Heavy Lies the Helmet

Episode 138 - Seizing Control w/Skyee Edwards

24 Apr 2026

Contributed by Lukas

Seizures demand fast decisions, but the best answers aren't always simple. In this episode, we sit down with Skyee Edwards, a pharmacist, to break do...

Episode 137 - Endocarditis: A Change of Heart

14 Mar 2026

Contributed by Lukas

In this podcast episode, we dive into the clinical chaos of Infective Endocarditis. It's a disease that can quietly destroy valves before showing its...

Episode 136 - Bronchoscope of Practice

14 Jan 2026

Contributed by Lukas

Airway management gets dangerous. In this episode of the podcast, we explore prehospital bronchoscopy—a true bleeding-edge concept—and where it ...

Episode 135 - Giving Patients Room to Breathe w/Melody Bishop (Part 2)

17 Dec 2025

Contributed by Lukas

Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, c...

Episode 134 - Giving Patients Room to Breathe w/Melody Bishop (Part 1)

21 Nov 2025

Contributed by Lukas

Mechanical ventilation doesn't have to feel like wizardry. In this podcast episode, we strip it back to what really matters—simple mental models, c...

Episode 133 - Tracheostomy: The Neck's Best Thing

03 Oct 2025

Contributed by Lukas

Tracheostomies are increasingly common in both prehospital and critical care transport settings, but they come with unique challenges. In this podcast...

Episode 132 - Prolonged Flight Care w/Dr. Tim Hurtado & Brett Weiner (Big Announcement)

18 Aug 2025

Contributed by Lukas

What happens when resources are limited, transport is delayed, or you’re forced to manage a critically ill patient far beyond the typical flight win...

Episode 131 - TXA: The Clot Thickens

14 Jul 2025

Contributed by Lukas

Tranexamic Acid (TXA) is a lot like hot sauce: People put it on everything — especially for apparent or suspected acute blood loss. In this podcast ...

Episode 130 - Opinion-Based Medicine w/Mike Carunchio

13 Jun 2025

Contributed by Lukas

Though evidence dictates much of what we do as emergency medical providers, some areas remain open to debate: How are we justifying stroke ambulances...

Episode 129 - Little Lung Problems w/Nate Brown

20 May 2025

Contributed by Lukas

Wet or dry. Air in or out. Reactive or obstructive. The possibilities may seem endless when treating the pediatric patient with undifferentiated respi...

Episode 128 - Keeping Trauma Close to the Chest

09 Apr 2025

Contributed by Lukas

'Tis the season for trauma. (If there truly is a season.) Chest trauma, specifically, can vary in subtlety and severity, primarily due to the presence...

Episode 127 - P.R.E.S. Sure

24 Feb 2025

Contributed by Lukas

Does your patient have high blood pressure? Are they seizing or showing other signs of a neurological disorder? It could be PRES! Unfortunately, Poste...

Episode 126 - Certification Versus Qualification

23 Jan 2025

Contributed by Lukas

Do certifications accurately reflect an individual's qualifications? This is an ongoing argument depending on what side of the exam you are on. How mu...

Episode 125 - Breaking the Case: The Point of Ultrasound

24 Dec 2024

Contributed by Lukas

Previously, we recorded a podcast episode about the utility surrounding Point of Care Ultrasound (POCUS). In this episode, we apply that knowledge to ...

Episode 124 - Canine Care w/George Tarver III

18 Nov 2024

Contributed by Lukas

Humans are easy. That's why we are able to do what we do as prehospital providers. But what happens when your patient is a canine? These working dogs ...

Episode 123 - To Treat or Not to Treat: Hypertension

21 Oct 2024

Contributed by Lukas

It can be difficult to determine whether you should treat undifferentiated hypertension or not. Many clinicians are distracted the number rather than ...

Episode 122 - Stay Positive When Preoxygenating (PREOXI Trial)

30 Sep 2024

Contributed by Lukas

The principles of preoxygenation and passive oxygenation should be familiar to any experienced intubator. Best practice recommends the use of a nasal ...

Episode 121 - Outside the Box: Cardiac Arrest Management

22 Aug 2024

Contributed by Lukas

Not all cardiac arrests are created equal. Whether the presenting rhythm is asystole, ventricular fibrillation, or PEA, these patients require tailore...

Episode 120 - Sorry, We Are Closed: Interfacility Transfers w/Austin Wingate

29 Jun 2024

Contributed by Lukas

Interfacility transfers are not always indicated at the time and place of which they are being requested. Whether it's referring provider misinformati...

Episode 119 - Losses and Gains: Antidiuretic Hormone

06 May 2024

Contributed by Lukas

Antidiuretic hormone (ADH) plays an essential part in the body's osmotic/fluid balance, sodium homeostasis, and blood pressure regulation. This hormon...

Episode 118 - Trigger Warning: Angioedema

25 Mar 2024

Contributed by Lukas

Angioedema is defined by upper airway swelling secondary to an immune response. The trigger and subsequent physiological response are how we categoriz...

Episode 117 - Dye or Die: Methylene Blue w/Will Heuser

28 Feb 2024

Contributed by Lukas

When discussing methylene blue, management and treatment of methaemoglobinaemia is usually the first indication mentioned. But in this podcast, we cha...

Episode 116 - Around the World: HEMS in México w/Daniel Peñaflor

27 Jan 2024

Contributed by Lukas

Though we have delved into foreign HEMS systems in the past (See Episode 61 – Down Under Dynamics w/Dr. Cliff Reid), we have not dedicated an entire...

Episode 115 - Me, My Self-Loading Baggage, and I w/Miles Dunagan and Brett Reeder

20 Dec 2023

Contributed by Lukas

"Self-loading baggage" is a derogatory term often used by pilots to describe lazy or disengaged medical crew members in the air medical industry. Whet...

Episode 114 - You Train Ukraine w/Kevin Collopy and Brock Jenkins

30 Nov 2023

Contributed by Lukas

The Russo-Ukrainian War is an ongoing international conflict between Russia and Ukraine. At times such as these, medical training is essential and som...

Episode 113 - Being B.R.A.S.H. When Treating Bradycardia w/Dr. Kate Connelly and Jake Miller

15 Nov 2023

Contributed by Lukas

B.R.A.S.H. Syndrome is a phenomenon with a constellation of Bradycardia, Renal failure, AV nodal blockade, Shock, and Hyperkalemia requiring identific...

Episode 112 – Acid Base Trifecta (Presentation)

31 Oct 2023

Contributed by Lukas

Dan presented the talk “Metabolic Acidosis: The Eye Can Only See What the Mind Can Comprehend” at AMTC23. In this recording, he teaches you how to...

Episode 111 - Critical Comfort Care w/Brianna Fields

18 Oct 2023

Contributed by Lukas

As a critical care clinician, do you consider yourself well-versed in comfort care? Do you consider yourself well-rehearsed in having the discussions ...

Episode 110 - The Truth About A-Fib

23 Sep 2023

Contributed by Lukas

Atrial fibrillation, particularly A-Fib with RVR (Rapid Ventricular Response), is often an emergency requiring emergent intervention beyond ACLS and i...

Episode 109 - 10 Things Your Gastroenterologist Wants You to Know w/Dr. Josh Peck

05 Sep 2023

Contributed by Lukas

Continuing our "10 Things" series, we focus our attention on gastroenterology. GE/GI goes well beyond colorectal. From bleeding esophageal varices to ...

Episode 108 - 10 Things Your PEM Physician Wants You to Know w/Dr. Dominique Diggs

30 Jun 2023

Contributed by Lukas

Pediatric Emergency Medicine (PEM) is a sub-speciality that many clinicians find intimidating. Are pediatric patients truly unique or are they simply ...

Episode 107 - Vascular Disaster

25 May 2023

Contributed by Lukas

Vascular emergencies refer to any time-sensitive condition where perfusion is prevented secondary to bleeding or occlusion of a vessel. These can incl...

Episode 106 - Breaking the Case (Pt. 2)

04 May 2023

Contributed by Lukas

Reviewing case studies with trusted colleagues can be extremely beneficial. Not only does it provide a moment of reflection on actions taken, but it a...

Episode 105 - 10 Things Your Emergency Physician Wants You to Know

29 Mar 2023

Contributed by Lukas

Have you ever handed off to an ER doctor, and you felt they were displeased with your care? Have you ever received an order from an ER doctor, and you...

Episode 104 - OMI, I Almost Died

05 Mar 2023

Contributed by Lukas

Myocardial infarctions can present in a variety of ways depending on vessel involvement, timing of pathology, and interpretation of diagnostics (e.g.,...

Episode 103 - Arrest, ROSC, Repeat

06 Feb 2023

Contributed by Lukas

No matter what level of scope, management of medical and traumatic cardiac arrests is the focus of many clinicians. But what happens after return of s...

Episode 102 - Long and Short of Learning w/Will Wingfield

01 Jan 2023

Contributed by Lukas

The medical industry puts great emphasis on formal education via university and other training programs. Due to financial incentive, these institution...

Episode 101 - Anti-Antibiotics

08 Dec 2022

Contributed by Lukas

Whether it's antibiotic-resistant "super bugs" or administration prior to acquiring blood cultures, empirical use of antibiotics is controversial. Sho...

Episode 100 - Medical Science Theater 100

22 Nov 2022

Contributed by Lukas

It's not clinical. It's not non-clinical, really. Celebrating our 100th full podcast episode, Bryan and Mike sit down in a Mystery Science Theater 300...

Episode 99 - A Survivor's Story w/Jonathan Godfrey and Chris Stevenson

31 Oct 2022

Contributed by Lukas

Based on the Crash and Learn 2022 special feature presentation, we sit down with Jonathan Godfrey and Chris Stevenson to discuss the EMS helicopter cr...

Episode 98 - Ups and Lows of GI Bleeds

13 Oct 2022

Contributed by Lukas

Gastrointestinal hemorrhages can present in a variety of ways from a variety of sources. Bleeding esophageal varices, in particular, can be life-threa...

Episode 97 - How Do You Copy

23 Sep 2022

Contributed by Lukas

Whether it's radio or bedside reporting, communication is a requirement of safely handing off patients. How do we build confidence in our ability to c...

Episode 96 - Airway Management for Airheads w/Dr. Mario Rugna

28 Aug 2022

Contributed by Lukas

Having an appropriate mindset is crucial when it comes to airway management, particularly in a prehospital and/or emergency setting. Whether it's team...

Episode 95 - Busted Skulls and Myths

08 Aug 2022

Contributed by Lukas

Traumatic Brain Injury (TBI) is always in the back of our minds when treating polytrauma patients. Unfortunately, the evidence has a controversial his...

Episode 94 - Treat the Heat w/Dr. Justin Hensley

15 Jul 2022

Contributed by Lukas

Heat illness is prevalent around this time of year. And compared to hypothermia, hyperthermia has a lower threshold for danger. From heat cramps to ...

Episode 93 - Performing Under Pressure w/Dr. Stephen Hearns

19 Jun 2022

Contributed by Lukas

It's no secret that we as emergency and critical care professionals are expected to perform highly in high pressure situations. Unfortunately, none of...

Episode 92 - Flight Suit Pat Down (Audio Only)

31 May 2022

Contributed by Lukas

What should you carry in your flight suit as an American-based HEMS provider? In our opinion, no one can definitively tell you that. But we can attemp...

Episode 91 - Immobi-Lies w/Dr. Mike Hudson

30 Apr 2022

Contributed by Lukas

Mores lies! But this time, we focus on empirical use of spinal immobilization devices and the harm associated with them. The dogma surrounding this to...

Episode 90 - The Key to Ketoacidosis

15 Apr 2022

Contributed by Lukas

Diabetic Ketoacidosis (DKA) is a common metabolic disorder, particularly in the pediatric population. If treated inappropriately, these patients can q...

Episode 89 - Para-Lies

30 Mar 2022

Contributed by Lukas

There are a lot of "lies"/misunderstandings surrounding appropriate use of paralytics AKA neuromuscular blocking agents (NMBAs). When are these medica...

Episode 88 - Closing the Blood Gates

08 Mar 2022

Contributed by Lukas

The clotting cascade, particularly in the context of anti-coagulation reversal can be complex to understand. Unfortunately, many of our patients are o...

Episode 87 - The Lesser Evil Overdose w/Dr. Arne Skulberg

17 Feb 2022

Contributed by Lukas

Which is the lesser evil, opioid or naloxone overdose? To avoid adverse effects, how should we be administering naloxone in the presence of opioid ove...

Episode 86 - Pilot Down But Not Out w/Wade Dunford & Scott Davis

31 Jan 2022

Contributed by Lukas

An incapacitated pilot scenario is an unfortunate but potential reality of working in rotor and fixed wing EMS. What do you do as medical crew members...

Episode 85 - A Great First Compression w/Dr. Per Olav Berve

13 Jan 2022

Contributed by Lukas

Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) d...

Episode 84 - VAD Max w/Allen Wolfe

16 Dec 2021

Contributed by Lukas

Ventricular Assist Devices (VAD) come in many shapes and sizes. From right to left, extracorporeal to intracorporeal, pulsatile to continuous - It can...

Episode 83 - A Few Good Mentors w/Adam Tresidder & Shane Turner

10 Nov 2021

Contributed by Lukas

If "you can't handle the truth", you can't handle a mentor. Mentors come in the form of leaders, educators, guides, and advisors to help you with hone...

Episode 81 - Thyroid Storm Chaser w/Chase Turner

12 Oct 2021

Contributed by Lukas

Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition...

Episode 80 - Resus Kung Fu w/Dr. Michael Lauria

25 Sep 2021

Contributed by Lukas

"Kung" means "skillful work" and "Fu" means "time spent". "Resus Kung Fu" refers to the resuscitation skills we acquire over time to become a true mas...

Episode 79 - Medicine in the Wild w/David Fifer

05 Sep 2021

Contributed by Lukas

Have you ever been hiking in the woods and wondered what emergency medical services are available in case you got injured? The level of scope varies g...

Episode 78 - Eating Our Humble Pie (BaSICS Trial)

19 Aug 2021

Contributed by Lukas

Sometimes, we're wrong. And when it comes to normal saline, we might be. Tune in to a breaking news podcast of sorts where we discuss the recently pub...

Episode 77 - My First Crush w/Chris Stevenson

07 Aug 2021

Contributed by Lukas

Though the incidents of crush injuries may be low in frequency, major crush injury syndrome is associated with a high mortality rate. In this podcast ...

Episode 76 - Pressure to Intubate w/Jon Inkrott

15 Jul 2021

Contributed by Lukas

How do you decide between non-invasive and invasive ventilation? If you decide on non-invasive ventilation (NIV), how do you choose between heated hig...

Episode 75 - Door to Balloon and in Between w/Dr. Adam Gottula & Dr. Trevor Skrobut

27 Jun 2021

Contributed by Lukas

Managing Acute Myocardial Infarction (AMI) patients is a concept that many of us learn early on in our careers. Because of that, we can potentially un...

Episode 74 - These Aren't the Labs You're Looking For

04 Jun 2021

Contributed by Lukas

There are a lot of misconceptions surrounding the meaning of certain lab values and what a positive truly is. Are these numbers as black and white as ...

Episode 73 - Coming in Third w/Dr. Zaf Qasim

13 May 2021

Contributed by Lukas

Taking care of the High Risk OB patient is outside the comfort zone of many of us. The third trimester, specifically, presents unique challenges both ...

Episode 72 - The Business of Medicine w/Chris Smetana

26 Apr 2021

Contributed by Lukas

Has administration ever made a decision that you didn't agree with and/or understand? Of course! As much as we don't like to admit it, the medical ind...

Episode 71 – Chicken, Starfish & Cat Scans (Audio Only)

08 Apr 2021

Contributed by Lukas

Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head...

Episode 71 - Chicken, Starfish & Cat Scans

08 Apr 2021

Contributed by Lukas

Due to the popularity of Episode 68 - X-Ray Vision, we've decided to extend our radiology series and focus on computerized tomography (CT) scans. Head...

Episode 70 - A Mind-Blowing Case Study (Presentation)

24 Mar 2021

Contributed by Lukas

Some clinicians may have a tendency to neglect performing a thorough neurological exam in a comatose patient. And when a neuro patient requires an adv...

Episode 69 - Resisting Traumatic Arrest w/Dr. Amanda Humphries

22 Feb 2021

Contributed by Lukas

Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But a...

Episode 68 – X-Ray Vision (Audio Only)

30 Jan 2021

Contributed by Lukas

Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identificatio...

Episode 68 - X-Ray Vision

30 Jan 2021

Contributed by Lukas

Though we are not Radiologists, we constantly find ourselves needing to interpret basic chest x-rays. Whether it's ETT placement or ARDS identificatio...

Episode 67 - The Calm After the Storm

30 Dec 2020

Contributed by Lukas

Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our ve...

Episode 66 - The Silent Seizure

08 Dec 2020

Contributed by Lukas

Non-Convulsive Seizures (NCS) or Non-Convulsive Status Epilepticus (NCSE) is defined as cerebral ictal activity without obvious clinical signs. Altere...

Episode 65 - One Hiring to Rule Them All (Graduation Presentation)

15 Nov 2020

Contributed by Lukas

Acquiring a job in flight medicine is only the beginning. In this presentation to the 2020 Flight Crew Academy graduating class, Mike discusses three ...

Episode 64 - Trapped Inside: Obstructive Lung Diseases (ASTNA Webinar)

06 Nov 2020

Contributed by Lukas

With the upcoming respiratory season, many of us will be caring for an increased number of pediatric and adult patients with pulmonary disease process...

Episode 63 - Flight Medicine Rules w/Chris Stevenson

08 Oct 2020

Contributed by Lukas

Chris Stevenson is back for a third go-round, so I think that makes him a regular guest on the show. This time, he came at us with a non-clinical topi...

Episode 62 - Fast Rhythms, Furious Management w/Dr. Salim Rezaie (Bonus Feature)

14 Sep 2020

Contributed by Lukas

Due to 'The Big C', ECHO Yacht Club was cancelled... but life goes on, and so does our podcast. We decided to turn lemons into lemonade and have our f...

Episode 61 - Down Under Dynamics w/Dr. Cliff Reid

25 Aug 2020

Contributed by Lukas

Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the pri...

Episode 60 - Save Your Life w/Randy Mains (Part 2)

06 Aug 2020

Contributed by Lukas

This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is...

Episode 59 - Save Your Life w/Randy Mains (Part 1)

30 Jul 2020

Contributed by Lukas

This could quite possibly be one of our most important podcast episodes to date featuring one of the most interesting persons in our industry. What is...

Episode 58 - Going With the Flow (Presentation)

15 Jul 2020

Contributed by Lukas

High flow nasal cannula is an increasingly popular modality for Acute Respiratory Distress and Failure. Previously, we saw it used mostly in the pedia...

Episode 57 - Weight and Calculate w/Lynn Lamkin

30 Jun 2020

Contributed by Lukas

How do you calculate your drug dosages? What do you base it on? In this podcast episode, we are joined by Lynn Lamkin, EM pharmacist, to discuss weigh...

Episode 56 - Where There's Smoke, There's Injury w/Chris Stevenson & Dr. Michael Feldman

15 Jun 2020

Contributed by Lukas

You asked. We answered. In a follow-up to our burn resuscitation podcast episode, we are joined by Chris Stevenson and his burn center Medical Directo...

Episode 55 - The Art of Titration (Vasopressors)

02 May 2020

Contributed by Lukas

Titrating intravenous drips is a source of contention for many providers. This is, in part, due to a wide range of approaches depending on the patien...

Episode 54 - A World Upside Down: Transporting Prone (Presentation)

04 Apr 2020

Contributed by Lukas

With the rising number of COVID-19 patients, many of our listeners have requested additional information regarding transporting patients in the prone ...

Episode 53 - From Beginning to End-Tidal (Presentation)

30 Mar 2020

Contributed by Lukas

Recently, Bryan was asked to present at a local EMS conference. The majority of the audience was ground personnel and student nurses, so he decided to...

Episode 52 - Ins and Outs of Influenza

15 Mar 2020

Contributed by Lukas

Due to a recent outbreak, influenza and COVID-19 have been in the forefront of people's minds. Influenza, in particular, continues to affect all age g...

Episode 51 - Interrogating a Pulmonologist (Featuring Dr. Deep Sharma)

28 Feb 2020

Contributed by Lukas

In this podcast episode, we are joined by Dr. Deep Sharma, Interventional Pulmonologist, to answer listener questions in a rapid fire format. We cove...

Episode 50 - Crash & Burn Resuscitation w/Chris Stevenson

29 Jan 2020

Contributed by Lukas

Proper fluid management in burns is critical to survival. But what happens when we administer too little or too much fluid therapy? In this podcast ep...

Episode 49 - Addressing SALAD w/Matt Jensen

12 Jan 2020

Contributed by Lukas

Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit ...

Episode 48 - Win Win w/Jason Peng & Ellen Parsley

26 Dec 2019

Contributed by Lukas

The Annual Sim Cup at the Air Medical Transport Conference (AMTC) is a prestigious event that gathers flight clinicians from all over the world to com...

Episode 47 - Refrain and Restrain w/Nyssa Hattaway

30 Nov 2019

Contributed by Lukas

RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medi...

Episode 46 - The Stethoscope Replacement w/Dr. Cynthia Griffin

14 Nov 2019

Contributed by Lukas

Making her second debut on the podcast, Dr. Cynthia Griffin joins us at AMTC19 to discuss the utility of ultrasound/POCUS. Cynthia presented on this t...

Episode 45 - 10 Things Your Intensivist Wants You to Know

25 Oct 2019

Contributed by Lukas

As an air medical provider, our bread and butter is interfacility transports. Whether at the referring or receiving facility, we deal with Intensivist...

G.E.A.R. 2020 Trailer

05 Oct 2019

Contributed by Lukas

The title says it all. We hope you will join us. *Standby for more information regarding this unique opportunity to expand your knowledge. -----------...

Episode 44 - Blood, Sweat, and GEAR (2019)

01 Oct 2019

Contributed by Lukas

In our final Guatemala Educational Aircrew Retreat (GEAR) 2019 podcast episode, we summarize the overall experience. G.E.A.R. was memorable, to say th...

Episode 43 - Surviving Culture, Part 2 (GEAR 2019)

16 Sep 2019

Contributed by Lukas

Part 1 is on our other podcast platform, After the Call. In this podcast episode, we are again joined by survival experts Chris “Gibbo” Gibson an...

Episode 42 - From Cockpit to Firepit (GEAR 2019)

02 Sep 2019

Contributed by Lukas

With kick off our Guatemala Educational Aircrew Retreat (GEAR 2019) series with an open forum. Located at Guatemala's aviation training center, we sat...

Episode 41 - Advanced Practice Makes Perfect w/Bill Hinckley (Part 2)

07 Aug 2019

Contributed by Lukas

In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models in HEMS. Bill is a rare breed that defines "passion" ...