In this episode of FOAMfrat, Tyler speaks with paramedic Kyle Rice to discuss a deeply personal and eye-opening experience—rolling his ambulance after running a red light. Kyle shares the lessons he learned about complacency, crew resource management, and the often-overlooked dangers of driving with lights and sirens. Together, they explore how EMS providers can stay vigilant behind the wheel, adopt safer driving practices, and shift their mindset when responding to emergencies. If you're an...

In this episode, I sit down with Dr. Jeffrey Jarvis, author of a fascinating paper on the impact of lights and siren (L&S) use in EMS responses. If you’re like most of us, when you hear those blaring sirens and see flashing lights, you think, “Wow, someone’s really in trouble!” But the truth, according to Dr. Jarvis’ study, might surprise you.

In this podcast, we discuss the nuances and strategy of the T1 ventilator with RRT, Joe Hylton. Whether you're a paramedic or a healthcare professional involved in critical care transport, understanding the nuances of this advanced ventilator is essential to safe and effective patient transport. We break down the pressure-controlled ventilation with volume adaptive options and offer practical guidance on managing obstructive lung conditions like asthma during transport. Plus, we cover...

Thoracic dissections are surgical emergencies that require precise temporizing measures until surgery can be performed. In this session, participants will gain critical knowledge on recognizing key symptoms such as ripping back pain and unequal pulses, indicative of thoracic dissections. The discussion will focus on anti-impulse therapy, emphasizing using beta-blockers like esmolol and calcium channel blockers like nicardipine to control blood pressure and prevent further damage. Pain...

In this conversation, Tyler and Dr. Cynthia Griffin discuss the finger thoracostomy procedure. They cover topics such as when to choose finger thoracostomy over needle decompression, the equipment needed for the procedure, the technique for performing the procedure, and potential complications and tips for success. They also touch on the use of chest tubes and the management of tension physiology. Overall, the conversation provides a comprehensive overview of the finger thoracostomy...

Alaina Martini, a flight nurse at Allegheny Life Flight, shares her expertise on transporting patients with external ventricular drains (EVDs). She explains the indications for EVD insertion, such as aneurysmal subarachnoid hemorrhage and obstructive hydrocephalus. Alaina discusses the importance of assessing the color and texture of the cerebrospinal fluid (CSF) to detect changes and potential rebleeding. She also explains the process of inserting the EVD and how it is guided by CT scans to...

Dr. John Aho discusses needle decompression and the procedure's indications, techniques, and potential pitfalls. He emphasizes the importance of high clinical suspicion and the limitations of external signs in diagnosing tension pneumothorax. The conversation also covers the choice of needle insertion sites, the use of ultrasound, and the need for proper training and practice. Dr. Aho provides insights into the anatomical considerations and common mistakes made during needle decompression....

An iceberg typically shows only 10% of its mass above water. To appreciate the other 90%, you need to dive deep. That’s precisely what we’re doing in this series—discovering the deeper knowledge about obstetric topics. These topics can be massive, and much of the information is below the ‘surface-level’ knowledge that EMS is presented with.  In this episode, Demi Wilkes & I will discuss Placenta Previa and the closely associated Placenta Accrete Spectrum.

The conversation is about a paper on false electrical capture and pre-hospital transcutaneous pacing by paramedics. The guests, Tom Boutilet, Josh Kimbrell, and Judah Kreinbrook, discuss their research findings and the implications for paramedics. They conducted a retrospective study and found that paramedics often mistakenly believe they have electrical capture when they do not. They emphasize the importance of confirming electrical capture before assuming mechanical capture. They also...

In this episode we discuss whether the concept of having a "max dose" of your pressor has any evidence or physiological backing. Joining me in this discussion are Dan Rauh, Shane O'Donnell, and Shad Ruby.  

How do you talk to a patient experiencing suicidal ideation? What if you're the one having these thoughts? We're interviewing James Boomhower from Stay Fit 4 Duty in this episode. We discuss suicidal ideation, therapeutic communication, and verbal de-escalation.

Chris Carlstrom is a flight nurse at Life Link III and also works part-time at a ketamine infusion clinic.  We’ve had some interesting conversations on shift regarding his experiences with ketamine in the clinic versus emergency medicine and I finally was able to get one of these conversations recorded for the podcast. Enjoy Podcast 163 - What Can We Learn From A  Ketamine Infusion Clinic? w/ Chris Carlstrom.

When I became a paramedic, being able to provide pain management was one of the "new interventions" that I looked forward to most. As an EMT, I remember countless times I was without ALS resources and had to watch a patient suffering in pain until we got to the hospital. Trying to obtain any history or perform an assessment on someone writhing in pain can be nearly impossible. As a BLS provider, I would attempt non-pharmacological ways to relieve pain, such as ice packs, warm packs, elevating...

Taking on pharmacology in EMT school is a big hurdle. We wanted to write something that not only explained the basics of the medications but also helped bridge the gap between what EMTs are taught and what paramedics learn when they go back over these medications in paramedic pharmacology. Each chapter discusses how the medications work, why they're given for specific indications, and the logistics of medication administration! We've also included medication profiles, tips and tricks from...

I had the privilege to bring on two passionate fathers of children with Autism to help me better understand how to approach and communicate with a neuro-diverse child. This episode is chock-full of insight, tips, tricks, and logistics of approaching a child in the field with Autism. Josh Chan is a Life Link III flight paramedic/base lead and a Glenwood FD firefighter. Matthew Yelton is a flight paramedic/base lead for Mercy Flight Central and works as a fire captain at Constableville...

EMS providers encounter various infectious diseases daily and need to know the routes of exposure, risks, and preventive measures to protect themselves and their families. In this episode, We talk with Dr. Hudson Garrett, an infectious disease expert with the medical college of Louisville University, to discuss the practical points of infectious disease for the everyday provider. Want CE for this episode? Sign up for FOAMfrat Studio and access 300+ hours of continuing education for EMS &...

In this episode, Dan Rauh & Mike Boone from Heavy Lies The Helmet join me to hash out our workflows and drugs of choice for four particular scenarios you may come across.   The combative head injury patient that needs to be intubated but has five firefighters holding them down and is actively trying to rip off his collar and IV.   The septic hypotensive patient is no longer protecting their airway but also needs resuscitation prior to induction.   The snoring head...

Moments after the heart stops the entire circulatory system finally has a chance to bring venous and arterial pressures to equilibrium. Cardiac arrest resuscitation requires the provider to have a strong mental model of physiology and the logistics to carry out a series of interventions crucial to preserving life. This class will serve not as a routine basic life support model, but as a deeper understanding and framework to guide resuscitation during your next cardiac arrest.

AI will be integrated into everything we do in medicine, perhaps sooner than we think. It will help keep our patients safe, our providers informed, and our communications connected, and change how we think about how we care for patients (if implemented correctly).  Systems like ChatGPT are only the beginning, and many companies are already working on or have already integrated with other healthcare specialties. We will see the same integration happen with EMS. While the response to this...

In this episode, Tyler is joined by Shaylah Montgomery to discuss decision-making, human factors, and mental shortcuts utilizing pattern detection. Shaylah is a flight nurse and paramedic for Pafford Air One and a member of the FOAMfrat team.

0.9. When a patient is in shock, their volume of distribution changes, and peripheral blood flow is reduced. This means more blood is shunted to the brain,, and lower doses of sedation will give the agent therapeutic brain levels.","type":"unstyled","depth":0,"inlineStyleRanges":[],"entityRanges":[],"data":{}}],"entityMap":{},"VERSION":"9.3.6"}"> What aspects of temperature-targeted management are most important to EMS, and how should EMS guide sedation for the patient with a return of...

We just finished re-recording our pediatric arrest class in Studio and decided to play the unedited version of my discussion with Dr. Paul Banerjee. Banerjee is a prolific researcher and medical director in Florida with a particular emphasis on pediatric arrest. Check out the class in Studio for more information on the logistics.

Sam Henne is the creator of Mind Over Medic and a co-worker of mine at Life Link III. In this episode, we discuss the components of critical incident stress and ways to reduce adrenaline during threat appraisal. Check out www.mindovermedic.com   

EMS is well-trained in peripheral intravenous as well as intraosseous access. However, central lines remain off-limits for many clinicians in various response areas. If accessing these types of lines is allowed, it’s usually permitted when the patient is (nearly) dead. This isn’t very surprising since the scope of practice of the EMS clinician usually focuses on emergent treatments. Unless it’s learned during a critical care class, little thought is typically given to topics like central,...