Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Ross Orpet, Paramedic turned EMS Physician
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Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers

Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters.

  1. MAR 13

    Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature

    Let's discuss the intricacies of evidence-based medicine (EBM) with Dr. Ben Li. The conversation dives deep into understanding different types of medical studies, their hierarchies, and how EMS providers can apply them to their practice. The episode covers evaluating research, the importance of study design, confounders, sample size, and how to discern the relevance and applicability of research findings. Dr. Li provides practical advice for critically appraising literature and emphasizes doing so in a way that is personally relevant to the listener's practice. This episode is essential for anyone in EMS or emergency medicine looking to deepen their understanding of medical research and how it impacts patient care. Enter to win Airpods, Cric-a-lot, and a belt buckle! Resources that can help Critical appraisal guides: https://casp-uk.net/casp-tools-checklists/ (my personal favorite) https://jbi.global/critical-appraisal-tools Reporting guidelines (similar to appraisal guides, but more are standards for the investigators to use and follow): https://www.equator-network.org/reporting-guidelines   00:00 Introduction and Priorities 00:34 Show Restructure Announcement 01:42 The Evolution of EMS Practices 03:57 Understanding Evidence-Based Medicine 05:23 Interview with Dr. Ben Lee 07:20 Approaching and Appraising Medical Studies 08:14 Challenges in EMS Research 13:47 Study Design and Hierarchy 31:33 Applying Research to Practice 39:26 Final Thoughts and Takeaways   Resources The Resus Tailor Enter to win Airpods, Cric-a-lot, and a belt buckle! Website show notes link Other episodes you might like: Podcast announcements Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Host- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com

    41 min

  2. FEB 28

    Why Your EMS Bag Could Be Failing You: Essential Design Tips You Need

    We discuss the importance of equipment design in EMS with Adam LaChapelle, founder of The Resus Tailor. Together we delve into the impact that effective design has on performance and patient outcomes, exploring principles such as reducing friction and visual checklists. Adam shares compelling stories and practical tips on organizing your equipment to enhance efficiency and care. The episode also includes a special giveaway announcement for listeners. SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle   00:00 Introduction to Bag Design Challenges 00:44 Real-Life Emergency Scenario 02:33 The Importance of Equipment Layout 03:15 Exciting Announcements and Rebranding 04:00 Meet the Hosts and Today's Guest 05:27 Adam LaChapelle's Journey and Passion 11:32 The SCRAM Bag and Its Impact 16:20 Principles of Effective Design 21:42 Innovative Bag Design for Quality Care 22:19 The Importance of Iteration in EMS Gear 23:49 Key Considerations for Bag Design 28:05 Reducing Friction in Emergency Response 30:46 Challenges and Solutions in EMS Bag Design 35:33 Customizing Bags for Specific Needs 36:54 Practical Tips for EMS Providers 39:40 Partnering with Recess Tailor for Custom Solutions 42:45 Exciting Giveaway Announcement 44:03 Summary and Key Takeaways   Resources SPECIAL GIVEAWAY- AirPods, Cric-a-lot, Belt Buckle The Resus Tailor Website show notes link Podcast announcements- NEW NAME, Loud & Clear: EMS Guiding Principles Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Adam LaChapelle, Founder and CEO of The Resus TailorHost- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emsloudandclear YouTube- @emsloudandclear Website- www.emspodcast.com   Creative Commons - Attribution 3.0 Unported - CC BY 3.0Music sponsored by Audio Library https://youtu.be/JoyIRE5k2YoDaylight by Alex-Productions https://soundcloud.com/alexproductionsmusic

    46 min

  3. FEB 21 · BONUS

    NEW NAME! The podcast gets a new name, find out what and why...

    Hello everyone, we have an exciting announcement. Today we are announcing our brand new name: Loud & Clear: EMS Guiding Principles. My name is Ross, and alongside my co-host, Will, we're thrilled to present this fresh chapter in our podcast journey. Let's start with why we're rebranding and renaming. For close to five years now, we've been bringing you valuable continuing education through our podcast, originally named EMS Cast. Each year we have become more and more dedicated to our mission. However, as time passed, it became clear that our name didn't quite capture the essence of what we stand for—our mission or our identity as educators in the EMS field. Will and I devoted significant effort into clarifying our mission this last year. Determining how we could create a framework to help you navigate the inevitable uncertainties in EMS, to put an emphasis on what truly and what principles will guide you through the uncertainty. This framework is going to allow us  to bring you even better content with clearer messaging. We wanted a name that resonates with our commitment to provide in-depth discussions that extend beyond paramedic school learning but yet never loses sight of the fundamentals and guiding principles that actually matter. After months of brainstorming and reflection, Loud & Clear: EMS Guiding Principles felt like the perfect match—an embodiment of our dedication to make every lesson resonate strongly and clearly with you, the listener. In the world of EMS, ‘loud and clear’ is a phrase many of us know very well, whether you’re checking in with dispatch over the radio at the start of your shift or confirming the receiving hospital can clearly understand you. It signifies that there is clarity and understanding in the message that is received. We aim to bring this clarity  to every topic we discuss. Reinforcing our commitment to delivering information that is easy to comprehend and apply in real-life EMS situations, even when uncertainty abounds. While our name may have changed and our episode framework has evolved, our mission has not. We will continue to provide high level education, seeking to teach you principles that enrich your knowledge beyond the textbooks you read in paramedic school, preparing you for the unexpected scenarios you’ll face in the field. You won’t find cookie-cutter approaches here—we’re dedicated to helping you understand and fall back on an understanding of fundamental principles that allow you to navigate the uncertainty and chaos with confidence. Each episode of Loud & Clear will present high-level discussions about pathophysiology and treatment options. But more than that, every episode will guide you back to those time-tested EMS principles crucial for effective decision-making. This year promises ever more engaging content rich episodes, with an updated name, cover art, social media presence, and more as we embrace this exciting transition. We can't wait to embark on this new journey with you, our dedicated listeners. Thank you for your support and enthusiasm. Remember—we’re here to ensure your learning experience is loud and clear.

    4 min

  4. FEB 11

    Unlocking Syncope: A Harbinger of Hidden Perils, Differentiating Benign from Life-Threatening Causes

    Syncope is a symptom, not a diagnosis. Often it's a symptom of a benign etiology but it can indicate a life-threatening condition. So how do we distinguish between the two? We dive into the complex topic of syncope with guest Matt Mendes. We discuss the importance of recognizing syncope, differentiating it from seizures, and identifying who are the high-risk patients and why. The episode covers the guiding principles syncope- a good history, physical exam findings, and the ECG. It also delves into common presentations, risk stratifying strategies, and real-world cases to equip EMS providers with the knowledge needed to manage syncope calls effectively.    00:00 Intro 01:07 Welcome to EMS Cast, host and guest introductions 04:51 Guiding Principles for Syncope Assessment 07:22 High-Risk Syncope Patients 09:14 Initial Approach to Syncope Patients 15:15 Syncope vs. Seizure 20:08 Physical Exam and EKG Importance 25:14 Identifying Arrhythmias in Syncope Patients 26:37 Understanding Wolf Parkinson White Disease 27:46 QT Prolongation and Its Implications 29:49 Left Ventricular Hypertrophy and Its Risks 31:28 Recognizing Brugada Pattern 32:02 Arrhythmogenic Right Ventricular Dysplasia 33:04 Bifascicular Block and Its Dangers 35:00 EKG Interpretation and Syncope Risk Stratification 39:53 Emergency Department Workups for Syncope 55:49 Case Studies and Memorable Syncope Calls   Resources The Resus Tailor EMS Cast Syncope Blog Post Other episodes you might like: Wide Complex Tachycardia Podcast announcements- WE'RE RENAMING THE SHOW TO, LOUD & CLEAR: EMS GUIDING PRINCIPLES Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Matt Mendes, EM doc, Resident didactics coordinator, former EMS Cast Co-HostHosts- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com Creative Commons - Attribution 3.0 Unported - CC BY 3.0Music sponsored by Audio Library https://youtu.be/JoyIRE5k2YoDaylight by Alex-Productions https://soundcloud.com/alexproductionsmusic

    59 min

  5. JAN 31

    Invisible Scars: The Battle for Mental Health in EMS - PATH4EMS

    Let's discuss the pressing issue of mental health among first responders, particularly within the EMS community. Will gets vulnerable and shares a personal story of trauma on the job to highlight the urgent need for mental health resources and support. Unfortunately, his story is not unique, we will all experience some level of emotional trauma while on the job. This episode features Jessica Nelson, the coordinator of the groundbreaking program and first of its kind state legislation, PATH4EMS. PATH4EMS provides free and confidential mental health care for EMS professionals. We delve into strategies for normalizing mental health conversations, the importance of trauma-informed care, and the benefits of proactive mental health practices. The discussion also covers the need for tailored, evidence-based resources and the unique challenges faced by rural first responders. Tune in to learn about the vital steps being taken to ensure the well-being of those who brave the front lines.   00:00 The Struggles of First Responders 00:53 A Personal Story of Trauma 04:57 The Turning Point: Seeking Therapy 05:42 Introduction to EMScast 06:34 Meet Jessica Nelson: A Pioneer in EMS Mental Health 09:54 The Importance of Confidentiality and Specialized Care 12:17 Effective Mental Health Practices for EMS Providers 19:54 Path for EMS: A Groundbreaking Initiative 30:37 Future Directions and Final Thoughts   Resources PATH4EMS website Today's Sponsor- The Resus Tailor Today's episode blog post Podcast announcements- We're rebranding! New name will be- Loud & Clear: EMS Guideline Principles. Look out for the changes coming soon. Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Jessica Nelson, PATH4EMS coordinatorHost- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com

    37 min

  6. JAN 14

    Wide Complex Tachycardia: Get Comfortable With Uncertainty

    Learn a systematic approach to management of wide complex tachycardia that doesn't rely on exact rhythm identification or scoring systems with guest Dr. Kevin Butler. By understanding the physiology rather than memorizing a score or algorithm you can use Kevin's approach and ABCD mnemonic to help differentiate between ventricular tachycardia, SVT with aberrancy, and other arrhythmias. Learn how not to miss the vital mimics with his SPAM filter. And finally by understanding which treatments are safe and which treatments potentially dangerous you can understand how to move forward even when you're not exactly sure what the arrhythmia is. Whether you're an EMT, paramedic, or emergency physician, this episode provides the essential principles and stepwise strategies to ensure effective and safe patient management. 00:00 Introduction to Arrhythmia Management 00:29 Personal Anecdote: Lessons from Paramedic School 02:04 Introducing Dr. Kevin Butler 02:16 Sponsor Message: The Recess Tailor 03:35 Welcome to EMS Cast 04:04 Understanding Wide Complex Tachycardia 05:37 Approach to Arrhythmia Management 07:02 Principles of Managing Wide Complex Tachycardia 08:39 Pathophysiology of Wide Complex Tachycardia 18:30 Identifying and Treating Mimics 26:55 Regular vs. Irregular Wide Complex Tachycardia 29:59 Understanding Torsades and Its Management 30:25 Identifying Atrial Fibrillation with Pre-Excitation 32:14 Treatment Considerations for AFib with WPW 35:02 Distinguishing Between VT and SVT with Aberrancy 37:09 Physiological Approach to ECG Interpretation 40:24 ABCD Mnemonic for VT Diagnosis 47:49 EMS Treatment Protocols for Wide Complex Tachycardia 51:54 Pre-Hospital Cardioversion Tips 55:22 Emergency Department Approach to Wide Complex Tachycardia 58:00 Final Thoughts and Key Takeaways Resources The Resus Tailor Episode Blog Post with EKG examples Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Dr. Kevin Butler, Emergency Physician, Lead Instructor for DHREM's EKG didactic curriculumHost- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com

    1 hr

  7. 12/28/2024

    Trailer - Loud & Clear: EMS Guiding Principles

    You’ve looked at other paramedic continuing education resources but it’s the same basic material they taught you in school. There’s more you need to know, or you might miss something, someone might get hurt, or worse someone might die. You don’t feel ready. Your goal is to control the chaos. To become an expert in the field of prehospital medicine. And this is all driven by the desire to be there for someone on the worst day of their life. To change an outcome that would have otherwise been catastrophic if you weren’t there. There’s no resource for the practicing paramedic to plug the holes that were left behind by paramedic school. Everything seems stuck in basic algorithms of “A” then “do B” but what do you do when "A” wasn’t in the book. We need to get away from the algorithmic thinking and instead shift to understanding the principles behind WHY if A then B. The truth is, you can’t learn it all. Emergency Medicine includes too many pathologies and 911 calls are too unique and chaotic to know the answer to every situation. Instead of trying to learn every answer to every call, you need guiding principles for your knowledge to stand on. If you build these principles they become the foundation for every call no matter the complaint, for every situation, no matter the chaos surrounding you. If you have the foundation you can be stable when the storm comes. You can know when to push forward or when to change course. And then each additional piece of advanced content that you learn can be added to that foundation to build on, because mastery is not a destination, it’s a journey and the journey never ends. We are your hosts, Ross Orpet & Will Berry and this is EMS Cast. Come on this journey with us to mastering emergency medicine. We will cover topics in more depth than you learned in paramedic school, we will teach one step further and talk about what will happen to that patient in the Emergency Department after you drop them off. And we will connect all of this back to the principles that will guide you not just on this call but on all the calls. These principles will allow you to answer the question, at the end of the day, what’s really important to me, the paramedic, in the field, in that moment. You may not feel ready, you may not feel like you know enough, but you can understand the principles and that will make all the difference. Because what you do matters.

    3 min

  8. 12/23/2024

    From Novice to Navigator: Mastering the Art of EMS Field Training

    Joined by Josh, Cody, and Moose from the AlertMedicOne podcast, we explore key principles of good training, leadership, and the importance of making mistakes in a safe learning environment. We discuss strategies to foster critical thinking, introspection, and continuous improvement among trainees in the EMS field. A big part of EMS is learning to be a leader and a teacher no matter what level you are at so whether you are a trainee, a field trainer, teach students during their rides, or merely work with a partner there's something for everyone to learn in this one. Tune in for an insightful discussion on how to develop and become excellent EMS professionals through solid training and leadership.   00:00 Whitewater Rafting Adventure 00:25 The Importance of Training 01:02 Creating a Safe Learning Environment 01:43 Introducing the AlertMedicOne Podcast 02:06 Meet the Hosts 04:37 Whitewater Rafting Lessons for EMS 05:48 Encouraging Autonomy in Training 08:01 Balancing Guidance and Independence 10:25 The Role of Field Training Officers 15:03 Ownership and Leadership in EMS Training 24:50 Handling Mistakes and Failures 31:33 Striving for Continuous Improvement 34:11 Embracing Continuous Improvement 34:34 Learning from Experienced Paramedics 35:35 The Importance of Preparation 36:47 Humility and Self-Awareness 38:23 Handling Mistakes and Growth 40:12 Training and Mental Health 41:54 Effective Preceptorship 43:13 Teaching Techniques in Action 45:12 Building Confidence in Trainees 47:21 The Role of a Trainer 01:03:06 Final Thoughts and Reflections   Resources Contact The Resus Tailor Watch this episode on YouTube Read the blog post for this episode Other episodes you might like: Values Driven Leadership with Chris Pfingsten from EMS 20/20 podcast 10 lessons from a real austere rescue How to Master the Resuscitation - EMCRITs Scott Weingart Podcast announcements- Big news coming in 2025! Stay Tuned! Survey- Help us learn what content you want Gear We Like Good Stethoscope - https://amzn.to/3YJJrf2 Good Shears - https://amzn.to/40FROuF or https://amzn.to/3ChZ4Tn  Notepad for taking notes on calls - https://amzn.to/3Z1X21J Sunglasses - https://frontline-optics.com/discount/EMSCAST15 Books we recommend -  The Dichotomy of Leadership - https://amzn.to/4fiCAjN Extreme Ownership - https://amzn.to/3O1FWfa  Managing the Unexpected: Sustained Performance in a Complex World -        https://amzn.to/3V7BwYf Thinking Fast and Slow - https://amzn.to/4fiJG85 A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back -  https://amzn.to/3YJJrf2 Guest/Cast/Crew information-Guest- Josh, Cody, MooseHost- Ross Orpet, Will Berry Catch up with us after the show Instagram- @emscast Twitter- @ems_cast Website- www.emspodcast.com

    1h 7m
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About

Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters.

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