“Everyone has a plan until they get punched in the mouth.” – Mike Tyson

Mental preparedness is not taught to us in emergency medicine or in healthcare generally, but it is something we are all doing to a degree.  However, we need to improve our abilities and expand on them to do our jobs better.  There are many approaches and everyone has their own style, but we will go over some approaches today to help improve your shifts and hopefully lead to you being a better clinician.​

Everyone talks about airway all the time, and I was at first reluctant to give this talk.  However, I believe it is time to talk about this important subject in a slightly different way.  The last time we talked about airway management in regards to intubation was with Kris Maday (from the PAINE Podcast) in Podcast #18 where we went over the basics (a great review to listen to first if needed).  There we talked mostly about rapid sequence intubation (RSI).  Although commonly used, this is not for every patient.  Today, we talk about RTI, which is what we need in most patients.

No matter what aspect of emergency medicine you work in (EMS, fast track, main ED, rural, remote, urban, suburban, or whatever else), you need to be a resuscitationist in my book.  This is entirely my opinion, but I believe it is important one worth your time in both reading and listening.

​Envision a busy night shift.  It is three in the morning and somehow you still have a waiting room full of people waiting to be seen in your small ED that is hours away by ground to tertiary care.  Scattered thunderstorms and overwhelmed emergency services have made it difficult to transfer out patients.  You would swear it was a full moon, but when you were outside just to get a quick breath of fresh air from all the chaos you look up and it is not.  Suddenly, you hear sirens in the distance and EMS reports are all coming in at once...

Tranexamic acid (TXA) is an old drug, but one that we in emergency medicine have found love for once again.  In preparation for an upcoming talk at a conference, I realized I had not yet made a post regarding TXA.  This is a quick summary of TXA and links to a lot of great #FOAMed resources out there you can also check out regarding the same.  I have also included one bit that I have recently found very successful but with little evidence currently.  Listen to the podcast for more!

​After Podcast #44 regarding how to incorporate change, our friend Patrick Bafuma reached out to provide his thoughts on how to make change happen in your department.  He has championed the process and has pearls that are well worth the listen.