MCHD Paramedic Podcast29 Maj 2018

Episode 9 - The State Of EMS Stroke Care In 2018

In the past 24 months, stroke care has evolved in the way we evaluate strokes in the pre-hospital space and how they are worked up and treated in the hospital. Large vessel Occlusion (LVO) stoke is a large caliber vessel clot causing stroke symptoms. New techniques and devices in endovascular retrieval of these clots along with intravenous Tpa has shown great success in five randomized trials published in 2015.(1) The number we need to treat for one improved neurologic outcome at 90 days according to data from these trials is 2.6 patients. This is a massive breakthrough in the way we approach acute stroke care. Improved outcomes in these trials are directly associated with times to reperfusion therapy and EMS must change the way we diagnose and rank stroke patients in order to get them an endovascular capable facility when appropriate. In the first podcast our team will review all of the pertinent data from these trials and suggest how EMS should approach this LVO stroke diagnosis. In the second part of our stroke awareness series we talk with Dr. Peter Antevy, an EMS medical director from Florida who is an expert of developing regional systems of care for these LVO stroke patients. He will discuss development of their system and exciting new data that demonstrates a treatment benefit up to 24 hours after onset of symptoms in some subsets of these stroke patients. (2, 3) References 1.Hermes Collaboration: Lancet 2016 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00163-X/abstract 2. Dawn Trial: NEJM 2018 http://www.nejm.org/doi/full/10.1056/NEJMoa1706442 3. DEFUSE 3 Trial: NEJM 2018 http://www.nejm.org/doi/full/10.1056/NEJMoa1713973

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Avsnitt(201)

Episode 197 - Altered Mental Status - The Next 30 Minutes

We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with an altered patient once the ER doctor ...

10 Aug 46min

Episode 196 - Cervical Spine Immobilization In 2026: Evidence Vs. Dogma

We recently made some cervical spine immobilization protocol changes here at MCHD. Dr. Patrick and Dr. DePasquale discuss the history and literature that provide the foundation for rigid cervical col...

13 Juli 26min

Episode 195 - Cold Water Immersion For Heatstroke - Lessons From Phoenix

Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mir...

15 Juni 41min

Episode 194 - Mental Health Matters In EMS With Dr. Joe Gill

MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being...

18 Maj 38min

Episode 193 - What Can EMS Learn From An Emergency Pharmacist? - Part 2

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the ini...

20 Apr 31min

Episode 192 - What Can EMS Learn From An Emergency Pharmacist? - Part 1

23 Mars 30min

Episode 191 - EMS Protocols 101

As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creati...

23 Feb 36min

Episode 190 - Geriatric Considerations In EMS With Dr. Maia Dorsett

The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when car...

26 Jan 49min