Just Culture Podcast

Just Culture Podcast

In this episode of the Erik and Matt Show (EMS) we explore "just culture" in EMS and fire service—a value-based accountability model that balances honest mistake reporting with appropriate accountability to improve patient safety and team trust.

Pediatric Sepsis

In this episode of The Erik and Matt Show (EMS) with Erik Axene and Matt Ball, an emergency physician and a firefighter/paramedic break down how to recognize and manage pediatric sepsis in the field starting from why kids compensate so well that they look fine right up until they fall off the cliff. They explain why sepsis belongs on your differential for any sick kid, not just the nursing-home patient. Walk through the pediatric assessment triangle and the age-normal vitals that tell you a child is in trouble before the blood pressure ever drops, and cover the history that changes everything: wet diapers, feeding, fever and the meds already given. From cap refill over SpO2 to fluids before hypotension and resuscitating before you intubate, they lay out the field judgment that catches a septic kid early, plus a down-and-dirty drug-math trick that takes the fear out of weight-based dosing. Early recognition saves lives, and with little kids, delay kills.

Dialysis Patients in EMS

In this episode of The Erik and Matt Show (EMS) with Erik Axene and Matt Ball, an emergency physician and a firefighter/paramedic break down how to recognize and manage dialysis emergencies in the field, starting from what healthy kidneys actually do so the failures finally make sense. They connect the volume-overloaded dialysis patient to the congestive heart failure patient, walk through why missing a single session can trigger a cascade of problems, and explain why you cannot lower a patient's potassium in the back of the truck, only buy them time with calcium and albuterol until definitive care.

Cognitive Bias in EMS

In this episode of The Erik and Matt Show (EMS), Erik and Matt unpack the 12 cognitive biases that quietly drive missed diagnoses and bad calls in prehospital medicine. They cover anchoring, confirmation bias, premature closure, availability bias, framing, overconfidence, diagnostic momentum, action bias, search satisfaction, the Dunning-Kruger effect, authority bias, and sunk cost. Each bias is paired with a real field story, including Erik's anxiety patient who turned out to be in florid DKA, the SVT call that was actually WPW, the prolonged extrication where the patient was secretly having a STEMI and a fractured spleen, and Erik's now famous case of lecturing his medics about not anchoring while completely missing a necrotic appendix in the back of the ambulance.

EMS Stroke Assessment and Management

When seconds decide whether someone walks out of the hospital or never speaks again, your EMS stroke assessment has to be fast, accurate, and repeatable. In this episode of The Erik and Matt Show (EMS) with Erik Axene and Matt Ball, an emergency physician and a firefighter/paramedic break down how to recognize a stroke in the field, why "last known well" is the single most important question you can ask the family, and how to spot a Large Vessel Occlusion before you ever leave the driveway. Erik and Matt walk through Cincinnati, LAMS, and FAST, then dig into the subtle presentations that get missed: Bell's palsy mimics, posterior strokes, dizziness, and the wake-up stroke.