Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Paramedic training is over, you’re in the front seat now. Whether day 1 or day 1,000 you can’t shake the fear you’re underprepared. You were taught to systematically decide if A... do B. But what if “A” wasn’t in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things don’t make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- “at the end of the day, what actually matters to the patient I have in front of me?” Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters. Loud & Clear: EMS Guiding Principles is an EMS Cast LLC production
Episodes
What happens when a 24-year-old woman is found frozen in a tree well after last being seen 8 hours prior, with a core temperature of 62°F (17°C)? In this extraordinary case, paramedic Miles Randell and his team performed 4 hours of CPR in knee-deep snow on April Fool's Day 2014—and she walked away with zero neurological deficits.
This wasn't luck. Miles breaks down the critical decision to defy transport protocols and how they mana...
What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality.
Critical care transport legend Allen Wolfe joins us to dissect a real case, a conscious patient with a self-inflicted shotgun wound—no mandible, no nose, no midface—just open tissue and blood spraying everywhere.
This conversa...
Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever).
Recorded on-site at Fast25, James Boomhower, founder of StayFit4Duty, breaks down why the EMS culture of "pushing through" is fundamentally flawed. Using the metaphor of muscle training, he explains that continuing to stress a system...
Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vulnerable stories about impostor syndrome, burnout, and finding your way as a new paramedic.
Sophie's path to EMS started in the most unexpected way—from a 39-day hospitalization that included being intubated over th...
Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment
"Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.
Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challenge how EMS providers think about opi...
What do you do when the blood pressure monitor shows a number you don’t like? Most providers hit the button again—but what if it’s real? In this episode, we’re joined by critical care transport specialist James Boomhower from Boston MedFlight, recorded live at the FASTCAN conference in Calgary, to break down modern vasopressor management.
We explore how norepinephrine replaced dopamine as the first-line vasopressor, the evidence ...
Why do some paramedics stay unshakable under pressure while others crumble on the exact same call? The answer isn't about years of experience—it's about understanding the neuroscience of stress and having the right mental tools.
Cody Winterford delivers an incredible breakdown of the five psychological "circles of hell" that providers face in high-stress situations. Starting with the amygdala hijack that triggers your fight-or-fl...
What if the evidence hierarchy you learned in school is incomplete? Dr. Eddie Lang, who helped develop the GRADE system now used by WHO and major resuscitation councils, explains why clinical practice guidelines—not RCTs or meta-analyses—should guide your practice decisions.
Join us at FASTCAN 25 as Dr. Lang, who's helped shap guidelines for the World Health Oganization (WHO) and the International Liaison Committee on Resuscitati...
Understanding the toxidromes provides you with vital diagnostic tools in high-stakes environments. In this episode, we break down the clinical patterns that define toxidromes- the clusters of signs and symptoms that point to poisoning or overdose. We explore the hallmark features of the most common toxidromes, highlight common pitfalls in recognition, and explain how early pattern recognition changes patient outcomes. But not all s...
Melody Bishop helps us simplify the physiology of bag-valve-mask (BVM) techniques. This episode highlights common mistakes like insufficient exhalation time, discusses driving pressure, and explains the importance of proper technique to avoid lung injury. We also explore the nuances of endotracheal tube size, laminar flow, and the transition from BVM to mechanical ventilation. From FASTCAN in Calgary this episode will enhance your ...
Dr. Jeff Jarvis, EMS medical director and host of the EMS Lighthouse Project, delves into the latest emerging EMS literature and guidelines from the National Association of EMS Physicians. We explore best practices for blood use in trauma, up-to-date trauma arrest recommendations, postpartum hemorrhage, and severe hypertension in pregnancy. Additionally, we discuss recent studies on field intubation times, pre-hospital treatment of...
What's the real difference between paramedics who stay calm under pressure and those who panic when everything goes wrong? It's the ability to already know what comes next. In this episode we explore the power of consistency and how one simple tool, often dismissed, can improve patient care and outcomes. Geoff Murphy, founder of Master Medics, sat down with us onsite at FAST25 to discuss how checklists can not only save lives but a...
Were have we been? Well, the truth is, we've been incredibly busy working on some really exciting projects.
If you're interested in joining the founding members cohort of the Paramedic Confidence Builder Course reach out to me at ross@emspodcast.com before August 15th.
Project #1: Understanding New Paramedic ChallengesWe launched a research project diving deep into understanding exactly what newer paramedics struggle with as they...
Renowned airway enthusiast, Dr. Rich Levitan, on mastering airway management. Explore his approach to simplifying complex tasks into achievable and believable steps. Every complexity incurs a debt to crisis performance, instead, learn how we can decrease stress and engineer success in crisis performance.
Resources
- YouTube link- https://www.youtube.com/watch?v=UWMJS-pKYKw
- The Resus Tailor - https://www.theresustailor.com/
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 h...
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