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Tyler Christifulli
22 November 2019
You jump in the back of an ambulance and see the crew you intercepted with is currently ventilating the patient through a supraglottic airway (SGA). Your partner looks at you and says: "should we just swap and intubate?What factors influence your decision to yank the SGA and perform endotracheal intubation? Here is a decision tree I made to he...
FOAMfrat
10 October 2019
A few days ago I put up a thought experiment blog on generalizing the dose of rocuronium to 100 mg for anyone over the age of 18 years old. You can find that post here.  Here are my thoughts:  ...
FOAMfrat
01 October 2019
The Dreaded Cold ReadDoes anyone ever send you a cold read? A cold read is when you get a piece of information, but really no context. An example of this would be the ECG or lab panel that you get sent you with the predictable question: "What would you do?" This is a difficult question to answer, because the person is generally asking you to m...
FOAMfrat
19 September 2019
Recently I was asked to come in and speak to a critical care paramedic class on the topic of hemodynamics - not monitoring them, just the dynamics. I have often imagined the ideal way to teach a class on hemodynamics would be to build a simplified plumbing system of the body. This would consist of: 1. Hand Pump2. Large flexible/compliant&...
FOAMfrat
16 August 2019
  This month we had the privilege to chat with Cliff Reid (@cliffreid)- a Retrieval Physician with Sydney HEMS. Dr. Reid has an extensive history in HEMS and emergency/critical care medicine. I wanted to pick his brain on a variety of topics such as: Receiving a report from the crew you are intercepting with....
FOAMfrat
18 July 2019
 Sam and I sit down and and chat with our new friend @ChillaPharmD about : -Intubating the hypotensive patient.-Her perspective on the push dose pressor craze.-Long term sedation strategies....
FOAMfrat
14 July 2019
You will have to forgive me as this piece will not do intersectionality enough justice. I acknowledge whole-heartedly the complexities that come with being of a different race, sexual orientation, ability, etc, but this has the potential to turn into a dissertation if I delve too deeply. I humbly welcome opinions and perspectives that further open ...
FOAMfrat
25 June 2019
Sam and I ran into Brendan Riordan (@concernecus) at Camp ECHO a few months ago in West Virginia. We had a fantastic conversation out in the lobby of the conference center on all the right ventricle! In this podcast we address questions like:How can we differentiate sepsis from pulmonary embolism (PE)?Does a dilated RV in arrest always mean PE? (I ...
FOAMfrat
31 May 2019
A few weeks ago Brian Behn (The Brian Behn) put out a blog on FOAMfrat raising the question "When is a patient too sick to transport?"This question sparked a TON of good conversation on social media with a very diverse population of opinions."As long as crew safety is addressed, then we should make every effort to get this pt to definitive care. De...
FOAMfrat
22 May 2019
I was listening to Eric give a lecture during his ventilator pre-conference workshop. I forget the exact context, but he mentioned that lactate was a normal product of glycolysis. While lactate can be produced through glycolysis, this statement somewhat shook my understanding of how and why lactate is produced. I approached him later and asked him ...
FOAMfrat
27 March 2019
Let's have a little chat about static and dynamic tube confirmation.I organized a few graphs to show my current thought process.When you combine that concept with this..I believe we reach the best dynamic ETT monitoring system.Stuff not covered in the podcast:Can I use ultrasound?Are you currently doing it? No, only because I honestly need more pra...
FOAMfrat
11 March 2019
The Airway Gauntlet!Is there any benefit to reap from the obligatory "Airway Gauntlet" day of medic school. Remember this day? Intubating patients upside down, in the dark, and wedged by the toilet. Dr. Pickett believes so, and here is why.Dr. Pickett is an awesome dude with a commendable proactive approach to improving system performance in EMS.He...
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