MCHD Paramedic Podcast

We recently made some cervical spine immobilization protocol changes here at MCHD. Dr. Patrick and Dr. DePasquale discuss the history and literature that provide the foundation for rigid cervical collar use, along with the new MCHD protocol implementation. This has been a collaborative process with our local hospital partners, which has definitely involved give-and-take on both sides.

REFERENCES
1. Davies G, Deakin C, Wilson A. The effect of a rigid collar on intracranial pressure. Injury. 1996 Nov;27(9):647-9.
2. Mobbs RJ, Stoodley MA, Fuller J. Effect of cervical hard collar on intracranial pressure after head injury. ANZ J Surg. 2002 Jun;72(6):389-91.
3. Hunt K, Hallworth S, Smith M. The effects of rigid collar placement on intracranial and cerebral perfusion pressures. Anaesthesia. 2001 Jun;56(6):511-3.
4. Lerner EB, Billittier AJ 4th, Moscati RM. The effects of neutral positioning with and without padding on spinal immobilization of healthy subjects. Prehosp Emerg Care. 1998 Apr-Jun;2(2):112-6.
5. Totten VY, Sugarman DB. Respiratory effects of spinal immobilization. Prehosp Emerg Care. 1999 Oct-Dec;3(4):347-52
6. Mitra B, Bernard S, Yankoff C, Somesh A, Stewart C, Koolstra C, Talarico C, Nehme Z, Fitzgerald MC, Cameron PA. Change from semi-rigid to soft collars for prehospital management of trauma patients: An observational study. J Am Coll Emerg Physicians Open. 2024 Jul 17;5(4):e13239.
7. Sundstrøm T, Asbjørnsen H, Habiba S, Sunde GA, Wester K. Prehospital use of cervical collars in trauma patients: a critical review. J Neurotrauma. 2014 Mar 15;31(6):531-40.
8. Millin MG, Innes JC, King GD, Abo BN, Kelly SM, Knoles CL, Vezzetti R, White CC 4th, Yee A, Gallagher JM. Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries - A NAEMSP Comprehensive Review and Analysis of the Literature. Prehosp Emerg Care. 2025 Aug 7:1-13.
9. Ramasamy A. Advanced trauma life support 2025: A brief review of updates. Injury. 2026 Apr;57(4):113079. doi: 10.1016/j.injury.2026.

Drs. Geoff Comp and Jerry Snow join the podcast to discuss their recent paper describing their experience treating undifferentiated heatstroke in Phoenix with cold water immersion. Their protocol mirrors ours here in Montgomery County. Heatstroke is a time-sensitive emergency, and the rate of cooling directly correlates with mortality reduction. Learn how to implement CWI in your service. It's the best of all worlds: inexpensive, impactful, and applies to all EMS clinician levels.

REFERENCES
1. Comp G, Finch C, Kupanoff K, Sandoval M, Lloyd M, Aldaco N, Kirk D, Pugsley P, Nordstrom L, Koenig BW, Narang A, Snow J, Kamer M, Foster A, Patel G, Stowell JR. Fighting Fire with Ice: A Multisite Collaboration to Evaluate the Impact of Prehospital Cold Water Immersion on Heat Stroke Patients. Prehosp Emerg Care. 2026 Mar 13:1-11.

MCHD's Spencer Lantz and Fort Bend County EMS Medical Director, Dr. Gill join the podcast to discuss the importance of allowing an open conversation around the mental health issues and strain of being an EMS clinician. We've finally started to recognize the issue, Spencer and Dr. Gill have some concrete solutions for the future.

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. This is the second episode of our two-part series!

REFERENCES
1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.

One of our major 2026 clinical and educational focus areas here at MCHD is medication error reduction. While medication errors are complex and have no simple solution, recognizing the issue is the initial step in changing culture. We're lucky to have a special guest with a unique perspective on this episode. Kevin Mercer, an emergency department pharmacist, joins Dr. Patrick to discuss all things medication administration. The episode went so well, we had to create a two-part series!

REFERENCES
1. Harmer BM, Hoyle JD Jr, Edwards A, Fredericks T, Wells L, Lecznar A, Christopher K, Dunwoody S, Hong G, Rantz W, Popov V, Mahajan P, Fogarty K. Assessing the Influence of a Statewide Dosing Reference Aid on Prehospital Pediatric Medication Dosing Errors: A Mixed-Methods Simulation-Based Investigation. Prehosp Emerg Care. 2026 Mar 9:1-8.