FOAMfrat Podcast

A young pediatric patient is having nausea and vomiting at school and is said to not be 'staying awake very well.' You discover assessment findings such as hypotension, hypoglycemia, and maybe even peaked T waves on the ECG. You receive information indicating that the child has something called "CAH". Or, perhaps... An older patient is having dizziness upon standing, and persistent hypotension. You note a somewhat jaundiced appearance. They become unconscious in their kitchen while searching for a salty snack, and they appear rather sick. Or... A middle-aged patient has suddenly stopped taking their high-dose prednisone for their asthma and is now feeling very weak and cannot stand. We already know what this episode is about - adrenal insufficiency. However, what if those scenarios up above were in the form of a test question? Or worse yet, a real patient? Would we be aware of what's causing the signs and symptoms, and what the appropriate treatment is? Endocrinology does not get the respect it deserves in EMS, probably due to its low volume - we just do not see that many patients with endocrine emergencies outside of diabetes. Or do we, and we just don't notice?

In this episode, we talk with Matt Schneider, a Battalion Chief and Paramedic for the Mequon fire department in Ozaukee County. Sam and I had the privilege of sitting in on a guideline update presented by Matt a few weeks ago. One of the guidelines that caught our attention was the decision to remove nitroglycerin from the STEMI guideline. Listen in as Matt describes how their guideline committee arrived at this decision. "Matt's views, comments, and opinions expressed in this segment do not represent the position of his employer(s), or associated agencies/institutions".

Nothing is scarier than watching an awake patient struggle to breathe with a trach. Do you have an approach to troubleshoot? Make sure you watch to the end to see our first FOAMfrat reaction video!

In this episode, Tyler & Sam discuss everything you need to know about the Bougie. Traditional use Modified pre-loaded techniques Common pitfalls.

Welcome to the fourth and final installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond.

One of my first calls as a paramedic was to our local ski hill for a 26-year-old guy who crashed into a tree while snowboarding. The ski patrol brought him down to the patrol room and we met them inside. The guy was literally screaming in pain and saying: "just put me out, man!" I could see his leg was obviously deformed below the knee. Now, this dude was covered in gear, and starting an IV was going to take a little while. I looked at my partner and remembered we had just got this new gadget that connects to the end of a syringe and lets you inject medication into someone's nose. It was called a mucosal atomizer device (MAD). I pulled up 100 mcg (2 ml) and gave 1 ml per nare. I told the guy that he would be feeling reeeeallll good anytime now. we waited.. and waited..

Welcome to the third installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond. Previously we've explored Cations (located here) and Anions (located here), but don't feel like you need to read these in any particular order. These blogs are meant as a reference for you to come back to. There's a lot of information in each, so they might be better absorbed in chunks. I'm writing these as the reference I wish I had when I started learning lab values. This week we're going to tackle the renal values on our chemistry panel! Renal physiology can be more than a little intimidating, but you're going to totally understand these labs by the time we're done! Because this renal section is a little different than the other sections, I'm going to start us off with a little refresher on the nephron, using a couple of illustrations.

What does jaundiced skin, right upper quadrant pain, and a fever mean? In this episode, Dr. Cynthia Griffin and I discuss everything gallbladder and biliary colic! Check out the blog post here: https://www.foamfratblog.com/post/when-gall-bladders-attack

Welcome to the second installment of this metabolic panel series, where we're exploring what happens when various lab values reach their outer limits (or beyond). Each part in the series can be read on its own, but if you want to start at the beginning, go check out the first blog on cations HERE. This series of blogs and podcasts are meant as a reference for you to come back to. There is a lot of information on each one of the lab values we'll cover, so it might be best to read it in parts. As I mentioned in the last blog, I'm writing these as the reference that I wish I had when I started learning to interpret lab values. In this portion of the series we'll be discussing anions - the negative changes in the serum. We'll be starting off with chloride, which accounts for the majority of the negative charge in our blood!

In this episode, Sam and I discuss warfarin's mechanism of action and reversal. Check out the blog for more information! https://www.foamfratblog.com/post/podcast-132-reversal-rehearsal-warfarin