MCHD Paramedic Podcast

MCHD Paramedic Podcast

The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Director Dr. Casey Patrick invites you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.

Episodes

Episode 184 - Recording Video Laryngoscopy In EMS

August 11, 2025 • 30 mins
On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD. What device did you use? How did you train? What lessons have you learned? All these and more will be addressed and answered. REFERENCES: 1. Zhao, Y., Zang, B., & Wang, Q. (2024). The Effectiveness of Bougie Use on First-Attempt Success in Tracheal Intubations. Annals of emergency medicine, 84(3), 331–33...
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Episode 183 - Pain Control In EMS - The MCHD Analgesia Ladder

July 14, 2025 • 19 mins
The podcast crew takes on the topic of prehospital analgesia. What pain medication do we choose when facing a complex patient with all analgesics available? Are there better options for hypotensive patients? What about pregnancy and the elderly? On this episode, we'll walk through our MCHD pain medication options, take a moment for a BLS reminder, and discuss some specific situations where certain medications are the best fit. ...
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Episode 182 - Traumatic Arrest With The Prehospitalist

June 16, 2025 • 40 mins
Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patients are exceptions to the rules? Lindsey had a tough case, asked some hard questions, and will provide solid answers—our favorite recipe for a jam-packed educational session. REFERENCES 1. Witt, C...
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Episode 181 - Why You Should Attend The Resuscitation Academy

May 19, 2025 • 37 mins
We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons have we implemented here at MCHD? Learn how to improve your cardiac arrest survival rates without breaking the bank. REFERENCES 1. https://www.resuscitationacademy.org
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Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?

April 21, 2025 • 20 mins
Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinical decision-making? Has anyone ever evaluated their use in EMS? Could standing a patient to check their heart rate actually be harmful? Join the podcast crew as they address these questions and mor...
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Episode 179 - Transcutaneous Pacing Pearls and Pitfalls

March 18, 2025 • 38 mins
On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsribing EMS pacing capture. Like many of our favorite topics this came from a paramedic asking a clinical question with loads of dogma and little evidence. What they found should motivate us all to ...
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Episode 178 - A STEMI Unlike Any Other

February 17, 2025 • 21 mins
We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/chest pain presentation with lessons that we can all apply to our daily care. REFERENCES 1. https://www.mchd-tx.org/media/podcasts/SITUS-Fig-1.pdf 2. https://www.mchd-tx.org/media/podcasts/SITUS-Fig...
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Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration

January 21, 2025 • 80 mins
This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was gracious enough to share the audio for a dual release. This episode has been out in the world on Medic Mindset for a couple of months, but we wanted to offer it to our MCHD Paramedic Podcast listeners a...
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Episode 176 - Antibiotics & Open Fractures

December 27, 2024 • 20 mins
MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES: Lack, W. D., Karunakar, M. A., Angerame, M. R., Seymour, R. B., Sims, S., Kellam, J. F., & Bosse, M. J. (2015). Type III open tibia fractures: immediate antibiotic prophylaxis minimizes infect...
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Episode 174 - Push Dose Norepinephrine

November 1, 2024 • 25 mins
We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild. REFERENCES: 1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Norepinephrine a Better Choice? The wes...
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Episode 175 - The Rear View Mirror - Tunnel Vision

October 28, 2024 • 31 mins
Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the positives that can come if we get past our egos and allow ourselves to have insight for future cases.
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Episode 173 - Med Minute - Magnesium

September 26, 2024 • 15 mins
We're working on a new series focusing on high-yield pharmacology reviews. Dr. Patrick starts us off with some background, mechanism of action discussion and common uses for magnesium sulfate. Mag is one of the true pharmacologic swiss army knives of emergency care. REFERENCES 1. Touyz RM, de Baaij JHF, Hoenderop JGJ. Magnesium Disorders. N Engl J Med. 2024 Jun 6;390(21):1998-2009. doi: 10.1056/NEJMra1510603.
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Episode 172 - The MCHD EKG Manifesto - Part 3

September 26, 2024 • 27 mins
Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge. REFERENCES 1. https://www.emdocs.net/ecg-pointers-stemi-equivalents-from-the-american-college-of-cardiology/
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Episode 171 - Surgical Airway Lessons With Dr. Al Lulla

September 16, 2024 • 32 mins
One of the most fear-inducing procedures in all of emergency care is the surgical cricothyrotomy. Dr. Al Lulla from Dallas Fire joins the podcast to discuss our recent collaboration on a retrospective look at MCHD's surgical airway experience over the past decade. Can paramedics successfully perform cricothyrotomies? Who needs surgical airway placement in the field? What can we learn for our next "can't oxygenate/can't ventilate" s...
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Episode 170 - The MCHD EKG Manifesto - Part 2

July 13, 2024 • 39 mins
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is vital as well. Join the podcast crew as they start at the end with the killer/"can't miss" EKG patterns and combine those with common chi...
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Episode 169 - Agitation Awareness - Fixed-Dose Ketamine

June 17, 2024 • 24 mins
We've initiated a multi-pronged, system wide overhaul of our agitation management at MCHD. This included a move to fixed-dose ketamine for the severely agitated patients. Evidently we weren't the only ones thinking of this as there is exciting new data from Buffalo supporting this approach. Join the podcast crew as they review the recent literature and MCHD protocol changes. REFERENCES 1. O'Brien MC, Kelleran KJ, Burnett SJ, Hausr...
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Episode 168 - The VTach FACTs

May 20, 2024 • 35 mins
We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge. Learn the V-Tach FACT, and you'll feel more comfortable with your next wide rhythm at a rate of 185. REFERENCES 1. https://litfl.com/vt-versus-svt-ecg-library/ 2. https://www.youtube.com/watch?v=UXh8PS9dtmo 3. Marill KA, Wolfram S, Desouza IS, Nishijima DK, Kay...
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Episode 167 - Ketamine Only Intubations With Dr. Andrew Partain

April 22, 2024 • 27 mins
The podcast crew is joined by a special guest, Dr. Andrew Partain, an EMS Fellow from UTSW in Dallas. We will dissect his recent data surrounding ketamine-only intubation from MedStar in Fort Worth. This is not just another boring data rehash. There are some vital and applicable pearls that must be applied to the world of prehospital airway management. REFERENCES: 1. Driver BE, Prekker ME, Reardon RF, Sandefur BJ, April MD, Wal...
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Episode 166 - The MCHD EKG Manifesto - Part 1

March 25, 2024 • 35 mins
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration of how to combine the 12-lead and patient presentation is vital as well. Join the podcast crew as they start at the end with the killer/"can't miss" EKG patterns and combine those with common chi...
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Episode 165 - Intracerebral Hemorrhage

February 26, 2024 • 32 mins
We've spent countless hours (rightfully so) discussing ischemic stroke management over the past several years. Sometimes, the other 20% of strokes, the hemorrhagic version, can get neglected. No, we don't have stroke-mobiles at MCHD to diagnose an ICH in the field, but there are some patient care keys to emphasize for EMS when we suspect non-traumatic, acute intracranial bleeding. REFERENCES 1. Qureshi AI, Palesch YY, Barsan WG, H...
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