show episodes
 
"Heavy lies the crown" is a common misquote of "uneasy lies the head that wears the crown" from Shakespeare's Henry IV, Part 2. It refers to the responsibility and insecurity of governing an entire kingdom. Likewise, "heavy lies the helmet" refers to the responsibility we face as critical care transport providers working in an autonomous and often unpredictable environment. Our minds are eased with education that better prepares us for any situation that we may encounter. That is exactly wha ...
 
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show series
 
If "you can't handle the truth", you can't handle a mentor. Mentors come in the form of leaders, educators, guides, and advisors to help you with honest self-reflection in order to improve yourself and your practice. Join us from AMTC21 where we discuss the importance of this arrangement with our close friends and fellow mentors, Adam Tresidder and…
 
Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a patient who is refractory to conventional therapy? Joined by EM pharmacist, Chase Turner, we discuss all things hyperthyroidism in this…
 
"Kung" means "skillful work" and "Fu" means "time spent". "Resus Kung Fu" refers to the resuscitation skills we acquire over time to become a true master. But how do we achieve mastery of these cognitive abilities and technical skills? And what role does stress inoculation play in training? Join us and Dr. Michael Lauria in this podcast episode whe…
 
Have you ever been hiking in the woods and wondered what emergency medical services are available in case you got injured? The level of scope varies greatly across the country for wilderness emergency medical and SAR technicians. From first aid to critical care, in this podcast episode, we discuss who is coming, what their capabilities are, and how…
 
Sometimes, we're wrong. And when it comes to normal saline, we might be. Tune in to a breaking news podcast of sorts where we discuss the recently published BaSICS Randomized Clinical Trial, and how it affects our practice in regard to balanced fluid resuscitation. Get CE hours for our podcast episodes HERE! ----------------------------------------…
 
Though the incidents of crush injuries may be low in frequency, major crush injury syndrome is associated with a high mortality rate. In this podcast episode, we sit down with regular guest, Chris Stevenson, to discuss the "why". We highlight the pathophysiology behind re-perfusion injury and pre- and post-treatment options. Get CE hours for our po…
 
How do you decide between non-invasive and invasive ventilation? If you decide on non-invasive ventilation (NIV), how do you choose between heated high flow nasal cannula (HFNC), C-pap, or Bipap? And what critical decision-making tools do you utilize when escalating to intubation? In this podcast episode, we are joined by Flight Respiratory Therapi…
 
Managing Acute Myocardial Infarction (AMI) patients is a concept that many of us learn early on in our careers. Because of that, we can potentially underestimate the importance of our interventions. In this podcast episode, we are joined by Dr. Gottula and Dr. Skrobut to discuss timely management of AMI's, when coronary intervention (PCI) is indica…
 
There are a lot of misconceptions surrounding the meaning of certain lab values and what a positive truly is. Are these numbers as black and white as they are perceived? In this podcast episode, we discuss sensitivity versus specificity, define some of the most common labs and how to avoid tunnel vision when it comes to your clinical interpretation…
 
Taking care of the High Risk OB patient is outside the comfort zone of many of us. The third trimester, specifically, presents unique challenges both pregnancy-related and otherwise. Why are normal physiologic changes related to pregnancy ABNORMAL in the third trimester? How do we determine if the pregnant patient is sick or not sick? And how do yo…
 
Has administration ever made a decision that you didn't agree with and/or understand? Of course! As much as we don't like to admit it, the medical industry is a business. For that reason, finances play a significant factor in decision-making. How do we maintain balance between profit and patient care? How do we bridge the gap between leadership and…
 
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this ext…
 
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this ext…
 
Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an advanced airway, some clinicians may not be mindful of cerebral perfusion pressure and how to optimize it effectively. In this podcast episode, we provide you with the recording of Bryan's presentation f…
 
Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But are the studies skewed by inappropriate management and our resistance to act? When do we intervene, and when do we not? And how can we help improve these poor mortality rates? Join us as we discuss thi…
 
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwh…
 
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwh…
 
Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this podcast episode where we discuss the SAR and relief work he was a part of during that dire time. We highlight mission preparation, p…
 
Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altered mental status is usually the only notable deficit, so it's important to know how to identify and treat this life-threatening disorder. Tune in to find out how through a casual discussion and real-li…
 
Acquiring a job in flight medicine is only the beginning. In this presentation to the 2020 Flight Crew Academy graduating class, Mike discusses three archetypes of new hires. He highlights positive and negative behaviors, systematically addressing incompetence, and how to ultimately get off orientation successfully. --------------------------------…
 
With the upcoming respiratory season, many of us will be caring for an increased number of pediatric and adult patients with pulmonary disease processes. Obstructive physiology, specifically, can result in an increased strain of resources to effectively care for this critically ill population. In this webinar, Mike, Bryan, and Jordan focus on statu…
 
Chris Stevenson is back for a third go-round, so I think that makes him a regular guest on the show. This time, he came at us with a non-clinical topic that peeked our interest... Likely over the years, we find ourselves giving or receiving advice related to flight medicine. As our years of experience have accumulated, so has the length of our rule…
 
Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a discussion based on what-would-have-been our Yacht Club presentation. Everyone carries a card that says they know how to manage tac…
 
Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the privilege of welcoming the infamous Dr. Cliff Reid to the show to discuss his and Sydney HEMS' approach to all of these areas. Tune in and learn how to be a high level transport provider from one of the …
 
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is the opposite of complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and t…
 
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors…
 
High flow nasal cannula is an increasingly popular modality for Acute Respiratory Distress and Failure. Previously, we saw it used mostly in the pediatric population. But as time has went on, especially with the COVID-19 outbreak, this has become an effective means of O2 delivery in all patient groups. With its increased frequency of use, it is onl…
 
How do you calculate your drug dosages? What do you base it on? In this podcast episode, we are joined by Lynn Lamkin, EM pharmacist, to discuss weight based versus non-weight based drug dosages. We also breakdown when true body weight (TBW), ideal body weight (IBW), lean body weight (LBW) or adjusted body weight (ABW) is a more appropriate option.…
 
You asked. We answered. In a follow-up to our burn resuscitation podcast episode, we are joined by Chris Stevenson and his burn center Medical Director, Dr. Mike Feldman, to discuss inhalation injuries. Tune in as we discuss the mechanism surrounding inhalation injuries and how to treat them affectively based on anatomical location and poison type.…
 
Titrating intravenous drips is a source of contention for many providers. This is, in part, due to a wide range of approaches depending on the patient's condition. Further attribution is based on each individual's comfort level and respective professional background (e.g. ICU versus EMS). But what does the literature say regarding this topic? In th…
 
With the rising number of COVID-19 patients, many of our listeners have requested additional information regarding transporting patients in the prone position. Despite refractory hypoxemia, many of these patients are benefiting from the prone position. Based on Episode 17 of the podcast, we updated our information in presentation-form. The followin…
 
Recently, Bryan was asked to present at a local EMS conference. The majority of the audience was ground personnel and student nurses, so he decided to present the why and how of measuring waveform capnography. EtCO2 truly should be the 5th vital sign, so we hope you appreciate this recording. ------------------------------------------------ Twitter…
 
Due to a recent outbreak, influenza and COVID-19 have been in the forefront of people's minds. Influenza, in particular, continues to affect all age groups despite it being late in the typical season. In this podcast episode, we discuss the entire course of this disease process; from positive nasopharyngeal swab to downstream ARDS and the complex v…
 
In this podcast episode, we are joined by Dr. Deep Sharma, Interventional Pulmonologist, to answer listener questions in a rapid fire format. We cover everything from modes of ventilation to respiratory decompensation to snorting sugar dust. You asked. He answers. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavy…
 
Proper fluid management in burns is critical to survival. But what happens when we administer too little or too much fluid therapy? In this podcast episode, we are joined by Chris Stevenson to discuss epidemiology and appropriate resuscitation for the prehospital provider. Our discussion includes an assessment of past and current formularies and wh…
 
Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to discuss this technique and his most recent Air Medical Journal study aimed at investigating its usefulness in training prehospital eme…
 
The Annual Sim Cup at the Air Medical Transport Conference (AMTC) is a prestigious event that gathers flight clinicians from all over the world to compete. Jason Peng (ED and Flight NP) and Ellen Parsley (Flight Nurse) of University of Cincinnati Air Care joined forces and took home the 1st place trophy at AMTC19. We use this opportunity to sit dow…
 
RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medical management and aircraft safety considerations surrounding the patient with acute agitation, excited delirium, and/or drug-induced psychosis. We also touch on Droperidol; an old drug that is findin…
 
Making her second debut on the podcast, Dr. Cynthia Griffin joins us at AMTC19 to discuss the utility of ultrasound/POCUS. Cynthia presented on this topic and highlighted its indication when following your XABC's (Hemorrhage, Airway, Breathing, Circulation) exam. Are you currently using ultrasound in your practice? If not, are you actively trying t…
 
As an air medical provider, our bread and butter is interfacility transports. Whether at the referring or receiving facility, we deal with Intensivists on a regular basis. What are their expectations? How can we provide the best care for our ICU level patients while simultaneously pleasing the facility staff? Our resident nocturnal Intensivist, Dan…
 
The title says it all. We hope you will join us. *Standby for more information regarding this unique opportunity to expand your knowledge. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email heavyliesthehelme…
 
In our final Guatemala Educational Aircrew Retreat (GEAR) 2019 podcast episode, we summarize the overall experience. G.E.A.R. was memorable, to say the least. It resulted in currency, competency, and confidence through camaraderie and collaboration. But what do Black Wolf Special Helicopter Operations, RED MED, and HeliSOS Servicios Medicos mean? W…
 
Part 1 is on our other podcast platform, After the Call. In this podcast episode, we are again joined by survival experts Chris “Gibbo” Gibson and Jimmy “Jungle” McSparron to discuss the concept of tacticool. This common expression is regularly featured on social media when individuals inquire about various gear options for one’s person. We discuss…
 
With kick off our Guatemala Educational Aircrew Retreat (GEAR 2019) series with an open forum. Located at Guatemala's aviation training center, we sat in a mock airplane, pulled out the lapel mics, and decided to discuss the broad topic of survival. The morning after our jungle excursion inspired a multitude of discussions ranging from fire to surv…
 
In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models in HEMS. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to cheat your experience, so we split the podcast episode into two s…
 
Is the Registered Nurse/Paramedic crew configuration optimal for HEMS? In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to ch…
 
In this podcast episode, we are joined by Flight Physician Mike Abernethy to discuss the importance of high fidelity, simulation training. We discuss common pitfalls of simulation learning, EMS education, and highlight tips and tricks for building successful moulage; the art of applying mock injuries for the purpose of training emergency response t…
 
Armchair Air is at it again with this is the second installment of the "Breaking the Case" series where we discuss case studies related to previously covered topics. Even though some content from Episode 33 - P.E. MERGENCY is reviewed, we recommend listening to it before proceeding. It will provide the foundation needed to understand the concepts t…
 
Earlier this year, we were asked to present at a local critical care conference. Due to the recent release of the 1-hour bundle, this was a timely discussion regarding pre-hospital sepsis. We touched on various definitions, diagnostics, treatments, and the ongoing controversy surrounding the Surviving Sepsis Campaign. Since we try to record most of…
 
Ladies and gentlemen, welcome to the main event. This long awaited, highly anticipated match-up is finally here. Dan received feedback, after giving a recent talk, that we wanted to address in a fun way. What causes peri-intubation hypotension and death? Is positive pressure ventilation (PPV) or induction agents the primary contributing factor? Tun…
 
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