Pharm Foundations: Levophed, Ancef, and Early Shock Management

Hyperkalemia: When Calcium Helps vs Hurts

In this QuikCrit, we break down when calcium actually helps in hyperkalemia, and when it doesn’t. Starting with a crashing patient and a wide QRS, we walk through the cardiac action potential, why hyperkalemia slows conduction, and how calcium stabilizes the myocardium without lowering potassium. We cover: * Why Vₘ follows potassium (Vₘ ≈ Eₖ) * How calcium raises threshold potential and restores conduction * ECG changes in hyperkalemia * Calcium chloride vs gluconate * The role of calcium in PEA arrest * Why giving calcium blindly may not help, and may cause harm Bottom line: Calcium isn’t a routine arrest drug, it’s targeted therapy for hyperkalemia. Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast. References: https://pubmed.ncbi.nlm.nih.gov/36403820/ [https://pubmed.ncbi.nlm.nih.gov/36403820/] https://pmc.ncbi.nlm.nih.gov/articles/PMC9550532/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC9550532/]

Experience vs Exposure

After a brief Spring break, The NewlyMeds is back with a conversation on one of the biggest questions in EMS: does time on the job actually make you better, or does real exposure, repetition, and continuous learning matter more? In this episode, we break down the difference between years of experience and meaningful experience, skill degradation in low-volume systems, confidence versus competence, and why evidence-based practice has to keep pushing EMS forward. We also talk rural vs urban volume, the value of simulation and training, and why every patient contact, including IFTs, can be a rep that makes you better. Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast. https://medicalxpress.com/news/2026-02-frequent-patients-years-job-ems.html [https://medicalxpress.com/news/2026-02-frequent-patients-years-job-ems.html] https://www.sciencedirect.com/science/article/abs/pii/0736467987902149 [https://www.sciencedirect.com/science/article/abs/pii/0736467987902149] https://www.cafsti.org/wp-content/uploads/Advanced-Life-Support-Skill-Deterioration-Among-Paramedics-in-Low-Call-Volume-Emergency-Medical-Service-Systems.pdf [https://www.cafsti.org/wp-content/uploads/Advanced-Life-Support-Skill-Deterioration-Among-Paramedics-in-Low-Call-Volume-Emergency-Medical-Service-Systems.pdf]

Sepsis in the Field: How One EMS System Brought Antibiotics Prehospital

Sepsis is one of the most common and deadly emergencies we see, and it often presents quietly before crashing hard. In this episode, we’re joined by Zac, a deputy chief at a Pennsylvania EMS agency launching a first-of-its-kind pilot program in the state for prehospital antibiotics in suspected sepsis. We break down practical sepsis recognition in the field, why early treatment matters, and how clinical judgment beats rigid checklists alone. Zac walks us through the real work behind the pilot: antibiotic stewardship, drawing clean blood cultures before antibiotics, aligning with hospital sepsis bundles, crew training, documentation, and making all of it operationally realistic on scene. Whether your system is progressive or just getting started, this episode gives you concrete takeaways to improve sepsis care today and a roadmap for advocating change tomorrow. If you want to connect with Zac or learn more about the pilot, email the podcast at thenewlymedspod@gmail.com [thenewlymedspod@gmail.com]Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast https://sccm.org/survivingsepsiscampaign/guidelines-and-resources/surviving-sepsis-campaign-adult-guidelines?_gl=1*1uwmjkl*_gcl_au*MTU3NTI3MTkwNy4xNzY5MDM3NjMx [https://sccm.org/survivingsepsiscampaign/guidelines-and-resources/surviving-sepsis-campaign-adult-guidelines?_gl=1*1uwmjkl*_gcl_au*MTU3NTI3MTkwNy4xNzY5MDM3NjMx] https://emcrit.org/pulmcrit/ssc-1-hour/ [https://emcrit.org/pulmcrit/ssc-1-hour/] https://www.who.int/news-room/fact-sheets/detail/sepsis [https://www.who.int/news-room/fact-sheets/detail/sepsis] https://emcrit.org/pulmcrit/understanding-lactate-in-sepsis-using-it-to-our-advantage/ [https://emcrit.org/pulmcrit/understanding-lactate-in-sepsis-using-it-to-our-advantage/] https://www.handtevy.com/wp-content/uploads/2025/04/2025-Prehospital-Sepsis-Recognition-and-Antibiotic-Administration-A-Retrospective-Analysis.pdf [https://www.handtevy.com/wp-content/uploads/2025/04/2025-Prehospital-Sepsis-Recognition-and-Antibiotic-Administration-A-Retrospective-Analysis.pdf] https://journal.chestnet.org/article/S0012-3692%2818%2930074-6/fulltext [https://journal.chestnet.org/article/S0012-3692%2818%2930074-6/fulltext] https://link.springer.com/article/10.1186/s12873-024-01137-0 [https://link.springer.com/article/10.1186/s12873-024-01137-0] https://pmc.ncbi.nlm.nih.gov/articles/PMC10324699/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC10324699/] https://journals.sagepub.com/doi/10.1177/27536386231207055 [https://journals.sagepub.com/doi/10.1177/27536386231207055] https://pmc.ncbi.nlm.nih.gov/articles/PMC10228518/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC10228518/]

Pharm Foundations: Levophed, Ancef, and Early Shock Management

In this episode of the NewlyMeds Podcast, we go back to pharmacology basics with a focused deep dive into two critical medications we’re seeing more and more in EMS: norepinephrine (Levophed) and cefazolin (Ancef). We break down how norepinephrine works at a physiologic and cellular level, why it’s become a first-line vasopressor in shock, and what matters when titrating pressors in critically ill patients. We also walk through cefazolin from the ground up, including bacterial cell wall physiology, beta-lactam antibiotics, and why early antibiotic administration plays a major role in trauma, sepsis, and septic shock outcomes. This episode is intentionally foundational. We’re setting the stage for a much deeper upcoming discussion by reinforcing the why behind these medications, not just the dosing or protocols. If pharmacology ever felt rushed or confusing in medic school, this is your chance to slow it down, reconnect the dots, and build a stronger clinical framework for critical care decision-making in the field. Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast References: https://pmc.ncbi.nlm.nih.gov/articles/PMC12057179/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC12057179/] https://www.sciencedirect.com/science/article/pii/S1198743X25002356 [https://www.sciencedirect.com/science/article/pii/S1198743X25002356] https://pmc.ncbi.nlm.nih.gov/articles/PMC12057179/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC12057179/] https://www.sciencedirect.com/science/article/pii/S1198743X25002356 [https://www.sciencedirect.com/science/article/pii/S1198743X25002356] https://www.instagram.com/p/CnCKhWuu6HO/?img_index=2 [https://www.instagram.com/p/CnCKhWuu6HO/?img_index=2] https://emcrit.org/ibcc/shock/ [https://emcrit.org/ibcc/shock/] https://rebelem.com/wp-content/uploads/2019/09/Mgmt-of-Shock-Educational-Reinforcement-Material.pdf [https://rebelem.com/wp-content/uploads/2019/09/Mgmt-of-Shock-Educational-Reinforcement-Material.pdf]

Endocrine Collapse: Thyroid and Adrenal Crisis

Welcome to Season 3 of TheNewlyMeds! Today starts with a classic “not acting like herself” call that looks like sepsis, until it isn’t. Dan and Wil break down the endocrine emergencies EMS can miss when we anchor on infection. We cover thyroid and adrenal crises that can silently worsen, then crash fast: Graves and thyrotoxicosis, thyroid storm, apathetic hyperthyroidism in older adults, myxedema coma, Addison’s disease and adrenal crisis, plus Cushing syndrome. You’ll get practical prehospital recognition tips you can use without labs, along with what matters most in the field: airway, temperature, rhythms, glucose, fluids, and key pitfalls to avoid. Quick pattern recap: too fast and too hot: thyroid excess. too slow with hypoventilation: thyroid failure. shocky and refractory: adrenal failure. Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast References: Myxedema crisis (2024 Chen et al.): https://journals.sagepub.com/doi/full/10.1089/thy.2023.0559 [https://journals.sagepub.com/doi/full/10.1089/thy.2023.0559] Thyroid storm (2024 Elendu et al.): https://pmc.ncbi.nlm.nih.gov/articles/PMC10977538/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC10977538/] Addison’s disease (2023 Carsote et al.): https://pmc.ncbi.nlm.nih.gov/articles/PMC10243343/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC10243343/] Graves disease (2022 Hoang et al.): https://pmc.ncbi.nlm.nih.gov/articles/PMC9174594/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC9174594/] Cushing’s syndrome (2025 Dillon et al.): https://pmc.ncbi.nlm.nih.gov/articles/PMC12484323/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC12484323/] Adrenal crisis (2022 Lentz et al.): https://www.sciencedirect.com/science/article/abs/pii/S0736467922003481 [https://www.sciencedirect.com/science/article/abs/pii/S0736467922003481] Apathetic thyrotoxicosis (2023 Lee et al.): https://pmc.ncbi.nlm.nih.gov/articles/PMC10873132/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC10873132/] https://pmc.ncbi.nlm.nih.gov/articles/PMC9627317/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC9627317/]