Episodios

  • Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It

    Why Two Paramedics Watched Their Trainer Nearly Kill a Patient (And Said Nothing): How Lessons From The Aviation Industry Could Have Prevented It
    Jun 1 2025

    A field trainer administers a non-indicated medication while two trainees watch in silence. Sound familiar?

    In this eye-opening episode, we dive deep into how the aviation industry transformed from a punitive, hierarchical culture to one where crews actively prevent catastrophic errors—and how YOU can apply these same principles on your next EMS shift.

    Our guest, Glen, a commercial airline pilot and aviation safety expert, shares how the aviation industry has revolutionized itself through such methodologies as just culture, crew resource management, and error prevention tools like the inquiry, advocacy, assertiveness model. We explore how these principles can be effectively applied in our EMS world to improve safety and performance. By the end of this episode, you'll walk away with practical tactics to implement on your next shift, ensuring you and your crew can handle high-stress situations with confidence and competence.

    Key Concepts Covered:

    • Crew Resource Management (CRM)
    • Just Culture principles
    • Aviation Safety Action Program (ASAP)
    • Power distance in medical teams
    • Human factors in emergency medicine
    • Error prevention strategies

    Books Mentioned by Glen:

    • Just Culture by Sidney Dekker - https://amzn.to/3Su0A9Y
    • The Myth of Multitasking: How "doing it all" gets nothing done - https://amzn.to/4dAFa4E
    • Crew Resource Management Practice and Principles- https://amzn.to/3ZIjXzZ
    • Threat & Error Management resources - https://skybrary.aero/articles/threat-and-error-management-tem

    Other Resources:

    • The Resus Tailor - https://www.theresustailor.com/
    • This Episodes Blog Post- https://emspodcast.com/what-airplane-crashes-teach-us-about-saving-lives-in-ems-lessons-in-crew-resource-management-and-just-culture-from-the-aviation-industry/

    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

    Other 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- Glen Host- Ross Orpet, Will Berry Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    Más Menos
    1 h y 15 m
  • The Art of Managing Agitated Patients

    The Art of Managing Agitated Patients
    May 25 2025
    Effective agitated patient management requires a fundamental shift from viewing these encounters as behavioral problems to recognizing them as medical emergencies with underlying pathophysiological processes. By systematically addressing safety, identifying root causes, selecting appropriate pharmacological interventions, and maintaining rigorous post-sedation monitoring, EMS providers can dramatically improve outcomes for these challenging patients. Remember: you cannot talk someone out of a hypoglycemic crisis, hypoxic emergency, or sympathomimetic overdose. When verbal de-escalation fails, it's not your failure as a provider—it's an indication that medical intervention is required to address the underlying pathophysiology driving the patient's agitation. The goal isn't just to control behavior—it's to provide definitive medical care that addresses the root cause of the patient's distress while maintaining safety for everyone involved. Our guest is Patrick Hendley, a practicing paramedic and an expert in agitated patient management. We'll explore the pathophysiology behind agitation and essential strategies for EMS providers faced with these calls. We'll also examine sedation choices, restraint use, and post-sedation care through a lens of real-world EMS principles. Join us as we look at more than just de-escalation, but understanding and acting effectively and ethically to safeguard everyone involved. Don't forget to check out our sponsor, The Resus Tailor, for custom bag designs tailored to your EMS needs. Reach out to them at theresustailor.com. 00:00 Introduction to Loud and Clear EMS 00:27 Today's Topic: Managing the Agitated Patient 01:00 Guest Introduction: Patrick Henley 02:17 Sponsor Message: The Recess Tailor 03:01 Case Study: Agitated Patient Scenario 06:04 Understanding Agitation and Safety Principles 08:12 Sympathetic Nervous System and Agitation 10:00 Factors Contributing to Agitation 13:02 Drug Influence on Agitation 19:05 Safety Hierarchy in EMS 30:34 Transport Safety and Patient Management 33:07 Treating Underlying Causes of Agitation 39:08 Managing Patient Anxiety with Fentanyl and Oxygen 39:45 Using Ketamine for Pain Control and Sedation 40:25 Addressing Mixed Presentations: Schizophrenia and Substance Use 41:38 Treating Sympathomimetic Overdose and Psychosis 42:56 The Importance of Post-Sedation Monitoring 43:51 Verbal De-escalation and Benzodiazepines 45:00 Using Time as a Tool for Postictal Patients 46:11 Understanding Benzodiazepines and GABA Receptors 47:59 Antipsychotics and Ketamine: When Benzos Aren't Enough 59:17 The Role of Physical Restraints in Patient Management 01:08:43 Effective Handoff and Continuity of Care 01:18:11 Final Thoughts and Core Principles Resources
    • The Resus Tailor - https://www.theresustailor.com/
    • The Art of Managing Agitated Patients Supplemental Blog Post - https://emspodcast.com/the-art-of-managing-agitated-patients/
    Gear We Like
    • 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
    • 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
    Guest/Cast/Crew information- Guest- Patrick Hendley Host- Ross Orpet, Will Berry Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    Más Menos
    1 h y 19 m
  • Upper GI Bleed: Rescue Strategies From Recognition to Stabilization

    Upper GI Bleed: Rescue Strategies From Recognition to Stabilization
    Apr 30 2025
    Let's delve into the critical steps required to manage an upper GI bleed in the field. This episode breaks down the recognition of risk factors, vital airway and circulation interventions, and best practices for transporting and notifying the hospital. We discuss important historical clues and provide insights on airway handling and circulatory support. Learn how to navigate these time-sensitive emergencies with speed and thoroughness to improve patient outcomes. 00:30 Host Introduction and Episode Overview 01:22 Recognizing Upper GI Bleeds 01:45 Sponsor Message: The Resus Tailor 02:38 Four Clues to Identify GI Bleeds 06:17 Critical Questions for GI Bleed Patients 09:47 Airway Management Strategies 15:21 Circulatory Support and IV Access 19:26 Medication Considerations 22:28 Transport and Hospital Notification 23:41 Conclusion and Viewer Engagement

    Resources

    • Get 10% off FAST25 with promo code- loud&clear
    • The Resus Tailor - https://www.theresustailor.com/
    • 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- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    Más Menos
    25 m
  • These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS

    These Conversations Aren't Black and White: DNR, Advanced Directives, and the Intersection with EMS
    Apr 14 2025
    These challenging scenarios represent opportunities to provide truly patient-centered care at life's most vulnerable moments. By combining your medical expertise with thoughtful communication, you can help ensure patients' wishes are honored while supporting families through difficult transitions. In this episode we dive into the complex ethical and legal dilemmas faced by EMS providers when arriving on scenes involving Do Not Resuscitate (DNR) and goals of care forms. With special guest Dr. Daniel Markwalter, an emergency physician and hospice/palliative care expert, the discussion touches on understanding the importance of these forms, the challenges of making decisions without clear directives, and strategies for effective communication with family members when they suddenly disagree with the form. This episode provides valuable insights and practical advice for EMS professionals who can be faced with these sometimes challenging scenarios. 00:00 Introduction: The Ethical Dilemma in EMS 00:49 Sponsor Message: The Recess Tailor 01:53 Case Study: Evening Shift Dilemma 03:33 Expert Insights: Dr. Daniel Mark Walter 04:40 Understanding Hospice and DNR 09:48 Advanced Directives and Code Status 19:20 Challenges with Comfort Care and Advanced Directives 26:19 Aligning Medical Knowledge with Patient Goals 28:34 Understanding Goals of Care 29:03 Respecting Autonomy in Medical Decisions 30:02 Effective Communication with Families 31:45 Navigating Family Overrides in Critical Moments 32:36 Legal Aspects of Surrogate Decision Making 36:00 Exploring Illness Understanding and Prognosis 45:46 Symptom Management in Palliative Care 49:43 Final Thoughts and Summary Resources
    • Get 10% off FAST25 with promo code- loud&clear
    • The Resus Tailor
    • Todays Episode Show Notes
    • 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- Daniel Markwalter, MD Host- Ross Orpet, Will Berry Catch up with us after the show
    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    Más Menos
    56 m
  • BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There.

    BONUS: Wise Guys from FAST24- Allen Wolfe and Michael Frakes On Where We Were, Where We're Going, and How We Get There.
    Mar 28 2025
    Get 10% off FAST25 with promo code- loud&clear. In this special episode of Loud & Clear: EMS Guiding Principles, we learn from the wisdom of 2 industry leaders with nearly 70 years worth of combined experience, Allen Wolfe and Michael Frakes. This episode explores the evolution of EMS education, effective training strategies, and the importance of lifelong learning. Whether you're an educator, a learner, or just passionate about EMS, you'll find valuable insights on how to improve your skills and knowledge. Enjoy this bonus episode filled with expert advice, engaging discussions, and practical tips to level up your EMS game! 00:00 Episode Quotes 00:38 Welcome to Loud and Clear EMS 01:19 Upcoming Fast 25 Conference 02:10 Meet the Guests: Allen Wolfe and Michael Frakes 04:20 Allen's Background and Experience 05:41 Changes in Clinical Education 07:51 Future of Education: VR and Edutainment 09:09 Advice for Education Directors 11:34 Field Training Officer Tips 15:08 Choosing the Right Workplace for Critical Care Experience 16:31 Real-Life Trauma Cases and Lessons Learned 19:36 The Importance of Self-Education and Lifelong Learning 21:48 Michael Frakes Introduction- Insights from a Career in Critical Care Transport 22:44 Advancements and Challenges in Medical Education 27:59 Final Thoughts and Key Takeaways

    Resources

    • The Resus Tailor - https://www.theresustailor.com/
    • Get 10% off FAST25 with promo code- loud&clear
    • 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- Allen Wolfe, Michael Frakes Host- Ross Orpet, Will Berry Catch up with us after the show

    • Instagram- @emsloudandclear
    • YouTube- https://www.youtube.com/@EMSLoudandClear
    • Website- www.emspodcast.com
    Más Menos
    31 m
  • Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature

    Unlocking Practice Changing Insights: A Paramedics Guide to Reviewing the Medical Literature
    Mar 13 2025
    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
    Más Menos
    41 m
  • Why Your EMS Bag Could Be Failing You: Essential Design Tips You Need

    Why Your EMS Bag Could Be Failing You: Essential Design Tips You Need
    Feb 28 2025
    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 Tailor Host- 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 3.0 Music sponsored by Audio Library https://youtu.be/JoyIRE5k2Yo Daylight by Alex-Productions https://soundcloud.com/alexproductionsmusic
    Más Menos
    46 m
  • NEW NAME! The podcast gets a new name, find out what and why...

    NEW NAME! The podcast gets a new name, find out what and why...
    Feb 21 2025

    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.
    Más Menos
    4 m
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