Shows
The Inflection Point: Conversations in Care, Culture and ChangeEffective Leadership in Paramedicine with Chief Marc Goudie | Frontenac Paramedic ServiceIn this special episode, we sit down with Marc Goudie, the Chief of Frontenac Paramedics.About Chief Marc Goudie:Chief Goudie holds multiple graduate degrees, including a Master of Health Management from McMaster University and a Master of Arts in Disaster and Emergency Management from Royal Roads University. He brings a wealth of clinical, academic, and strategic leadership experience to his new role — and in this conversation, he offers valuable lessons for current and future leaders in emergency services.Part 1: We delve into the qualities that define effective leadership in paramedicine. Chief Goudie shares his ex...2025-07-1631 minThe Inflection Point: Conversations in Care, Culture and ChangeHow Human Factors Can Save Lives | Dr. Joseph Cafazzo on Fixing Healthcare SystemsAbout Dr. Joseph CafazzoDr. Cafazzo is the Executive Director of Biomedical Engineering and Health Systems at UHN and the founder of Healthcare Human Factors, North America’s largest health-focused human factors team. He is also a Professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation (IHPME), where he trains future healthcare leaders in system design and quality improvement. His work bridges engineering, human-centred design, and policy to bring meaningful change to patient care.🔗 University of Toronto Research Profile🔗 IHPME Faculty Profile🔗 Healthcare Human Factors Bio🔗 LinkedIn🔗 TEDx Talk – The Patient Will See You NowJoin us in this insightful...2025-06-2733 minThe Inflection Point: Conversations in Care, Culture and ChangePrehospital COPD Care: Oxygen Myths, Steroids, and What Paramedics Must Know Before the HospitalIn this video, we delve into the challenges and best practices for treating COPD patients in pre-hospital settings. We discuss the daily struggles of COPD patients, the use of medications like Salbutamol and Dexamethasone, and the importance of early steroid administration to reduce hospitalizations and improve outcomes. The video also addresses the myths and realities of oxygen therapy, the significance of accurately targeting oxygen saturation levels, and the use of CPAP to prevent the need for intubation. Additionally, we highlight the critical role of chronic management, including vaccinations and home oxygen therapy, for preventing severe exacerbations and improving patient...2025-06-1721 minThe Inflection Point: Conversations in Care, Culture and ChangeCOPD for Paramedics: Emphysema, Chronic Bronchitis, and Acute Management ExplainedIn this video, we dive deep into Chronic Obstructive Pulmonary Disease (COPD), exploring its pathophysiology, prevalence, and management, particularly for paramedics. The conversation covers the factors contributing to COPD, including smoking and inflammatory responses, as well as the differentiation between chronic bronchitis and emphysema. We discuss the significance of early smoking cessation and the tools available to help patients quit. The video also examines the role of paramedics in managing acute exacerbations, emphasizing the use of bronchodilators, steroids, oxygen therapy, and CPAP. Additionally, we touch on chronic care, patient education, and the importance of vaccinations to prevent exacerbations. Join...2025-06-1018 minThe Inflection Point: Conversations in Care, Culture and ChangeStatus Epilepticus in the Pre-hospital Setting | Ketamine Evidence & Pediatric Seizure ManagementIn this episode, we dive into the intricacies of managing status epilepticus in prehospital settings. We discuss the significant risks associated with delayed or underdosed benzodiazepines, and the evolving guidelines that now define status epilepticus as a seizure lasting more than 5 minutes or multiple seizures without full recovery. Experts explore the pros and cons of ketamine as an adjunctive treatment, emphasizing the need for robust clinical trials to establish its efficacy. The episode also highlights the importance of a randomized controlled trial to determine safe and effective protocols for seizure management. Additionally, the conversation extends to pediatric considerations and...2025-06-0222 minThe Inflection Point: Conversations in Care, Culture and ChangePrehospital Seizure Management Made Easy: VITAMINS Acronym, Medications & MoreIn this episode, we delve into seizure management for pre-hospital settings, beginning with a detailed case study of a 67-year-old male experiencing his first seizure. The discussion covers differential diagnoses, including the use of the 'VITAMINS' acronym to identify potential causes, ranging from infections to metabolic issues. Key seizure management strategies are outlined, emphasizing the importance of immediate intervention and medication administration. Differences between focal, generalized, and unclassified seizures are explained, along with a breakdown of seizure phases and treatments. The conversation also touches on the role of Midazolam, its effects, and the necessary approach to managing a seizing...2025-05-2420 minThe Inflection Point: Conversations in Care, Culture and ChangeTXA Timing & Hypothermia: The 2 Silent Killers in Trauma Care | Dr. Jeannie CallumAbout Dr. Callum:https://research.sunnybrook.ca/researchers/jeannie-callum/https://pathology.queensu.ca/faculty-staff/jeannie-callumhttps://www.researchgate.net/profile/Jeannie-Callumhttps://www.youtube.com/watch?v=paAvUuXDChU&t=962s In this insightful part 2 episode, we explore the critical importance of temperature management and the timely administration of Tranexamic Acid (TXA) for trauma patients in pre-hospital settings. The discussion covers the mechanics and benefits of TXA administration, including its proven effects on reducing mortality in trauma and obstetric hemorrhage cases, as well as its applications in various surgical procedures. We examine the evidence from key trials like Crash-2 and the WOMAN...2025-05-2036 minThe Inflection Point: Conversations in Care, Culture and ChangeHow Dr. Jeannie Callum Helped Bring TXA to Ontario Paramedics | Prehospital Trauma BreakthroughDr. Jeannie Callum: The Architect of Prehospital TXA in OntarioWhat does it take to change an entire province’s approach to trauma care? For Dr. Jeannie Callum—hematologist, transfusion medicine specialist, and researcher—it took relentless advocacy, bold data, and a vision for saving lives before patients even reach the hospital. Known internationally for her expertise in bleeding disorders and transfusion science, Dr. Callum played a pivotal role in bringing tranexamic acid (TXA) out of the hospital and into the hands of Ontario paramedics.About Dr. Callum:https://research.sunnybrook.ca/researchers/jeannie-callum/https://pathology.queensu.ca/faculty-staff/jeannie-callumhttps://www.re...2025-05-1630 minThe Inflection Point: Conversations in Care, Culture and ChangeDr. Andrew Petrosoniak on Psychological Safety | Saving Lives with Better TeamworkIn this second episode, we delve into the crucial role of psychological safety within medical teams, particularly in high-stress environments like trauma care. The discussion highlights the importance of the phrase 'What else am I missing?' as a tool for team leads to flatten hierarchies and encourage open communication. Case studies, such as Elaine Bromley's tragic story, are explored to underline the significance of teamwork and decision-making. The episode further discusses techniques like pre-briefings, signposting decisions, and setting clear objectives to ensure optimal team performance and patient safety. Practical advice and strategies are shared for both current and...2025-05-1226 minThe Inflection Point: Conversations in Care, Culture and ChangeKetamine vs Morphine for Trauma Pain | PACKMaN Trial Explained for ParamedicsIn this episode, we delve into the PACKMaN trial, a recent study comparing ketamine and morphine for the treatment of traumatic pain. The discussion covers critical appraisal methods, study methodologies, sample size considerations, and the implications of the study's findings for paramedic practice in Ontario. We also explore the side effects, patient populations, and operational contexts in which ketamine and morphine might be chosen. This educational content is aimed at providing paramedics with evidence-based insights and supplemental knowledge for their practice.Chapters:00:00 Introduction to Ketamine vs. Morphine00:44 Overview of the Pac-Man Trial01:12 Critical Appraisal of the Study01:19 Understanding Critical...2025-05-0734 minThe Inflection Point: Conversations in Care, Culture and ChangeTXA in Prehospital Trauma: What Ontario Paramedics Need to KnowIn this episode, we dive deep into the life-saving benefits of Tranexamic Acid (TXA) for trauma patients. We discuss what TXA is, how it works, and why it is considered one of the safest and most effective drugs in critical care. Join us as we explore the evidence supporting its use, common concerns, contraindications, and the importance of timely administration. Whether administered intravenously or intramuscularly, TXA has been proven to significantly reduce morbidity and mortality in trauma cases. Learn about its application in various scenarios, from pre-hospital care to emergency departments, and understand why TXA is a game-changer in...2025-05-0422 minThe Inflection Point: Conversations in Care, Culture and ChangeClip | How Trauma Teams Thrive Under Pressure | Dr. Andrew Petrosoniak on Decision-Making in ChaosThis is a clip from our first podcast episode. In this powerful episode, Dr. Andrew Petrosoniak shares what it takes for trauma teams to perform under extreme pressure. From human factors to psychological safety, this conversation dives deep into how elite medical teams make decisions, stay focused, and save lives—even in total chaos.🎯 Topics covered:High-stakes decision-making in trauma careBuilding psychological safety in medical teamsLessons from simulation and real-world casesFlattening hierarchies to improve outcomesThe question every team leader should ask: "What else am I missing?"🎙 Hosted by Jakob Rodger and Ryan Cichowski – Paramedic Educators & Podcast Hosts🔗 Subscribe for more insights...2025-04-3002 minThe Inflection Point: Conversations in Care, Culture and ChangeHow Dr. Andrew Petrosoniak Designs High-Performance Healthcare SystemsIn this episode, Dr. Andrew Petrosoniak, an emergency and trauma doctor at St. Michael's Hospital in Toronto and Medical Director at Unity Health, shares his expertise in optimizing team performance in high-stress situations. He discusses the importance of designing systems that promote correct actions, the lessons learned from his work in simulation and design, and the value of borrowing strategies from other industries like aviation and athletics. Dr. Petrosoniak highlights the significance of interprofessional training, team coordination, and iterative feedback in improving clinical outcomes. Learn more about Dr. Petrosoniak's work: https://research.unityhealth.to/profiles/andrew-petrosoniak/ https...2025-04-2727 minThe Inflection Point: Conversations in Care, Culture and ChangeJustin Mausz Part 2 | Work, Trauma & PurposeJustin is an Advanced Care Paramedic and researcher with Peel Regional Paramedic Services, a member of the Department of Family and Community Medicine at the University of Toronto, and a Scientist with the McNally Project for Paramedicine Research. His work focuses on psychological health and safety among paramedics. Justin is the research lead of the External Violence Against Paramedics (EVAP) program and co-leads the Violence Against Paramedics project with Dr. Donnelly. Connect with Justin on LinkedIn, follow him on Twitter, or see more of his work on ResearchGate.LinkedIn: https://www.linkedin.com/in/justinmausz/Twitter: 2025-04-2220 minThe Inflection Point: Conversations in Care, Culture and ChangeWhy Are Paramedics Facing More Violence? | Justin Mausz on Culture, Safety & ResilienceAbout Justin:Justin is an Advanced Care Paramedic and researcher with Peel Regional Paramedic Services, a member of the Department of Family and Community Medicine at the University of Toronto, and a Scientist with the McNally Project for Paramedicine Research. His work focuses on psychological health and safety among paramedics. Justin is the research lead of the External Violence Against Paramedics (EVAP) program and co-leads the Violence Against Paramedics project with Dr. Donnelly. Connect with Justin on LinkedIn, follow him on Twitter, or see more of his work on ResearchGate.In this episode, we discuss the unacceptable...2025-04-1630 minThe Inflection Point: Conversations in Care, Culture and ChangeEmergency Intubation & Epinephrine: What Every Paramedic Must Know | The 10-8 ShowIn this episode, we delve into the best practices for intubation and the administration of epinephrine during emergency scenarios. Our discussion focuses on avoiding the use of epinephrine through the ETT, the importance of IV and IO routes, the benefits of video laryngoscopy, and the significance of preparation and teamwork. We also touch on airway management challenges, especially in cases with potential C-spine injuries, and emphasize the importance of setting up a systematic and well-coordinated approach to maximize patient outcomes.Chapters:00:00 Introduction: Epinephrine Administration Dilemma00:45 Optimizing Intubation...2025-04-1021 minThe Inflection Point: Conversations in Care, Culture and ChangeAvoid These Drowning Pitfalls: Prehospital Drowning Resuscitation Tips That Matter | The 10-8 ShowIn this podcast episode, we dive deep into pre-hospital management strategies for drowning incidents, focused on both adult and pediatric patients. We explore the critical differences between drowning in cold and warm water, the impact of these factors on patient outcomes, and key considerations for initial resuscitation. The discussion covers scene safety, airway management, the effectiveness of PEEP and CPAP in treating pulmonary edema, and the role of epinephrine in these emergencies. The hosts also share best practice guidelines, evidence-based approaches, and practical tips to optimize patient care and improve outcomes.Chapters:00:00 I...2025-04-0424 minThe Inflection Point: Conversations in Care, Culture and ChangeWhat Should Paramedics Prioritize After Achieving ROSCIn this comprehensive episode, we delve into the nuances of post-arrest care, focusing on the role of epinephrine, the importance of 12-lead ECG timing, and understanding false positives. The discussion covers essential post-resuscitation strategies, optimizing patient outcomes, and effective communication during patient handover. We also explore the ongoing changes in post-arrest care, including recommendations for paramedics to improve patient safety and outcomes. Key takeaways include the importance of slowing down after ROSC, thorough assessment, and detailed reporting to receiving hospitals.Chapters:00:00 Introduction and Anecdotes00:37 Medication Strategies Post-ROSC00:51 Importance of 12-Lead ECG02:19...2025-04-0118 minThe Inflection Point: Conversations in Care, Culture and ChangeThe Truth About Prehospital ROSC ManagementIn this episode, Jakob and I dive into the complexities of managing post-arrest patients. We discuss the critical shift in mindset required once a pulse is regained and emphasize the importance of preventing secondary injuries before transport. Key topics include the priorities in post-arrest care, the role of vital signs, the use of dopamine for treating hypotension, and the ideal oxygen saturation and end-tidal CO2 levels for optimizing patient outcomes. We also explore the challenges of pre-hospital care and share practical tips for ensuring the best possible results for post-arrest patients.Chapters:00:00 Introduction and Initial Thoughts2025-03-2826 minThe Inflection Point: Conversations in Care, Culture and ChangePediatric Cardiac Arrest | Defibrillation, Meds & Family PresenceIn this episode, Jakob and I discuss handling pediatric patients in shockable rhythms, including calculating defibrillation dosages—2 joules per kilogram for the first shock and 4 joules per kilogram for subsequent shocks. We delve into antiarrhythmic medications, highlighting that amiodarone and lidocaine are considered equivalent and outlining their dosages. The importance of family presence and communication during resuscitation efforts is stressed, with evidence suggesting it aids in their recovery from traumatic events. A recent trial on standardized intramuscular epinephrine injections to mitigate delays in administration is also explored. Lastly, the episode touches on the impact of socioeconomic factors on pediatric ca...2025-03-1908 minThe Inflection Point: Conversations in Care, Culture and ChangeShould We Stay on Scene for 20 Minutes for a Prehospital Pediatric Cardiac Arrest?In this episode, Jakob and I delve into essential aspects of pediatric cardiac arrest management. Key topics include the importance of on-scene resuscitation, differences in pediatric versus adult cardiac arrest causes, optimal treatment strategies, and best practices for airway management. We'll also discuss the significance of early epinephrine administration and the current evidence on supraglottic airways and intubation. Additionally, we touch on the importance of caregiver communication, the PRIME trial, and the impact of social determinants of health on pediatric outcomes.Chapters:00:00 Introduction to Pediatric Cardiac Arrest00:59 Key Differences Between Pediatric and Adult...2025-03-1233 minThe Inflection Point: Conversations in Care, Culture and ChangePre-hospital Airway Management: Best Practices and InnovationsThis video explores the critical aspects of pre-hospital airway management, emphasizing the importance of oxygenation and the variables affecting intubation success. The discussion covers systematic reviews, the pros and cons of endotracheal tubes versus SGAs in managing brain injuries, and the latest recommendations from medical guidelines. It highlights the benefits of simulation training in improving first-pass success rates and delves into the logistics of intubation positions, tools, and techniques. Expert insights are shared on the complexities of achieving better procedural outcomes and the importance of a multimodal approach in education and practice. Finally, the video outlines actionable steps and...2025-03-0716 minThe Inflection Point: Conversations in Care, Culture and ChangeIs Video laryngoscopy Better than Direct Laryngoscopy in the Pre-hospital Setting?In this episode, we delve into Jakob's master thesis comparing the first pass success rate and overall success rate of laryngoscopy with video laryngoscopy for intubation by ACPs. The discussion covers the importance of advancing airway management, the challenges faced by paramedics in pre-hospital settings, educational and systemic interventions to improve first pass success rates, and the future of simulation in airway management training. Join us for an in-depth conversation on improving patient outcomes in paramedicine.Chapters:00:00 Introduction to the Master's Thesis00:27 Motivation Behind the Research03:17 Challenges in Pre-Hospital Intubation04:58 Improving First Pass Success Rate07:15 The Role of Bougies in In...2025-03-0135 minThe Inflection Point: Conversations in Care, Culture and ChangeUnderstanding Pediatric Sepsis: Early Recognition, Treatment, and Key InterventionsJoin us as Jakob and I delve into the complexities of pediatric sepsis in this informative podcast episode. We cover essential topics, including the mean arterial pressure targets for fluid and vasopressor administration, the appropriateness of vasopressors in pre-hospital settings, and the impact of socioeconomic status on sepsis outcomes. Learn about the critical differences between sepsis and septic shock, the main causes of mortality, and the importance of timely antibiotic treatment. We also discuss practical approaches to fluid administration, key clinical signs to look out for, and the role of early warning scores in improving patient outcomes. This episode...2025-02-1645 min