In this episode of The FAST Archives, join one of our favorite Kiwis, Rob Bryant as he takes a critical look at Ketamine, a drug that's as much a star in the medical field as it is a subject of debate. Rob, who has an extensive background in Emergency and Critical Care Medicine, explores the not-so-glamorous side of Ketamine, including its cardiovascular impacts, effects on mental health, and potential long-term damage to the bladder.Ketamine has long been a celebrated player in emergency and critical care for its versatility and effectiveness. However, like any celebrity, it has its controversies. His talk explores the evidence for and against the use of Ketamine in various settings and circumstances, challenging its pristine reputation and highlighting the importance of cautious and informed use. Whether you're a staunch supporter or a skeptic of Ketamine, this episode offers a balanced view that will enrich your understanding of one of the most talked-about drugs in medicine. Tune in to uncover the complexities of Ketamine through the expert lens of Rob Bryant.If you enjoyed this podcast, check out the other FAST Archives episodes we've recently released, and don't forget to join us at FAST24! Thank you so much for listening!

This episode from The FAST Archives explores a rare and high-stakes medical emergency: amniotic fluid embolism (AFE). Allison Herman, a seasoned RN with seventeen years of experience across ER, ICU, and helicopter EMS, shares a remarkable case involving this critical obstetrical complication.Allison, who spent a decade flying with a hospital-based helicopter EMS program in California, has recently returned to the ER as the pediatric emergency care coordinator. Her passion for emergency medicine and high-risk obstetrics shines through as she recounts how her team tackled a challenging AFE case.During this talk, you'll learn the importance of quick thinking, teamwork, and solid training in navigating unexpected emergencies during childbirth. Alli describes the collaborative efforts that led to a positive patient outcome and provides valuable insights into managing high-risk obstetrical cases.Whether in emergency medicine, critical care, or simply interested in understanding how EMS teams handle rare and complex scenarios, this episode offers a compelling and educational experience.If you enjoy this episode, please check out the other FAST Archives episodes that we have recently released. Enjoy the episode!

Join us for an insightful episode from The FAST Archives, featuring "Stayin' Alive: Impella Device and Left Ventricular Mechanical Circulatory Support in Critical Care Transport," presented by Michael Lauria. A former USAF Pararescueman and Critical Care/Flight Paramedic, Michael is now an EMS and Critical Care Fellow at the University of New Mexico Health Science Center. He brings his extensive experience to this engaging talk on Left Ventricular Assist Devices (LVADs) and their use in critical care transport.In this episode, Michael dives into the technical aspects of LVADs, including their design, application, and relevance in transport situations. You'll learn about anatomy, physiology, pharmacology, pressure waveforms, and point-of-care ultrasound (POCUS) as they relate to these devices. Michael’s presentation is thorough and engaging, perfect for anyone in critical care or emergency transport.Whether you're already familiar with LVADs or new to the topic, this episode offers valuable insights and practical knowledge. As these devices become more common in the field, you'll want to be prepared. Tune in to expand your understanding and equip yourself for future transports involving LVADs.

In this episode from The FAST Archives, we explore the powerful talk, "A Difficult Pill to Swallow: 3 Unforgivable Sins in Medicine." As pressures mount to keep emergency services running smoothly, many first responders are driven to work extra shifts and put their community's needs ahead of their own. But what happens when this "rescuer" mentality seeps into our personal lives?Kris and Sara Kaull share personal stories and discuss why it's so hard to let go of the high-intensity mindset when we're not on duty. They challenge us to think about the impact this can have on our relationships and overall well-being. As they peel back the layers, they offer insights into building meaningful connections and prioritizing self-care.Tune in to find out why maintaining balance is crucial for a healthy and fulfilling life. This episode provides a fresh perspective on stepping back from work, embracing a more balanced lifestyle, and rediscovering the things that matter most.

In this episode of The FAST Archives miniseries, we're replaying Geoff Murphy's talk from a previous FAST event, "Paramedics: The Master Multitasker... Right?" In this captivating talk, Geoff, from Master Your Medics, delves into the challenge paramedics (as well as nurses, physicians, and other medical professionals) face in multitasking, especially when they're often the most experienced provider.How well do we juggle life-saving skills while making critical decisions? And is multitasking always in the best interest of our patients? Through a personal story and insightful research, Geoff challenges our assumptions and invites us to consider the potential risks and rewards of multitasking in pre-hospital, critical care, and emergency medicine.If you're interested in learning more about Geoff Murphy and Master Your Medics, visit https://www.masteryourmedics.com, and if you're interested in joining us at FAST24 for more talks like this, visit https://flightbridgeed.com/fast24. Thanks for listening, and we hope you enjoy this episode!

Catch our latest episode with Brian Behn sharing his talk from a previous FAST event entitled, 'The Folk Science of Sepsis.' Brian explores and exposes possible gaps in the understanding of sepsis by EMS and critical care transport providers because of poor/incomplete education about it. He offers essential insights and practical advice to enhance our understanding and management of this deadly condition. Tune in to transform your approach to sepsis treatment and join us at FAST24 in Wilmington, June 10th-12th, for more talks like this one!

Welcome to the second episode of the FAST Archives mini-series! In this episode, we dive into a crucial conversation with Ginger Locke titled "Finding Feedback," where she examines the culture of feedback in EMS and Critical Care Transport. Unlike other professions, feedback in EMS usually comes only after extraordinary events. Ginger proposes a shift towards a continuous feedback loop that fosters growth and learning from every call/situation, not just the emergencies. This talk is a must-listen for anyone in EMS looking to build a more supportive and effective work environment. Join us as we explore practical steps to make feedback a regular part of our daily practice, enhancing personal and team performance.Please subscribe to The FlightBridgeED Podcast anywhere you listen to podcasts, and don't forget to pass on the knowledge! Share the podcast with friends and co-workers. We couldn't make this podcast without you! Thank you so much for listening! Enjoy the episode.** Special thanks to Mark Mennie, our wonderful and talented photographer at FAST for the last couple of years!SHOW NOTESMore information about Finding Feedback at the Medic Mindset website:https://medicmindset.com/2022/02/08/finding-feedback-uwash-great-rounds-notes/

Welcome to the FlightBridgeED Podcast! We're kicking off this special mini-series, "The FAST Archives," replaying some of our favorite talks from past FAST conferences. These moments made us laugh, think twice, and gave us the tools to be better providers.First up:  Pediatric patients on ventilators... it's a high-stakes game where small changes mean everything. In this essential talk, "Silent Killers in Pediatric Mechanical Ventilation", our very own Eric Bauer takes center stage breaking down the pitfalls to avoid and the strategies that will level up your vent skills for the littlest patients.Please subscribe to The FlightBridgeED Podcast anywhere you listen to podcasts, and don't forget to pass on the knowledge! Share the podcast with friends and co-workers. We couldn't make this podcast without you! Thank you so much for listening! Enjoy the episode.** Special thanks to Mark Mennie, our wonderful and talented photographer at FAST for the last couple of years!

In this gripping episode of "Mind Over Medicine," we dive deep into the critical, often unseen world of cognitive bias in emergency medicine. With the clock ticking and lives in the balance, emergency room professionals make split-second decisions that can mean the difference between life and death. But what happens when the human mind's inherent biases seep into these critical judgments? Join Ashley as she explores the various forms of cognitive bias - from anchoring bias to confirmation bias - that challenge medical professionals in high-stakes environments. "Mind Over Medicine: Navigating Cognitive Bias in Emergency Medicine" is a must-listen for anyone wanting to refine their decision-making processes and examine the complexities of human cognition under pressure. Tune in to uncover the unseen challenges of emergency medicine and the strides being made toward safer, more effective patient care. Please like and review on your current podcast app, including Spotify, Google Play, iTunes, PodBean, and many more. We appreciate your support over the past 12 years! 

Mechanical Ventilation and ARDS – Podcast Summary and ReferencesThis is the sixth of a special podcast series on obstetric critical care.  I am joined on this series by Dr. Elizabeth Garchar, MD, FACOG.  She is an OB/GYN and Maternal Fetal Medicine (MFM) specialist who has a particular interest in obstetric critical care.  She is also unique in that she flies regularly with our critical care transport teams as a retrieval OBGYN/MFM and is one of our Assistant Medical Directors for the flight program. The topic of this podcast is Mechanical Ventilation and ARDS in pregnancy.  Although respiratory distress requiring intubation and ARDS in pregnancy is not very common, it is more common than some of the other pathologies we have discussed recently.  Mechanical ventilation of the pregnant patient can be intimidating, but rest assured that if you have the capabilities to manage other patients on a vent, you can manage the pregnant patient.  Generally speaking solid outcomes data is sparse and, generally speaking, most guidelines recommend vent management of mechanical ventilation in patients with or without ARDS similarly to non-pregnant patients…with a few exceptions.  This podcast reviews the basics of ARDS and evidence-based management.  It reviews some specific features of obstetric physiology and fetal gas exchange that are important to keep in mind.  Finally, we will review what guidance is available and review general recommendations for managing these patients in transport.For additional learning and a more in-depth review of the evidence check out this talk on gas exchange and mechanical ventilation in critically ill patients by Dr. Allison Lankford (part of the amazing Maryland CC Project lecture series): http://maryland.ccproject.com/2023/05/30/lankford-gas-exchange-and-pulmonary-ventilation-in-the-critically-ill-obstetric-patient/References1. Abou-Arab O, Huette P, Debouvries F, Dupont H, Jounieaux V, Mahjoub Y. Inhaled nitric oxide for critically ill Covid-19 patients: a prospective study. Crit Care. Nov 12 2020;24(1):645. doi:10.1186/s13054-020-03371-x2. Barrantes JH, Ortoleva J, O'Neil ER, et al. Successful Treatment of Pregnant and Postpartum Women With Severe COVID-19 Associated Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation. Asaio j. Feb 1 2021;67(2):132-136. doi:10.1097/mat.00000000000013573. Bhatia PK, Biyani G, Mohammed S, Sethi P, Bihani P. Acute respiratory failure and mechanical ventilation in pregnant patient: A narrative review of literature. J Anaesthesiol Clin Pharmacol. Oct-Dec 2016;32(4):431-439. doi:10.4103/0970-9185.1947794. Boelig RC, Saccone G, Bellussi F, Berghella V. MFM guidance for COVID-19. Am J Obstet Gynecol MFM. May 2020;2(2):100106. doi:10.1016/j.ajogmf.2020.1001065. Campbell LA, Klocke RA. Implications for the pregnant patient. Am J Respir Crit Care Med. Apr 2001;163(5):1051-4. doi:10.1164/ajrccm.163.5.163536. Carter AM. Factors affecting gas transfer across the placenta and the oxygen supply to the fetus. J Dev Physiol. Dec 1989;12(6):305-22. 7. Carter AM. Placental Gas Exchange and the Oxygen Supply to the Fetus. Compr Physiol. Jul 1 2015;5(3):1381-403. doi:10.1002/cphy.c1400738. Cavalcante FML, Fernandes CDS, Rocha LDS, Galindo-Neto NM, Caetano J, Barros LM. Use of the prone position in pregnant women with COVID-19 or other health conditions. Rev Lat Am Enfermagem. 2021;29:e3494. doi:10.1590/1518-8345.5181.34949. Cojocaru L, Turan OM, Levine A, et al. Proning modus operandi in pregnancies complicated by acute respiratory distress syndrome secondary to COVID-19. J Matern Fetal Neonatal Med. Dec 2022;35(25):9043-9052. doi:10.1080/14767058.2021.201346410. Cole DE, Taylor TL, McCullough DM, Shoff CT, Derdak S. Acute respiratory distress syndrome in pregnancy. Crit Care Med. Oct 2005;33(10 Suppl):S269-78. doi:10.1097/01.ccm.0000182478.14181.da11. D'Souza R, Ashraf R, Rowe H, et al. Pregnancy and COVID-19: pharmacologic considerations. Ultrasound Obstet Gynecol. Feb 2021;57(2):195-203. doi:10.1002/uog.2311612. Danish MA. Mechanical Ventilation in Critically Ill Obstetric Patient. Principles of Critical Care in Obstetrics. 2016:133-141:chap Chapter 14.13. Delyoa-Tomas E M-LT, Lopez-Fermin J, Perez-Nieto OR, et al. Consideration for Mechanical Ventilation in the Critically Ill Obstetric Patient. Crit Care Obst Gyne. 2020;6(10):1-8. 14. Douglass KM, Strobel KM, Richley M, et al. Maternal-Neonatal Dyad Outcomes of Maternal COVID-19 Requiring Extracorporeal Membrane Support: A Case Series. Am J Perinatol. Jan 2021;38(1):82-87. doi:10.1055/s-0040-171869415. Ende H, Varelmann D. Respiratory Considerations Including Airway and Ventilation Issues in Critical Care Obstetric Patients. Obstet Gynecol Clin North Am. Dec 2016;43(4):699-708. doi:10.1016/j.ogc.2016.07.00216. Gattinoni L, Camporota L, Marini JJ. Prone Position and COVID-19: Mechanisms and Effects. Crit Care Med. May 1 2022;50(5):873-875. doi:10.1097/ccm.000000000000548617. Grasselli G, Calfee CS, Camporota L, et al. ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med. Jul 2023;49(7):727-759. doi:10.1007/s00134-023-07050-718. Griffiths MJ, Evans TW. Inhaled nitric oxide therapy in adults. N Engl J Med. Dec 22 2005;353(25):2683-95. doi:10.1056/NEJMra05188419. Guérin C, Reignier J, Richard JC, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. Jun 6 2013;368(23):2159-68. doi:10.1056/NEJMoa121410320. Huang C-Y, Tsai Y-L, Lin C-K. The prone position ventilation (PPV) as an approach in pregnancy with acute respiratory distress syndrome (ARDS). Taiwanese Journal of Obstetrics and Gynecology. 2021/05/01/ 2021;60(3):574-576. doi:https://doi.org/10.1016/j.tjog.2021.03.03621. Khalil M, Butt A, Kseibi E, Althenayan E, Alhazza M, Sallam H. COVID-19-Related Acute Respiratory Distress Syndrome in a Pregnant Woman Supported on ECMO: The Juxtaposition of Bleeding in a Hypercoagulable State. Membranes (Basel). Jul 17 2021;11(7)doi:10.3390/membranes1107054422. Kodali BS, Wong MJ, Lankford A, Lee K, Bharadwaj S. Effect of Fetal Delivery on Pao2/Fio2 Ratio During Mechanical Ventilation in Parturients With COVID-19: A Case Series. A A Pract. Jul 1 2022;16(7):e01587. doi:10.1213/xaa.000000000000158723. Lam GK, Stafford RE, Thorp J, Moise KJ, Jr., Cairns BA. Inhaled nitric oxide for primary pulmonary hypertension in pregnancy. Obstet Gynecol. Nov 2001;98(5 Pt 2):895-8. doi:10.1016/s0029-7844(01)01549-624. Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med. Sep 2015;8(3):126-32. doi:10.1177/1753495X1558922325. Lapinsky SE, Posadas-Calleja JG, McCullagh I. Clinical review: Ventilatory strategies for obstetric, brain-injured and obese patients. Crit Care. 2009;13(2):206. doi:10.1186/cc714626. Lapinsky SE, Viau-Lapointe J. Mechanical Ventilation and Delivery During Pregnancy. Chest. Mar 2023;163(3):473-474. doi:10.1016/j.chest.2022.10.02527. Lim MJ, Lakshminrusimha S, Hedriana H, Albertson T. Pregnancy and Severe ARDS with COVID-19: Epidemiology, Diagnosis, Outcomes and Treatment. Seminars in Fetal and Neonatal Medicine. 2023;28(1)doi:10.1016/j.siny.2023.10142628. Linassi F, Campagnolo M, Busato E, Ortolani V, Peta M. Prolonged prone position in pregnant woman with COVID-19 pneumonia. Journal of Anesthesia, Analgesia and Critical Care. 2022/04/12 2022;2(1):16. doi:10.1186/s44158-022-00044-929. Lucarelli E, Behn C, Lashley S, Smok D, Benito C, Oyelese Y. Mechanical Ventilation in Pregnancy Due to COVID-19: A Cohort of Three Cases. Am J Perinatol. Aug 2020;37(10):1066-1069. doi:10.1055/s-0040-171366430. Magala Ssekandi A, Sserwanja Q, Olal E, Kawuki J, Bashir Adam M. Corticosteroids Use in Pregnant Wom...