SMFR EMS Podcast

Episode 27: Pediatric Emergencies - Pattern Recognition

In this episode of the SMFR EMS Podcast, we sit down with our Medical Director Jonathan Apfelbaum, and Associate Medical Director of EMS of Children's Hospital Dr. Claire Gahm to review pediatric emergencies, a patient population we don't run often but one that can catch you off guard when we do. The conversation covers clinical assessment, why pediatric presentations can be deceptively subtle, and how to build the pattern recognition that keeps your approach sharp. A solid refresher on staying confident and prepared when kids need us most.

Episode 26: Adenosine and Wolff-Parkinson-White (WPW)

In this episode, Dusty King and Medical Director Jonathan Apfelbaum break down adenosine in a practical, field-ready way. They review how the medication works at the AV node, when it is appropriate for narrow-complex regular tachycardia, and why Wolff-Parkinson-White (WPW) does not automatically rule it out. The conversation also highlights patient preparation, what to expect after administration, key contraindication concerns, and how to think through WPW with atrial fibrillation versus regular Supraventricular Tachycardia (SVT).

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.

Episode 24: Difficult Airways - Right Tool, Right Patient

In this episode of Real Calls. Real Conversations. Real EMS., we take you into the cadaver lab at Link to Learn for a real-time look at managing difficult airways. We break down airway assessment, first-pass success, SALAD suction technique, bougie vs rigid stylet use, and how to adjust tools and approach based on patient anatomy, not provider comfort. The focus stays where it belongs: oxygenation, ventilation, and minimizing hypoxia while adapting in real time.

Episode 23: Epi - Volume vs Tone

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.