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PHARM Podcast 001 – Minh Interviews Cliff Reid

This is not an EMCrit Podcast, this is the first episode of a possible new podcast from EMCrit frequent poster Minh Le Cong.

You know Minh from posts like:

Needle vs. Knife

the king vision review

How to do a needle cric

He interviews Cliff Reid on Prehospital Airway Management and they discuss this paper:

Critical Care 2012, 16:R24

Now on to the Podcast

Right Click and Choose Save as to Download

21 Comments Post a comment
  1. Jakob Mathiszig-Lee #

    great podcast. really liked the debate between the two of you. will definitely listen to more but please buy a better mic minh!

    March 14, 2012
    • Minh Le Cong #

      Yeah sorry for the audio quality. Will do better next time!

      March 14, 2012
  2. Joseph #

    fantastic – really enjoyed how the authors weighed the human factors associated with practising in pre-hospital environments. Could you guys link the papers referred to in the podcast? I believe Minh referred to the Silverton paper in March’s annals (Glidescope vs Flex FO in Awake Laryngoscopy)… would love the links for the meta-analysis and awake crich paper which he also mentioned.

    March 14, 2012
  3. Minh Le Cong #

    Thanks Joseph

    Yes Cliff Reid referred to the Silverton paper in Ann EM March 2012 for awake laryngoscopy using VL. I did not reference a specific paper on my comment about awake surgical airway, more so what I have heard Darren Braude talk about on conferences like Essentials of EM 2011 as well as Airway World webcast lecture on prehospital airway management. However there is this nice case report from the Australian Defence Force library

    http://www.defence.gov.au/health/infocentre/journals/ADFHJ_apr04/ADFHealth_5_1_22-24.pdf

    March 14, 2012
  4. Nathan Gilbert #

    Great episode. Please, more prehospital topics would be amazing. I think this is right on the money. I work as a paramedic in a progressive hospital based system. We utilize RSI in our airway management successfully. I feel that the key to any program of airway management is proper training, preparation and most important aggressive Q/A review. The reason flight services have a good overall reputation for proper airway management is because of the way the Q/A is set up. For example- they must record a time from successfully passing the chords to obtaining end tidal waveform of under X amount of seconds. Every aspect of the airway management that the monitor can record is reviewed. And every airway is peer reviewed overall. We take our program seriously and imitate successful programs designed by successful services. Many flight programs require that they run an airway algorithm on the training manikin at the beginning of each shift! I respect that. That’s taking the job seriously. Getting the ego out of the way and practicing the steps properly each shift no matter how “experienced” the provider is. Bottom line is ET intubation and RSI are essential parts of the whole airway management bag. The answer is not to take the skill away from the provider it’s to force the provider to preform the skill better and with more clinical finess.

    March 15, 2012
  5. Minh Le Cong #

    thanks Nathan. as Cliff and I talk about its not just about getting the tube in. what you do with that tube after you get it in, is more important. lots more prehospital podcasts to come!

    March 15, 2012
  6. Minh and Cliff,
    This stuff is gold. Great discussion. Please keep the critical care transport medicine discussion going! Thanks for doing what you do to elevate the standard of care worldwide.

    March 16, 2012
  7. Minh Le Cong #

    Thanks Bill. Will do. Cliff and I got a bunch of colleagues with similar passion for this work. Am going to try to interview all of them as well as folks from overseas! Lots of areas of controversy to discuss and get opinions on.

    March 18, 2012
  8. Adam #

    Thanks for a great podcast. We have lots of EMS people listening here in Iowa.
    Thank you.

    March 20, 2012
  9. Minh Le Cong #

    thankyou Adam! total respect for EMS and flight crews…its a very tough job the prehospital work. But we need to discuss and improve what we do every day..thats what I am about here.

    March 20, 2012
  10. Don Diakow #

    Thanks Minh and Bill (Dr. Weingart as well)! I’m a Field Training Officer in Alberta Canada for Alberta Health Services EMS and this episode was a very thought provoking podast. We are self confessed Emcrit/ Weingart junkies here and I promote the blog and Podcasts to my crews to push them forward to excellence.
    Thank-you for reminding other listeners about the dramatic difference that faces anyone (physician or medic) when they leave the confines of the Emergency Dept and face these and other unique advanced airway management issues.
    Keep up the Pre-hospital focus, our Ipods, Iphone and Ipads await.

    March 20, 2012
  11. Minh Le Cong #

    Hey Don. thanks for the feedback. Love to visit Alberta one day! The job that Cliff and I work in here in OZ, we get to ride in helos, fixed wing , ambulances and sometimes even private vehicles as makeshift ambulances! Ventilated patient in back of Toyota 4WD SUV..I got some footage of that one..interesting case ..yeah its pretty eye opening stuff if you have only ever worked in an air conditioned ED or ICU. the military EMS folks probably have the hardest job on Earth..they are getting shot at as well!

    March 20, 2012
  12. James French #

    Hi Guys, Great Podcast. Cliff, which video laryngoscope do you carry prehospital? Also what was the name of the single use fibroscope; how did you learn to use it?

    March 23, 2012
  13. Minh Le Cong #

    Hi James
    I know that Cliff’s team have the king Vision video laryngoscope and Ambu Ascope flexible optical scope. There is footage of them training with these devices during their January 2012 induction process for new doctors

    March 23, 2012
  14. Mat Goebel #

    While I have a deep love for EMCrit…I think if this starts being published regularly, it may be my new favourite podcast.

    March 24, 2012
    • This is the sound of EMCrit crying

      March 26, 2012
  15. Doug Lynch #

    Fantastic start Minh & Cliff.

    I really hope you can continue this.
    I know there are many many juicy matters to get stuck into.
    Airway issues are only the beginning.

    (I might buy a new microphone and bring it in to you tomorrow morning as a well earned reward for your efforts.)

    Get behind them Scott and I like the idea of keeping this within the greater EMCrit Empire as pre-hospital and retrieval medicine are inextricably linked to not just emergency/critical care but almost all areas of health care from psychiatry to trauma.

    Look up Minhs published approach to the management and transport of the agitated patient;

    http://emj.bmj.com/content/early/2011/05/12/emj.2010.107946.abstract

    Brilliant.

    Doug

    March 25, 2012
  16. Minh Le Cong #

    thanks Doug
    Keep the mike for your own use. I got one coming in the mail already! I was In ED yesterday when one of our flying doctor colleagues brought in a retrieval of an agitated patient with exarcebation of schiZophrenia. He had used our ketamine protocol during the retrieval. I received the patient and recovered him. we have a unique opportunity to observe both states of the patient requiring retrieval, at the referring location and then at the receiving facility. He was fine, apart from some drowsiness. These are the matters that need wider discussion and debate..what is best practice in prehospital and retrieval medicine?

    March 25, 2012
  17. Great discussion!
    I think Cliff Reid’s approach to the patient with upper airway obstruction was just brilliant

    March 25, 2012
  18. John Wood #

    Fantastic podcast – please can we have more. I am a UK Critical Care Paramedic working in a similar set up as London HEMS but in the South West (Dave Lockey works at our local major trauma centre). Really enjoyed the debate and case study. I look forward to your next offering. Thanks fellas.

    March 25, 2012
  19. Great pocast! I am a listener of Dr. Weingarts podcast and enjoyed this topic and debate. As a fairly new flight paramedic I am always looking for things such as this to stimulate thought and learning for myself and the folks around me. Thanks for the podcast and I hope you continue this podcast. I will spread the word.

    April 15, 2012

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