Ten Minute Medic

Welcome to my classroom!  Bladder infections in geriatric patients can lead to sepsis due to weakened immune systems, anatomical changes, and decreased antibody production, allowing bacteria to spread rapidly from urinary tract to bloodstream.  In this short podcast, listen in on part of the reason as to why urinary tract infections can lead to sepsis in the older patient thus becoming deadly.

This series explores the importance of toxidrome recognition for paramedic students. Listeners will gain a clear understanding of how identifying toxidromes supports accurate assessments, guides treatment decisions, and improves patient outcomes in poisoning and overdose scenarios.

Join us in this episode of The Ten-Minute Medic Podcast, where we look a fascinating topic suggested by his former student, now ER physician Dr. Caleb Morris: When VT is Not VT. In this multi-episode series, Dr. Young explores how a common condition—Supraventricular Tachycardia (SVT) with Aberrancy—can mimic the dangerous appearance of Ventricular Tachycardia (VT). Learn about the key differences and why understanding this subtle distinction is critical in emergency medicine. Learn new insights on how a simple conduction delay in the heart can cause confusion and how to spot the telltale signs!

In this  episode of 'The Ten Minute Medic,' host Dr. Bill Young takes us on a  journey into the world of end-tidal CO2 monitoring - a critical but often misunderstood tool in emergency medicine. From cardiac arrests to traumatic brain injuries, Dr. Young breaks down how this simple measurement of exhaled breath can tell us everything from whether chest compressions are effective to when a patient is coming back to life. 

Today, we're delving into a critical topic that you'll undoubtedly encounter in the field: hemorrhagic shock. By the end of this podcast, you'll have a comprehensive understanding of what hemorrhagic shock is, why it's so dangerous, and why rapid recognition and treatment are crucial. This knowledge will be fundamental to your ability to save lives in emergency situations.

Welcome to "The Ten Minute Medic," your go-to podcast for concise, expert insights into emergency medicine. In our latest episode, we take a look at the critical topic of the pathophysiology of shock.   Join us as we explore how the heart, vasculature, and blood can fail during the shock process, leading to life-threatening consequences. We'll break down the mechanisms behind cardiac output reduction, vascular resistance abnormalities, and blood volume deficits, providing you with a succinct understanding of this complex condition. Whether you're a seasoned paramedic or just starting out, this episode will equip you with the knowledge to better recognize and manage shock in the field.

Thanks to Yusuf Ahady for his suggestion on this week's episode.  I'll be in touch with Yusuf to get his SWAG package headed his way. End-tidal CO2 (ETCO2) monitoring, a noninvasive technique measuring the concentration of carbon dioxide in exhaled air, is emerging as a valuable tool in the management of sepsis, a systemic response to infection with potentially life-threatening consequences. In sepsis, the body's response to infection can lead to altered cellular metabolism and changes in respiratory function, both of which can affect CO2 levels. ETCO2 monitoring provides real-time insights into a patient's respiratory status and metabolic activity, which are crucial in sepsis management. I'd love to hear from you as to the topics that you would like to hear covered.  Visit the Ten Minute Medic Facebook page and leave a post on that topic.  If it is selected, I'll send you some awesome SWAG!

Eclampsia, a life-threatening condition occurring during pregnancy, involves seizures and is preceded by preeclampsia. Understanding eclampsia is crucial for paramedics as it requires immediate medical attention to prevent severe complications for both mother and baby, highlighting the need for prompt recognition and emergency management in pre-hospital settings.   In this episode, we look at the pathophysiology, assessment and treatment of pre eclampsia and eclampsia.  In particular a deep dive on the role of magnesium sulfate at the primary prevention and treatment of seizures in this deadly disease. 

Pulmonary embolism is a condition where one or more blood clots travel from elsewhere in the body, commonly from deep veins in the legs (a condition known as deep vein thrombosis), and lodge in the arteries of the lungs. This blockage can critically reduce blood flow to the lung tissue, causing damage. The lack of perfusion leads to impaired gas exchange as the alveoli are not able to oxygenate the blood effectively. Additionally, the presence of a clot in the pulmonary arteries increases the resistance against which the right ventricle must pump, which can lead to strain and potentially right-sided heart failure, a condition known as acute cor pulmonale.   Make sure to join us for our next episode where we will do a review of pre-eclampsia and eclampsia in the pregnant patient.   Visit our Facebook link.  While there, tell us what you would like for us to cover in future Ten Minute Medic episodes.  If selected, we'll give you a shout out as well as send you some cool SWAG.

Understanding Sgarbossa's Criteria is important for paramedic students, similar to knowing that a defibrillator is not just a high-tech paperweight. These criteria are a set of electrocardiographic findings designed to sniff out myocardial infarction (MI) in the presence of a tricky accomplice—left bundle branch block (LBBB) or a paced rhythm. Understanding this, you can navigate through the confusion of LBBB, where AMIs might be playing an expert game of hide and seek. Applying the criteria allows for the early identification of ST-elevation MI, potentially saving precious heart muscle and, more importantly, the patient's life—making the difference between a good day and a "why did I get out of bed" day. In the world of emergency medicine, where 'time is muscle,' knowing Sgarbossa's Criteria ensures that paramedics don't just bring patients to the hospital faster but smarter, with a keener eye for those not-so-obvious cardiac events. This knowledge can turn a paramedic from a simple transporter to a life-saving detective, one ECG at a time. Don't forget that we need your help as to what you would like to see in future episodes.  Visit the Ten Minute Medic Facebook page and leave your suggestions.  If selected, we'll give you a shout out and send you a small gift as our appreciation.

In this episode of the Ten Minute Medic, we delve into the complex pathophysiology of cardiac arrest in pregnant patients, emphasizing why a deep understanding of these unique physiological changes is crucial for effective pre-hospital care and improved maternal and fetal outcomes.   After you have listened, visit the Ten Minute Medic Facebook page and let me know what topic you would like to hear.  If your idea is selected, I'll give you a shout out during the podcast.

 In this episode of The Ten Minute Medic, we dive into the essential aspects of asthma for paramedic students.  Like the song Hotel California, air checks into the alveoli, but doesn't (tend) to leave without help. Join us as we explore the pathophysiology behind this common respiratory condition, understanding the inflammation and bronchoconstriction that can lead to life-threatening situations. Learn how to assess a patient experiencing an asthma attack, including key signs and symptoms to watch for. We'll also discuss emergency treatment options, from administering bronchodilators like albuterol to the importance of oxygen therapy. Whether you're a seasoned paramedic or a newcomer to the field, this episode equips you with the knowledge and skills to manage asthma emergencies effectively in just ten minutes. After you listen, jump over to The Ten Minute Medic Facebook page at https://www.facebook.com/TenMinuteMedic/.  While there leave us a topic or two that you would like to see covered in a future episode.  Thanks!

Welcome to our podcast, where we dive into the critical world of cardiology and explore a topic that's of paramount importance for paramedic students. Today, we're shining a spotlight on the often subtle, sometimes deceptive, yet incredibly significant issue of STEMI (ST-segment elevation myocardial infarction) mimics. These impostors can lead to misdiagnoses and mistreatment, potentially with life-altering consequences. Join the Ten Minute Medic, as we unravel the complexities of recognizing these mimics, understanding their impact, and ultimately, saving lives through informed decisions and early interventions. Discover the key to differentiating fact from fiction in the realm of cardiac emergencies. Once you have finished listening, head over to our Facebook page @The Ten Minute Medic and let us know what topics you would like to see covered.  If selected, we'll give you credit and a shout out on the podcast.

Picture insulin as a key that unlocks the doors of our cells, allowing glucose to enter and power our bodies. When this intricate dance falters, as in diabetes, it can lead to a terrible symphony of health issues. So, think of insulin as the ultimate conductor, directing the harmonious flow of energy that keeps us in tune with life's rhythms. In this week's episode of the Ten-Minute Medic, we look at how important this hormone is and a little deeper at how it works.  Our next podcast is entitled "The Three Great Imposters"...a look at three common STEMI imposters.  Identifying STEMI imposters is like distinguishing a wolf in sheep's clothing in the world of heart emergencies. These cunning look-alikes, such as pericarditis or benign chest pain, mimic the deadly ST-elevation myocardial infarction (STEMI), leading to unnecessary panic and invasive treatments.

The assessment skills of the paramedic are the most important ones that she has.  Yet this area continues to be one of the weakest parts of paramedic education.  In this episode, we take a look at how to have an organized assessment routine of our pediatric patients.  A brand new episode will drop by the middle of the week.  During this new session, we will review the important work that insulin does towards regulating blood sugar levels.

Respiratory syncytial virus (RSV) is not limited to pediatrics and can affect geriatric populations too. In older adults, RSV can lead to severe respiratory infections, causing symptoms like coughing, wheezing, and shortness of breath, often requiring hospitalization. In this weeks podcast, we'll review the pathophysiology, symptomology and treatment of this dangerous respiratory disease.

Mechanism of injury is important for the paramedic student to learn as it takes you beyond the obvious.  You become a detective when you evaluate the clues found at the scene of a trauma...not to convict the perpetrator, but to ensure your assessment finds all of the injuries that could threaten your patient's life.

Having a basic understanding of the physical forces behind trauma will help you to begin to suspect injuries that may not always be obvious.  In this first podcast, of a three part series, we will look at how Newton (the scientist, not the fig guy!) is important to the paramedic as well as the role the multiple collisions that take place during trauma can increase the incidence of trauma. 

In this episode we will take a look at the signs and symptoms of compartment syndrome.  We'll also take a look at the types of fractures and how they might impact your patient.

In this extended podcast, we take a look at the causes, pathophysiologies and treatments of some of the more common classifications of shock that you might see in your pediatric patient. 

The early recognition of shock in the pediatric patient is imperative to the survival of your young patient. It's is important to remember that this condition does not always exhibit itself the same as it would in the adult.  In this first of a multi-podcast series, we will take a look at pathophysiology of shock and how to recognize some of the subtle symptoms. 

Watching a child struggle to breath is difficult to deal with.  However, what you do in the first few minutes of care could determine the outcome for your patient.  In this episode, we take a brief look at the issue of respiratory distress versus respiratory failure. 

Pediatric cardiac arrests are rare, but can be among the most stressful calls that the paramedic will encounter.  In this podcast, we take a look at the PALS algorithm for dealing with such high risk calls. 

The assessment skills of the paramedic are the most important ones that she posses.  In this episode, we take a look at how to have an organized assessment routine of our pediatric patients. 

Effective communication is imperative for the paramedic who is called upon to care for a pediatric patient. Failure to communicate raises both the human, social and economic costs of medicine.  In today’s podcast, we take a look at what some of the components of an effective resuscitation team are.  benefit from increased access to their medical histories, which reduces chances of medical errors.  

For most pediatric patients, the cause of cardiac arrest can be traced to a respiratory issue.  In emergencies dealing with children, having impeccable BLS skills is critical.  In this podcast, we take a look at the importance of high quality CPR and other issues that address cardiac arrest in the pediatric patient.

It is important for the paramedic student to understand the pathophysiology that accompanies chest trauma, both blunt and penetrating.  In this podcast, we take a look at: 1.  Simple pneumothorax 2.  Open pneumothorax 3.  Tension pneumothorax

In this week's podcast, you will learn 1.  The pathophysiology behind an asthma attack 2.  The three types of asthma attacks 3.  The role of bronchodilators and corticosterioids in the treatment of asthma. Additional Resources for Students The Pathophysiology of Asthma-The Khan Academy What is Asthma-Dr. Alex Thomas Paramedic Student Review Questions: Of the following, which would be considered an extrinsic trigger for an atopic asthma attack? A.  Viral infection B.  Bacterial infection C.  Stress D. None of the above The correct answer is C. Stress. The other responses indicate nonatopic asthma triggers and all of them are instrinsic.   Why might your bronchodilator not be effective in the status asthmaticus patient? A.  Medicine is out of date B.  Severity of the bronchospasm C.  Rapidity of respiratory rate D.  Poor cardiac output The correct answer is B.  Because the bronchospasm is so severe, there may be difficulty in getting the medicine down to the lower bronchioles. 

Trauma has become the most frequent cause of death of the OB patient in the United States. Although maternal mortality due to other causes such as infection, hemorrhage, hypertension, and thromboembolism, has declined over the years, the number of maternal deaths due to penetrating trauma, suicide, homicide and motor vehicle accidents has risen steadily. Accidental injuries occur in 6 to 7 % of all pregnant patients. Penetrating trauma accounts for as many as 36 % of maternal deaths.  In this podcast the student will: 1.  review the statistics that deal with death of mother an baby after trauma; 2.  understand the importance of aggressive resuscitation of the mother as a treatment modality; 3.  grasp the role of IV infusion and its effect on the secretion of oxytocin. Additional Resources Bosson, Nichole, et al. “Evaluation of Trauma Triage Criteria Performance in a Regional Trauma System.” Prehospital Emergency Care, 2019, pp. 1–10.   Cairo, Sarah B., et al. “Prehospital Education in Triage for Pediatric and Pregnant Patients in a Regional Trauma System without Collocated Pediatric and Adult Trauma Centers.” Journal of Pediatric Surgery, vol. 53, no. 5, 2018, pp. 1037–1041.   Nawrocki, Philip S., et al. “Interfacility Transport of the Pregnant Patient: A 5-Year Retrospective Review of a Single Critical Care Transport Program.” Prehospital Emergency Care, vol. 23, no. 3, 2018, pp. 377–384.   TMM Review Your patient is a 25 year, 28 week gestational female.  She has been shot twice in the abdomen.  The best course of action for survival of the fetus would be to apply MAST trousers and inflate the legs only aggressively resuscitate the mother infuse 20 cc/kg of normal saline rapidly transport to the local medical center The best course of action for the survival of the fetus after any trauma to the mother is to be aggressive in her resuscitation.  Keep in mind that the baby is dependent upon the mother for oxygenation, glucose delivery as well as waste removal.  Any disruption of this could be fatal to the fetus.    A bolus of 20 cc/kg of fluid will stimulate the secretion of what hormone that may help with the reduction of bleeding in the pregnant patient? Oxytocin Vasopressin ADH Epinephrine Because it is secreted from the same area of the pituitary gland as is vasopressin (also known as anti diuretic hormone or ADH), the administration of a bolus of fluid will stimulate oxytocin.  Which of the following is the MOST useful in determining the fetal age? Fundal height Abdominal circumference Conception date Date of last menses Determining fetal age is very useful when considering factors that may influence survival of the baby after an early delivery.  The MOST useful as well as the most accurate is the conception date of the fetus, although this may not be known. 

This is the second part of our Autism and What EMS Needs to Know series.    My guests are Dustin Young, Licensed Clinical Social Worker with the Tillamook Family Counseling Corporation and Nick Watts, Community Paramedic with Tillamook County EMS.  In this week’s presentation the student will Identify the changes in autism as a child transitions into an adult. How autistic patients learn how to self-regulatef their behavior. What EMS should know to minimize confrontations with autistic patients. When to and when not to restrain autistic patients. Some resources that you might find helpful in learning more about autism include: Auggies Hope-The idea of Auggie’s Hope is to advocate for Autism. A lot has changed in the past few years but their core belief of advocating for special needs has not. They have grown and continue to focus our mission training first responders on how to help a special needs family in crisis. Autism Risk Management- Are you searching for autism training curriculum for police and law enforcement? Dennis Debbaudt develops current, relevant, sustainable and memorable autism and law enforcement curriculum and digital video content. Debbaudt has over two decades of experience in autism and law enforcement curriculum development. National Autism Association-Toolbox of resources for interactions between first responders and patients with autism. 

This week’s podcast will be a two parter!  Recently I was with the paramedic students at Arkansas State University and they requested a podcast on the EMS response to autism.  In response to their request, I’ve changed the format just a bit from that of a monologue to an interview.  My guests are Dustin Young, Licensed Clinical Social Worker with the Tillamook Family Counseling Corporation and Nick Watts, Community Paramedic with Tillamook County EMS.  In this weeks presentation the student will Learn what autism is How the autistic patient may present Learn what some of the telling rituals that the autistic patient may do. Some resources that you might find helpful in learning more about autism include: Auggies Hope-The idea of Auggie’s Hope is to advocate for Autism. A lot has changed in the past few years but their core belief of advocating for special needs has not. They have grown and continue to focus our mission training first responders on how to help a special needs family in crisis. Autism Speaks-For people with autism, learning to interact with first responders is critical. On the other hand, it is just as essential for first responders to understand autism and be prepared to respond effectively and safely to situations that arise involving individuals on the spectrum. Autism Society-Tips for First Responders-Great information for interactions between EMS and patients with autism. 

In this episode of the Ten Minute Medic, we take a look at the ability of your patient to make competent decisions.  At the end of this podcast, the student will 1.  Understand the difference between competency and capacity 2.  Understand the legal ramifications of failing to recognize competency 3.  Understand the ASSET method of assessing competency. In the podcast, I reference an article entitled, "EMS, Capacity and Competence".  That full article can be found at this link:  https://www.ncbi.nlm.nih.gov/books/NBK470178/  

In this episode, the paramedic student will: 1.  Understand the pathophysiology behind the cellular immune response 2.  Be able to recognize the differences between anaphylaxis and a localized allergic reaction 3.  Understand the role of epinephrine and diphenhydramine in the treatment of anaphylaxis.

It's that time of the year when EMS students begin to sign up for their NREMT exams.  In this podcast, we take a look a couple of urban legends regarding the exam, how the exam is constructed and what you can do to give yourself that added edge when you are sitting in front of that computer in the testing center.

In this episode of the Ten Minute Medic the listener will: 1.  understand the pathophysiology behind the development and destruction of clots after trauma; 2.  learn the findings of the CRASH 2 study regarding TXA administration; 3.  review one potential protocol for the administration of TXA.  

 At the end of this podcast the paramedic student will: 1.  understand the signs and symptoms of hypoglycemia 2.  understand the treatment of hypoglycemia 3.  be able to differentiate the different levels of hyperglycemia 4.  verbalize the treatment approaches for hyperglycemia Please consider leaving us a rating with your favorite podcast delivery service.  Doing so will help us to reach more paramedic students!

Some forms of diabetes have been called a disease of lifestyle.  There is no doubt that, in western culture, it is increasing.  In this two part podcast we will : 1.  review the anatomy and physiology of the pancreatic system 2.  understand the role that insulin, glucose and glycogen play in homeostasis Thanks for listening!

In this final session of this two part podcast, the student will 1.  weigh the benefits versus the risks of moving from basic airway maneuvers to more advanced ones. 2.  understand the importance of adequate airway suctioning versus limiting it to 10-15 seconds. 3. be introduced to the concepts of rapid sequence intubation and drug assisted intubation.  The protocol established by the Kentucky Board of EMS will be used for this discussion.  Please refer to the EMS governing agency of your state for your particular regulation and protocol.  

The Ten Minute Medic takes a look at the airway of the trauma patient.  In this session, you will learn: 1.  the role of external and internal respiration. 2.  factors that influence alveolar and cellular gas exchange. 3.  the dangers of hyperventilation of your patient. Next weeks podcast will continue the discussion of the airway of the trauma patient.  If you would like to have a topic covered, drop me a line at bill.young@eku.edu. 

This is the second part of the Pathophysiology of Shock episode.  In this recording we'll look at: 1.  Why relying on a BP for indication of shock could be deadly for your patient, 2.  The three stages of shock and why you must be aggressive in its recognition and treatment and, 3.  How the movement of fluid in and out of the cells affects the hemostatic status of your patient. 

This week and next week the Ten Minute Medic will cover the workings of the body in shock and why this topic is probably the most important lecture you will cover in your paramedic class.  This is a two part episode. 

The rules of engagement for active shooting scenes have changed.  No longer can EMS sit back until the "scene is secure".  In this podcast, we will review the kinematics of gunshot wounds that will enable you to better assess, recognize and treat your gunshot patient. 

We come to the end of our series on acid base balance with a look at metabolic acidosis and alkalosis.  In this podcast you will learn: 1.  The most common cause of metabolic acidosis 2.  Why the administration of sodium bicarbonate for your patient in metabolic acidosis may be deadly 3.  A summary of pathophysiology pearls to remember when addressing acid base issues.

For your patient, there is, probably, no more frightening sensation than that of not being able to breathe.  This is never more true than in the patient who is in respiratory alkalosis.  In this podcast we look at: 1.  What respiratory alkalosis is. 2.  The pathophysiology behind it. 3.  The best way to treat, and not treat, your patient.

Respiratory acidosis is commonly seen in the pre-hospital patient.  In this episode, we take a look at the pathophysiology and treatment approach of this frequently encountered condition. 

We've all been there!  What do you do after that massive chili cheese burger?  You reach for an antacid!  In this episode, we take a look at the mechanisms that the body uses to help maintain a homeostatic pH so that we live the best life.  This also introduces a four part series in which we will take a look at each of the syndromes that occur when acid-base balance gets out of kilter. 

Conventional EMS education says that T wave abnormalities are present with an elevated potassium.  Is that always true.  In today's podcast, Dr. Bill Young takes a look at some of the most common symptoms of hyperkalemia as well as the importance of understanding the pathophysiology behind it. 

Could oxygen be detrimental to our cardiac patients? You bet your sweet nitroglycerine it could be. Learn more from this week's podcast!

Although a newcomer to the drug bags of paramedics, ketamine was first developed in 1962 and used as an anesthetic in surgery.  Over the last couple of years, it has become an attractive option for use in the prehospital arena because of it many applications, it’s safety as an anesthetic and fairly rapid onset of action. 

It is fall of the year and this is the time that health care providers begin to think about childhood respiratory diseases.  In this podcast, we will take a brief look at some of the more common pediatric respiratory diseases that you may come into contact with. 

The presence of a right ventricular MI has always been something that has a mysterious hold for paramedics.  In the past, any patient with a RVMI was prohibited from receiving NTG because of a possibility that they would suffer from life threatening hypotension.  However, is this the case.  In this podcast, we will look at the pathophysiology of the RVMI and maybe even dispel some myths