Podcasts about ekg

The crew welcomes back Dr. Greg Stefano and  Geoff Patty, RN from the interventional cardiology department.  If you're listening to this episode, head over to our YouTube channel to see the visuals of actual cases. An interesting discussion ensues about human and computer interpretations of various EKG strips.

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2025 Emergency Medicine Practice article, Diagnosis and Management of Cannabis-Related EmergenciesEpisode Outline: [0:00] IntroductionWelcome and show overview by Sam AshooMention of resources at ebmedicine.net[0:46] Episode StartHosts introduce themselves: Sam Ashoo and Dr. T.R. EcklerDr. Eckler's background and experience with cannabis cases in Colorado[1:16] Topic IntroductionFocus on diagnosis and management of cannabis-related emergenciesPrevalence and importance in emergency medicine[1:34] Legal LandscapeOverview of cannabis legality across statesMedicinal vs. non-medicinal use[3:03] Increase in ED VisitsStatistics: ~1 million cannabis-related ED visits annuallyDemographics: younger population most affected[3:52] Synthetics and ChallengesDiscussion of synthetic cannabinoids and their risksIssues with detection and legality[4:50] Clinical SpectrumRange of presentations: from nausea/vomiting to psychosis and seizuresImpact on different age groups[6:34] FDA-Approved UsesCannabis-derived products approved for specific medical conditions[7:20] Physiology and PathophysiologyCannabinoid receptors (CB1 and CB2) and their effectsDifferences between plant-derived and synthetic cannabinoids[9:10] Chronic Use and WithdrawalDownregulation of receptors, withdrawal symptoms, and persistent nausea[10:20] Product Forms and Delivery MethodsSmoking, edibles, oils, tinctures, suppositories, topicals, etc.Risks associated with concentrated forms (e.g., wax, oils)[12:00] Clinical Effects by SystemPsychiatric: anxiety, psychosis, paranoiaCardiovascular: tachycardia, MI risk, QT prolongationPulmonary, renal, metabolic, dental, and ocular effects[13:50] Cannabinoid Hyperemesis Syndrome (CHS)Phases: prodrome, hyperemesis, recoveryHot showers as a diagnostic clue[16:00] Withdrawal SyndromeSymptoms and timelineExacerbation with synthetic cannabinoids[18:15] Counseling and ManagementImportance of cessation and patient educationTimeline for symptom improvement[18:42] Differential DiagnosisBroad differential for persistent nausea/vomiting and abdominal painImportance of considering other causes[20:55] Diagnostics and TestingLimitations of drug screens (false positives/negatives)Importance of EKG, labs, and imaging as indicated[23:10] Treatment ApproachesFirst-line: benzodiazepines, antiemetics (ondansetron, metoclopramide)Second-line: butyrophenones (haloperidol, droperidol), olanzapineCapsaicin as adjunct therapy[29:50] Complications and Special ConsiderationsRisks of undertreatment (e.g., Boerhaave syndrome, aspiration)Pediatric and pregnant populations: unique risks and reporting requirements[36:00] Five Practice-Changing TakeawaysElicit cannabis use historyKnow testing limitationsConsider ECG and appropriate labsUse butyrophenones when indicatedAdmit if symptoms are refractory[39:00] ConclusionEmergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In this live episode, Tricia Eastman joins to discuss Seeding Consciousness: Plant Medicine, Ancestral Wisdom, Psychedelic Initiation. She explains why many Indigenous initiatory systems begin with consultation and careful assessment of the person, often using divination and lineage-based diagnostic methods before anyone enters ceremony. Eastman contrasts that with modern frameworks that can move fast, rely on short trainings, or treat the medicine as a stand-alone intervention. Early Themes: Ritual, Preparation, and the Loss of Container Eastman describes her background, including ancestral roots in Mexico and her later work at Crossroads Ibogaine in Mexico, where she supported early ibogaine work with veterans. She frames her broader work as cultural bridging that seeks respect rather than fetishization, and assimilation into modern context rather than appropriation. Early discussion focuses on: Why initiatory traditions emphasize purification, preparation, and long timelines Why consultation matters before any high-intensity medicine work How decades of training shaped traditional initiation roles Why people can get harmed when they treat medicine as plug and play Core Insights: Alchemy, Shadow, and Doing the Work A major throughline is Eastman's critique of the belief that a psychedelic alone will erase trauma. She argues that shadow work remains part of the human condition, and that healing is less about a one-time fix and more about building capacity for relationship with the unconscious. Using alchemical language, she describes "nigredo" as fuel for the creative process, not as something to eliminate forever. Key insights include: Psychedelics are tools, not saviors You cannot outsource responsibility to a pill, a modality, or a facilitator Progress requires practice, discipline, and honest engagement with what arises "Healing" often shows up as obstacles encountered while trying to live and create Later Discussion and Takeaways: Iboga, Ethics, and Biocultural Stewardship Joe and Tricia move into a practical and ethically complex discussion about iboga supply chains, demand pressure, and the risks of amplifying interest without matching it with harm reduction and reciprocity. Eastman emphasizes medical screening, responsible messaging, and supporting Indigenous-led stewardship efforts. She also warns that harm can come from both under-trained modern facilitators and irresponsible people claiming traditional legitimacy. Concrete takeaways include: Treat iboga and ibogaine as high-responsibility work that demands safety protocols Avoid casual marketing that encourages risky self-administration Support Indigenous-led biocultural stewardship and reciprocity efforts Give lineage carriers a meaningful seat at the table in modern policy and clinical conversations Frequently Asked Questions Who is Tricia Eastman? Tricia Eastman is an author, facilitator, and founder of Ancestral Heart. Her work focuses on cultural bridging, initiation frameworks, and Indigenous-led stewardship. What is Seeding Consciousness about? The book examines plant medicine through initiatory traditions, emphasizing consultation, ritual, preparation, and integration rather than reductionistic models. Why does Tricia Eastman critique modern psychedelic models? She argues that many models remove the ritual container and long-form preparation that reduce risk and support deeper integration. Is iboga or ibogaine safe? With the right oversite, yes. Eastman stresses that safety depends on cardiac screening, careful protocols, and experienced oversight. She warns against informal or self-guided use. How can people support reciprocity and stewardship? She encourages donating or supporting Indigenous-led biocultural stewardship initiatives like Ancestral Heart and aligning public messaging with harm reduction. Closing Thoughts This episode makes a clear case that Tricia Eastman Seeding Consciousness is not only a book about psychedelics, but a critique of how the field is developing. Eastman argues that a successful future depends on mature containers, serious safety culture, and respectful partnership with lineage carriers, especially as interest in iboga and ibogaine accelerates. Links https://www.ancestralheart.com https://www.innertraditions.com/author/tricia-eastman Transcript Joe Moore Hello, everybody. Welcome back. Joe Moore with you again from Psychedelics Today, joined today by Tricia Eastman. Tricia, you just wrote a book called Seeding Consciousness. We're going to get into that a bunch today, but how are you today? [00:00:16.07] - Tricia Eastman I'm so good. It's exciting to be live. A lot of the podcasts I do are offline, and so it's like we're being witnessed and feels like just can feel the energy behind It's great. [00:00:31.11] - Joe Moore It's fun. It's a totally different energy than maybe this will come out in four months. This is real, and there's people all over the world watching in real-time. And we'll get some comments. So folks, if you're listening, please leave us some comments. And we'd love to chat a little bit later about those. [00:00:49.23] - Tricia Eastman I'm going to join the chat so that I can see... Wait, I just want to make sure I'm able to see the comments, too. Do I hit join the chat? [00:01:01.17] - Joe Moore Sometimes you can, sometimes you can't. I can throw comments on the screen so we can see them together. [00:01:07.02] - Tricia Eastman Cool. [00:01:08.03] - Joe Moore Yeah. So it'll be fun. Give us comments, people. Please, please, please, please. Yeah, you're all good. So Tricia, I want to chat about your book. Tell us high level about your book, and then we're going to start digging into you. [00:01:22.10] - Tricia Eastman So Seeding Consciousness is the title, and I know it's a long subtitled Plant Medicine, Ancestral Wisdom, Psychedelic Initiation. And I felt like it was absolutely necessary for the times that we are in right now. When I was in Gabon in 2018, in one of my many initiations, as as an initiative, the Fung lineage of Buiti, which I've been practicing in for 11 years now, I was given the instructions. I was given the integration homework to write this book. And I would say I don't see that as this divine thing, like you were given the assignment. I think I was given the assignment because it's hard as F to write a book. I mean, it really tests you on so many levels. I mean, even just thinking about putting yourself out there from a legal perspective, and then also, does it make any sense? Will anyone buy it? And on Honestly, it's not me. It's really what I was given to write, but it's based on my experience working with several thousand people over the years. And really, the essence of it is that in our society, we've taken this reductionistic approach in psychedelics, where we've really taken out the ritual. [00:02:54.05] - Tricia Eastman Even now with the FDA trial for MDMA for PTSD. There's even conversations with a lot of companies that are moving forward, psychedelics, through the FDA process, through that pathway, that are talking about taking the therapy out. And the reality is that in these ancient initiatic traditions, they were very long, drawn out experiences with massive purification rituals, massive amounts of different types of practice in order to prepare oneself to meet the medicine. Different plants were taken, like vomatifs and different types of purification rituals were performed. And then you would go into this profound initiatic experience because the people that were working with you that were in, we call it the Nema, who gives initiations, had decades of training and experience doing these types of initiatic experiences. So if you compare that to the modern day framework, we have people that go online and get a certificate and start serving people medicine or do it in a context where maybe there isn't even an established container or facilitator whatsoever. And so really, the idea is, how can we take the essence of this ancient wisdom wisdom, like when you look at initiation, the first step is consultation, which is really going deep into the history of the individual using different types of techniques that are Indigenous technologies, such as different forms of divination, such as cowrie shell readings. [00:04:52.18] - Tricia Eastman And there's different types of specific divinations that are done in different branches of And before one individual would even go into any initiation, you need to understand the person and where they're coming from. So it's really about that breakdown of all of that, and how can we integrate elements of that into a more modern framework. [00:05:24.23] - Joe Moore Brilliant. All right. Well, thank you for that. And let's chat about you. You've got a really interesting past, very dynamic, could even call it multicultural. And you've got a lot of experience that informed this book. So how did this stuff come forward for you? [00:05:50.02] - Tricia Eastman I mean, I've never been the person to seek anything. My family on my mother's side is from Mexico, from Oaxaca, Trique, Mixtec, and Michica. And we had a long lineage of practice going back to my, at least I know from my great, great grandmother, practicing a blend of mestiza, shamanism, combining centerea and Catholicism together. So it's more of like a syncratic mestiza, mestiza being mixed tradition. And so I found it really interesting because later on, when my grandfather came to the United States, he ended up joining the military. And in being in the US, he didn't really have a place. He's very devout spiritual man, but he didn't have a place to practice this blended spiritual tradition. So the mystical aspect of it went behind. And as I started reconnecting to my ancestral lineage, this came forth that I was really starting to understand the mystical aspect of my ancestry. And interestingly, at the same time, was asked to work at Crossroads Abigain in Mexico. And it's so interesting to see that Mexico has been this melting pot and has been the place where Abigain has chosen to plant its roots, so to say, and has treated thousands of veterans. [00:07:36.28] - Tricia Eastman I got to be part of the group of facilitators back over 10 years ago. We treated the first Navy Seals with Abogaine, and that's really spurred a major interest in Abogaine. Now it's in every headline. I also got 10 I got initiated into the Fung lineage of Buiti and have really studied the traditional knowledge. I created a nonprofit back in 2019 called Ancestral Heart, which is really focused on Indigenous-led stewardship. Really, the book helps as a culmination of the decade of real-world experience of combining My husband, Dr. Joseph Barzulia. He's a psychologist. He's also a pretty well-known published researcher in Abigain and 5MEO-DMT, but also deeply spiritual and deeply in respect for the Indigenous traditions that have carried these medicines before us. So we've really been walking this complex path of world bridging between how we establish these relationships and how we bring some of these ancient knowledge systems back into the forefront, but not in a way of fetishizing them, but in a way of deeply respecting them and what we can learn, but from our own assimilation and context versus appropriation. So really, I think the body of my work is around that cultural bridging. [00:09:31.07] - Joe Moore That's brilliant. And yeah, there's some really fun stuff I learned in the book so far that I want to get into later. But next question is, who is your intended audience here? Because this is an interesting book that could hit a few categories, but I'm curious to hear from you. [00:09:49.02] - Tricia Eastman It's so funny because when I wrote the book, I wasn't thinking, oh, what's my marketing plan? What's my pitch? Who's my intended audience? Because it was my homework, and I knew I needed to write the book, and maybe that was problematic in the sense that I had to go to publishers and have a proposal. And then I had to create a formula in hindsight. And I would say the demographic of the book mirrors the demographic of where people are in the psychedelic space, which It's skewed slightly more male, although very female. I think sex isn't necessarily important when we're thinking about the level of trauma and the level of spiritual healing and this huge deficit that we have in mental health, which is really around our disconnection from our true selves, from our heart, from our souls, from this idea of of what Indigenous knowledge systems call us the sacred. It's really more of an attitude of care and presence. I'm sure we could give it a different name so that individuals don't necessarily have any guard up because we have so much negative conditioning related to the American history of religion, which a lot of people have rejected, and some have gone back to. [00:11:37.06] - Tricia Eastman But I think we need to separate it outside of that. I would say the demographic is really this group of I would say anywhere from 30 to 55 male females that are really in this space where maybe they're doing some of the wellness stuff. They're starting to figure some things out, but it's just not getting them there. And when something happens in life, for example, COVID-19 would be a really great example. It knocks them off course, and they just don't have the tools to find that connection. And I would say it even spans across people that do a lot of spiritual practice and maybe are interested in what psychedelics can do in addition to those practices. Because when we look at my view on psychedelics, is they fit within a whole spectrum of wellness and self-care and any lineage of spiritual practice, whether it's yoga or Sufism or Daoist tradition. But they aren't necessarily the thing that... I think there's an over focus on the actual substance itself and putting it on a pedestal that I think is problematic in our society because it goes back to our religious context in the West is primarily exoteric, meaning that we're seeking something outside of ourselves to fulfill ourselves. [00:13:30.29] - Tricia Eastman And so I think that when we look at psychedelic medicines as this exoteric thing versus when we look at initiatory traditions are about inward and direct experience. And all of these spiritual practices and all of these modalities are really designed to pull you back into yourself, into having a direct relationship with yourself and direct experience. And I feel like the minute that you are able to forge that connection, which takes practice and takes discipline, then you don't need to necessarily look at all these other tools outside of yourself. It's like one of my favorite analogies is the staff on the Titanic were moving the furniture around as it was sinking, thinking that they might save the boat from sinking by moving the furniture around. I think that's how we've been with a lot of ego-driven modalities that aren't actually going into the full unconscious, which is where we need to go to have these direct experiences. Sorry for the long answer, but it is for everybody, and it's not just about psychedelics. Anyone can take something from this doing any spiritual work. But we talk a lot about the Indigenous philosophy and how that ties in alongside with spiritual practice and more of this inner way of connecting with oneself and doing the work. [00:15:21.22] - Tricia Eastman And I think also really not sugar coating it in the sense that the psychedelics aren't going to save us. They're not going to cure PTSD. Nothing you take will. It's you that does the work. And if you don't do the work, you're not going to have an 87 % success rate with opioid use disorder or whatever it is, 60 something % for treatment-resistant depression or whatever. It's like you have to do the work. And so we can't keep putting the power in the modality reality or the pill. [00:16:03.18] - Joe Moore Yeah, that makes sense. So you did an interesting thing here with this book, and it was really highlighting aspects of the alchemical process. And people don't necessarily have exposure. They hear the words alchemy. I get my shoulders go up when I hear alchemizing, like transmutation. But it's a thing. And how do we then start communicating this from Jung? I found out an interesting thing recently as an ongoing student. Carl Jung didn't necessarily have access to all that many manuscripts. There's so many alchemical manuscripts available now compared to what he had. And as a result, our understanding of alchemy has really evolved. Western alchemy, European alchemy, everybody. Perhaps Kmetic, too. I don't know. You could speak to that more. I don't keep track of what's revealed in Egypt. So it's really interesting to present that in a forward way? How has it been received so far? Or were you nervous to present this in this way? [00:17:25.10] - Tricia Eastman I mean, honestly, I think the most important The important thing is that in working with several thousand people over the years, people think that taking the psychedelic and the trauma is going to go away. It's always there. I mean, we We archetypically will have the shadow as long as we need the shadow to learn. And so even if we go into a journey and we transcend it, it's still there. So I would say that the The feedback has been really incredible. I mean, the people that are reading... I mean, I think because I'm weaving so many different, complex and deep concepts into one book, it might be a little harder to market. And I think the biggest bummer was that I was really trying to be respectful to my elders and not say anything in the title about Iboga and Abigain, even though I talk a lot about it in the book, and it's such a hot topic, it's really starting to take off. But the people that have read it really consider it. They really do the work. They do the practices in the book, and I'm just getting really profound feedback. So that's exciting to me because really, ultimately, alchemy... [00:18:55.22] - Tricia Eastman Yeah, you're right. It gets used Used a lot in marketing lingo and sitting in the depth of the tar pit. For me, when I was in Gabon, I remember times where I really had to look at things that were so dark in my family history that I didn't even realize were mine until later connected to my lineage. And the dark darkness connected to that and just feeling that and then knowing really the truth of our being is that we aren't those things. We're in this process of changing and being, and so nothing is is fixed, but there is a alchemical essence in just learning to be with it. And so not always can we just be with something. And and have it change, but there are many times that we can actually just be with those parts of ourselves and be accepting, where it's not like you have to have this intellectualized process It's just like, first you have the negrado, then you tune into the albeda, and you receive the insights, and you journal about it, and da, da, da, da, da Action, Mars aspect of it, the rubeda of the process. It's not like that at all. [00:20:44.15] - Tricia Eastman It's really that the wisdom that comes from it because you're essentially digesting black goo, which is metaphoric to the oil that we use to power all of society that's pulled deep out of the Earth, and it becomes gold. It becomes... And really, the way I like to think of it is like, in life, we are here to create, and we are not here to heal ourselves. So if you go to psychedelic medicine and you want to heal yourself, you're going to be in for... You're just going to be stuck and burnt out because that's not what we're here to do as human beings, and you'll never run out of things to heal. But if you You think of the negrado in alchemy as gasoline in your car. Every time you go back in, it's like refilling your gas tank. And whatever you go back in for as you're moving in the journey, it's almost like that bit of negrado is like a lump of coal that's burning in the gas tank. And that gets you to the next point to which there's another thing related to the creative process. So it's like As you're going in that process, you're going to hit these speed bumps and these obstacles in the way. [00:22:07.29] - Tricia Eastman And those obstacles in the way, that's the healing. So if you just get in the car in the human vehicle and you drive and you continue to pull out the shadow material and face it, you're going to keep having the steam, but not just focus on it, having that intention, having that connection to moving forward in life. And I hate to use those words because they sound so growth and expansion oriented, which life isn't always. It's evolutionary and deevolutionary. It's always in spirals. But ultimately, you're in a creative process would be the best way to orient it. So I think when we look at alchemy from that standpoint, then it's productive. Effective. Otherwise, it sounds like some brand of truffle salt or something. [00:23:09.12] - Joe Moore Yeah, I think it's a... If people want to dig in, amazing. It's just a way to describe processes, and it's super informative if you want to go there, but it's not necessary for folks to do the work. And I like how you framed it quite a bit. So let's see. There is one bit, Tricia, that my ears really went up on this one point about a story about Actually, let me do a tangent for you real quick, and then we're going to come back to this story. So are you familiar with the tribe, the Dogon, in Africa? Of course. Yeah. So they're a group that looks as though they were involved in Jewish and/or Egyptian traditions, and then ended up on the far side of like, what, Western Africa, far away, and had their own evolution away from Egypt and the Middle East. Fascinating. Fascinating stories, fascinating astronomy, and much more. I don't know too much about the religion. I love their masks. But this drew an analogy for me, as you were describing that the Buiti often have stories about having lineage to pre-dynastic Egyptian culture. I guess we'll call it that for now, the Kometic culture. [00:24:44.23] - Joe Moore I had not heard that before. Shame on me because I haven't really read any books about Buiti as a religion or organization, or anything to this point. But I found that really interesting to know that now, at least I'm aware of two groups claiming lineage to that ancient world of magic. Can you speak about that at all for us? Yeah. [00:25:09.24] - Tricia Eastman So first off, there really aren't any books talking about that. Some of the things I've learned from elders that I've spoke with and asked in different lineages in Masoco and in Fong Buiti, there's a few things. One, We lived in many different eras. Even if you go into ancient texts of different religions, creation stories, and biblical stories, they talk about these great floods that wiped out the planet. One of the things that Atum talks about, who is one of my Buiti fathers who passed a couple years ago, is Is the understanding that before we were in these different areas, you had Mu or Lumaria, you had Atlantis, and then you had our current timeline. And the way that consciousness was within those timelines was very different and the way the Earth was. You had a whole another continent called Atlantis that many people, even Plato, talks about a very specific location of. And what happened, I believe during that time period, Africa, at least the Saharan band of the desert was much more lush, and it was a cultural melting pot. So if you think about, for example, the Pygmy tribes, which are in Equatorial Africa, they are the ones that introduced Iboga to the Buiti. [00:27:08.08] - Tricia Eastman If you look at the history of ancient Egypt, what I'm told is that the Pygmies lived in Pharaonic Egypt, all the way up until Pharaonic Egypt. And there was a village. And if you look on the map in Egypt, you see a town called Bawiti, B-A-W-I-T-I. And that is the village where they lived. And I have an interesting hypothesis that the God Bess, if you look at what he's wearing, it's the exact same to a T as what the Pygmies wear. And the inspiration for which a lot of the Buiti, because they use the same symbology, because each part of the outfit, whether it's the Mocingi, which is like this animal skin, or the different feathers, they use the parrot feather as a symbology of speech and communication, all of these things are codes within the ceremony that were passed along. And so when you look at Bess, he's wearing almost the exact same outfit that the Pygmies are wearing and very similar to if you see pictures of the ceremonies of Misoko or Gonde Misoko, which I would say is one of the branches of several branches, but that are closer to the original way of Buiti of the jungle, so closer to the way the Pygmies practice. [00:28:59.16] - Tricia Eastman So If you look at Bess, just to back my hypothesis. So you look at Neteru. Neteru were the... They called them the gods of Egypt, and they were all giant. And many say the word nature actually means nature, but they really represented the divine qualities of nature. There's best. Look at him. And a lot of the historians said he's the God of Harmeline and children and happiness. I think he's more than the God of Harmeline, and I think that the Pygmies worked with many different plants and medicines, and really the ultimate aspect of it was freedom. If you think about liberation, like the libation, number one, that's drunkiness. Number two, liberation, you of freeing the joyous child from within, our true nature of who we are. You look at every temple in Egypt, and you look at these giant statues, and then you have this tiny little pygmy God, and there's no other gods that are like Bess. He's one of a kind. He's in his own category. You've You've got giant Hathor, you've got giant Thoth, you've got giant Osiris, Isis, and then you've got little tiny Bess. And so I think it backs this hypothesis. [00:30:48.27] - Tricia Eastman And my understanding from practitioners of Dogon tradition is that they also believe that their ancestors came from Egypt, and they definitely have a lot of similarity in the teachings that I've seen and been exposed to just from here. I mean, you can... There's some more modern groups, and who's to know, really, the validity of all of it. But there are some, even on YouTube, where you can see there's some more modern Dogon temples that are talking in English or English translation about the teachings, and they definitely line up with Kamehdi teachings. And so my hypothesis around that is that the Dogon are probably most likely pygmy descendants as, And the pygmy were basically run out of Bawiti because there was jealousy with the priest, because there was competition, because all of the offerings that were being made in the temple, there was a lot of power, connected to each of the temples. And there was competitiveness even amongst the different temples, lining the Nile and all of that, of who was getting the most offerings and who was getting the most visits. And so the Pygmies essentially were run out, and they migrated, some of them migrated south to Gabon and Equatorial Africa. [00:32:43.07] - Tricia Eastman And then If you think about the physical changes that happened during these planetary catastrophes, which we know that there had been more than one based on many historical books. So that whole area went through a desertification process, and the Equatorial rainforest remained. So it's highly likely even that Iboga, at one point, grew in that region as well. [00:33:18.00] - Joe Moore Have you ever seen evidence of artwork depicting Iboga there in Egypt? [00:33:24.17] - Tricia Eastman There are several different death temples. I'm trying to remember the name of the exact one that I went to, but on the columns, it looked like Iboga trees that were carved into the columns. And I think what's interesting about this... So Seychet is the divine scribe, the scribe of Egyptian wisdom. And she was basically, essentially the sidekick of Thoth. Thoth was who brought a lot of the ancient wisdom and people like Pythagoras and many of the ancient philosophers in Roman times went and studied in a lot of these Thoth lineage mystery schools. When you look at the the river of the Nile on the east side, east is the energy liturgy of initiation. It's always like if you go into a sweat lodge or if you see an ancient temple, usually the doorway is facing the east. West is where the sun sets, and so that's the death. And what's interesting about that is that it was on the west side in the death temple that you would see these aboga plants. But also Seixat was the one who was the main goddess depicted in the hieroglyphs, and there was other hieroglyphs. I mean, if you look at the hieroglyphs of Seixat, it looks like she has a cannabis leaf above her head, and a lot of people have hypothesized that, that it's cannabis. [00:35:16.03] - Tricia Eastman Of course, historians argue about that. And then she's also carrying a little vessel that looks like it has some mushrooms in it. And obviously, she has blue Lotus. Why would she be carrying around blue Lotus and mushrooms? I don't know. It sounds like some initiation. [00:35:36.19] - Joe Moore Yeah, I love that. Well, thanks so much for going there with me. This photo of Seixet. There's some good animations, but everybody just go look at the temple carvings picturing this goddess. It's stunning. And obviously, cannabis. I think it's hard to argue not. I've seen all these like, mushroom, quote, unquote, mushroom things everywhere. I'm like, Yeah, maybe. But this is like, Yes, that's clear. [00:36:06.27] - Tricia Eastman And if you look at what she's wearing, it's the exact same outfit as Bess, which is classic Basically, how the medicine woman or medicine man or what you would call shaman, the outfit that the healers would wear, the shamans or the oracles, those of the auracular arts, different forms of divination would wear. So if you really follow that and you see, Oh, what's Isis wearing? What's Hathor wearing? What's Thoth wearing? You can tell she's very specifically the healer. And it's interesting because they call her the divine scribe. So she's actually downloading, my guess is she's taking plants and downloading from the primordial. [00:37:02.00] - Joe Moore Well, okay. Thanks for bringing that up. That was a lovely part of your book, was your... There's a big initiation sequence, and then you got to go to this place where you could learn many things. Could you speak to that a little bit? And I hope that's an okay one to bring up. [00:37:22.22] - Tricia Eastman Are you talking about the time that I was in initiation and I went to the different ashrams, the different realms in, like Yogananda calls them astral schools that you go and you just download? It seemed like astral schools, but it seemed like it was a Bwiti initiation, where you were in silence for three days, and then Yeah, that one. So there were several different... I mean, I've done seven official initiations, and then I've had many other initiatic experiences. And I would say this one was incredible. Incredibly profound because what it showed me first was that all of the masters of the planet, it was showing me everyone from Kurt Cobain to Bob Marley to Einstein, all the people that had some special connection to an intelligence that was otherworldly, that they were essentially going to the same place, like they were visiting the same place, and they would go. And so the first thing I noticed was that I recognized a lot of people, and current, I'm not going I don't want to say names of people, but I recognize people that are alive today that I would say are profound thinkers that were going to these places as well. [00:38:57.05] - Tricia Eastman And interestingly, then I was taken into one of the classrooms, and in the classroom, this one, specifically, it showed me that you could download any knowledge instantaneously That essentially, having a connection to that school allowed you to download music or understand very complex ideas ideas of mathematics or physics or science that would take people like lifetimes to understand. So it was essentially showing this. And a lot of people might discredit that, that that might be a specific... That we as humans can do that. Well, I'm not saying that it's not that. I don't I don't want to say that it's anything. But what I can say is that I have definitely noticed the level of access that I have within my consciousness. And also what I notice with the masters of Bwiti, specifically in terms of the level of intelligence that they're accessing and that it's different. It's got a different quality to it. And so it was a really profound teaching. And one of the things, too, that I've learned is I use it to help me learn specific things. I don't know if I can give a positive testimonial, but I am learning French. [00:40:55.00] - Tricia Eastman And I noticed when I was in Aspen at the Abigain meeting, and I was with Mubeiboual, who speaks French, I started saying things French that I didn't even realize that I knew to say. I've had these weird moments where I'm actually using this tool And I'm also using it. I have a Gabonese harp. I don't know if you can see it up on the shelf over there. But I also went and asked for some help with downloading some assistance in the harp, then we'll see how that goes. [00:41:38.17] - Joe Moore Yeah. So that's brilliant. I'm thinking of other precedent for that outside of this context, and I can think of a handful. So I love that, like savant syndrome. And then there's a classic text called Ars Notoria that helps accelerate learning, allegedly. And then there's a number of other really interesting things that can help us gain these bits of wisdom and knowledge. And it does feel a little bit like the Dogon. The story I get is the receiving messages from the dog star, and therefore have all sorts of advanced information that they shouldn't we call it. Yeah. Yeah, which is fascinating. We have that worldwide. I think there's plenty of really interesting stuff here. So what I appreciated, Tricia, about how you're structuring your book, or you did structure your book, is that it it seems at the same time, a memoir, on another hand, workbook, like here are some exercises. On the other hand, like here's some things you might try in session. I really appreciated that. It was like people try to get really complicated when we talk about things like IFS. I'm like, well, you don't necessarily have to. You could. Or is this just a human thing, a human way to look at working with our parts? [00:43:20.15] - Joe Moore I don't know. Do you have any thoughts about the way you were approaching this parts work in your book versus how complicated some people make it feel? [00:43:30.00] - Tricia Eastman Yeah. I find that this is just my personal opinion, and no way to discredit Richard Schwartz's work. But parts work has existed in shamanism since forever. When we really look at even in ancient Egypt, Issus, she put Osiris act together. That was the metaphorical story of soul retrieval, which is really the spiritual journey of us reclaiming these pieces of ourselves that we've been disconnected from a society level or individually. And within the context of parts work, it's very organic and it feels other worldly. It's not like there's ever a force where I'm in the process with someone. And a lot of times I would even go into the process with people because they weren't accustomed to how to work with Iboga or game, and so they would be stuck. And then the minute I was like, you know, Iboga, in the tradition, it's really about... It's like the game Marco Polo. It's call and response. And so you're really an active participant, and you're supposed to engage with the spirits. And so the minute that things would show up, it'd be more about like, oh, what do you see? What's coming up here? Asking questions about it, being curious. [00:45:17.07] - Tricia Eastman If you could engage with it, sometimes there's processes where you can't really engage with things at all. So everything that I'm talking about is It was organically shown up as an active engagement process that it wasn't like we were going in. There have been some where you can guide a little bit, but you never push. It might be something like, go to your house, and it being completely unattached. And if they can't go there, then obviously the psyche doesn't want to go there, but it's really an exercise to help them to connect to their soul. And then in contrast, IFS is like, let's work on these different parts and identify these different parts of ourselves. But then let's give them fixed titles, and let's continually in a non-altered state of consciousness, not when we're meditating, not when we're actively in a state where we have the plasticity to change the pathway in the unconscious mind, but we're working in the egoic mind, and we're talking to these parts of ourselves. That could be helpful in the day-to-day struggles. Let's say you have someone who has a lot of rumination or a very active mind to have something to do with that. [00:46:57.01] - Tricia Eastman But that's not going to be the end-all, be-all solution to their problem. It's only moving the deck chairs around on the Titanic because you're still working in the framework where, I'm sorry, the Titanic is still sinking, and it may or may not be enough. It may or may not produce a reliable outcome that could be connected with some level of true relief and true connection within oneself. And so I think that people just... I feel like they almost get a little too... And maybe it's because we're so isolated and lonely, it's like, Oh, now I've got parts. I'm not by myself. I've got my fire I've got my firefighter, and I've got my guardian, and all these things. And I definitely think that IFS is a really great initiator into the idea of engaging with parts of ourselves and how to talk to them. But I don't think it's... And I think doing a session here and there, for some people, can be incredibly helpful, but to all of a sudden incorporate it in like a dogma is toxic. It's dangerous. And that's what we have to be really careful of. [00:48:23.25] - Joe Moore So thank you for that. There's a complicated discussion happening at the Aspen meeting. I think I was only sitting maybe 30 feet away from you. Sorry, I didn't say hi. But the folks from Blessings of the Forest were there, and I got a chance to chat with a number of them and learn more about nuclear protocols, biopiracy, literal piracy, and smuggling, and the works. I'm curious. This is a really complicated question, and I'm sorry for a complicated question this far in. But it's like, as we talk about this stuff publicly and give it increased profile, we are de facto giving more juice and energy to black markets to pirate. We're adding fuel to this engine that we don't necessarily want to see. Cameroon has nothing left, pretty much. From what I'm told, people from Cameroon are coming in, stealing it from Cabona, bringing it back, and then shipping it out. And there's It's like a whole worldwide market for this stuff. I witnessed it. This stuff. Yeah, right? This is real. So the people, the Buiti, and certain Gabanese farmers, are now being pirated. And international demand does not care necessarily about Nagoya compliance. United States didn't sign Nagoya protocol for this biopiracy protection, but we're not the only violator of these ethics, right? [00:50:00.22] - Joe Moore It's everywhere. So how do we balance thinking about talking about IBOCA publicly, given that there's no clean way to get this stuff in the United States that is probably not pirated materials? And as far as I know, there's only one, quote unquote, Nagoya compliant place. I've heard stories that I haven't shared publicly yet, that there's other groups that are compliant, too. But it's a really interesting conversation, and I'm curious of your perspectives there. [00:50:34.04] - Tricia Eastman I mean, this is a very long, drawn-out question, so forgive me if I give you a long, drawn-out answer. [00:50:41.01] - Joe Moore Go for it. [00:50:41.26] - Tricia Eastman It's all good. So in reality, I do believe... You know the first Ebo, Abogaine, that was done in the country was experiments on eight Black prisoners at a hospital under the MK program. [00:51:01.16] - Joe Moore Pre-lutz off, we were doing Abogaine tests on people. [00:51:06.00] - Tricia Eastman Yeah, so pre-Lutz off. I have a hypothesis, although a lot of people would already know me. [00:51:12.07] - Joe Moore No, I didn't know that. Thank you for sharing that with me. [00:51:14.13] - Tricia Eastman That's great. I'll send you some stuff on that. But the Aboga wanted to be here. The Abogaine wanted to be here. I think it's a complex question because on one side of the coin, you have the spirit of plants, which are wild and crazy sometimes. And then you have the initiatory traditions, which create a scaffolding to essentially put the lightning in a bottle, so to say, so that it's less damaging. [00:51:51.13] - Joe Moore It's almost like a temple structure around it. [00:51:53.16] - Tricia Eastman I like that. Yeah. Put a temple structure around it because it's like, yeah, you can work with new nuclear energy, but you have to wear gloves, you have to do all these different safety precautions. I would say that that's why these traditions go hand in hand with the medicine. So some people might say that the agenda of Iboga and even Abogaine might be a different agenda than the Buiti. And ultimately, whether we are Indigenous or not, the Earth belongs to everyone. It's capitalism and the patriarchy that created all these borders and all these separations between people. And in reality, we still have to acknowledge what the essence of Buiti is, which is really the cause and effect relationship that we have with everything that we do. And so some people might use the term karma. And that is if you're in Abogaine clinic and you're putting a bunch of videos out online, and that's spurring a trend on TikTok, which we already know is a big thing where people are selling illegal market, iBoga, is Is any of that your responsibility? Yes. And if I was to sit down with a kogi kagaba, which are the mamus from Colombia, or if I were to sit down with a who said, Hey, let's do a divination, and let's ask some deep questions about this. [00:53:54.01] - Tricia Eastman It would look at things on a bigger perspective than just like, Oh, this person is completely responsible for this. But when we're talking about a medicine that is so intense, and when I was younger, when I first met the medicine, I first was introduced in 2013 was when I first found out about Abigain and Iboga. And in 2014, I lived with someone who lived with a 14th generation Misoko, maybe it was 10th generation Misoco in Costa Rica. And then he decided to just start serving people medicine. And he left this person paralyzed, one person that he treated for the rest of his life. And Aubrey Marcus, it was his business partner for On It, and he's publicly talked about this, about the story behind this. If you go into his older podcasts and blog posts and stuff, he talks about the situation. And the reality is that this medicine requires a massive amount of responsibility. It has crazy interactions, such as grapefruit juice, for example, and all kinds of other things. And so it's not just the responsibility towards the buiti, it's also the responsibility of, does me talking about this without really talking about the safety and the risks, encourage other people. [00:55:49.10] - Tricia Eastman One of the big problems, back in the day, I went to my first guita conference, Global Abogaine Therapy Alliance in 2016. And And then, ISEARs was debating because there was all these people buying Abogaine online and self-detoxing and literally either dying or ending up in the hospital. And they're like, should we release protocols and just give people instructions on how to do this themselves? And I was like, no, absolutely not. We need to really look at the fact that this is an initiatory tradition, that it's been practiced for thousands of that the minimum level at which a person is administering in Gabon is 10 years of training. The way that we've made up for those mistakes, or sorry, not mistakes, lack of training is that we've used medical oversight. Most of the medical oversight that we've received has been a result of mistakes that were made in the space. The first patient that MAPS treated, they killed them because they gave them way over the amount of what milligrams per kilogram of Abigain that you should give somebody. Every single mistake that was made, which a lot of them related to loss of life, became the global Abogane Therapy Safety Guidelines. [00:57:28.19] - Tricia Eastman And so we've already learned from our mistakes here. And so I think it's really important that we understand that there's that aspect, which is really the blood on our hands of if we're not responsible, if we're encouraging people to do this, and we're talking about it in a casual way on Instagram. Like, yeah, microdosing. Well, did you know there was a guy prosecuted this last year, personal trainer, who killed someone And from microdosing in Colorado, the event happened in 2020, but he just got sentenced early 2025. These are examples that we need to look at as a collective that we need. So that's one side of it. And then the other side of it is the reciprocity piece. And the reciprocity piece related to that is, again, the cause and effect. Is A Abogaine clinic talking about doing Abogaine and doing video testimonials, spurring the efforts that are actively being made in Gabon to protect the cultural lineage and to protect the medicine. The reality is every Abogaine clinic is booked out for... I heard the next year, I don't know if that's fact or fiction, but someone told me for a year, because because of all the stuff with all the celebrities that are now talking about it. [00:59:05.20] - Tricia Eastman And then on top of that, you have all these policy, all these different advocacy groups that are talking about it. Essentially, it's not going to be seven... It's going to be, I would say, seven to 10 years before something gets through the FDA. We haven't even done a phase one safety trial for any of the Abigain that's being commercialized. And even if there's some magic that happens within the Trump administration in the next two years that changes the rules to fast track it, it's not going to cut it down probably more than a year. So then you're looking at maybe six years minimum. That whole time, all that strain is being put on Gabon. And so if you're not supporting Gabon, what's happening is it's losing a battle because the movement is gaining momentum, and Gabon cannot keep up with that momentum. It's a tiny country the size of Colorado. So my belief is that anyone who's benefiting from all the hype around Iboga and Abogayne or personally benefited with healing within themselves should be giving back, either to Ancestral Heart, to Blessings of the Forest, to any group that is doing authentic Indigenous-led biocultural stewardship work. [01:00:45.21] - Joe Moore Thanks for that. It's important that we get into some detail here. I wish we had more time to go further on it. [01:00:54.17] - Tricia Eastman I'll do a quick joke. I know. I have a lot. [01:00:57.17] - Joe Moore Yes. Now do Mike Tyson. Kidding. Yeah. So what did we maybe miss that you want to make sure people hear about your book, any biocultural stuff that you want to get out there? You can go for a few more minutes, too, if you have a few things you want to say. [01:01:20.03] - Tricia Eastman I mean, really, thank you so much for this opportunity. Thank you for caring and being so passionate about the context related to Buiti, which I think is so important. I would just say that I've been working with this medicine for... I've known about it for 13 years, and I've been working with it for 11 years, and this is my life. I've devoted my life to this work, me and my husband, both. And there isn't anything greater of a blessing that it has brought in our life, but it also is it's a very saturnian energy, so it brings chaos. It brings the deepest challenges and forces you to face things that you need to face. But also on the other side of the coin, everything that I've devoted and given back in service to this work has exponentially brought blessing in my life. So again, I see the issue with people doing these shortened processes, whether it's in an Abigain clinic where you just don't have the ritualistic sacred aspects of an initiatic context and really the rituals that really help integrate and ground the medicine. But you still have this opportunity to continue to receive the blessings. [01:03:09.23] - Tricia Eastman And I really feel in our current psychedelic movement, we essentially have a Bugatti. These medicines are the most finely-tuned sports car that can do every... Even more than that, more like a spaceship. We have this incredible tool, but we're driving it in first gear. We don't even really know how to operate it. It's like, well, I guess you could say flight of the Navigator, but that was a self-driving thing, and I guess, psychedelics are self-driving. But I feel that we are discounting ourselves so greatly by not looking into our past of how these medicines were used. I really think the biggest piece around that is consulting the genuine lineage carriers like Buiti elders, like Mubu Bwal, who's the head of Maganga Manan Zembe, And giving them a seat at the head of the table, really, because there's so much I know in my tradition, about what we do to bring cardiac safety. And why is it that people aren't dying as much in Gabon as they're dying in Abigan clinics. [01:04:37.28] - Joe Moore Shots fired. All right. I like it. Thank you. Thank you for everything you've done here today, I think harm reduction is incredibly important. Let's stop people dying out there. Let's do some harm reduction language. I actually was able to sweet talk my way into getting a really cool EKG recently, which I thought really great about. If you can speak clinician, you can go a long way sometimes. [01:05:11.20] - Tricia Eastman Yeah. Oh, no, go ahead. Sorry. [01:05:15.17] - Joe Moore No, that's all. That's all. So harm reduction is important. How do we keep people safe? How do we keep healing people? And thank you for all your hard work. [01:05:27.22] - Tricia Eastman Thank you. I really appreciate it. We're all figuring it out. No one's perfect. So I'm not trying to fire any shots at anybody. I'm just like, Guys, please listen. We need to get in right relationship with the medicine. And we need to include these stakeholders. And on the other side of the coin, I just want to add that there's a lot of irresponsible, claimed traditional practitioners that are running retreat centers in Mexico and Costa Rica and other places that are also causing a lot of harm, too. So the medical monitoring is definitely, if you're going to do anything, Because these people don't have the training, the worst thing you could do is not have someone going in blind that doesn't have training and not have had an EKG and all that stuff. But we've got a long way to go, and I'm excited to help support in a productive way, all coming together. And that's what me and Joseph have been devoted to. [01:06:45.02] - Joe Moore Brilliant. Tricia Eastman, thank you so much. Everybody should go check out your book Seeding Consciousness out now. The audiobook's lovely, too. Thank you so much for being here. And until next time. [01:07:00.14] - Tricia Eastman Thank you.    

I give my perspective on being an APP in the ED, be humble and teachable and strike an affect that allows the physicians to speak into your practiceWhen in doubt, consult the specialistJulie talks about what makes her proud about her careerShe is proud of the connections she made, that she treated her patients how she would have wanted to be treatedRemember to take that intentional time with patients to help reassure and connect with themJulie talks about a the expectation she sets for patients with abdominal pain -  that we don't find a clear answer most of the time and when we do it's usually something emergent and surgical so sometimes no answer is good newsSet the right expectation for the ER visit earlyShe talks about how she reassures patients that may be embarrassed for coming in when they end up not having anything emergent going onJulie highlights the need to eat and hydrate on shiftJulie talks about the next generation of providers and how she hopes they continue to keep their observation skills and clinical thinking skills intact considering technology advances and AI incorporation Julies advice to her younger self would be to not let people drag you downA big thing we need to learn is to not let others poor behavior or flexing of their ego affect us personally, it speaks more about them than usWe need to learn to give constructive criticism without judgingSupport 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

I am thrilled to reconnect with Dr. Sanjay Bhojraj today. Dr. Bhojraj is a board-certified interventional cardiologist who became a pioneer in functional medicine. In our conversation, we dive into palpitations, which are a common complaint among perimenopausal and menopausal women. We explore red flag symptoms, the physiological effects of progesterone, estrogen, and testosterone as they relate to heart arrhythmias, EKG changes during the perimenopause-to-menopause transition, and wearable technologies. We unpack the differences between benign and more concerning arrhythmias, risk factors for atrial fibrillation, and the process of taking a thorough history, ordering the correct tests, and using imaging or sleep studies when appropriate. We cover treatment pathways, from lifestyle modifications to medications, channelopathies, and the genetic propensities for conditions such as Long QT, Brugada Syndrome, WPW (Wolff-Parkinson-White syndrome), and sudden cardiac death. We also highlight the importance of genetic testing for individuals with a family history of those conditions. Today's conversation with Dr. Sanjay Bhojraj is full of practical wisdom and clinical pearls, so you will most likely want to listen to it more than once. IN THIS EPISODE, YOU WILL LEARN: Why thyroid function should always be taken into account when assessing heart rhythm issues   How stress and life circumstances can trigger palpitations  The benefits of magnesium supplementation for supporting heart health What ventricular arrhythmias (from the bottom chambers) and atrial arrhythmias (from the top chambers) are commonly related to The value of monitoring for identifying the nature and severity of arrhythmias How sleep apnea can increase the risk of arrhythmia   The importance of exercise, stress management, and healthy lifestyle habits for supporting heart rhythm Why certain arrhythmias may require procedural interventions Why various types of athletic activity matter when evaluating arrhythmias How genetic factors can impact specialized heart assessments Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community (The Midlife Pause/Cynthia Thurlow)  Cynthia's Menopause Gut Book is on presale now! Cynthia's Intermittent Fasting Transformation Book The Midlife Pause supplement line Connect with Dr. Sanjay Bhojraj On his website On social media: @DoctorSanjayMD The Curious Cardiologist Podcast

We are in our 3rd week of our 4-part series on the #1 killer in America.   And we're talking about the Diagnostics that Dr. Prather uses to get to the root cause of Cardiovascular Disease. In this episode, you'll learn:—How Diagnostics are "even more important and more complete" in the Structure-Function Health Care model than in Disease Care.—Why the electrical system of the Heart is so important.   And how Dr. Prather uses what he considers "the best" in Holter monitors to measure a patient's electrical system.—The way a patient's EKG will completely normalize though the therapeutic exercise External CounterPulsation (ECP) Therapy at Holistic Integration .—The impact of the Nervous System on the Heart's electrical system, which can be improved through Chiropractic care.  And the way Holistic Integration measures the Vagus Nerve and the Parasympathetic and Sympathetic balance through their Autonomic Nervous System (ANS) Test. —Why Minerals are "critical" to the electrical system of the Heart.  And how Minerals are best measured through Hair Analysis and Bloodwork. —The amazing story of the patient whose WATCH was throwing off his heart's electrical system. —How Dr. Prather sees many Heart problems cleared up by clearing Heavy Metals out of people.—Why getting to the root cause of a patient's Heart problem is "like detective work". —The link between infections and Cardiovascular Disease, such as the Coxsackie B virus which can cause Cardiomyopathy.  And how infections, most commonly Strep, can also cause Heart Valve Issues.—How the Heart CAN be healed and has an amazing ability to regenerate.http://www.TheVoiceOfHealthRadio.com*Receive exclusive bonus content as a member of our Voice Of Health Patreon Community:https://www.patreon.com/cw/VoiceofHealthPodcast

Mindsets to avoid burnout – Julie humanizes the patient and understands that whatever difficult things we are dealing with are temporary and have gratitudeWe must constantly recognize possible anchor bias and avoid cynicism to appropriately treat our patientsWe talk about our interactions with EMSBoth Julie and I remember working in EMS and the value that EMS brings in their report because they often see a lot of things we don't get from the history of the patientJulies advice for the new APP/ER doc - don't come to premature closure on a diagnosis, don't be afraid to ask questions, pay off your loans over buying the biggest house and latest toysWe talk about the baseline level of stress we deal with We talk about technological changes over time and imaging improvementsShe talks about the challenges that the Covid pandemic presented and the shortages of different things we have now encounteredJulie still finds meaning in finding the hard differential diagnosis and working towards positive patient interactions, the teamwork in the ERI talk about the importance of creating an approachable affect so everyone feels free to voice concernsGo look at the patient when the nurse is concerned Julie talks about the benefit for new EMT's and paramedics to reach out and ask for feedback and follow up on their patients, often we don't have time to pull them asideEMS doesn't have the best mechanisms in place for good feedback on every case like we do in the ER, where we see in real time how accurate our assessment may have been when the work up comes backSupport 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 dieser besonderen Folge von Retterview erzählt Samy eine echte Einsatzgeschichte aus dem Rettungsdienst – im Stil einer True-Crime-Erzählung, aber ohne Verbrechen. Eine Geschichte aus dem echten Einsatzalltag. Echt passiert. Echt gefühlt. Echt entschieden. Was als Routineeinsatz beginnt – „Zweimal Sturz, Hausnotruf“ – entwickelt sich zu einer komplexen Lage mit zwei Patient:innen, knappen Ressourcen, medizinischen Entscheidungen unter Druck und der Frage, wie dünn die Linie zwischen „harmlos“ und „lebensgefährlich“ manchmal ist. Samy nimmt euch mit mitten hinein: zwischen Blaulicht und Wohnzimmer, EKG und Bauchgefühl, Fachwissen und Menschlichkeit. ⚠️ Hinweis & Disclaimer Diese Folge basiert auf einem realen Einsatz aus dem Rettungsdienst. Alle Namen, Orte und identifizierbaren Details wurden aus Datenschutzgründen verändert. In dieser Episode wird mit lebendiger Erzählweise gearbeitet, teilweise auch mit realitätsnahen Geräuschen und emotionalen Momenten. Wenn dich medizinische Notfallsituationen, Atemnot, Stürze oder intensive Einsatzschilderungen triggern könnten, höre diese Folge bitte nicht allein oder überspringe sie. Medizinische Inhalte werden laienverständlich erklärt, ersetzen jedoch keine ärztliche Beratung oder Ausbildung. Rettungsdienst ist Teamarbeit – und diese Geschichte soll zeigen, was hinter dem Blaulicht wirklich passiert. Mit Respekt für alle Beteiligten.

We are in week 2 of a 4-part series on the #1 killer in America.   And our focus this week is on Holistic Treatments for Cardiovascular Disease  In this episode, we talk about:—How a shift to the left of the Thoracic spine indicates heart problems, which can often be reversed once everything is aligned properly. —The number one treatment for every kind of Cardiovascular Disease.  And the External CounterPulsation (ECP) Therapy that produces even better results than doing aerobic exercise.—Why Dr. Prather gets even better patient results than expected by the researchers of ECP Therapy.  And the importance of proper nutritional supplementation alongside ECP Therapy "that does miracles". —How ECP Therapy helps fight aging, keeps the brain working better, and improves oxygenation to all the organ systems of the body.  And Dr. Prather's own story of how ECP Therapy has helped his heart heal from damage caused by a spider bite. —Why the combination of ECP Therapy and proper nutrients produces great results for patients suffering from Congestive Heart Failure, with hearts twice the normal size going completely back to normal after 7 weeks.—How you'd look like you were 21 for the rest of your life if you had no Free Radical damage, which causes Cataracts, Macular Degeneration, age or Liver spots, Cancer cells, Cardiovascular damage, and Dementia. —The "critical" importance of Minerals for Heart health. And how Dr. Prather can tell which mineral deficiencies a patient has just by looking at their EKG. —How Holistic Integration can actually test which Vitamins, Minerals, and Amino Acids that will work best for the patient. —Why Dr. Prather calls Homeopathy "our secret weapon".  And how most Medical Doctors don't realize that Nitroglycerin is actually a homeopathic. —The "immediate" changes in the EKG that Dr. Prather often sees after a patient receives a Chiropractic adjustment.  And the power of Acupuncture in reducing inflammation and increasing the healing ability of the body internally. http://www.TheVoiceOfHealthRadio.com*Receive exclusive bonus content as a member of our Voice Of Health Patreon Community:https://www.patreon.com/cw/VoiceofHealthPodcast

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.

Blutdruck, Cholesterinspiegel, Zuckerwerte, EKG... was bringen solche Check-ups beim Hausarzt? Zahlt die Kasse alles, was nötig und sinnvoll ist? Antworten vom Hausarzt und Prof. für Allgemeinmedizin Jörg Schelling.

Snart er det nasjonal eksamen og tradisjon tro prøver vi å gjette oppgavene som kommer på eksamen. En tydelig trend er at det blir mer sammensatte oppgaver som tester fysiologiforståelse - og det kommer nesten alltid noen oppgaver fra hvert tema. Den største risikoen fra et pasientsikkerhetsperspektiv er sorte huller i forståelsen, og dette gjenspeiles i oppgavene de siste årene.Episoden starter med noen gode studietips for de siste ukene frem til eksamen. En oppsummering av de viktigste anatomifigurene du må kunne ligger i⁠ bloggen vår på MedEasy⁠ I denne episoden går Nils Christian og Erik gjennom femten kjerneområder i anatomi og fysiologi som nesten alltid dukker opp på eksamen. Blant annet regulering av respirasjon og ventilasjon. Regulering av blodtrykk og arterioler. Hjertets oppbygning og elektriske ledningssystem med EKG. Gassutveksling i lungene og oksygentransport i blodet. ADH EPO væskebalanse og kapillærvæskestrøm. Sympatikus parasympatikus og stresshormonene adrenalin og noradrenalin. Homeostase og temperaturregulering.Masse lykke til med innspurten!

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? 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

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!  

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/

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

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

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/

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.