MCHD Paramedic Podcast
Health, Fitness & Longevity
About
The MCHD Paramedic Podcast is a place for prehospital providers to discuss best practices and offer clinical insights relevant to our daily practice. MCHD Medical Director Dr. Casey Patrick invites you to explore the many aspects of prehospital care. Along the way you can expect guest appearances by some of the brightest minds that influence modern EMS.
Episodes
- Episode 194 - Mental Health Matters In EMS With Dr. Joe Gill
MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally starte…
- Episode 193 - What Can EMS Learn From An Emergency Pharmacist? - Part 2
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lu…
- Episode 192 - What Can EMS Learn From An Emergency Pharmacist? - Part 1
One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lu…
- Episode 191 - EMS Protocols 101
As discussed on prior episodes, we recently overhauled our entire protocol structure here at MCHD. One of our MCHD paramedics, David Lozano, joins us to discuss the foundations of EMS protocol creation. Who writes them and how? Where are t…
- Episode 190 - Geriatric Considerations In EMS With Dr. Maia Dorsett
The most common podcast requests over the past couple of years have been focused on prehospital geriatric care. Dr. Maia Dorsett, EMS geriatric expert, joins us to discuss pearls and pitfalls when caring for elderly patients in the prehosp…
- Episode 189 - EMS Airway Updates 2025 - Part 2
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why can't we take a look after sedation only?" "Why doesn't MCHD have a crash airway protocol?" Join the podcast crew to discus…
- Episode 188 - Prehospital OB Updates 2025
Recently, some paramedics, obstetricians, and EMS medical directors were locked in a room and produced some fantastic collaborative prehospital guidelines for managing post-partum hemorrhage, eclampsia, and pre-eclampsia. Have a listen, ta…
- Episode 187 - EMS Airway Updates 2025 - Part 1
There are always airway management questions floating around the Department of Clinical Services here at MCHD. "Why don't we intubate our cardiac arrest patients like we used to?" "MCHD has been hyper-focused on recording video laryngoscop…
- Episode 186 - A Paramedic's Guide To The Opiate Epidemic
We're lucky to have a special guest on this podcast episode to discuss a topic that, unfortunately, all of us in emergency care encounter all too frequently: the opiate epidemic. Peter Canning is a paramedic who has lived through the epide…
- Episode 185 - Chest Pain - The Next 30 Minutes
We're going to take our "Serial Killers" series and continue into the transition from the ambulance to the emergency department. What happens to the patient with chest pain once the ER doctor takes over? How does the workup advance? What i…
- Episode 184 - Recording Video Laryngoscopy In EMS
On this episode, the podcast crew discusses the recent introduction of video laryngoscopy with recording capability at MCHD. What device did you use? How did you train? What lessons have you learned? All these and more will be addressed an…
- Episode 183 - Pain Control In EMS - The MCHD Analgesia Ladder
The podcast crew takes on the topic of prehospital analgesia. What pain medication do we choose when facing a complex patient with all analgesics available? Are there better options for hypotensive patients? What about pregnancy and the el…
- Episode 182 - Traumatic Arrest With The Prehospitalist
Lindsey Ewing (IG's The Prehospitalist) joins us to discuss updates and questions surrounding the EMS management of traumatic arrest. Sure, we must address the "reversible" causes, but what about ACLS/compressions/epinephrine? Which patien…
- Episode 181 - Why You Should Attend The Resuscitation Academy
We're joined by Dallas-area cardiac arrest management thought leaders from Best EMS and Parker County Hospital District to discuss the Resuscitation Academy. Where did this thing start? How can you and your service benefit? What RA lessons…
- Episode 180 - Orthostatic Vitals - Should They Stay or Should They Go?
Orthostatic vitals are taught throughout medical training as a quick and easy way to assess patient volume status objectively. We also frequently see these documented in MCHD charts. Is there any evidence that orthostatics help our clinica…
- Episode 179 - Transcutaneous Pacing Pearls and Pitfalls
On today's episode, we're lucky to have a couple of special guests to discuss prehospital transcutaneous pacing. Medics turned medical students and EMS researchers, Josh Kimbrell and Judah Kreinbrook recently published a case series decsri…
- Episode 178 - A STEMI Unlike Any Other
We often discuss "one in a million" and "once in a career" cases in emergency medicine and EMS, and do we ever have one of those for you in this episode! MCHD Captain, Jason Jones, joins Dr. Patrick to discuss an exeedingly rare STEMI/ches…
- Episode 177 - A-Fib With RVR - A Medic Mindset Collaboration
This is a special edition of the MCHD Paramedic Podcast. Ginger Locke, of the absolutely amazing Medic Mindset podcast, invited Dr. Patrick on to discuss rate control of rapid atrial fibrillation in the prehospital setting. She was graciou…
- Episode 176 - Antibiotics & Open Fractures
MCHD recently rolled out Ceftriaxone for long-bone open fracture care. The podcast crew welcomes our new assistant medical director, Dr. Mike DePasquale, to discuss some background evidence and danger spots within this protocol. REFERENCES…
- Episode 174 - Push Dose Norepinephrine
We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have a…
- Episode 175 - The Rear View Mirror - Tunnel Vision
Dr. Patrick is joined by MCHD District Chief Kelcie Adams to discuss the role of clinical case reviews at MCHD. Why are these so important, and what's the big deal? Kelcie is brave enough to use one of her recent calls as an example of the…
- Episode 173 - Med Minute - Magnesium
We're working on a new series focusing on high-yield pharmacology reviews. Dr. Patrick starts us off with some background, mechanism of action discussion and common uses for magnesium sulfate. Mag is one of the true pharmacologic swiss arm…
- Episode 172 - The MCHD EKG Manifesto - Part 3
Our final entry into the EKG Manifesto series moves into the STEMI/OMI world of acute coronary occlusion. Who do we activate and why? Where is the STEMI paradigm headed? Join Dr. Patrick and Dr. Dickson to refresh your EKG knowledge. REFER…
- Episode 171 - Surgical Airway Lessons With Dr. Al Lulla
One of the most fear-inducing procedures in all of emergency care is the surgical cricothyrotomy. Dr. Al Lulla from Dallas Fire joins the podcast to discuss our recent collaboration on a retrospective look at MCHD's surgical airway experie…
- Episode 170 - The MCHD EKG Manifesto - Part 2
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration…
- Episode 169 - Agitation Awareness - Fixed-Dose Ketamine
We've initiated a multi-pronged, system wide overhaul of our agitation management at MCHD. This included a move to fixed-dose ketamine for the severely agitated patients. Evidently we weren't the only ones thinking of this as there is exci…
- Episode 168 - The VTach FACTs
We've recently had several challenging, wide-complex tachycardia cases here at MCHD, so the podcast crew decided to bring forth some VT vs. SVT with aberrancy knowledge. Learn the V-Tach FACT, and you'll feel more comfortable with your nex…
- Episode 167 - Ketamine Only Intubations With Dr. Andrew Partain
The podcast crew is joined by a special guest, Dr. Andrew Partain, an EMS Fellow from UTSW in Dallas. We will dissect his recent data surrounding ketamine-only intubation from MedStar in Fort Worth. This is not just another boring data reh…
- Episode 166 - The MCHD EKG Manifesto - Part 1
Applied EKG interpretation is often a difficult task in EMS and emergency medicine education. Getting bogged down in minutiae can obscure the patient. While an understanding of EKG foundational physiology is an absolute must, consideration…
- Episode 165 - Intracerebral Hemorrhage
We've spent countless hours (rightfully so) discussing ischemic stroke management over the past several years. Sometimes, the other 20% of strokes, the hemorrhagic version, can get neglected. No, we don't have stroke-mobiles at MCHD to dia…
- Episode 164 - EMS HOCUS POCUS
MCHD's POCUS program has definitely involved both forward progress and lessons learned. In this episode, we'll discuss some of the reasons POCUS can be a game changer in the prehospital setting. However, unintended consequences do exist. W…
- Episode 163 - Back Pain Beware
MCHD paramedic Wes Hall joins the podcast crew to discuss a recent seemingly mundane back pain call. Please listen to find out how avoidance of premature closure, a thorough exam, and professional patient advocacy led to an excellent outco…
- Episode 162 - Post-ROSC Pressor Choice
We recently made a significant vasopressor protocol change at MCHD, prioritizing norepinephrine in all shock situations except anaphylaxis and bradycardia. The evidence supporting norepinephrine in septic and even cariogenic shock is relat…
- Episode 161 - MMQ#9 - The Angioedema Airway
MCHD District Chief April Currie joins the podcast crew to discuss an angioedema case that repeatedly left more questions than answers. Dr. Patrick was tasked with managing the airway and definitely has some lessons learned to share with t…
- Episode 160 - ST Elevation in aVR With Diffuse ST Depression
The podcast crew dives deep into one of the early "STEMI equivalent" ECG patterns: ST elevation in aVR with diffuse ST depression. What does the evidence say about this pattern? Is there a FOAM lesson to be learned? How should we incorpora…
- Episode 159 - MMQ#8 - The Head and the Heart
Dr. Dickson leads the discussion with recent cases involving the PECARN pediatric head injury decision rule and some super sneaky toxicology. There is some high-level detective work happening during this episode. Listen so you don't miss v…
- Episode 158 - Terrible Tracheostomy 2023
The podcast crew is joined by MCHD In-Charge Paramedics, Ben Breaux, and Jesus Contreras to discuss a critical case that demonstrates why continuing education and intentional mental reps are vital in emergency care. We've discussed the "ho…
- Episode 157 - Cardiac Arrest During EMS Care - Making MOVES
There is nothing more stressful than seeing EMS peri-arrest progress to pulseless. CARES data suggest that cardiac arrest during transport is not an uncommon event. Additionally, there is new evidence that these patients may not be as diff…
- Episode 156 - MMQ#7 A Shocking Save And Sneaky Serial Killer
Sometimes it's easy on the individual level to miss the positive drift within EMS as systems of care evolve and change toward positive innovation. Dr. Patrick hits the hot seat on this episode to discuss two recent cases where some of MCHD…
- Episode 155 - MMQ#6 - A Rapid AFib Riddle
Join the podcast crew as they discuss one of the more sticky situations in all of emergency care: stable vs. unstable narrow complex tachycardia. 1. How do we even define unstable? 2. Is it cardiac versus an underlying illness? 3. How do w…
- Episode 154- Death Notification Lessons Learned
The concept of emphasizing, discussing, and training on giving prehospital death notification is, unfortunately for medics and our patient's families, a relatively new concept. Additionally, newer evidence shows that an increased frequency…
- Episode 153 - MMQ#5 From The PNW - Spokane Frozen Solid
The Podcast Crew is joined by Spokane Valley Fire Paramedic Noah Martinez to discuss a recent patient that he delivered to Dr. Patrick. After you hear what Noah found on the scene, this story will likely not end exactly how you expect. Lea…
- Episode 152 - The MCHD SNORES Sedation Safety Bundle
Chemical sedation is one of the riskiest decisions made in EMS clinical care, period. We've been working overtime at MCHD over the past couple of years to decrease the risk and improve our safety profile for the entire clinical package whe…
- Episode 151 - MMQ#4 - Dr. Dickson's Strokes
Join us as Dr. Dickson brings a couple of extremely difficult recent emergency department cases to take a hard look in his own clinical mirror. These will highlight the difficult and often dynamic nature of assessing airway patency and pro…
- Episode 150 - Hyperkalemia, BRASH syndrome, And Amiodarone BEWARE
MCHD paramedic, Lily Trosclair, joins the podcast to discuss some in-depth hyperkalemia treatment details, including BRASH syndrome. We'll also pivot to the dangers of giving amiodarone to a hyperkalemic patient that's mistaken for ventric…
- Episode 149 - Finding Joy In The Common
This may seem like a curveball-type episode upon your initial listen, but this topic should be core material for all emergency medical clinicians. Too much time and emphasis within paramedic education are placed on rare presentations. Dr.…
- Episode 148 - ET3 And Beyond With Dr. Gerad Troutman
The podcast crew is joined, live at Texas EMS 2022, by Dr. Gerad Troutman to discuss the world of alternate destination EMS transports, EMS-facilitated telehealth, nurse navigation, and "hospital at home." Dr. Troutman leads the ET3 initia…
- Episode 147 - MMQ#3 - CAB For The Win
MCHD medics Kelcie Adams and Rich Serra join the podcast to discuss a critically ill trauma patient they delivered to Dr. Patrick in the emergency department. Our default is so often airway, airway, airway first, but prioritizing circulati…
- Episode 146 - NTG In RVMI With Matt Wilkinson-Stokes
Special guest alert!! We're lucky to have superstar Aussie medic and University of Melbourne Ph.D. candidate Matt Wilkison-Stokes, on this episode to discuss his recent paper looking at the risk of hypotension with nitroglycerin administra…
- Episode 145 - Where Do We Look? Who Do We Trust?
We have MCHD Cpt. Megan Powell to thank for this episode as she posed an excellent question about where and how to look for trusted educational information as a practicing paramedic interested in continuing clinical growth and progression.…