Podcasts about acls

Most ACLS medications are given IV push. But, what happens if we can't get an IV?Why IO is better than ETT as an alternative route.The locations we should place an IO when running a code and a location we should avoid.The ACLS medications that can be given intraosseous.Where you can find more information about intraosseous access during resuscitation efforts.In the absence of an IV or IO, some medications may be given down the endotracheal tube.The disadvantages of medication administration via ETT.Review of the medications that can be given down the tube and how they should be given.Medications should not be given down the tube when anything other than an endotracheal tube is used as an advanced airway.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The chain of survival for a cardiac emergency and stroke start the same:1. preparedness & recognition of an emergency;2. activation of EMS;3. delivery of Advanced Life Support; and4. transporting to the most appropriate facility.ALS ambulances are staffed with paramedics who have training in ACLS skills.Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference.ACLS's timed benchmarks for:point of first medical contact to PCI for ST elevation MI;door to tPA for ischemic stroke; andonset of symptoms to EVT for LVO strokes.Why EMS should bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.

Performing good CPR and delivering a shock as soon as possible to a patient in Ventricular Fibrillation or pulseless V-Tach are the two most critical interventions that have been shown to increase survival from sudden cardiac arrest.Studies have demonstrated significantly better out-of-hospital cardiac arrest survival outcomes in communities with robust public CPR training and public access/first responder AEDs.The general use of AED including: indications for use; attaching the AED pads; following verbal prompts; and safely administering a shock.Following the Adult Cardiac Arrest algorithm while using an AED.Contraindications to AED use.General safety considerations to remember.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

For apneic patients without a carotid pulse or patients with only gasping/agonal respirations, we will follow the Adult Cardiac Arrest algorithm. For pulseless patients that the AED doesn't advise a shock, the patient's ECG shows asystole, or a non-perfusing organized rhythm (PEA), we will follow the right side of the Adult Cardiac Arrest algorithm.Initial steps are aimed at delivery of high-quality CPR to keep the brain and vital organs alive. Epinephrine administration.Placement of an advanced airway.Considering possible reversible H & T causes of cardiac arrest including three common causes of PEA and their emergent interventions.When we should discontinue resuscitation efforts and call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Providing good, high-quality CPR with minimal interruptions and early defibrillation are two key interventions shown to improved cardiac arrest outcomes.A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rate.Characteristics of songs that will help us perform good CPR.Advantages & disadvantages of using a song during CPR.Selected songs from various genres and time periods from AHA's "Don't Drop The Beat" playlist on Spotify.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn AHA's "Don't Drop The Beat" playlist on Spotify at https://open.spotify.com/playlist/2mU2FNAhSOtQwW0hBgQMaK

A patient's medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible.Examples of information obtained in a medical history that will impact the treatment we provide.There are several mnemonics and memory aids that people use to guide their history taking.Review the SAMPLE-PQRST medical history format.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Fill out this short listener survey to help us improve the show: https://forms.gle/bbcRiPTRwKoG2tJx8In this episode, Simon Eskildsen, co-founder and CEO of TurboPuffer, lays out a compelling vision for how AI-native infrastructure needs to evolve in an era where every application wants to connect massive amounts of context to large language models. He breaks down why traditional databases and even large context windows fall short—especially at scale—and why object-storage-native search is the inevitable next step. Drawing on his experience from Shopify and Readwise, Simon introduces the SCRAP framework to explain the limits of context stuffing and makes a clear case for why cost, recall, performance, and access control drive the need for smarter retrieval systems. From practical lessons in building highly reliable infra to hard technical problems in vector indexing, this conversation distills the future of AI infra into first principles—with clarity and depth. [0:00] Intro[0:49] The Evolution of AI Context Windows[2:32] Challenges in AI Data Integration[3:56] SCRAP: Scale, Cost, Recall, ACLs, and Performance[9:21] The Rise of Object-Oriented Storage[16:47] Turbo Puffer Use Cases[22:32] Challenges in Vector Search[27:02] Challenges in Query Planning and Data Filtering[27:53] Focusing on Core Problems and Simplicity[28:28] Customer Feedback and Future Directions[29:11] Reliability and Simplicity in Design[30:39] Evaluating Embedding Models and Search Performance[32:17] The Role of Vectors in Search Engines[34:16] Balancing Focus and Expansion[35:57] AI Infrastructure and Market Trends[38:36] The Future of Memory in AI[43:01] Table Stakes for AI in SaaS Applications[45:55] Multimodal Data and Market Observations[46:57] Quickfire With your co-hosts: @jacobeffron - Partner at Redpoint, Former PM Flatiron Health @patrickachase - Partner at Redpoint, Former ML Engineer LinkedIn @ericabrescia - Former COO Github, Founder Bitnami (acq'd by VMWare) @jordan_segall - Partner at Redpoint

Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes.Identification of Torsades on the ECG.Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest.Procainamide use for stable patients with a monomorphic wide-complex tachycardia.Procainamide dosing and when to stop the infusion. Tip for determining whether magnesium or Procainamide should be used when treating stable patients with V-Tach.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Cardiac arrest in the operating room presents unique challenges that standard Advanced Cardiovascular Life Support (ACLS) protocols simply were not designed to address. This eye-opening exploration with APSF author, Zachary Smith, reveals why traditional resuscitation guidelines fall short when emergencies strike during surgery and anesthesia care.The dynamics of cardiac arrest differ dramatically in the perioperative environment. While out-of-hospital arrests typically stem from arrhythmic events, OR emergencies often result from hemorrhage, embolism, hypoxemia, or critical drug reactions like malignant hyperthermia or local anesthetic toxicity. These scenarios demand immediate, specialized interventions beyond standard ACLS algorithms.Physical constraints further complicate matters. What happens when cardiac arrest occurs while a patient is positioned prone, lateral, or in steep Trendelenburg? Traditional compressions become impossible, and emerging research suggests prone CPR might actually be superior in some scenarios. Moreover, the advanced monitoring capabilities in the OR – arterial lines, central venous pressure readings, and echocardiography – provide critical data not incorporated into standard protocols.The American Society of Anesthesiologists has responded with their Perioperative Resuscitation and Life Support Certificate program, addressing these gaps through specialized training that combines ACLS principles with OR-specific knowledge.  Ready to enhance your skills beyond basic ACLS? Explore the ASA's certificate program to earn patient safety CME credits while gaining life-saving expertise tailored to the unique challenges of the operating room. Your specialized knowledge could make all the difference when seconds count.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/264-rethinking-resuscitation-in-the-operating-room-beyond-acls/© 2025, The Anesthesia Patient Safety Foundation

When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia.The most obvious cause of hypovolemia is from bleeding.Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic.Classic signs & symptoms of hypovolemic shock.Volume replacement with crystalloids vs blood.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome.Morphine's use in the Acute Coronary Syndrome (ACS) algorithm.Why Morphine is helpful for patients with ACS.Contraindications and considerations for the safe administration of Morphine.Morphine as an alternative to nitro for patients with chest pain that take PDE inhibitors.Common dosing & administration of Morphine.Monitoring of the patient's level of consciousness, pain, blood pressure, and respirations after administration.Possible side effects of Morphine administration.Narcan as an antidote to Morphine if needed.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Even good CPR is far less efficient at circulating blood than a functioning heart.The indicators of high-quality CPR that were identified at the 2012 AHA CPR QualitySummit in order of importance include:Chest compression fraction (CCF);Chest compression rate;Chest compression depth;Allowing for full recoil; andAdequate ventilations.Using real-time feedback devices and ETCO2 to assess CPR quality.Three tips to limit pauses in CPR compressions to 10 seconds or less.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms.The use of epinephrine for severe anaphylaxis and unstable bradycardia.Review epinephrine's effects on blood vessels and bronchioles.Why epinephrine is helpful for patients with anaphylaxis.Using an epi drip for unstable bradycardia.Epinephrine administration during cardiac arrest.Starting an epinephrine or Dopamine drip for patients that have ROSC.Review the effects of Dopamine based on mcg/kg/min dosing.Monitoring the patient and titrating epi or Dopamine drips to prevent harm.For more information on ACLS medications, check out the pod resource page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Providing rescue breathing to apneic patients with a palpable pulse.Normal end tidal CO2 for patients with a pulse.Identification of cardiac arrest and our immediate actions.Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place.Using quantitative waveform capnography to confirm placement of an advanced airway, assess the quality of CPR, and identify ROSC.The effects of hyperventilating patients in cardiac arrest. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Hypothermic patients aren't dead until they are warm and dead.When a patient's core body temperature drops below 96.8 F (36 C), they are hypothermic. As the body's temperature drops below 36 C, hypothermia may further be classified as moderate or severe:· Moderate if the patient's body core temp is between 30-34 C; and· Severe if it's below 30 C.Modifying the ACLS Adult Cardiac Arrest algorithm for patients with severe hypothermia.Following the ACLS algorithm for patients with a body core temperature above 30 C.Methods for rewarming patients with moderate vs severe hypothermia.Continuation of CPR and ACLS efforts until the patient's body core temp is above 36 C.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation.The primary use of calcium channel blockers in ACLS.Use of calcium channel blockers for SVT refractory to Adenosine and A-Fib or A-Flutter with RVR.Contraindications of calcium channel blockers.Nicardipine use during the treatment of ischemic strokes.For more information on ACLS medications, tachycardia, or stroke check out the pod resource page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.Post-arrest care and recovery are the final two links in the chain of survival.Identification of ROSC during CPR.Initial patient management goals after identifying ROSC.Indications for starting TTM.Monitoring the patient's core temperature.Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries.Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient's blood pressure, sometimes to the point of making a patient hypotensive.Assessment of vital signs prior to administering nitro is necessary to ensure patient safety.Indications for use of nitroglycerine.Nitroglycerine's contraindications & considerations for use.Effects of nitro on patients taking PDE inhibitors.Administration of nitroglycerine to patients with ischemic chest pain.Considerations for patients that took their home nitroglycerine.Monitoring patient's pain and vital signs after nitro administration.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node. The ECG characteristics of A-Fib and A-Flutter. Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR).Suggested energy settings for synchronized cardioversion of unstable patients with a narrow complex tachycardia. Team safety when cardioverting an unstable patient in A-FIB/Flutter.Adenosine's role for stable SVT patients with underlying atrial rhythms.Treatment of stable patients in A-Fib/Flutter with RVR.For other medical podcasts that cover narrow complex tachycardias, visit the pod resource page at passacls.com. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

As an ACLS provider you do not need to be familiar with all of the different signs of various types of poisoning. You should be able to obtain a history and know to order toxicology.The majority of toxins don't have a specific antidote. There are a few toxins for which we have emergency interventions and ACLS providers should be familiar with.Reviewing the patient's medical history for indicators that may lead us to suspect a tablet/toxin cause of cardiac arrest. Administration of Narcan for suspected narcotics overdose following the Opioid Associated Emergency algorithm. Other common ACLS Tablet Toxin scenarios with possible treatments.Medications commonly used to treat specific toxins that are regularly stocked on crash carts or carried in EMS med bags.ACLS providers that suspect a specific toxin should consult with their Pharmacy or call Poison Control for treatment directions.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Poison Myths and Misconceptions on The Pharmacists Voice podcast: https://www.thepharmacistsvoice.com/podcast/poison-myths-and-misconceptions-discussion-part-1-of-5-with-angel-bivens-rph-and-wendy-stephan-phd/

The ACLS algorithms are designed to make it easier to remember the key interventions we should deliver, and the order in which they should be delivered, to provide the best evidence-based care possible.Generally speaking, if there's a change in a patient's condition, we should ensure we're using the correct algorithm.Three key points to remember when using ACLS algorithms:1. If a patient's condition changes, we should do an assessment and use the algorithm that matches the patient's current state.2. If an action was already done, we don't need to repeat it.3. We only do actions that are clinically appropriate and within our scope of practice.Walk through of an example mega code scenario with explanations of when and why we change to a different ACLS algorithm. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Beta blocking medications attach to Beta receptors to inhibit or “block” the effects of epinephrine (adrenaline) and norepinephrine in the body.The primary locations of Beta I, II, and III receptors.Effects of epinephrine & norepinephrine's stimulation of beta receptors on the heart.Beta blockers effects on the heart.When we should consider the use of beta blockers in the Acute Coronary Syndrome (ACS)and Tachycardia algorithms.Contraindications to the use of beta blocker medications.More detailed information about beta blocker's mechanism of action and specific instances for their use can be found on the Pod Resource page at PassACLS.com. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

This episode we review the use of advanced airways in the adult cardiac arrest algorithm.When we should consider insertion of an advanced airway for patients in a shockable vs non-shockable rhythm.In addition to an endotracheal tube (ETT), other ACLS advanced airways include the Laryngeal Mask Airway (LMA) and the Laryngeal Tube airway.The advantages of using an advanced airway over basic airway maneuvers.Use of end tidal CO2 waveform capnography to confirm placement and assess the adequacy of CPR. Identification and management of a misplaced ET tube.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

As storm clouds gather over Wales' Euro 2025 HQ, Rachel Rowe sits down with Carl to discuss her journey from being a civil servant and prison officer to a professional footballer. The 32-year-old midfielder has already enhanced her reputation as a versatile member of the squad by helping the ground staff to the cut the grass on the training pitch - using lawn mowers shipped over by the Football Association of Wales. Catrin Heledd and Michael Pearlman have also been busy interviewing other members of the squad, with some updates on Gemma Evans' teeth and Elise Hughes' knee.

Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient's vital organs and decreasing cerebral damage.Post-arrest goals for O2 saturation, ETCO2, and BP/MAP.Indications for use of an antiarrhythmic after ROSC.Determining which antiarrhythmic to use post cardiac arrest. Administration of Amiodarone or Lidocaine to control ventricular ectopy after ROSC.The use of Amiodarone post arrest if no antiarrhythmics were administered prior to obtaining ROSC.Links to other medical podcasts that cover antiarrhythmics and other ACLS-related topics are on the Pod Resource page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Hydrogen ions is on one of the Hs in ACLS's H&T reversible causes of cardiac arrest. When considering hydrogen ions as a cause, what we're looking at is the patient's pH, or acid/base balance, and conditions that affect it.The body's normal pH.Using patient history, ABGs, & labs to determine acidosis or alkalosis.Common conditions/causes that may lead us to suspect acidosis.Common conditions/causes that may lead us to suspect alkalosis.Correcting acidosis by changing the rate of ventilations.The indications, dose, and considerations for use of Sodium Bicarbonate.Treatment of alkalosis depends on the type (metabolic or respiratory) and is aimed at correcting the underlying cause.Other podcasts that cover acid/base balance and conditions that cause acidosis or alkalosis can be found on the Pod Resource Page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest.If the patient is in a non-shockable rhythm on the ECG such as PEA or asystole, we will go down the right side of the Adult Cardiac Arrest Algorithm.If the patient is in a shockable rhythm on the ECG such as V-Fib or V-Tach, we will go down the left side of the Adult Cardiac Arrest Algorithm. An example of a code's flow for shockable rhythms when an antiarrhythmic such as Amiodarone or Lidocaine is administered. We will follow the algorithm until the patient has ROSC or we call the code.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Other Pass ACLS episodes mentionedObjective Measures of Good CPR https://passacls.com/bls/objective-measures-of-good-cpr

For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is the first medications we should consider along with morphine, oxygen, and nitroglycerine; if indicated & safe. Aspirin's mechanism of action & benefits for Acute Coronary Syndrome (ACS) patients.Contraindications and considerations for aspirin's use.The dose and route of administration of aspirin for ACS patients.The use of aspirin in the ACLS Stroke algorithm.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

This week on SMX Insider, Jason Weigandt and Jason Thomas preview the only sand track on the Pro Motocross schedule. The famous Dr. H Rey Gubernick (Dr. G) sits down for a candid interview. Chad Reed makes the AMA Hall of Fame, and Jett Lawrence and Haiden Deegan extend carry big points leads into round 5. In the SMX Medical Update, Dr. McGinley talks ACLs and Chance Hymas, and James Stewart and Clinton Fowler bring you the Inside line on where to put your money at Southwick.

To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam.If you don't normally monitor patients as part of your job, I suggest two things:1. Find a system for ECG interpretation that works well for you; and2. Practice reading ECGs every day for a few weeks before your class.Review of normal ECG morphology of P wave, QRS complex, and T wave in lead II.Characteristics of first degree heart block.Characteristics of third degree (complete) AV block.Treatment of unstable patients in third degree block following the ACLS Bradycardia algorithm. Special considerations for use of Atropine when patients are in a third degree heart block.The use of TCP, Dopamine, & Epinephrine drip for unstable bradycardic patients refractory to Atropine.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine.The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine.Review of Lidocaine dosing and administration to patients in persistent V-Fib or pulseless V-Tach.Review of Amiodarone dosing and administration to patients in persistent V-Fib or pulseless V-Tach. Use of antiarrhythmic infusions post-cardiac arrest to suppress ventricular ectopy.Amiodarone use & dosing for stable patients in V-Tach with a pulse.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The tongue is the most common airway obstruction in an unconscious patient.For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA).Examples of when a NPA should be considered.Contraindications and considerations for nasal airway insertion.Measuring a nasal airway for appropriate length and diameter.Insertion of a nasopharyngeal airway into the right vs left nostril.Patients with a NPA in place can receive supplemental O2, be ventilated with a BVM, have ETCO2 monitored, and have their upper airway suctioned as needed. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Kevin Durant is officially a Houston Rocket. ITL reacts to the blockbuster trade — how does it feel, and what does it mean for the Rockets' future? Plus, the Oklahoma City Thunder are NBA champions after a Game 7 win — what lessons can be taken from their journey? QOTD: What injury — in sports or your own life — has affected you the most? From torn ACLs to heartbreaks, the crew and listeners share their stories.

When blood, or other fluids, accumulate in the sac around the heart it's called a cardiac tamponade or pericardial tamponade.The effects of tamponade on the electrical system and chambers of the heart.Cardiac tamponade can be acute or chronic and caused by traumatic, iatrogenic, or pathological etiologies.Common traumatic events, medical procedures, and diseases that can result in a pericardial tamponade. Signs & symptoms of cardiac tamponade.Treatment of cardiac tamponade with pericardiocentesis.For additional information on cardiac tamponade, check out the Pod Resources page at PassACLS.com. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Two things have changed in recent years to aid students that don't use ACLS in their daily practice.1. The role of the team leader; and2. The ability to use your quick reference cards.The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help.Using closed-loop communication to ensure the clarity of orders and speaking up if there's any doubt about an order or action.Use of your course's approved text book and quick reference cards during the megacode and written exam.Tips to help you pass the ACLS written exam.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation.The most common dysrhythmia present during the first few minutes of cardiac arrest is ventricular fibrillation.The chance of successful defibrillation decreases every minute that passes.How our chance of successfully defibrillating a patient into a perfusing rhythm significantly changes when good CPR is delivered vs when it isn't.Why bystander CPR is important for out-of-hospital cardiac arrest (OHCA) outcomes.The role of the CPR coach.Five tips to aid us in limiting CPR interruptions to less than 10 seconds so we can maintain a chest compression fraction (CCF) of at least 80%.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Quantitative waveform capnography is used in ACLS to objectively assess good CPR;confirm placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care.We can use waveform capnography with, and without, an advanced airway in place.Monitoring end tidal CO2 during rescue breathing.Use of capnography to objectively measure good CPR.Capnography is a preferred method of confirming endotracheal tube (ETT) placement over x-ray during a code.During CPR, a sudden increase in ETCO2 may indicate ROSC.Quantitative waveform capnography use in the post-cardiac arrest algorithm.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case, asked some hard questions, and will provide solid answers—our favorite recipe for a jam-packed educational session. REFERENCES 1. Witt, C. E., Shatz, D. V., Robinson, B. R. H., Campion, E. M., Shapiro, M. L., Bui, E. H., Meizoso, J. P., & Dorlac, W. C. (2025). Epinephrine in Prehospital Traumatic Cardiac Arrest-Life Saving or False Hope?. Prehospital emergency care, 1–9. 2. Breyre, A. M., George, N., Nelson, A. R., Ingram, C. J., Lardaro, T., Vanderkolk, W., & Lyng, J. W. (2025). Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest - A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP. Prehospital emergency care, 1–15. 3. https://www.anzcor.org/assets/anzcor-guidelines/guideline-11-10-1-management-of-cardiac-arrest-due-to-trauma-253.pdf

Patients with a narrow complex tachycardia with a rate over 150 BPM are in SVT.Unstable patients in SVT or V-Tach with a pulse, should be cardioverted with a synchronized shock. Assessment & treatment of stable tachycardic patients.Commonly used vagal techniques.A less common technique to stimulate the vagus nerve. Indications and use of Adenosine for stable patients in SVT refractory to vagal maneuvers.Possible treatments for patients found to be in A-Fib or A-Flutter with RVR after administration of Adenosine.Carotid sinus massage.Additional medical podcasts that have episodes on tachycardia can be found on the pod resources page at passacls.com. Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Remembering all the different energy setting needed for synchronized cardioversion and defibrillation used to be confusing for a lot of people.Defibrillators can be broken down into three basic categories:1. Automated External Defibrillator (AED);2. Biphasic defibrillators; and3. Monophasic defibrillators.Use of an AED to rapidly deliver a shock.Advantages & use of Biphasic defibrillators.For monophasic defibrillators, use 360J to defibrillate V-Fib or pulseless V-Tach.AEDs must not be used on patients with a pulse. Cardioversion of patients in unstable SVT or V-Tach with a pulse using biphasic vs monophasic monitor/defibrillators.Team safety when performing synchronized cardioversion.Energy needed to cardiovert unstable patients with a narrow vs wide complex tachycardia.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Patients with a heart rate less than 60 are bradycardic. Some people can have a resting heart rate in the 40s without any compromise. For others, a heart rate of 50 or less could signify the need for immediate intervention and warrants additional assessment.Signs & symptoms that indicate a bradycardic patient is unstable.Monitoring oxygen saturation with pulse oximetry and indications for administration of oxygen.Calcium channel blockers and beta blocker medication as treatable causes of bradycardia.The indications and dosage of Atropine.Precautions for Atropine use in patients with second or third degree AV blocks.The use of transcutaneous pacing (TCP) for unstable bradycardic patients refractory to Atropine.The use and dosing of Dopamine and Epinephrine drips.For additional information about causes and treatment of bradycardia, check out the pod resources page at PassACLS.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.Post-arrest care and recovery are the final two links in the chain of survival.Identification of ROSC during CPR.Initial patient management goals after identifying ROSC.The patient's GCS/LOC should be evaluated to determine if targeted temperature management (TTM) is indicated.Patients that cannot obey simple commands should receive TTM for at least 24 hours.Recently published studies on TTM and ACLS's current standard.Monitoring the patient's core temperature during TTM.Patients can undergo EEG, CT, MRI, & PCI while receiving TTM.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

The chain of survival for ACLS is the same as was learned in your BLS class.The beginning steps of the Cardiac Emergency and Stroke chain of survival.ACLS's timed goals for first medical contact to PCI for STEMI and door-to-needle for ischemic stroke.Characteristics of areas that have significantly better stroke and out-of-hospital cardiac arrest outcomes.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Heart muscle contraction and repolarization is dependent on Sodium, Calcium, Magnesium, and Potassium ions crossing cellular membranes.When a patient's potassium levels get too low or too high, hypokalemia or hyperkalemia results respectively.Two things that may lead us to suspect hypo or hyperkalemia.Medical conditions & medications that can cause potassium imbalance.ECG changes seen in hypo and hyperkalemia.Critical lab values that would indicate a need for treatment.Emergent, ACLS interventions for hypokalemia and hyperkalemia.Additional information on causes of hypo and hyperkalemia can be found on Ninja Nerd podcast. Check out the pod resources page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

When treating patients having an MI or stroke, more minutes equals more dead cells. Because the majority of strokes are the ischemic type, the treatment for stroke is similar to an MI – to reestablish perfusion to the ischemic tissues. The first four steps in the Stroke Chain of Survival. Time criteria for the administration of tPA (or a similar fibrinolytic medication) or EVT of LVO strokes. Stroke benchmarks for door to:assessment;completing a non-contrast CT; andadministration of fibrinolytic medication such as tPA (door-to-needle).EMS interaction with stroke teams and destination protocols to reduce time to definitive care.The difference for timed goals for the identification & treatment of AMI vs Stroke. Additional information about timed goals for stroke and how EMS affects outcomes, can be found on the PassACLS.com pod resources page.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

Adenosine is the first IV medication given to stable patients with sustained supraventricular tachycardia (SVT) refractory to vagal maneuvers.Symptoms indicating a stable vs unstable patient.Common causes of tachycardia.Cardiac effects of Adenosine. Indications for use in the ACLS Tachycardia algorithm.Considerations and contraindications. Adenosine as a diagnostic for patients in A-Fib or A-Flutter with RVR.Dosing and administration.Other podcasts that cover common ACLS antiarrhythmics in more detail and another covering Brugata Criteria used to differentiate V-Tach from SVT with an aberrancy, can be found on the Pod Resources page at passacls.com.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn

This week on In The Vet’s Office, Dr. Josie Horchak is joined by reality TV favorite Victoria Fuller for a chat about life with her fur family. Victoria opens up about her diva Tortie cat, Miss Ma’am, who’s been staging a bathroom rebellion. Dr. Josie gets to the bottom of what might be causing the litterbox boycott, from texture preferences to feline stress—and yes, cat Prozac is on the table. Victoria also shares about her father/son Labrador duo Buxton & Cash. She spills the story of how she has a doggie dating app to thank for Cash and his siblings. While the entire litter found loving homes, one adopter took in three siblings—and now they're in behavioral chaos. Dr. Josie explains why bringing home littermates is rarely a good idea and offers tips for untangling bad habits. Plus, hear about Buxton’s recent ACL surgery and why Dr. Josie warns that a second tear might be looming. In this week’s "Case of the Week," Dr. Josie shares the wild (and dangerous) tale of a dog who ate raw bread dough. And don't miss her "Paw & Order" list—the top things she’d never do with her own pets.See omnystudio.com/listener for privacy information.

To pass the written ACLS exam and mega code, students need to be able to identify basic ECG dysrhythmias, including the two types of second-degree heart block.One method of ECG rhythm identification is to ask a series of questions such as:What's the rate (150);Is the rhythm regular or irregular;What's the shape, width, and frequency of P waves and QRS complexes; andWhat's the P-R interval and is it constant?ECG characteristics of a second-degree Mobitz type I (Wenckebach).Identification of unstable bradycardia and its treatment with Atropine.ECG characteristics of a second-degree Mobitz type II.Possible effect of using Atropine on patients with a second-degree type II AV block.Treatment of unstable bradycardic patients refractory to Atropine using TCP, Dopamine, or Epinephrine drip.Starting dose and titration of Dopamine and Epinephrine drips.Good luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn The Curious Clinicians: History of Doctor Wenckebach & Mobitzhttps://curiousclinicians.com/2022/07/06/episode-52-way-back-wenckebach/

When treating patients with Acute Coronary Syndrome (ACS), MONA is an acronym sometimes used to help us remember the initial interventions.The O in MONA is Oxygen.When we should administer oxygen to ACS patients.When O2 administration is unnecessary based on an accurate pulse ox.Monitoring patient's oxygen saturation (SaO2) using a pulse oximeter.Review two common ACLS pre-arrest mega code scenarios.Oxygen administration during CPR and post cardiac arrest.You can find additional medical podcasts that cover ACLS-related topics, on the Pod Resources page at PassACLS.comGood luck with your ACLS class!Links: Buy Me a Coffee at https://buymeacoffee.com/paultaylor Practice ECG rhythms at Dialed Medics - https://dialedmedics.com/Free Prescription Discount Card - Download your free drug discount card to save money on prescription medications for you and your pets: https://safemeds.vipPass ACLS Web Site - Episode archives & other ACLS-related podcasts: https://passacls.com@Pass-ACLS-Podcast on LinkedIn Check out ConveyMed.io for more free online medical education (#FOAMed) opportunities.

You just stumbled onto the Gnar Couch Podshow—yes, “podshow,” because “podcast” is for people with functioning attention spans and fewer deeply repressed issues about outdoor furniture. We're the audio equivalent of finding a slightly wet couch at a trailhead: deeply unsettling, weirdly comfy, and probably hiding at least two species of insect (metaphorically). Our not-so-highly-trained panel dives straight into three pillars of modern mountain bike culture: (1) sending it big and eating it just as hard—broken bones, torn ACLs, and the never-ending pursuit of avoiding therapy bills by riding bikes off cliffs; (2) the sacred (and vaguely inappropriate) art of shuttling and cuddling, because real friendship is when you don't question how the couch got wet; and (3)the life of UCI racers Luke and Alex Mallen and the mainline reality check of working your ass off to chase down racing dreams while surviving on hand-me-down underwear and side-hustles aerating strangers' lawns. All delivered with enough self-loathing to fill a foam pit and enough edge to tear your shins up worse than cheap flat pedals. So while we're never going to be the podshow your mom wants to hear, we are the one you can't mention at work without getting a visit from HR. Grab the least-suspicious seat in the trailer, ignore the scent (just like we ignore the rules), and brace for the greatest self-sabotaging, semi-inspirational, off-the-rails mountain bike podshow to grace your undeserving ears. Welcome to Gnar Couch, where we race, we crash, and occasionally, we actually learn something—but only by accident.