FlightCrit Podcast

In this episode, we chat with Melissa Verseman of Beyond The BVM about the current overwhelming state of pediatric respiratory illnesses in Colorado, and Nationwide, and the proper approach to managing pediatric patients with critical RSV and Bronchiolitis.Melissa shares with us her Pearls of managing the patient with RSV:Nasotracheal SuctioningFluid Boluses (20ml/kg x 3)Utilization of Positive End Expiratory Pressure (PEEP) to stint open airways.Maximum flow of High Flow Nasal Cannula / Nasal CPAP should be 1liter/kg or 10 liters per min before escalating care to mask BiPapConsider your pediatric assessment triangle and be quick to recognize a patient who's in cardiorespiratory shock.Links mentioned in this podcastPeds SCUBA Mask - Full Face Pediatric BPap MaskPediatric Assessment TriangleMelissa can be contacted at www.beyondthebvm.com.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the podcast, we sit down with Dr. Zack Shinar of the EDECMO Podcast, and co-author of "ECPR AND Resuscitative ECMO," the world's first ECMO CPR textbook.Dr. Shinar is a world-renowned expert on ECPR and resuscitative ECMO, and he was gracious enough to share a bit of his time with the FlightCrit community.In this episode Dr. Shinar shares with us:The history of ECPR including results from some of the very first casesHow ECPR is changing the culture of cardiac arrest resuscitation worldwideWhat EMS, and Critical Care Transport Teams, can do to help optimize the delivery of ECPR therapy to eligible patients.and how ECMO therapy can be applied in other peri-arrest settings.Links discussed in this podcast:www.edecmo.orgReanimate ConferenceARREST Trial ECPR AND Resuscitative ECMO textbookSupport the showMedic and RN CE's available over at academy.flightcrit.com

In this episode, we're joined by Dr. Haney Mallemat from @critcarenow to discuss the patient with a massive pulmonary embolism and how we need to manage these patients in the acute phase to keep them alive until we can get them to definitive care.Below are several resources Dr. Mallemat referenced in our talk, as well as links to Critical Care Now and the ResusX conference.Please do us a favor and check out Dr. Mallemat's site.  You'll be happy you did.Critical Care Now - https://criticalcarenow.com/ResusX Conference - https://www.resusx.com/PEAPETT Trial - https://pubmed.ncbi.nlm.nih.gov/27422214/RebelEM Post about PEAPETT - https://rebelem.com/peapett-trial-half-dose-tpa-pea-due-massive-pulmonary-embolism/PERT Teams - https://pertconsortium.org/about/PERT Teams - https://onlinelibrary.wiley.com/doi/10.1002/rth2.12216Nebulized Nitro from PulmCrit - https://emcrit.org/pulmcrit/ntg/Nebulized nitro from the American Academy of Emergency Physicians - https://www.aaem.org/UserFiles/file/CS21_MarAprCCMS.pdf Nebulized Nitro - https://rc.rcjournal.com/content/57/3/444Support the show

Join us for an exciting talk with our friend and colleague Ami Bess, Chief Flight Nurse for UCHealth LifeLine about one of the most unnerving topics in Adult Critical Care Transport - Management of the HROB patient with severe Antepartum & Postpartum Hemorrhage.Topics discussed in this episode includeAssessment of the patient with severe Antepartum and Postpartum HemorrhageCause of APH and PPHManagement of APH and PPH includingMedicationsBlood ProductsMechanical Tamponade devices including the Bakri Balloon and Jada Systemand Surgical ProceduresIn this podcast, Ami makes reference to the WOMEN Trial, a trial looking at the use of TXA in pregnant women.  You can find that trial here.  WOMAN Trial - LancetAmi can be contacted by email at flightrnami@gmail.comSupport the show

In this episode of the podcast, we discuss some new ideas about the use of TXA as well as provide some new insight into the use of Whole Blood Resuscitation.Links to articles mentioned in the podcast coming.Support the show

In this episode of the podcast Hunter and I sit down with Joe again to discuss the role of optimizing Flow in our mechanically ventilated patients, and how to manipulate this on our vents.We also discuss some of the risks associated with certain vent modes for patients who Flow Hunger and one strategy for correcting ventilator asynchrony.We highly recommend you check out the video that accompanies this podcast over in the FlightCrit Academy.Support the show

In this week's class, we talk with Dr. Jeremy Kaswer, better known as @TacTraumaMD, about his approach to the initial stabilization of the poly-trauma patient.From Assessment to Chest Tubes, Shock Index to REBOA, Dr. Kaswer shares his experience as an ED physician, Army Flight Surgeon, and Critical Care Fellow at SHOCK Trauma with our community.And be sure to stick around to the end when Dr. Kaswer's drops a BOMB on us about obstructive physiology in the trauma patient and why he believes more prehospital providers should be using POCUS in the field.

In this episode of the FlightCrit Podcast Hunter discusses Adrenal Emergencies.

In this episode of the FlightCrit Podcast Hunter introduces the fundamental concepts of interpreting a chest x-ray, an essential skill for all critical care and transport providers to master.This episode relies heavily on the visuals to support the concepts presented, so we recommend watching the video of this presentation over at academy.flightcrit.com where you can join for free and then watch the video in its entirety.

In this episode of the FlightCrit Podcast we chat with Dr. David Convissar, Critical Care and Cardiothoracic Anesthesiologist, from "Count Backwards from 10" about his approach to managing the airway of the crashing heart failure patient.  Hang on as Dr. Convissar shares with us his knowledge about:Differentiate between cardiogenic shock and distributive shock based on assessment findings.Describe Pulse Pressure and explain how it can be used to assess a patient in cardiogenic shock.Provide appropriate preintubation resuscitation to a patient in cardiogenic shock.Explain why Sodium Bicarb and Calcium can be beneficial preintubation medications for the patient in cardiogenic shock.Recognize the physiologic effects of hypoxia during intubation on the lungs and describe how this can complicate the hemodynamics of patients with heart failure.@countbackwardsfrom10@flightcrit

Mechanical Ventilators, such as the Hamilton T1, ReVel, and ZOLL Z-Vent, are not only vital pieces of equipment used in the ICU and in Critical Care Transport, but they are becoming more popular for use by EMS services for interfacility transport so it's vitally important that EMS and Critical Care providers have a deep understanding of not only how these devices work, but also how different disease processes changes the way our patient interacts with the ventilator.And who better to learn from than a Respiratory Therapist.In this episode, we have the pleasure of chatting with Joe Lewis, better known as the Respiratory Coach, as he schools us on Dynamic and Static Compliance, how we can use our PIPs and Plateau Pressures to identify changes in both, and how we can optimize PEEP by looking at changes in Static Compliance.  We also go off the deep end discussing Driving Pressure and how this just may be the future of mechanical ventilation.Check out the video that goes along with this episode over at academy.flightcrit.com.Have an idea for a future episode?  Send us a message at www.askflightcrit.com. If we include your question in a future episode we'll send you a T-shirt.

In this episode of the podcast, I'm joined by my co-host Huster as we discuss the physiology of Oxygenation, Ventilation, and Driving Pressures as they related to the Mechanically Ventilated patient.https://academy.flightcrit.com/courses/oxygenation-ventilation-and-driving-pressure

EVDs, External Ventricular Drains.  What are they, how are they managed, and what should we know about them if we happen to see one in transport.

For year EMS providers have relied on certain clinical signs and symptoms to predict clinically unstable trauma patients and the need for emergent transport for definitive surgical care. Commonly EMS providers have used HR>120, systolic BP

There’s a severe lack of evidence about how to best utilize the drug Ketamine in the out of hospital environment. Any “research” that’s done comes from either the OR, ICU, or if we’re lucky the ED. We’re forced to extrapolate from those studies what we can about how to best apply their findings to the out of hospital environment.

This week on the podcast we're reviewing a lesson from the Burn Section of the EPICC Review Course concerning fluid resuscitation.  Listen in as I discuss the most current recommendations from the American Burn Association on the Prehospital and Early Hospital management of IV fluids in the burn patient.  I also give you 1 easy tip to simplify the ABA's recommendation even further, as well as review what you need to know about determining Total Body Surface Area burned and Fluid Resuscitation for the FP-C, CCP-C, and CFRN exam.

Spend any amount of time working in the air medical environment and you'll absolutely hear people talk about the gas laws.  In this episode, I discuss what I believe to be the 5 essential gas laws any air medical professional must understand to work in this industry. Listen in as we discuss Boyle's Law, Dalton's Law, Charles Law, Henry's Law and Fick's Law.

There are 8 different stressors of flight that you as a Flight Paramedic or Flight Nurse must be familiar with.  In this episode of the podcast, I discuss the most important of these flight stressors: hypoxia. I discuss the 4 different types of hypoxia and the most common causes of each.  I also share with you the three guidelines that regulate when we, as air medical professionals, must utilize oxygen ourselves during transport.

Being thrust into a survival situation as a result of an accident or unplanned event while on duty can be unnerving, to say the least. But being both mentally and physically prepared for the unexpected can go along way towards making sure we make it home. In this, the third episode in my series 52 weeks of EPICC I'm sharing with you some of the most important lessons on Survival from the EPICC Review Course. It is my belief that with the proper mindset, a little planning, and a few pieces of equipment, we can drastically improve our chances of survival if the unthinkable happens.

How many have actually read through the CAMTS standards in preparation for the Flight Paramedic or Critical Care Paramedic exam? My guess is not many. This week, the second week of 52 weeks of EPICC, I dug deep into the newly released CAMTS 11th edition standards to find the good stuff. From Duty Shift Times and Crew Fatigue to Part 135 requirements to Ambulance Operations, this episode gives you the most important topics from each section of the CAMTS standards so you can feel confident you’re ready when you sit down for your exam.

I’m kicking off a series I’m calling 52 Weeks of EPICC to celebrate completing the EPICC Review Course and its pending approval by the International Board of Speciality Certifications. In this, the first of 52 episodes for 2019, I’m pulling directly from Section 1 of the EPICC Review Course where I discuss VFR and IFR flight rules, and Inadvertent Instrument Meteorological Conditions. I’ll be defining each for you, giving you some genearly parameters for what constitutes VFR and IFR, and discussing what makes IIMC so dangerous and how we as crew members can respond in the event of an IIMC situation to ensure the safety of the entire crew.

In this episode of the podcast, I answer a question from a listener who is a new flight nurse with a background in trauma who’s looking to improve her skills at reading 12-lead ECGs quickly while on a call. Listen in as I share my process for reading 12-lead ECGs and share some tips on how you can improve your skills no matter how long you've been working in the field. Show notes for this episode can be found over at www.flightcrit.com/podcast/006.

Prehospital Surgical Airways: The Truth Behind the Procedure. Very few paramedics have ever actually performed a surgical airway on a patient.  In the past 15 years, I've met only a handful of paramedics who have utilized this skill. In fact, I've met more providers that tell me stories about patients they should have cric'ed, but didn’t, because they were either uncomfortable with the procedure or they feared a backlash from their peers and managers. When we fail to perform a potentially life-saving intervention we’ve been trained to do (that is within our guidelines) it is imperative to ask why. In this episode, I briefly explore why I feel “fears of backlash” surround the surgical airway and share with you 5 lessons I learned from my first field cric. Show notes for this episode can be found over at www.flightcrit.com/podcast/005.

From surviving your orientation phase to making it through your first year on the job, these tips will make the process of becoming a flight paramedic a lot easier. So you’ve landed (pardon the pun) a new job as a Flight Paramedic or Critical Care Paramedic.  Now what?  In this episode, I share 10 Tips to guide you through your orientation phase and help you survive your first year on the job. These tips, along with the show notes over at FlightCrit.com/podcast/004, will go a long way towards smoothing out your transition from working in a 911 EMS system, ER, or ICU to working as a member of a Flight or Critical Care transport team.

In this episode I share 5 Tips to help you stand out from the other candidates and overcome interview anxiety as you pursue a job as a Flight or Critical Care Paramedic.

Looking to become a Flight Paramedic? Make sure you're taking the right steps to set yourself up for success. In this episode I share 5 Tips you need to know as you start to purse a job as a Flight Paramedic.  I give a few ideas for steps you can take early on in your career to make sure you're to best candidate for one of these coveted positions plus a few tips you should be taking in the immediate months before you start applying for jobs to make sure you give yourself the best chance at landing an interview and getting hired.

Welcome to the first episode of the FlightCrit Podcast.  In this episode, I share my reason for creating FlightCrit, and the FlightCrit Podcast, and explains a little bit about what you can expect in the coming episodes.