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Showing episodes and shows of
& Dr. Amanda Humphries
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Heavy Lies the Helmet
Opinion-Based Medicine w/Mike Carunchio
Though evidence dictates much of what we do as emergency medical providers, some areas remain open to debate: How are we justifying stroke ambulances, CCT speciality teams, AHA guidelines, and our choice of crystalloids? How are we justifying what professionals are allowed to post on social media? And do we agree with the currently accepted norms? Who better to join us in this discussion than Mike Carunchio of The World's Okayest Medic Podcast. Diving into these and other controversial topics, we see if our two platforms can come to a consensus in a...
2025-06-13
1h 10
Heavy Lies the Helmet
Little Lung Problems w/Nate Brown
Wet or dry. Air in or out. Reactive or obstructive. The possibilities may seem endless when treating the pediatric patient with undifferentiated respiratory distress. It is confounded by the fact that pediatrics are outside the comfort zone of many novice critical care transport providers. In this podcast episode, neonatal/pediatric specialist Nate Brown eases your worries with concise and effective means of diagnostics and intervention. Primarily, we cover croup, bronchiolitis, and asthma disease processes. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2025-05-20
1h 07
Heavy Lies the Helmet
Keeping Trauma Close to the Chest
'Tis the season for trauma. (If there truly is a season.) Chest trauma, specifically, can vary in subtlety and severity, primarily due to the presence of multiple vital organs and vessels. In this podcast, we discuss these potentials while focusing on those injuries that are associated with the highest mortality rate. We also discuss why you should think twice before intervening. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Dis...
2025-04-09
55 min
Heavy Lies the Helmet
P.R.E.S. Sure
Does your patient have high blood pressure? Are they seizing or showing other signs of a neurological disorder? It could be PRES! Unfortunately, Posterior Reversible Encephalopathy Syndrome (PRES) is difficult to diagnose unless you are aware of its existence. In this podcast episode, we discuss this infrequent condition and how can you appropriately diagnose and treat it. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or...
2025-02-24
43 min
Heavy Lies the Helmet
Certification Versus Qualification
Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How much value should we on that piece of paper? And, regardless, how do we work towards obtaining and maintaining qualifications? In this podcast episode, we discuss it all including Dunning-Kruger Effect and Hierachy of Competence. We also delve into teaching strategies that can help newcomers gain their confidence after achieving whatever got them there in the first place. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet
2025-01-23
50 min
Heavy Lies the Helmet
Breaking the Case: The Point of Ultrasound
Previously, we recorded a podcast episode about the utility surrounding Point of Care Ultrasound (POCUS). In this episode, we apply that knowledge to specific case scenarios as a continuation of our "Breaking the Case" series. We also ask the question, is POCUS really all it's cracked up to be, or should we be re-thinking our approach, particularly in the prehospital setting? Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Dis...
2024-12-24
45 min
Heavy Lies the Helmet
Canine Care w/George Tarver III
Humans are easy. That's why we are able to do what we do as prehospital providers. But what happens when your patient is a canine? These working dogs are highly regarded by their handlers and require care just like anyone else that may be ill or injured. Considering that, are you equipped to care for them? If not, how can you successfully start and maintain a K9 program at your agency? Tune in to another podcast to discuss this unique topic, but this time, we are joined by HLTH team member Rick Maricle and his colleague George...
2024-11-18
56 min
Heavy Lies the Helmet
To Treat or Not to Treat: Hypertension
It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than focusing on the patient in front of them. Asymptomatic hypertension, in particular, is often benign. In fact, treating asymptomatic hypertension in a patient who a primary medical history of hypertension can harm them. In this podcast, we discuss these adverse effects related to blood pressure physiology, acute versus chronic hypertension, and how you can determine whether anti-hypertensives or other forms of therapy are indicated. Get CE hours for our podcast episodes HERE!
2024-10-21
1h 00
Heavy Lies the Helmet
Stay Positive When Preoxygenating (PREOXI Trial)
The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal cannula in conjunction with either a non-rebreather mask or bag-valve mask (BVM) to prevent hypoxemia during the apneic phase of Rapid Sequence Intubation (RSI). In the PREOXI Trial, the authors pushed this concept further, questioning whether non-invasive positive pressure ventilation (NIPPV) might be more effective than these formally mentioned adjuncts. In this podcast, we dive into the strengths and weaknesses of the trial and explore whether its findings are truly practice-changing. We might even disagree...
2024-09-30
1h 01
Heavy Lies the Helmet
Outside the Box: Cardiac Arrest Management
Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailored interventions beyond "blanket" protocol and ACLS/PALS algorithms. When refractory to conventional therapy, the pulseless V-Tach/V-Fib patient, in particular, requires critical thinking "outside the box" in order to gain ROSC (Return of Spontaneous Circulation) and preserve neurological outcomes. What are some of the measures we can consider when presented with these refractory patients? We answer that question in this podcast episode. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @h...
2024-08-22
46 min
Heavy Lies the Helmet
Sorry, We Are Closed: Interfacility Transfers w/Austin Wingate
Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformation or a lack of advocacy by the transport agency, these transfers can result in unnecessary risk for crew members and patients. Specifically, weather conditions, time of day, crew fatigue, and other important factors are not always considered when blindly accepting these transfers. As the transport specialists, how can we ensure that we are accepting and performing these transports safely? In this episode, Austin Wingate provides a holistic method that you, too, can integrate into your...
2024-06-29
1h 04
Heavy Lies the Helmet
Losses and Gains: Antidiuretic Hormone
Antidiuretic hormone (ADH) plays an essential part in the body's osmotic/fluid balance, sodium homeostasis, and blood pressure regulation. This hormone is synthesized in the hypothalamus and released from the posterior pituitary gland. In conditions such as Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH), there is a lack of synthesis or over-production of this hormone which results in negative downstream effects. At the request of a podcast listener, we have decided to cover these conditions in this episode. Tune in as we discuss DI (central and nephrogenic), SIADH, and hypo/hypernatremia. Get CE...
2024-05-06
43 min
Heavy Lies the Helmet
Trigger Warning: Angioedema
Angioedema is defined by upper airway swelling secondary to an immune response. The trigger and subsequent physiological response are how we categorize it. In this podcast, we discuss how to diagnose and treat both types: IgE/Histamine-mediated and Bradykinin-mediated. We also touch on how to address the difficult airway that may or may not lead to intubation. All in all, do not fear angioedema but respect it. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Em...
2024-03-25
46 min
Heavy Lies the Helmet
Dye or Die: Methylene Blue w/Will Heuser
When discussing methylene blue, management and treatment of methaemoglobinaemia is usually the first indication mentioned. But in this podcast, we challenge you to increase the size of your lense and focus on its benefits in other states (e.g., septic shock). Of course, we could not do this alone, so we invited a Flight Paramedic, Pharmacist, Toxicologist, and Professor to join us. And fortunately for us, they are all the same person. Tune in as Will Heuser helps us discuss the pathophysiology of distributive shock, the pharmacodynamics and pharmacokinetics of methylene blue related to its effects on...
2024-02-28
50 min
Heavy Lies the Helmet
Around the World: HEMS in México w/Daniel Peñaflor
Though we have delved into foreign HEMS systems in the past (See Episode 61 – Down Under Dynamics w/Dr. Cliff Reid), we have not dedicated an entire series to it. Having now rubbed shoulders with many clinicians and operators around the world, it is evident that these conversations need to take place on a regular basis. Why? Because operating in a vacuum can lead to bad decision making. Our new "Around the World" series attempts to mitigate this by interviewing prehospital and intrahospital disciplines from around the world and finding out how they do things, whether for better or for wo...
2024-01-27
58 min
Heavy Lies the Helmet
Me, My Self-Loading Baggage, and I w/Miles Dunagan and Brett Reeder
"Self-loading baggage" is a derogatory term often used by pilots to describe lazy or disengaged medical crew members in the air medical industry. Whether intentional or not, this behavior sets a bad precedent for those of us that want to embrace aviation cross-training and be able to assist the pilot effectively. In this podcast episode, we are joined by pilots Miles Dunagan and Brett Reeder to discuss how pilots and clinicians alike can be a cohesive team before, during, and after the flight. We touch on complacency, Crew Resource Management (CRM), and specific skills required of an...
2023-12-20
1h 06
Heavy Lies the Helmet
You Train Ukraine w/Kevin Collopy and Brock Jenkins
The Russo-Ukrainian War is an ongoing international conflict between Russia and Ukraine. At times such as these, medical training is essential and sometimes required of laypersons. International Medical Corps partnered with the Harvard Humanitarian Initiative (HHI) to provide comprehensive emergency and trauma care training to healthcare workers, public safety professionals, and the Ukrainian community. Course Coordinator Kevin Collopy and Instructor Brock Jenkins, live from AMTC23, join us for an eye-opening podcast episode where we discuss their role in this mission and the personal experiences motivating them to continue their efforts. Get CE hours for our podcast episodes H...
2023-11-30
37 min
Heavy Lies the Helmet
Being B.R.A.S.H. When Treating Bradycardia w/Dr. Kate Connelly and Jake Miller
B.R.A.S.H. Syndrome is a phenomenon with a constellation of Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia requiring identification and management in the prehospital and transport setting. In this podcast episode, live from AMTC23, we discuss the pathophysiology of BRASH Syndrome, highlighting the synergy between its components, as well as relevant pharmacotherapy and treatment considerations. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: Th...
2023-11-15
30 min
Heavy Lies the Helmet
Acid Base Trifecta (Presentation)
Dan presented the talk “Metabolic Acidosis: The Eye Can Only See What the Mind Can Comprehend” at AMTC23. In this recording, he teaches you how to identify the prevalence of acid-base disorders including triple disturbances, how to calculate anion gap and determine the etiology of the gap, and how to identify adequacy of compensation for a primary metabolic acidosis. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views...
2023-10-31
56 min
Heavy Lies the Helmet
Critical Comfort Care w/Brianna Fields
As a critical care clinician, do you consider yourself well-versed in comfort care? Do you consider yourself well-rehearsed in having the discussions leading up to the patient's or family's decision to implement it? This concept may be outside your comfort zone, especially if you work in emergency medicine. But the fact of the matter is, from the prehospital environment all the way to the ICU, we are provided many opportunities for implementation of this type of care plan. Join us for a discussion with an ICU charge nurse where we tell you how to do so effectively and tactfully.
2023-10-19
47 min
Heavy Lies the Helmet
The Truth About A-Fib
Atrial fibrillation, particularly A-Fib with RVR (Rapid Ventricular Response), is often an emergency requiring emergent intervention beyond ACLS and its associated algorithms. Identification of A-Fib can be challenging in itself, much less trying to determine what intervention(s) are indicated. This includes chemical and/or electrical cardioversion. So where do we start? And where should we end up? Dan and Mike will let you know in this podcast episode. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com
2023-09-23
43 min
Heavy Lies the Helmet
10 Things Your Gastroenterologist Wants You to Know w/Dr. Josh Peck
Continuing our "10 Things" series, we focus our attention on gastroenterology. GE/GI goes well beyond colorectal. From bleeding esophageal varices to pancreatitis to liver failure, these patients require specific diagnostics and interventions to improve their mortality and morbidity. Join us for a "pearl packed" episode where we discuss practical steps you can take to improve your care of this specialized patient population. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com ...
2023-09-05
46 min
Heavy Lies the Helmet
10 Things Your PEM Physician Wants You to Know w/Dr. Dominique Diggs
Pediatric Emergency Medicine (PEM) is a sub-speciality that many clinicians find intimidating. Are pediatric patients truly unique or are they simply "little adults"? In this podcast episode, we are joined by Dr. Dominique Diggs, board certified PEM physician, to demystify pediatric emergency care with 10 tips that will help you the next time you care for this patient population. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, in...
2023-06-30
1h 19
Heavy Lies the Helmet
Vascular Disaster
Vascular emergencies refer to any time-sensitive condition where perfusion is prevented secondary to bleeding or occlusion of a vessel. These can include, but is not limited to, the superior mesenteric artery (SMA) and aorta. And depending on the severity of the aneurysm or embolism/thrombus, downstream ischemia can significantly impact a patient's quality of life. How do we identify these conditions? When are they classified as a true emergency? And how do we treat patients with the notion that strict hemodynamic parameters are indicated? Join us for a clinical heavy podcast episode where we focus on ischemic...
2023-05-25
1h 01
Heavy Lies the Helmet
Breaking the Case (Pt. 2)
Reviewing case studies with trusted colleagues can be extremely beneficial. Not only does it provide a moment of reflection on actions taken, but it also provides different approaches that may be applicable to future scenarios. Occasionally we like to challenge each other, and this episode is no exception. Tune in as Amanda, Dan, and Mike present three real case studies and see if they would approach the same patient differently. We start from "bread and butter" to the complex critically ill. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @h...
2023-05-04
45 min
Heavy Lies the Helmet
10 Things Your Emergency Physician Wants You to Know
Have you ever handed off to an ER doctor, and you felt they were displeased with your care? Have you ever received an order from an ER doctor, and you didn't quite understand why? In this podcast episode, we continue our "10 Things" series with a focus on the emergency department. Our very own Dr. Amanda Humphries, Emergency Physician and Assistant Professor of Emergency Medicine and Emergency Medical Services, leads the discussion. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website he...
2023-03-29
1h 02
Heavy Lies the Helmet
OMI, I Almost Died
Myocardial infarctions can present in a variety of ways depending on vessel involvement, timing of pathology, and interpretation of diagnostics (e.g., 12-lead EKG). Unfortunately, not every patient with a myocardial infarction will fit STEMI criteria's paradigm, which has lead to the adoption of a new term: OMI (Occlusion Myocardial Infarction). In this podcast episode, we are joined by our very own Nick Zuber to discuss his recent OMI and why he's able to sit down and talk with us today. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet
2023-03-05
37 min
Heavy Lies the Helmet
Arrest, ROSC, Repeat
No matter what level of scope, management of medical and traumatic cardiac arrests is the focus of many clinicians. But what happens after return of spontaneous circulation (ROSC) is achieved? Many do not appreciate the fact that the likeliness of re-arrest is high. How can we avoid return of spontaneous arrest by appropriately treating the patient during the peri-arrest phase and subsequently improving quality of life? Tune in to another nugget-filled podcast episode where the team discusses everything from etiology identification to treatment methods beyond the scope of PALS and ACLS. Get CE hours for our podcast...
2023-02-06
52 min
Heavy Lies the Helmet
Long and Short of Learning w/Will Wingfield
The medical industry puts great emphasis on formal education via university and other training programs. Due to financial incentive, these institutions often discourage independent learning despite it usually having a greater impact on patient care quality. For example, paramedics are often non-degree holders, yet they effectively practice medicine on a daily basis as a result of learning via unconventional methods (e.g., podcasts). How much actual value is in formal education? Do we need a practitioner track for prehospital providers on the university level? And regardless of degree, how can we teach with the goal of long-term...
2023-01-01
56 min
Heavy Lies the Helmet
Anti-Antibiotics
Whether it's antibiotic-resistant "super bugs" or administration prior to acquiring blood cultures, empirical use of antibiotics is controversial. Should we be administering antibiotics in the prehospital environment for open long bone fractures and/or sepsis? When are antibiotics truly indicated? And is that more important than the timing of the antibiotic itself? This podcast is not only "Antibiotics 101", but we also address these important issues. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email contact@hea...
2022-12-08
36 min
Heavy Lies the Helmet
Medical Science Theater 100
It's not clinical. It's not non-clinical, really. Celebrating our 100th full podcast episode, Bryan and Mike sit down in a Mystery Science Theater 3000 format and make fun of our 1st episodes ever. If you're looking for some light-hearted entertainment including a reflection of how far the platform as come, this is the podcast for you. And one last thing... THANK YOU FOR 5 YEARS! Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Em...
2022-11-22
55 min
Heavy Lies the Helmet
A Survivor's Story w/Jonathan Godfrey and Chris Stevenson
Based on the Crash and Learn 2022 special feature presentation, we sit down with Jonathan Godfrey and Chris Stevenson to discuss the EMS helicopter crash that had a dramatic effect on both of their lives. Jonathan is the sole survivor of a 3-person crew, and Chris was part of his leadership team at the time of the incident. We carefully examine both perspectives and how the rest of us can learn from their experiences. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2022-10-31
1h 03
Heavy Lies the Helmet
Ups and Lows of GI Bleeds
Gastrointestinal hemorrhages can present in a variety of ways from a variety of sources. Bleeding esophageal varices, in particular, can be life-threatening. How do we manage these patients? When is it appropriate to establish an advanced airway? Are gastrointestinal tubes contraindicated even though the patient is vomiting? And what do we do when an esophageal tamponade device is indicated or already in place? Tune in to another podcast episode where we discuss GI bleeds. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2022-10-13
44 min
Heavy Lies the Helmet
How Do You Copy
Whether it's radio or bedside reporting, communication is a requirement of safely handing off patients. How do we build confidence in our ability to communicate about our patients? How do we develop qualities such as professionalism, accuracy, and conciseness that are essential to our reports? And if we experience interpersonal conflict, how do we resolve it? Tune in to this podcast episode where we discuss how to effectively communicate with other medical providers. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2022-09-23
1h 14
Heavy Lies the Helmet
Airway Management for Airheads w/Dr. Mario Rugna
Having an appropriate mindset is crucial when it comes to airway management, particularly in a prehospital and/or emergency setting. Whether it's team dynamics or the tools at our disposal, we need to have a different outlook when it comes to addressing the A in ABC's. If you are looking for a comprehensive guide on how to RSI, this is not the episode for you. This is simply a table discussion about appropriate perspective. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet I...
2022-08-28
49 min
Heavy Lies the Helmet
Busted Skulls and Myths
Traumatic Brain Injury (TBI) is always in the back of our minds when treating polytrauma patients. Unfortunately, the evidence has a controversial history. More and more, we are reminded of how a basic approach is much more important than other therapies that have little evidence to support their effectiveness. In fact, some may even cause harm. Tune in to a podcast where we debunk these common TBI myths. Also, this is the debut episode of Dr. Amanda Humphries-Ventura as an official HLTH team member. Get CE hours for our podcast episodes HERE! --------------------------------------------
2022-08-08
1h 02
Heavy Lies the Helmet
Treat the Heat w/Dr. Justin Hensley
Heat illness is prevalent around this time of year. And compared to hypothermia, hyperthermia has a lower threshold for danger. From heat cramps to heat stroke, clinicians need to know how to identify and treat each stage appropriately. But what contributes to severe heat illness? How do we treat each stage of illness? And how much time do we have before it becomes fatal? From Texan turned Aussie, we are joined by Dr. Justin Hensley, Flight Physician, to discuss. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @h...
2022-07-15
1h 13
Heavy Lies the Helmet
Performing Under Pressure w/Dr. Stephen Hearns
It's no secret that we as emergency and critical care professionals are expected to perform highly in high pressure situations. Unfortunately, none of us are immune to limited cognitive capacity, task saturation/fixation, time pressure, negative team dynamics, and poor communication. How can we mitigate these variables, so that we can continue to effectively operate in our respective fields? Join us for an insightful podcast episode where Dr. Stephen Hearns explains how. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet W...
2022-06-19
49 min
Heavy Lies the Helmet
Flight Suit Pat Down (Audio Only)
What should you carry in your flight suit as an American-based HEMS provider? In our opinion, no one can definitively tell you that. But we can attempt to share some ideas based on our personal experiences and training. In this vodcast, Mike shares what he currently carries in his flight suit; from survival gear to medical equipment. Watch the vodcast on our YouTube channel at /heavyliesthehelmet. Brands include: One Shear ER Life Benchmade Foursevens Fisher Space Pen Littmann Nite Ize
2022-05-31
33 min
Heavy Lies the Helmet
Immobi-Lies w/Dr. Mike Hudson
Mores lies! But this time, we focus on empirical use of spinal immobilization devices and the harm associated with them. The dogma surrounding this topic is staggering, to say the least. From EMS agencies to Level 1 tertiary centers, cervical collars and long spine boards (LSB) remain a "standard" predicated on a lack of evidence. What evidence DO we have regarding spinal immobilization? And how should we restrict spinal movement of polytrauma patients based on that evidence? Tune in to another eye-opening podcast episode where we are joined by air medical director, Dr. Mike Hudson, who has been leading the...
2022-04-30
38 min
Heavy Lies the Helmet
The Key to Ketoacidosis
Diabetic Ketoacidosis (DKA) is a common metabolic disorder, particularly in the pediatric population. If treated inappropriately, these patients can quickly decompensate to the point of hypovolemic shock, acute respiratory failure, and even cerebral herniation. What are the physiological differences behind DKA verses HHS (Hyperglycemic Hyperosmolar Syndrome)? What are some simple methods to identify DKA in the field? How do we effectively treat DKA? And how should we monitor our interventions? Tune in to a bittersweet podcast episode where we discuss this derangement in its entirety. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @h...
2022-04-15
41 min
Heavy Lies the Helmet
Para-Lies
There are a lot of "lies"/misunderstandings surrounding appropriate use of paralytics AKA neuromuscular blocking agents (NMBAs). When are these medications truly indicated? How do we appropriately administer them? How do we accurately monitor these patients? And how do we reverse the effects of NMBAs? Tune in to another pharmacologically driven podcast where we draft our EM pharmacist friend, Chase Turner, to discuss. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Em...
2022-03-30
53 min
Heavy Lies the Helmet
Closing the Blood Gates
The clotting cascade, particularly in the context of anti-coagulation reversal can be complex to understand. Unfortunately, many of our patients are on anti-coagulation agents that require reversal in the presence of life-threatening hemorrhage. How do we choose the most appropriate agent based on which step of the coagulation cascade that it antagonizes? And when is it time to pull the trigger on doing so? In this podcast episode, we discuss this intense topic. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2022-03-08
59 min
Heavy Lies the Helmet
The Lesser Evil Overdose w/Dr. Arne Skulberg
Which is the lesser evil, opioid or naloxone overdose? To avoid adverse effects, how should we be administering naloxone in the presence of opioid overdose? In this podcast episode, we are joined by Dr. Arne Skulberg, anesthesiologist and lead author, to discuss his recently published RCT comparing intranasal with intramuscular naloxone. We highlight naloxone dose discrepancies and the pitfalls surrounding intravenous administration of it. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com ...
2022-02-17
50 min
Heavy Lies the Helmet
Pilot Down But Not Out w/Wade Dunford & Scott Davis
An incapacitated pilot scenario is an unfortunate but potential reality of working in rotor and fixed wing EMS. What do you do as medical crew members if your pilot becomes incapacitated? What training and capabilities do you have to revive the pilot and/or get the aircraft on the ground? Do some Controlled Flight Into Terrain (CFIT) incidents actually involve an incapacitated pilot? In this podcast episode, we are joined by Pilot Wade Dunford and Flight Paramedic Scott Davis to discuss their Incapacitated Pilot Working Group (IPWG) and how they have taken steps to address this issue...
2022-01-31
1h 16
Heavy Lies the Helmet
A Great First Compression w/Dr. Per Olav Berve
Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) devices are recommended to reduce risk and maintain chest compression quality. However, such transports have inherent pitfalls to both patient and provider safety. This is a poorly studied field of our practice and no clear consensus for how this should be done exists. In this podcast episode, we are joined by Dr. Per Olav Berve to discuss the practical challenges of these missions, CPR physiology, hemodynamics, and hopefully some hard-earned advice on how to get a patient...
2022-01-13
53 min
Heavy Lies the Helmet
VAD Max w/Allen Wolfe
Ventricular Assist Devices (VAD) come in many shapes and sizes. From right to left, extracorporeal to intracorporeal, pulsatile to continuous - It can be confusing. Join us for a podcast episode where Allen Wolfe clarifies the confusion and gives us the maximum amount of knowledge we need to succeed while taking care of these patients. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The v...
2021-12-16
56 min
Heavy Lies the Helmet
A Few Good Mentors w/Adam Tresidder & Shane Turner
If "you can't handle the truth", you can't handle a mentor. Mentors come in the form of leaders, educators, guides, and advisors to help you with honest self-reflection in order to improve yourself and your practice. Join us from AMTC21 where we discuss the importance of this arrangement with our close friends and fellow mentors, Adam Tresidder and Shane Turner. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.c...
2021-11-10
45 min
Heavy Lies the Helmet
Love and Haiti w/Charlie Lazar
Charlie Lazar is an American HEMS nurse who has volunteered to work in Haiti on multiple tours. In this podcast episode, we discuss the history of Haiti, its effects on healthcare, and the current climate that requires charitable organizations such as Haiti Air Ambulance (HAA) to exist. We also touch on some of her personal experiences and why she fell in love with the people and culture there. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet ...
2021-10-31
1h 06
Heavy Lies the Helmet
Thyroid Storm Chaser w/Chase Turner
Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a patient who is refractory to conventional therapy? Joined by EM pharmacist, Chase Turner, we discuss all things hyperthyroidism in this podcast episode. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: T...
2021-10-12
43 min
Heavy Lies the Helmet
Resus Kung Fu w/Dr. Michael Lauria
"Kung" means "skillful work" and "Fu" means "time spent". "Resus Kung Fu" refers to the resuscitation skills we acquire over time to become a true master. But how do we achieve mastery of these cognitive abilities and technical skills? And what role does stress inoculation play in training? Join us and Dr. Michael Lauria in this podcast episode where we answer these questions. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com ...
2021-09-25
54 min
Heavy Lies the Helmet
Medicine in the Wild w/David Fifer
Have you ever been hiking in the woods and wondered what emergency medical services are available in case you got injured? The level of scope varies greatly across the country for wilderness emergency medical and SAR technicians. From first aid to critical care, in this podcast episode, we discuss who is coming, what their capabilities are, and how David Fifer is trying to change that model. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet...
2021-09-05
1h 06
Heavy Lies the Helmet
Eating Our Humble Pie (BaSICS Trial)
Sometimes, we're wrong. And when it comes to normal saline, we might be. Tune in to a breaking news podcast of sorts where we discuss the recently published BaSICS Randomized Clinical Trial, and how it affects our practice in regard to balanced fluid resuscitation. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed on the Heavy Lies t...
2021-08-19
25 min
Simply Stories Podcast
Episode 92 :: Amanda Cleary Eastep :: Stories of Faith, Growing Up, and the Moral Imagination
Today on the podcast, we have book editor, author, professional encourager and just all around amazing human, Amanda Cleary Eastep. I got to meet Amanda several years ago at a writing conference when she was part of a panel representing Moody Publishing. During this conversation she shares what it's like to be a book editor at Moody Publishers, as well as a middle-grade books author, which means she writes books for kids ages 8-12, and we look at what draws us as people to stories that captivate children and adults alike with their unique humor, whimsy, wonder, fun and...
2021-08-12
1h 19
Heavy Lies the Helmet
My First Crush w/Chris Stevenson
Though the incidents of crush injuries may be low in frequency, major crush injury syndrome is associated with a high mortality rate. In this podcast episode, we sit down with regular guest, Chris Stevenson, to discuss the "why". We highlight the pathophysiology behind re-perfusion injury and pre- and post-treatment options. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed o...
2021-08-07
44 min
Heavy Lies the Helmet
Pressure to Intubate w/Jon Inkrott
How do you decide between non-invasive and invasive ventilation? If you decide on non-invasive ventilation (NIV), how do you choose between heated high flow nasal cannula (HFNC), C-pap, or Bipap? And what critical decision-making tools do you utilize when escalating to intubation? In this podcast episode, we are joined by Flight Respiratory Therapist, Jon Inkrott, to answer those questions and more. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@h...
2021-07-15
48 min
Heavy Lies the Helmet
Door to Balloon and in Between w/Dr. Adam Gottula & Dr. Trevor Skrobut
Managing Acute Myocardial Infarction (AMI) patients is a concept that many of us learn early on in our careers. Because of that, we can potentially underestimate the importance of our interventions. In this podcast episode, we are joined by Dr. Gottula and Dr. Skrobut to discuss timely management of AMI's, when coronary intervention (PCI) is indicated, and what medications we should consider to achieve maximal medical management of a patient suffering an AMI in 2021. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet ...
2021-06-28
1h 04
Heavy Lies the Helmet
These Aren't the Labs You're Looking For
There are a lot of misconceptions surrounding the meaning of certain lab values and what a positive truly is. Are these numbers as black and white as they are perceived? In this podcast episode, we discuss sensitivity versus specificity, define some of the most common labs and how to avoid tunnel vision when it comes to your clinical interpretation. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com
2021-06-04
41 min
Heavy Lies the Helmet
Coming in Third w/Dr. Zaf Qasim
Taking care of the High Risk OB patient is outside the comfort zone of many of us. The third trimester, specifically, presents unique challenges both pregnancy-related and otherwise. Why are normal physiologic changes related to pregnancy ABNORMAL in the third trimester? How do we determine if the pregnant patient is sick or not sick? And how do you change your treatment based on these findings? Tune in as we sit down with Dr. Zaf Qasim to address these important questions. We also touch on peri-mortem cesarean sections at the end. Get CE hours for our...
2021-05-13
57 min
Heavy Lies the Helmet
The Business of Medicine w/Chris Smetana
Has administration ever made a decision that you didn't agree with and/or understand? Of course! As much as we don't like to admit it, the medical industry is a business. For that reason, finances play a significant factor in decision-making. How do we maintain balance between profit and patient care? How do we bridge the gap between leadership and staff members? Tune in to this brutally honest episode where we sit down with Chris Smetana, former Flight Medic and CEO of IA MED, and our very own Bryan Boone, ED Director, to discuss this very important...
2021-04-26
1h 04
Heavy Lies the Helmet
Chicken, Starfish & Cat Scans (Audio Only)
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may encounter. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2021-04-09
55 min
Heavy Lies the Helmet
Chicken, Starfish & Cat Scans
Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head CT scans, specifically, are often viewed by emergency and transport clinicians when patients require tertiary neurovascular services. Tune in to another visually-guided episode as we discuss this extremely important topic, providing ways to easily interpret the various forms of intracranial hemorrhages with some additional findings that you may encounter. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2021-04-09
55 min
Heavy Lies the Helmet
A Mind-Blowing Case Study (Presentation)
Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an advanced airway, some clinicians may not be mindful of cerebral perfusion pressure and how to optimize it effectively. In this podcast episode, we provide you with the recording of Bryan's presentation from ICON (IA MED Conference Online) 2021. After introducing a case study, he breaks down the various neuro assessment techniques that can be used when assessing comatose patients and how to best control their ICP when interventions are indicated. *This recording...
2021-03-24
25 min
Heavy Lies the Helmet
Resisting Traumatic Arrest w/Dr. Amanda Humphries
Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But are the studies skewed by inappropriate management and our resistance to act? When do we intervene, and when do we not? And how can we help improve these poor mortality rates? Join us as we discuss this important topic with Dr. Amanda Humphries, Flight Physician and EMS Fellow. We touch on determining medical versus traumatic arrest, prioritization of interventions, and special patient populations. Get CE hours for our podcast episodes HERE!
2021-02-22
1h 06
Heavy Lies the Helmet
X-Ray Vision (Audio Only)
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. *Reference the show notes for this episode at heavyliesthehelmet.com/068 for the x-ray images we discuss. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet
2021-01-30
53 min
Heavy Lies the Helmet
X-Ray Vision
Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identification, it is important to know what you're looking at. Join us for a visually-assisted podcast episode where our very own Intensivist and Medical Director, Dan Rauh, helps break down this seemingly overwhelming topic. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The v...
2021-01-30
53 min
Heavy Lies the Helmet
The Calm After the Storm
Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this podcast episode where we discuss the SAR and relief work he was a part of during that dire time. We highlight mission preparation, prioritization of victims, and several high risk incidents that will help you be a safer crew person. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram...
2020-12-30
1h 13
Heavy Lies the Helmet
The Silent Seizure
Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altered mental status is usually the only notable deficit, so it's important to know how to identify and treat this life-threatening disorder. Tune in to find out how through a casual discussion and real-life example. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, o...
2020-12-08
34 min
Heavy Lies the Helmet
One Hiring to Rule Them All (Graduation Presentation)
Acquiring a job in flight medicine is only the beginning. In this presentation to the 2020 Flight Crew Academy graduating class, Mike discusses three archetypes of new hires. He highlights positive and negative behaviors, systematically addressing incompetence, and how to ultimately get off orientation successfully. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and d...
2020-11-15
16 min
Heavy Lies the Helmet
Trapped Inside: Obstructive Lung Diseases (ASTNA Webinar)
With the upcoming respiratory season, many of us will be caring for an increased number of pediatric and adult patients with pulmonary disease processes. Obstructive physiology, specifically, can result in an increased strain of resources to effectively care for this critically ill population. In this webinar, Mike, Bryan, and Jordan focus on status asthmaticus and COPD exacerbation. They discuss etiology, diagnostic criteria, and the latest evidence-based treatment ranging from medication administration to mechanical ventilator management. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website...
2020-11-06
1h 01
Heavy Lies the Helmet
Flight Medicine Rules w/Chris Stevenson
Chris Stevenson is back for a third go-round, so I think that makes him a regular guest on the show. This time, he came at us with a non-clinical topic that peeked our interest... Likely over the years, we find ourselves giving or receiving advice related to flight medicine. As our years of experience have accumulated, so has the length of our rules and mantras related to flying. From military to mentors to pop culture, these are our 'Rules for Surviving Flight Medicine'. *We take no credit for this list. It is only a compilation...
2020-10-08
58 min
Heavy Lies the Helmet
Fast Rhythms, Furious Management w/Dr. Salim Rezaie (Bonus Feature)
Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a discussion based on what-would-have-been our Yacht Club presentation. Everyone carries a card that says they know how to manage tachydysrhythmias. But what happens when your interventions don’t work? In this podcast episode, we focus on recent evidence suggesting alternate means of management when the patient remains refractory to conventional therapy. Though controversial, we will NOT be...
2020-09-14
1h 17
Heavy Lies the Helmet
Down Under Dynamics w/Dr. Cliff Reid
Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the privilege of welcoming the infamous Dr. Cliff Reid to the show to discuss his and Sydney HEMS' approach to all of these areas. Tune in and learn how to be a high level transport provider from one of the best in our industry. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com
2020-08-25
1h 04
Heavy Lies the Helmet
Save Your Life w/Randy Mains (Part 2)
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is the opposite of complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the chain, and ultimately save your life. The...
2020-08-06
42 min
Heavy Lies the Helmet
Save Your Life w/Randy Mains (Part 1)
This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is complacency? And how do you know if you are? In this podcast episode, we are joined by Randy Mains, pilot and safety expert, to discuss all things Crew Resource Management (CRM) and the human factors that kill our colleagues. We also discuss how you can arm yourself with the knowledge to make good decisions, break a link in the chain, and ultimately save your life. The discussion was so...
2020-07-30
47 min
Heavy Lies the Helmet
Going With the Flow (Presentation)
High flow nasal cannula is an increasingly popular modality for Acute Respiratory Distress and Failure. Previously, we saw it used mostly in the pediatric population. But as time has went on, especially with the COVID-19 outbreak, this has become an effective means of O2 delivery in all patient groups. With its increased frequency of use, it is only natural that we as transport providers will adopt this therapy. Tune in to Mike's ICON 2020 presentation regarding this topic. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook...
2020-07-15
21 min
Heavy Lies the Helmet
Weight and Calculate w/Lynn Lamkin
How do you calculate your drug dosages? What do you base it on? In this podcast episode, we are joined by Lynn Lamkin, EM pharmacist, to discuss weight based versus non-weight based drug dosages. We also breakdown when true body weight (TBW), ideal body weight (IBW), lean body weight (LBW) or adjusted body weight (ABW) is a more appropriate option. Get CE hours for our podcast episodes HERE! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.c...
2020-06-30
51 min
Heavy Lies the Helmet
Where There's Smoke, There's Injury w/Chris Stevenson & Dr. Michael Feldman
You asked. We answered. In a follow-up to our burn resuscitation podcast episode, we are joined by Chris Stevenson and his burn center Medical Director, Dr. Mike Feldman, to discuss inhalation injuries. Tune in as we discuss the mechanism surrounding inhalation injuries and how to treat them affectively based on anatomical location and poison type. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the H...
2020-06-15
42 min
Heavy Lies the Helmet
The Art of Titration (Vasopressors)
Titrating intravenous drips is a source of contention for many providers. This is, in part, due to a wide range of approaches depending on the patient's condition. Further attribution is based on each individual's comfort level and respective professional background (e.g. ICU versus EMS). But what does the literature say regarding this topic? In this podcast episode, we are joined by our CMO and After the Call host, Jordan White, to discuss appropriate titration of vasopressors, inotropes, and chronotropes from a first-line perspective. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet
2020-05-02
54 min
Heavy Lies the Helmet
A World Upside Down: Transporting Prone (Presentation)
With the rising number of COVID-19 patients, many of our listeners have requested additional information regarding transporting patients in the prone position. Despite refractory hypoxemia, many of these patients are benefiting from the prone position. Based on Episode 17 of the podcast, we updated our information in presentation-form. The following is a live recording of our talk being given at AMTC19. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opin...
2020-04-04
21 min
Heavy Lies the Helmet
From Beginning to End-Tidal (Presentation)
Recently, Bryan was asked to present at a local EMS conference. The majority of the audience was ground personnel and student nurses, so he decided to present the why and how of measuring waveform capnography. EtCO2 truly should be the 5th vital sign, so we hope you appreciate this recording. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely tho...
2020-03-30
33 min
Heavy Lies the Helmet
Ins and Outs of Influenza
Due to a recent outbreak, influenza and COVID-19 have been in the forefront of people's minds. Influenza, in particular, continues to affect all age groups despite it being late in the typical season. In this podcast episode, we discuss the entire course of this disease process; from positive nasopharyngeal swab to downstream ARDS and the complex ventilator management associated with refractory hypoxemia. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opi...
2020-03-15
50 min
Heavy Lies the Helmet
Interrogating a Pulmonologist (Featuring Deep Sharma)
In this podcast episode, we are joined by Dr. Deep Sharma, Interventional Pulmonologist, to answer listener questions in a rapid fire format. We cover everything from modes of ventilation to respiratory decompensation to snorting sugar dust. You asked. He answers. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not nece...
2020-02-28
50 min
Heavy Lies the Helmet
Crash & Burn Resuscitation w/Chris Stevenson
Proper fluid management in burns is critical to survival. But what happens when we administer too little or too much fluid therapy? In this podcast episode, we are joined by Chris Stevenson to discuss epidemiology and appropriate resuscitation for the prehospital provider. Our discussion includes an assessment of past and current formularies and what you should be using. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The views, information, or opinions expressed during the Hea...
2020-01-29
1h 00
Heavy Lies the Helmet
Addressing SALAD w/Matt Jensen
Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to discuss this technique and his most recent Air Medical Journal study aimed at investigating its usefulness in training prehospital emergency providers to improve their ability to intubate a contaminated airway. Video of Matt's colleague Will Hicks performing the SALAD technique with the screen split between external and internal views: https://drive.google.com/file/d/1SKgwcp3Up1YuKKNRV7FpbBehzeqK_3mI/view?usp=sharing Y...
2020-01-12
41 min
Heavy Lies the Helmet
Win Win w/Jason Peng & Ellen Parsley
The Annual Sim Cup at the Air Medical Transport Conference (AMTC) is a prestigious event that gathers flight clinicians from all over the world to compete. Jason Peng (ED and Flight NP) and Ellen Parsley (Flight Nurse) of University of Cincinnati Air Care joined forces and took home the 1st place trophy at AMTC19. We use this opportunity to sit down with them and discuss their experience, the preparation leading up to their participation, and their approach to the various scenarios that ultimately lead to success. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet I...
2019-12-26
46 min
Heavy Lies the Helmet
Refrain and Restrain w/Nyssa Hattaway
RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medical management and aircraft safety considerations surrounding the patient with acute agitation, excited delirium, and/or drug-induced psychosis. We also touch on Droperidol; an old drug that is finding its way back into the Pyxis and hearts of emergency providers everywhere. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email contact@heavyliesthehelmet.com Disclaimer: The vie...
2019-11-30
47 min
Heavy Lies the Helmet
The Stethoscope Replacement w/Dr. Cynthia Griffin
Making her second debut on the podcast, Dr. Cynthia Griffin joins us at AMTC19 to discuss the utility of ultrasound/POCUS. Cynthia presented on this topic and highlighted its indication when following your XABC's (Hemorrhage, Airway, Breathing, Circulation) exam. Are you currently using ultrasound in your practice? If not, are you actively trying to convince your medical director to implement it? If so, you don't want to miss this episode! ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email heavyliesthehelmet@gmail.com...
2019-11-14
50 min
Heavy Lies the Helmet
10 Things Your Intensivist Wants You to Know
As an air medical provider, our bread and butter is interfacility transports. Whether at the referring or receiving facility, we deal with Intensivists on a regular basis. What are their expectations? How can we provide the best care for our ICU level patients while simultaneously pleasing the facility staff? Our resident nocturnal Intensivist, Dan Rauh, leads a discussion in this podcast episode regarding 10 random things that your Intensivist wants you to know when caring for their patients. Consider this a tasting menu for potential future episodes. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet I...
2019-10-25
48 min
Heavy Lies the Helmet
G.E.A.R. 2020 Trailer
The title says it all. We hope you will join us. *Standby for more information regarding this unique opportunity to expand your knowledge. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email heavyliesthehelmet@gmail.com Disclaimer: The views, information, or opinions expressed during the Heavy Lies the Helmet, LLC podcast are solely those of the individuals involved and do not necessarily represent those of their employers and their employees. Heavy Lies the Helmet, LLC is not responsible for...
2019-10-05
02 min
Heavy Lies the Helmet
Blood, Sweat, and GEAR (2019)
In our final Guatemala Educational Aircrew Retreat (GEAR) 2019 podcast episode, we summarize the overall experience. G.E.A.R. was memorable, to say the least. It resulted in currency, competency, and confidence through camaraderie and collaboration. But what do Black Wolf Special Helicopter Operations, RED MED, and HeliSOS Servicios Medicos mean? Where do Chris Sharpe and Chris Gibson come from? What is their motivation behind this training? And how can you experience firsthand what we've been through? Through blood, sweat, and tears. Take a listen. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @h...
2019-10-01
1h 16
Heavy Lies the Helmet
Surviving Culture, Part 2 (GEAR 2019)
Part 1 is on our other podcast platform, After the Call. In this podcast episode, we are again joined by survival experts Chris “Gibbo” Gibson and Jimmy “Jungle” McSparron to discuss the concept of tacticool. This common expression is regularly featured on social media when individuals inquire about various gear options for one’s person. We discuss the dangerous mindset surrounding this toxic ideal, highlighting the importance of factual preparedness. If you’re new or old to the industry, this episode is our reply. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehel...
2019-09-16
55 min
Heavy Lies the Helmet
From Cockpit to Firepit (GEAR 2019)
With kick off our Guatemala Educational Aircrew Retreat (GEAR 2019) series with an open forum. Located at Guatemala's aviation training center, we sat in a mock airplane, pulled out the lapel mics, and decided to discuss the broad topic of survival. The morning after our jungle excursion inspired a multitude of discussions ranging from fire to survival gear to everything in between. ------------------------------------------------ Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet YouTube /heavyliesthehelmet Website heavyliesthehelmet.com Email heavyliesthehelmet@gmail.com Disclaimer: The views, information, or opinions exp...
2019-09-03
31 min
Heavy Lies the Helmet
Advanced Practice Makes Perfect w/Bill Hinckley (Part 2)
In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models in HEMS. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to cheat your experience, so we split the podcast episode into two separate parts. This second part focuses on the big picture. We talk about the Airline Disregulation Act (ADA), HEMS bureaucracy, over-saturation, and billing practices. We touch on the need for advanced practice models in our cu...
2019-08-07
47 min
Heavy Lies the Helmet
Advanced Practice Makes Perfect w/Bill Hinckley (Part 1)
Is the Registered Nurse/Paramedic crew configuration optimal for HEMS? In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models. Bill is a rare breed that defines "passion" in HEMS, to say the least. His experience coupled with being an overwhelmingly nice guy led to a lengthy discussion. We did not want to cheat your experience, so we split the podcast episode into two separate parts. This first part focuses primarily on Bill's experience as an EM physician, flight physician, and medical director for University of Cinncinatti Health's Air Care and Mo...
2019-08-01
45 min
Heavy Lies the Helmet
Moulage Rouge w/Mike Abernethy
In this podcast episode, we are joined by Flight Physician Mike Abernethy to discuss the importance of high fidelity, simulation training. We discuss common pitfalls of simulation learning, EMS education, and highlight tips and tricks for building successful moulage; the art of applying mock injuries for the purpose of training emergency response teams and other medical and military personnel. Also, Mike advocates for a specific trauma course that seems to be doing things right across the pond. Summary: CREATE THE ENVIRONMENT! ------------------------------------------------ Follow our Twitter @heavyhelmet Follow our Facebook @heavyliesthehelmet ...
2019-07-09
44 min
Heavy Lies the Helmet
Breaking the Case: P.E. MERGENCY
Armchair Air is at it again with this is the second installment of the "Breaking the Case" series where we discuss case studies related to previously covered topics. Even though some content from Episode 33 - P.E. MERGENCY is reviewed, we recommend listening to it before proceeding. It will provide the foundation needed to understand the concepts that we base our decision-making on. With that being said, this episode discusses three patient scenarios where pulmonary embolism plays a factor in their presentations. We discuss diagnostics and treatment methods based on the severity of each case. We also hi...
2019-06-24
49 min
Heavy Lies the Helmet
Prehospital Sepsis (Presentation)
Earlier this year, we were asked to present at a local critical care conference. Due to the recent release of the 1-hour bundle, this was a timely discussion regarding pre-hospital sepsis. We touched on various definitions, diagnostics, treatments, and the ongoing controversy surrounding the Surviving Sepsis Campaign. Since we try to record most of our talks, we decided to share this particular presentation with you on the podcast. We hope you enjoy this format for a change of pace. ------------------------------------------------ Follow our Twitter @heavyhelmet Follow our Facebook @heavyliesthehelmet Follow o...
2019-06-05
32 min
Heavy Lies the Helmet
Induction Death Match
Ladies and gentlemen, welcome to the main event. This long awaited, highly anticipated match-up is finally here. Dan received feedback, after giving a recent talk, that we wanted to address in a fun way. What causes peri-intubation hypotension and death? Is positive pressure ventilation (PPV) or induction agents the primary contributing factor? Tune in to this special podcast episode where our own Dan "Macho Man" Rauh and Bryan Boone "The Doom" debate this heated topic. (Refereed by yours truly, Mike Boone.) We detail various sympatholytics used for induction, thoracic pressure consequences of PPV, and our ultimate concerns re...
2019-05-14
43 min
Heavy Lies the Helmet
Provider Zero w/Shane Turner (CAMP ECHO)
How do you become an asset rather than a lability at work? In this podcast episode, we are joined by multi-keynote speaker Shane Turner to discuss the difference between an employee and a professional. We highlight topics such as work ethic and personal drive. We also bring out how to stay engaged, using past mistakes as present motivators, and how to fight negativity at the base level. We also give tips on how to bring up uncomfortable topics to infect others with positive change as 'provider zero'. ------------------------------------------------ Follow us on Twitter @HLTHPodcast F...
2019-05-01
44 min