FlightCrit Podcast

In this episode of the podcast, we sit down with Dr. Zack Shinar of the EDECMO Podcast, and co-author of "ECPR AND Resuscitative ECMO," the world's first ECMO CPR textbook.Dr. Shinar is a world-renowned expert on ECPR and resuscitative ECMO, and he was gracious enough to share a bit of his time with the FlightCrit community.In this episode Dr. Shinar shares with us:The history of ECPR including results from some of the very first casesHow ECPR is changing the culture of cardiac arrest resuscitation worldwideWhat EMS, and Critical Care Transport Teams, can do to help optimize the delivery of ECPR therapy to eligible patients.and how ECMO therapy can be applied in other peri-arrest settings.Links discussed in this podcast:www.edecmo.orgReanimate ConferenceARREST Trial ECPR AND Resuscitative ECMO textbookSupport the showMedic and RN CE's available over at academy.flightcrit.com

In this episode, we're joined by Dr. Haney Mallemat from @critcarenow to discuss the patient with a massive pulmonary embolism and how we need to manage these patients in the acute phase to keep them alive until we can get them to definitive care.Below are several resources Dr. Mallemat referenced in our talk, as well as links to Critical Care Now and the ResusX conference.Please do us a favor and check out Dr. Mallemat's site.  You'll be happy you did.Critical Care Now - https://criticalcarenow.com/ResusX Conference - https://www.resusx.com/PEAPETT Trial - https://pubmed.ncbi.nlm.nih.gov/27422214/RebelEM Post about PEAPETT - https://rebelem.com/peapett-trial-half-dose-tpa-pea-due-massive-pulmonary-embolism/PERT Teams - https://pertconsortium.org/about/PERT Teams - https://onlinelibrary.wiley.com/doi/10.1002/rth2.12216Nebulized Nitro from PulmCrit - https://emcrit.org/pulmcrit/ntg/Nebulized nitro from the American Academy of Emergency Physicians - https://www.aaem.org/UserFiles/file/CS21_MarAprCCMS.pdf Nebulized Nitro - https://rc.rcjournal.com/content/57/3/444Support the showMedic and RN CE's available over at academy.flightcrit.com

Join us for an exciting talk with our friend and colleague Ami Bess, Chief Flight Nurse for UCHealth LifeLine about one of the most unnerving topics in Adult Critical Care Transport - Management of the HROB patient with severe Antepartum & Postpartum Hemorrhage.Topics discussed in this episode includeAssessment of the patient with severe Antepartum and Postpartum HemorrhageCause of APH and PPHManagement of APH and PPH includingMedicationsBlood ProductsMechanical Tamponade devices including the Bakri Balloon and Jada Systemand Surgical ProceduresIn this podcast, Ami makes reference to the WOMEN Trial, a trial looking at the use of TXA in pregnant women.  You can find that trial here.  WOMAN Trial - LancetAmi can be contacted by email at flightrnami@gmail.comSupport the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the podcast, we discuss some new ideas about the use of TXA as well as provide some new insight into the use of Whole Blood Resuscitation.Links to articles mentioned in the podcast coming.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the podcast Hunter and I sit down with Joe again to discuss the role of optimizing Flow in our mechanically ventilated patients, and how to manipulate this on our vents.We also discuss some of the risks associated with certain vent modes for patients who Flow Hunger and one strategy for correcting ventilator asynchrony.We highly recommend you check out the video that accompanies this podcast over in the FlightCrit Academy.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this week's class, we talk with Dr. Jeremy Kaswer, better known as @TacTraumaMD, about his approach to the initial stabilization of the poly-trauma patient.From Assessment to Chest Tubes, Shock Index to REBOA, Dr. Kaswer shares his experience as an ED physician, Army Flight Surgeon, and Critical Care Fellow at SHOCK Trauma with our community.And be sure to stick around to the end when Dr. Kaswer's drops a BOMB on us about obstructive physiology in the trauma patient and why he believes more prehospital providers should be using POCUS in the field.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the FlightCrit Podcast Hunter discusses Adrenal Emergencies.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the FlightCrit Podcast Hunter introduces the fundamental concepts of interpreting a chest x-ray, an essential skill for all critical care and transport providers to master.This episode relies heavily on the visuals to support the concepts presented, so we recommend watching the video of this presentation over at academy.flightcrit.com where you can join for free and then watch the video in its entirety.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the FlightCrit Podcast we chat with Dr. David Convissar, Critical Care and Cardiothoracic Anesthesiologist, from "Count Backwards from 10" about his approach to managing the airway of the crashing heart failure patient.  Hang on as Dr. Convissar shares with us his knowledge about:Differentiate between cardiogenic shock and distributive shock based on assessment findings.Describe Pulse Pressure and explain how it can be used to assess a patient in cardiogenic shock.Provide appropriate preintubation resuscitation to a patient in cardiogenic shock.Explain why Sodium Bicarb and Calcium can be beneficial preintubation medications for the patient in cardiogenic shock.Recognize the physiologic effects of hypoxia during intubation on the lungs and describe how this can complicate the hemodynamics of patients with heart failure.@countbackwardsfrom10@flightcritSupport the showMedic and RN CE's available over at academy.flightcrit.com

Mechanical Ventilators, such as the Hamilton T1, ReVel, and ZOLL Z-Vent, are not only vital pieces of equipment used in the ICU and in Critical Care Transport, but they are becoming more popular for use by EMS services for interfacility transport so it's vitally important that EMS and Critical Care providers have a deep understanding of not only how these devices work, but also how different disease processes changes the way our patient interacts with the ventilator.And who better to learn from than a Respiratory Therapist.In this episode, we have the pleasure of chatting with Joe Lewis, better known as the Respiratory Coach, as he schools us on Dynamic and Static Compliance, how we can use our PIPs and Plateau Pressures to identify changes in both, and how we can optimize PEEP by looking at changes in Static Compliance.  We also go off the deep end discussing Driving Pressure and how this just may be the future of mechanical ventilation.Check out the video that goes along with this episode over at academy.flightcrit.com.Have an idea for a future episode?  Send us a message at www.askflightcrit.com. If we include your question in a future episode we'll send you a T-shirt.Support the showMedic and RN CE's available over at academy.flightcrit.com

In this episode of the podcast, I'm joined by my co-host Huster as we discuss the physiology of Oxygenation, Ventilation, and Driving Pressures as they related to the Mechanically Ventilated patient.https://academy.flightcrit.com/courses/oxygenation-ventilation-and-driving-pressureSupport the showMedic and RN CE's available over at academy.flightcrit.com

EVDs, External Ventricular Drains.  What are they, how are they managed, and what should we know about them if we happen to see one in transport.Support the showMedic and RN CE's available over at academy.flightcrit.com

For year EMS providers have relied on certain clinical signs and symptoms to predict clinically unstable trauma patients and the need for emergent transport for definitive surgical care. Commonly EMS providers have used HR>120, systolic BP<90mmHg, and MAP’s <60mmHg as benchmarks for clinically unstable patients. However, these indicators can frequently be misleading if not carefully evaluated in the context of a patient’s overall clinical presentation leading prehospital providers to underestimate the severity of our patient's injuries or illness.  The Shock Index and Modified Shock Index can help providers make better decisions about prehospital trauma care.Support the showMedic and RN CE's available over at academy.flightcrit.com

There’s a severe lack of evidence about how to best utilize the drug Ketamine in the out of hospital environment. Any “research” that’s done comes from either the OR, ICU, or if we’re lucky the ED. We’re forced to extrapolate from those studies what we can about how to best apply their findings to the out of hospital environment.Support the showMedic and RN CE's available over at academy.flightcrit.com

This week on the podcast we're reviewing a lesson from the Burn Section of the EPICC Review Course concerning fluid resuscitation.  Listen in as I discuss the most current recommendations from the American Burn Association on the Prehospital and Early Hospital management of IV fluids in the burn patient.  I also give you 1 easy tip to simplify the ABA's recommendation even further, as well as review what you need to know about determining Total Body Surface Area burned and Fluid Resuscitation for the FP-C, CCP-C, and CFRN exam.Support the showMedic and RN CE's available over at academy.flightcrit.com

Spend any amount of time working in the air medical environment and you'll absolutely hear people talk about the gas laws.  In this episode, I discuss what I believe to be the 5 essential gas laws any air medical professional must understand to work in this industry. Listen in as we discuss Boyle's Law, Dalton's Law, Charles Law, Henry's Law and Fick's Law.Support the showMedic and RN CE's available over at academy.flightcrit.com

There are 8 different stressors of flight that you as a Flight Paramedic or Flight Nurse must be familiar with.  In this episode of the podcast, I discuss the most important of these flight stressors: hypoxia. I discuss the 4 different types of hypoxia and the most common causes of each.  I also share with you the three guidelines that regulate when we, as air medical professionals, must utilize oxygen ourselves during transport.Support the showMedic and RN CE's available over at academy.flightcrit.com

Being thrust into a survival situation as a result of an accident or unplanned event while on duty can be unnerving, to say the least. But being both mentally and physically prepared for the unexpected can go along way towards making sure we make it home. In this, the third episode in my series 52 weeks of EPICC I'm sharing with you some of the most important lessons on Survival from the EPICC Review Course. It is my belief that with the proper mindset, a little planning, and a few pieces of equipment, we can drastically improve our chances of survival if the unthinkable happens.Support the showMedic and RN CE's available over at academy.flightcrit.com

How many have actually read through the CAMTS standards in preparation for the Flight Paramedic or Critical Care Paramedic exam? My guess is not many. This week, the second week of 52 weeks of EPICC, I dug deep into the newly released CAMTS 11th edition standards to find the good stuff. From Duty Shift Times and Crew Fatigue to Part 135 requirements to Ambulance Operations, this episode gives you the most important topics from each section of the CAMTS standards so you can feel confident you’re ready when you sit down for your exam.Support the showMedic and RN CE's available over at academy.flightcrit.com

I’m kicking off a series I’m calling 52 Weeks of EPICC to celebrate completing the EPICC Review Course and its pending approval by the International Board of Speciality Certifications. In this, the first of 52 episodes for 2019, I’m pulling directly from Section 1 of the EPICC Review Course where I discuss VFR and IFR flight rules, and Inadvertent Instrument Meteorological Conditions. I’ll be defining each for you, giving you some genearly parameters for what constitutes VFR and IFR, and discussing what makes IIMC so dangerous and how we as crew members can respond in the event of an IIMC situation to ensure the safety of the entire crew.Support the showMedic and RN CE's available over at academy.flightcrit.com