Podcast 166: JR Pickett on Excited Delerium
In this podcast episode, Dennis interviews JR Pickett, an ER physician and EMS medical director, about excited delirium. They discuss the definition and history of excited delirium, the challenges faced by law enforcement and medical providers in managing these cases, and the importance of timely intervention. They also explore the differences between excited delirium and other conditions, such as combative patients in combat situations. The conversation highlights the need for proper assessment and observation of patients exhibiting excited delirium and the selection of appropriate medications for sedation. The podcast concludes with a discussion on the criminalization of medical care and the impact it may have on patient outcomes.
Podcst 164: Anoxic Brain Injury with Jeff
In this podcast episode, Dennis and Jeff discuss anoxic brain injury, its causes, progression, and treatment. They emphasize the importance of preventing anoxic brain injury by following the March algorithm and maintaining blood flow, airway patency, and oxygenation. They also discuss the role of monitoring and airway management in identifying and treating anoxic brain injury. The podcast covers the decision-making process for airway management and the importance of maintaining adequate oxygenation and blood pressure. The hosts also highlight the need to prevent secondary problems, such as pain, agitation, and seizures, and discuss resuscitation goals for anoxic brain injury.
PFC Podcast 152: Esketamine with PAC
Dennis welcomes his friend PAC to discuss “S-Ketamine.” PAC, an anesthetist with extensive experience, shares insights on using it in various medical settings including his experience in providing medical care during the Russian invasion of Afghanistan. He highlights its potential advantages, such as improved analgesia and reduced hallucinogenic effects in mid-doses.
Podcast 146: Versed and Procedural Sedation with Kevin and Paul
This episode, is all about “Versed.” We’ve got Kevin and Paul here, chatting about patient positioning and the intricacies of using Versed, a benzodiazepine, for sedation. They touch on how different patients react to the drug, emphasizing the art of medicine over strict calculations, especially in challenging scenarios. The podcast delves into dosing strategies, dealing with hemodynamically unstable patients, and the complexities of maintaining sedation during procedures. Remember, every patient is unique, so adapt the approach accordingly.
Podcast 144: Pain Pathway
Today, Winston and I dive into pain pathways. You know, those definitions of pain like visceral or psychogenic, they’ve never helped me treat pain practically. So, understanding the nervous system might just boost my pain management skills. The pain pathway consists of transduction, where energy turns into nerve impulses, ascending pathways, spinal cord travel, brain processing, and descending pathways. Remember, understanding the whole system aids better pain management.
Podcast 142: Carfentanil
Dennis is joined by Aaron, an emergency medicine physician and medical toxicologist. In this episode they discuss carfentanil, a synthetic opioid used in the 2002 Moscow hostage rescue. Carfentanil can cause CNS depression, pinpoint pupils, respiratory depression, and decreased gut motility. Reversing its effects may require higher doses of naloxone. However, its potency and unknown modifications make it challenging to combat. We’re still waiting for better treatments and auto-injectors. In the field, it’s crucial to differentiate opioid overdoses from other injuries, considering opioids’ widespread use and potential for weaponization.