In this episode, the team tackles some of the most enduring myths in emergency medical services and asks a simple question: are we still doing things because they work, or because it’s how they’ve always been done?
Topics include analgesia and pain management, soft tissue injuries and the RICE principle, oxygen use in COPD patients, ketamine and haemodynamic effects, tourniquet use, and other long-held assumptions in pre-hospital care.
Through evidence, physiology and reflective practice, the conversation highlights how clinical practice continues to evolve and why staying curious and adapting to new evidence is essential for delivering high-quality patient care.
A thought-provoking listen for clinicians at any stage of their career.
References:
- April, M. D., Arana, A., Schauer, S. G., Davis, W. T., Oliver, J. J., Fantegrossi, A., ... & NEAR Investigators. (2020). Ketamine versus etomidate and peri‐intubation hypotension: a national emergency airway registry study. Academic Emergency Medicine, 27(11), 1106-1115.
- Kamran, H., Salciccioli, L., Kumar, P., Pushilin, S., Namana, V., Trotman, S., & Lazar, J. (2010). The relation between blood pressure changes induced by passive leg raising and arterial stiffness. Journal of the American Society of Hypertension, 4(6), 284-289.
- ICED! The illusionary treatment option. Gary Rein
- Dubois, B., & Esculier, J. F. (2020). Soft-tissue injuries simply need PEACE and LOVE. British journal of sports medicine, 54(2), 72-73.
- Walsh B, Cone DC, Meyer EM, Larkin GL. Paramedic attitudes regarding prehospital analgesia. Prehosp Emerg Care. 2013 Jan-Mar;17(1):78-87. doi: 10.3109/10903127.2012.717167. Epub 2012 Sep 12. PMID: 22971168.
- Oxygen and Carbon Dioxide Retention in COPD • LITFL • CCC Respiratory
- Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. doi: 10.1186/cc11475. PMID: 23106947; PMCID: PMC3682248.
- https://doi.org/10.1016/j.ajem.2023.08.040
- Morgan MM, Perina DG, Acquisto NM, Fallat ME, Gallagher JM, Brown KM, Ho J, Burnett A, Lairet J, Rowe D, Gestring ML. Ketamine Use in Prehospital and Hospital Treatment of the Acute Trauma Patient: A Joint Position Statement. Prehosp Emerg Care. 2021 Jul-Aug;25(4):588-592. doi: 10.1080/10903127.2020.1801920. Epub 2020 Aug 27. PMID: 32776812.
- Xacur-Trabulce A, Casas-Fuentes G, Ruiz-Vasconcelos V, Reitz MM, Henry SM, Scalea TM, Ribeiro MAF Jr. Tourniquet-related complications in extremity injuries: a scoping review of the literature. World J Emerg Surg. 2025 Jun 25;20(1):57. doi: 10.1186/s13017-025-00625-3. PMID: 40556023; PMCID: PMC12188649.
- Pascoe B, Weinrauch P. Timeline effects of tourniquets used in trauma care. JHTAM. 2024;6(2):26-32
