Medical Director Minute Jeff Myers, DO

Its estimated that up to 20 % of strokes involve what is called the posterior circulation of the brain. The significance of this fact is these strokes are not picked up or scored well on the NIH stroke scale and many other stroke scales because those scales are looking for larger territory anterior and middle cerebral artery strokes. Posterior circulation strokes affect the cerebellum, the balance center of the brain, the occipital lobe, responsible for interpreting visual input, and the brain stem. These strokes can involve significant deficits and yet score very low on these standardized scales. In this episode, we discuss the anatomy of the posterior circulation, the signs and symptoms that often occur with posterior circulation stroke syndromes and how to detect posterior strokes

Epinephrine has been one of the mainstays of cardiac arrest management since the early days of cardiac arrest management. The recently published PARAMEDIC2 trial examined patient outcomes, and more importantly neurologic outcomes, in out of hospital cardiac arrest comparing epinephrine with placebo. Tune in for the surprising results that question epinephrine's value in out of hospital cardiac arrest. 
 
The Medical Director Minute podcast is a high yield, rapid fire podcast bringing you high impact discussions on clinical topics right to your smart phone. We're keeping these podcasts to no more than ten minutes in length to make it easy to listen with your busy schedule.

Ketamine received some negative press last summer (2018) as I’m sure most of you have seen. With ketamine being used more frequently in prehospital medicine for the agitated patient, we wanted to provide a brief review of ketamine use in the setting of the agitated patient.
The Medical Director Minute podcast, hosted by Jeff Myers, DO, is a high yield, rapid fire podcast bringing you high impact discussions on clinical topics right to your smart phone. We’re keeping these podcasts to no more than ten minutes in length to make it easy to listen with your busy schedule.

In this episode, we discuss the modified Sgarbossa criteria used to identify STEMI equivalents in patients who have an existing or not known to be old left bundle branch block (LBBB). identifying a STEMI in the setting of a LBBB can be challenging because there are ST segment deviations that can be normal in LBBB. We discuss the modified Sgarbossa criteria that can help the paramedic identify this important STEMI equivalent.
paramedicine, paramedic, EMS, STEMI equivalent, Sgarbossa, LBBB
The Medical Director Minute podcast is a high yield, rapid fire podcast bringing you high impact discussions on clinical topics right to your smart phone. Each podcast is around 10 minutes in length to make it easy to listen with your busy schedule.

This is the second part of a two part episode reviewing the decision rules that form the base of selective spinal immobilization protocols. In order to properly apply a rule and identify those patients at low risk for spinal injury who do not require spinal motion restriction (SMR). Part two covers the application of the decision rules to our individual patients. Follow along in the show notes at http://medicaldirectorminute.com/cspinepart2.  
paramedicine, paramedic, c-spine, SMR, trauma
The Medical Director Minute podcast is a high yield, rapid fire podcast bringing you high impact discussions on clinical topics right to your smart phone. Each podcast is around 10 minutes in length to make it easy to listen with your busy schedule.

This is the first part of a two part episode reviewing the decision rules that form the base of selective spinal immobilization protocols. In order to properly apply a rule and identify those patients at low risk for spinal injury who do not require spinal motion restriction (SMR). Part one covers the two decision rules that many protocols are based on, the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian C-Spine Rule. Both have pros and cons, which we discuss in the episode. Follow along in the show notes at http://medicaldirectorminute.com/cspinepart1.  
paramedicine, paramedic, c-spine, SMR, trauma
The Medical Director Minute podcast is a high yield, rapid fire podcast bringing you high impact discussions on clinical topics right to your smart phone. Each podcast is around 10 minutes in length to make it easy to listen with your busy schedule.