Critical Levels
In this episode of Critical Levels, Zach sits down with Dr. Anna-Maria Carvalho, a Royal Collegeâcertified emergency physician with a subspecialty in aviation medicine, to unpack what really happens when someone asks, âIs there a medical professional on board?â From the physiology of flying at 36,000 feet to the realities of managing cardiac arrest in a cramped aircraft cabin, this episode tackles the fears, logistics, and practical considerations of in-flight medical emergenciesâespecially for paramedics, nurses, and physicians who may be called upon to help. âď¸ What We Cover...
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On this unique episode, we attend the First60 Toronto Resuscitation Conference and interview several of the speakers. For more detailed information, check out our website, criticallevels.ca
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In this episode, Zach sits down with Dr. Ian Drennan and Dr. Sheldon Cheskes to dissect the newly released 2025 AHA and ILCOR resuscitation guidelines. They break down the evidence, controversies, and real-world implications for paramedic practice. Key Topics Covered đš How guidelines are actually created đš Mechanical CPR đš Heads-Up CPR đš IV vs IO Access đš Medications đš Defibrillation Science đš Airway Management đš Post Cardiac Arrest Care
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In this episode, we explore the science, history, and frontline application of End-Tidal COâ (ETCOâ) â a tool that offers real-time insight into ventilation, perfusion, and metabolism. Danny and Rance from DnR explain how paramedics can use ETCOâ to assess and guide care across multiple patient presentations. Key Takeaways: ETCOâ is the sixth vital sign â reflecting ventilation, perfusion, and metabolism in real time. Capnography vs. Oximetry: SpOâ shows what was happening; ETCOâ shows whatâs happening now. Waveform interpretation: Alpha and beta angles reveal...
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Delta Air Crash: Paramedics on the Frontline of a Mass Casualty Incident In this gripping episode of Critical Levels, host Zach Cantor sits down with Ornge Critical Care paramedics Colin and Darren to discuss their response to the February 2025 Delta crash at Torontoâs Pearson International Airport. From the initial plume of smoke spotted mid-flight to interagency coordination on the ground, they share how training, adaptability, and teamwork guided decisions under extreme pressure. Key Topics: ⢠First impressions from the air and immediate decision-making...
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What is a paramedic â really? In this thought-provoking episode of Critical Levels, Zach sits down with Dr. Alan Batt to unpack the evolving identity, responsibilities, and future of the paramedic profession. Together, they explore the disconnect between what paramedics are trained for versus what they actually do, the consequences of outdated education models, and the urgent need for professionalization and system-level change. They discuss: Why current training doesnât match real-world workload How we define scope, identity, and autonomy in modern paramedicine The concept of career...
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Neonates are one of the most feared patient populations in EMSâand for good reason. In this episode, Zach Cantor talks with Anthony Iacolucci, a pediatric respiratory therapist and paramedic, about how to confidently approach neonatal calls. Anthony introduces NEO SECRETS, a practical acronym covering the top 10 causes of neonatal illness, and offers insight into assessment, common pitfalls, and key treatment considerations. NEO SECRETS Breakdown: ⢠N â Inborn errors of metabolism ⢠E...
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In this episode of Critical Levels, we dive into the cutting-edge strategies shaping pre-hospital and emergency department care. Our guests discuss how data-driven decision-making, high-performance CPR, and improved handover processes are revolutionizing patient outcomes. Key Topics Covered: â High-Performance CPR: The role of real-time feedback, mechanical CPR devices, and quality metrics in improving survival rates. â Data-Driven Protocols: How data influences resuscitation techniques, including push-dose epinephrine, early vasopressor administration, and optimizing CPR pauses. â ...
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đš Key Topics: đ¸ Why medics need to understand K9 trauma care The overlap between human and canine emergency medicine Common injuries in police, military, and search-and-rescue dogs đ¸ MARCH for CaninesâWhatâs Different? The first "M" stands for Muzzleâsecuring the dogâs âweaponâ before treatment Understanding the similarities in trauma care between humans and dogs Key differences in how canines respond to injury and shock đ¸ Massive Hemorrhage ControlâWhy Tourniquets Donât Work on Dogs Anatomical challengesâwhy dogs' limbs arenât suited for tourniquets When...
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In this episode of Critical Levels, we tackle frostbite with Dr. Maria Doubova, exploring its pathophysiology, symptoms, and treatment. From outdoor enthusiasts to vulnerable populations, frostbite affects diverse groups. Learn about early early recognition and management of frostbite - from mild frostnip to severe cases requiring advanced interventions - and the latest classification system to improve outcomes in this insightful discussion. What Youâll Learn in This Episode: What frostbite is and who is most at risk. Symptoms and early detection techniques. Frostbite...
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đ¸ Why medics need to understand K9 trauma care
- The overlap between human and canine emergency medicine
- Common injuries in police, military, and search-and-rescue dogs
đ¸ MARCH for CaninesâWhatâs Different?
- The first "M" stands for Muzzleâsecuring the dogâs âweaponâ before treatment
- Understanding the similarities in trauma care between humans and dogs
- Key differences in how canines respond to injury and shock
đ¸ Massive Hemorrhage ControlâWhy Tourniquets Donât Work on Dogs
- Anatomical challengesâwhy dogs' limbs arenât suited for tourniquets
- When to use direct pressure, wound packing, and hemostatic agents
- Junctional bleedingâwhere life-threatening hemorrhages happen in dogs
đ¸ Airway & BreathingâWhy Intubating a Dog Is Easier Than You Think
- How to recognize respiratory distress vs. normal panting
- Why dogs have larger, straighter airways than humans
- Needle decompression for pneumothoraxâlandmarks and technique
đ¸ Transporting an Injured K9âAvoid These Mistakes
- Best positions and vehicles for safe transport
- What paramedics, police, and handlers need to plan for before an emergency
đ¸ Shock & Fluid ResuscitationâThe Critical Role of Femoral Pulse Checks
- How to assess perfusion in a dog without a blood pressure cuff
- Why EZ-IO is the best choice for vascular access in canines
- When and how to administer fluids, TXA, and blood products
đ¸ CPR for DogsâDoes It Work?
- When CPR can save a dogâand when it wonât
- How to perform chest compressions correctly
- Naloxone for K9 opioid overdosesâit works, but dosing is different
đ¸ Medications & Pain ManagementâWhat Paramedics Can Safely Use
- NSAIDs are dangerous for dogsâavoid them in trauma cases
- Opioids, TXA, ketamine, and antibioticsâwhatâs safe and effective?