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Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care ProvidersAuthor: Ross Orpet, Paramedic turned EMS Physician
Paramedic training is over, youre in the front seat now. Whether day 1 or day 1,000 you cant shake the fear youre underprepared. You were taught to systematically decide if A... do B. But what if A wasnt in the book? The truth is each emergency call is too unique to teach the right response to every situation. We need to go beyond algorithmic thinking and understand deeper principles, the WHY behind the algorithm. When every decision counts you want to rely on a framework that will guide you when things dont make sense. Loud & Clear: EMS Guiding Principles is your resource to build that framework. Through discussions with experts, review of evidence-based best practices, and real-world case studies we teach you one step past what you learned in paramedic school. But all of this advanced education is connected back to the guiding principles that answer the question- at the end of the day, what actually matters to the patient I have in front of me? Our mission is to elevate your practice and help you improve patient outcomes in every emergency situation. You may not feel ready, you may not feel like you know enough, but by understanding the guiding principles of emergency medicine you can become an expert EMS clinician. Because what you do matters.Loud & Clear: EMS Guiding Principles is an EMS Cast LLC production Language: en Genres: Education Contact email: Get it Feed URL: Get it iTunes ID: Get it Trailer: |
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Post-ROSC Care and Pacing: Prove the Perfusion
Episode 134
Monday, 31 August, 2026
Getting a pulse back feels like a win. Seeing pacer spikes and something that resembles a pulse feels reassuring. But in both situations, the monitor can make you feel better before the patient actually is. Geoff Murphy of Master Your Medics breaks down the fragile minutes after return of spontaneous circulation. He explains why hypotension deserves immediate attention, how falling end-tidal CO2 can warn that cardiac output is deteriorating, and when fluids can serve as a short bridge to vasopressors. Then, paramedic Jacob Miller challenges some of the assumptions clinicians learn about transcutaneous pacing. He discusses pad placement, pacing current, ultrasound, pharmacologic support, and why clinicians need to keep reassessing even after they think they have capture. In this episode, you’ll learn: Why an initially normal blood pressure after ROSC can be falsely reassuring How skeletal muscle contraction during pacing can create ECG artifact and a false sense of mechanical capture What can improve your chances of capturing a patient when transcutaneous pacing is needed Why practicing the pacer during routine monitor checks can make a rare, high-stress call much easier to manage Want more? Sign up for our weekly newsletter, The Confidence Dispatch. Want individualized coaching and mentorship? Check out The Loud & Clear Fellowship. Interested in ABLS Now? Our listeners get 10% off with code LOUD26POD. Jacob’s Resources: Article with images of false vs true electrical capture: Kimbrell J, Kreinbrook J, Poke D, et al. False Electrical Capture in Prehospital Transcutaneous Pacing by Paramedics: A Case Series. Prehosp Emerg Care. 2024;28(7):928-936. doi: 10.1080/10903127.2024.2321287 Link to Scott Weingart's EMCrit podcast episode discussing false positive SpO2 signal without actual capture: https://emcrit.org/emcrit/tcp-pulse-ox-fail/ Jacobs website with handout version of my slides: https://jacobmilleracnp.com/slides/ Guests: Geoff Murphy, Founder and Lead Educator of Master Your Medics Jacob Miller, paramedic, flight nurse, critical care nurse, nurse practitioner, and DNP
