Podcasts about ekg

Started out her medical career as an EKG tech and in EMS as an EMT for one of the first ambulance companies in the areaShe saw the disconnect between the provider that people wanted to become and who they became, and she didn't want that to be true for herselfShe became an attending in 1991 and now has close to 40 years in emergency medicineShe became a physician when it was predominantly a male fieldJulie talks about some of the things that have changed over timeWe need to have empathy for the people that come in for non-emergent complaints and realize that we have the honor in the ED to fill all the gaps in the wider medical systemWe talk about the increase in transparency with patients and the access they now have to their lab work, imaging and chart and this helps us increase trust with patientsJulie talks about a paramedic partner she really admired and how well she treated patients, and how there wasn't a lot of female role models for her in med schoolI talk about how I also had partners that really improved the trajectory I was on as a new EMTSeek first to understand is one of the 7 habits of highly effective people and this relates directly to taking care of patientsJulie talks about how it was to be a woman in medicine and how her voice got dismissed as well as the dynamics that are at play with patientsJulie talks about burnout and how labyrinth therapy helped her. How you need something that helps you look beyond yourself to have a moment of awe and gratitudeSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

In this episode, the CardioNerds (Dr. Naima Maqsood, Dr. Akiva Rosenzveig, and Dr. Colin Blumenthal) are joined by renowned educator in electrophysiology, Dr. Joshua Cooper, to discuss everything atrial flutter; from anatomy and pathophysiology to diagnosis and management. Dr. Cooper's expert teaching comes through as Dr. Cooper vividly describes atrial anatomy to provide the foundational understanding to be able to understand why management of atrial flutter is unique from atrial fibrillation despite their every intertwined relationship. A foundational episode for learners to understand atrial flutter as well as numerous concepts in electrophysiology. Audio editing for this episode was performed by CardioNerds intern Dr. Bhavya Shah.  CardioNerds Atrial Fibrillation PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls "The biggest mistake is failure to diagnose”. Atrial flutter, especially with 2:1 conduction, is commonly missed in both inpatient and outpatient settings so look carefully at that 12-lead EKG so you can mitigate the stroke and tachycardia induced cardiomyopathy risk  Decremental conduction of the AV node makes it more challenging to rate control atrial flutter than atrial fibrillation  Catheter Ablation is the first line treatment for atrial flutter and is highly successful, but cardioversion can be utilized as well prior to pursuing ablation in some cases.  Class I AADs like propafenone and flecainide may stability the atrial flutter circuit by slowing conduction and thus may worsen the arrhythmia. Therefore, the preferred anti-arrhythmic medication in atrial flutter are class III agents.  Atrial flutter can be triggered by firing from the left side of the heart, so in patients with both atrial fibrillation and flutter, ablating atrial fibrillation makes atrial flutter less likely to recur.  BONUS PEARL: Dr. Cooper's youtube video on atrial flutter is a MUST SEE!  Notes Notes: Notes drafted by Dr. Akiva Rosenzveig  What are the distinguishing features of atrial fibrillation and flutter?  Atrial flutter is an organized rhythm characterized by a wavefront that continuously travels around the same circuit leading to reproducible P-waves on surface EKG as well as a very mathematical and predictable relationship between atrial and ventricular activity  Atrial fibrillation is an ever changing, chaotic rhythm that consists of small local circuits that interplay off each other. Consequently, no two beats are the same and the relationship between the atrial activity and ventricular activity is unpredictable leading to an irregularly irregular rhythm  What are common atrial flutter circuits?  Cavo-tricuspid isthmus (CTI)-dependent atrial flutter is the most common type of flutter. It is characterized by a circuit that circumnavigates the tricuspid valve.  Typical atrial flutter is characterized by the circuit running in a counterclockwise pattern up the septum, from medial to lateral across the right atrial roof, down the lateral wall, and back towards the septum across the floor of the right atrium between the IVC and the inferior margin of the tricuspid valve i.e. the cavo-tricuspid isthmus. Surface EKG will show a gradual downslope in leads II, III, and AvF and a rapid rise at end of each flutter wave.   Atypical CTI-dependent flutter follows the same route but in the opposite direction (clockwise). Therefore, we will see positive flutter waves in the inferior leads   Mitral annular flutter is more commonly seen in atrial fibrillation patients who've been treated with ablation leading to scarring in the left atrium.  Roof-dependent flutter is characterized by a circuit that travels around left atrium circumnavigating a lesion (often from prior ablation), traveling through the left atrial roof, down the posterior wall, and around the pulmonary veins  Surgical/scar/incisional flutter is seen in people with a history of prior cardiac surgery and have iatrogenic scars in right atrium due to cannulation sites or incisions  How does atrial flutter pharmacologic management differ from other atrial arrhythmias?  The atrioventricular (AV) node is unique in that the faster it is stimulated, the longer the refractory period and the slower it conducts. This characteristic is called decremental conduction. In atrial fibrillation, the atrial rate is so fast that the AV node becomes overwhelmed and only lets some of those signals through to the ventricles creating an irregular tachycardia but at lower rates. In atrial flutter, the atrial rate is slower, therefore the AV node has more capability to conduct allowing for higher ventricular rates. Therefore, to achieve rate control one will need a higher dose of AV blocking medications. Atrial tachycardia may require even higher doses due to the increased ability of the AV node to conduct, as the atrial rates are slower than in atrial flutter.  Sodium channel blockers (Class I) such as flecainide and propafenone slow wavefront propagation, making it easier for the AV node to handle the atrial rates. This will end up leading to increased ventricular rates which can be dangerously fast. That is why AV nodal blockers should be used in conjunction with flecainide and propafenone.  What is the role of cardioversion in atrial flutter management?  Due to high success rate with atrial flutter ablation, ablation is the first line treatment. However, sometimes cardioversion may be utilized in patients depending on how symptomatic they are and how long it will take to get an ablation. Cardioversion may also be utilized preferentially when the atrial flutter was triggered by infection or cardiac surgery to see if it will come back.   If cardioversion is pursued, the patient will need to be anticoagulated due to the stroke risk after the procedure due to post-conversion stunning.  How effective is atrial flutter ablation?  The landmark Natale et al study in 2000 demonstrated 80% success rate after radiofrequency ablation as compared to 36% in patients on anti-arrhythmic therapy. The LADIP study in 2006 further corroborated these findings. Contemporary data shows above 90% success rate of atrial flutter ablation.  In patients who have had both atrial fibrillation and atrial flutter, most electrophysiologists would ablate both. However, in patients with atrial fibrillation, the atrial flutter usually is initiated by trigger spots firing in the left atrium. Once the atrial fibrillation is ablated, the flutter will become less likely. Therefore, there are those who say there's no need to ablate the flutter circuit as well. Alternatively, if a patient has severe comorbidities and/or is high risk for ablation, one may consider performing the atrial flutter ablation only since atrial flutter is harder to manage medically compared with atrial fibrillation.   How do you manage atrial flutter in the acute inpatient setting?  In the inpatient setting, electrical cardioversion is often limited by blood pressure and the hypotensive effects of the sedatives required. If one is awake and too hypotensive, chemical cardioversion can be pursued. The most effective anti-arrhythmic for this is ibutilide. Amiodarone is not effective for acute cardioversion. Since ibutilide prolongs refractoriness in atrial and ventricular tissue, there's a risk of long QT induced torsades de pointes. Pretreating with magneisum reduces the risk to 1-2%.  References Jolly WA, Ritchie WT. Auricular flutter and fibrillation. 1911. Ann Noninvasive Electrocardiol. 2003;8(1):92-96. doi:10.1046/j.1542-474x.2003.08114.x  McMichael J. History of atrial fibrillation 1628-1819 Harvey - de Senac - Laënnec. Br Heart J. 1982;48(3):193-197. doi:10.1136/hrt.48.3.193  Lee KW, Yang Y, Scheinman MM; University of Califoirnia-San Francisco, San Francisco, CA, USA. Atrial flutter: a review of its history, mechanisms, clinical features, and current therapy. Curr Probl Cardiol. 2005;30(3):121-167. doi:10.1016/j.cpcardiol.200  2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e167. doi:10.1161/  Cosío F. G. (2017). Atrial Flutter, Typical and Atypical: A Review. Arrhythmia & electrophysiology review, 6(2), 55–62. https://doi.org/10.15420/aer.2017.5.2  https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-11/Atrial-flutter-common-and-main-atypical-forms Natale A, Newby KH, Pisanó E, et al. Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter. J Am Coll Cardiol. 2000;35(7):1898-1904. doi:10.1016/s0735-1097(00)00635-5  Da Costa A, Thévenin J, Roche F, et al. Results from the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter. Circulation. 2006;114(16):1676-1681. doi:10.1161/CIRCULATIONAHA.106.638395  https://www.acc.org/Membership/Sections-and-Councils/Fellows-in-Training-Section/Section-Updates/2015/12/15/16/58/Atrial-Fibrillation#:~:text=The%20first%20'modern%20day'%20account,in%20open%20chest%20animal%20models.&text=In%201775%2C%20William%20Withering%20first,(purple%20foxglove)%20in%20AFib.

Brian talks about his experience being on the “other side” of the bedside with his wife's cancer treatmentHe really appreciated the extra time that the doctors spent with him and his wife to explain things – repetition is very helpful for your patients to really hear youBrian talks about balancing fatherhood and being a husband with our emergency medicine schedules and the challenges of being in a physician couple You have to figure out family priorities and what works well in your situationDate night is the most important investment you can makeWe talk about how to transition from ER mode to husband and father modeBrian talks about how finishing his notes helps to make his mind move on or answer some questions he may have to resolve a conflict he might be havingWe talk about church attendance as ChristiansBrian tells a powerful story where he was able to save and prolong a patient life so he could talk with his family“Sometimes it's more important to help someone die than to help them live”We need to be intentional about remembering the big and the small good things that happen throughout our dayYou never know when you might be the last person to interact with someone and may make the difference between them, deciding to give the ER another chanceBrian talks about advice to his younger self – don't work as hard, take more time offPrayer will get you to the right answer, if you call yourself Christian you should be displaying the Christian examples we are givenYou shouldn't have to leave your faith at home, it's your best ally at work Support the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Click to Send us a text!We lay out the 10 annual vitality tests that turn off-season into a competitive edge, from basic blood work to root-cause labs, heart scans, and biological age. The goal is simple: find what's holding you back, fix it fast, and add years to your racing career.• baseline blood work and why it still matters• the big five root cause labs and what each reveals• coronary calcium and heart risk for drivers• low-cost lifeline screenings that catch issues early• full-body MRI and multi-cancer blood testing• FIT stool testing for colon cancer signals• VO2 Max, CRF, and grip strength benchmarks• annual physical with skin check and EKG• biological age testing and reversing pace of aging• how to stack tests into a clear action planTake your free High Performance Health Assessment at victorylanewellness.com and schedule your complimentary consultationSupport the showAs a token of gratitude, of course you're interested in these FREE and powerful resources, and because you enjoy the show, first be sure to leave your 5-STAR Review HERE!

We talk about setting the right mindset, culture and tone as a leader of the department and especially in smaller facilitiesYou don't have to be perfect, but you can avoid the little negative comments and criticismsBeing a good example goes a long wayAs a Christian we are supposed to act like Christ wouldWe have a lot of metrics we have to worry about as clinicians but, as Christians, we need to worry about the metric of mercyUnderstanding that we are not as far removed from the homeless, drug addicted patient as we might thinkWe have to remember that, as we care for the homeless and drug addicted person that no one else will care for, we are doing it for JesusBrian tells his students to spend as much time with the patient as they need, you don't have to be the fastest provider right awayWe have to be careful about bias getting passed on from triage and from EMS reports as well, sometimes the problem is more subtle and requires more time with the patientHow we word things when talking with patients makes a big differenceWe talk about providing respect and dignity to those patients that dieBrian talks about some on-shift practices he uses to re-center himself on his purposeWe talk about the grey area in which we practice in the EDI try to practice assuming good intent on othersSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Welcome to Episode 210 of Unfiltered and Undiscovered! Join Curly, Braggy, and Rossy—three lifelong music lovers—as they dive deep into the world of Australian independent music. This week, we chat with Perth's rising easycore band Belgravia about their new single 'Die Nasty,' songwriting through grief, and the realities of being an indie band in Australia. Plus, get the latest on music news, festival stories, and shoutouts to emerging artists making waves across the country. Whether you're a fan of pop punk, classic Aussie rock, or just love discovering new tunes, this episode is packed with laughs, insights, and must-hear tracks.Australian music podcast, Belgravia band interview, independent music Australia, easycore bands, pop punk Australia, music industry stories, new music releases, Aussie rock legends, undiscovered artists, music podcast 2024,Enjoyed the show? Hit LIKE, SUBSCRIBE, and SHARE to help more music fans discover hidden gems! Follow us on Spotify for our curated playlist, and check out the links below for guest music, voting, and more. Got music to share? Reach out—we love hearing from new artists!Vote for Laura Frank “ What Do We Tell the Kids” for the Environmental Prize https://environmentalmusicprize.com/vote-now/ ⏱️⏱️VIDEO CHAPTERS⏱️⏱️:00:00:00 - Podcast Introduction, Hosts, and Latest Australian Music News00:07:16 - Recent Gigs, Touring Stories, and Environmental Music Prize Nominees00:14:09 - Australian Band Memories: Cockroaches, Tribesmen, and Birthday Celebrations00:20:58 - AC/DC, Metallica, and the Legacy of Australian Rock Legends00:28:03 - Belgravia Interview: Easycore, Songwriting, and Perth Music Scene00:35:50 - Song 'Die Nasty': Grief, Loss, and Catharsis in Music Creation00:43:02 - Band Dynamics: DIY Production, Visual Branding, and Live Harmonies00:50:03 - Touring Western Australia: Challenges, Regional Gigs, and Independent Bands00:57:04 - Music Industry Realities: Genre Trends, Ageism, and Artistic Authenticity01:03:48 - Upcoming Releases, Final Thoughts, and Podcast Wrap-Up 

The panel of Chuck Joiner, Marty Jencius, Michael D.J. Eisenberg, and Patrice Brend'amour kicks off the 2025 Holiday Gift Guide series with practical, travel-friendly, and tech-savvy picks. From MagSafe wallets and AirTag-friendly money clips to AI development tools, travel routers, power banks, and portable speakers, each round offers creative and useful gift ideas for Apple users and frequent travelers looking to upgrade their daily gear. (Part 1)  MacVoices is supported by SurfShark. Go to https://surfshark.com/macvoices or use code “macvoices" at checkout to get 4 extra months of Surfshark VPN! Show Notes: Chapters: [0:00] Introduction to the 2025 Holiday Gift Guide[0:10] How the gift rounds work and panel introductions[1:26] Marty's pick: MagSafe wallet and stand[5:11] Michael's counterpick: AirTag-ready money clip[6:41] Patrice's pick: Windsurf AI development tool[9:36] Michael's pick: Travel surge protector[12:30] Chuck's pick: Rolling Square credit-card tracker[13:46] Discussion: Digital IDs and travel concerns[15:13] Surfshark sponsorship segment[17:39] Round 2 begins: Cardia Mobile 6-lead EKG device[23:41] Patrice's pick: GL.iNet travel router[26:56] Michael's pick: Anker Prime 26K power bank[29:49] Chuck's pick: JBL Flip Series Bluetooth speakers Links: Marty Jencius MagSafe Wallet, Card Holder with Stand, Magnetic Phone Wallet Stand for iPhone Pro Max Air Plus Series, RFID Blocking Vegan Leather AliveCor KardiaMobile   EKG Monitor - Six Views of The Heart - Detects AFib and Irregular Arrhythmias- Instant Results in Seconds Patrice Brend'amour Windsurf GL.iNet GL-MT3000 (Beryl AX) Portable Travel Router, Pocket Wi-Fi 6 Wireless 2.5G Router, Portable VPN Routers WiFi for Travel Michael D.J. Eisenberg Eaton Tripp Lite TRAVELER3USBC Travel Power Strip & USB Charger, Flat Plug, 306J Surge Protector, USB-C + USB-A Port, 2-Outlets, 18" Cord & Cable Wrap Anker Prime Power Bank (26K, 300W) Chuck Joiner Rolling Square AirCard Pro - Apple Find My only – Bluetooth Tracker Card, Wireless Charging, Digital ID, Anti-Loss Wallet Tracker JBL Flip 7 - Portable Waterproof and Drop-Proof Speaker, Bold Pro Sound with AI Sound Boost, 16Hrs of Playtime, and PushLock System with Interchangeable Accessories   Guests: Patrice Brend'amour is the creator, advocate and Product Manager of a global healthcare software initiative, which is not only pushing the industry to provide user-centered solutions using the latest advances in UX and technology, but also advancing the sharing of medical information between healthcare providers across the world. She is also an avid podcaster, mainly in the technology space, as well as a maintainer and contributor to a number of open source projects. Everything she does can be linked to from The Patrice, Michael D.J. Eisenberg is a is a solo practitioner based in Washington, DC, advocating for veterans, military members, and their families for nearly two decades. He has been helping lawyers and law offices utilize technology tools to promote efficiency and effectiveness for decades. He created the blog and podcast in 2019 to share that information and more with the world. Find information on his initiatives and his podcast at The Tech Savvy Lawyer. Dr. Marty Jencius has been an Associate Professor of Counseling at Kent State University since 2000. He has over 120 publications in books, chapters, journal articles, and others, along with 200 podcasts related to counseling, counselor education, and faculty life. His technology interest led him to develop the counseling profession ‘firsts,' including listservs, a web-based peer-reviewed journal, The Journal of Technology in Counseling, teaching and conferencing in virtual worlds as the founder of Counselor Education in Second Life, and podcast founder/producer of CounselorAudioSource.net and ThePodTalk.net. Currently, he produces a podcast about counseling and life questions, the Circular Firing Squad, and digital video interviews with legacies capturing the history of the counseling field. This is also co-host of The Vision ProFiles podcast. Generally, Marty is chasing the newest tech trends, which explains his interest in A.I. for teaching, research, and productivity. Marty is an active presenter and past president of the NorthEast Ohio Apple Corp (NEOAC). Support:      Become a MacVoices Patron on Patreon     http://patreon.com/macvoices      Enjoy this episode? Make a one-time donation with PayPal Connect:      Web:     http://macvoices.com      Twitter:     http://www.twitter.com/chuckjoiner     http://www.twitter.com/macvoices      Mastodon:     https://mastodon.cloud/@chuckjoiner      Facebook:     http://www.facebook.com/chuck.joiner      MacVoices Page on Facebook:     http://www.facebook.com/macvoices/      MacVoices Group on Facebook:     http://www.facebook.com/groups/macvoice      LinkedIn:     https://www.linkedin.com/in/chuckjoiner/      Instagram:     https://www.instagram.com/chuckjoiner/ Subscribe:      Audio in iTunes     Video in iTunes      Subscribe manually via iTunes or any podcatcher:      Audio: http://www.macvoices.com/rss/macvoicesrss      Video: http://www.macvoices.com/rss/macvoicesvideorss

The panel of Chuck Joiner, Marty Jencius, Michael D.J. Eisenberg, and Patrice Brend'amour kicks off the 2025 Holiday Gift Guide series with practical, travel-friendly, and tech-savvy picks. From MagSafe wallets and AirTag-friendly money clips to AI development tools, travel routers, power banks, and portable speakers, each round offers creative and useful gift ideas for Apple users and frequent travelers looking to upgrade their daily gear. (Part 1)  MacVoices is supported by SurfShark. Go to https://surfshark.com/macvoices or use code "macvoices" at checkout to get 4 extra months of Surfshark VPN! Show Notes: Chapters: [0:00] Introduction to the 2025 Holiday Gift Guide [0:10] How the gift rounds work and panel introductions [1:26] Marty's pick: MagSafe wallet and stand [5:11] Michael's counterpick: AirTag-ready money clip [6:41] Patrice's pick: Windsurf AI development tool [9:36] Michael's pick: Travel surge protector [12:30] Chuck's pick: Rolling Square credit-card tracker [13:46] Discussion: Digital IDs and travel concerns [15:13] Surfshark sponsorship segment [17:39] Round 2 begins: Cardia Mobile 6-lead EKG device [23:41] Patrice's pick: GL.iNet travel router [26:56] Michael's pick: Anker Prime 26K power bank [29:49] Chuck's pick: JBL Flip Series Bluetooth speakers Links: Marty Jencius MagSafe Wallet, Card Holder with Stand, Magnetic Phone Wallet Stand for iPhone Pro Max Air Plus Series, RFID Blocking Vegan Leather AliveCor KardiaMobile   EKG Monitor - Six Views of The Heart - Detects AFib and Irregular Arrhythmias- Instant Results in Seconds Patrice Brend'amour Windsurf GL.iNet GL-MT3000 (Beryl AX) Portable Travel Router, Pocket Wi-Fi 6 Wireless 2.5G Router, Portable VPN Routers WiFi for Travel Michael D.J. Eisenberg Eaton Tripp Lite TRAVELER3USBC Travel Power Strip & USB Charger, Flat Plug, 306J Surge Protector, USB-C + USB-A Port, 2-Outlets, 18" Cord & Cable Wrap Anker Prime Power Bank (26K, 300W) Chuck Joiner Rolling Square AirCard Pro - Apple Find My only – Bluetooth Tracker Card, Wireless Charging, Digital ID, Anti-Loss Wallet Tracker JBL Flip 7 - Portable Waterproof and Drop-Proof Speaker, Bold Pro Sound with AI Sound Boost, 16Hrs of Playtime, and PushLock System with Interchangeable Accessories Guests: Patrice Brend'amour is the creator, advocate and Product Manager of a global healthcare software initiative, which is not only pushing the industry to provide user-centered solutions using the latest advances in UX and technology, but also advancing the sharing of medical information between healthcare providers across the world. She is also an avid podcaster, mainly in the technology space, as well as a maintainer and contributor to a number of open source projects. Everything she does can be linked to from The Patrice, Michael D.J. Eisenberg is a is a solo practitioner based in Washington, DC, advocating for veterans, military members, and their families for nearly two decades. He has been helping lawyers and law offices utilize technology tools to promote efficiency and effectiveness for decades. He created the blog and podcast in 2019 to share that information and more with the world. Find information on his initiatives and his podcast at The Tech Savvy Lawyer. Dr. Marty Jencius has been an Associate Professor of Counseling at Kent State University since 2000. He has over 120 publications in books, chapters, journal articles, and others, along with 200 podcasts related to counseling, counselor education, and faculty life. His technology interest led him to develop the counseling profession 'firsts,' including listservs, a web-based peer-reviewed journal, The Journal of Technology in Counseling, teaching and conferencing in virtual worlds as the founder of Counselor Education in Second Life, and podcast founder/producer of CounselorAudioSource.net and ThePodTalk.net. Currently, he produces a podcast about counseling and life questions, the Circular Firing Squad, and digital video interviews with legacies capturing the history of the counseling field. This is also co-host of The Vision ProFiles podcast. Generally, Marty is chasing the newest tech trends, which explains his interest in A.I. for teaching, research, and productivity. Marty is an active presenter and past president of the NorthEast Ohio Apple Corp (NEOAC). Support:      Become a MacVoices Patron on Patreon      http://patreon.com/macvoices      Enjoy this episode? 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Dr. Carole Keim welcomes pediatric cardiologist Dr. Tal Gospin, MD, to The Baby Manual to talk about what pediatric cardiology is and how it differs from adult cardiology. Dr. Gospin explains how much of pediatric cardiology is concerned with congenital heart disease, abnormalities people are born with. She watches for the shape of an infant's heart and the sounds it makes, even in utero, and discusses exactly what she looks for with Dr. Keim. They explore fetal echocardiograms, infant heart function, and what parents can watch for in newborns to see if a pediatric cardiologist needs to be consulted. Dr. Gospin and Dr. Keim discuss when a baby's heart murmur should be referred to a pediatric cardiologist and the differences between an innocent murmur and a pathologic murmur. Innocent murmurs that appear in newborns typically disappear in infancy. Dr. Gospin shares that some types of pediatric cardiac issues will show up as a lack of weight gain in infants, and when to reach out to a pediatrician for a referral. They talk about echocardiograms and what to expect, whether the baby feels any discomfort or not from an EKG, and what the scans are looking for. They discuss breathholding episodes, fainting, and explain what's happening and what a parent can do. This episode provides a lot of insight into pediatric cardiology and gives parents insight into the functioning of their infant's heart.  Dr. Tal Gospin, MD:Dr. Tal Gospin graduated with honors from Washington University in St. Louis with her undergraduate degree in Psychology. She obtained a Masters in Physiology and her Medical Doctorate from Georgetown University School of Medicine, where she was elected into Alpha Omega Alpha, the National Medical Honor Society. Dr. Gospin continued on to pursue a pediatrics residency at New York Presbyterian Hospital/Columbia University in New York City. She then completed her fellowship in pediatric cardiology at Baylor College of Medicine/Texas Children's Hospital in Houston, Texas. Dr. Gospin's fellowship training included caring for patients with a broad spectrum of cardiac conditions and working with leading experts in the field of pediatric cardiology and cardiac surgery. She concentrated her fellowship training on echocardiography, outpatient care for children with complex congenital heart disease, as well as fetal imaging and prenatal counseling.Dr. Gospin is board-certified in Pediatrics and Pediatric Cardiology. She is a fellow of the American Academy of Pediatrics and the American College of Cardiology. Her clinical interests include transthoracic echocardiography, fetal imaging, evaluation and treatment of children with congenital and acquired heart disease, pediatric arrhythmias, as well as hypercholesterolemia and hypertension. Dr. Gospin brings her diverse knowledge base and training into the community to provide comprehensive medical care with a passion for personalized attention.__ Resources discussed in this episode:The Holistic Mamas Handbook is available on AmazonThe Baby Manual is also available on Amazon__Contact Dr. Carole Keim, MDlinktree | tiktok | Instagram Contact Dr. Tal Gospin, MDwebsite | Pediatric Cardiology Care Houston Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of the Jewish Inspiration Podcast, Rabbi Aryeh Wolbe continues in the Orchot Tzaddikim (Day 105, page 615), summarizing the first 12 daily remembrances—Hashem creating us from nothing, granting health, wisdom, Torah, mercy, repentance, and constant closeness—before introducing four more. The 13th urges recognizing when our wisdom and wealth exceed our deeds: if blessed with intellect or money, we must act accordingly now, not delay with “when I earn more, then I'll give.” Rabbi Wolbe shares a young donor who gave $130,000 already toward a $250,000 goal and a Shabbat table debate on lottery winnings, exposing how the yetzer hara pushes charity to “later.” The 14th teaches greeting everyone with a warm smile (sever panim yafot), as water reflects a face, so does the heart (Mishlei 27:19); his great-grandfather perfected this trait for two years despite personal suffering.The 15th reminds us to prepare for the World to Come like stocking a pantry or travel food—accumulate mitzvot, kindness, and Torah, as we don't know when our time ends. The 16th stresses the soul's purity: strong, healthy people die suddenly because Hashem reclaims His “deposit.” Like collateral or a leased car, life is lent; we must keep the soul pristine, repenting daily “one day before death” (as tomorrow may be it). Rabbi Wolbe likens life's ups and downs to a living EKG—flatlines are dead—urging us to embrace curveballs, swing hard, and turn tough days into home runs.Recorded at TORCH Centre in the Levin Family Studios (B) to a live audience on April 7, 2025, in Houston, Texas.Released as Podcast on November 18, 2025_____________This series on Orchos Tzadikim/Ways of the Righteous is produced in partnership with Hachzek.Join the revolution of daily Mussar study at hachzek.com.We are using the Treasure of Life edition of the Orchos Tzadikkim (Published by Feldheim)_____________Listen, Subscribe & Share: Apple Podcasts: https://podcasts.apple.com/us/podcast/jewish-inspiration-podcast-rabbi-aryeh-wolbe/id1476610783Spotify: https://open.spotify.com/show/4r0KfjMzmCNQbiNaZBCSU7) to stay inspired! Share your questions at aw@torchweb.org or visit torchweb.org for more Torah content.  _____________About the Host:Rabbi Aryeh Wolbe, Director of TORCH in Houston, brings decades of Torah scholarship to guide listeners in applying Jewish wisdom to daily life.  To directly send your questions, comments, and feedback, please email: awolbe@torchweb.org_____________Support Our Mission:Our Mission is Connecting Jews & Judaism. Help us spread Judaism globally by sponsoring an episode at torchweb.org.Your support makes a HUGE difference!_____________Listen MoreOther podcasts by Rabbi Aryeh Wolbe: NEW!! Prayer Podcast: https://prayerpodcast.transistor.fm/episodesJewish Inspiration Podcast: https://inspiration.transistor.fm/episodesParsha Review Podcast: https://parsha.transistor.fm/episodesLiving Jewishly Podcast: https://jewishly.transistor.fm/episodesThinking Talmudist Podcast: https://talmud.transistor.fm/episodesUnboxing Judaism Podcast: https://unboxing.transistor.fm/episodesRabbi Aryeh Wolbe Podcast Collection: https://collection.transistor.fm/episodesFor a full listing of podcasts available by TORCH at http://podcast.torchweb.org_____________Keywords:#JewishInspiration, #Mussar, #MasterClass, #Remembrance, #Generosity, #Self-awareness, #Charity, #Scholarship, #Wisdom, #Opportunity, #Giving, #Procrastination, #ActsofKindness, #Spiritual, #Resilience, #Adversity, #Rest, #Productivity, #GoodDeeds, #Urgency ★ Support this podcast ★

In this episode of the Jewish Inspiration Podcast, Rabbi Aryeh Wolbe continues in the Orchot Tzaddikim (Day 105, page 615), summarizing the first 12 daily remembrances—Hashem creating us from nothing, granting health, wisdom, Torah, mercy, repentance, and constant closeness—before introducing four more. The 13th urges recognizing when our wisdom and wealth exceed our deeds: if blessed with intellect or money, we must act accordingly now, not delay with “when I earn more, then I'll give.” Rabbi Wolbe shares a young donor who gave $130,000 already toward a $250,000 goal and a Shabbat table debate on lottery winnings, exposing how the yetzer hara pushes charity to “later.” The 14th teaches greeting everyone with a warm smile (sever panim yafot), as water reflects a face, so does the heart (Mishlei 27:19); his great-grandfather perfected this trait for two years despite personal suffering.The 15th reminds us to prepare for the World to Come like stocking a pantry or travel food—accumulate mitzvot, kindness, and Torah, as we don't know when our time ends. The 16th stresses the soul's purity: strong, healthy people die suddenly because Hashem reclaims His “deposit.” Like collateral or a leased car, life is lent; we must keep the soul pristine, repenting daily “one day before death” (as tomorrow may be it). Rabbi Wolbe likens life's ups and downs to a living EKG—flatlines are dead—urging us to embrace curveballs, swing hard, and turn tough days into home runs.Recorded at TORCH Centre in the Levin Family Studios (B) to a live audience on April 7, 2025, in Houston, Texas.Released as Podcast on November 18, 2025_____________This series on Orchos Tzadikim/Ways of the Righteous is produced in partnership with Hachzek.Join the revolution of daily Mussar study at hachzek.com.We are using the Treasure of Life edition of the Orchos Tzadikkim (Published by Feldheim)_____________Listen, Subscribe & Share: Apple Podcasts: https://podcasts.apple.com/us/podcast/jewish-inspiration-podcast-rabbi-aryeh-wolbe/id1476610783Spotify: https://open.spotify.com/show/4r0KfjMzmCNQbiNaZBCSU7) to stay inspired! Share your questions at aw@torchweb.org or visit torchweb.org for more Torah content.  _____________About the Host:Rabbi Aryeh Wolbe, Director of TORCH in Houston, brings decades of Torah scholarship to guide listeners in applying Jewish wisdom to daily life.  To directly send your questions, comments, and feedback, please email: awolbe@torchweb.org_____________Support Our Mission:Our Mission is Connecting Jews & Judaism. Help us spread Judaism globally by sponsoring an episode at torchweb.org.Your support makes a HUGE difference!_____________Listen MoreOther podcasts by Rabbi Aryeh Wolbe: NEW!! Prayer Podcast: https://prayerpodcast.transistor.fm/episodesJewish Inspiration Podcast: https://inspiration.transistor.fm/episodesParsha Review Podcast: https://parsha.transistor.fm/episodesLiving Jewishly Podcast: https://jewishly.transistor.fm/episodesThinking Talmudist Podcast: https://talmud.transistor.fm/episodesUnboxing Judaism Podcast: https://unboxing.transistor.fm/episodesRabbi Aryeh Wolbe Podcast Collection: https://collection.transistor.fm/episodesFor a full listing of podcasts available by TORCH at http://podcast.torchweb.org_____________Keywords:#JewishInspiration, #Mussar, #MasterClass, #Remembrance, #Generosity, #Self-awareness, #Charity, #Scholarship, #Wisdom, #Opportunity, #Giving, #Procrastination, #ActsofKindness, #Spiritual, #Resilience, #Adversity, #Rest, #Productivity, #GoodDeeds, #Urgency ★ Support this podcast ★

Has been an attending physician since 2019Brian volunteered when he was a teenager in the ER and the staff that got him involved really drew him toward emergency medicine in med schoolBrian worked in the ED as an EMT as wellHe talks about early mentors and the impact they have, including helping him get loans for medical schoolWe need to remember to be like that mentor that encouraged us when we were new and pay it forward to the next generation of studentsYou must have something that drives you in emergency medicine, it is a difficult specialty. At first the dopamine drive from the excitement can carry you a ways but it will fade over timeBrian talks about how faith led him to where he is nowWe talk about the fulfillment of just having good conversations with patients and making sure they feel cared for and understoodBrian talks about recognizing burnout, it's a “general sense of not being whole” like something has been taken from youHe talks about the golden handcuffs of being a physicianBrian talks about how he overcomes exhaustion and burnoutCold plunging - forces you to be in the moment, control you heart rate and breathing Choosing hard things makes those hard things that are forced on you easierLiving in the moment is largely equated with happiness, the more you can do this the more you can be happy. Meditation and many other therapies are simply teaching you to keep your mind in the momentA wandering mind is an unhappy mindPrayer is another method for focusing your mindSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

John Kosar updates viewers on the Asbury 6, an “EKG for the market.” 5 of 6 metrics are positive as of November 10, and he thinks this is bullish short term. He notes 7,000 is a “big psychological number” for the SPX, which may make it more difficult to break. He charts DIA vs SPY performance to compare major indexes and discusses what could be ahead.======== Schwab Network ========Empowering every investor and trader, every market day. Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/ About Schwab Network - https://schwabnetwork.com/about

Advice for the new EMT, paramedic, nurse, physician who is also a believerBuild your faith in the easier times so your faith doesn't shake when times are hardYou have more reason than anyone on the planet who doesn't believe to strive to do this job better every day, you are held to a higher standardAdam still finds joy in emergency medicine, doing hard things, interacting with many different humans, seeking an answer, the intellectual stimulationYou must be able to embrace the hard stuff, embrace the suckAdam talks about the priority he gives to family and being mentally present when he is physically present with his kidsHe talks about the training that is required to make yourself mentally present outside of work and how to move on from a hard shift“He told me to cast my cares to him because he cares for me”Take care of yourself before you take care of othersIn our line of work sometimes quality is better than quantity timeAdam gives the advice he would give to his younger selfHe knows himself well enough to know he should say “Stay scared my friend,” because he can take that in stride and not panic. This job can be out to get youYou don't know what you don't knowDon't step over the line between confidence and cockinessAdam talks about some practices he has that allow him to move from ER physician mode to father, husband modePraise and worship music on the way home helps himI try to remember to keep my eyes above the waves, like the story of Peter when he walks towards Jesus on the waterSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Faith and burnoutAdam talks about how he tends to spend his spare time reading the Bible, going to church, spending time in prayer and how this develops character and is better than pursuing time wasting activities or the easy dopamine dump that does not add to sustainability or self-improvementWe are designed to do hard things – mental or physical – including pursuing Jesus – this builds stamina, character and makes you better in your careerChoosing hard things makes the hard things that you don't choose much easier to handleSeeking hard, painful things can reset your own personal pain scaleWe can find more reward and satisfaction in the suffering than the result, less satisfaction in being done“Re-shift your mindset to find that the goal is the struggle and you are overcoming it”Journey over destination“The reward comes from striving, from the journey”“That's the example of Jesus”We talk about the apostle Paul and his exampleSocial media skews our view of other humans; it polarizes us and makes us see the worst of humanity instead of seeing the goodThere is some benefit to boredom All sacred texts talk about the need to meditate on these things, allow yourself to sit in silence and seek what you are trying to findSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Heute sprechen Masha und Claus über Dinge an Bord, die man nicht auf Anhieb sieht oder bemerkt. So haben wir beispielsweise die Möglichkeit an Bord ein EKG zu messen und die Daten in Echtzeit an einen Spezialisten zu senden. Oder wir haben Tabletten gegen Seekrankheit an Bord - nur für den sehr sehr unwahrscheinlichen Fall einer Notwasserung - wo diese dann an Bord der zum Floß umfunktionierten Rutschen ausgegeben werden. Wofür man aber einen Peillöffel braucht - oder was genau ababonnieren bedeutet - das erfahrt in unserer heutigen Folge! Viel Freude beim Hören! Insta: @captain.queen.podcast @ayshe_tv_ @quax747

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases are presented from EMM's recent event, Tox Talk 2025. Talk 1- Digoxin Overdose Dr. Adam Greenhaw presents a case of a Digoxin overdose along with many pearls. During the studio listen in, Dr. Prakash helps to answer the questions of: How does digoxin work? Why might a patient still be on digoxin in 2025? What are the EKG findings of digoxin toxicity? Is there any utility in atropine for bradycardia caused by digoxin? Should you use calcium to treat hyperkalemia in the setting of a digoxin overdose? If/when might a cardiologist get involved in a patient with a digoxin overdose? Talk 2- Propranolol Overdose Dr. Travis Barlock presents a case of a beta blocker overdose as well as many associated pearls. During our studio listen in, Dr. Prakash helps to answer the questions of: What are the different beta blockers and how do they work? If you are worried about a propranolol overdose, what medications do you want on hand? What POCUS cardiac view can give you the most information for different scenarios? Why or why not might transcutaneous or intravenous pacing be a good idea for a beta blocker overdose? If/when might you want a cardiologist to get involved in a patient with a beta blocker overdose? References Alahmed AA, Lauffenburger JC, Vaduganathan M, Aldemerdash A, Ting C, Fatani N, Fanikos J, Buckley LF. Contemporary Trends in the Use of and Expenditures on Digoxin in the United States. Am J Cardiovasc Drugs. 2022 Sep;22(5):567-575. doi: 10.1007/s40256-022-00540-x. Epub 2022 Jun 24. PMID: 35739347; PMCID: PMC10263277. Chan BS, Buckley NA. Digoxin-specific antibody fragments in the treatment of digoxin toxicity. Clin Toxicol (Phila). 2014 Sep-Oct;52(8):824-36. doi: 10.3109/15563650.2014.943907. Epub 2014 Aug 4. PMID: 25089630. Hack JB, Wingate S, Zolty R, Rich MW, Hauptman PJ. Expert Consensus on the Diagnosis and Management of Digoxin Toxicity. Am J Med. 2025 Jan;138(1):25-33.e14. doi: 10.1016/j.amjmed.2024.08.018. Epub 2024 Sep 11. PMID: 39265879. Krenz JR, Kaakeh Y. An Overview of Hyperinsulinemic-Euglycemic Therapy in Calcium Channel Blocker and β-blocker Overdose. Pharmacotherapy. 2018 Nov;38(11):1130-1142. doi: 10.1002/phar.2177. Epub 2018 Oct 4. PMID: 30141827. Patocka J, Nepovimova E, Wu W, Kuca K. Digoxin: Pharmacology and toxicology-A review. Environ Toxicol Pharmacol. 2020 Oct;79:103400. doi: 10.1016/j.etap.2020.103400. Epub 2020 May 7. PMID: 32464466. Rotella JA, Greene SL, Koutsogiannis Z, Graudins A, Hung Leang Y, Kuan K, Baxter H, Bourke E, Wong A. Treatment for beta-blocker poisoning: a systematic review. Clin Toxicol (Phila). 2020 Oct;58(10):943-983. doi: 10.1080/15563650.2020.1752918. Epub 2020 Apr 20. PMID: 32310006. Produced by Jeffrey Olson, MS4 Donate: https://emergencymedicalminute.org/donate/

Former paramedic and has been an ER physician for 7-8 yearsHe pursued emergency medicine after his experience as a paramedic because he feels it is more in line with his personality We talk about how emergency medicine checks a lot of exciting boxes that we enjoyAdam talks about his burnout symptoms as well as how he course-correctsHe talks about symptoms like lacking as much compassion/empathy as he should have. So he corrects by talking with his wife, focuses on getting enough sleep etcHe has let go, to some degree, of all the “techniques” we learn to combat burnout and refocused on his “why” – he knows his purpose. He was called by God to do this job“Without question, I was called to be in this position by God – it changes everything”Part of the difficulty of the ER is the sheer volume of people we see on a given day, in a lot of ways, we are managing a lot of mental health conditions in that volume – it can be an opportunity and a gift rather than just viewing it as something to get through. Seeing people as human beingsThis perspective can help us avoid cynicism – I've found that assuming good intentions on the part of everyone I encounter during the day goes a long way towards avoiding cynicism and taking better care of patientsWe must intentionally hold on to the victories, the grateful patient, the lifesaving situation When you look for the good, you tend to find itWe talk about setting tone for the rest of the staff in the EDWe talk faith in emergency medicine as Christians, it has everything to do with everything that we do in life and in the job“I would have chosen an easier job with an easier route to get to it if it wasn't for God”“The hope I have in Jesus sustains me”Why do awful things happen to good peopleFree will leads to the world we see and proves that we are not God, yet we are called to His standardThe potential of every human to do self-seeking, evil is why we see some of the horrible things we see, the answer is where do we take these burdensI discuss my view of free will and its ramifications and our mission on earth as Christians“Should only bring patience and kindness and hope to an interaction with another human who is suffering” Support the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Mohamed: Good day Dr.Cabral, thanks for all your amazing work and shout out to the amazing staff at Equilife/IHP. My question is regarding my EKG, had a bit of an issue one day so I got it done. Eveything looked normal however it said “Consider Right Atrial Enlargement (CRAE)”. I'm 26 years old, I use Equilife products such as DNS, DVB, Full spectrum Mag. My CBC lab looked fine. However I was slightly leaning towards hyponaterima. (Ref range: 135-145), I was 136 (Canadian values). My resting HR is 72, however, I do exercise 2-3 times a week. I do have stress sometimes.. if I get really worked up (emotionally)… I feel it in my chest.. however exercise-wise I can run and run..please advise. Thanks      Carlos:  i have searched your database and cannot find your nighttime routine for cleaning/moisturizing your face. I am wondering what I could do to try and prevent wrinkles and have a healthy, smooth face.                                                              Anonymous: Can you explain a little on under eye eyebags and puffiness. I love listening to your podcast! I tell my friends and family. Thanks for all you do.                                                                                                                                                       Lori: Hello Dr. Cabral, I've recently noticed more joint stiffness and mild aches when I wake up in the morning. I'm only in my 40s, so I was surprised by this. What are the most common underlying causes of early joint discomfort, and are there natural ways to support joint health before it gets worse?                                                                              Rocco: Hi Stephen, LOVE your work and your the main person i trust for my health! 2 quick questions, in my morning smoothie (containing avocado, blueberries, banana, psyllium husk, kale), i open 4 capsules of your daily multivitamin, blend it up then drink it over the next 30 minutes. Is that okay that i open the capsules and empty them into my smoothie pre blending, or should i be swallowing them in full capsule form? Finally, is it best to take all vitamins with food, or just follow instructions. I usually take 2-3 Cal-Mag capsules right before bed, as the instructions do not say i need to have it with a meal. Why do some vitamins need to be taken with food, and others not need to be? Thanks !                                   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!    - - - Show Notes and Resources: StephenCabral.com/3550 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!  

V pubertě mě kvůli nedomykavosti srdeční chlopně poslali na EKG. Tento přístroj vymyslel holandský fyziolog Willem Einthoven jako spolehlivý prostředek ke snímání srdeční aktivity. Na citlivou pubescentku mého typu ale byla tato sterilní procedura trochu moc.Všechny díly podcastu Glosa Plus můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

Give the escalating patients some room, you don't have to be within arm's reachI talk about what a bad code blue looks like and what a good code blue looks like and how this translates to running a good code greyAssign roles, we don't have to surround every aggressive patient with a ton of peopleDon't join in the fight or flight mindset that the patient may be operating inWe talk about who should be lead in these situations and how we should be handling behavioral health emergencies when they escalateWe deal with staff and nurses leaving the field related to these negative interactions, so part of the goal needs to deal with the emotional toll it leaves on the healthcare individuals involvedSometimes patients don't choose the ideal plan that we may want for them, but we can't let this burn us out and instead, focus on making a great alternate plan that will serve themJosh shares a great personal story where he went above and beyond to help a grieving family member that still remembers him from a decade agoSometimes all we can do is plant a good seed and the harvest is much laterGreat customer service is an important concept, respect and dignity, empathy and understandingFight to understand, not fight to winWe have to frequently check our bias, we can miss opportunities and even medical emergencies if we write off a patients behavior as just a behavioral issueWe cannot help others until we take care of ourselvesHydrate, use the bathroom, eat while on shiftWe are all at risk of developing cynicism from negative encounters, so we have to be intentional of seeing the goodSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Josh has 20 years in Public SafetyCurrently doing crisis prevention instructionWe often don't get any education in med school or PA school in how to communicate well with patients or how to de-escalate their behaviorCode greys are the behavior health emergency response; someone has some concern that a patient is escalating to potentially violent behavior and a team will respondStaff safety is priorityWe are there to provide excellent medical care, if it's safe to do soWe recommend calling code greys earlier to avoid worsening scenarios Code grey assures staff safety then de-escalation of the patientRecognizing when you need help with patient interaction from some other staff member is importantTypically, negative behavior is a result of an unmet need or wantRationally detachGive people options, this helps give them a measure of control when they feel out of controlGet consent to do a physical exam, taking that extra few seconds to explain what you're doing and getting that quick permission goes a long wayWe forget that we ignore many social norms in the ED, patients may not be used to thisAlways introduce yourselfA huge component to de-escalation of patients with negative and violent behaviors is that, if not done properly, they are a primary source of burnout. They become a huge negative experience that it sticks with you, not to even speak of the potential for an injury. Avoiding these negative experiences at all costs will be key to thriving in emergency medicineJosh talks about a severe ankle injury he sustained and how he found a way to keep helping people anyway. He talks about how he strived to get the struggling people back connected to community. He helped them re-establish trust in others so that they could accept helpWe talk about the resources available for financially struggling patientsSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

In this episode of Frontline Headliners, we talk with the EM cardiology and EKG guru, Dr. Amal Mattu. We talk about his upbringing and how he got into emergency medicine and eventually because the face of EM EKGs.

Lucas gives his pitch for why it is still worth it to be a physician - it's one of the best jobs in the world but you have to have the ability to adapt to change over timeBeing a physician still allows you a rewarding, stable and consistent job. A comfortable lifestyle. Job portabilityAs a PA, this can be even better because you can switch between specialtiesOur variable schedule in the ED has its cons but it has a lot of pros as wellWe talk about things that we find rewarding in emergency medicineEven the non-work-related rewards when we often do nothing at all but reassure our family, our friends is fulfilling The cascade from relieving anxiety and saying “you are okay” is powerfulA brilliant ER mind said “Don't just do something, stand there”If you are well, aggressive medical interventions are more likely to harm you than help youTake care of yourself, take care of your relationships, the lone wolves die, humans need other humans to surviveIn your journey in a career that is very difficult and very easy to burnout, the rewards are much more magnified on the other side. The rewards are much more in your control than you think. With the right mindset you can change how rewarding your career will beThis is an amazing setting, you have one of the coolest jobs in the whole worldWhat other job is there where you see people on the worst day of their lives, save a life and can allow other people's lives to touch youThere is an honor to be there on someone's worst dayIntentionally look for the positive, it is thereSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

As has been the routine in 2025, the Extra Monday Episodes are dedicated to interpreting EKG rhythms. This month, the crew discusses, wide complex bradycardias and tachycardias, the symptoms and the treatments.

Longevity in a tough field is something you need to consider as well as the right mindsets that keep you there – be intentional about being gratefulLucas gives some advice in doing triage shifts and focusing on the good people you have the privilege to interact with and trying to be intentional about not focusing on the mean, angry patientIntentionality behind the things that improve your well-being are more important to prioritize than you might think Allow your family, significant other to help youFatherhood and dual income houses are more the norm now so both parents have to work toward raising children and workingLucas gives advice to the new ER physicianThe busier you are, the more stressed you are, the more you need to maintain hobbiesThe PA profession has done a good job of setting people up for success with having a good work and life balanceCommunity is super important to cultivate, the lone wolf diesIt can be easy to justify allowing relationships to wane when you are busy in medicine and education, but this cannot be put off foreverBreak the pattern of pushing off community in favor of careerSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

ER physician for 15 yearsHe talks about this path into med school and emergency medicine as his first choiceHe likes the challenge, lack of predictability and wide scope of problems we must solve. We have the honor to accept patients when no one else willLucas talks about how the term emergency medicine is almost becoming antiquated when we are doing acute, undifferentiated careSome of the care is emergencies, but not all. And that's probably for the best so we don't get burned outHe talks about burnout and how we should focus on how to manage it when it happens as opposed to how to prevent it all the timeYou need to accept that burnout will happen, so you don't have an expectation mismatchBeing aware of your own burnout is key to correcting itOptimizing the other things in your life outside of work like exercise, nutrition, community is keyBe intentional about focusing on the enriching case, appreciative patient, positive conversation you have throughout the day. If you look for the positive you will find it and then do whatever you need to do to get it in your long-term memoryLucas talks about gratitude and how this requires intentionality as wellWe talk about how much to share with spouses We talk about the role of the clinician in the ED and how we have a lot of things to manage that other staff may not seeWe talk about how to manage our limited resourcesSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Leave work on time•David's story: a skilled, compassionate paramedic who deeply connected with patients, especially during psychiatric crises.oStruggled to separate work from life.oRelied on alcohol as a coping mechanism, which ultimately cost him his life.•Core lesson: In emergency medicine, you must leave work at work—emotionally and physically—otherwise burnout and unhealthy coping are inevitable.•Healthy separation:oBalance connection with patients while avoiding over-identification.oRemember: “It is not your emergency.”•Practical strategies to get off on time:oCheck labs/imaging in real time.oComplete charting as you go.oPlan handoffs 1–2 hours before end of shift.oControl what's controllable—systems, shift crossover, advocate for better staffing.•Mental discipline:oSet down burdens from tragic or unjust cases (e.g., drunk drivers, preventable deaths).oFind something greater than yourself (faith, higher power, or another anchor) to release what you can't control.•Work–life balance:oCreate a clear line between work and home (physical transition, dedicated space, or ritual).oAccept that some seasons demand more grind, but don't let it become a lifestyle.oYour family will notice the time you miss more than your employer ever will.•Identity check:oYou are not your job title; resilience and character matter more.oOver-identifying with work justifies staying late and sacrificing home life.•Universal takeaway: No matter the field, burdens from work will bleed into family life unless you intentionally lay them down. Getting off on time = preserving resilience, family, and long-term health.Chapter 3: Take Care of Yourself Before You Take Care of Others•Past struggles:oPrioritized school and work over health.oPoor sleep, binge eating, energy drinks, inconsistent workouts.oLack of discipline → foggy brain, poor performance as a paramedic.•Core principle:oYou cannot care for others well if you neglect yourself.oIn EMS/ED, emergencies are unpredictable, but most patients are not crashing—there's time to hydrate, eat, and reset.•Practical applications:oDrink water, eat proper nutrition, and rest before/during shifts.oPrioritize morning routines (hydration, exercise, food) → sets the tone for the day.oMeal prep to avoid cafeteria junk food and impulsive choices.oCreate habits that are accessible (water bottles, packed meals).•Mindset shift:oCaring for yourself Support the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

IntroductionMy first experience with a cardiac arrest as a new EMT → exhilarating, confirmed calling to emergency medicine.Early struggles: dropped out of college, lacked discipline, but EMT training provided a direction and purpose.Spent years balancing work as EMT/paramedic with school → long path to becoming a PA.Lessons from emergency medicine shaped clinical skills and mindset.Concept of standards:Standards = benchmarks, measurable expectations, non-negotiable habits.Different from principles (general truths) → standards are concrete, either met or not.Standards build consistency, resilience, and preparation.Personal struggles: binge eating, lack of discipline, repeated failures to meet daily goals.Turning point: completing 75 Hard program → developed discipline, consistency, higher personal standards.Standards spill over into clinical performance, family life, and personal growth.Emphasizes locus of control:Focus on what you can control, not external factors.Even in chaotic emergency medicine, there are controllable elements.Warns that neglected habits eventually become emergent problems (health, mindset, life).Family story: father's heart attack → personal wake-up call about health and discipline.Core message: Raising standards in personal life and medicine leads to thriving, not just surviving.Purpose: help others raise their own standards without taking 16 years to learn the lessons.Chapter 1: Do Not Seek to DiagnoseCase study: elderly woman with shortness of breath and chest pain.No pulmonary embolism, but fluid in lungs and around heart → problem found, but no definitive diagnosis yet.Highlight: in the ED, the goal is to rule out life-threatening conditions, not always find the exact cause.Key principle: Diagnosis is often less important than identifying and stabilizing dangerous conditions.Emergency medicine limits:Not every test or long-term treatment available.Focus on acute, life-threatening issues; leave underlying cause to specialists.Patients often expect answers and certainty, but ED care is about safety and ruling out the worst cases.Overdiagnosis problems:Incidental findings (lung nodules, brain aneurysms, ultrasound anomalies) → create stress, anxiety, or unnecessary proceSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

We break down pneumothorax: risks, diagnosis, and management pearls. Hosts: Christopher Pham, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Pneumothorax.mp3 Download Leave a Comment Tags: Chest Trauma, Pulmonary, Trauma Show Notes Risk Factors for Pneumothorax Secondary pneumothorax Trauma: rib fractures, blunt chest trauma (as in the case). Iatrogenic: central line placement, thoracentesis, pleural procedures. Primary spontaneous pneumothorax Young, tall, thin males (10–30 years). Connective tissue disorders: Marfan, Ehlers-Danlos. Underlying lung disease: COPD with bullae, interstitial lung disease, CF, TB, malignancy. Technically, anyone is at risk. Symptoms & Differential Diagnosis Typical PTX presentation: Dyspnea, chest pain, pleuritic discomfort. Exam clues: unilateral decreased breath sounds, focal tenderness/crepitus. Red flags (suggest tension PTX): JVD Tracheal deviation Hypotension, shock physiology Severe tachycardia, hypoxia Differential diagnoses: Pulmonary: asthma, COPD, pneumonia, pulmonary edema (SCAPE), ILD, infections. Cardiac: ACS, CHF, pericarditis. PE and other acute causes of dyspnea. Diagnostics Bloodwork: limited role, except type & screen if intervention likely. EKG: reasonable given chest pain/shortness of breath.

Advice for new EKG techs:Trust your knowledge and build your confidence over time, stay calm and take deep breaths when you start to get busyStay humble, ask for helpNo one comes out of school knowing everything, you need to know your limitsRegardless of your role, don't be afraid to advocate for the patientProviders need to remember to project an approachable demeaner so that everyone has a level of comfort bringing things to their attentionIt's important to take your job seriously and do it to the best of your abilityCheyenne talks about the stress of scribingSean talks about some frustrations he has with nursing putting in frequent EKG orders without the right indication We talk about some of the specialties within cardiology If you are looking into getting into medicine, look at EMT or EKG tech. They both give you a great insight into the greater medicine worldThere are a lot of great jobs that introduce you to medicine before you take the risk of PA school or medical schoolSometimes the only way to really understand what you are getting into is to get into the field instead of reading about it or watching videos about itSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Contributor: Taylor Lynch, MD Educational Pearls: What is atrial fibrillation with rapid ventricular response (AFib with RVR) and how does it differ from atrial fibrillation (AFib)? AFib is an abnormal heart rhythm in which the heart has disorganized atrial electrical activity. This causes the atria to quiver with only select signals being conducted through the Atrioventricular (AV) Node to reach the ventricles and result in ventricular contraction. Often described as “irregularly irregular”, a patient's EKG will present with no discernible P-waves, and irregular R-R intervals. AFib with RVR is distinguished from AFib when the patient's ventricular rate is greater than 100-110 beats per minute in AFib with RVR. What is the treatment for AFib with RVR? Diltiazem is considered one of the first line therapeutic agents in the treatment of AFib with RVR. Diltiazem inhibits L-Type calcium channels in the AV Node, reducing the amount of signals conducted to the ventricles, thus reducing the ventricular rate. Why pretreat patients receiving Diltiazem for AFib with RVR with calcium? While diltiazem inhibits cardiac calcium channels, it may also cause peripheral vasodilation, resulting in diltiazem-induced hypotension. A recent study found that this hypotension can be blunted by pretreating with 1-2g IV Calcium Chloride (IV Calcium Gluconate can be used in the ED). Calcium is thought to peripherally stabilize the vascular smooth muscle, preventing vasodilation without impacting the desired calcium channel blocker action at the AV node. Key takeaways? In combination with slower pushes of diltiazem for patients in AFib with RVR (AFib with ventricular rate >100-110 bpm) with borderline low blood pressures, 1-2 g of IV Calcium Gluconate can combat diltiazem induced hypotension peripherally without negating the cardiac effect of diltiazem to reduce the heart rate.  References 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156. doi:10.1161/CIR.0000000000001193 Az A, Sogut O, Dogan Y, et al. Reducing diltiazem-related hypotension in atrial fibrillation: Role of pretreatment intravenous calcium. Am J Emerg Med. 2025;88:23-28. doi:10.1016/j.ajem.2024.11.033 Summarized by Dan Orbidan, OMS2 | Edited by Dan Orbidan and Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/  

We talk about stat vs routine EKG orders as well as metrics that they are always working to hit on timeWhen EKG's are not done on time the source of the problem needs to be found, sometimes it is the providers' fault for not realizing the EKG order had not been placed We talk about how we should communicate between provider and EKG tech and how much info we like to get as providersI talk about how providers need to become good at task switching frequently and this includes signing EKG'sWe talk about the responsibility of the PA or NP to sign EKG's (calling STEMI's or deciding not a STEMI) and how this responsibility is currently in the hands of the physicians onlySean talks about how important EKG's can still fall through the cracks at times and people will still point the blame all the way back to the EKG techIt's important to make sure you do your job well and then realize some things are out of your handsCheyenne talks about an experience she had with an end-of-life patient she cared forEven being just peripherally involved in a patient's care can really affect you emotionallyAvoiding burnout:Cheyenne likes to go to the gym or hang out at home with her dogsSean talks about how he avoids burnout doing a job that can sometimes be repetitiveSean also talks about the importance of calmness in front of patients, even when an EKG might be alarmingDon't sweat the small things, especially in the ED, everyone is under a lot of stress, and you can't allow a small comment from a stressed-out coworker to get under your skin and make you spiral Sean talks about some methods to reassure patients despite not being able to diagnose their EKG We talk about the importance of stress management in the ED so that you can think clearly about the next patientIt is not your emergency, we must be the calm in the stormSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Heart disease is the leading cause of death for women in the United States, yet many of us don't recognize the warning signs until it's too late. This week, we welcome Sarah Hill, CEO of Helium and former award-winning journalist. At just 53 years old, Sarah experienced a heart attack while on vacation in Las Vegas, despite being healthy, active, and having a normal EKG. It was only because of her husband's persistence that doctors ran the tests that ultimately saved her life.In this powerful conversation, Sarah opens up about what happened, how it changed her perspective, and why every woman needs to take her heart health seriously. We talk about the risks, the signs you shouldn't ignore, and what we can all be doing right now to protect our hearts and prevent more lives from being lost too soon.Whether you're in your 30s, 50s, or beyond, this episode will leave you both informed and inspired to prioritize your health. Special Guest: Sarah HillSarah Hill is the CEO & Chief Storyteller of Healium, a mental fitness company blending neuroscience, immersive media, and storytelling to help people *see their feelings and learn to self-regulate. Backed by research in 9 peer-reviewed journals, Healium's clinically validated biofeedback experiences are used by the world's top health, education, and sports organizations.A 12-time Mid-America Emmy-winning journalist, Sarah spent 25 years leading media teams and reporting from global trauma zones working for NBC, ABC, and CBS news affiliates. After covering trauma for years, she flipped the script and began crafting stories that help people heal from it.A media technologist, Sarah holds multiple patents for biometrically-powered stories—experiences fueled by EEG, heart rate, skin conductance, and respiration. She speaks globally on media as medicine, AI, mental fitness, and the intersection of spatial and sentient computing.Sarah lives in Missouri with her husband (whom she lovingly counts as child #3), two grown kids, and a delightfully spoiled grandchild.And wait, there's one more thing you should know about Sarah. She can now add to her long list of accomplishments - she's a heart attack survivor!Show notes:5 morning signs that signal heart trouble. https://share.google/?link=https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/5-morning-signs-thatsignal-heart-trouble/photostory/122871717.cms&utm_source=sharelaunchiga,sh/x/discover/m1/5Heart Attack: Men vs. Women: https://theheartfoundation.org/2017/03/29/heart-attack-men-vs-women/

Welcome to the show Sean and Cheyenne, EKG tech experience and scribe experienceSean talks about certifications and expectations that go beyond merely obtaining an EKG as well as the stress testing roleCheyenne talks about the role that scribes play in the EDScribing for providers is often used as a role to gain patient experience for medical school or PA schoolThey talk about how they got into scribing and EKG technician work and Sean talks about how it is also a role that is used as a steppingstone12 leads are complicated to interpret and require a lot of training and experience to get good at. They are even harder to interpret when the patient is not in front of youSTEMI's are the key EKG's to recognize because they are so time sensitive, but we don't see these frequently – it can be very helpful when the tech recognizes this and can recognize the urgencyKnowing early signs of impending problems on the 12 lead can be helpful for patient prioritization as wellBeing an EKG tech requires good resource utilization, sometimes there are not a ton of EKG techs available in the hospital, so they need to prioritize – communication is keyCommunication between roles is so important when we are trying to get quickly get imaging, labs, assessments and EKG simultaneously At the end of the day, the patient is the top priorityScribes do deal with a lot of stress, they must finish notes, write new notes and keep up with high volume, they like active communication with the providerSean talks about how a typical day can vary quite a bitSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

John Kosar breaks down the latest on the Asbury 6, a method of measuring market health he calls an “EKG for the market.” With 4 metrics turning green, he says the market is “repairing itself.” He explains how his firm uses the Asbury 6 in its investment strategies. John argues sectors to avoid right now are health care, financials and energy. He also looks at the Mag 7, saying “the market needs leadership” to keep going higher.======== Schwab Network ========Empowering every investor and trader, every market day. Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/ About Schwab Network - https://schwabnetwork.com/about

Today Dr. Karl Hanson and Dr. Samia Suleman of Infinity Health Direct Primary Care in Kenner, Louisiana share about their DPC journey. They share their experiences transitioning from insurance-based models, and the evolution and benefits of DPC. Dr. Hanson and Dr. Suleman discuss the challenges of establishing and joining a DPC practice, their personal motivations, and the importance of physician autonomy. The episode also covers the partnership between the doctors, the structure of their practice, and their future plans, including efforts to educate medical residents about DPC. Additionally, the formation and goals of the Louisiana Direct Primary Care Coalition are highlighted, emphasizing the potential of DPC to transform healthcare across the state.Call in with your questions about how the "Big Beautiful Bill" affects HSAs and DPC. LEAVE A VOICEMAIL HERE.Get your copy of ELATION HEALTH'S HOW TO LAUNCH YOUR OWN DPC PRACTICE CHECKLIST. Get a practice audit and 80 FREE hours of VA work for your DPC with Cool Blue VA! Check out the latest Cool Blue VA Episode HERE!Schedule a demo with Cerbo today!Spruce Health: All-In-One Patient Co Hint Clinical: Run your dream practice with Hint's DPC softwareA-S Medication Solutions: medication management made simple for DPC. Learn more about JumpStart DPC Solutions: Marketing solutions modeled after DPC Elation Health. Empowering DPC practices to thrive through clinical-first innovation..See how at elationhealth.com.SmartHeart: THE 12-lead EKG for your DPC!Support the showBe A My DPC Story PATREON MEMBER! SPONSOR THE PODMy DPC Story VOICEMAIL! DPC SWAG!FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

I'd like to welcome to the show Dr. David M. Berry, MD, he is a growing voice in the recovery and addiction space, an area that we deal with a ton across EMS and the emergency departments. He is an Emergency Medicine physician with over two decades of experience. You can reach him at dberrymd@hotmail.com Burnout and moral injury – how do we avoid these in dealing with the addicted and psychiatric patients? We can't control most factors involving their long term care but David says: “give these folks the best care I know how to give them.” We can control what WE do We talk about the best way to communicate between providers when passing on patients to the next shift Dr. Berry talks about a patient he advocated for that he felt needed in-patient psychiatric admission but had been initially turned down He talks about the importance of working patients up appropriately and not ignoring patient complaints, getting the emotion out of it What would you do objectively if the patient was not a frequent flyer? Dr. Berry talks about a substance use clinic he helped open in Western Colorado He talks about meth addiction and how recovery works in his clinic He tells a story about the devastating effects of meth on a young patient The danger of meth is not in the withdrawal but the effects of it on your body Dr. Berry talks about the limbic system, the reptilian part of our brain. People who struggle with addiction have a missed connection. Normally, when the average person drinks, a message gets relayed back from the brain saying slow down, you have responsibilities, you have work, you have a family. The addict's brain doesn't send this message back, they just get the message to drink more cause it feels good. This applies to any addiction Their decider is broken, that's why they need a sponsor, and their brain can eventually rewire and make the needed connections The anatomy problem of missed or failing brain neurons is what is going wrong in the addict's brain This helps us understand where the blame truly needs to be placed, not on the addict for poor moral character or poor self-control but on a brain that isn't wired correctly Winston Churchill said everyone has an addiction, the key is finding one that is socially acceptable Dr. Berry talks about Recovered on Purpose, an organization in Denver, CO that is working on new treatments for addictions and help market treatment centers and help get peoplSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

In this episode, we speak with Sarah Gebauer MD anesthesiologist and RAND Senior Researcher, who discusses the critical questions facing healthcare professionals as AI becomes integrated into clinical practice. She's the author of "Machine Learning for MDs" newsletter  and published research on physician attitudes toward AI including the BMJ Evidence-Based Medicine article Survey of US physicians' attitudes and knowledge of AI. Her company Validara Health works on evaluation frameworks for healthcare AI implementation. Physicians have been using AI for EKG interpretation for decades without fully understanding the algorithms, highlighting that transparency should focus on appropriate usage rather than complete technical knowledge. Most current AI tools operate as Software as a Service rather than regulated Medical Devices, while the FDA struggles to keep pace with rapid AI development. Despite their challenging history with EHR implementation, physicians show strong interest in learning about AI when they believe it will help patients. The medical liability landscape remains uncertain until legal precedents are established through jury awards, making documentation of clinical decision-making crucial when using AI as additional information alongside other clinical data. Traditional machine learning evaluation metrics often fail to predict real-world clinical performance, where workflow integration and clinician experience prove more important than laboratory results. For professional development, busy physicians benefit most from resources that push information directly to them, such as newsletters and targeted social media follows, rather than formal courses requiring active searching. Some places to follow along with AI in healthcare: Machine Learning for MDs newsletter TLDR AI newsletter a16z healthcare If you enjoy the show, please leave a ⭐⭐⭐⭐⭐ rating on Apple or a

I'd like to welcome to the show Dr. David M. Berry, MD, he is a growing voice in the recovery and addiction space, an area that we deal with a ton across EMS and the emergency departments. He is an Emergency Medicine physician with over two decades of experience. You can reach him at dberrymd@hotmail.com We must remember, when working up these patients with addiction, they can have poor health baseline anyway, so they are at higher risk for something emergent to be going on Dr. Berry talks about this approach to opiate OD We have a small window between the ED and definitive care to help addicted patients move forward with treatment – a warm handoff to a treatment center or primary care that can monitor recovery is key We have specific rules for most emergencies but often psychiatry is not on a set system Holds may not always accomplish what we hope they will, it will not force someone to changeBut there is certainly a role for the patient who is genuinely suicidal  We talk about good structure of evaluation and treatment of the psychiatric emergencies  David talks about some patients he has been able to help with addiction recovery from his experience Don't underestimate the difference we can and do make with patients just because we don't always see the result Dr. Berry talks about the message he has for clinicians:We deal with a lot of emergencies, people actively dying, so when we hear a psych complaint or substance abuse complaint, we tend to mentally shuffle them into a lower priority. We need to remember to have empathy and take their complaints seriously, slow down with these patients We talk about the balance between empathy and detachment and burnout David talks about some methods of humanizing the experience for your patients and getting them to open up more We talk about anchor bias and how to protect from it David talks about conformation bias and how it relates in piloting an aircraft and emergency medicine A key question to ask before you leave a patient room is “Do you have any questions?” – This can be hard to ask because we often want to move on but it's so important to the patientSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

I'd like to welcome to the show Dr. David M. Berry, MD, he is a growing voice in the recovery and addiction space, an area that we deal with a ton across EMS and the emergency departments. He is an Emergency Medicine physician with over two decades of experience. You can reach him at dberrymd@hotmail.com He has an incredible story. He was conceived following a one-night stand and was almost aborted before being put up for adoption to a loving family. He had his first child and felt the gift of knowing his first genetically related family member for the first time.Tragically, his first daughter was diagnosed with spinal muscular atrophy, a diagnosis not compatible with life and she later died around 9 months of age.This led David to turn to alcohol to help deal with the pain. His family took notice of this, so he transitioned to opiates instead of alcohol, something that he could hide more easily. He was eventually found out and spent some time in jail and tried some treatment centers. He lost his medical license, his family left him and he became homeless.His rock bottom was when he found himself homeless living under a bridge with no ID and realized that no one would even realize if he had died. With the help of another doctor, David started taking Suboxone, which helped him to overcome opiate addiction.This opened a path to Dr. Berry getting his medical license back and eventually led to a role as chief of staff of his hospital as well as opening up a rehab clinic in Colorado. Hearing David's story helps put in perspective the fact that none of us are that far removed from the homeless, drug addicted patient we care for in the ER. He talks about his new appreciation for his life and his family We talk about techniques to get patients to open up to us despite our short time with them: “Do you mind if I examine you?” gives the patient some control in the situation Some of our biggest misconceptions about these addicted patients is “They are trying to game the system,” maybe they are, but maybe they are totally out of options or are having a real emergency. “What can I do to help you?” may open up a conversation about what they feel they need Small, short conversations can make a big difference over time We often don't have enough time with patients to label them with anxiety disorder or opiate use disorder, so avoiding labels is probably best in the ED Have a way to work up patients that avoids your biasSupport the showFull show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition Everything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

This week, Dr. Prather gives a preview of his upcoming free seminar about the Holistic Heart program at Holistic Integration.  In this episode, we talk about:—The philosophy behind Holistic Heart and how it integrates Structure-Function Care and the medical model for the best patient outcomes.—How our Holistic Heart program is designed to give our patients safe, non-invasive, and medically-sound cardiac care that is more than just stents and statins. —The unique diagnostic tests Dr. Prather orders for patients that most cardiologists do not do. —The shocking study from the National Institutes of Health study that revealed stents and bypass surgeries are NOT effective for long-term heart health outcomes. —The External CounterPulsation (ECP) Therapy developed 60 years ago by Harvard and how it duplicates 5 years of marathon training for the heart in just 7 weeks. And the touching story of how Dr. Prather came to bring this treatment into his office.—How Magnesium for men and Potassium for women are "absolutely critical" for those situations where a person dies suddenly and unexpectedly from a heart attack. —Why high Cholesterol is NOT the underlying problem, but an indicator of Cardiovascular Disease. And why Dr. Prather describes Cholesterol as the firefighters showing up to put out the fire. —How Chiropractic care helps with the Vagus Nerve, POTS (Postural orthostatic tachycardia syndrome), and can play a big role for atrial fibrillation (AFib). Plus, the Acupuncture points that can settle down the EKG of a patient while they are having a heart attack.—The Cardiac C-Reactive Protein Blood Test that is the biggest indicator of having a heart attack. And how Cardiologists are "amazed" by how Dr. Prather can quickly and effectively get positive changes in this measurement.—How you can get our Autonomic Nervous System Test for just $49 (normally a $195 value) by attending our next free Holistic Heart seminar with Dr. Prather on Wednesday, July 30th at 6:30 p.m.http://www.TheVoiceOfHealthRadio.com

Get ready to demystify the 2025 Tax Bill.Hosts Tait Duryea and Ryan Gibson sit down with Nathan Sosa, tax strategist at Hall CPA, to uncover what this sweeping legislation really means for pilots and high-income earners. From the return of 100% bonus depreciation to new deductions for auto loans and overtime, Nathan breaks down exactly who benefits and how. Whether you're building passive income or just want to keep more of what you earn, this is required listening.Nathan Sosa is a Certified Public Accountant (CPA) with Hall CPA, a firm specializing in real estate tax strategy. As a seasoned tax strategist, Nathan works closely with high-income professionals and investors to navigate complex tax codes and optimize financial outcomes. With expertise in Opportunity Zones, real estate syndications, and tax planning, Nathan empowers clients with proactive strategies to minimize tax liabilities and build wealth.Show notes:(0:00) Intro(02:29) The one test every pilot over 40 should do(05:25) Treat your medical like a checkride(07:09) Primary care vs. AME: What's the risk?(12:33) EKG tip that can save your exam(16:01) Why most AMEs can't coach you(19:43) ADHD, mental health, and new FAA standards(25:07) Screening tests to do by age group(31:02) MedExpress simulator and application tips(35:06) How to access your past FAA medicals(49:00) OutroConnect with Nathan Sosa:Book a Discovery Call with Nathan Sosa: https://bit.ly/HallCPA —If you're interested in participating, the latest institutional-quality self-storage portfolio is available for investment now at: https://turbinecap.investnext.com/portal/offerings/8449/houston-storage/— You've found the number one resource for financial education for aviators! Please consider leaving a rating and sharing this podcast with your colleagues in the aviation community, as it can serve as a valuable resource for all those involved in the industry.Remember to subscribe for more insights at PassiveIncomePilots.com! https://passiveincomepilots.com/ Join our growing community on Facebook: https://www.facebook.com/groups/passivepilotsCheck us out on Instagram @PassiveIncomePilots: https://www.instagram.com/passiveincomepilots/Follow us on X @IncomePilots: https://twitter.com/IncomePilotsGet our updates on LinkedIn: https://www.linkedin.com/company/passive-income-pilots/Do you have questions or want to discuss this episode? Contact us at ask@passiveincomepilots.com See you on the next one!*Legal Disclaimer*The content of this podcast is provided solely for educational and informational purposes. The views and opinions expressed are those of the hosts, Tait Duryea and Ryan Gibson, and do not reflect those of any organization they are associated with, including Turbine Capital or Spartan Investment Group. The opinions of our guests are their own and should not be construed as financial advice. This podcast does not offer tax, legal, or investment advice. Listeners are advised to consult with their own legal or financial counsel and to conduct their own due diligence before making any financial decisions.

CardioNerds (Dr. Claire Cambron and Dr. Rawan Amir) join Dr. Ayan Purkayastha, Dr. David Song, and Dr. Justin Wang from NewYork-Presbyterian Queens for an afternoon of hot pot in downtown Flushing. They discuss a case of congenital heart disease presenting in adulthood. Expert commentary is provided by Dr. Su Yuan, and audio editing for this episode was performed by CardioNerds Intern, Julia Marques Fernandes. A 53-year-old woman with a past medical history of hypertension visiting from Guyana presented with 2 days of chest pain. EKG showed dominant R wave in V1 with precordial T wave inversions. Troponin levels were normal, however she was started on therapeutic heparin with plan for left heart catheterization. Her chest X-ray revealed dextrocardia and echocardiogram was suspicious for the systemic ventricle being the morphologic right ventricle with reduced systolic function and the pulmonic ventricle being the morphologic left ventricle. Patient underwent coronary CT angiography which confirmed diagnosis of congenitally corrected transposition of the great arteries (CCTGA) as well as minimal non-obstructive coronary artery disease. Her chest pain spontaneously improved and catheterization was deferred. Patient opted to follow with a congenital specialist back in her home country upon discharge.   US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- A Case of Congenital Heart Disease Presenting in Adulthood Congenitally Corrected Transposition of the Great Arteries (CCTGA) is a rare and unique structural heart disease which presents as an isolated combination of atrioventricular and ventriculoarterial discordance resulting in physiologically corrected blood flow.   CCTGA occurs due to L looping of the embryologic heart tube. As a result, the morphologic right ventricle outflows into the systemic circulation, and the morphologic left ventricle outflows into the pulmonary circulation.   CCTGA is frequently associated with ventricular septal defects, pulmonic stenosis, tricuspid valve abnormalities and dextrocardia.   CCTGA is often asymptomatic in childhood and can present later in adulthood with symptoms of morphologic right ventricular failure, tricuspid regurgitation, or cardiac arrhythmias.   Systemic atrioventricular valve (SAVV) intervention can be a valuable option for treating right ventricular failure and degeneration of the morphologic tricuspid valve.  notes- A Case of Congenital Heart Disease Presenting in Adulthood Notes were drafted by Ayan Purkayastha.  What is the pathogenesis of Congenitally Corrected Transposition of the Great Arteries?   Occurs due to disorders in the development of the primary cardiac tube   Bulboventricular part of the primary heart forms a left-sided loop instead of right-sided loop, leading to the normally located atria being connected to morphologically incompatible ventricles   This is accompanied by abnormal torsion of the aortopulmonary septum (transposition of the great vessels)   As a result, there is ‘physiologic correction' of blood flow. Non-oxygenated blood flows into the right atrium and through the mitral valve into the morphologic left ventricle, which pumps blood into the pulmonary artery. Oxygenated blood from the pulmonary veins flows into the left atrium and through the tricuspid valve to the morphologic right ventricle, which pumps blood to the aorta. Compared with standard anatomy, the flow of blood is appropriate, but it is going through the incorrect ventricle on both sides.  Frequent conditions associated with CCTGA include VSD, pulmonic stenosis and dextrocardia  

RE-RELEASE This was first published in 2023 but it's so good we are running it back! Buckle up, PGY-1's! Intern year is starting whether you're ready or not. Don't fret, BTK has your back to make sure you dominate the first year of residency. Today, we're hitting the wards and tackling some of the scary clinical scenarios you will see as an intern. Hosts: Shanaz Hossain, Nina Clark Tips for new interns: THINGS TO REMEMBER ·       BREATHE. In most cases, you have a little bit of time – at least enough to take a breath and calm down outside the room before heading into an emergency. Panic doesn't help anybody. ·       See the patient. Getting a bunch of pages? Worried about someone? Confused as to what's going on? Go see the patient and chat with the bedside team. ·       Know your toolbox. There are a ton of people around who can help you in the hospital, and knowing the basic labs/imaging studies and when to use them can help you to triage even the sickest patients. ·       Load the boat. You've heard this one from us all week! Loop senior level residents in early. HYPOTENSION ·       Differential: measurement error, patient's baseline, and don't miss – SHOCK.            - Etiologies of shock: hemorrhagic, hypovolemic, ·       On the phone: full set of vitals, accurate I/Os, ·       On the way: recent notes, PMH/PSH including from this hospital stay, and vitals/I&Os/studies from earlier in the day ·       In the room: ABCDs – rapidly gives you a sense of how high acuity the patient is ·       Get more info: labs, consider imaging, work up specific types of shock based on clinical concern. ·       Initial management: depends on etiology of hypotension; don't forget to consider peripheral or central access, foley catheterization for close monitoring of urine output, and level of care HYPOXEMIA ·       Differential: atelectasis, baseline pulmonary disease, pneumonia, PE, hemo/pneumothorax, volume overload ·       On the phone: full set of vitals, amount of supplemental oxygen required and delivery device, rate of escalation in oxygen requirement ·       On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection ·       In the room: ABCDs, pulmonary and cardiac exam, volume status exam ·       Get more info: basic labs, ABG if worried about oxygenation, CXR, consider bedside US of the lungs/heart, if high suspicion for PE consider CTA chest ·       Initial Management: supplemental O2, higher level of care, consider intubation or other supplemental oxygenation adjuncts, additional management dependent on suspected etiology ·       ABG Vs VBG (IBCC): https://emcrit.org/ibcc/vbg/ ALTERED MENTAL STATUS ·       Differential: stroke, medication effect, hypoxemia or hypercarbia, toxic or medication effect, endocrine/metabolic, stroke or MI, psychiatric illness, or infections, delirium ·       On the way: review PMH/PSH, recent notes for evidence of altered mentation or agitation, or signs hinting at above etiologies ·       In the room: ABCDs, focal neuro deficits?, alert/oriented? Be sure the patient's mental status is adequate for airway protection! ·       Get more info: basic labs, blood gas/lactate, CT head noncontrast if concerned for stroke. ·       Initial management: rule out above; if concerned about delirium, optimize sleep/wake cycles, pain control, and lines/drains/tubes. OLIGURIA ·       Differential: prerenal due to hypovolemia or low effective circulating volume, intrinsic renal disease, post-renal obstruction ·       On the phone: clarify functional foley or bladder scan results, full set of vitals ·       On the way: review PMH/PSH, known injuries (known hemothorax/pneumothorax? Rib fractures? Chest tubes in already?), risk factors for DVT/PE, review I/Os for evidence of volume status, vitals and labs for evidence of infection ·       In the room: ABCDs, confirm functioning foley catheter ·       Get more info: basic labs, urine electrolytes, consider fluid challenge to evaluate responsiveness, consider adjuncts including renal US ·       Initial management: typically consider IVF bolus initially, but if patient not volume responsive, don't overload them -- look for other etiologies! TACHYCARDIA ·       Differential: sinus tachycardia (pain, hypovolemia, agitation, infection), cardiac arrhythmia, MI, PE ·       On the phone: full set of vitals, acuity of change in heart rate, updated I/Os ·       On the way: Review PMH/PSH, known cardiac history, cardiac and PE risk factors, volume resuscitation, signs concerning for infection, updated I/Os ·       In the room: ABCDs, cardiac/pulmonary exam, evaluate for any localizing signs for infection ·       Get more info: basic labs, EKG, consider CXR, troponins ·       Initial management: depends heavily on etiology Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our new how-to video series on suture and knot-tying skills – https://behindtheknife.org/video-playlists/btk-suture-practice-kit-knot-tying-simulator-how-to-videos/

What could cost you your flying career? Not being prepared for your medical. Hosts Tait Duryea and Ryan Gibson welcome back Dan Monlux of Wingman Med to discuss how pilots can protect their FAA medical certificates. Dan breaks down what happens during a medical exam, the importance of primary care, and why early detection matters. This is a must-listen for pilots over 40 and anyone serious about staying in the skies.Dan Monlux is a retired Navy F-18 pilot and dual-trained physician in family and aerospace medicine. As co-founder of Wingman Med, he now helps pilots navigate complex FAA medical certification issues. With thousands of pilots successfully guided through the process, Dan combines flight experience and deep regulatory insight to keep aviators flying safely and confidently.Show notes:(0:00) Intro(03:29) The one test every pilot over 40 should do(06:25) Treat your medical like a checkride(08:09) Primary care vs. AME: What's the risk?(13:33) EKG tip that can save your exam(17:01) Why most AMEs can't coach you(20:43) ADHD, mental health, and new FAA standards(26:07) Screening tests to do by age group(32:02) MedExpress simulator and application tips(36:06) How to access your past FAA medicals(50:00) Outro

Tracy and Holly share experiences of having their hearts monitored using EKG technology. They also talk about whether or not Albert Bierstadt had any natural talent. See omnystudio.com/listener for privacy information.

Episode 2648: Vinnie Tortorich talks with Robert Soulliere about learning to just breathe for performance, mindfulness, your nervous system, and more.  https://vinnietortorich.com/2025/05/just-breathe-with-robert-soulliere-episode-2648 PLEASE SUPPORT OUR SPONSORS YOU CAN WATCH ALL THE PODCAST EPISODES ON YOUTUBE -  Just Breathe Robert helps people learn how to breathe properly for performance and health. (3:00) Breathing correctly can improve your nervous system, mental clarity, and even your eyesight. (8:00) Doing Zone 2 cardio while breathing through your nose can improve your health. (11:30) The longer you can stay in an aerobic state, the less lactic acid builds up. (20:00) The goal is to keep your breathing calm regardless of the intensity of the exercise. (23:00) Breathing can help regulate your emotions and your nervous system response. (35:00) You can get the effects of Viagra or nitrous oxide by breathing through your nose; proper breathing increases NAD, which is a vasodilator. (41:00) Breathing through the mouth is similar to rusting (causing oxidation) because it allows free radicals to remain in your system. (43:00) Robert enjoys using measuring devices such as continuous glucose monitors (CGMs) that track numbers over time. He uses a device that measures HRV by using an EKG patch attached to your chest. Robert has training events to help optimize performance and mindfulness. You can find out more about Robert and his training programs at breatheryourpower.com. More News If you are interested in the NSNG® VIP group, closed for registration, but you can get on the wait list - Don't forget to check out Serena Scott Thomas on Days of Our Lives on the Peacock channel.  “Dirty Keto” is available on Amazon! You can purchase or rent it . Make sure you watch, rate, and review it! Eat Happy Italian, Anna's next cookbook, is available!  You can go to  You can order it from .  Anna's recipes are in her cookbooks, website, and Substack–they will spice up your day!  Don't forget you can invest in Anna's Eat Happy Kitchen through StartEngine.  Details are at Eat Happy Kitchen.  There's a new NSNG® Foods promo code you can use! The promo code ONLY works on the NSNG® Foods website, NOT on Amazon. https://nsngfoods.com/   PURCHASE  DIRTY KETO (2024) The documentary launched in August 2024! Order it TODAY! This is Vinnie's fourth documentary in just over five years. Visit my new Documentaries HQ to find my films everywhere:  Then, please share my fact-based, health-focused documentary series with your friends and family. Additionally, the more views, the better it ranks, so please watch it again with a new friend! REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! PURCHASE BEYOND IMPOSSIBLE (2022) Visit my new Documentaries HQ to find my films everywhere:  REVIEWS: Please submit your REVIEW after you watch my films. Your positive REVIEW does matter! FAT: A DOCUMENTARY 2 (2021) Visit my new Documentaries HQ to find my films everywhere:  FAT: A DOCUMENTARY (2019) Visit my new Documentaries HQ to find my films everywhere: 

As we are having these necessary conversations on how to be prepared for unexpected medical events or natural disasters, I saw a friend of mine Sarah Hart Unger had one of her own. I asked her to come on the podcast so we could talk about what happened, how she handled it, what she learned from it, and how she may improve her preparedness. I'm Healthy Sarah shared how she was so excited to get back into running marathons. There she was in Miami in about mile 11 of her half marathon when all the sudden she heard her body say something wasn't right. She bunked (marathon runner speak for running out of steam) and she was surprised and disappointed, why was this happening? Her friend took her to the medical tent and they told her all was well. She was so confused because she was a runner and she considered herself a very healthy person. Five steps into leaving the tent something told her no, and to go back. Moments later she was on her way to the hospital. She was pleading with them to just let her get to the hospital to be put under so they could shock her heart there, not that moment in the ambulance! Sarah has been diagnosed with a rare condition called Arrhythmic Cardio Myopathy. What Systems were in place?  Thankfully Sarah was near where her in-laws live so they could support Sarah during her hospital stay and gave comfort to her daughters that someone was there comforting their mom. Sarah appreciated the medical team that took care of her, she felt heard, that they were honest with her, and was thankful for the way they cared for her. She wrote questions down because sometimes there wasn't anyone to ask if it was like 2am. And she had realistic expectations of how long it may take to get a diagnosis.  She got images in hand for additional specialists she wanted to see for second opinions. She advises to always ask for the images and reports. I feel like digital records help us to be productive and physical records help us to look, analyze, and see patterns. We're all under this false pretense that our records are digital. And they may be, but, do you want your doctor visit to consist of tracking results down or do you want it to be focused on the course of action for treatment? Remember the mini medical binder is available for free right now. If you even show up with that you are ahead of other people. You can just start putting the medical papers in a pile and bring them. Sarah is a Pediatric Endocrinologist and says that she'd rather have people show up with results and reports messy than not at all.  How to better prepare?  Sarah wishes she had her old labs and EKG's for comparison sake. I remember being able to show my doctor my cholesterol history and I avoided being put on medicine. I showed that for years my normal is in the “yellow” zone. Sarah also wishes she would have headed the advice to get another EKG years ago but life got busy and she forgot. Sarah stressed that we have to take care of ourselves just like we do our children. She accredits their amazing nanny for being able to step in and fill in the gaps. However, because they always plan their week out and share it with the nanny, they nanny knew how to fill out the schedule for the family. Sarah suggested a family member maybe come observe a couple days at your house to see the day to day unfold and be aware of what they may need to do in your absence. It's ok if the ship sinks a little like if someone has to miss soccer, that's ok. Sarah warned “Don't ever assume ‘I'm healthy, nothing can happen to me.” EPISODE RESOURCES: Mini Medical Binder Sunday Basket® Sign Up for the Organize 365® Newsletter Did you enjoy this episode? Please leave a rating and review in your favorite podcast app. Share this episode with a friend and be sure to tag Organize 365® when you share on social media.

The Dow Jones looks like an EKG chart. The world economy feels like the Cuban Missile Crisis. And the sycophantic administration's policy is more volatile than the Denver Nuggets' front office. But to Stephanie Ruhle — the former banker turned host of MSNBC's The 11th Hour, receiving frantic calls from investors and C-suite execs — the real problem underneath America's tariff turbulence is more fundamental: trust that was gained in droplets is now lost in buckets. Who's suffering the consequences of the art of the deal while Trump and his cronies profiteer from golf tournaments? Probably you. Plus: the dark heart of a Twitter warrior, Stephen A. Smith's tariff strategy...and a basement taco joint with A-Rod and J-Lo. Learn more about your ad choices. Visit podcastchoices.com/adchoices