Free Radicals Paramedic Podcast

Aaron is joined by Dr Dani Hall, an paedatric emergency medicine consultant from Dublin, Ireland. She is also the executive director of the FOAM website "Don't Forget the Bubbles". This is an amazing resource for information on paedatric emergency medicine. We can't recommend it enough. Dani shares her insight and knowledge regarding paediatric trauma, and how we can become more confident and capable at managing these patients. You can check out "Don't Forget the Bubbles" at https://dontforgetthebubbles.com/

Scott is immensely proud of his service in the US Marine Corps.  We know that he misses it.  He talks about this thing that he misses, this thing that since leaving the military he has never been able to find.  So what was this thing?  It was collective purpose.  The idea that every member of the team, those to your left, to your right, the leaders, the followers, everyone was collectively focused on the mission.  The collective purpose existed because they believed that someday there would be a moment where all the training, all the focus, all the sacrifice would be the difference between failure and success.  Success in that moment, would be one of the greatest accomplishments of one's life. Scott send us a quote of that moment, described by a young marine during the Battle of Peleliu in 1944.  We had a chat about it all one day, and decided we would release our chat as a podcast. 

Tonight we sit down with Peter Drew, a Critical Care Paramedic and PHD candidate from Queensland. Peter shares with us his work on occupational violence and his recent paper on mitigation strategies and recommendations for future practice.  Are all violent incidents the same? Does the idea of  "zero tolerance" fit in with why and how these violent incidents occur? Is there a place for body worn cameras? Where do we sit now with the emergence of chemical sedation into our practice? Does organisational self defense training work? These are  just some of the ideas we explore.  If you would like to read more, you can access Peter's paper below.  "Paramedic occupational violence mitigation: a comprehensive systematic review of emergency service worker prevention strategies and experiences for use in prehospital care"  https://connect.jbiconnectplus.org/ViewSourceFile.aspx?0=19494

Today Nick sits down with Tori and Tammy, two communication officers from an Australian state service. We work with comms every day, we can't do our job without them, yet very few of us  really understand how they work.  Today we look at how call taking and dispatch works, how they deal with cognitive overload, and break down some common misconceptions. 

Aaron sits down with three fantastic academics to delve into the world of tertiary paramedic education.  Andy Bell, Georgina Sanger and Sandy Macquarrie work to design, deliver and develop university curriculum's within Australia.  How do we design a course when we are still searching for our identity? What would the ideal course look like? Why it's ok for students to fail. We would love to hear your thoughts on this topic. 

We had the privilege of sitting down with David Krygger, an extended care clinician from Queensland. David is passionate about this area of paramedic practice, and its potential for growth within our profession. We thoroughly enjoyed this conversation. 

Today the team take us through hyperkalemia, a tricky and potentially deadly electrolyte imbalance. From physiology to examination and treatment, we summaries the key points that will help you to better manage these patients in your future practice. 

Scott sits down with Ryan and Nicole Levinson all the way from the tiny island nation of French Polynesia.   Ryan has a rare form of muscular dystropy, but after 10 years as an EMT in California, Ryan and his wife Nicole chose to not let the diagnosis slow them down. Instead they began a new adventure sailing across the pacific.  Today's episode is all about overcoming life's challenges, choosing your attitude and not letting anything get in the way of your dreams.I can safely say, this is our best podcast yet. What a remarkable duo, Ryan you're our heroYou can check them out on their youtube channel, TwoAfloat. 

Aaron and Scott sit down with a very special guest, Sunny Whitfield. Sunny shows us how paramedicine can take you to places you never thought possible. From Nepal, to the south pacific and even Mars. Making a difference doesn't mean you have to work for an state ambulance service and that any idea can grow, as long as you have a pen and a napkin.  

Today's episode comes from our first education night in Ipswich. Nick sits down with Andy Bell to talk all things mentoring. We have all been mentored, will mentor at some stage in our career. How do we do this well? 

After 15 years working in Australia, Scott and his family recently took on the challenge of a career and life in Vanuatu. Today Scott shares with us his experiences of working in such a difference system and country.  If you have ever thought about taking your craft overseas, then this is the episode for you. 

Today we challenge your knowledge and understanding of tension pneumothorax.  Not only is tracheal deviation rubbish, but there are differences found between pneumothorax's created in spontaneous breathing patients and those being ventilated.  Understanding the difference in mechanics and their presentation is key to diagnosis. 

The abdomen can be intimidating, and assessing  it thoroughly can sometimes end up in the "too hard" basket.  But with almost 10% of abdominal complaints being life threatening, we want to get the assessment right.  Today we look at the abdominal assessment, red flags to watch out for, and talk about some of the less commonly known conditions you can look out for on your next case. 

Paramedics bodies face high demands from the job.  10-15% will suffer an injury at work that can affect our lives and career.  Strengthening our bodies not only prevents injury but reduces fatigue, helping us to make better decisions and live happier lives.  #hirewill 

Today the lads sit down to discuss sepsis in pediatric populations. How do we identify it? What are the red flags to watch out for? Why do we sometimes get it wrong?    

Today we are joined by Harriet Walker from Athletic Eating.  We sit down to discuss the obstacles and challenges paramedics face with nutrition and how it affects our performance and well being. We also look at some small steps that we can take to improve the way we eat at work. 

CPR induced consciousness is rare but can have a significant impact on how we deliver care.  CPR induced consciousness or CPRIC, is a phenomenon where by the CPR being performed is so effective, that it produces varying states of consciousness.  Your patient  is in VF arrest, but may be "politely" asking you to get off their chest Management is based on reducing awareness, recall and pain, as well as gaining control of the patient to facilitate resuscitation.  check out the link below for a great example of CRPRIC https://emupdates.com/cpric/ 

Today we are joined by special guest Rory Jackson. Rory is a senior critical care paramedic, and practicing midwife.  Rory takes us through his journey as well as some insights on how to improve our pre-hospital obstetric practice.  Music Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Not every paramedic works in the big city, with a partner and a mass of resources at their disposal.  Some work by themselves, with limited resources, and limited help.  Today we talk about remote paramedicine, its perks, its pitfalls and how to thrive. 

Today we look at how we go about clearing c-spine injuries in the pre-hospital setting.  The evidence behind NEXUS and how it stacks up again other tools.  Can we use these tools in the elderly? We would like to thank of our listeners Bruce for bringing this topic to our attention. 

Thanks to everyone who joined us for our live event.  Today's episode covers our first topic from the night.  There is no right or wrong answer to this question, but there is a lot to consider. 

We sat down with Jason and Aaron from the Pragmatic paramedic podcast and discuss the differences in education and certification between the US and Australia. 

Today the boys talk all things retrieval. The basics, the different modalities and those emerging, and how you can prepare your patient, your team and your environment for an incoming asset. 

What advice would you give to a new graduate, student or fresh paramedic? How do you stay current, motivated, compassionate and healthy? We asked that question on social media, today we discuss some of the amazing responses from our community.

We are back with clinical priorities.  This week we discuss some tips for approaching your toxicology patient as well as a health debate on the use of adrenaline in COPD. 

Paediatrics are not easy. They can't tell you whats wrong and we don't go to them that often.  A solid history and assessment will help us to identify the likely causes,  provide informed clinical advice and stop us from missing the subtle signs of serious disease.   Today we look at some pearls of assessment and what you can do to improve your practice. 

Today we are back with our second clinical priorities episode. The boys pick apart and discuss how they would approach cases involving significant burns and maternal trauma. 

This episode is the sequel to Episode 14 - Traumatic arrest, A paradigm shift. Last episode we looked at shifting our mindset to a pro-resuscitation model. Today, we look at how we go about that care. Pearls from experience, practical tips and a little bit of controversy. Music Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Today we sit down with Dr Stephen Rashford and talk about the Queensland Ambulance Service's clinical consultation line.  We are independent thinkers and clinicians. But sometimes cases fall outside our previous experience and knowledge. Consultation with others leads to  enhanced decision making, a collective approach and ultimately better patient care.  Remember, there is always time to call. 

Do we see code 1 transport to hospital as a clinical intervention? Like any intervention, there are potential risks and benefits. Is there a benefit in getting to hospital a few minutes faster when 19 million responses in the US have shown us that the risk is immense? Is it worth risking our own lives and that of the patient? Reference Watanabe et al. Is Use of Warning Lights and Sirens Associated With Increased Risk of Ambulance Crashes? A Contemporary Analysis Using National EMS Information System (NEMSIS) Data https://www.annemergmed.com/article/S0196-0644(18)31325-8/fulltext   Maguire et al. Occupational injury risk among Australian paramedics: an analysis of national data https://www.mja.com.au/journal/2014/200/8/occupational-injury-risk-among-australian-paramedics-analysis-national-data

Last week at the Australian Tactical Medical Conference, Nick caught up with Jeremy from TacMed Australia, to talk tips and tricks surrounding external limb and junctional haemorrhage control.  External haemorrhage is a PREVENTABLE cause of death in trauma. Simple measures can make a HUGE difference.  Basics will save lives.  Check out ATMA and TacMed below at https://www.atma.net.au/ https://tacmedaustralia.com.au/

Today we challenge the idea that working traumatic arrests is futile.  They are young, they are healthy and 5-7% will walk out of hospital neurologically intact.  Presenting ECG rhythm is not a good determinate of outcome. Outside of cranial destruction, hemicorporectomy and incineration, there are no good indicators of futility. So if in doubt, resuscitate these patients.

Today the boys interview Dr Minh Le Cong. Minh is a rural generalist with the Royal Flying Doctor's Service in Queensland, Australia, with a keen interest in all things pre-hospital. He is also the creator and host of the PHARM podcast, and blog  https://prehospitalmed.com/about/ Today we chat about the challenges of the pre-hospital environment, education, social media and what the future may hold. 

This week Scott interviews the team on their experiences with resilience and burnout.  Have we wanted to quit at times? Yes,  Have we ever been burnt out? Yes,  How were these experiences, how did we push on and how do we build resilience for the future.     

Episode 11 Recorded live from SMACC Sydney 2019, Today is summary of our leanings from the conference. Non haemorrhagic causes of shock in trauma and their red flags Bougie versus stylet for intubation Sepsis  The sick asthma patient and more!

The coronary reperfusion package is arguably the most influential clinical intervention on patient outcomes.  Today we look at this package, and how we go about delivering it well.   It comes down to three principles of excellence.  Accuracy, Efficiency, Safety.

Aaron takes us through a number of cases this week and asks "What are your clinical priorities?" Today is a more based on opinion and experience, which always makes for a good debate.  Topics include STEMI's, multi-system trauma, and sepsis.  Music by Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

This week is all about Followership. This is opposite of leadership but equally as important.  Today we touch on the different types of followers, and how this relates to the pre-hospital world. Music by Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Today is all about back pain. There are a fair few generic red flags for this complaint. **These are the big take home points!** Saddle Anesthesia Bowel or Urinary dysfunction or loss of control Lower limb weakness or neurology Vulnerable clients (immuno-compromised, cancer, steroid users, IVDU,  Music by  Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

This is the first installment in our series on clinical assessment. Red flags refer to signs and symptoms found in the patients history of examination which are clinical indicators of possible underlying serious disease. This week it is all about headaches. Aaron takes us through primary and secondary headaches, common features and of course the red flags.  Music by  Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

**Episode 5 : Deadly Diarrhea and Vomiting. ** Its not what you think, today we talk about cognitive bias and how it can affect our practice. We relate this back to a case of deadly D's and V's where bias played a role. Here is a great link on cognitive bias in medicine    https://first10em.com/cognitive-errors/  Music by  Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Today we discuss the article "15 things Mattis taught me about real leadership" https://taskandpurpose.com/gen-mattis-no-mad-dog-told-1st-marine-division-proves  These relate not only to military but to pre-hospital clinicians as well.  **Key points ** "Train train train" "Failure is learning, support the team when we make a mistake" "Never be too big to do the small things when they need to be done" "Attitude is a weapon"  "Engage your brain before you engage your trigger" **From Us!** "Believe in the mission – if you believe, your team will too" "Be the change you want to see" "Everyone can be a leader" **Music ** Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Nick, Scott and Aaron are back, discussing a process of delivering bad news. **A Death Script** _"A reproducible method of effectively telling someone that their loved one is dying or has died". _ We discuss what makes up a death script, how we go about having this difficult conversation, and how to get better.  **Music** Say Good Night by Joakim Karud @joakimkarud Creative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 creativecommons.org/licenses/by-sa/3.0/ Music promoted by Audio Library youtu.be/SZkVShypKgM

Part 1: Tonight we hear from Scott and Nick as we discuss "The OMI Manifesto". For about the topic and to download the original article go to Dr. Smith's ECG Blog http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html Music by @iksonofficial or https://soundcloud.com/ikson

Part 2: Tonight we hear from Scott and Nick as we discuss "The OMI Manifesto". For about the topic and to download the original article go to Dr. Smith's ECG Blog http://hqmeded-ecg.blogspot.com/2018/04/the-omi-manifesto.html Music by @iksonofficial or https://soundcloud.com/ikson

Scott and Nick delve into the hot topic of mental health and PTSD. We are in no way content experts, but both have been affected by symptoms in the past. Today we talk about stigma, support services, personal experiences and coping strategies.   Contact the team at freeradicalsparamedicpodcast@gmail.com or just us on facebook and twitter.

Scott and Nick delve into the hot topic of mental health and PTSD. We are in no way content experts, but both have been affected by symptoms in the past. Today we talk about stigma, support services, personal experiences and coping strategies.