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
290 episodes
The Synapse Season 4 Episode 16 - Trauma Diamond of Death Isn't So Shiny Now
Most of us are familiar with the trauma triangle of death. Recently the trauma diamond of death was touted as the shiny upgrade, focusing heavily on calcium's role amongst the three other components. However, is there more to this than meets th...
The Synapse Season 4 Episode 15 - Dopamine Revisited...Can I Change Your Mind?
So many people lately seem to have very negative views of Dopamine. And for good reason! I have heard the arguments of how bad of a drug it is, how there are so many better options out there, how it causes all kinds of issues and is unpredictab...
The Synapse Season 4 Episode 14 - Trauma Arrest Management
Stop killing our trauma arrest patients...sounds weird to say right? But many of them may not actually be in arrest. So yes, stop killing them with improper care! Let's look at what happens when the right thing is the wrong thing here, and how ...
The Synapse Season 4 Episode 13 - MetHb Detection, Effects, and Treatment
What is MetHb? How does it affect our body? Is this something that occurs naturally, or is a foreign invader of sorts? Once we know what it is, how do we detect it, and what can we do to lower the levels?
The Synapse Season 4 Episode 12 - Ketamine, Propofol, and Etomidate in Status Epilepticus
What do these three sedative drugs have in common when it comes to status epilepticus? Are there uses for them? Together or separate? How do they work in our favor and our patient's favor? Tune in to find out!
The Synapse Season 4 Episode 11 - I See Your MABP of 65mmHg and I Raise It...
"Shoot for a target MABP of 65mmHg!" It sounds great in theory, except like many other numbers and concepts in medicine, this is one of those that I truly feel make us as the Provider feel better than it actually does much for our patient. We k...
The Synapse Season 4 Episode 10 - Cyanokit for...Vasoplegic Shock??
Yes, Cyanokits...Hydroxocobalamin...the same expensive medication we can administer to patients who have been exposed to smoke inhalation from say, a structure fire. Why would we ever consider giving it to a patient suffering from Vasoplegic sh...
The Synapse Season 4 Episode 9 - Inhaled vs. IV Nitric Oxide
It is the same drug, right? Whether I give NO via IV or nebulization, it will do the same thing, won't it? Won't it??? If I had to devote an entire episode to this one topic, I am sure you have guessed at this point that this is not the case. J...
The Synapse Season 4 Episode 8 - Central vs Peripheral Arterial Monitoring
How many times have you run into issues with dampening, arterial monitoring collapse, etc? How often have you stopped to wonder if the issues you were having in the shock patients with poor arterial tracing might be avoided if you switched from...
The Synapse Season 4 Episode 7 - Kissing Walls in the Hyperdynamic Left Ventricle
What does it mean when the left ventricle is hyperdynamic? What are we looking at exactly on ultrasound? What do the ventricular walls "kissing" tell us about the patient?
The Synapse Season 4 Episode 6 - Physiologic Changes in Pregnancy
I recently had a few EMS crews asking about the pregnancy-related emergencies they may encounter. When I asked them about what is "normal" in each trimester, it became clear that this is a topic area that is not often covered in initial trainin...
The Synapse Season 4 Episode 5 - The Shock Indices
Shock is not just about BP. In fact, in adults in hemorrhagic shock, we typically need to lose at least 1.5L of blood before BP changes, which is stage III shock. In kids? That can vary but is much more on the occult side. You can be in shock w...
The Synapse Season 4 Episode 3 - Sodium Channel Blocker Toxicity Review
Sodium channel blockers can cause a host of nasty effects in the body, and the heart unfortunately can take the brunt of a lot of it. We will examine this in today's episode with what to look for, signs and symptoms, treatments, etc.
The Synapse Season 4 Episode 2 - The OXY-PICU Trial Said to do What??
For those who aren't aware, there really isn't much benefit to SpO2 >94%. We have talked about this ad nauseum in other episodes before. The AHA tells us 94-99% for an SpO2 range for various reasons. However a recently-released trial, the Ox...
The Synapse Season 4 Episode 1 - Bye-Bye, Orthostatics!
Welcome to Episode 1 of our 4th Season! I can't express how grateful I am for the continued support from around the world as this podcast continues to grow! We are now hosted on multiple streaming sites and have listeners regularly tuning in fr...
The Synapse Season 4 Episode 4 - Aortic Dissections and Rupture
This episode brings a review of the appropriate diagnostics and care for patients with aortic dissections and rupture as well as a review of the pathophysiology and classification types. Are you familiar with the newer HR and BP goals? Why is t...
The Synapse Season 3 Episode 100 - Ultrasound of the IVC is NOT a Stand-alone Assessment Tool
Thank you for tuning into the last episode of Season 3! This episode dissects the highs and lows of ultrasound of the IVC for volume status. Where does it excel? Where does it let us down, and how do we add other components of assessments in to...
The Synapse Season 3 Episode 99 - Autonomic Nervous System Exercise Map
This seems to be an area many people struggle with, trying to figure out sympathetic vs parasympathetic, muscarinic vs nicotinic, and how these all relate. Who has what for primary transmitters? How do we navigate this? I am showing you a quick...
The Synapse Season 3 Episode 98 - Occlusion of the LVOT in CPR
Is hand placement on the sternum mid-line halfway up the breastbone really the best place for compressions? What does the evidence show? How can we use POCUS in and out of the hospital to determine where hand placement is most effective, and ho...
The Synapse Season 3 Episode 97 - Antibiotic Infusions...Not All Are Rapid in 30 Minutes!
There are certain aspects of Pharmacology and Pharmacokinetics that are non-negotiable. One of those is the aspect of time in relation to antibiotic effectiveness. How much time is the antibiotic in the system for, vs how long does it take to r...
The Synapse Season 3 Episode 96 - Calcium Does NOT "Stabilize the Cardiac Cell Membrane" in Hyperkalemia
Ok...I get it. We were and still are often told that Calcium's role in the treatment of hyperkalemia is to "stabilize the cell membrane walls." In the most simplistic of explanations, this is still not entirely correct. This episode brings actu...
The Synapse Season 3 Episode 95 - CPAP and the Failing Heart...Why PPV Can *Sometimes* Increase Cardiac Output
PPV is notorious for dropping cardiac output by changing intrathoracic pressures and decreasing preload return by forcing lung tissue against major vessels and alveoli compression. However, is there ever a circumstance when PPV can actually imp...
The Synapse Season 3 Episode 94 - ECG Precordial Lead Placement in Men & Women with Large Breasts
Many of us were taught to place ECG precordial "V" leads under large breast tissue, replace/set down the tissue after, and then obtain the image. However, did you ever stop to think about how much large breast tissue can displace the ECG leads ...
The Synapse Season 3 Episode 93 - Cord Syndromes, Spinal vs Neurogenic Shock, and SCIWORA
Today is a review of most things having to do with spinal injuries. Anterior, posterior, and Brown-Sequard syndromes...Spinal vs Neurogenic shock differentiation (yes they are different!), and SCIWORA. We will examine each of these and what you...