Episode 144 Deep Dive: End Tidal CO2 in Cardiac Arrest

  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

Ready for the latest insights in prehospital care? The new Prehospital Emergency Care (PEC) Podcast, Episode 148 (Vol 28, Number 6), has dropped! This episode explores vital findings published in the Prehospital Emergency Care Journal, Volume 28, Number 3. We're tackling essential themes for every prehospital clinician: Fluids, Vascular Access, and Resuscitation Strategies. Get the breakdown on significant research, such as the study "Retrospective Comparison of Upper and Lower Extremity Intraosseous Access During Out-of-Hospital Cardiac Arrest Resuscitation" authored by Tanner Smida, Remle Crowe, Jeffrey Jarvis, Taylor Ratcliff, and Mat Goebel. Learn about the nuances of IO access in OHCA! Don't miss this important discussion. Check out PEC Podcast Episode 148 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

Title: Remembering Freedom House: A Legacy in EMS Join us for a special episode of the Prehospital Emergency Care (PEC) Podcast as we delve into the rich history and enduring legacy of Freedom House. In alignment with our commitment to Diversity, Equity, and Inclusion, we're honored to welcome two distinguished guests: Chief John Moon from Freedom House and Dr. Ameera Hamid, EMS physician at the University of Chicago. Chief John Moon Dr. Ameera Haamid In this powerful conversation, we'll take a nostalgic journey back to the origins of Freedom House, exploring its groundbreaking contributions to the world of Emergency Medical Services. Chief Moon and Dr. Hamid will share their personal insights and reflections, highlighting the pivotal role Freedom House played in shaping modern EMS. This episode is more than just a history lesson; it's a tribute to the pioneers who broke barriers and paved the way for a more inclusive and equitable EMS system. Listen as we celebrate the remarkable story of Freedom House and its lasting impact on prehospital care. Key Topics: The historical significance of Freedom House. Personal stories and reflections from Chief John Moon and Dr. Ameera Hamid. Freedom House's impact on diversity, equity, and inclusion in EMS. The enduring legacy of Freedom House in modern prehospital care. Listen Now: https://traffic.libsyn.com/pecpodcast/Ep._147_Chief_Moon_Dr._Haamid.mp3 Learn More: Achieving Equity in EMS Care and Patient Outcomes Through Quality Management Systems: A Position Statement American Sirens (Chief Moon's book)   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

PEC Podcast Episode 146: Consensus Statement of the National Association of EMS Physicians International Association of Fire Chiefs and the International Association of Chiefs of Police: Best Practices for Collaboration Between Law Enforcement and Emergency Medical Services During Acute Behavioral Emergencies 📢 New Episode Alert! 📢 The Prehospital Emergency Care Podcast is back with a special episode you won't want to miss! This month, we delve into the groundbreaking "Consensus Statement of the National Association of EMS Physicians, International Association of Fire Chiefs, and the International Association of Chief of Police: Best Practices for Collaboration Between Law Enforcement and Emergency Medical Services During Acute Behavioral Emergencies." Join us as we welcome esteemed guest authors Dr. Mike Levy, Dr. David Tan, Dr. Diane Miller, and Mike McEvoy to discuss the critical insights and recommendations within this vital document. Here's what you can expect: Expert analysis: Gain a deep understanding of the consensus statement's key components and practical implications. Collaboration in action: Discover how law enforcement and EMS can collaborate seamlessly to provide optimal care during behavioral emergencies. Real-world application: Learn how these best practices can translate into improved outcomes for patients and increased safety for first responders. Tune in today and discover how collaboration can transform the way we approach acute behavioral emergencies! Available on all major podcast platforms. Click here to download today! 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 Elijah Robinson MD

PEC Podcast Episode 145: Quick Hits from Prehospital Emergency Care Journal Get ready for a rapid-fire review of the latest prehospital research! In Episode 145 of the PEC Podcast, we dive into the original research section of the Prehospital Emergency Care Journal (Volume 28, Number 3). Join our expert panel as we dissect key findings and discuss the implications for EMS practice. This episode covers manuscripts like: Challenges Locating the Scene of Emergency: A Qualitative Study of the EMS System in Rwanda Prehospital Validation of the Assessment of Blood Consumption (ABC) Score Evidence for Use of Validated Sepsis Screening Tools in the Prehospital Population: A Scoping Review ...and more! Tune in for a concise and informative discussion that will keep you up-to-date on the latest advancements in prehospital care. Click here to download today! 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 Elijah Robinson MD

Cardiac arrest in the prehospital setting continues to be a critical area of focus for EMS clinicians, especially when it comes to measuring ventilation and perfusion. In this episode, we’ll do a deep dive on new research investigating the role of end tidal carbon dioxide (ETCO2) as a potential indicator of survival in out-of-hospital cardiac arrests. The study looks at how both high and low ETCO2 levels affect mortality and why these numbers alone may not be enough to guide resuscitation decisions. Stick around for all the insights!  In this podcast, we interview the lead author Tanner Smida MD/PhD Candidate AEMT West Virginia University  on the manuscript:  The Association of Prehospital End-Tidal Carbon Dioxide with Survivial Following Out-of-Hospital Cardiac Arrest Click here to download it today! 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 Elijah Robinson MD

The PEC podcast team covers the Prehospital Emergency Care Journal Volume 28 Number 3...Kind of.  As the PEC Journal grows, the PEC podcast team is breaking up Volume 28 Number 3 to allow for more discussion.  In this episode we cover the Out of Hospital Cardiac Arrest section. We talk about engaging manuscripts in this journal like: COVID-19 Testing Among Out-of-Hospital Cardiac Arrest Patients: Implications for Public Health & Prehospital Administration of Norepinephrine and Epinephrine for Shock after Resuscitation from Cardiac Arrest Click here to download it today! 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 (@weberMD4) Rebecca Cash PhD (@CashRebeccaE) Michael Kim MD (@michaelkim_md) Rachel Stemerman PhD (@steminformatics) Nikolai Arendovich MD Elijah Robinson MD