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.
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.
Whatever your beliefs regarding God or lack of a God as you work in emergency medicine, I hope this episode will uplift and encourage you
Laurie likes to reflect on the one patient she was there to help during the day. Or the one patient she was there to interact with
It is important to reflect on your highs, your lows and even things that made you laugh
Where is that line of caring for people and balancing your own family and priorities?
Jesus said the poor you will have with you always. You will never be able to fix every problem. We can’t take on a God complex. We have to check on ourselves to know when we are giving too much of ourselves
Daniel raises a point in his book, that the fruits of the Spirit are produced by you going through difficult situations with difficult people
Overcoming difficult things can make us better if we allow it to and we can be a light to those around us
Every day is not “I am blessed and highly favored”, there are some days where you feel bright and full and others where everything is difficult
Jesus knows that the pain of getting well is sometimes greater than the pain of staying stuck
Is emergency medicine your purpose?
Eric talks about the blessing it is to directly impact another person, but it is not his life’s mission. His identity is not an ER physician, it is a child of God
Laurie overall agrees but she stresses that she is called to be an ER PA. It’s the expression of the skills God has given her
I think I am somewhere in between the two of them, I definitely feel called to work in the ED but don’t want it to be my whole identity either
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.
12/22/24 • 33 min
New panel! Lucas (ER physician), Kendra (Charge RN, NP student), Ben (paramedic and educator)
Kendra talks about her advice for new charge RN’s
Have some ER experience first. She says it was difficult starting as a charge when she was so new to ER. Have a good set foundation.
You need to be able to have difficult conversations with people in a tactful way to address problems
Getting to know the providers on a more personal level also allows you to better counteract interpersonal conflicts
Lucas talks about how a good charge nurse is a problem solver. He doesn’t view himself as the captain of the ship as an ER physician. He views the charge nurse as the problem solver and it’s their job to make sure every patient is managed in the department
The progression from EMT to paramedic is a similar advancement as RN to charge RN. Thinking outside the box instead of just task-oriented work
Paramedics must learn to allocate resources appropriately rather than do the tasks themselves
Simulation based training has help new paramedics learn to lead calls and see the time it takes for tasks to get completed
Paramedics do tend to have chips on their shoulders, a lot of this has to do with the difficulty of the job and how it is fairly new by comparison and the history of EMS is often us trying to prove ourselves
Lucas discusses efficiency tips in the ED
Chart with the same basic structure regardless of the chief complaint
The physical exam can be very basic and general with a very detailed focused physical exam based on the complaint
Sometimes documenting a physical exam that is too thorough can bite you later when you have to answer why you did a cranial nerve exam on an abdominal pain patient
Document what was done and do what you document
More is not always better
Document twice as much as you think you need to on the relevant components
When you are new as a physician or APP you should be ordering more and documenting more
Try to batch tasks. When you get up go see multiple patients rather than one at a time
It’s better to do the right tests rather than use a shot gun approach every time
You should be able to answer what you are looking for with a given test
On most patients, you should be able to form a plan after getting the HPI and physical exam
We should seek to avoid stacking orders, sometimes it’s inevitable when unexpected results pop up
Stacking orders reall
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.
My Journey to the Boulder Half Ironman
Practical EMS
06/17/23 • 10 min
I have no experience with triathlons. I would have never considered myself athletic. I've run one race longer a 5k my entire life. I decided that a half ironman would be a very ambitious race to train for and complete.
I'm a big believer in trying hard things that put you outside of your comfort zone to help improve yourself as a human. You don't even need to know everything about a difficult task before you start. Colin O'Brady talks in his book, The 12 Hour Walk, about life's 1's and 10's. In his many physical accomplishments, like hiking across Antarctica, he has had a lot of 1's: almost dying, being so physically exhausted that he thought this task was going to prove impossible. But he claims that these "1's" are there so you can experience the 10's in life: finishing a task so big that no other human can claim to have finished.
This is what the half ironman represented for me. An ambitious task that sounded almost impossible. It required me keeping a lot of commitments to myself. It required me to start training without all the head knowledge already in place and learn along the way. There were a lot of 1's in this journey but it was totally worth it for the 10 of crossing that finish line and seeing my wife and two girls waiting for me. Whatever your ambition I want to encourage you to get started. You don't have to know all the ends and outs. You don't have to even feel confident you can finish. Just start. Take little steps each day and the finish line with be there before you know it.
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.
Batching work applies with nurses too. Do multiples things when you enter the room, so you don’t have to go in and out many times
Ben talks about efficiency in the field being important due to the limited time and resources
As providers we must get comfortable with saying “I don’t know”
In medicine in general we don’t know everything, nor can we diagnose everything. Especially true in emergency medicine
Chest pain is a great example. We don’t get a clear answer or diagnose most of the time
We must be careful what we tell patients is going on when there is not a clear answer. Specific diagnoses will follow patient for a long time
Ben talks about some struggles new EMT and paramedics have and how the scope of a paramedic is still poorly understood, they often hear “I didn’t know you could do that?”
Teaching the EMT and paramedic students the context of the “why” behind treatments and not just the skills themselves
The difference between magic and medicine is we can trouble shoot and analyze medicine, we know why it works and if it doesn’t there is usually an explanation
Keep your mind open and learn from others. You can usually find someone that has a similar style as you, but you can also learn a ton from those who practice different from you
Ask a lot of questions, grow your confidence gradually
You need to master the more mundane tasks before moving to the exciting in some circumstances
Charge nurses need to help develop their team and communicate well
Be a mentor and correct people in a non-public setting, grow people instead of getting rid of them if they are struggling
Find a mentor or multiple mentors when you are new and when you have some experience, mentor people
You must be constantly teaching newer people and learning from more experienced people in medicine
You can make or break someone’s medical experience when they are new to the field
Cultures can be developed by the poor attitudes of a few crews or staff
You have to guard against the bias that those that are burned out can bring
Constructive criticism can come from even those that are not nice or not tactful if you can be open enough to take the feedback
You can learn from anyone, even those lower on the perceived hierarchy
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 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.
02/25/24 • 35 min
We meet our new panel and some returning guests!
Kiley – ER RN and new NP
Sarah – Paramedic in EMS for 8 years
Welcome back Adam ( ER MD), Casey (paramedic) and Nate (EMT).
Nate talks about the transition from field EMT to ER EMT. It’s a new world with new things to learn.
Sometimes a change in environment can get you out of a rut.
Sarah also worked in the ER but as a paramedic and loved learning new aspects of medicine but her scope was diminished compared to the field.
Paramedics are still a new asset in the ED and have a fluid job description.
Principles in emergency medicine
1. We do not diagnose in the ER.
2. Take care of yourself before you take care of patients.
Sarah recommends outlets and hobbies that are totally separate from medicine.
Make yourself a priority or you will end up neglecting yourself.
Sleep deprivation will affect you more than you think.
Casey talks about how you can get lolled into relaxing by low acuity calls but then you may be tested to your limits the very next call.
Kiley talks about patient autonomy and how it is our job to present options and educate but the patient must ultimately decide to accept or reject our options whether we agree with it or not.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm products. 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.
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.
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FAQ
How many episodes does Practical EMS have?
Practical EMS currently has 97 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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