: Resources from the Prehospital Care Research Forum Demystifying EMS Research lecture slides Novel Coronavirus 2019 (COVID-19) on EM:RAP Corependium ASHP Assessment of Evidence for COVID-19-Related Treatments (positive and possibly harmful)

In this episode, Samuel Kordik, Zach Dunlap, Lynne Singleton, and Steven Beesley discuss some of the recent protocol changes at Cypress Creek EMS relating to clinical care for COVID-19 patients. Specific items discussed include: Why there is no "cookbook recipe" for treating these patients. How we should approach being clinicians and making good judgement calls during this crisis. The primary focus we have in treating these patients is protecting ourselves and our future patients and doing what's right for patients. How to manage respiratory distress patients without using nebulized medications or CPAP. How to approach pre-oxygenation and RSI. The revised cardiac arrest algorithm And much more! In this episode, we recommend being familiar with a wide range of inputs and approaches to treating these patients during this pandemic crisis. Some podcasts you should subscribe to include: MCHD Paramedic Podcast Austin-Travis County EMS OMD Podcast FOAMFrat Podcast ERCast podcast FlightBridgeEd podcasts Some exceptional reference resources: COVID-19 Chapter on the Internet Book of Critical Care (EMCrit) Novel Coronavirus 2019 chapter in CorePendium Emergency Medicine Textbook(EMRAP) CCEMS Protocols, Procedures, & Guidelines on creekshare.org

In this episode, Steven Beesley, Samuel Kordik and Lynne Singleton discuss how to spot misinformation on social media and online and how to get better information sources. How to evaluate claims you see online: SIFT Stop and don't accept or share the claim until you've validated it. Investigate the source Find better coverage Trace claims, quotes, and media to the original context How to get reliable information: Official sources: HC Public health, HC OEM, Texas DSHS, CDC, WHO Known, vetted sources on Twitter (infectious disease list!) Information from CCEMS Here Are Some of the Coronavirus Hoaxes That Spread In The First Few Weeks Sifting Through the Coronavirus Pandemic The Simplest Way to Spot Coronavirus Misinformation on Social Media Resources from the Prehospital Care Research Forum Demystifying EMS Research

In this episode, CCEMS Operations Manager Mike Brown, Samuel Kordik and Steven Beesley discuss how the COVID-19 pandemic is impacting operations at CCEMS. We discuss possible schedule changes, how normal operational needs are continuing, and other operations details.

In this episode, Bobby Sellers, Lorena Sadler, Steven Beesley, and Samuel Kordik discuss how this crisis is affecting Law Enforcement and how EMS can support Law Enforcement during this crisis. Bobby Sellers is the Special Operations Director at Cypress Creek EMS, where he leads the tactical medic program supporting local law enforcement agencies. Sellers is also a deputy with Montgomery County Precinct 3.

In this episode, Steven Beesley, Samuel Kordik, Brian Cooper, and Lorena Sadler sit down to discuss practical things we can be doing to handle stress and increase resiliency during the COVID-19 pandemic. Resources mentioned: Tania Glenn Deployment Brief (YouTube video) GOOD Jocko Willink (YouTube Video) Medic Mindset: Medic Mindfulness with Mike Taigman (podcast) Medic Mindset: Dr. Tania Glenn, Warrior Healer (podcast) Medic Mindset: Tania Glenn. Back Again. (podcast) Why We Sleep by Matthew Walker, Ph.D. In Defense of Food by Michael Pollan Into the Magic Shop by James R. Doty, M.D. CCEMS EAP Portal (confidential): https://www.mygroup.com/portal/employee/

Samuel Kordik discusses why the medical community as a whole is working so tirelessly through this epidemic.

We address a few of the questions from field staff. Let us know what you think and make sure to submit questions at creekshare.org 

In this episode, we sit down with Communications Center Director Niky Smith to discuss how Comm Center calltakers and dispatchers protect first responders through screening questions and tracking locations identified by Public Health and CCEMS as having potential COVID-19 infected patients. We also answer some questions submitted by you. As a reminder, go to creekshare.org to find past episodes and to submit questions for the podcast. The Story of a Coronavirus Infection

Episode Overview Review of COVID and SARS-CoV-2 including how it differs from the common cold and flu. Clinical characteristics Caution regarding treatments Background on testing Discussion on CCEMS specific responses. Question & Answers Links mentioned in this episode: NEJM paper “Clinical Characteristics of Coronavirus Disease 2019 in China” https://www.nejm.org/doi/full/10.1056/NEJMoa2002032?query=TOC “Everything You Need to Know About Coronavirus Testing” https://www.wired.com/story/everything-you-need-to-know-about-coronavirus-testing/ Two articles on why curing this virus is so hard and what treatments and vaccines look promising: https://www.vox.com/2020/3/11/21163262/is-there-a-cure-for-coronavirus https://www.statnews.com/2020/03/19/an-updated-guide-to-the-coronavirus-drugs-and-vaccines-in-development/ Use this link to ask questions that may be answered on our next podcast! https://bit.ly/2wooWLJ