The Synapse Critical Care & Emergency Medicine Podcast
The Synapse is a Critical Care and Emergency Medicine podcast breaking down topics and case studies into simple easy-to-digest segments to help build paramedic, nurse, and other pre-hospital and hospital clinicians into more robust providers. This podcast is open to any and all Emergency Medicine and Critical Care healthcare providers both in and out-of-hospital. Every effort is made to put out as many various topics to cater to everyone's interests and levels. Leave your technician hat outside, put on your clinician hat, and join us!
**Disclosures:
1) This is a non-monetary podcast, created and edited for free for your enjoyment and learning purposes.
2) The opinions and information presented in these podcast episodes is based off of up-to-date research, the latest evidence-based-guidelines, and/or anecdotal experience/opinions of the author.
3) Under no circumstances does this podcast or the information presented within each episode serve as authorization to work outside your guidelines, protocols, or workplace rules otherwise. When in doubt, contact Medical Control for guidance.
Episodes
224 episodes
The Synapse Season 3 Episode 50 - Intralipid IV Therapy
For many of our medications we administer, we have to consider how they are absorbed and utilized in the body. Some various medications are what we call lipophilic, meaning they combine or dissolve in fats. When the levels of these drugs become...
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Season 3
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Episode 50
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11:58
The Synapse Season 3 Episode 49 - Is SIMV Dead?
For the longest time I was taught that SIMV, especially SIMV in pressure mode, was a great transport alternative for patients. As more and more evidence comes out, and more ventilation modes are developed, it is time to look at whether or not S...
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Season 3
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Episode 49
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12:50
The Synapse Season 3 Episode 48 - Changing the National EMS Model
A bit of a departure from the normal A&P, pathophys, and pharmacology topics but today is a look at how backwards and inconsistent the national EMS model is, and what steps *could* theoretically be taken to clean this mess up. I say theoret...
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Season 3
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Episode 48
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24:02
The Synapse Season 3 Episode 47 - Resuscitative TEE in the Field
We have discussed transthoracic POCUS in cardiac arrest and the challenges that come with that. We have discussed an alternative view of the carotids during arrest as well. But is there feasibility in performing resuscitative transthoracic echo...
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Season 3
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Episode 47
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11:57
The Synapse Season 3 Episode 46 - Digitalis Toxicity and the Stone Heart
Digitalis is not just a beautiful flower to look at. This drug was once widely prescribed, but has since fallen out of favor for other, newer, less-problematic options. However, patients are still seen with this in their medication list, and gi...
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Season 3
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Episode 46
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14:03
The Synapse Season 3 Episode 45 - LVH and RVH...A Quick Review
Most people have heard of left ventricular hypertrophy, but few have heard of Armstrong Algorithm used to identify MI hiding under the massive voltages of LVH. Even fewer seem to remember how to identify right ventricular hypertrophy on the ECG...
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Season 3
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Episode 45
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17:20
The Synapse Season 3 Episode 44 - Pericardial Tamponade
There are many conditions to be aware of in emergency and critical care medicine, and sometimes it can feel overwhelming to remember them all. However one to be very much aware of is pericardial tamponade, not just because it is one of the caus...
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Season 3
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Episode 44
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14:52
The Synapse Season 3 Episode 43 - Cardamyst in PSVT
The traditional treatment for PSVT's, whether AVNRT or AVRT, is vagals, Adenosine, and possibly synchronized cardioversion. These require trained medical professionals, IV access, etc. What if there was a way for repeat *stable* PSVT patients t...
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Season 3
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Episode 43
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15:51
The Synapse Season 3 Episode 42 - A Dive Into Neonatal Care
For those of you are nervous to deliver and care for a neonatal patient during the initial resuscitation and stabilization periods, this episode is for you. Traditional EMS initial training programs woefully fail to prepare you accurately for t...
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Season 3
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Episode 42
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17:47
The Synapse Season 3 Episode 41 - The 5-Step Advanced Acid-Base Method
We have discussed Acid-Base before, using various methods to identify the disorder, whether it is the First, Middle, Last Name method or others. Today, we take it a step further. In this episode, we move past whether this is just a respiratory/...
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Season 3
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Episode 41
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23:23
The Synapse Season 3 Episode 40 - Transcutaneous vs Transvenous Pacing
This episode is all about pacing bradycardic symptomatic patients. Transcutaneous vs transvenous pacing, pearls and pitfalls of both, how effective they are, etc. I also discuss the importance of receiving facility staff NOT TOUCHING the transp...
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Season 3
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Episode 40
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16:31
The Synapse Season 3 Episode 39 - FAST-ED vs NIHSS...How Do We Bridge The Gap?
The FAST-ED score is a modified stroke scale combining elements of the NIHSS and other simplified stroke scales used to evaluate for LVO in the front 2/3rd of the brain. NIHSS is a very detailed stroke assessment to identify severity. However, ...
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Season 3
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Episode 39
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14:05
The Synapse Season 3 Episode 38 - VT vs SVT With Aberrancy
This simple concept is responsible for what we call "Clean Kills" in medicine, especially when providers at any level are not aware of the various methods to discern VTach from SVT with pre-existing aberrant conduction (think bundle branch bloc...
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Season 3
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Episode 38
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16:36
The Synapse Season 3 Episode 37 - GCS vs SMS vs FOUR Score...Which One Will Prevail?
We all know the idea behind the GCS...but how good are you at it really? Are there times where it just doesn't work? Do you actually trend it out and obtain multiple scores? What about for intubated patients/sedated/paralyzed patients? In this ...
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Season 3
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Episode 37
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13:48
The Synapse Season 3 Episode 36 - Antibiotics...Before Obtaining Cultures?! Blasphemy! Or Is It...?
Ok folks, here's another episode that I must ask you to hang your dogmatic practices on the shelf before tuning in. If you can't do that, this episode may not be the one for you!We will look at the history behind obtaining two sets of cu...
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Season 3
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Episode 36
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13:36
The Synapse Season 3 Episode 35 - The Epinephrine-Calcium Trap
Ever find yourself in a seemingly endless conversation trying to identify the pros and cons of Epinephrine in cardiac arrest? Or maybe wondering why we blindly give it per the guidelines in every cardiac arrest when in reality very few may need...
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Season 3
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Episode 35
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19:37
The Synapse Season 3 Episode 34 - FloTrac Monitoring
For those hospitals and critical care transport teams who are not able to provide PAC/Swan-Ganz monitoring, but want real-time invasive monitoring that relies on something your patient probably already has, an arterial line, the FloTrac monitor...
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Season 3
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Episode 34
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10:36
The Synapse Season 3 Episode 33 - Drug Rate Administration Reactions
Have you ever administered a drug to a patient too quickly and seen what can happen? Or are you one of those that brushes off that part of pharmacology? Rate of administration is just as important as drug choice and contraindications, and in th...
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Season 3
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Episode 33
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15:37
The Synapse Season 3 Episode 32 - Chest Drains Review
Remember what tidalling is? Are there supposed to be bubbles in the suction chamber? Why do we set suction to -20mmHg? This and more in this quick review of chest drain systems!
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Season 3
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Episode 32
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8:10
The Synapse Season 3 Episode 31 - Junctional Hemorrhage Tips
How confident are you at controlling possible junctional hemorrhage? It is not as simple as applying pressure. You can apply all the pressure you want, but if you are even an inch off the mark, it will not matter. Know your anatomy. Tune in to ...
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Season 3
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Episode 31
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12:40
The Synapse Season 3 Episode 30 - TXA in Trauma
Let's talk all things TXA. From the history to where it is going in the future, and everything in between. Clean up some myths, set some facts straight, and make sure you are comfortable using it on your trauma patients when the time is right!
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Season 3
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Episode 30
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15:59
The Synapse Season 3 Episode 29 - Goodbye Andexxa...and FDA Rapid Approval?
This episode is both a notice to providers about Andexxa's removal from the market for DOAC reversal, specifically Eliquis and Xarelto, as well as a dive into the FDA's rapid approval process for drugs that propose to be game-changers for lifes...
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Season 3
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Episode 29
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13:57
The Synapse Season 3 Episode 28 - 2026 AHA/ASA Stroke Guidelines Update
Similar to the ACLS, PALS, and BLS updates, the AHA and the ASA have released their joint 2026 Stroke Guidelines updates. This episode is a short review on what has changed, from mobile EMS stroke units, to tPA vs TNK, establishment of the firs...
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Season 3
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Episode 28
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15:18
The Synapse Season 3 Episode 27 - Early Repolarization...Good Or Bad? How About Both?
For as long as I can remember, I have been taught that Early Repolarization was, well, Benign...a good thing, a no-nothing finding that is very common in young males and athletes. However, back in 2008, that changed. Subsets of ER were found to...
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Season 3
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Episode 27
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14:43
The Synapse Season 3 Episode 26 - aVL and aVR...More Important Than You Might Think
aVR is often taught as the "non-diagnostic" lead, or the "forgotten" lead. aVL is often not viewed as the only truly reciprocal lead (to III), but also that isolated T-wave inversion or ST-elevation in aVL can be a very ominous finding, even th...
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Season 3
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Episode 26
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16:10