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
174 episodes
The Synapse Season 2 Episode 100a - AVNRT vs AVRT...The Re-Entrant Duel
Piggybacking off of episode 100, we examine AVNRT and AVRT, two types of PSVT's that can be brought on by seizure activity, or just from other causes, as well as each of their own specific sub-types. I discuss how to identify them on ECG and ho...
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Season 2
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Episode 100
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23:00
The Synapse Season 2 Episode 100 - When the Brain Attacks the Heart
Did you know that seizures can bring about a cardiac arrhythmia in your patient? Have you ever stopped to think about how the brain and heart are connected and how this could occur? In this episode I discuss the anatomy and physiology behind th...
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Season 2
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Episode 100
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17:13
The Synapse Season 2 Episode 99 - The "Anti-Winters" Formula
Ok, we talked about Winters Formula for expected PaCO2 in metabolic acidosis...but what happens if our patient has the opposite issue, and is metabolic alkalosis instead? Is there a magical (albeit empirical) equation to help with PaCO2 predict...
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Season 2
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Episode 99
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18:38
The Synapse Season 2 Episode 98 - Adrenal Stress Dosing
What is a stress dose? Why do the adrenal glands need help? Who exactly needs this, what do they need, and why? All important questions, friends. Join me on this episode and all will be explained!
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Season 2
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Episode 98
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10:36
The Synapse Season 2 Episode 97 - PIFT vs CCT...A Hospital "How-To"
The world of PIFT protocols vs CCT can be a very confusing place for sending hospitals to dwell in and navigate. Some crews are able to take patients at higher levels of care needs than others. Some don't have the same training or experience, o...
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Season 2
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Episode 97
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27:01
The Synapse Season 2 Episode 96 - VX-800...Goodbye Type 1 Diabetes?
Wouldn't it be amazing if Type 1 Diabetics had a cure? What would we see happen to our case load in healthcare from accidental insulin overdoses or hyperglycemia from under-dosing? Would it be that easy if there was an option? VX-880 is a novel...
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Season 2
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Episode 96
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13:57
The Synapse Season 2 Episode 95 - Sodium Bicarb Can Cause Pulmonary Edema?
Many of you that have been following along know I have put several episodes out on Sodium Bicarb, and you also know I don't typically put Sodium Bicarb high up on my Rx list. This episode looks at how NaHCO3 can actually cause or worsen pre-exi...
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Season 2
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Episode 95
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12:44
The Synapse Season 2 Episode 94 - The RSI Trial - Etomidate vs Ketamine...Again
It feels like Captain Sparrow and Captain Barbosa locked in eternal battle from the first Pirates movie...except it is Etomidate and Ketamine. The study just released purports that Etomidate is better than Ketamine again...but is it? Before we ...
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Season 2
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Episode 94
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29:22
The Synapse Season 2 Episode 93 - Winters Formula Pearls and Pitfalls
How can we determine where a patient with metabolic acidosis *should* be compensating in regard to expected PaCO2? Enter Winters Formula. In this episode we will talk about how it was derived, its strengths and weaknesses, how to use it, and mo...
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Season 2
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Episode 93
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31:37
The Synapse Season 2 Episode 92 - Gantacurium...the Paralytic That Almost Could
The search for a suitable replacement for Succinylcholine has been ongoing for decades...a non-depolarizing agent that has the same onset and duration times as Succinylcholine, but without all the nasty side effects...wouldn't that be wonderful...
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Season 2
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Episode 92
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11:10
The Synapse Season 2 Episode 91 - Methoxyflurane vs Nitrous Oxide
Nitrous? Sure...but it comes with a host of issues. Methoxyflurane? Wasn't that banned in the US by the FDA? It was...but it's making a comeback globally and stands poised to change inhaled analgesia for good. Want to know more? Join me in this...
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Season 2
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Episode 91
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13:51
The Synapse Season 2 Episode 90 - Violence Against Healthcare Workers
This is never an easy topic to discuss, but we are going to tackle it today. Whether you are EMS/pre-hospital or in the hospital, you are unfortunately involved in some of the most dangerous professions in our country today. Instances of violen...
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Season 2
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Episode 90
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34:06
The Synapse Season 2 Episode 89 - To Blindly Follow Where So Many Have Gone Before...
These are the voyages of the Starship AHA. And this episode is going to go where few have actually dared to go before...a path through space unencumbered by the numbingly binding dogma that is ACLS in cardiac resuscitation. Let me b...
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Season 2
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Episode 89
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22:40
The Synapse Season 2 Episode 88 - Sliding Scale Insulin is Not Really Helpful...Change My Mind
Sliding scale insulin is often used in the hospital, especially in-patient. However, there is a multitude of issues that comes with it for our hyperglycemic patients, with the primary issue being that SSI is more of a knee-jerk reaction than a ...
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Season 2
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Episode 88
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10:54
The Synapse Season 2 Episode 87 - Anticoagulant Therapy in Stroke...To Treat or Not to Treat?
There once was an anticoagulant agent named tPA...hold up, this isn't a fairytale and this story doesn't cover tPA or TNK! Those are different stories for different days. Does every stroke patient we encounter need to be anticoagula...
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Season 2
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Episode 87
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11:43
The Synapse Season 2 Episode 86 - Beta Blockers and the Metoprolol Mistake
We know beta blockers are a staple treatment in outpatient CHF/HFpEF and stable HFrEF patients. However, what is it about the nature of beta blockers that makes them potent killers in the decompensated HFrEF patient? Why do we routinely mix up ...
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Season 2
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Episode 86
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14:00
The Synapse Season 2 Episode 85 - Dobutamine Heaven or Dobutamine Hell
With this case review (fictional) and dive into the pharmacology behind Dobutamine, by the end of this episode you should hopefully have a firm understanding of what it is, what it does, how it can be helpful to our patients, but also how it ca...
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Season 2
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Episode 85
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11:48
The Synapse Season 2 Episode 84 - Post-Intubation Circulatory Shock
How do we prevent "death-by-induction?" How do you appropriately resuscitate a patient before intubation? Have you heard of the Shock Index before? Or are you aware that there is a difference between systolic shock index and diastolic shock ind...
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Season 2
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Episode 83
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19:17
The Synapse Season 2 Episode 83 - Plasma May Actually Be Better Than PRBC's...Change My Mind
In the absence of whole blood, if I had to choose between PRBC's or plasma in the prehospital environment for the bleeding patient with coagulopathy, and didn't get to carry both, I would choose (freeze-dried) plasma as the product to carry. Wh...
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Season 2
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Episode 83
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23:55
The Synapse Season 2 Episode 82 - RAD with ST Elevation is Highly Unlikely to be an MI
Right axis deviation with ST elevations? Listen in and I will explain why there is only one type of MI that will present like this. The purpose of this episode is to help cut down on false activations, understand how we can use the science behi...
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Season 2
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Episode 82
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22:25
The Synapse Season 2 Episode 81 - Lactate Elevation After Norepinephrine
Think back to the last sepsis patient you had. Maybe they had an elevated lactate to begin with and were hypotensive. Norepi was started, BP improves, but the serial lactate is even more elevated afterwards. Why is this happening? Is the patien...
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Season 2
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Episode 81
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15:05
The Synapse Season 2 Episode 80 - Tachycardia...To Treat or Not To Treat?
Is your patient's tachycardia the primary issue or compensatory? Will you treat it or leave it? If you are going to treat it, what will you use? This episode will discuss the nuances of tachycardia, when it is dangerous to treat, and how we can...
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Season 2
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Episode 80
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15:52
The Synapse Season 2 Episode 79 - Differential This!
Let's examine this case study, and put your differential diagnosis skills to the test. Is this DKA? Withdrawals? Tox? Or something more like a combination of all three? In this episode we will dissect this case as well as the science behind it ...
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Season 2
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Episode 79
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17:21
The Synapse Season 2 Episode 78 - Pressure Volume Waveform Loops
While this episode may be a bit Respiratory-"heavy," it is important to understand the basics of mechanical ventilation waveforms. If you are a paramedic tasked with transporting a patient on mechanical ventilation, or a paramedic or nurse in a...
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Season 2
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Episode 78
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15:57
The Synapse Season 2 Episode 77 - The DIFOCCULT-3 Trial...More Support for OMI and NOMI
In this episode, I dissect the DIFFOCCULT-3 Trial and the evidence that it continues to amass to further support getting away from STEMI and NSTEMI, and moving towards OMI/NOMI. Why does it make sense to make this change? What will actually cha...
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Season 2
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Episode 77
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31:28