The FlightBridgeED Podcast

In this episode of The FAST Archives, William Heuser brings his extensive experience as a clinical critical care pharmacist, clinical toxicologist, and certified Flight Paramedic to demystify the controversial world of resuscitative medicine. In his dynamic talk, "Do Any of These Medications Work in Cardiac Arrest? Demystifying the Controversies!", Will examines the debate surrounding the administration of certain medications during cardiac arrest. He discusses how these medications impact patient outcomes during resuscitation and offers a clear, evidence-based analysis of their risks and benefits. William’s unique blend of humor, energy, and knowledge makes this talk as entertaining as it is informative. Tune in to gain valuable insights into the evolving field of resuscitative medicine and explore the complexities of pharmacological interventions during cardiac arrest. Don't forget to check out the other podcasts in the FAST Archives miniseries and join us at FAST24 for more talks like this one, including a brand-new one from Will! We hope to see you there! Enjoy the episode. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Welcome back to The FAST Archives! In this episode, Ashley Liebig delivers a compelling talk, "Teaching, Trusting, and Teen Driving," where she explores the nuanced realities of learning, teaching, and belonging. Through her insights into psychological safety, cognitive learning theory, and feedback culture, Ashley opens up how the intricacies of how humans learn and interact... both the good stuff and the things we don't always have a great track record with as an industry. Maslow's hierarchy of needs emphasizes that our basic requirements must be met before we can focus on growth and learning. So grab yourself a snack and tune in to gain valuable knowledge from Ashley’s expertise, as she provides actionable advice that can enhance your approach to education and personal growth. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this compelling episode of the FlightBridgeED podcast, recorded at CCTMC24, we dive deep with Kevin Collopy, a distinguished figure in trauma care and awarded Best Research for his poster during the conference's Scientific Assembly. Kevin shares his groundbreaking work with just-in-time prehospital trauma training in Ukraine, a project that has garnered significant attention for its impact and innovation. Amidst the backdrop of conflict, Kevin, along with a dedicated team of providers and organizations, developed and delivered seven different trauma courses, (including Pre-Hospital Trauma Fundamentals, which he and his team created specifically for this area of need) tailored for Ukrainian communities. These courses aim to mitigate civilian casualties and enhance patient outcomes amid wartime conditions especially when there are a limited number of responders and providers available and civilians are helping other civilians. Throughout the podcast, Kevin unpacks the process of creating these programs, their execution, and the potential future of just-in-time training in other conflict and disaster zones. Kevin and host, Eric Bauer, also delve into a critical discussion on the undervalued importance of basic trauma skills (such as splinting, tourniquet and wound packing) which, as Kevin's research shows, play a vital role in managing war and disaster scenarios and are often overshadowed by more advanced skills. Tune in to this enlightening episode to understand the pivotal shifts in trauma training and how these lessons from the front lines can reshape our approach to emergency preparedness and response. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this episode of The FAST Archives, we explore an innovative approach to cardiac arrest treatment with Jason Bartos, a leading figure in the field of cardiology and critical care at the University of Minnesota. Jason delves into the world of extracorporeal cardiopulmonary resuscitation (ECPR), a lifesaving technique that has shown significant promise in improving survival rates among patients who do not respond to conventional ACLS. Currently, access to ECPR is limited, with only 1.68% of eligible patients receiving this treatment. Jason discusses how his team is working to expand ECPR’s availability in the Twin Cities, detailing the challenges, successes, and potential for replication of their mobile ECMO program in other regions. This talk offers valuable insights into the future of cardiac care and the possibilities of extending high-quality life-saving interventions to a broader population. Tune in to hear about the transformative efforts being made to increase ECPR access and how these advancements could serve as a blueprint for communities across the nation. If you enjoyed this talk, check out the other episodes of the FAST Archives miniseries! Thank you so much for listening. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this episode of The FAST Archives, join one of our favorite Kiwis, Rob Bryant as he takes a critical look at Ketamine, a drug that's as much a star in the medical field as it is a subject of debate. Rob, who has an extensive background in Emergency and Critical Care Medicine, explores the not-so-glamorous side of Ketamine, including its cardiovascular impacts, effects on mental health, and potential long-term damage to the bladder. Ketamine has long been a celebrated player in emergency and critical care for its versatility and effectiveness. However, like any celebrity, it has its controversies. His talk explores the evidence for and against the use of Ketamine in various settings and circumstances, challenging its pristine reputation and highlighting the importance of cautious and informed use. Whether you're a staunch supporter or a skeptic of Ketamine, this episode offers a balanced view that will enrich your understanding of one of the most talked-about drugs in medicine. Tune in to uncover the complexities of Ketamine through the expert lens of Rob Bryant. If you enjoyed this podcast, check out the other FAST Archives episodes we've recently released, and don't forget to join us at FAST24! Thank you so much for listening! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

This episode from The FAST Archives explores a rare and high-stakes medical emergency: amniotic fluid embolism (AFE). Allison Herman, a seasoned RN with seventeen years of experience across ER, ICU, and helicopter EMS, shares a remarkable case involving this critical obstetrical complication. Allison, who spent a decade flying with a hospital-based helicopter EMS program in California, has recently returned to the ER as the pediatric emergency care coordinator. Her passion for emergency medicine and high-risk obstetrics shines through as she recounts how her team tackled a challenging AFE case. During this talk, you'll learn the importance of quick thinking, teamwork, and solid training in navigating unexpected emergencies during childbirth. Alli describes the collaborative efforts that led to a positive patient outcome and provides valuable insights into managing high-risk obstetrical cases. Whether in emergency medicine, critical care, or simply interested in understanding how EMS teams handle rare and complex scenarios, this episode offers a compelling and educational experience. If you enjoy this episode, please check out the other FAST Archives episodes that we have recently released. Enjoy the episode! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Join us for an insightful episode from The FAST Archives, featuring "Stayin' Alive: Impella Device and Left Ventricular Mechanical Circulatory Support in Critical Care Transport," presented by Michael Lauria. A former USAF Pararescueman and Critical Care/Flight Paramedic, Michael is now an EMS and Critical Care Fellow at the University of New Mexico Health Science Center. He brings his extensive experience to this engaging talk on Left Ventricular Assist Devices (LVADs) and their use in critical care transport. In this episode, Michael dives into the technical aspects of LVADs, including their design, application, and relevance in transport situations. You'll learn about anatomy, physiology, pharmacology, pressure waveforms, and point-of-care ultrasound (POCUS) as they relate to these devices. Michael’s presentation is thorough and engaging, perfect for anyone in critical care or emergency transport. Whether you're already familiar with LVADs or new to the topic, this episode offers valuable insights and practical knowledge. As these devices become more common in the field, you'll want to be prepared. Tune in to expand your understanding and equip yourself for future transports involving LVADs. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this episode from The FAST Archives, we explore the powerful talk, "A Difficult Pill to Swallow: 3 Unforgivable Sins in Medicine." As pressures mount to keep emergency services running smoothly, many first responders are driven to work extra shifts and put their community's needs ahead of their own. But what happens when this "rescuer" mentality seeps into our personal lives? Kris and Sara Kaull share personal stories and discuss why it's so hard to let go of the high-intensity mindset when we're not on duty. They challenge us to think about the impact this can have on our relationships and overall well-being. As they peel back the layers, they offer insights into building meaningful connections and prioritizing self-care. Tune in to find out why maintaining balance is crucial for a healthy and fulfilling life. This episode provides a fresh perspective on stepping back from work, embracing a more balanced lifestyle, and rediscovering the things that matter most. FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this episode of The FAST Archives miniseries, we're replaying Geoff Murphy's talk from a previous FAST event, "Paramedics: The Master Multitasker... Right?" In this captivating talk, Geoff, from Master Your Medics, delves into the challenge paramedics (as well as nurses, physicians, and other medical professionals) face in multitasking, especially when they're often the most experienced provider. How well do we juggle life-saving skills while making critical decisions? And is multitasking always in the best interest of our patients? Through a personal story and insightful research, Geoff challenges our assumptions and invites us to consider the potential risks and rewards of multitasking in pre-hospital, critical care, and emergency medicine. If you're interested in learning more about Geoff Murphy and Master Your Medics, visit https://www.masteryourmedics.com, and if you're interested in joining us at FAST24 for more talks like this, visit https://flightbridgeed.com/fast24. Thanks for listening, and we hope you enjoy this episode! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Catch our latest episode with Brian Behn sharing his talk from a previous FAST event entitled, 'The Folk Science of Sepsis.' Brian explores and exposes possible gaps in the understanding of sepsis by EMS and critical care transport providers because of poor/incomplete education about it. He offers essential insights and practical advice to enhance our understanding and management of this deadly condition. Tune in to transform your approach to sepsis treatment and join us at FAST24 in Wilmington, June 10th-12th, for more talks like this one! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Welcome to the second episode of the FAST Archives mini-series! In this episode, we dive into a crucial conversation with Ginger Locke titled "Finding Feedback," where she examines the culture of feedback in EMS and Critical Care Transport. Unlike other professions, feedback in EMS usually comes only after extraordinary events. Ginger proposes a shift towards a continuous feedback loop that fosters growth and learning from every call/situation, not just the emergencies. This talk is a must-listen for anyone in EMS looking to build a more supportive and effective work environment. Join us as we explore practical steps to make feedback a regular part of our daily practice, enhancing personal and team performance. Please subscribe to The FlightBridgeED Podcast anywhere you listen to podcasts, and don't forget to pass on the knowledge! Share the podcast with friends and co-workers. We couldn't make this podcast without you! Thank you so much for listening! Enjoy the episode. ** Special thanks to Mark Mennie, our wonderful and talented photographer at FAST for the last couple of years! SHOW NOTES More information about Finding Feedback at the Medic Mindset website: https://medicmindset.com/2022/02/08/finding-feedback-uwash-great-rounds-notes/ FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Welcome to the FlightBridgeED Podcast! We're kicking off this special mini-series, "The FAST Archives," replaying some of our favorite talks from past FAST conferences. These moments made us laugh, think twice, and gave us the tools to be better providers. First up: Pediatric patients on ventilators... it's a high-stakes game where small changes mean everything. In this essential talk, "Silent Killers in Pediatric Mechanical Ventilation", our very own Eric Bauer takes center stage breaking down the pitfalls to avoid and the strategies that will level up your vent skills for the littlest patients. Please subscribe to The FlightBridgeED Podcast anywhere you listen to podcasts, and don't forget to pass on the knowledge! Share the podcast with friends and co-workers. We couldn't make this podcast without you! Thank you so much for listening! Enjoy the episode. ** Special thanks to Mark Mennie, our wonderful and talented photographer at FAST for the last couple of years! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this gripping episode of "Mind Over Medicine," we dive deep into the critical, often unseen world of cognitive bias in emergency medicine. With the clock ticking and lives in the balance, emergency room professionals make split-second decisions that can mean the difference between life and death. But what happens when the human mind's inherent biases seep into these critical judgments? Join Ashley as she explores the various forms of cognitive bias - from anchoring bias to confirmation bias - that challenge medical professionals in high-stakes environments. "Mind Over Medicine: Navigating Cognitive Bias in Emergency Medicine" is a must-listen for anyone wanting to refine their decision-making processes and examine the complexities of human cognition under pressure. Tune in to uncover the unseen challenges of emergency medicine and the strides being made toward safer, more effective patient care. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 12 years! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Mechanical Ventilation and ARDS – Podcast Summary and References This is the sixth of a special podcast series on obstetric critical care. I am joined on this series by Dr. Elizabeth Garchar, MD, FACOG. She is an OB/GYN and Maternal Fetal Medicine (MFM) specialist who has a particular interest in obstetric critical care. She is also unique in that she flies regularly with our critical care transport teams as a retrieval OBGYN/MFM and is one of our Assistant Medical Directors for the flight program. The topic of this podcast is Mechanical Ventilation and ARDS in pregnancy. Although respiratory distress requiring intubation and ARDS in pregnancy is not very common, it is more common than some of the other pathologies we have discussed recently. Mechanical ventilation of the pregnant patient can be intimidating, but rest assured that if you have the capabilities to manage other patients on a vent, you can manage the pregnant patient. Generally speaking solid outcomes data is sparse and, generally speaking, most guidelines recommend vent management of mechanical ventilation in patients with or without ARDS similarly to non-pregnant patients…with a few exceptions. This podcast reviews the basics of ARDS and evidence-based management. It reviews some specific features of obstetric physiology and fetal gas exchange that are important to keep in mind. Finally, we will review what guidance is available and review general recommendations for managing these patients in transport. For additional learning and a more in-depth review of the evidence check out this talk on gas exchange and mechanical ventilation in critically ill patients by Dr. Allison Lankford (part of the amazing Maryland CC Project lecture series): http://maryland.ccproject.com/2023/05/30/lankford-gas-exchange-and-pulmonary-ventilation-in-the-critically-ill-obstetric-patient/ References 1. Abou-Arab O, Huette P, Debouvries F, Dupont H, Jounieaux V, Mahjoub Y. Inhaled nitric oxide for critically ill Covid-19 patients: a prospective study. Crit Care. Nov 12 2020;24(1):645. doi:10.1186/s13054-020-03371-x 2. Barrantes JH, Ortoleva J, O'Neil ER, et al. Successful Treatment of Pregnant and Postpartum Women With Severe COVID-19 Associated Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation. Asaio j. Feb 1 2021;67(2):132-136. doi:10.1097/mat.0000000000001357 3. Bhatia PK, Biyani G, Mohammed S, Sethi P, Bihani P. Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature. J Anaesthesiol Clin Pharmacol. Oct-Dec 2016;32(4):431-439. doi:10.4103/0970-9185.194779 4. Boelig RC, Saccone G, Bellussi F, Berghella V. MFM guidance for COVID-19. Am J Obstet Gynecol MFM. May 2020;2(2):100106. doi:10.1016/j.ajogmf.2020.100106 5. Campbell LA, Klocke RA. Implications for the pregnant patient. Am J Respir Crit Care Med. Apr 2001;163(5):1051-4. doi:10.1164/ajrccm.163.5.16353 6. Carter AM. Factors affecting gas transfer across the placenta and the oxygen supply to the fetus. J Dev Physiol. Dec 1989;12(6):305-22. 7. Carter AM. Placental Gas Exchange and the Oxygen Supply to the Fetus. Compr Physiol. Jul 1 2015;5(3):1381-403. doi:10.1002/cphy.c140073 8. Cavalcante FML, Fernandes CDS, Rocha LDS, Galindo-Neto NM, Caetano J, Barros LM. Use of the prone position in pregnant women with COVID-19 or other health conditions. Rev Lat Am Enfermagem. 2021;29:e3494. doi:10.1590/1518-8345.5181.3494 9. Cojocaru L, Turan OM, Levine A, et al. Proning modus operandi in pregnancies complicated by acute respiratory distress syndrome secondary to COVID-19. J Matern Fetal Neonatal Med. Dec 2022;35(25):9043-9052. doi:10.1080/14767058.2021.2013464 10. Cole DE, Taylor TL, McCullough DM, Shoff CT, Derdak S. Acute respiratory distress syndrome in pregnancy. Crit Care Med. Oct 2005;33(10 Suppl):S269-78. doi:10.1097/01.ccm.0000182478.14181.da 11. D'Souza R, Ashraf R, Rowe H, et al. Pregnancy and COVID-19: pharmacologic considerations....

In this episode, we uncover the enigmatic world of refractory shock in prehospital trauma patients. Shock, often recognized as a critical condition, becomes even more complex when it resists conventional treatment. Join Eric as he discusses resuscitation in vasoplegic patients refractory to fluids and blood products. Tune in to "Hidden Harms" and embark on a journey to unveil the complexities of refractory shock in prehospital trauma patients. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 12 years! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

In this episode, we delve into the complexities surrounding a challenging COPD patient scenario, focusing on treatment considerations and the broader scope of mechanical ventilation management. We underscore essential lessons gleaned from this case, emphasizing the significance of adopting an obstructive approach, the nuanced application of I:E ratio, and the comprehensive management strategies for hypercapnic patients. Join us as we navigate through this intricate medical terrain, shedding light on effective approaches and valuable insights crucial for optimizing patient care in similar scenarios. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 12 years! FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

This is the fifth of a special podcast series on obstetric critical care. I am joined on this series by Dr. Elizabeth Garchar, MD, FACOG. She is an OB/GYN and Maternal Fetal Medicine (MFM) specialist who has a particular interest in obstetric critical care. She is also unique in that she flies regularly with our critical care transport teams as a retrieval OBGYN/MFM and acts as one of our Assistant Medical Directors for the flight program. The topic of this podcast is Amniotic Fluid Embolism (AFE). Another rare, but devastating disease that can often progress rapidly to cardiac arrest. In this podcast, we go through the epidemiology and definition/diagnosis of the disease. We also go into depth on underlying pathophysiology and the current hypotheses on what causes AFE. Spoiler alert: it’s not as simple as an embolism of amniotic fluid. Then we review the management, specifically focusing on the management of acute right heart failure in the setting of abrupt and pronounced pulmonary hypertension. Finally, Dr. Garchar and I deliver some spaced repetition and go over the management of maternal cardiac arrest, in the likely event that AFE progresses to that point. References 1. Abenhaim HA, Azoulay L, Kramer MS, Leduc L. Incidence and risk factors of amniotic fluid embolisms: a population-based study on 3 million births in the United States. Am J Obstet Gynecol. Jul 2008;199(1):49 e1-8. doi:10.1016/j.ajog.2007.11.061 2. Aissi James S, Klein T, Lebreton G, et al. Amniotic fluid embolism rescued by venoarterial extracorporeal membrane oxygenation. Crit Care. Apr 7 2022;26(1):96. doi:10.1186/s13054-022-03969-3 3. Clark SL, Montz FJ, Phelan JP. Hemodynamic alterations associated with amniotic fluid embolism: a reappraisal. Am J Obstet Gynecol. Mar 1 1985;151(5):617-21. doi:10.1016/0002-9378(85)90150-4 4. Clark SL, Romero R, Dildy GA, et al. Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies. Am J Obstet Gynecol. Oct 2016;215(4):408-12. doi:10.1016/j.ajog.2016.06.037 5. Conde-Agudelo A, Romero R. Amniotic fluid embolism: an evidence-based review. Am J Obstet Gynecol. Nov 2009;201(5):445 e1-13. doi:10.1016/j.ajog.2009.04.052 6. Creel-Bulos C, Hassani B, Stentz MJ, et al. Extracorporeal Membrane Oxygenation for Amniotic Fluid Embolism-Induced Cardiac Arrest in the First Trimester of Pregnancy: A Case Report. Crit Care Explor. Jul 2020;2(7):e0162. doi:10.1097/CCE.0000000000000162 7. Crissman HP, Loder C, Pancaro C, Bell J. Case report of amniotic fluid embolism coagulopathy following abortion; use of viscoelastic point-of-care analysis. BMC Pregnancy Childbirth. Jan 3 2020;20(1):9. doi:10.1186/s12884-019-2680-1 8. Durgam S, Sharma M, Dadhwal R, Vakil A, Surani S. The Role of Extra Corporeal Membrane Oxygenation in Amniotic Fluid Embolism: A Case Report and Literature Review. Cureus. Feb 26 2021;13(2):e13566. doi:10.7759/cureus.13566 9. Foley MR ST, Garite TJ. Obstetric Intensive Care Manual. 5th ed. McGraw-Hill Education; 2014. 10. Huybrechts W, Jorens PG, Jacquemyn Y, Colpaert C, Vrints C, Conraads V. Amniotic fluid embolism: a rare cause of acute left-sided heart failure. Acta Cardiol. Dec 2006;61(6):643-9. doi:10.2143/AC.61.6.2017964 11. James CF, Feinglass NG, Menke DM, Grinton SF, Papadimos TJ. Massive amniotic fluid embolism: diagnosis aided by emergency transesophageal echocardiography. Int J Obstet Anesth. Oct 2004;13(4):279-83. doi:10.1016/j.ijoa.2004.03.008 12. Lao TT. Acute respiratory distress and amniotic fluid embolism in pregnancy. Best Pract Res Clin Obstet Gynaecol. Dec 2022;85(Pt A):83-95. doi:10.1016/j.bpobgyn.2022.06.004 13. Lockwood CJ, Bach R, Guha A, Zhou XD, Miller WA, Nemerson Y. Amniotic fluid contains tissue factor, a potent initiator of coagulation. Am J Obstet Gynecol. Nov 1991;165(5 Pt 1):1335-41. doi:10.1016/0002-9378(91)90363-v 14. McDonnell NJ, Chan BO, Frengley RW. Rapid reversal of critical haemodynamic compromise with nitric oxide in a...

Disseminated Intravascular Coagulation This is the fourth of a special podcast series on obstetric critical care. I am joined on this series by Dr. Elizabeth Garchar, MD, FACOG. She is an OB/GYN and Maternal Fetal Medicine (MFM) specialist who has a particular interest in obstetric critical care. She is also unique in that she flies regularly with our critical care transport teams and acts as one of our Assistant Medical Directors for the flight program. So, Dr. Garchar has unique insight into managing this population in transport. The topic of this podcast is Disseminated Intravascular Coagulation (DIC) in the pregnant patient. Although very rare, this disease carries a high morbidity and mortality. The key features are the disease are diffuse and dysregulated coagulation that causes consumption of clotting factors (resulting in a paradoxical coagulopathic state), widespread endothelial damage, and is essentially always the result of some other disease process. In this podcast we go over how critical care transport crews can recognize DIC and identify the underlying process causing it. In addition, Dr. Garchar and I review the management in the transport environment and pearls regarding treating coagulopathy. In the podcast we give a shout out to a phenomenal OB Critical Care course that is put on by Banner University Medical Center and the Society for Maternal Fetal Medicine. Unfortunately, it’s a little late to sign up for this year’s session (November 2023), but put it on your radar for next year! Here is a link to the brochure and conference content to give you an idea. There is also a healthy component of simulation education. I have no conflict of interest with this course at all…it’s just a phenomenal educational opportunity. https://s3.amazonaws.com/cdn.smfm.org/media/1807/Brochure-Banner(FINAL).pdf References 1. Erez O. Disseminated intravascular coagulation in pregnancy: New insights. Thrombosis Update. 2022;6doi:10.1016/j.tru.2021.100083 2. Erez O, Novack L, Beer-Weisel R, et al. DIC score in pregnant women--a population based modification of the International Society on Thrombosis and Hemostasis score. PLoS One. 2014;9(4):e93240. doi:10.1371/journal.pone.0093240 3. Erez O, Othman M, Rabinovich A, Leron E, Gotsch F, Thachil J. DIC in Pregnancy - Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments. J Blood Med. 2022;13:21-44. doi:10.2147/JBM.S273047 4. Foley MR, Strong TH, Garite TJ. Obstetric Intensive Care Manual. 5th ed. McGraw-Hill Education; 2014. 5. Gando S, Nanzaki S, Sasaki S, Kemmotsu O. Significant correlations between tissue factor and thrombin markers in trauma and septic patients with disseminated intravascular coagulation. Thromb Haemost. Jun 1998;79(6):1111-5. 6. Kadikar SK, Divan FJ, Topiwala U, Agasiwala S. Study of pregnancy with disseminated intravascular coagulation. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2021;10(11)doi:10.18203/2320-1770.ijrcog20214335 7. Krikun G, Huang ST, Schatz F, Salafia C, Stocco C, Lockwood CJ. Thrombin activation of endometrial endothelial cells: a possible role in intrauterine growth restriction. Thromb Haemost. Feb 2007;97(2):245-53. 8. Levi M, Scully M. How I treat disseminated intravascular coagulation. Blood. Feb 22 2018;131(8):845-854. doi:10.1182/blood-2017-10-804096 9. Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation. British Committee for Standards in Haematology. Br J Haematol. Apr 2009;145(1):24-33. doi:10.1111/j.1365-2141.2009.07600.x 10. Papageorgiou C, Jourdi G, Adjambri E, et al. Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies. Clin Appl Thromb Hemost. Dec 2018;24(9_suppl):8S-28S. doi:10.1177/1076029618806424 11. Rabinovich A, Abdul-Kadir R, Thachil J, Iba T, Othman M, Erez O. DIC in obstetrics: Diagnostic score, highlights in...

Join Eric and Will Heuser, PharmD, discussing "The Influence of Low pH on Efficacy of Critical Care Pharmacology." Changes in acid-base balance have a profound influence on many aspects of the action of drugs. This is illustrated by data on the absorption of drugs from the stomach and intestine, changes in the distribution of drugs between plasma and cells, and the effect of changes in pH. Join us as Will breaks down the pathophysiology and decision-making in these low pH states. When do we deploy sodium bicarbonate? Is there a trade-off? How is pharmacology affected by low pH states? This episode is a can't-miss, with the brilliant Will Heuser, PharmD, BCCCP, MS, EMT-P, FP-C. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 11 years! Contact Info: Will Heuser, PharmD, BCCCP, MS, EMT-P, FP-C wheuser@northwell.edu FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.

Since the 2012 Berlin Definition of the Acute Respiratory Distress Syndrome (ARDS), several developments have supported the need for an expansion of the definition, including the use of high-flow nasal oxygen (HFNO), expanding the use of pulse oximetry in place of arterial blood gases, use of ultrasound for chest imaging, and the need for applicability in resource-limited settings. Join Eric as he dives into the previous ARDS definitions, the pathophysiology around "PseudoARDS," and the new global definition. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 11 years! New Global Definition for Acute Respiratory Distress Syndrome FAST24 | June 10 - 12, 2024 | Wilmington, North Carolina FAST24 is our annual conference for pre-hospital and critical care transport professionals, including nurses, paramedics, and other disciplines. It features engaging workshops, talks by industry leaders, and focused sessions on air and surface critical care transport medicine. The event also offers a unique vendor experience, special guest appearances from notable talent in the industry, catered lunches, as well as relaxing and entertaining networking and social opportunities. Tickets are limited so don’t wait! Visit https://fastsymposium.com for more information.