EMS Research with Professor Bram

This fast-paced video explores a long list of the latest research innovations shaping EMS with Bram Duffee, PhD, EMT-P including workplace culture, professional recognition, injury prevention, advancements in cardiac arrest care, and the transformative role of technology in the field.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-SettingsStay 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-monthConnections: 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: / @4emsresearchReferences:Alshehri, A. et al. (2025). Can we identify stroke sub-type without imaging? Medical Engineering & Physics. https://doi.org/10.1016/j.medengphy.2025.104364Feerick, F. et al. (2025). Barriers to paramedic professionalisation: A qualitative enquiry across the UK, Canada, Australia, USA and the Republic of Ireland. BMC Health Services Research. https://doi.org/10.1186/s12913-025-10993-7Gonzalez, J. M. et al. (2025). Enhancing trauma care: Machine learning-based photoplethysmography analysis for estimating blood volume during hemorrhage and resuscitation. Bioengineering. https://doi.org/10.3390/bioengineering12080833Johnston, S. et al. (2025). Why do emergency medical service employees (not) seek organizational help for mental health support?: A systematic review. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph22040629Kamholz, J. C. et al. (2025). Association between organizational culture and emergency medical service clinician turnover. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph22050756Marsh, E. et al. (2025). Profiling paramedic job tasks, injuries, and physical fitness: A scoping review. Applied Ergonomics. https://doi.org/10.1016/j.apergo.2025.104459McWilliam, S. E. et al. (2025). Should anything else be done besides prehospital CPR? The role of CPR and prehospital interventions after traumatic cardiac arrest. The Journal of Emergency Medicine. https://doi.org/10.1016/j.jemermed.2025.02.010Mpody, C. et al. (2025). Racial and ethnic disparities in use of helicopter transport after severe trauma in the US. JAMA Surgery. https://doi.org/10.1001/jamasurg.2024.5678Shekhar, A. C. et al. (2025). Use of a large language model (LLM) for ambulance dispatch and triage. The American Journal of Emergency Medicine. https://doi.org/10.1016/j.ajem.2025.05.004Tagami, T. et al. (2025). The impact of dispatcher-assisted CPR and prior bystander CPR training on neurologic outcomes in out-of-hospital cardiac arrest: A multicenter study. Resuscitation. https://doi.org/10.1016/j.resuscitation.2025.110617Zhou, T. et al. (2025). Racial and socioeconomic disparities in California ambulance patient offload times. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2025.10325

The 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care introduce significant updates, including a focus on on-scene resuscitation, cautious use of mechanical CPR devices, and prioritizing IV over IO access. While these changes aim to improve outcomes, they’ve sparked debate among seasoned paramedics like Jimmy Apple, the “EMS Avenger,” who highlights the challenges of implementation.Key Points:• On-Scene Resuscitation: Emphasis on achieving ROSC on scene rather than rapid transport.• Mechanical CPR Devices: AHA advises against routine use, but paramedics argue they’re essential for small or rural teams.• IV vs. IO Access: IV is prioritized, but practicality for resource-limited teams is questioned.• Empowering EMS Providers: Focus on critical thinking, quality compressions, and timely defibrillation.• Cultural Shift: Training crews for compassionate death notifications and clear family communication.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-SettingsStay 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-monthConnections: 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

Epinephrine is a cornerstone of medical cardiac arrest, but does it provide the same benefit in traumatic cardiac arrest (TCA)? Emerging research challenges long-held protocols, suggesting this go-to drug may not be the life-saver we assume it is—and could even cause harm. Host Bram Duffee, PhD, EMT-P, explores a groundbreaking study that could change how we manage these critical patients. This episode unpacks a February 2025 study in Prehospital Emergency Care that analyzed over 1,600 out-of-hospital trauma arrests. The findings were stark: epinephrine was linked to lower survival in blunt trauma and showed no clear benefit for penetrating injuries.Lead researcher Dr. Cordelie Witt shares critical insights on why epinephrine may be counterproductive in TCA:• Physiological Ceiling: Exogenous epinephrine may offer little benefit beyond the body's own sympathetic response to blood loss.• Myocardial Oxygen Debt: It can increase the heart's oxygen demand when coronary blood flow is already minimal, potentially worsening cardiac function.• Arrhythmia Risk: Epinephrine may induce arrhythmias in a heart already struggling.• Worsening Hemorrhage: Raising blood pressure before controlling the source of bleeding may be counterproductive.Watch the full interview with Dr. Witt to understand the science behind these findings. Don't forget to subscribe for more evidence-based discussions.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-SettingsStay 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-monthConnections: 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: / @4emsresearchReference: Witt, C. E., Shatz, D. V., Robinson, B. R. H., Campion, E. M., Shapiro, M. L., Bui, E. H., Meizoso, J. P., & Dorlac, W. C. (2025). Epinephrine in prehospital traumatic cardiac arrest—Life saving or false hope? Prehospital Emergency Care, 1(1), 1–9.

Severe hemorrhage is one of the toughest challenges faced in the pre-hospital environment, especially when every second counts and resources are limited. But a recent study on the use of 25% human serum albumin (HSA) in trauma care could change how responders approach these critical moments. The study was led by United States Army Scientist Alex Penn, Ph.D. The findings from his team suggest that this concentrated protein solution can stabilize blood pressure, reduce the need for additional fluids, and improve circulation in ways traditional methods cannot. For paramedics, this could mean a shelf-stable, easy-to-use solution that saves more lives in the toughest conditions, revolutionizing pre-hospital care as we know it.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... Take part in research: If you are a first responder who lives in the United States and would be open to an interview for a research study please connect with Bram Duffee by going to the website https://bduffee0.wixsite.com/ems-conf... 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... 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:Penn, A. H., Falabella, M., Sanchez, A., Hernandez, O., McFadden, K., & Hutcheson, J. (2023). 25% Human Serum Albumin Improves Hemodynamics and Prevents the Need for Nearly All Pre-Hospital Resuscitation in a Rat (Rattus Norvegicus) Model of Trauma and Hemorrhage. Shock, 10-1097

Discover the crucial insights behind managing pain in pediatric patients during prehospital care. Join us as we sit down with Dr. Hoi See Tsao, a pediatric emergency medicine expert, to discuss findings from her groundbreaking study, "Barriers and Enablers in Prehospital Pediatric Analgesia."Dr. Tsao sheds light on the unique challenges EMS providers face, from limited experience with pediatric transports and technical difficulties during ambulance rides to parental hesitation and concerns about administering pain medications. With untreated pain in children leading to long-term issues like increased anxiety and fear of future medical care, the stakes couldn’t be higher.Learn about promising solutions, including the use of intranasal fentanyl, an innovative treatment that simplifies pain relief without the need for IV access. Dr. Tsao also shares actionable strategies to improve care, such as enhanced training through high-fidelity simulations, effective communication with parents, and the development of standardized protocols.If you’re an EMS provider, healthcare professional, or someone passionate about pediatric care, this episode offers invaluable guidance on bridging the gaps in prehospital pediatric pain management. Tune in and explore how we can ensure children receive the compassionate, effective care they deserve—even before they reach the hospital.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 Take part in research: If you are a first responder who lives in the United States and would be open to an interview for a research study please connect with Bram Duffee by going to the website https://bduffee0.wixsite.com/ems-conflict/application 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: https://www.youtube.com/@4emsresearch?sub_confirmation=1Reference:Tsao, H. S., Sutcliffe, T., Wang, C., Vargas, S. E., Day, C., & Brown, L. L. (2024). Barriers and Enablers in Prehospital Pediatric Analgesia. Prehospital Emergency Care, 1–7.