The World’s Okayest Medic Podcast

Sal Cortez, a veteran paramedic and law enforcement officer with 40+ years including flight medic and executive protection work. He recounts responding to major active shooter incidents, building tactical medical programs, and evolving training at the International School of Tactical Medicine. Conversations cover realistic scenario training, integrating medicine with shooting drills, Rescue Task Force challenges, and modernizing tactical med courses.

Casual catchup and gear talk including boots and pants. A free critical care conference in Letts, Indiana is announced. Deep dive into EKG debates with focus on practical priorities for medics. Discussion of ondansetron, when ALS is warranted, and using inhaled isopropyl alcohol for nausea. A warning about protocol stagnation and the need for continuous QA and improvement.

Listener discretion is advised.

Mike discusses the switch to First Due for EMS charting, highlighting its AI features. He shares insights on how automation revamped charting habits and emphasizes the importance of POCUS in diagnosing a puzzling code. The conversation turns to end-tidal CO2 limits in resuscitation, as well as the significance of interfacility transport in EMS and patient flow. Mike advocates for professional appearance and fitness standards among EMS personnel, while also addressing cannabis use for first responders. The episode is both informative and reflective.

Mike reflects on the podcast's six-year journey and the post-holiday return to routine. He shares his New Year's resolutions, including protecting PTO and avoiding workplace drama. A believer in prehospital ultrasound, he debunks myths about spinal immobilization and the need for proximity over prehospital blood products. Celebrating the shift towards prehospital blood use, he critiques the 2025 AHA updates and advises on handling toxic work cultures. Tune in for practical tips and insights into the complexities of EMS!

Mike kicks off with holiday reflections and the new Stanley tumbler. He previews an intriguing discussion on medetomidine withdrawal. The podcast dives into Tiger Connect's role in improving STEMI communication and the surprising link between flu and heart issues. Mike shares insights on EKG interpretation and the importance of recognizing culprit arteries. A thought-provoking opinion piece argues that OB calls warrant advanced life support. He wraps up by addressing listener income questions and encourages engagement through social media.

The host reflects on the year's podcast journey and thanks supporters, touching on his upcoming speaking engagements. A deep dive into capnography reveals its strengths in monitoring ventilation, despite some surprising pitfalls. Concerns about rising drug adulterants like medetomidine replacing xylazine in fentanyl highlight significant withdrawal issues, prompting a warning for EMS about life-threatening situations. The episode wraps with a chilling personal experience involving a confused patient during transport.

Mike discusses a key trial comparing ketamine and etomidate for intubation, revealing the risks of hemodynamic collapse with ketamine. He critiques slow RSI policy adoption in Pennsylvania and underscores the need for better pre-intubation resuscitation strategies. A surprising study highlights the overuse of helicopter transport for trauma patients, driven by profit motives. He tackles the myth of albuterol causing flash pulmonary edema and shares wisdom for new EMTs on managing pressure in emergency situations.

Join aviation experts Dan Rau, a seasoned nurse practitioner in helicopter EMS, Ryan Mueller, an experienced flight medic and Air Force instructor, and Steve Wood, a tactical EMS clinician, as they dive into critical issues surrounding HEMS. They discuss the shift from trauma rescue to routine uses, highlight overutilization concerns, and expose financial drivers behind air transport decisions. With calls for reevaluation of launch criteria and greater regulatory oversight, the panel emphasizes the need for data-driven changes to enhance safety in this high-stakes field.

Mike dives into the intricacies of managing atrial fibrillation, emphasizing fluid support over traditional rate control in certain patients. He shares engaging case studies, including one involving a septic patient and a debate on wide complex tachycardia. The conversation expands to the implications of amiodarone in patients with Wolff-Parkinson-White syndrome and the role of rapid AF in triggering dangerous ventricular arrhythmias. Alongside these medical discussions, Mike humorously critiques AI's influence in content creation and highlights the importance of mental health.