EMS Research with Professor Bram

Workplace violence is an escalating crisis in EMS, often dismissed as just "part of the job." But what if you could predict which patients were likely to become aggressive before an incident occurred? In this episode, we sit down with researchers Dr. Son Chae Kim and Kathie Dunn to discuss the ABRAT-EMS, a new, evidence-based screening tool designed to help crews spot risk early and stay safe.

We break down how this simple three-item checklist works, the science behind its development from over 9,000 patient encounters, and how you can implement it on your next shift. This is a must-listen for any provider who wants to move from reactive defense to proactive prevention.
In this episode, we cover:

• The rising reality of workplace violence against EMS clinicians
• Why "gut feeling" isn't enough when assessing safety risks
• How the ABRAT-EMS tool was developed using real-world data
• The three specific behaviors that predict violence: agitation, confusion, and aggression
• How to score patients and determine their risk level (Low, Medium, High)
• Practical steps for using the score to make decisions about de-escalation and law enforcement
• Addressing special populations like patients with dementia or intoxication

Resources Mentioned:
Kim, S.C., Dunn, K., Youells, C., Whitmore, G., McComack, A., Dievendorf, E., Bell, C., Burnett, S.J., Kim, S. and Clemency, B., 2025. Aggressive Behavior Risk Assessment Tool for Emergency Medical Services. JACEP Open, 6(3), p.100095.

Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.

Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://routledge.pub/Hypnotic-Communication

Stay Connected:
Connect with Us: For more information, visit our website at www.ProfessorBram.com
Subscribe: If you enjoyed this episode, please consider subscribing to EMS Research on YouTube: /@4emsresearch
Monthly Research Review: Stay up to date with the latest research in EMS through the International PreHospital Medicine Institute's monthly article reviews: https://iphmi.com/ems-articles-of-the-month

Gastric lavage, a procedure for pumping the stomach after poisoning, was once a standard of care. Now, it's rarely used due to a lack of evidence and risk of complications. So why are we talking about it in 2026? A recent case report in Prehospital Emergency Care challenges us to reconsider if there’s a narrow, specific role for this intervention in the most critically ill overdose patients.

In this episode, we speak with Dr. Nicholas Studer, one of the study's lead authors, to explore this controversial topic. We'll examine the specific clinical cues that might justify gastric lavage in the field and discuss the strict contraindications that every provider must know. This is a critical conversation about balancing historical practices with modern, evidence-based medicine for the sickest patients.

In this episode, we cover:
• The history of gastric lavage and why its use has declined.
• A breakdown of a recent case where prehospital gastric lavage was successfully used.
• The very specific and narrow indications for considering gastric lavage in 2026.
• Clear contraindications and "hard stops" for the procedure in the field.
• How this procedure fits with current toxicology guidelines.

Resources Mentioned:
Studer, N. M., & Hoffman, R. S. (2025). Prehospital Gastric Lavage for the Treatment of Critically Ill Overdose or Poisonings: A Case Report. Prehospital Emergency Care, 1-3.

Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.

Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://www.routledge.com/Hypnotic-Communication-in-Emergency-Medical-Settings-For-Life-Saving-and-Therapeutic-Outcomes/JacobsFourArrows-Duffee/p/book/9781032360027

Stay Connected:
• Connect with Us: For more information, visit our website at www.ProfessorBram.com
• Subscribe: If you enjoyed this episode, please consider subscribing to EMS Research on YouTube: /@4emsresearch
• Monthly Research Review: Stay up to date with the latest research in EMS through the International PreHospital Medicine Institute's monthly article reviews: https://iphmi.com/ems-articles-of-the-month

Domestic violence calls are among the most complex and high-risk situations paramedics encounter. Often, the signs are subtle-confusion, headaches, or a hesitant patient-and mask a much darker reality of non-fatal strangulation or traumatic brain injury. In this episode, we speak with researcher Dr. Rory Marshall about a groundbreaking study that asked survivors of intimate partner violence (IPV) what they really needed from EMS.

Dr. Marshall discusses the disconnect between standard paramedic assessments and the lived reality of survivors. We explore the seven key challenges survivors face, from perceived bias to dangerous perpetrator dynamics on scene. Most importantly, we discuss three practical, actionable steps every medic can take to build trust, create safety, and identify hidden injuries.
In this episode, we cover:

•Why domestic violence calls are high-stakes moments for both patients and providers
•Key insights from survivor interviews about their EMS experiences
•The seven main challenges survivors face during EMS encounters, including bias, inadequate support, and system limitations
•The dangers and recognition of non-fatal strangulation and traumatic brain injury in IPV situations
•Practical steps for paramedics to build trust, foster safety, and communicate effectively on scene
•How to safely create opportunities for private conversation with survivors

Resources Mentioned:
Marshall, R. A., Merritt, N., Stranges, T. N., Bartlett, S., Sawyer, S., & van Donkelaar, P. (2025). “The questions made me realize how many times I could have been saved and removed from that situation”: The experiences of patients attended to by paramedics for intimate partner violence, and actionable implementations for paramedicine. BMC Women's Health, 25(1), 254.

Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.

Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders.  https://www.routledge.com/Hypnotic-Communication-in-Emergency-Medical-Settings-For-Life-Saving-and-Therapeutic-Outcomes/JacobsFourArrows-Duffee/p/book/9781032360027

Stay Connected:
For more information, visit our website at www.ProfessorBram.com
If you enjoyed this episode, please consider subscribing to EMS Research on YouTube: /@4emsresearch
Research Review: Stay up to date with the latest research in EMS through the International PreHospital Medicine Institute's monthly article reviews: https://iphmi.com/ems-articles-of-the-month

When does a quality improvement project become human research? If you're reviewing patient charts or surveying new hires, you might be stepping into the world of research ethics without even realizing it. In this episode, we sit down with Dr. Jeffrey Franc to demystify research ethics for EMS professionals. We break down why it's a crucial part of our professional responsibility, not just a bureaucratic hoop to jump through for publishing.
Dr. Franc explains the fundamentals of human participant research, the role of Institutional Review Boards (IRBs), and clears up common misconceptions that can lead to ethical missteps. This conversation is essential for any medic, educator, or leader who wants to improve patient care responsibly and maintain public trust.
Key Points Covered in This Episode:
Why research ethics matter in the day-to-day practice of EMS
Understanding what qualifies as "human participant research" and how it applies in EMS
The key role of Institutional Review Boards (IRBs) and why independent oversight is required
Clearing up misconceptions: de-identified data, patient consent, and the ethics approval process
The importance of comprehensive ethical review for quality improvement projects and education-based research
Practical advice for EMS providers on starting research responsibly and ethically
Dr. Jeffrey Franc’s expert insights on protecting patients, communities, and professional integrity
Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.
Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency/acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://routledge.pub/Hypnotic-Commun... 
Resources Mentioned:
Franc, J. M., & O’Mathúna, D. (2025). Navigating Research Ethics for Prehospital and Disaster Medicine. Prehospital and Disaster Medicine, 40(3), 125–128.
Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.
Stay Connected:
Connect with Us: For more information, visit our website at www.ProfessorBram.com
Subscribe: If you enjoyed this episode, please consider subscribing to EMS Research on YouTube: /@4emsresearch
Monthly Research Review: Stay up to date with the latest research in EMS through the International PreHospital Medicine Institute's monthly article reviews: https://iphmi.com/ems-articles-of-the...

For a pulseless trauma patient, starting CPR is an ingrained response. But in cases of pulseless electrical activity (PEA) from severe blood loss, could chest compressions do more harm than good? Host Bram Duffee, PhD, EMT-P, speaks with Dr. Patrick Greiffenstein, lead study author and Trauma ICU Director at LSU New Orleans, about new research that challenges a core tenet of resuscitation.

Dr. Greiffenstein’s study used a porcine model to simulate severe hemorrhagic shock. Researchers compared key outcomes between a group that received automated CPR during the shock phase and a group that did not, focusing on oxygen delivery to the brain and skin.

Key Findings:
• CPR provided no improvement in brain or skin oxygenation.
• Skin perfusion was significantly lower in the group receiving CPR.
• While systolic blood pressure increased, diastolic blood pressure—critical for organ perfusion—was significantly reduced.
• Intracranial pressure (ICP) showed a threefold increase with CPR, suggesting disruption of normal cerebral blood flow.

Disclaimer: This content is for educational and informational purposes only and does not constitute medical advice. Always follow your local protocols and medical direction.

Book announcement: Bram Duffee is a co-author of the latest book about how hypnosis has the potential to revolutionize medical care for those struggling with emergency / acute distress. Hypnotic Communication in Emergency Medical Settings: For Life-Saving and Therapeutic Outcomes demonstrates how hypnotic communication has the potential to improve patient outcomes in emergency care, integrating insights on the connection between mind and body for paramedics and other first responders. https://routledge.pub/Hypnotic-Communication-in-Emergency-Medical-Settings

Stay up to date: Review the most recent research in EMS through the monthly article reviews put out by the International PreHospital Medicine Institute https://iphmi.com/ems-articles-of-the-month 

Connections: If you want to connect with the EMS Research Podcast staff check out our website at www.ProfessorBram.com If you enjoyed this episode please consider subscribing to EMS Research on YouTube: / @4emsresearch

Reference: Greiffenstein, P., Cavalea, A., Smith, A., Sharp, T., Warren, O., Dennis, J., Gatterer, M. C., Danos, D., Byrne, T. C., Scarborough, A., Deville, P., & VanMeter, K. (2025). Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock. The Journal of Trauma and Acute Care Surgery, 98(2), 251–257.