The World’s Okayest Medic Podcast

Sal Cortez has over forty years of experience as a paramedic and LEO. He has responded to two major active shooter incidents, worked as a flight medic, served on the California Governor's protection detail, and now runs TEMS training at the International School of Tactical Medicine. Listener discretion is advised.

Listener discretion is advised. References: PMID 12776641, 29463461

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised. CORRECTION: I mentioned that Precedex is an alpha antagonist. I misspoke and meant to say that it is an "agonist." References: Ehrman-Dupre R, Kaigh C, Salzman M, Haroz R, Peterson LK, Schmidt R. Management of Xylazine Withdrawal in a Hospitalized Patient: A Case Report. J Addict Med. 2022 Sep-Oct 01;16(5):595-598. doi: 10.1097/ADM.0000000000000955. Epub 2022 Jan 11. PMID: 35020700. London KS, Huo S, Murphy L, Warrick-Stone T, Goodstein D, Montesi M, Carter M, Butt S, Alexander K, Satz W, Tasillo A, Xu L, Arora M, Casey E, McKeever R, Lowenstein M, Durney P, Hart B, Perrone J. Severe Fentanyl Withdrawal Associated With Medetomidine Adulteration: A Multicenter Study From Philadelphia, PA. J Addict Med. 2025 Aug 1. doi: 10.1097/ADM.0000000000001560. Epub ahead of print. PMID: 40747932. Reel B, Maani CV. Dexmedetomidine. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513303/

Listener discretion is advised. References: Casey, J., Seitz, K., et al. (2025). Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. NEJM. Available: https://www.nejm.org/doi/full/10.1056/NEJMoa2511420?query=featured_home Farkas. (Dec 10, 2025). PulmCrit: Hot take on RSI trial of ketamine vs etomidate. Available: https://emcrit.org/pulmcrit/rsitrial/ Srivatsa S, Chawla M, Hernandez M, et al. Helicopter transport of trauma patients continues to be overutilized: a call for universal transport criterion. Am Surg. Published online September 13, 2025:31348251378910. doi:10.1177/00031348251378910.

Listener discretion is advised.

LISTENER DISCRETION IS ADVISED. Kim YG, Choi YY, Han KD, Min K, Choi HY, Shim J, Choi JI, Kim YH. Atrial fibrillation is associated with increased risk of lethal ventricular arrhythmias. Sci Rep. 2021 Sep 13;11(1):18111. doi: 10.1038/s41598-021-97335-y. PMID: 34518592 Ren J, Yang Y, Zhu J, Wu S, Wang J, Zhang H, Shao X. The use of intravenous amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2021 Jan;44(1):35-43. doi: 10.1111/pace.14113. Epub 2020 Dec 9. PMID: 33118640.

Listener discretion is advised.

Listener discretion is advised. Greenhaw, R. & Jamali, M. (2021). Medical Helicopter Accident Review: Causes and Contributing Factors. Available: https://libraryonline.erau.edu/online-full-text/faa-aviation-medicine-reports/AM21-19.pdf Hinkelbein J, Schwalbe M, Genzwuerker HV. Helicopter emergency medical services accident rates in different international air rescue systems. Open Access Emerg Med. 2010;2:45-49. Millin MG, Innes JC, King GD, Abo BN, Kelly SM, Knoles CL, Vezzetti R, White CC 4th, Yee A, Gallagher JM. Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries - A NAEMSP Comprehensive Review and Analysis of the Literature. Prehosp Emerg Care. 2025 Aug 7:1-13.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised.

Listener discretion is advised. Thank you to Mike Damkot for coming onto the podcast. Check him out on his podcast "EMS On the Mountain."

Listener discretion is advised.

Listener discretion is advised. Thank you to Pulmonologist Nick Ghionni and host of the EmCrit Podcast, Dr. Scott Weingart for coming onto the podcast and talking about approaches to the assessment and management of the often vague and really sick patient with respiratory distress.

Listener discretion is advised.