SMFR EMS Podcast

Episode 23: Epi - Volume vs Tone

27 min · 1 de dic de 2025
Portada del episodio Episode 23: Epi - Volume vs Tone

Descripción

This episode features Medical Director Dr. Jonathan Apfelbaum and EMS Lieutenant Dusty King as they unpack when epi helps, when it adds nothing, and when it can actually work against your patient. Using real cases, they revisit alpha and beta receptor effects, walk through why there is no evidence-based role for epi in classic traumatic arrest, and contrast that with scenarios like neurogenic shock, tamponade, tension pneumothorax, and peri-RSI hypotension where carefully titrated push-dose epi can be appropriate. Along the way they review the MARCH algorithm, prehospital blood, TXA and calcium, ultrasound findings that clarify shock type, and those “medical vs trauma” MVCs where a cardiac event or PE causes the crash. The discussion blends fundamentals with nuance to give EMS providers practical tools to decide when the problem is volume, when it’s tone, and how to let physiology, not habit, drive the decision to reach for epi.

Comentarios

0

Sé la primera persona en comentar

¡Regístrate ahora y únete a la comunidad de SMFR EMS Podcast!

Prueba gratis

Empieza 7 días de prueba

$99 / mes después de la prueba. · Cancela cuando quieras.

  • Podcasts solo en Podimo
  • 20 horas de audiolibros al mes
  • Podcast gratuitos

Todos los episodios

28 episodios

episode Episode 28: Competent to Confident artwork

Episode 28: Competent to Confident

In this episode of the South Metro EMS Podcast, the crew tackles something that doesn't get talked about enough, the gap between competence and confidence in paramedicine. Host EMS Captain Dusty King sits down with Medical Director Dr. Jonathan Apfelbaum and EMS Lt. Mikel Hogestad to explore what it actually looks like to move from knowing your protocols to trusting your judgment in the gray areas of real patient care. From navigating psych calls and reluctant patients to the hard lessons learned from calls that didn't go by the book, the conversation is honest, practical, and grounded in lived experience. Whether you're a brand new medic still finding your footing or a seasoned provider reflecting on your own journey, this episode is a reminder that growing from competent to confident is a process, not a moment, and that staying curious might just be your greatest clinical superpower.

1 de jun de 202622 min
episode Episode 25: Blood on Board artwork

Episode 25: Blood on Board

In this episode of the South Metro EMS Podcast, “Blood on Board,” EMS Lieutenant Dusty King sits down with EMS Battalion Chief Glenn Maxson (Med 1) and Medical Director Dr. Jonathan Apfelbaum to break down SMFR’s prehospital blood program from the street level to the system impact. Using a recent trauma call as the anchor, they discuss how crews identify “blood calls,” why a brief on-scene delay can be worth it to get blood started sooner, and how blood integrates seamlessly with high-performance trauma care, including airway management and RSI when needed. They also cover the why behind pairing blood with TXA and calcium, walk through the field setup (cooler, warmer, pump, pressure bag), and share early program outcomes showing improved survival and downstream resource benefits.

1 de mar de 202623 min