The World’s Okayest Medic Podcast

Listener discretion is advised.

Listener discretion is advised. Thank you to Pulmonologist Nick Ghionni and host of the EmCrit Podcast, Dr. Scott Weingart for coming onto the podcast and talking about approaches to the assessment and management of the often vague and really sick patient with respiratory distress.

Mike dives into the latest AHA updates and state protocols while discussing the nuances of mechanical CPR with a state medical director. He questions the solid evidence behind common resuscitation practices, highlighting dual sequential defibrillation debates. There's a passionate discussion on when to update protocols versus waiting for more compelling data. Mike reflects on a colleague's retirement and evolving perspectives on POCUS in EMS, all while juggling personal recovery and workload challenges.

The host critiques the AHA's 2025 updates, deeming them underwhelming and cherry-picked. He discusses the downfall of Heads Up CPR and the shift towards IV access over IO. Key recommendations include stronger cardioversion guidelines for atrial arrhythmias and support for chest compressions during LVAD arrests. Concerns are raised about the efficacy of mechanical CPR devices and the reliance on epinephrine despite questionable outcomes. A balanced discussion on airway strategies rounds out a thorough examination of current practices in resuscitation.

Listener discretion is advised.

Dive into a casual Saturday chat as Mike shares his exhaustion from night shifts while juggling sick kids. He recaps a deep dive into AI's role in wilderness medicine, followed by a critique of the overuse of end-tidal CO2 monitoring. Mike challenges common misconceptions about pediatric blood transfusions and emphasizes the importance of training over experience alone. He warns against shallow medical advice online and stresses the need for a solid clinical context in practice. Tune in for insightful discussions and a lighter, personal touch!

Listeners are treated to a blend of humor and critical thinking, as Mike shares stories of meme culture in the medical community and a challenging pediatric transport situation. He dives into the complexities of pediatric hospital transfers and the confusion around their capabilities. A heated discussion follows on the utility of end-tidal CO2 monitoring, highlighting its limited value in various scenarios, especially with respiratory distress. The exploration of evidence around ETCO2 reveals weak support for its predictive power, making for a thoughtful examination of medical practices.

Listener discretion is advised.

Get a behind-the-scenes look as Mike discusses his plans for a new weekly coffee talk segment. He reflects on the chaotic live YouTube experience at Resus X and shares his thoughts on the controversial high-dose nitroglycerin debate. Delve into the complexities of end-tidal CO2 use and its limitations in respiratory failure. Plus, explore the excitement around prehospital blood resuscitation, especially the potential of spray-dried plasma. Tune in for insights on balancing professional demands while maintaining personal boundaries!

Join a lively discussion as Mike navigates the complexities of medical protocols, questioning the balance between guidelines and critical thinking. He dives into a debate on the use of high-dose nitroglycerin and shares personal anecdotes on IV versus sublingual applications. A captivating Kentucky case highlights the ethics of paramedics administering antivenom, stirring a conversation about acting beyond official scopes to save lives. Plus, a critical look at randomized controlled trials reveals the importance of understanding medications and regulatory expectations in EMS.