Country Hits: Rural Trauma from the Scene to the Emergency Department

Country Hits is an 8-episode podcast series for rural EMS, emergency departments, and surgeons. In each episode we explore a common management question and talk to national experts about the best way to take care of sick and injured patients in a rural environment. Topics include: What kills trauma patients; Novel anticoagulants; Clinical uses of carbon dioxide; Hip fractures; Fall prevention; Burn care; Communication challenges; Mental health and trauma-informed care.

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Episodes

Burns

Thursday Aug 12, 2021

Thursday Aug 12, 2021

There are few things scarier than a bad burn. If you don't work in or near a burn center, what do you need to know? Our expert on burn care in the first hour is Dr. Kathleen Romanowski from UC Davis Medical Center.
Resources:
American Burn Association fluid resuscitation guideline
University of Washington Burn 101 video series featuring a much younger Jonathan Kohler.
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Anticoagulants

Thursday Aug 12, 2021

Thursday Aug 12, 2021

In this episode, we talk to Drs. Scott Zakaluzny and Daniel Nishijima from UC Davis Medical Center about what to do when your patient is on an anticoagulant, and what to do when your patient is on an anticoagulant you've never heard of -- and can't even pronouce. 
Resources:
Daniel mentions this paper about how EMS ascertains whether a patient is on anticoagulation: Do EMS Providers Accurately Ascertain Anticoagulant and Antiplatelet Use in Older Adults with Head Trauma?
CHEST guidelines: https://journal.chestnet.org/action/showPdf?pii=S0012-3692%2812%2960122-6
 
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 
 

Thursday Aug 12, 2021

There are lots of ways to get injured, but what will truly kill a trauma patient? What are the snakes in the grass that you have to be vigilant about? Our experts in how to identify the truly sick patient, and rescue them, are Drs. Rachel Russo and Jim Holmes.
 
Resources:
More about thromboelastography
 
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Mental Health

Thursday Aug 12, 2021

Thursday Aug 12, 2021

By the time you meet a patient, they've experienced not just the injury that generated the call, but a lifetime of experiences that inform their response to your care. Our expert in mental health and trauma informed care is Dr. Angela Jarman from UC Davis Medical Center.
Resources:
Dr. Jarman talking about Trauma Informed Care 101 on the EM Pulse podcast from the UC Davis Department of Emergency Medicine.
Trauma Informed Care for opioid use disorders
 
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Hip Fractures

Thursday Aug 12, 2021

Thursday Aug 12, 2021

Hip fractures are common...and complicated. Our experts on all things hip are Drs. Katren Tyler and Philip Wolinsky.
 
Resources:
The Clinical Frailty Scale
CDC Fall Prevention Program: Still Going Strong
UC Davis Fall Prevention Program, including fall risk calculator and a video with 6 steps to reduce falls
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Falls

Thursday Aug 12, 2021

Thursday Aug 12, 2021

Falls are a huge problem for the elderly. Older folks are rightly terrified of falling, and preventing falls is one of the most important things we can do for our geriatric patients. Our experts are Drs. Christy Adams and Katren Tyler from UC Davis Medical Center.
Additional resources:
Stopping Elderly Accidents, Deaths, and Injuries (STEADI) project: https://www.cdc.gov/steadi/index.html
CDC Still Going Strong program: https://www.cdc.gov/StillGoingStrong/
Wisconsin Institute on Healthy Aging Stepping On program: https://wihealthyaging.org/stepping-on-consumer
UC Davis Fall Prevention Program, including fall risk calculator and a video with 6 steps to reduce falls
 
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Communication

Thursday Aug 12, 2021

Thursday Aug 12, 2021

Sometimes taking care of the patient is the easy part. It's talking to bystanders, parents, and patients who have communication challenges that's hard. Our experts are Drs. David Shatz and John Rose from UC Davis Medical Center.
Resources:
Group critical incident stress debriefing
Family presence during resuscitation
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

Carbon Dioxide

Thursday Aug 12, 2021

Thursday Aug 12, 2021

Carbon dioxide. We all breathe it in, and breathe more of it out. But just how a patient breathes carbon dioxide out can tell us a lot about how they are doing. Our experts are Drs. Matthew Greer and John Anderson from UC Davis Medical Center.
 
Resources:
https://www.aliem.com
https://emcrit.org
UpToDate on capnography
Dr. Anderson has a chapter in Capnography. (2011). (n.p.): Cambridge University Press.
 
Country Hits is a production of Wisconsin's South Central Regional Trauma Advisory Council. Special thanks to the  UC Davis Departments of Surgery and Emergency Medicine. Jonathan Kohler is @jekohler on Twitter and at RxCreative. 

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