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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 c ...
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Emergent Standards I address a comment about how we mentally handle the patients we care for that have committed violent crimes. We still care for them to the best of our ability; in fact we often learn the whole story after we have finished caring for them. We don’t judge because that is not our role. We find ways to move on from the horrible situ…
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Confidence in EMS: Nate talks about how he was reaffirmed when learning ALS meds and a physician agreed with his treatment plan. School does not make you confident. As a provider, give the crews feedback because it helps them grow and confirm their plans and treatments were accurate. Don’t just give negative feedback. Some students do need an extra…
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Random stories episode! We often don’t want to talk about the “craziest” call we’ve ever seen. I tell a story about a fireplace fueled by batteries and no real medical reason for the call. We talk about things that surprised you about emergency medicine Dealing with drunk people is a challenge. Other great random stories: Thoric dissection’s, tripl…
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Jumping back into our discussion on alcohol abuse in EMS. Everyone is susceptible to overuse of alcohol so abstaining can be powerful even without it being your vice. Interpersonal communication skills are key to developing in EMS. We need to connect with our patients. Patients care more about being understood and listened to than good medicine. Ad…
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New panel! We welcome Alex, paramedic and Kate, EMT. Welcoming back Sarah, paramedic and Nate, EMT. What makes a great paramedic? Treat your EMT’s like a partner. Talk about calls. Teach your EMT’s. Educate without belittling. Create an environment where your partners can question the plan if they don’t understand it. Learn from those that have bee…
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You guys ever see a dead family member in a patient? Like they look similar, act similarly? No? Maybe it’s just me. Nate talks about his life experiences and how it helps him talk with patients that are struggling with mental health. He talks about a patient experience where he really connected with a patient and how the patient was seen years late…
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Leadership in emergency medicine Good nurse to patient ratios is very important to good patient care and allowing those little moments where you can spend some extra time making sure the patient feels cared for. Management doesn’t always equal good leadership. Part of being a good leader is being the calming presence in a chaotic scene or situation…
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Is burnout moral injury? Is it out of your control? ZDoggMD talks about burnout being moral injury. Link here: (30) It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout" - YouTube We jump back into our discussion on the video. Casey says one of the great things about this job is that we have the privilege to be with people …
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Jumping back into Principles in Emergency Medicine Nate- People lie. Despite the fact that we are not judging them, and just need to know accurate details to provide the best possible care. Casey- Expect the unexpected. EMS is long periods of boredom punctuated by moments of sheer terror. Adam- the job is always out to get you. We see the 1%, it is…
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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 worke…
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We revisit the question “Where is God is emergency medicine? Doug- I’m a believer in science and a believer in God. There are some occurrences that we can’t explain with modern medicine. He tells the story of a cardiac arrest that woke back up an hour after pronouncement. Sarah- God has given us the science to learn and be able to use. We often see…
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Crazy stories episode Delivering babies! Not something most of us look forward to but it happens, nonetheless. Casey talks about a breech presentation birth that, thankfully, turned out just fine despite delivering at 28 weeks in an ambulance as well as a prolapsed cord case. Stabbing victims! In a sex shop, in their homes, we run them everywhere. …
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Pronouncing in the field is a difficult part of EMS. In a lot of ways, the ED insulates us from some of the aspects of this that make it challenging when you are in the patients actual home. The ED is mentally taxing in other ways. High volume, high acuity, multitasking, consulting etc. Nate talks about how “you’re just an EMT” gets thrown around a…
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Challenges in emergency medicine Burnout can creep up on you and can occur even in one shift. Nate got burned out working nights and started drinking heavily and almost got into blows with his partner. He went through a tough period and came out the other side. Substances will become an easy outlet and a way to avoid dealing with real problems if y…
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Jumping back into failures in emergency medicine Doug, ER physician, discusses how he missed a traumatic intraabdominal injury and an ectopic pregnancy. It’s easier in hindsight to see the things we could have done better. Admitting you screwed up can be difficult. Leave work at work as much as possible Nate talks about a patient that was initially…
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January Panel Episode 1 We’ve got some awesome experience here today. Physician, Nurse, PA, paramedic and EMT! We introduce Sarah, 9 year nurse with 4 years of experience in the ER. She is inspired by the team mentality in the ED as well as the unique situations. Inspired by her grandmother who was a nurse when emergency medicine was a developing s…
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I discuss the position of an ER PA and how it relates to the physician role. I strongly believe in practicing as a team with physicians, I see this as integral to the PA career. We talk about autonomy as a EMT/paramedic or PA. EMT’s and paramedic are a perfect career to step into the role of a PA because of their autonomy. Teaching is a key part of…
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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 loo…
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We welcome a new panelist. Flight paramedic Ashaley. She has been in emergency medicine for 11 years. Ashaley tells us about an impactful story from a patient that told her “Make sure you take moments. Life will always get out of control but, stop and go look at the sunset because sometimes you have things you can’t get back.” Kierra talks about so…
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Warning: This episode starts pretty heavy We talk about an absolutely horrific and tragic call that Nathan ran and how he has healed from something no one should ever have to see. Casey tells us about how patient's can impact us even in non-emergent settings. Casey and his partner help a patient attend his son's wedding and spark the inspiration fo…
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Real Stories in Emergency Medicine Part 1 Meeting our December panelists and diving into some real stories Nathan - EMT of 9 years Casey - Paramedic of 47 years Kierra - ER RN for 7 years Aaron (host) 15 years in EM as EMT, paramedic and ER PA Adam - ER Physician with 21 years in EM Do you work in emergency medicine? An absolutely crazy and intense…
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Full episode finally coming next Sunday! Last teaser episode until the full episodes release starting next Sunday December 10th! I introduce one of our final topics of discussion in the December panel series. Where is God in emergency medicine? This has been a question I have personally wrestled with over years of witnessing tragedy, horrific accid…
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Real Stories in Emergency Medicine Today's episode is a clip from our upcoming full episode on real stories in emergency medicine. Kierra is an ER nurse that goes above and beyond for her patients. She helps give some perspective on what it's like to be a new ER nurse, what it's like after you have some experience and the amazing opportunities you …
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I have a simple framework I wanted to lay out for the new EMT that is struggling to run a call. When I was a new EMT, my FTO would just throw me in there without a lot of guidance on HOW exactly a call worked and what the steps were exactly. If you follow these steps you won't get lost and can move the call along without any awkward pauses and blan…
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Feeling burned out, tired, frustrated as you work in emergency medicine? Are you an EMT, paramedic, nurse, PA, NP or physician? This show is for you. Today, I talk to an ER veteran. Susi has been in the ED for 26 years and still shows up with an awesome attitude and still puts patients first. She tells an awesome story about going above and beyond …
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Excited to announce a new podcast format coming soon! I've got a great group of healthcare professionals coming in to tell some awesome stories from their experiences working in emergency medicine. Stay tuned for more updates and subscribe at PracticalEMS.com so you don't miss the release! Also subscribe to Practical EMS on your favorite podcast pl…
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This might be the NUMBER ONE SKILL you need to be successful in medicine, especially emergency medicine. If you are newer to emergency medicine and you haven't had a patient surprise you or had a situation that humbled you, YOU LIKELY WILL SOON. I think it's very important to adopt a humble and teachable mindset no matter where you find yourself in…
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The Gap and The Gain, by Benjamin Hardy and Dan Sullivan is one of the few books I’ve read more than once. Despite its simplicity, I get something new out of it with each read and it is a great reminder of an important mindset that I always strive to achieve. The GAP is the trap you fall into when you compare your current life with that of your ide…
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Overall, I think this change is positive and should allow better patient access to quality care while also maintaining the team mentality and collaboration that is critical to our relationship with physicians. Full document at SB23-083 Fact Sheet.pdf (coloradopas.org) Let me know what you guys think at Aaron@practicalEMS.com Support the Show.…
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Why does efficiency matter? Beds are a limited commodity and the next patient that needs one might be dying Mindset changes Stop trying to diagnose. Try to rule out emergent diagnoses and determine if patient is safe or not safe to send home. Plan on negative work up before it comes back Sick vs Not Sick Not an innate skill. It’s learned over time …
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Super excited to share this episode with you guys. This was one of my favorite conversations I’ve had yet. Sara Townsend of Phoenix Fitness has a great story to share and amazing advice for women in firefighting, but men would do well to listen too. Sara Townsend is an amazing wife, mother, entrepreneur, fitness coach and retired firefighter parame…
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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 e…
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Part 2 of our discussion, this was available to premium members two weeks ago so join for FREE so you don’t have to wait! Three amazing ER RN’s give some great advice to our EMS crews as well as new APP’s. This was a really fun discussion with Meredith Thomson (ER RN, with lots of years’ experience on the ambulance as well), Amy Christopher Pryor (…
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If you don't want to wait to see Part 2, join now as a premium member to hear the entire discussion! Three amazing ER RN's give some great advice to our EMS crews as well as new APP's. This was a really fun discussion with Meredith Thomson (ER RN, with lots of years' experience on the ambulance as well), Amy Christopher Pryor (ER Charge RN) and Jer…
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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…
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Full episode up now for Premium members at PracticalEMS.com! 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. Check out the episode at the website to see the body…
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2nd half of our hour long discussion. Premium members got to see this two weeks ago! Video up at PracticalEMS.com NP and PA school do not prepare you for the steep learning curve that is emergency medicine. As APP’s we often don’t do a residency program and have to jump in and learn on the job in order to succeed. The environments we practice in ar…
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To access full episode, join as premium podcast subscriber. NP and PA school do not prepare you for the steep learning curve that is emergency medicine. As APP’s we often don’t do a residency program and have to jump in and learn on the job in order to succeed. The environments we practice in are as varied as the physicians we will often practice s…
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Continuing my discussion with Cody, Chris and Vince around scene management and etiquette. Believe me, I've made all the mistakes you can make as an EMT and Paramedic. My goal is to help YOU avoid these mistakes and decrease the amount of miscommunication and confrontation on scenes with other providers. At the end of the day it's all about the PAT…
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Thanks for checking out this new episode of Practical EMS. Don't forget to check out the video of this episode at PracticalEMS.com and subscribe to get updates on all new content, as well as receive the "How to Think Like an Emergency Physician" tip sheet PDF. In this episode I discuss scene management and etiquette with experienced Fire EMT Cody T…
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In emergency medicine we use a top-down approach. What does the patient need? Not, what does the patient have? 4 Responsibilities of the Emergency Physician: Resource stewardship - Not a lot of control over this variable Customer service - Evidence based medicine doesn’t equal good customer service. You must be able to communicate well with your pa…
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Thank you to Reuben Strayer for allowing me to reproduce his awesome content here. Check out his website at emupdates – return if worse for more emergency medicine content. Email me with comments or questions at Aaron@PracticalEMS.com Quick tips: Resuscitation Does the patient need resuscitation? - Vitals - AMS -Neuro deficits - Sick appearing - Th…
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