Episode 137 - Endocarditis: A Change of Heart

In this podcast episode, we dive into the clinical chaos of Infective Endocarditis. It's a disease that can quietly destroy valves before showing its hand. We discuss how it presents, why it matters in transport and critical care environments, and how it can spiral into life-threatening complications like Cardiogenic Shock. Along the way, we touch on early antibiotic considerations and talk through hemodynamic support strategies such as push-dose Epinephrine when things start to fall apart. As always, the goal is connecting physiology to practical decision-making for clinicians who manage sick patients in dynamic environments. Get CE hours for our podcast episodes HERE! -------------------------------------------- X @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Airway management gets dangerous. In this episode of the podcast, we explore prehospital bronchoscopy—a true bleeding-edge concept—and where it fits in managing airway obstruction before the hospital. We talk mucous plugs, massive hemoptysis, refractory hypoxia, how to address obstructions you can't fix with pressure or bronchodilators, and what to do when bronchoscopy is likely unavailable. This isn't about chasing new tools—it's about physiology, pattern recognition, and knowing when innovation may help. When it comes to considering prehospital bronchoscopy in your system, ask yourself the following: Is this something we need? Can we do the training to support it? Get CE hours for our podcast episodes HERE! -------------------------------------------- X @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, clean decision-making, and an approach that works whether you're in the back of a helicopter, a tight ambulance box, or a chaotic ED bay. We walk through the foundational concepts and the "why" behind each knob you touch. Then we zoom in on the Hamilton T1, the vent many of us love, hate, and still rely on every single shift. We cover what the T1 gets right, where people get tripped up, and how to let the machine work with you instead of against you. If you've ever wished mechanical ventilation felt less like memorizing settings and more like understanding physiology in motion, this episode will tighten up your practice and give you tools you can use on your very next flight or transport. Get CE hours for our podcast episodes HERE! -------------------------------------------- X @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, clean decision-making, and an approach that works whether you're in the back of a helicopter, a tight ambulance box, or a chaotic ED bay. We walk through the foundational concepts and the "why" behind each knob you touch. Then we zoom in on the Hamilton T1, the vent many of us love, hate, and still rely on every single shift. We cover what the T1 gets right, where people get tripped up, and how to let the machine work with you instead of against you. If you've ever wished mechanical ventilation felt less like memorizing settings and more like understanding physiology in motion, this episode will tighten up your practice and give you tools you can use on your very next flight or transport. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Tracheostomies are increasingly common in both prehospital and critical care transport settings, but they come with unique challenges. In this podcast episode, we break down short-term and long-term complications you may encounter, and how to troubleshoot them in high-stakes environments. From occlusions and dislodgements to bleeding, we'll cover practical strategies to keep these vulnerable patients safe. Whether you're new to airway management or a seasoned clinician, this discussion will sharpen your approach to one of the most intimidating airways you'll encounter. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

What happens when resources are limited, transport is delayed, or you're forced to manage a critically ill patient far beyond the typical flight window? In this podcast episode, Dr. Tim Hurtado and Brett Weiner help us dive into the challenges and realities of prolonged field care in air medical transport. We'll explore clinical considerations, crew dynamics, and decision-making strategies that can help you maintain high-quality care when time isn't on your side. We're also excited to announce our new in-person course. This immersive training opportunity is designed to push you beyond the textbook and prepare you for the complexities of prolonged care in austere or transport environments. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Tranexamic Acid (TXA) is a lot like hot sauce: People put it on everything — especially for apparent or suspected acute blood loss. In this podcast episode, we dive into a drug that's been both praised and questioned in trauma and prehospital care. We break down what TXA is, how it works, and the evidence behind its use. From CRASH-2 to CRASH-3, we explore the key studies, the controversies, and the real-world implications. Whether you're administering TXA in the back of a rig or evaluating its role in your protocols, this episode helps you make sense of when, why, and how TXA might—or might not—stop the bleeding. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Though evidence dictates much of what we do as emergency medical providers, some areas remain open to debate: How are we justifying stroke ambulances, CCT speciality teams, AHA guidelines, and our choice of crystalloids? How are we justifying what professionals are allowed to post on social media? And do we agree with the currently accepted norms? Who better to join us in this discussion than Mike Carunchio of The World's Okayest Medic Podcast. Diving into these and other controversial topics, we see if our two platforms can come to a consensus in a randomized, uncontrolled conversation. *Strong opinions were involved in this production. If something challenges your perspective, good—that's the point. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

Wet or dry. Air in or out. Reactive or obstructive. The possibilities may seem endless when treating the pediatric patient with undifferentiated respiratory distress. It is confounded by the fact that pediatrics are outside the comfort zone of many novice critical care transport providers. In this podcast episode, neonatal/pediatric specialist Nate Brown eases your worries with concise and effective means of diagnostics and intervention. Primarily, we cover croup, bronchiolitis, and asthma disease processes. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com

'Tis the season for trauma. (If there truly is a season.) Chest trauma, specifically, can vary in subtlety and severity, primarily due to the presence of multiple vital organs and vessels. In this podcast, we discuss these potentials while focusing on those injuries that are associated with the highest mortality rate. We also discuss why you should think twice before intervening. Get CE hours for our podcast episodes HERE! -------------------------------------------- Twitter @heavyhelmet Facebook @heavyliesthehelmet Instagram @heavyliesthehelmet Website heavyliesthehelmet.com Email [email protected] Disclaimer: Heavy Lies the Helmet's content is for educational purposes only and does not constitute medical advice. Always follow local guidelines and consult qualified professionals before applying any information. The hosts and guests are not responsible for errors, omissions, or outcomes. Views expressed are their own and do not reflect their employers or affiliates. --------------------------------------------  Crystals VIP by From The Dust | https://soundcloud.com/ftdmusic Music promoted by https://www.free-stock-music.com