The World’s Okayest Medic Podcast

Listener discretion is advised. References: Casey, J., Seitz, K., et al. (2025). Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. NEJM. Available: https://www.nejm.org/doi/full/10.1056/NEJMoa2511420?query=featured_home Farkas. (Dec 10, 2025). PulmCrit: Hot take on RSI trial of ketamine vs etomidate. Available: https://emcrit.org/pulmcrit/rsitrial/ Srivatsa S, Chawla M, Hernandez M, et al. Helicopter transport of trauma patients continues to be overutilized: a call for universal transport criterion. Am Surg. Published online September 13, 2025:31348251378910. doi:10.1177/00031348251378910.

Listener discretion is advised.

Mike dives into the intricacies of managing atrial fibrillation, emphasizing fluid support over traditional rate control in certain patients. He shares engaging case studies, including one involving a septic patient and a debate on wide complex tachycardia. The conversation expands to the implications of amiodarone in patients with Wolff-Parkinson-White syndrome and the role of rapid AF in triggering dangerous ventricular arrhythmias. Alongside these medical discussions, Mike humorously critiques AI's influence in content creation and highlights the importance of mental health.

Dive into the fascinating world of Tactical Emergency Medical Services with insights from PrepMedic. Discover how he began his journey with SWAT medics and the differences in team structures. The discussion covers high-risk calls in rural versus urban settings, the complexities of organization and funding, and the importance of medics' specialized roles. They debate the pros and cons of arming medics, the utility of dedicated vehicles, and evolving medical kit strategies. This engaging chat unveils the critical integration of medics within tactical teams.

In a lively discussion, Mike reflects on working during Thanksgiving, highlighting a notably quiet shift. He revisits pressing safety concerns in helicopter emergency medical services, arguing for improved transparency and better training. Mike critiques the industry’s pressures leading to accidents, comparing U.S. crash rates to international standards. He passionately advocates for strict safety protocols while discussing the impact of student training and professionalism in the field. In a call for reform, he emphasizes the importance of using chest straps and critiques the ineffectiveness of C-collars.

In this discussion, Dr. Peter Antevy, an expert in pre-hospital resuscitation, and Dr. Mark Piehl, specialized in pediatric trauma, delve into critical topics in pediatric emergency care. They reveal that pre-hospital blood transfusions can significantly lower trauma mortality in children, emphasizing evidence from recent studies. They also debate the pros and cons of whole blood versus component therapy and tackle concerns about transfusion safety. Their insights encourage EMS clinicians to challenge existing protocols based on emerging data.

The podcast opens with a disclaimer and a preview of exciting upcoming topics, including pediatric blood and mobile stroke units. A deep dive into mobile stroke units changes a guest's perspective, sparking listener feedback. The host shares insights on hybrid programs, balancing pros and cons, and addresses criticism surrounding them. A personal update on exiting HEMS reveals fears after air medical crashes. Trust in the flight team is emphasized, and a serious discussion about industry safety and the need for urgent changes unfolds.

Listener discretion is advised.

Listener discretion is advised.

In this engaging conversation, Mike Damkot, a wilderness/hoist paramedic and tech enthusiast, dives into the transformative role of AI in emergency medical services. He discusses how AI can augment clinical decision-making without replacing clinicians and explores its current applications in EMS charting and EKG interpretation. The conversation highlights the potential legal risks associated with AI documentation and emphasizes the importance of maintaining accurate records. Mike also encourages healthcare professionals to embrace AI tools to stay ahead in a rapidly evolving field.