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Cypress Creek EMS Podcast

Cypress Creek EMS Podcast

By Cypress Creek

A podcast for Cypress Creek EMS, a progressive EMS service in the Northwest Houston area. Subscribe for EMS-specific clinical education, discussion, and protocol updates.
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Currently playing episode

Dr. Ely Discusses Airways

Cypress Creek EMS PodcastJun 06, 2020

00:00
23:44
Dr. Jason and the Current State of COVID
Jan 28, 202141:18
Death and Dying Part 1
Aug 02, 202032:04
COVID Protocol Updates 07-03-2020

COVID Protocol Updates 07-03-2020

These changes go into effect on July 4th, 2020 at 7am.

In this episode, we are joined by our medical director, Dr. Levon Vartanian, along with our assistant medical director Dr. Ziherl and discuss protocols to reduce ED overcrowding during this pandemic. We talk about Paramedic Initiated Referral, COVID-19 Non-Transport, and transport to freestanding EDs. 

Download our protocol app or visit Creekshare.org to download copies of these protocols and the patient handout brochures that go along with them. ———————— 

General PIR: 

Purpose 

What kinds of patients can be referred 

Who cannot be 

Why a consult is required 


Prehospital discharge instructions 

COVID-19 non-transport

 Purpose 

Criteria 

Process 

Handout 

Scripting 

Recommendations for testing/treatment at home/etc. 

Freestanding ED 

What they are 

What they have 

What kinds of patients should go there 

What kinds of patients should not

Jul 04, 202018:21
Field Staff Thoughts on the ESD Meeting

Field Staff Thoughts on the ESD Meeting

Following the ESD 11 meeting on June 9th, ICPs Chris Conn and Megan Spearman sit down with UO Steven Beesley to articulate their thoughts. These field staff providers share their perspective about the latest development in the CCEMS/ESD relationship. This format is being tested for bringing information to the field staff…please let us know what you think!

One note about recent "news"; be mindful that CCEMS is your best source of information. While you may find opinions and statements elsewhere online, sensationalism and propaganda is widespread. Please allow us the chance to provide information before spreading something that you "heard". We are so thankful for your loyalty to CCEMS and in turn, we are committed to keeping you informed.

Stay tuned for a question and answer session with Wren Nealy releasing next week on the CCEMS podcast!

Jun 10, 202014:10
Dr. Ely Discusses Airways

Dr. Ely Discusses Airways

In this episode, we discuss airways with Dr. Rachel Ely, who is doing a rotation with CCEMS as an Assistant Medical Director as part of the military's EMS and Disaster Medicine Fellowship based at Brooke Army Medical Center in San Antonio. Dr. Ely has a background in EMS and actively worked as a paramedic for a few years before and during medical school. Passionate about all things "airway", Dr. Ely outlines some of her "must-dos" for a successful advanced airway while providing insight from her years of experience.

Before the call:

  • Visualization and mental rehearsal
  • Physical rehearsal: have a plan, and a backup, and a backup, and practice all of them
  • Location of equipment is key

Airway preparation

During the call:

  • Pre-oxygenate early. Once you decide they need an advanced airway, give all the oxygen.
  • Resuscitate before you intubate, Laryngoscope as a Murder Weapon (Scott Weingart)
  • Hypotension
  • O2/Hypoxemia
  • pH/acidosis.  The apneic period can be deadly in certain patients. Recognizing this is trickier in EMS because you don’t have all the data (like blood gases).  Fear this in the DKA patient, the septic shock patient, any metabolic acidosis
  • Position the patient: it is worth your time to try do this right.
  • The donut works, sometimes towels/pillows are needed, but just having a FF lift the head off of the floor will give you a 100% better view.
  • Head off stretcher works for some, but may actually make things worse as the angle of oropharynx to glottis becomes more steep (glottis more anterior).
  • Neck flexed, head extended gives optimal alignment
Jun 06, 202023:44
What’s the deal with nebulizers?

What’s the deal with nebulizers?


In this episode, Steven Beesley, Christy Stermer, Alex Moore, and Samuel Kordik sat down to discuss aerosol-generating procedures, PPE requirements, and how to find answers to your questions during COVID-19.

If you have questions, needs, or just would like someone to talk to, here's a list you can start with. Everyone on here cares deeply about you and would be happy to help:

Samuel Kordik

Elizabeth Breaux

Casey Pile

Zach Dunlap

Lynne Singleton

Ryan Jones

References:

K., T., K., C., M., S., C., P.-S., & J., C. (2011). Aerosol generating procedures (AGP) and risk of transmission of acute respiratory diseases (ARD): A systematic review. BMC Proceedings.

Heinzerling, A., Stuckey, M. J., Scheuer, T., Xu, K., Perkins, K. M., Resseger, H., Magill, S., Verani, J. R., Jain, S., Acosta, M., & Epson, E. (2020). Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient - Solano County, California, February 2020. MMWR. Morbidity and Mortality Weekly Report69(15), 472–476. https://doi.org/10.15585/mmwr.mm6915e5

Loeb, M., McGeer, A., Henry, B., Ofner, M., Rose, D., Hlywka, T., … Walter, S. D. (2004). SARS among Critical Care Nurses, Toronto. Emerging Infectious Diseases10(2), 251–255. https://doi.org/10.3201/eid1002.030838

Orman, R., & Weingart, S. (2020). COVID-19: Weingart Q & A on Airway, Vents, Tubes, Lungs, ECMO, and CPAP. Retrieved from https://ercast.libsyn.com/covid-19-weingart-q-a-on-airway-vents-tubes-lungs-ecmo-and-cpap

Raboud, J., Shigayeva, A., McGeer, A., Bontovics, E., Chapman, M., Gravel, D., … Green, K. (2010). Risk factors for SARS transmission from patients requiring intubation: A multicentre investigation in Toronto, Canada. PLoS ONE5(5). https://doi.org/10.1371/journal.pone.0010717

Teleman, M. D., Boudville, I. C., Heng, B. H., Zhu, D., & Leo, Y. S. (2004). Factors associated with transmission of severe acute respiratory syndrome among health-care workers in Singapore. Epidemiology and Infection132(5), 797–803. https://doi.org/10.1017/S0950268804002766

Links to Help with mental stress

https://pca.st/nini28vt The Boiling Point of Stress - Stimulus (FOAM education)

https://medicmindset.com/2019/11/28/antifragile/ Antifragile - Medic Mindset

https://www.artofmanliness.com/articles/beyond-sissy-resilience-on-becoming-antifragile/ Blog post explaining the antifragile concept.

https://disasterassets.org/events/ Zoom meetings (Healthcare workers - free)

May 27, 202015:54
Questions and Answers Session 2

Questions and Answers Session 2

In this episode, we answer questions submitted from field staff. Discussion of PTO, assigned roles at Admin, self-monitoring, quarantine criteria and COVID-19 documentation are all addressed...and a few more. If you have questions for the administrative staff during the response to COVID-19, submit a question on creekshare.org. Stay safe!

May 19, 202011:14
Mental Health in EMS providers
May 01, 202038:50
COVID Transmission and Masks

COVID Transmission and Masks

SHOW NOTES
There's a lot of confusion around how masks protect you from getting COVID-19, how the virus is transmitted, and what PPE to wear when. We break down transmission mechanisms and how masks and PPE work in this episode.
Links:
Twitter thread about SARS-CoV-2 Transmission
They Say Coronavirus Isn't Airborne—but It's Definitely Borne by Air (Wired)
Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19 (JAMA Insights) (great videos and photos of gas clouds from sneezes, breathing, coughs, etc)
How Diseases and Epidemics Move Through a Breath of Air (TED talk)
Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review
Videos showing Droplet Spread using Glo-Germ
Apr 18, 202042:47
Meet Dr. Ely

Meet Dr. Ely

In this episode, we sit down with Dr. Rachel Ely, who is a United States Air Force Emergency Medicine physician. Dr. Ely is doing a rotation with CCEMS as an assistant medical director as part of the military's EMS and Disaster Medicine fellowship based at Brooke Army Medical Center in San Antonio. Dr. Ely became an EMT and then a paramedic before going on to medical school and residency. We discuss her background in EMS, why she went to medical school, what medical school and residency was like, as well as glean some valuable insights into critical thinking, "paramagic", airway management, and a few pearls on COVID-19.

Apr 14, 202031:09
ATH Stay at Home Fitness and Nutrition Tips
Apr 09, 202019:09
Combating Misinformation Part 2
Apr 08, 202022:43
COVID Protocols and Clinical Treatment Conversations
Apr 07, 202039:31
CCEMS COVID 19 Podcast 6 Combating Misinformation
Apr 06, 202020:30
CCEMS COVID 19 Podcast Episode 5

CCEMS COVID 19 Podcast Episode 5

In this episode, CCEMS Operations Manager Mike Brown, Samuel Kordik and Steven Beesley discuss how the COVID-19 pandemic is impacting operations at CCEMS. We discuss possible schedule changes, how normal operational needs are continuing, and other operations details.

Apr 04, 202021:30
CCEMS COVID 19 Podcast Episode 4

CCEMS COVID 19 Podcast Episode 4

In this episode, Bobby Sellers, Lorena Sadler, Steven Beesley, and Samuel Kordik discuss how this crisis is affecting Law Enforcement and how EMS can support Law Enforcement during this crisis.

Bobby Sellers is the Special Operations Director at Cypress Creek EMS, where he leads the tactical medic program supporting local law enforcement agencies. Sellers is also a deputy with Montgomery County Precinct 3.

Mar 27, 202026:02
CCEMS COVID 19 Podcast Episode 3
Mar 26, 202034:32
Why We Are Doing All of This

Why We Are Doing All of This

Samuel Kordik discusses why the medical community as a whole is working so tirelessly through this epidemic.

Mar 25, 202006:57
Questions and Answers Session 1
Mar 23, 202015:14
CCEMS COVID 19 Podcast Episode 2
Mar 23, 202015:07
CCEMS COVID 19 Podcast Episode 1
Mar 20, 202044:49