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Practical EMS

Practical EMS

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My mission is to use the stories we all have in emergency medicine to encourage and uplift you where you are. EMT, Paramedic, nurse, PA, NP or physician. Emergency medicine is a very difficult specialty with unique challenges, and it calls us all to be better than the average person in order to stay healthy for our patients, our families and own mental wellness. I want to connect with EMS crews, fire crews, ER RN's, ER techs and new ER advanced practice providers to better understand their c ...
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Kevin Hazzard Author of A Thousand Naked Strangers and American Sirens (you can find these on Amazon or wherever books are sold). You can find Kevin Hazzard at KevinHazzard.com Paramedic from 2004-2013 for Grady hospital in Atlanta He talks about the self-doubt he had in the writing process and how he wasn’t sure anyone would relate to his stories …
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Don’t make your career your entire personality, extra shifts will affect you over time. Sometimes the extra money is not worth the burnout The culture is shifting from working a ton to a better work life balance Your family will remember that extra shift you worked far longer than your employer Get off on time Control the variables you can control …
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Batching work applies with nurses too. Do multiples things when you enter the room, so you don’t have to go in and out many times Ben talks about efficiency in the field being important due to the limited time and resources As providers we must get comfortable with saying “I don’t know” In medicine in general we don’t know everything, nor can we di…
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New panel! Lucas (ER physician), Kendra (Charge RN, NP student), Ben (paramedic and educator) Kendra talks about her advice for new charge RN’s Have some ER experience first. She says it was difficult starting as a charge when she was so new to ER. Have a good set foundation. You need to be able to have difficult conversations with people in a tact…
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Lorihodges.com (4) Lori Hodges, MA, CCP, PMP | LinkedIn Shaking In The Forest: Finding Light in the Darkness: Hodges, Lori R.: 9798888244005: Amazon.com: Books Debriefing helps to learn from a big crisis and then move on without continuing to judge yourself and your mistakes We all make mistakes, getting stuck in the mindset of constantly reviewing…
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Lorihodges.com (4) Lori Hodges, MA, CCP, PMP | LinkedIn Shaking In The Forest: Finding Light in the Darkness: Hodges, Lori R.: 9798888244005: Amazon.com: Books Lori Hodges, is the author of Shaking in the Forest, Finding Light in the Darkness. She is a former paramedic and firefighter in Colorado and currently works as an emergency manager, recentl…
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Kelly Grayson is a very experienced paramedic, educator, speaker and author that serves the EMS community. You can follow him here: (10) Kelly Grayson (@AmboDriver) / X (20+) Facebook You can find his books on Amazon Amazon.com: On Scene: More Stories of Life, Death and Everything In Between (A Paramedic's Stories of Life, Death and Everything In B…
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Kelly Grayson is a very experienced paramedic, educator, speaker and author that serves the EMS community. You can follow him here: (10) Kelly Grayson (@AmboDriver) / X (20+) Facebook You can find his books on Amazon Amazon.com: On Scene: More Stories of Life, Death and Everything In Between (A Paramedic's Stories of Life, Death and Everything In B…
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Nick talks about a difficult RSI intubation and his struggle to overcome the feeling that he didn’t do his best We talk about how intubation success was such a critical point as a paramedic that everyone would have judged you on in the past We talk about the direct laryngoscopy vs the new video techniques Advice for the newbies: Brent: You’re going…
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Nick talks about a difficult traffic accident and how something that seems like not a big deal but actually affected him – we can’t choose the things that affect us Is there something protective in the fire or law enforcement world that helps with longevity? Is it the wider variety of calls? EMDR (eye movement desensitization and reprocessing) is a…
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Why did Nick switch to law enforcement? He burned out on medicine What does he miss the most: The team mentality. The fire crews that he grew close to. He felt certain they could handle whatever call came their way We talk about the struggles working a 48-hour shift with a rural fire department but also having to manage the expectation from the pri…
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Mark (paramedic) | Brent (fire officer and EMT) | Nick (former paramedic and current police officer) Mark has worked in urban and very rural 911 ambulances and does part time EMT education now Community paramedicine is an emerging field and can vary a lot from region to region. Paramedics are flexible providers, so the potential is huge Brent has s…
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Nate talks about a motorcycle crash he stopped at on his way home and how he was critical in saving an injured patient and how he became close with the family who still talk to him today. Even though the patient ultimately died, the impact he made on that family was immense. Patients remember us We need to remember we treat a person not a complaint…
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The paradigm around rapid sequence intubation is evolving and becoming much safer with more education and procedures. Sometimes in emergency medicine slow is better. We need to stay mindful and calm in chaos and this requires us to detach and be above the fray and walk slowly instead of run. This will actually increase effectiveness and efficiency.…
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EMS varies significantly from state to state so you get a wide range in the abilities of EMT’s and paramedics nation wide Case reviews are moving to an educational rather than a punitive model There is no true national standard for EMT’s and paramedic’s which further complicates things The regions that EMS is practiced in vary a ton as well. Skills…
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Meet our new panel Kash (EM physician) Casey (Paramedic) Nate (EMT) Why emergency medicine? Kash: Likes to see results in the short term rather than manage long-term problems. Decided on EM and even an EMS fellowship before starting med school after getting his EMT Aaron: When in PA school you really need to be at least considering primary care but…
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Matt talks about our reliance on technology and how sometimes it is nice to remember that to assess a patient it is actually really simple without using technology Andrew: I am mostly paid to not get tricked into missing something big. Standards in medical education changing when there is emphasis on getting people through programs Keep holding hig…
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Imminent baby delivery stories Burnout tips: avoid the overtime. Sometimes the extra money is not worth the additional life stress. Make sure you get off on time and make that transition to home life. Andrew uses audio books so he has something to look forward to while driving to and from shift. Patients are often not even the source of our stress,…
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The team mentality at all levels in the ED is key to a harmonious, efficient and effective environment In EMS, this can be difficult on a given scene when you may not know the other responders all that well and it can be easy to get offended when no offense was meant Developing a thick skin is important in emergency medicine. You can’t allow negati…
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Meet our new panel Matt (EMT) Julie (RN) Sarah (paramedic) Schasny (paramedic) Andrew (EM physician) Advice for the newbies: Don’t panic, it is not your emergency Find the balance of detachment while still making sure the patient feels cared for and understood Part of avoiding burnout is taking some time to access the human side of youself in carin…
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Keep asking “why” do get to a full understanding of what is going on As providers we do want questions asked of us if someone is not sure about something we ordered Tracey has found techniques to avoid burnout despite 24 years in emergency medicine, she says it is very individualized how you overcome burnout Belligerent patients do cause burnout an…
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We talk about EKG interpretation Adam talks about the power of teaching Ongoing learning is key to performing well in emergency medicine and medicine in general We discuss confidence in emergency medicine and The Dunning-Kruger effect: People with limited competence tend towards an overestimation of their abilities It is very dangerous at the top o…
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Stress exposure in school is very helpful for real life practice A good analogy for lay people: EMT is like CNA, AEMT is LPN, paramedic is RN. This helps people understand the progression of levels of care better Paramedics need to be learning provider type assessments on rotation not nursing assessments Kim talks about the zero to hero debate: Exp…
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We meet our new panelists Kate (EMT) Kim (Paramedic and educator) Tracey (Former paramedic and current PA) Adam (Former paramedic and current EM physician) Kate talks about how the public doesn’t know the difference between EMT’s and paramedics Tracey talks about a humbling experience in her early career where she did not know where her equipment w…
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Be willing to speak up. Sometimes you might be the only person to notice something important. We need resiliency in this field. We are all still learning, so stand up and advocate for your patient. Regardless of your level of care, you need to advocate for your patient. The hierarchy is largely in your mind. Don't be afraid to approach someone with…
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Nate (EMT) shares his story and the issues he has been dealing with. Nate overdosed on medication and ended up in inpatient psych care which helped him immensely. He still feels grief from time to time but does have happiness more now. Nate wants people to know that these struggles are real and you are not alone. Don’t be afraid to talk about it. S…
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We meet our new panel: Eric (EM Physician) Shelby (EMT) Nate (EMT) and returning guest Sam (Prior EMT, ER RN) DeTessa (ER RN) Part of the fun part of the ER is getting to start from scratch and figure out the puzzle Stories do change as the patient talks with different providers We are not equipped to diagnosis or resolve chronic problems in the ED…
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Chris and I talk about my background and motivation for my podcast. I talk about a pediatric arrest I ran that had a huge impact on me. We tend to dehumanize patients in this job to keep our distance, but that is not always the best technique. Emergency standards are standards I have developed working in the ER. One of those standards is to walk sl…
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Chris and I talk about my background and motivation for my podcast. I talk about a pediatric arrest I ran that had a huge impact on me. We tend to dehumanize patients in this job to keep our distance, but that is not always the best technique. Emergency standards are standards I have developed working in the ER. One of those standards is to walk sl…
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Wrapping up our conversation with Brian and Kristina (PA’s and prior paramedics) and Casey (paramedic) Shadow PAs in different specialties so you really know what the career looks like practically. Use this to find out what specialties you like, school doesn’t always give you enough time and you may not get a job in your desired specialty every tim…
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We jump back into our conversation with Brian, Kristina and Casey Advice for newbies Reflect on the calls that you run. What went well and what went poorly? Are there providers that did a great job that are worth emulating? Find those mentors that are worth emulating. Also make note of those that are worth avoiding. Keep in mind there are multiple …
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We meet our new panelists Brian and Kristina (PA’s and former paramedic’s). Casey is back! Transitioning from paramedic to PA Professionalism is a big emphasis in PA school. This was something I learned as an EMT from a great paramedic partner early in my career as well. Professionalism in EMS is a cultural and personal aspect to strive for. PA sch…
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We discuss what things we want others to know about our careers. In EMS we can tend to jump immediately to being confrontational, even when the other person isn’t meaning to be confrontational. We all have different scopes and different levels of knowledge. Casey wants people to know that paramedic’s get extensive training in 12 lead interpretation…
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Meaningful patient interactions – Hold on to them. The mundane calls, the rude patients, the horrible things we see - those are the price we pay for the one call where you save someone or have a meaningful interaction. It is an honor to take care of patients that can’t get help in any other medical setting except the ER. Find one thing every shift …
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Our new panelists: Lucas- ER Physician, Micaela- Paramedic, Alex- Paramedic, Rebecca- ER RN, Casey- Paramedic We discuss struggles with caring for patients that have perpetrated violent crimes. Recognize your own bias and your personal history that may affect patient care. It’s important to have a good self-care plan because you can’t pour from an …
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Struggles in emergency medicine Casey struggles with keeping up with the changes, especially the technological changes. If you worry about keeping up, put yourself in a position to teach the new people. They will force you to learn as well. Micaela talks about her personal struggle with burnout and the significantly high acuity calls she has run Sh…
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We welcome our new panelists. Micaela (paramedic) Simone (former ER RN and now ER NP) Paramedic’s Alex and Casey returning. Simone gives us a glimpse into the tough transition from ER RN to ER NP. You need to love the medicine. Having to know so much of so many things was one of the toughest parts. You must be second best at every specialty. Alex t…
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Emergent Standards I address a comment about how we mentally handle the patients we care for that have committed violent crimes. We still care for them to the best of our ability; in fact we often learn the whole story after we have finished caring for them. We don’t judge because that is not our role. We find ways to move on from the horrible situ…
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Confidence in EMS: Nate talks about how he was reaffirmed when learning ALS meds and a physician agreed with his treatment plan. School does not make you confident. As a provider, give the crews feedback because it helps them grow and confirm their plans and treatments were accurate. Don’t just give negative feedback. Some students do need an extra…
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Random stories episode! We often don’t want to talk about the “craziest” call we’ve ever seen. I tell a story about a fireplace fueled by batteries and no real medical reason for the call. We talk about things that surprised you about emergency medicine Dealing with drunk people is a challenge. Other great random stories: Thoric dissection’s, tripl…
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Jumping back into our discussion on alcohol abuse in EMS. Everyone is susceptible to overuse of alcohol so abstaining can be powerful even without it being your vice. Interpersonal communication skills are key to developing in EMS. We need to connect with our patients. Patients care more about being understood and listened to than good medicine. Ad…
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New panel! We welcome Alex, paramedic and Kate, EMT. Welcoming back Sarah, paramedic and Nate, EMT. What makes a great paramedic? Treat your EMT’s like a partner. Talk about calls. Teach your EMT’s. Educate without belittling. Create an environment where your partners can question the plan if they don’t understand it. Learn from those that have bee…
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You guys ever see a dead family member in a patient? Like they look similar, act similarly? No? Maybe it’s just me. Nate talks about his life experiences and how it helps him talk with patients that are struggling with mental health. He talks about a patient experience where he really connected with a patient and how the patient was seen years late…
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Leadership in emergency medicine Good nurse to patient ratios is very important to good patient care and allowing those little moments where you can spend some extra time making sure the patient feels cared for. Management doesn’t always equal good leadership. Part of being a good leader is being the calming presence in a chaotic scene or situation…
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Is burnout moral injury? Is it out of your control? ZDoggMD talks about burnout being moral injury. Link here: (30) It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout" - YouTube We jump back into our discussion on the video. Casey says one of the great things about this job is that we have the privilege to be with people …
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Jumping back into Principles in Emergency Medicine Nate- People lie. Despite the fact that we are not judging them, and just need to know accurate details to provide the best possible care. Casey- Expect the unexpected. EMS is long periods of boredom punctuated by moments of sheer terror. Adam- the job is always out to get you. We see the 1%, it is…
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We meet our new panel and some returning guests! Kiley – ER RN and new NP Sarah – Paramedic in EMS for 8 years Welcome back Adam ( ER MD), Casey (paramedic) and Nate (EMT). Nate talks about the transition from field EMT to ER EMT. It’s a new world with new things to learn. Sometimes a change in environment can get you out of a rut. Sarah also worke…
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We revisit the question “Where is God is emergency medicine? Doug- I’m a believer in science and a believer in God. There are some occurrences that we can’t explain with modern medicine. He tells the story of a cardiac arrest that woke back up an hour after pronouncement. Sarah- God has given us the science to learn and be able to use. We often see…
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Crazy stories episode Delivering babies! Not something most of us look forward to but it happens, nonetheless. Casey talks about a breech presentation birth that, thankfully, turned out just fine despite delivering at 28 weeks in an ambulance as well as a prolapsed cord case. Stabbing victims! In a sex shop, in their homes, we run them everywhere. …
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Pronouncing in the field is a difficult part of EMS. In a lot of ways, the ED insulates us from some of the aspects of this that make it challenging when you are in the patients actual home. The ED is mentally taxing in other ways. High volume, high acuity, multitasking, consulting etc. Nate talks about how “you’re just an EMT” gets thrown around a…
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