Cover art for podcast Heavy Lies the Helmet

Heavy Lies the Helmet

85 EpisodesProduced by Mike Bryan BooneWebsite

"Heavy lies the crown" is a common misquote of "uneasy lies the head that wears the crown" from Shakespeare's Henry IV, Part 2. It refers to the responsibility and insecurity of governing an entire kingdom. Likewise, "heavy lies the helmet" refers to the responsibility we face as critical care trans… read more

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

January 13th, 2022

53:37

Transport of patients with ongoing CPR to the correct treatment center is a high risk but potentially lifesaving intervention. Mechanical CPR (mCPR) devices are recommended to reduce risk and maintain chest compression …

Episode 84 - VAD Max w/Allen Wolfe

December 16th, 2021

56:38

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

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

November 10th, 2021

45:00

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 honest self-reflection in order to improve yourself and your practice. …

Episode 81 - Thyroid Storm Chaser w/Chase Turner

October 12th, 2021

43:51

Thyroid Storm and Thyrotoxicosis are often misdiagnosed due to presenting similarly to many other disease processes. How do we identify this condition? What are the standard treatment options? And how do we treat a …

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

September 25th, 2021

54:40

"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 …

Episode 79 - Medicine in the Wild w/David Fifer

September 5th, 2021

1:06:31

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 greatly across the country for wilderness emergency medical and SAR …

Episode 78 - Eating Our Humble Pie (BaSICS Trial)

August 19th, 2021

25:26

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 published BaSICS Randomized Clinical Trial, and how it affects our …

Episode 77 - My First Crush w/Chris Stevenson

August 7th, 2021

44:39

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

July 15th, 2021

48:43

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

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

June 27th, 2021

1:04:37

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 underestimate the importance of our interventions.

In this podcast …

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

June 4th, 2021

41:55

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

May 13th, 2021

57:35

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

April 26th, 2021

1:04:06

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 industry is a business. For that reason, finances play a significant …

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

April 8th, 2021

55:42

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. …

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

March 24th, 2021

25:56

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

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

February 22nd, 2021

1:06:53

Pre-hospital resuscitation of the traumatic arrest patient is controversial, to say the least. Some evidence has shown our efforts to be futile. But are the studies skewed by inappropriate management and our resistance …

Episode 68 – X-Ray Vision (Audio Only)

January 30th, 2021

53:22

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

Episode 67 - The Calm After the Storm

December 30th, 2020

1:13:27

Recently, Central America was devastated by back-to-back Category 4 tropical storms including Hurricane Eta and Lota. As a Guatemalan resident, our very own Chris 'Razor' Sharpe was in the thick of it. Tune in to this …

Episode 66 - The Silent Seizure

December 8th, 2020

34:07

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

Episode 63 - Flight Medicine Rules w/Chris Stevenson

October 8th, 2020

58:30

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 …

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

September 14th, 2020

1:17:54

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 friend and emergency medicine powerhouse Dr. Sal Rezaie join us for a …

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

August 25th, 2020

1:04:46

Whether it's in regard to scope of practice, clinical judgment, or professional communication, transport is a very dynamic environment. We had the privilege of welcoming the infamous Dr. Cliff Reid to the show to …

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

August 6th, 2020

42:46

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 …

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

July 30th, 2020

47:05

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 …

Episode 57 - Weight and Calculate w/Lynn Lamkin

June 30th, 2020

51:10

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 …

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

June 15th, 2020

42:00

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 …

Episode 55 - The Art of Titration (Vasopressors)

May 2nd, 2020

54:36

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 patient's condition. Further attribution is based on each individual's …

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

March 30th, 2020

33:00

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 present the why and how of measuring waveform capnography. EtCO2 …

Episode 52 - Ins and Outs of Influenza

March 15th, 2020

50:19

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 …

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

February 28th, 2020

50:04

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

Episode 50 - Crash Burn Resuscitation w/Chris Stevenson

January 29th, 2020

1:00:52

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 …

Episode 49 - Addressing SALAD w/Matt Jensen

January 12th, 2020

41:10

Suction-assisted laryngoscopy and airway decontamination (SALAD) was created to assist with the decontamination of a massively soiled airway. We sit down with flight nurse, researcher, and lead author Matt Jensen to …

Episode 48 - Win Win w/Jason Peng Ellen Parsley

December 26th, 2019

46:38

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 compete. Jason Peng (ED and Flight NP) and Ellen Parsley (Flight Nurse) …

Episode 47 - Refrain and Restrain w/Nyssa Hattaway

November 30th, 2019

47:27

RSI, chemical restraint, or physical restraint? In this podcast episode, we are joined by ED and Flight Nurse Nyssa Hattaway at AMTC19 to discuss medical management and aircraft safety considerations surrounding the …

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

November 14th, 2019

50:45

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 …

Episode 45 - 10 Things Your Intensivist Wants You to Know

October 25th, 2019

48:56

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

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

October 1st, 2019

1:16:26

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

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

September 16th, 2019

55:41

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 and

Episode 42 - From Cockpit to Firepit (GEAR 2019)

September 2nd, 2019

31:20

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

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

August 7th, 2019

47:13

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" in HEMS, to say the least. His experience coupled with being an …

Episode 40 - Advanced Practice Makes Perfect w/Bill Hinckley (Part 1)

July 31st, 2019

45:43

Is the Registered Nurse/Paramedic crew configuration optimal for HEMS? In this podcast episode, we are joined by Dr. Bill Hinckley to discuss advanced practice models. Bill is a rare breed that defines "passion" in …

Episode 39 - Moulage Rouge w/Mike Abernethy

July 9th, 2019

44:12

In this podcast episode, we are joined by Flight Physician Mike Abernethy to discuss the importance of high fidelity, simulation training. We discuss …

Episode 38 - Breaking the Case: P.E. MERGENCY

June 23rd, 2019

49:16

Armchair Air is at it again with this is the second installment of the "Breaking the Case" series where we discuss case studies related to previously covered topics. Even though some content from Episode 33 - P.E. …

Episode 37 - Prehospital Sepsis (Presentation)

June 4th, 2019

32:05

Earlier this year, we were asked to present at a local critical care conference. Due to the recent release of the 1-hour bundle, this was a timely discussion regarding pre-hospital sepsis. We touched on various …

Episode 36 - Induction Death Match

May 14th, 2019

43:02

Ladies and gentlemen, welcome to the main event. This long awaited, highly anticipated match-up is finally here. 

Dan received feedback, after giving a recent talk, that we wanted to address in a fun way. What causes …

Episode 35 - Provider Zero w/Shane Turner (CAMP ECHO)

April 30th, 2019

44:24

How do you become an asset rather than a lability at work? In this podcast episode, we are joined by multi-keynote speaker Shane Turner to discuss …

Episode 34 - The REBOA Constrictor w/Liam Madigan

April 16th, 2019

47:31

The Endovascular Balloon Occlusion of the Aorta (REBOA) of 2015 is drastically different than the REBOA of 2019. In order to understand new …

Episode 33 - P.E. MERGENCY

March 30th, 2019

48:04

In this podcast episode, we discuss massive, sub-massive, and non-massive pulmonary embolism. This common diagnosis is often misunderstood and …

Episode 32 - Nacho Everyday Perforation w/Brian King

March 13th, 2019

28:30

Esophageal perforation/rupture is a rare, but life-threatening condition that requires immediate intervention. Late identification can result in …

Episode 31 - The I in Team Safety

February 17th, 2019

43:59

Especially with recent events, safety is at the forefront of every flight clinician’s mind. How do we work together to make sure everyone goes home after every shift? Chris, our resident safety expert, joins us in a …

Episode 30 - Breaking the Case: Nephro No!

January 26th, 2019

49:34

We are introducing a new podcast series that focuses purely on case studies. In this episode, Dan helps us analyze three examples of nephrology …

Episode 29 - Blocker? Near Killed Her! (Featuring Dan Rusyniak)

December 30th, 2018

44:36

Though similar presentations, beta blocker (BB) and calcium channel blocker (CCB) overdoses can affect your patients in very different ways. In this …

Episode 28 - AKI: Just Kidneying Around

December 10th, 2018

29:27

Acute Kidney Injury (AKI), formally Acute Renal Failure (ARF), is a prevalent disease process that affects over 50% of ICU admissions. AKI is not …

Episode 27 - Podcast Row w/Eric Bauer Mike Verkest (AMTC18)

November 15th, 2018

26:29

We wrap up AMTC18 in style with our exhibit hall neighbors and fellow podcasters Eric Bauer & Mike Verkest of FlightBridgeEDand SecondShift. Tune …

Episode 26 - Hard Headed w/Carlos Andino (AMTC18)

November 6th, 2018

20:02

Protect your head! In this next AMTC18 Podcast Row episode, we are joined at our booth by Carlos Andino, Market Development Director at Paraclete Aviation Life Support. Tune in as we continue our discussion of helmet …

Short Final - Sunset Eyes (AMTC18)

October 30th, 2018

6:00

Live from Podcast Row, we continue our AMTC18 series with a brief, “Short Final”. It is no secret that signs and other physical phenomenon are …

Episode 25 - Hole in One w/Cynthia Griffin (AMTC18)

October 26th, 2018

41:33

Kicking off our AMTC18 series, we are joined at our Podcast Row booth by the beloved Dr. Cynthia Griffin. Cynthia is an Emergency and Flight Physician for University of Wisconsin, and a member of the FOAMfrat team. …

Episode 24 - ECHONOOGA Debrief w/Brad Garmon

September 24th, 2018

1:08:04

In this informal podcast episode, we are joined by Brad Garmon; Flight Medic, Educator, and overall good dude. Brad was our fellow "Sick Lung" clinical category presenter at the 2018 Every Coast Helicopter Operations …

Episode 23 - Triple Threat w/Dan Rauh (ECHONOOGA)

September 16th, 2018

31:39

In this special podcast episode, we are joined by a third person: Flight NP and PT Intensivist, Dan Rauh. Dan joins us at the 2018 Every Coast Helicopter Operations (ECHO) annual conference as a fellow clinical track …

Episode 22 - The Dark Side of Electrolytes (Part 5: Magnesium)

August 14th, 2018

16:13

Magnesium is a co-factor in more than 300 enzyme systems that are responsible for biochemical reactions in the body. This includes protein synthesis, …

Episode 21 - OG or NG Tubes: Who Nose?

July 20th, 2018

15:39

Gastric tubes are commonly used in both the pre-hospital and hospital environment for a variety of reasons. Depending on the patient and/or provider, these range from orogastric to nasogastric in nature. In this podcast …

Episode 20 - Measuring Up: ETT Cuff Manometry

June 27th, 2018

19:04

The vast majority of endotracheal tubes (ETT) are now cuffed. In general practice, appropriate cuff pressures are assessed by external palpation or cession of an audible leak. But is this conventional method safe? In …

Episode 19 - Beneath the Surface w/Chris Sharpe

May 17th, 2018

46:09

Helicopter ditching is a harsh reality of the HEMS industry that can affect any crew flying near bodies of water; large or small. In this podcast episode, we are joined by Chris Sharpe who, among other things, is an …

Episode 18 - Fluid Resuscitation: What to Base It On

May 2nd, 2018

15:20

Base deficit and excess are reliable biomarkers in determining the severity of our patients’ conditions. But is a deficit an automatic indicator for fluid resuscitation, as some may believe? Tune in as we discuss …

Short Final - Dilution is not the Solution

April 6th, 2018

11:33

Dilution of intravenous medications is a common practice in most healthcare settings. Often times, this stems from ease of administration and other variables based on the provider's comfort level and past experience. …

Episode 17 - A World Upside Down: Transporting Prone

March 17th, 2018

25:25

Prone positioning in the presence of Acute Respiratory Distress Syndrome (ARDS) has been a controversial topic over the years due to variable …

Episode 16 - Your Roll in Securing the Pediatric Airway

February 27th, 2018

16:12

In this episode, we discuss the logistics of securing pediatric endotracheal tubes and its relation to the pre-hospital environment. Tune in as we touch on the pro's and con's of commercial devices versus adhesive tape. …

Episode 15 - Pick a Valve, Any Valve: Multivalvular Disease

January 31st, 2018

28:28

In this episode, we discuss Multivalvular Disease. Multivalvular Disease is a fluid and complex disease process that requires expert evaluation on …

Episode 14 - Not All Cannulas Are Created Equal w/Tyler Christifulli

January 10th, 2018

19:48

In this episode, we are joined by Tyler Christifulli of the FOAMfrat blog and podcast (formally Lifestar Podcast), and FlightBridgeEd. Apneic …

Episode 13 - Serotonin Syndrome: When Medications Go Wrong

December 25th, 2017

22:45

Most of us carry and commonly administer medications that affect the neurotransmitter serotonin (e.g. Fentanyl). Additionally, most of our patients with a history of depression and/or anxiety are prescribed selective …

Episode 12 - The Dark Side of Electrolytes (Part 4: Calcium)

December 2nd, 2017

23:56

In this episode, we continue our electrolyte series by focusing on one of the most abundant minerals in our body: calcium.  Calcium is an ion that …

Episode 11 - Gearing Up for Transport w/Todd Hope

November 7th, 2017

26:28

Are you new to transport medicine and are looking for your first set of personal gear? Or, are you a seasoned critical care transport provider looking to change your current setup and upgrade to a more quality system? …

Episode 10 - AMTC 17 Debrief (Day 3)

October 26th, 2017

36:59

In this episode, we continue our discussion of AMTC 17. Tune in as we touch on key points from the AMTC talks that we attended that will provide you with several clinical pearls that may apply to your practice. Due to …

Episode 9 - AMTC 17 Debrief (Day 2)

October 23rd, 2017

19:55

In this episode, we continue our discussion of AMTC 17. Tune in as we touch on key points from the AMTC talks that we personally attended. Due to the large amount of discussion, this podcast is split into 3 episodes; 1 …

Episode 8 - AMTC 17 Debrief (Day 1)

October 21st, 2017

27:06

Were you unable to attend AMTC?  If you were, were you able to attend every talk that you wanted to?  Or, are you wondering if you missed a key point during a talk that you were able to attend?  Tune in as we discuss …

Episode 7 - The Dark Side of Electrolytes (Part 3: Potassium)

October 13th, 2017

20:41

In this episode, we continue our electrolyte series by discussing one of the most infamous electrolytes: potassium.  Tune in as we cover hypo and …

Episode 6 - Coagulate or Bust: DIC

September 26th, 2017

14:58

In this episode, we discuss one of the most dangerous secondary complications seen in the critically ill:  Disseminated Intravascular Coagulation …

Short Final - Should Nurses Intubate?

September 8th, 2017

11:21

This is the next installment of our "Short Final" series.  In this particular episode, we discuss a controversial topic regarding nurses' …

Episode 5 - The Dark Side of Electrolytes (Part 2: Sodium)

August 30th, 2017

20:49

In Part 1, we discussed chloride and touched on its close relationship with sodium.  In this episode, we continue our multi-part series focusing …

Episode 4 - Active Shooter: Briefing with a SWAT Doc

August 14th, 2017

38:49

In this episode, we interview Dr. Robert McKnight; an emergency physician who specializes in tactical medicine.  Active shooter scenarios are increasingly common and require specialized training for pre-hospital medical …

Episode 3 - The Dark Side of Electrolytes (Part 1: Chloride)

July 27th, 2017

16:53

In this episode, we begin a multi-part series regarding electrolytes. Listen in as we discuss hypo and hyper states, and the obscure changes that …

Short Final - How to Get a Job

July 17th, 2017

11:20

This is the first episode of our "Short Final" series where we discuss topics that do not necessitate a full length episode.  That includes, but is …

Episode 2 - The Sick Sickle Cell Patient

July 4th, 2017

20:38

Most of us are familiar with resuscitation of the standard sick person. But how do we change our course of treatment when caring for the patient with Sickle Cell Disease (SCD)? In this episode, we bring out a case study …

Episode 1 - To Vagal or Not to Vagal: Traumatic Bradycardia

June 24th, 2017

15:25

In this episode, we discuss potential bradycardia in traumatic injuries. We touch on main differential diagnoses and their treatment options; …

Episode 0 - Introductions

June 14th, 2017

5:10

In this episode, we introduce ourselves and explain the intent of our podcast. We are extremely excited to begin this journey and hope to contribute valuable information to the critical care transport industry. 

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