Ep. 158: Special Episode - Prehospital Care for Patients with Opioid Use Disorder

Are you ready for NAEMSP?! In this special edition of the Prehospital Emergency Care podcast, host Greg Muller is joined by Guest Editor Remle Crowe to discuss the journal's latest special issue: "Enhancing Prehospital Care for Patients with Opioid Use Disorder". This episode goes beyond the statistics to explore the deeply human experiences behind the data. The episode features in-depth conversations with leading researchers on the front lines of the crisis: • Bringing Treatment to the Streets: Dr. Andrew Godfrey and Advanced Practice Paramedic Vicki Coles discuss the implementation of a prehospital buprenorphine program in Wake County, North Carolina, sharing lessons on clinician education and the vital role of "buprenorphine champions" in bridging the gap to long-term recovery. • The Pediatric Perspective: Drs. Stephen Sandelich and Garrett Cavaliere reveal surprising findings on how the opioid epidemic affects children and adolescents, discussing how the crisis transcends socioeconomic boundaries and why EMS must shift its approach to screening younger patients. • Innovative Strategies: A preview of the issue's 30 peer-reviewed articles, covering topics from drone-delivered naloxone and natural language processing to the qualitative lived experiences of clinicians facing burnout.   This episode serves as a vital primer for EMS professionals, policymakers, and researchers looking to move from traditional response models toward sustainable, patient-centered pathways for care.   Access the full special edition here: https://www.tandfonline.com/toc/ipec20/29/   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

Happy Turkey Day! Join host Dr. Phil Moy as we dive straight into a topic that has "stirred up more conversation than a potluck dinner at an EMS station": the prehospital management of spinal injuries. We are here to highlight the critical manuscript "Prehospital Management of Spinal Cord Injuries, an NAEMSP Comprehensive Review and Analysis of the Literature", a pivotal document within the Prehospital Trauma Compendium. To discuss this hot topic, Dr. Moy welcomes two very special guests. First, we have Dr. John Gallagher, an emergency and EMS physician from Kona, Hawaii, and one of the authors of this comprehensive review. Second, we are thrilled to welcome Dr. Ken Milne, recognized as the podcaster from The Skeptic's Guide to Emergency Medicine. Our goal is to provide an objective discussion about the pros and cons of this manuscript so that you, our EMS clinicians and NAEMSP audience, can make your own informed decisions based on the facts. Featured Article: Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries – A NAEMSP Comprehensive Review and Analysis of the Literature: https://www.tandfonline.com/doi/full/10.1080/10903127.2025.2541258 Link to The Skeptic's Guide to EM review of this paper: SGEM#493: You Can't Hold Me Down with Spinal Motion Restrictions: https://thesgem.com/2025/11/sgem493-you-cant-hold-me-down-with-spinal-motion-restrictions/ As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

  Is Air EMS Overutilized for Kids? Tune in to the latest PEC Podcast! Editors Maia Dorsett and Joelle Denofrio-Odmann sit down with authors Dr. Vishal Naik and Dr. Sriram Ramgopal to unpack their compelling research, "Rapid Discharge Following Air Transport in Children". This multicenter study, published in Prehospital Emergency Care, reveals that more than two-thirds (66.0%) of children transported to the Emergency Department (ED) by air EMS are either discharged directly from the ED (20.0%) or within 48 hours of admission. While air transport is crucial for critically ill children, these findings emphasize the need for additional research into the decision-making processes surrounding pediatric air EMS to support optimal resource utilization and patient care. Dr. Naik and Dr. Ramgopal discuss key factors associated with rapid discharge, including lower triage acuity and certain diagnoses like musculoskeletal and connective tissue diseases. Discover what this high rate of rapid discharge implies for potential over-triage in pediatric air medical transport systems. Read the full article here: https://www.tandfonline.com/doi/full/10.1080/10903127.2025.2531074?src=#abstract.   Featured Article Naik, V., Bhardwaj, P., & Ramgopal, S. (2025). Rapid Discharge Following Air Transport in Children. Prehospital Emergency Care, 1–8. https://doi.org/10.1080/10903127.2025.2531074 🔗 Read the article: https://www.tandfonline.com/doi/full/10.1080/10903127.2025.2531074?src=#abstract.   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

  Welcome to the Prehospital Emergency Care Journal Podcast! In this PEC Podcast Deep Dive, Rebecca Cash and Maia Dorsett interview Dr. Tony Fernandez about his recent PEC paper comparing initial prehospital adenosine doses of 6 mg versus 12 mg for presumed SVT. We explore the study's origins, dataset design, and results—including the finding that starting with 12 mg was associated with higher rates of cardioversion and fewer redoses without an increase in complications. Along the way, we discuss the quirks of EMS data, why some "standard" practices exist without strong evidence, and how retrospective studies fit into the bigger picture of protocol change. For those whose interest in study methods was piqued, here's a great short primer on odds ratios versus relative risk: https://www.youtube.com/watch?v=dWtzaKYFg00&t=175s Featured Article Fernandez, A. R., Bourn, S. S., Duncan, D., Slovis, C. M., Crowe, R. P., Treichel, A., & Myers, J. B. (2025). Comparing Prehospital Adenosine Initial Dosing of 6 mg Versus 12 mg for Presumed Paroxysmal Supraventricular Tachycardia (PSVT). Prehospital Emergency Care, 1–6. https://doi.org/10.1080/10903127.2025.2504521 🔗 Read the article: https://www.tandfonline.com/doi/abs/10.1080/10903127.2025.2504521   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

  Welcome to the Prehospital Emergency Care Journal Podcast! Today, we're tackling a critical and often deadly emergency seen at mass gatherings like music festivals: psychostimulant-induced hyperthermia (PIH). This condition carries high mortality rates, but what if early, aggressive intervention could dramatically improve outcomes? Join us as we discuss the paper, "Physician Directed Prehospital Treatment in Psychostimulant Induced Hyperthermia: A Case Series," with one of its lead authors, Dr. Dorothy Habrat. Dr. Habrat will share insights into their physician-directed prehospital guideline, which integrates on-scene sedation, intubation, and rapid ice-water submersion for severe hyperthermia patients at electronic dance music festivals in San Bernardino County, California. Discover how this innovative guideline, incorporating ice-water immersion before transport, offers a significant potential to decrease the mortality risk of PIH in the prehospital setting and achieve neurologically intact survival. Featured Article Habrat, D. A., Dukes, W. S., Neeki, M. M., & Schlesinger, S. A. (2025). Physician Directed Prehospital Treatment in Psychostimulant Induced Hyperthermia: A Case Series. Prehospital Emergency Care, 1–9. https://doi.org/10.1080/10903127.2025.2508788 🔗 Read the article: https://www.tandfonline.com/doi/full/10.1080/10903127.2025.2508788   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

How well do EMS teams manage critically ill pediatric patients—and how do we know? In this special crossover episode with the EMS Educator Podcast, hosts Rob Lawrence and Maia Dorsett speak with Mark Cicero, lead author of a landmark study published in Prehospital Emergency Care. The study used simulation to assess EMS performance in pediatric emergencies. From medication dosing errors to missed fundamentals like cap refill checks, Dr. Cicero breaks down what the study revealed across more than 150 simulations in three states. Dr. Dorsett shares how the findings challenged her own assumptions as an educator and led to reflections on curriculum design, quality improvement, and the need for deliberate, high-frequency pediatric practice. Featured Article Quality of Care and Opportunities for Improvement in Prehospital Care of Critically Ill Pediatric Patients, An Observational, Simulation-Based Study 🔗 Read the article: https://www.tandfonline.com/doi/full/10.1080/10903127.2025.2500715 Special Thanks to Prodigy EMS: https://www.prodigyems.com/ems-educator   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

  In this episode, we are joined by Dr. Amelia Breyre, the lead author of Multidisciplinary Lessons from Palliative Extubations at Home, to discuss the complexities and collaborative efforts involved in facilitating palliative extubations at home. Dr. Breyre shares insights from two remarkable cases, highlighting how multidisciplinary coordination between critical care, palliative care, EMS, and hospice teams made it possible for patients to return home for end-of-life care. This conversation offers important lessons for EMS clinicians and physicians committed to improving patient-centered care at the end of life. Featured Article Breyre, A. M., Grammatico, M., Policastro, A., Ingram, C. J., Prsic, E., Sussman, L. S., & Couturier, K. (2024). Multidisciplinary Lessons from Palliative Extubations at Home. *Prehospital Emergency Care*, 1-4. 🔗 Read the article: https://www.tandfonline.com/doi/abs/10.1080/10903127.2024.2420198 Resources EMS Care of Adult Hospice Patients – A Position Statement and Resource Document of NAEMSP and AAHPM 🔗 Access the document: https://www.tandfonline.com/doi/full/10.1080/10903127.2023.2193978   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

Today, host Rachel Stemerman sits down with two authors of a groundbreaking paper: Ira Harmon and Jennifer Fishe. Their research tackles a significant challenge in emergency medical services: accurately identifying prehospital pediatric asthma exacerbations from complex EMS data. Asthma exacerbations are a common reason for pediatric EMS encounters. Accurately identifying these encounters is crucial for research and quality improvement in prehospital care. However, the nature of asthma symptoms and EMS data makes this difficult. In this episode, Ira and Jennifer will discuss their study, which focused on developing computable phenotypes (CPs) – reusable computer queries that identify specific clinical events using electronic data. They evaluated existing rule-based CPs and developed new ones, including machine learning-based models, using a large dataset of pediatric EMS encounters. Tune in to learn more about this innovative approach to leveraging EMS data for better pediatric care. As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaeljukim) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

Ready for the latest insights in prehospital care? In this episode, we're diving into an eye opening question in emergency medicine: could giving just a single dose of epinephrine during cardiac arrest be more effective than the standard approach? This topic isn't just about changing a drug protocol—it challenges the way we think about resuscitation itself. We're spotlighting a new study that's sparking important conversations in the field, and it's part of a broader theme in the latest issue of Prehospital Emergency Care, which also features articles on pediatric emergencies, compelling case studies, and new insights into cardiac arrest care. Join Niko and Michael as they speak with authors Dr. Tyler George and Dr. Nick Ashburn about their study - you don't want to miss it.  Check out PEC Podcast Episode 149 today! Available now on your favorite podcast platform.   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaelkim_md) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD

Ready for the latest insights in prehospital care? Improving health and safety in our communities starts with a commitment to equity. We explore how systemic disparities in Emergency Medical Services (EMS) affect patient care, outcomes, and trust. Join our guests - Remle Crowe, Andra Farcas, and Ameera Haamid - as we unpack the National Association of EMS Physicians' recommendations for making equity a strategic priority, published in Prehospital Emergency Care Journal, Volume 28, Number 6.  Hear how EMS agencies can leverage improvement science, community engagement, and quality monitoring to ensure that all patients receive high-quality, respectful care—regardless of who they are or where they live. This is more than a conversation; it's a call to action. Don't miss this important discussion. Also available for CE Credit!  Check out PEC Podcast Episode 149 today! Available now on your favorite podcast platform.   As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) Scott Goldberg MD, MPH (@EMS_Boston) Jeremiah Escajeda MD, MPH (@jerescajeda) Joelle Donofrio-Odmann DO (@PEMems) Maia Dorsett MD PhD (@maiadorsett) Lekshmi Kumar MD, MPH(@Gradymed1) Greg Muller DO (@DrMuller_DO) Ariana Weber MD (@aweberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaelkim_md) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD