The Synapse (Memorial Hospital MaineHealth)
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 tailored to the staff of the Mount Washington Valley EMS Program and the Memorial Hospital, but is open to any and all Emergency Medicine and Critical Care healthcare providers both in and out-of-hospital. Leave your technician hat outside, put on your clinician hat, and join us!
Episodes
101 episodes
The Synapse Season 2 Episode 28 - AVAPS...The Future of Smart NiPPV?
If you have been paying attention to mechanical ventilation in the past few years, you know there have been significant changes and improvements to the reliability and options, proprietary modes, etc. Some have been reliable, some not so much. ...
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Season 2
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Episode 28
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15:55
The Synapse Season 2 Episode 27 - Fluid Choice in Hyperkalemic Resuscitation
Is NS better? What about LR? Plasmalyte? What does "better" actually mean? Should we instead focus on which one(s) might do more harm in the hyperkalemic patient? Can you take a guess? I will give you a hint...don't focus on the potassium conce...
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Season 2
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Episode 27
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14:00
The Synapse Season 2 Episode 26 - Hypokalemia and Hypomagnesemia...When the K+ is Stubborn
If you have ever participated in potassium repletion before, you are probably aware that for every 10mEq of K+ we administer, we should expect the serum K+ lab value to increase by 0.1mEq/L. Well, what happens when we give K+, and lots of it, b...
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Season 2
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Episode 26
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10:59
The Synapse Season 2 Episode 25 - Propranolol...as a Sedation Adjunct???
In today's world of medication shortages, particularly the seemingly near-constant eb-and-flow of sedative shortages, who would have thought that a beta-blocker like Propranolol might actually be useful in assisting with sedation and decreasing...
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Season 2
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Episode 25
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10:31
The Synapse Season 2 Episode 24 - Challenging Concepts in Ventilation
We have all probably encountered the hypoxic patient who did not improve with oxygen. Why might that have been? Did you stop at that moment and consider which of the four types of hypoxia they may be suffering from? Or whether this was a ventil...
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Season 2
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Episode 24
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46:28
The Synapse Season 2 Episode 23 - LV Unloading in MI: Time to...Delay the Cath???
Hang on...didn't I just spend almost an entire episode talking about how we should not delay getting OMI and "NSTEMI" patients to the cath lab??? Now what is this about delaying catheterization??? Join me and find out about this potential game-...
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Season 2
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Episode 23
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14:14
The Synapse Season 2 Episode 22 - OMI and NOMI...the Death of the NSTEMI?
STEMI and NSTEMI have been the unchallenged terminology for too long. However, unlike the modern culture of just simply changing things to see them changed, the push across interventional cardiology to change "STEMI" and "NSTEMI" to OMI and NOM...
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Season 2
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Episode 22
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32:36
2025 Mt. Washington Valley Emergency Medicine Conference Announcement
Coming soon to a valley near you!What: 2025 Mt. Washington Valley Emergency Medicine ConferenceWhen: Saturday, June 14th and Sunday June 15thWhere: Grand Summit Hotel at Attitash (Bartlett)Open t...
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Season 2
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6:55
The Synapse Season 2 Episode 21: Mirror, Mirror, On The Wall...
...Which is the better of them all? Alkalosis, or Acidosis? We know both can be incredibly challenging to treat, but what about the theory that athletes are intentionally making themselves alkalotic to see improved health benefits? How can ther...
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Season 2
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Episode 21
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24:40
The Synapse Season 2 Episode 20: Your ECG Machine is NOT a Crystal Ball
Sound like a cryptic title? So too can ECG's seem cryptic...however, if you approach them all with a standardized approach, apply rules of cardiology, the world opens up and much more is possible with them than just ST-elevations and depression...
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Season 2
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Episode 20
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29:37
The Synapse Season 2 Episode 19 - Knockout Round: Dobutamine vs Milrinone
Taking a deeper dive after our Cardiogenic Shock episode, we will look at Dobutamine and Milrinone more in-depth, compare the two, and see which one is more beneficial at specific times.
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Season 2
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Episode 19
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13:54
The Synapse Season 2 Episode 18 - All Things LVH
If you have taken any type of 12-Lead ECG training, you have probably heard of a condition known as LVH, or left ventricular hypertrophy. It is possible that you also heard there is no way to diagnose an Occlusion Myocardial Infarction (OMI/STE...
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Season 2
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Episode 18
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22:13
The Synapse Season 2 Episode 17 - Cardiogenic Shock Traps
Considered one of the more challenging types of shock to treat, Cardiogenic shock can present in different ways in different patients, and each patient may require a different treatment modality depending on cause, physiologic differences, etc....
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Season 2
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Episode 17
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20:40
The Synapse Season 2 Episode 16 - Sodium Bicarb, Revisited.
Ok, because we touched on Sodium Bicarb in the last episode, I felt it made sense to not only re-visit this topic, but to also look at ways to reduce the negative effects of the hypertonicity with dilution in D5W, when to consider diluting and ...
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Season 2
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Episode 16
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19:32
The Synapse Season 2 Episode 15 - The End of Calcium (and Bicarb) in Hyperkalemia???
First of all...no. Not quite. But I got your attention, didn't I? Recently a *Retrospective case study with meta-analysis* was released that basically purports that there is no place or evidence for Calcium Chloride/Gluconate in Hyperkalemia wi...
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Season 2
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Episode 15
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21:57
The Synapse Season 2 Episode 14 - tPA vs TNK
Where are my tPA holdouts? And what about my TNK fans? Let's take a look at why TNK is quickly becoming the "ringleader" for STEMI, and more frequently, in off-label usage in CVA situations.
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Season 2
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Episode 14
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9:22
The Synapse Season 2 Episode 13 - Differential Diagnosis' for Cardiopulmonary Causes of Syncope
Why do we obtain a 12-lead ECG on every syncope patient? What are we looking for? What are the possible causes of syncope from the cardiac and pulmonary side of the anatomy/physiology "house?" Tune into this episode and add these to your mental...
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Season 2
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Episode 13
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22:53
The Synapse Season 2 Episode 12 - Droperidol Rapid Review
Have you ever administered Droperidol before? What would we give it for, and what do we need to consider when it comes to age of the patient, medication clearance, and what can go wrong if administration is done properly? We will explore these ...
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Season 2
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Episode 12
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15:12
The Synapse Season 2 Episode 11 - Cardiac Arrest Case Review....With a Sweet Tooth??
When you think causes of cardiac arrest, I bet your mind doesn't typically go right to candy as the cause. Maybe when we talk about our H's & T's, we should expand our "toxicology T" to something more than just opioids/opiates...what else c...
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Season 2
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Episode 11
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12:05
The Synapse Season 2 Episode 10 - Pediatric Cardiac Arrest Case Review
Pediatric resuscitations can be incredibly challenging mentally and physically. From maintaining your composure and separating yourself mentally, to ensuring you provide the best care possible, it is never easy. Now throw in massive trauma as w...
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Season 2
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Episode 10
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11:57
The Synapse Season 2 Episode 9 - Don't Forget the Analgesia!
Intubation of the conscious or semi-conscious patient is an incredibly invasive and painful experience. Propofol alone is not sufficient nor appropriate for a patient. Join me as I discuss not only sedation strategies, but just as important, an...
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Season 2
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Episode 9
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12:02
The Synapse Season 2 Episode 8 - Cardiac Arrest Updates
From Epinephrine administration to dual-sequential defibrillation, changes for hypothermic arrests, and much more, let's look at some considerations for your next cardiac arrest resuscitation!
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Season 2
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Episode 8
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35:35
The Synapse Season 2 Episode 7 - Lactate and CRP? Tell me More!
Let's take a look at commonly asked questions surrounding lactate, as well as a dive into the use of and background surrounding C-Reactive Protein, or CRP. What can we really use these for, and what do their results indicate? Join me and let's ...
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Season 2
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Episode 7
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25:32
The Synapse Season 2 Episode 6 - Drew's Story
This episode dissects an unfortunate case from across the country, where a significant number of medical errors in decision-making were made, and little accountability was taken, if any. The father of the patient has made it his goal for the re...
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Season 2
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Episode 6
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20:26
The Synapse Season 2 Episode 5 - Early Vasopressor Use in Massive PE
We know large fluid bolus' in massive PE are not helpful. What about early vasopressor usage while awaiting the TNK? This begs the question of which pressor and why? Perhaps Norepi is not the one we should reach for first, and maybe look for so...
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Season 2
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Episode 5
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9:39