The World’s Okayest Medic Podcast Random Ramblings: Dan Rauh
Aug 10, 2025
In this insightful discussion, Dan Rauh, a seasoned paramedic and medical director, shares his vast experience in emergency and critical care. He dives into the complexities of diagnosing overlapping physical and neurological pain, highlighting the emotional hurdles in the process. Dan also emphasizes the vital skills of scene management for new paramedics and addresses the challenges of toxic leadership within organizations. Their anticipation for an upcoming conference on drowning patients adds an exciting layer to this engaging conversation.
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Ambiguous EKG That Triggered A STEMI Call
- Dan describes an elderly woman with neck/left-arm pain whose first EKG looked like LBBB and later printed as acute STEMI.
- He transported her to a PCI center where cardiology debated and ultimately waited on troponin, showing uncertainty even in hospitals.
Don't Trust EKG Labels Over Clinical Context
- Automated EKG interpretations and differing prints can create confusion and don't replace clinical judgment.
- When in doubt, default to the patient's presentation and consult colleagues rather than relying solely on the machine.
Uncertainty Is Universal, Not A Weakness
- Uncertainty is normal across prehospital and hospital providers; experts also face indecision.
- Sometimes more knowledge increases paralysis, so aim for decisive, prioritized action rather than overanalysis.