Dr. Selbak joins Steve, Dan, and Holly to discuss a few unique case studies. The episode begins with Steve walking the team through a call that raises many questions for his crew. As the case is discussed, the listener is encouraged to critically consider the patient’s history, symptoms, presentation, and additional lab values as they are given. At the same time, Dr. Ramsay discusses his process for assessing and managing this patient and ultimately comes to a diagnosis.

The second half of this episode provides an overview of hyperkalemia – what it is, how it happens, how it often presents, and how it may be stabilized in the field and definitively treated in the hospital setting. Field providers do not often understand hyperkalemia and its field treatment, so the team breaks down the etiology of hyper-k and the mechanisms of action for the classic medications used to treat it in the field. The listener also gets insight into how these patients are managed in the hospital in the short and long term, which helps paint a complete picture of the hyper-k patient.

This episode demonstrates the importance of history gathering and provides a deeper insight into lab values and how they are used to diagnose patients with less obvious disease processes. Listeners should walk away feeling better equipped to identify both endocrine and electrolyte imbalances in patients with unique presentations.

In this episode, Steve presents two trauma case studies for the group to discuss. While patient care in both of these calls went well, and these scenarios provide an overview of successful extrication and patient management following both an MVA and significant blunt force trauma, the distinguishing factor in each is a particular element that caught Steve “off guard” and forced him to revisit the call days or weeks later. As first responders, we often arrive on scenes that we assume will be “routine” or similar to calls we have been to before; however, it is essential to understand that sometimes there are elements of a call that, while on scene, may not affect our patient care or ability to perform, but later they stick with us and prevent us from adequately processing the call. The element that sticks or “catches us off guard” will vary, but the result is often the same…the memory refuses to file itself into our mental Rolodex of calls properly. It is like a page of a book that has folded and torn, catching on the pages around it and preventing the book from closing properly. For these calls, we hope to recognize these “sticking points” and seek help from a trusted mental health professional to prevent these points from gumming up the surrounding mental space and preventing us from processing all incoming information and future calls.

This episode provides an interesting insight into trauma patient assessment, management, and transport. However, it also emphasizes the work we, as healthcare providers and first responders, must do to maintain pique mental health and continue to provide a high level of care to patients in unpredictable and ever-changing scenarios. 

In today’s episode, the team talks with Daniel Sundahl, a 20-year Firefighter/Paramedic, and artist. Daniel discusses how his experiences navigating PTSD led him to create powerful artwork, which is now helping open the conversation around mental health for first responders. For decades, mental health care was neglected for those working in the field, meaning responders were repeatedly exposed to traumatic events with little (if any) time to process what they saw, heard, treated, and experienced. While stigmas are still attached to seeking care for mental health, the concept that only the weak need help is slowly being dismantled. Therefore, the team takes the time to broach this sensitive subject with the hopes of helping first responders across the country, continent, and world seek help and care while recognizing they are not alone.

This episode delves into the evolution of mental health care with expanding research around mental health and traumas. It also emphasizes the value of those with years of experience using their history in the field to build a foundation of support and care for current and future first responders.

If you or someone you know is in crisis or having thoughts of suicide, please call 988 (U.S.) or go to https://988lifeline.org/.

If you want to view Daniel’s artwork, read more about his story, or see where his artwork will be on display, visit https://www.dansunphotos.com/.

In this episode, Steve, Dan, Holly, and Dr. Selbak review a few of their calls involving aortic dissections. Because aortic dissection is a relatively uncommon disease process, and many severe cases never make it to the hospital, reviewing these cases provides a unique opportunity for the listener to gather abundant knowledge in one sitting that may otherwise take years to gather in the field. The team also discusses how patient presentation, vital signs, and history gathering can point a provider towards aortic dissection over other cardiac or pulmonary conditions and how a few relatively simple tests in the ER can help confirm a field provider’s suspicions.

The goal of this episode is to encourage listeners to be on high alert for a few key phrases and to be cautious about falling into the classic trap of overlooking a patient simply because their signs and symptoms may not be glaringly obvious or particularly alarming. We all know that two patients with the same etiology can present drastically differently, and this podcast not only provides a few clear examples of this but also sheds light on why that might occur. 

In this episode, Steve, Dan, and Holly talk with Dr. Ramsey Selbak about the increasing prevalence of violence in healthcare. They each take a turn providing examples of dangerous situations they’ve been involved in, how they handled them, and how they have adjusted their tactics as providers since. This episode introduces a much-needed conversation about provider safety in healthcare and how it has long been neglected. The team touches on why violent incidents seem to be more commonplace, why they often go unreported, and the lack of debriefing many EMS providers have following these events.

The team goes on to explore how a lack of training on entering unsafe scenes often puts providers at risk, and how much of this is because, historically, EMS providers did not enter unsafe situations without law enforcement. However, this seems to be changing, and EMS providers often have to call for law enforcement after the situation has already devolved. This episode forces the listener to reflect on their own experiences and consider steps each of us may need to take to keep ourselves, our patients, our crews, and future EMS providers safe in an ever-changing field.