Prehospital Emergency Care Podcast

Ep. 162: Route of Midazolam Administration for Pediatric Seizures

Welcome to the Prehospital Emergency Care Podcast! Rapid seizure termination is one of the most important priorities in pediatric prehospital care, yet establishing intravenous access can delay treatment. In this episode, Maia Dorsett and Joelle Donofrio-Odmann speak with Jonathan Mohnkern about his recent systematic review and meta-analysis comparing intranasal and intramuscular midazolam for pediatric seizures. Together, they review the available evidence, discuss the pharmacologic differences between administration routes, examine the implications for EMS protocols and medication dosing, and explore how these findings may influence future prehospital seizure management. Featured Article: Mohnkern, J. D., Khalid, A., Ibrahim, M., Dave, V., Chierighini, P. P., Riaño, A. S., ... & Martins Shehan, T. S. (2026). Intranasal versus intramuscular midazolam in pediatric seizure control: a systematic review and meta-analysis. Prehospital Emergency Care, 1-9. https://doi.org/10.1080/10903127.2026.2658592 [https://doi.org/10.1080/10903127.2026.2658592] Additional References: Shah, M. I., Macias, C. G., Dayan, P. S., Weik, T. S., Brown, K. M., Fuchs, S. M., ... & Lang, E. S. (2014). An evidence-based guideline for pediatric prehospital seizure management using GRADE methodology. Prehospital emergency care, 18(sup1), 15-24. Shah, M. I., Ostermayer, D. G., Browne, L. R., Studnek, J. R., Carey, J. M., Stanford, C., ... & Lerner, E. B. (2021). Multicenter evaluation of prehospital seizure management in children. Prehospital Emergency Care, 25(4), 475-486. Remick, K., Redgate, C., Ostermayer, D., Kaji, A. H., & Gausche-Hill, M. (2017). Prehospital glucose testing for children with seizures: a proposed change in management. Prehospital Emergency Care, 21(2), 216-221. Silbergleit, R., Durkalski, V., Lowenstein, D., Conwit, R., Pancioli, A., Palesch, Y., & Barsan, W. (2012). Intramuscular versus intravenous therapy for prehospital status epilepticus. New England journal of medicine, 366(7), 591-600. Mohammed, M. Z., Elagouza, I., El Gaafary, M., El-Garhy, R., & El-Rashidy, O. (2024). Intranasal versus buccal versus intramuscular midazolam for the home and emergency treatment of acute seizures in pediatric patients: a randomized controlled trial. Pediatric Neurology, 158, 135-143. Further Resources: Pediatric EMS Podcast: Managing Prehospital Pediatric Seizures: https://naemsp.org/podcast-pediatric-em/expedite-the-route-simplify-the-dose-managing-pediatric-prehospital-seizures/ [https://naemsp.org/podcast-pediatric-em/expedite-the-route-simplify-the-dose-managing-pediatric-prehospital-seizures/]

Ep. 161: Willingness to Recommend the Profession

Welcome to the Prehospital Emergency Care Podcast! In this episode, Greg Muller discusses the article Promotion of Emergency Medical Services: A National Analysis of Clinician Willingness to Recommend the Profession with authors Jacob Kamholz and Ash Panchal. This article explores a novel approach to assessing EMS workforce sentiment using the Net Promoter Score (NPS). Guests Jacob Kamholtz and Ash Panchal discuss how NPS can serve as a benchmark for EMS career advocacy, workforce sustainability, and future planning, highlighting key findings and implications for EMS leadership. Featured Article Kamholz JC, Gage CB, van den Bergh SL, Riel KM, Powell JR, Panchal AR. Promotion of Emergency Medical Services: A National Analysis of Clinician Willingness to Recommend the Profession. Prehosp Emerg Care. 2026 Feb 20:1-7. doi: 10.1080/10903127.2026.2619038. As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) [https://twitter.com/PECpodcast] Scott Goldberg MD, MPH (@EMS_Boston [https://twitter.com/EMS_Boston]) Jeremiah Escajeda MD, MPH (@jerescajeda [https://twitter.com/JerEscajeda]) Joelle Donofrio-Odmann DO (@PEMems) [https://twitter.com/PEMEMS] Maia Dorsett MD PhD (@maiadorsett [https://twitter.com/maiadorsett]) Lekshmi Kumar MD, MPH(@Gradymed1 [https://twitter.com/GradyMED1]) Greg Muller DO (@DrMuller_DO [https://twitter.com/DrMuller_DO]) Ariana Weber MD (@aweberMD4 [https://twitter.com/aweberMD4]) Rebecca Cash PhD (@CashRebeccaE [https://twitter.com/CashRebeccaE]) Michael Kim MD (@michaeljukim [https://www.threads.com/@michaeljukim]) Rachel Stemerman PhD (@steminformatics [https://twitter.com/steminformatics?lang=en]) Nikolai Arendovich MD

Ep. 160: The Prehospital Trauma Compendium - Prehospital Blood, Vasopressors, TXA, and Traumatic Cardiac Arrest

Welcome to the Prehospital Emergency Care Podcast! In this episode, hosts Jeremiah Escajeda, Greg Muller, and Ariana Weber discuss four of the sixteen articles from the Prehospital Trauma Compendium. In 2025, the Prehospital Trauma Compendium introduced crucial guidelines and insights regarding the management of traumatic injuries in prehospital settings. This episode summarizes four significant articles that focus on the use of blood products, vasopressors, tranexamic acid, (TXA), and care for patients in traumatic cardiac arrest. If you're an EMS professional or a medical provider involved in trauma care, these insights are vital for improving patient outcomes. Featured Articles Brown, J. B., Yazer, M. H., Kelly, J., Spinella, P. C., DeMaio, V., Fisher, A. D., … Guyette, F. X. (2025). Prehospital Trauma Compendium: Transfusion of Blood Products in Trauma – A Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care, 1–10. https://doi.org/10.1080/10903127.2025.2476195 Orpet, R. E., Barrett, W. J., Kaucher, K. A., Colwell, C. B., & Lyng, J. W. (2024). Prehospital Trauma Compendium: Vasopressors in Trauma – a Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care, 1–7. https://doi.org/10.1080/10903127.2024.2437656 Barrett, W. J., Kaucher, K. A., Orpet, R. E., Campion, E. M., Goodloe, J. M., Fischer, P. E., … Lyng, J. W. (2025). Prehospital Trauma Compendium: Tranexamic Acid in Trauma – A Joint Position Statement and Resource Document of NAEMSP, ACEP, and ACS-COT. Prehospital Emergency Care, 1–8. https://doi.org/10.1080/10903127.2025.2497056 Breyre, A. M., George, N., Nelson, A. R., Ingram, C. J., Lardaro, T., Vanderkolk, W., & Lyng, J. W. (2025). Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest – A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP. Prehospital Emergency Care, 1–15. https://doi.org/10.1080/10903127.2024.2428668 As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) [https://twitter.com/PECpodcast] Scott Goldberg MD, MPH (@EMS_Boston [https://twitter.com/EMS_Boston]) Jeremiah Escajeda MD, MPH (@jerescajeda [https://twitter.com/JerEscajeda]) Joelle Donofrio-Odmann DO (@PEMems) [https://twitter.com/PEMEMS] Maia Dorsett MD PhD (@maiadorsett [https://twitter.com/maiadorsett]) Lekshmi Kumar MD, MPH(@Gradymed1 [https://twitter.com/GradyMED1]) Greg Muller DO (@DrMuller_DO [https://twitter.com/DrMuller_DO]) Ariana Weber MD (@aweberMD4 [https://twitter.com/aweberMD4]) Rebecca Cash PhD (@CashRebeccaE [https://twitter.com/CashRebeccaE]) Michael Kim MD (@michaeljukim [https://www.threads.com/@michaeljukim]) Rachel Stemerman PhD (@steminformatics [https://twitter.com/steminformatics?lang=en]) Nikolai Arendovich MD

Ep. 159 Deep Dive: Trends in Prehospital First-Attempt Use of Supraglottic Airwasy in Non-Cardiac Arrest Patients: A Descriptive Study

Welcome to the Prehospital Emergency Care Journal Podcast! In this Deep Dive episode, host Maia Dorsett speaks with Aaron E. Robinson, Sarah K. S. Knack, and Michael C. Perlmutter about their paper, Trends in Prehospital First-Attempt Use of Supraglottic Airways in Non-Cardiac Arrest Patients: A Descriptive Study [https://www.tandfonline.com/doi/10.1080/10903127.2025.2593579?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed]. The conversation explores how airway management in EMS may be evolving, including growing interest in supraglottic airways as a first-line approach rather than solely a rescue device. The authors discuss key airway concepts—such as RSI, DSI, and rapid sequence airway—and review what their national dataset reveals about current practice patterns. Along the way, they examine variations in medication strategies, including the continued use of sedation-only approaches and airway placement without neuromuscular blockade or medications. The discussion raises important questions about how EMS clinicians balance speed, safety, and skill maintenance when managing critically ill airways in the field. Featured Article Robinson, A. E., Knack, S. K. S., Driver, B. E., Prekker, M. E., Perlmutter, M. C., Bunting, A. J., … Puskarich, M. A. (2026). Trends in Prehospital First-Attempt Use of Supraglottic Airways in Non-Cardiac Arrest Patients: A Descriptive Study. Prehospital Emergency Care, 1–8. https://doi.org/10.1080/10903127.2025.2593579 As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) [https://twitter.com/PECpodcast] Scott Goldberg MD, MPH (@EMS_Boston [https://twitter.com/EMS_Boston]) Jeremiah Escajeda MD, MPH (@jerescajeda [https://twitter.com/JerEscajeda]) Joelle Donofrio-Odmann DO (@PEMems) [https://twitter.com/PEMEMS] Maia Dorsett MD PhD (@maiadorsett [https://twitter.com/maiadorsett]) Lekshmi Kumar MD, MPH(@Gradymed1 [https://twitter.com/GradyMED1]) Greg Muller DO (@DrMuller_DO [https://twitter.com/DrMuller_DO]) Ariana Weber MD (@aweberMD4 [https://twitter.com/aweberMD4]) Rebecca Cash PhD (@CashRebeccaE [https://twitter.com/CashRebeccaE]) Michael Kim MD (@michaeljukim [https://www.threads.com/@michaeljukim]) Rachel Stemerman PhD (@steminformatics [https://twitter.com/steminformatics?lang=en]) Nikolai Arendovich MD

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/ [https://www.google.com/url?sa=E&q=https%3A%2F%2Fwww.tandfonline.com%2Ftoc%2Fipec20%2F29%2F4] As always THANK YOU for listening. Hawnwan Philip Moy MD (@pecpodcast) [https://twitter.com/PECpodcast] Scott Goldberg MD, MPH (@EMS_Boston [https://twitter.com/EMS_Boston]) Jeremiah Escajeda MD, MPH (@jerescajeda [https://twitter.com/JerEscajeda]) Joelle Donofrio-Odmann DO (@PEMems) [https://twitter.com/PEMEMS] Maia Dorsett MD PhD (@maiadorsett [https://twitter.com/maiadorsett]) Lekshmi Kumar MD, MPH(@Gradymed1 [https://twitter.com/GradyMED1]) Greg Muller DO (@DrMuller_DO [https://twitter.com/DrMuller_DO]) Ariana Weber MD (@aweberMD4 [https://twitter.com/aweberMD4]) Rebecca Cash PhD (@CashRebeccaE [https://twitter.com/CashRebeccaE]) Michael Kim MD (@michaeljukim [https://www.threads.com/@michaeljukim]) Rachel Stemerman PhD (@steminformatics [https://twitter.com/steminformatics?lang=en]) Nikolai Arendovich MD