Practical EMS
Practical EMS
My mission is to use the stories we all have in emergency medicine to encourage and uplift you where you are. EMT, Paramedic, nurse, PA, NP or physician. Emergency medicine is a very difficult specialty with unique challenges, and it calls us all to be better than the average person in order to stay healthy for our patients, our families and own mental wellness. I want to connect with EMS crews, fire crews, ER RN's, ER techs and new ER advanced practice providers to better understand their current struggles. I also want to bridge the gap between prehospital medicine and the emergency department and to encourage those seeking to become an advanced practice provider. Disclaimer: All Practical EMS content is opinion only. It is unaffiliated with any company or organization and does not represent any company or organization that Aaron currently works for or has worked for in the past. No content should be taken as medical advice.
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Top 10 Practical EMS Episodes
Goodpods has curated a list of the 10 best Practical EMS episodes, ranked by the number of listens and likes each episode have garnered from our listeners. If you are listening to Practical EMS for the first time, there's no better place to start than with one of these standout episodes. If you are a fan of the show, vote for your favorite Practical EMS episode by adding your comments to the episode page.
Overcoming burnout, having purpose, showing grace for patients while also having healthy boundaries
Practical EMS
08/25/24 • 31 min
Keep asking “why” do get to a full understanding of what is going on
As providers we do want questions asked of us if someone is not sure about something we ordered
Tracey has found techniques to avoid burnout despite 24 years in emergency medicine, she says it is very individualized how you overcome burnout
Belligerent patients do cause burnout and the job to be very difficult in general
Taking intentional time to connect with your patients will help overcome burnout
Tracey has advice to give patients grace
Adam: purpose in life is important to avoid burnout. He believes he is called to be here.
Exercise, spend time with family, move your body, work less or even work more now to work less later
Force yourself to be social on days off, even if you might not feel like it. This will often help your mental well-being.
Owning your mistakes is key to avoiding burnout
Understand we will make mistakes and even when everything goes perfect, we cannot save the patient every time
We really aren’t built to see a lot of the things we have to see in emergency medicine
Be patient with the patients we deal with. They are going through something that we are not and have concerns we may not know about. They are scared, they are frustrated.
You need to have a sense of humor and the ability to compartmentalize
Compartmentalization helps to move on to other tasks that need to be done
Kate tells a story about compartmentalization
It is okay to set boundaries with patients that push on the limits
Deescalating belligerent patients is a skill that can be learned
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
72 | Nate’s off-duty call | That human connection | Moral injury vs burnout | Newbie advice
Practical EMS
10/20/24 • 32 min
Nate talks about a motorcycle crash he stopped at on his way home and how he was critical in saving an injured patient and how he became close with the family who still talk to him today. Even though the patient ultimately died, the impact he made on that family was immense.
Patients remember us
We need to remember we treat a person not a complaint or a room number
The balance is finding the human connection while not over-empathizing and taking on burdens that are not yours to bare
We talk about moral injury vs burnout – I do agree that we do not need to blame the individual for their burnout. It is certainly caused from many factors outside of their control factor BUT I like to place the responsibility for overcoming burnout on the individual because no one is coming to save us. Looking to blame external factors doesn’t help us in the long run
Mental health struggles are not always obvious to us in people we spend time with
Casey talks about how the cooperate leaders are actually trying to do the right thing for the front-line workers in spite of what we might think about them
What advice for yourself 5-10 years ago?
Nate: Slow down. Listen to those with experience. Bring your love of the job to someone else, especially new people.
Kash: Remember that you don’t have to do everything on your own. EM is a team sport.
Aaron: Enjoy teaching the newbies. You can make or break their experience based on your affect.
Casey: Journal your days in EMS. The babies you deliver. The skills you perform. Something to look back on can be very valuable.
We mean a lot to new people and students so remember the influence you have on people
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Nick talks about a difficult RSI intubation and his struggle to overcome the feeling that he didn’t do his best
We talk about how intubation success was such a critical point as a paramedic that everyone would have judged you on in the past
We talk about the direct laryngoscopy vs the new video techniques
Advice for the newbies:
Brent: You’re going to struggle with burnout. You need to recognize it early. Prepare for that possibility.
Nick: The things that affect you are different for everyone. Certain things you think may not affect you will actually become a problem for you later. You can’t choose the things that you will struggle with. Always treat the patient well and don’t blame them for the problem they are having. It is not all about you. Treat people with respect and give them options. Let them save face.
Mark: Recognize that your happiness is up to you. Don’t expect the company or organization to give you your happiness or your wellbeing. If you see yourself getting less happy, you don’t owe the organization anything. You make the decisions that affect your life. We can’t blame the environment we choose. Make a change if you need to.
The mountain will always be the mountain. We have better gear than we did before but that doesn’t make the challenge itself that much easier. EMS is tough field and that will always be the case
Knowing when to step away is also important
Nick’s metaphor: Event horizons are the edge of a black hole. If you were in space and you passed into an event horizon you probably wouldn’t even notice. But from the outside, you would just appear to disappear. Event horizons appear in our careers as well. You may not really understand you are at that point of terminal burnout but looking back you might be able to pinpoint that point of no return that you crossed.
Where is the event horizon on a call? That point of no return where the outcome is assured.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
12/08/24 • 31 min
Lorihodges.com
(4) Lori Hodges, MA, CCP, PMP | LinkedIn
Lori Hodges, is the author of Shaking in the Forest, Finding Light in the Darkness. She is a former paramedic and firefighter in Colorado and currently works as an emergency manager, recently working on hurricane Milton in Florida.
She talks about trusting your paramedic intuition on scenes and gives a vivid example of how trusting herself on a scene, despite others adamant that there were no other victims on scene, found another ejection victim of a motor vehicle accident
We talk about some of the unexplainable experiences we have as paramedics and how many of us have these similar stories
Lori talks about a feeling she would get the morning of a shift where she would know that a patient would die before it would actually happen and how the feeling would resolve after running the call
I always try to take the patient more seriously when the EMS crews have been concerned enough to put on the defibrillation pads
An important rule in EMS is no running and no yelling. We must be the calm. Lori talks about how this is even more important as an emergency manager. As leaders, we are watched and people take their cues from us. They will tend to mirror our behavior
We have to detach to make sure we take everything in and not get stuck doing one specific task
It is hard to be the one that stands back and doesn’t do the skills as a new paramedic, but it helps you take in the whole picture
Lori dealt with addiction and it’s affects while working at a detox center. She also dealt with it personally in her relationship with her father. She had to learn to set up boundaries with him
Our partners and fellow EMS coworkers are fighting their own battles, remember to have grace for people. Sometimes how they come across is not how they intend
EMS challenges
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
10/27/24 • 31 min
Mark (paramedic) | Brent (fire officer and EMT) | Nick (former paramedic and current police officer)
Mark has worked in urban and very rural 911 ambulances and does part time EMT education now
Community paramedicine is an emerging field and can vary a lot from region to region. Paramedics are flexible providers, so the potential is huge
Brent has stuck with firefighting from his early days as a recruit all the way to becoming a fire officer
Nick has transitioned from EMS to law enforcement in the last several years
The history of the spine board is a good lesson for new people: The way we practice medicine is a constantly moving target. Best practice is not always based on good data. We used to put EVERYONE on a spine board, but this has turned out to likely be doing more harm than good
Even though logically something might make sense, it doesn’t mean it always does in reality. Backboards and epi are big examples of this
Mark talks about the history of backboards and how this practice came to be
An important point to remember in emergency medicine: If you have nothing really wrong with you, we are more likely to harm you than help you with treatment. This is because nothing comes without risk and if there is truly nothing to treat, the scale weighs entirely to the risk side.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
December Panel - Real Stories Part 4 - Overlooking the simple and advocating for a patient
Practical EMS
12/31/23 • 28 min
Welcome Dr. Les to the show. Finished his EM residency in 1999, 24 years spend as an attending, estimates 130K patient seen in that time. He tells us about a busy night shift in the ED where he had to take care of an easy laceration but how the busyness of the night made him overlook something simple.
I follow this up with a story that makes me look like an idiot but sometimes it’s okay to laugh at yourself.
Les would tell his younger self that all the work he has done is worth it but some things don’t matter. Grinding is not always appreciated so killing yourself for the convenience of people is probably going to go unnoticed a lot of time.
Nathen talks about how EMT’s are often not listened to. If you aren’t listening to your EMT, you are missing a lot of valuable info and they can help you avoid getting stuck on a differential that no longer fits the picture.
Ashaley talks about challenges in critical care and flight vs the ambulance. The benefit of listening to/valuing volunteers and how much they care about their communities.
Casey talks about how TV shows will often depict paramedics as stupid and give the impression that they save everyone when the reality is they have a huge knowledge base and saving lives isn’t always possible.
Kierra gives us a story about advocating for your patient and sticking with it even when the provider disagrees.
I hope you guys enjoyed this episode. We have one more December panelist episode coming next week where we discuss a big topic I think you will really appreciate.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Professionalism in EMS Part 2
Practical EMS
05/08/23 • 21 min
Benn Taylor and I review the body cam footage from the unfortunate case in Illinois from last year where the EMS crew has been charged with murder and discuss lessons to be learned from this as well as professionalism in EMS in general.
How we present ourselves to the public matters. How we treat people matters.
Most of us that have been doing this for any period of time have had those partners that have great bed side manner and treat all people with dignity and respect.
We've also had those partners that are burned out, lack any compassion and have a tendency to escalate every volatile patient encounter.
We all initially got into EMS out of a desire to help and serve other people and when we find ourselves in a mindset that is anything close to what this crew displayed, we must recalibrate.
Always start with the assumption that a patient has as life threat until proven otherwise. When you start by assuming the patient is "not sick" these types of encounters have higher potential of recurring.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
07/14/24 • 32 min
We meet our new panel:
Eric (EM Physician)
Shelby (EMT)
Nate (EMT) and returning guest
Sam (Prior EMT, ER RN)
DeTessa (ER RN)
Part of the fun part of the ER is getting to start from scratch and figure out the puzzle
Stories do change as the patient talks with different providers
We are not equipped to diagnosis or resolve chronic problems in the ED, we can’t provide every answer for every symptom
The mindset of the public of what the ER is vs reality is often quite different
We do need to understand that waiting for your ER work up can be very difficult as a patient, especially when you are in pain.
We need to have grace for this patient perspective
We talk about GSW patients and chaos that is present on scene and in the hospital
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If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
The team mentality at all levels in the ED is key to a harmonious, efficient and effective environment
In EMS, this can be difficult on a given scene when you may not know the other responders all that well and it can be easy to get offended when no offense was meant
Developing a thick skin is important in emergency medicine. You can’t allow negative emotions of others to affect you all day long.
Patients can be really mean. This is just a fact that can be expected so you can make a plan to deal with it.
One of the cool things about being an emergency medicine provider is that we are the provider that the patient has access to any time of day or night. We are not a expert in any one specialty and that is okay.
Sarah talks about a rough shift in the fast-track part of the ED
Andrew talks about the first code he ran as a medical student and the impact it had on him
It is an honor to be there at a patients last moments and to help their families through it.
It is very easy to forget the human side of emergency medicine. Ask yourself how you would act if it was your family, you were taking care of.
Slow down. Focus on making a connection.
I naturally fall out of making that human connection, so I have to be intentional about connection it or I won’t happen.
Paramedics and EMT’s have a tendency to measure success and contentment by the acuity of the calls they run. I would venture to say we need a better metric: human connection. If you can connect with your patients, this will prevent burnout in your own life and improve your patient care as well.
Strategies for avoiding burnout: music on shift, nebulizing coffee to neutralize bad smells and planning trips
Crazy stickers for comedic relief
We talk about the inaccuracy of pain scales and alternate pain scales
Schasny talks about a patient with an ingrown toenail that got up and left after hearing multiple traumas and code blues announced overhead.
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
The paradigm around rapid sequence intubation is evolving and becoming much safer with more education and procedures.
Sometimes in emergency medicine slow is better. We need to stay mindful and calm in chaos and this requires us to detach and be above the fray and walk slowly instead of run. This will actually increase effectiveness and efficiency.
Nate recounts his EMT rides with myself and a great paramedic partner I had named Justin
Nate actually paid in EMT school to do more third rides so he could learn from the crews that were good at teaching
Crews can make or break an EMT students experience
Nate talks about how you really have to love EMS. The things we see are difficult, the shifts are long, the pay is not great. Something has to get you through
What affects one person may not affect another.
Casey talks about how it can be tough when things don’t affect you at all. That can be a form of struggle as well.
We talk about some of the hardest things to see in EMS, the cries of a mother or father at the loss of a child.
I talk about, how as an ER PA, I am a little more insulated from the death and the conversations with family than I was as a paramedic.
Nate talks about looking for the good differences you make with people. His job is not to save a life but to prolong lives.
Be intentional about marking those good moments
Casey talks about how a patients family remembered him long after a call
Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics
Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition
Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.
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FAQ
How many episodes does Practical EMS have?
Practical EMS currently has 85 episodes available.
What topics does Practical EMS cover?
The podcast is about Health & Fitness, Physician Assistant, Ems, Medicine, Paramedic, Podcasts, Education, App and Emergency Medicine.
What is the most popular episode on Practical EMS?
The episode title 'Are paramedics well equipped to go to PA school?' is the most popular.
What is the average episode length on Practical EMS?
The average episode length on Practical EMS is 28 minutes.
How often are episodes of Practical EMS released?
Episodes of Practical EMS are typically released every 7 days.
When was the first episode of Practical EMS?
The first episode of Practical EMS was released on Dec 21, 2022.
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