FOAMfrat Podcast

A few months ago Sam published a blog on the oxyhemoglobin dissociation curve. If you haven't checked it out I highly recommend reading that before listening to us discuss what this curve teaches us about airway management.

My buddy Bryan Winchell and I sit down and record a conversation about PEEP. We have way more questions than answers, but here's some shop talk on what we are currently doing to optimize PEEP. Check out the full blog and show notes at FOAMfrat.com

If I give this patient a fluid bolus, will it increase cardiac output? What does wall tension have to do with myocardial oxygen demand? In this episode, we will give you a step-by-step guide into assessing LV function utilizing pulse pressure and ultrasound. FOAMfrat is an online library for EMS professionals who are looking to take their knowledge and skills to the next level. www.foamfrat.com

Anne keeps asking "is my baby ok?!" There may be some momentum to just break out the ultrasound and look for a fetal heart rate right now, but you know that taking care of mom means taking care of the baby. In this episode, Cynthia and I discuss the prehospital fetal assessment and how to communicate with mom what you see. www.foamfrat.com

WPW is an incredibly interesting disease process that can initially cause some trepidation on the part of the clinician due to the perceived nuance of treatment. However, we might just be psyching ourselves out a little bit. Check out Sam & Tyler as they break down the dos and don'ts of WPW management. www.foamfrat.com

In this episode, Sam and I break down the different clinical signs and diagnostics of the dreaded pulmonary embolism. Make sure you check out the show notes at foamfrat.com for references and videos mentioned throughout the episode!

Yesterday Sam released a blog on the various flavors of prolonged Q-T syndrome. As a complement to that blog, Sam and Jake sit down and tease out some of the nuances and treatments of this interesting pathology.

Expert Bryan Winchell joins hosts to discuss ventilator setup strategies: optimize volume, analyze flow waveforms, adjust inspiratory time for maximal alveolar tidal volume. Debate on CO2 correction formulas, pressure vs volume ventilation, ASV efficiency in different patient cases.

We realized the other day that we have yet to do a podcast on diabetic ketoacidosis (DKA). In this episode, we spend a little bit of time talking about the pathophysiology, but the majority is focused on the logistics of running a DKA transfer. Here are the highlights: DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. DO EVERYTHING YOU CAN TO AVOID STOPPING THE INSULIN. The way you do this safely is by pre-planning! Ask for these things before you leave the hospital: IV Potassium Liter bag of D5W Bag of lactated ringers Three amps of sodium bicarbonate (if renal failure is suspected) If I add weak acids (ketones) into the anion side, the body will dump bicarbonate to maintain electrical neutrality. The only way to get the bicarbonate to return to normal is to get rid of the ketones. I got rid of all my ketones but my bicarb has not returned to normal!! Why?! You gave too much chloride which is now hogging all the anion space. The kidneys aren't working properly and you need to give sodium bicarbonate.

So, my buddy, Bryan Selvage released a blog a few weeks ago called "The Curious Case of The Brain & The Octopus Trap." This case study caught me off guard because it did not match my mental model of a brain bleed patient. I called Bryan and had a great conversation regarding mental models and how they can either make us look like we have superhuman powers or trip us up. Bryan started working on a blog to address the perils of mental models at the same time my friend Tom Grawey was writing a piece for FOAMfrat on the "sick versus not sick" assessment. Both of the blogs complimented each other perfectly and I figured we could do a podcast and release both blogs as a package. I loved the discussion and feel this will likely lead to more podcasts/blogs down the road. Would love to hear what some of my friends like Cliff Reid, Mike Brown, and Michael Lauria have to say on this topic. Now let's get to the podcast!