Wednesday, June 27

Conversation starters for Paramedics talking to Anesthesiologists

In Paramedic School we had to perform a mock intubation every day.  In the lab there was a check off sheet and a person in the class had to sign you off that you had completed the skill.  We were building muscle memory.  It was a chore, but I'm glad we did it.

Later on in our clinical rotations we were in the Operating Room for a minimum of 5 intubations.  There is nothing more awkward than asking a pretty girl for a date than asking a person freaking out about surgery if someone who has never intubated can practice on you.

I was able to talk 5 people into letting me learn in one morning.  I sank all 5.

Anesthesiologists are rock stars of the operating room.  They saunter in, briefcase of sweet drugs, mix a cocktail, knock you the F out, then drop a tube, attach the vent and chill.

I thought intubations were super easy until I got into the field.

Turns out the 5 tubes I got were on people in the following condition:

Have been fasting, no food in the last 8 hours
No liquids in the last 2 hours
Free of fever, cough or other respiratory issues
No traumatic injury to the head, neck or chest.

Damn, dude.

Tomorrow morning I am going for what Billy Crystal's character in City Slickers would refer to as "a procedure" but I'll need general anesthesia.
The questionnaire I filled out was amazing!  It pretty much said that if I did any of the things everyone I've ever had to intubate did, I'd have to delay the procedure.

So tomorrow, at table height, in a well lit room, with every tool and medication nearby, a Doctor will do to me what I do to strangers with sometimes 5 minute notice, in the rain, in the dark, with suction running non stop, clogged ETCO2 lines and so much noise lung sounds are a joke.

But I still want them to be successful not just on their first pass, like the standard we are held to, but maybe agree that my full recovery without injury to my teeth, throat or lungs is maybe more important.

Big question is...

Is there a Paramedic student there tomorrow?  Hells yes I'll let them try, right after I tell them who I am and what I do...but not until right after the Doc pushes the meds.

Tuesday, June 12

the Crossover Show - X3 Bar Giveaway

In this episode, MC and HM welcome back Dr. John Jaquish from  MC finished out his 12-week program using the Doc’s amazing product, the X3 bar.

The guys and the doc talk about new directions X3 is headed as well as the most undervalued part of physical training: Nutrition. (Would you believe the doc only eats one freaking meal a day?!)

Oh…and the doc has agreed to give away an X3 bar!!! That’s right! You can win your very own X3 and start making huge leaps in your physical fitness. Click the link above to enter!

In addition, MC and HM make a huge announcement about the future of The Crossover Show…that is to say, it’s done.

*Cue shocking music

Not to worry, friends, they’ll be back with a brand new show in a few weeks. New name. New art. New guests. New format.
We’re only moving up from here!

BOLO – Sponsored by* (Use “motorcop” at checkout to save $50!)


*Get a FREE 30-day trial for and one free audiobook. As a sponsor of the podcast, Audible will throw a few bucks at the show for the honor of giving you some free audio goodness!

Sunday, May 13

the Crossover Show - ep 154 - ROUSs

In this episode, MC and HM sat down for a quick Facebook Live to find out what you wanted to talk about. Listener Ashley Woz asked the guys to discuss Carroll County, Maryland, and the flagrant use of deadly force against an endangered species: RoUS’s.That’s right, friends, Rodents of Unusual Size. Okay, it was a groundhog…but still.

The best part? There’s video.
From there, the boys discuss listener Jessie Polk’s question about fatigue in the three disciplines and wonder if fatigue may have led to a woodchuck being shot in the road.
The guys welcome new BOLO sponsor, Audible, by offering a free trial and free audiobook. Click over to to sign up and join the guys in what they’re reading!

BOLO – Sponsored by* (Use “motorcop” at checkout to save $50!)


Friday, April 20

Resuscitation, Can you perform a task and still run the code?

The short answer is YES.

The long answer is also YES.

A quote running around the interwebs today I first saw in my feed from Sam Ghali @EM_RESUS on Twitter.

I get the gist of the message, that we need a team approach to Resus and every team needs a leader who can stand back and run things without getting tunnel vision on any one task.

I also don't believe the statement to be accurate that "If you're running a resuscitation while performing a procedure you're likely doing neither very well."  Multitasking has been proven to reduce the attention given to each task, so don't try to burn me there, but there are tasks at a resus our rural friends are well familiar with.
Back in the day (it was a Thursday) we ran codes with 3 people.  2 EMTs and 1 Paramedic.  Sometimes one of the EMTs was an intermediate and we could throw them on the access task.

Now that I'm in the urban setting we have plenty of people to run a code effectively.  Eventually.

There have been a number of times I have been running the recus while performing a task.  Usually access.  It's muscle memory and can be accomplished rather quickly and easily while still monitoring CPR quality, BVM usage and the rhythm on the monitor.  I'll grab the sharp and run a BGL, open the airway kit and place it next to the head as they set up the BVM, there are a number of tasks and skills that can be done effectively by the team leader.  If I don't get involved and we delay access, are we helping?  Not really.

There is a big push for us to focus on the Pit Crew method, or High Performance Method, or whatever it will be called next week and I understand why.  It helps.

Sam's statement was meant to provoke thought and challenge the old ways, not to establish new policy in our systems and I understand that, but we also need to be realistic about the ability of EMS providers to complete one task while monitoring others.  I'm not going to BVM and try to get access at the same time, but I may need to BVM and run the code at the same time until more help arrives.  And that's OK.

Challenge the norms, find the weaknesses, address them, learn from near misses and apply sound judgement.

Wednesday, April 18

FDIC - Let's Do This!

Pack your bags and get ready for a full conference next week as we once again take over Inianapolis, IN for FDIC!

This year I'll be bringing back Engine Company: First Strike MCI, a class focused on the Engine Company being first in on an MCI.  We discuss pre-planning, setting expectations of your Company and how to make the first 90 seconds go smoothly.

Leave your vests, tarps and fancy tags for later, this is the nitty gritty of MCI Initial Operations.

Crowd estimation, what it means to transmit "Business as usual," tasks for your engine driver...all this and more will be covered!  Hope to see you there!  Thursday, 3:30 PM, Room 120-122!

Monday, April 16

Happy Medic on the Code 3 Podcast - Visiting a Firehouse Without Being a Jerk

Awhile back I was contacted by Scott Orr, award winning journalist and host of the Code 3 Podcast, the Firefighters podcast."  He wanted to ask me about an article I wrote about how to visit a firehouse without being a jerk.

The article got a wide array of comments, as you can imagine, but Scott just wanted to find out how to visit a firehouse without being "that guy."
From the podcast page:

If you’re like most firefighters, when you go on vacation, you like to stop by firehouses and say hello, check out the apparatus, the gear…
But sometimes, firefighters make the worst guests. They just don’t seem to know the rules.
As a guide, Justin Schorr wrote a column for on how to visit a firehouse without being a jerk. He was a guest on this episode of Code 3 to explain the hows and whys of being a guest.

It was fun to be on, go have a listen!

Friday, April 13

the Crossover Podcast - ep 150 - Listener Takes Exception to the "Three Disciplines"

In this episode, HM and MC get called out on their bullshit! “Three disciplines, indeed,” says listener and The Crossover Show supporter, Art.
Well, “Art”…if that’s your real name…jokes on you! Just when the guys started hashing out Art’s complaint, they realize Art made a crucial error.

In other news, a former Missouri medic is in a wee bit o’ trouble after stealing some meds.
How did he get away with it?
Simple answer: Shitty Bookkeeping.
Cue Happy Medic losing his mind about the quality of Kansas City Fire’s management of inventory and record keeping.


US Cryotherapy – Walnut Creek
Paddle Your Own Canoe by Nick Offerman
Build Stuff with Wood by Asa Christiana
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Friday, April 6

the Crossover Podcast - Ep 149 - Death and Taxes and Beer

In this episode, HM and MC have a special in-studio guest, Kim from KMS Tax Prep…better known as Mrs. HM.

Nepotism is alive and well at #TheCrossoverShow, friends!
Regardless, it is indeed tax season and Kim is here to give you some tax tips! You may not like taxes, but they are, as the show title intimates, inevitable. So, pay attention!
Kim and the boys discuss, amongst other things:
  • Do you need a CPA to prepare your taxes?
  • Can you write-off your meals/haircut/etc.?
  • Why aren’t your taxes due on April 15th this year?
  • And much more…
Listen, friends, taxes are unavoidable. You can be smart with your money and be prepared or you can choose to half-ass your hard-earned cash and wonder what happened when the IRS repossesses your life. Don’t be a sucker…get you a certified tax preparer.
You know…like KMS Tax Prep!
The Final Day by William Forstchen
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Tuesday, March 20

the Crossover Podcast - Ep 146 - Chillin.

Chillin' as in just hanging out?  No.  Chillin' as in 170 degrees below zero.

In this epsiode, the guys chill…to the extreme. MC and HM take a little sojourn to MC’s newest obsession: Cryotherapy.
Cool, right?
Beyond machine gun-like puns, the guys talk to the proprietor of US Cyrotherapy – Walnut Creek, Tim Fitzgerald, about exactly what “Cryo” (that’s the lingo, I’m told) is and what it can do for you. Beyond simply being really friggin’ cold, the facility at US Cryotherapy offers an array of services including:
  • Red light therapy
  • Hydro-massage
  • Infrared sauna
  • Normatech sleeves
  • Localized cryotherapy for troublesome spots
Stiff or sore after a long shift? Cryo can help mitigate that problem.
Got joint issues from carrying God knows how much weight on your belt, back, vest for countless years? Cryo can help relieve that pain.
Want ten minutes to yourself and get a wee-bit pampered at the same time? Cryo, baby.
If you’re local to Walnut Creek, stop in at US Cryotherapy and tell them you heard about them from Motorcop and, if you’re a first responder (to include ER docs/nurses and military), you can choose from three services and get them for free on your first visit. If you’re a civvie, they’ll give you the first visit for only $37 (that’s $10 off!)
Supporters of The Crossover Show (over at also get a bonus…video of MC and HM experiencing HM’s first-ever cryo session. (HE’S NOT WEARING A SHIRT, Y’ALL!)

Quick aside from me a week later: When you go in for these treatments or any others make sure you are 100% honest with yourself and the proprietors.  I went in feeling less than 100% under an intense amount of self administered stress about work.  My hopes were to see if the treatments helped.  The resulting intensity overwhelmed my body and made me very sick.  I have since recovered, mostly, but wish I had been honest with myself and said "You've stressed yourself to the edge of sickness, don't give your body more than it can handle."

It does not turn me off from possibly visiting US Cryotherapy again, but I first must get healthy in the brain hole.  Not an easy task, as many of you know.

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Sunday, March 4

The Frequent Frequent Flier Flier

It happened. Gorram it, Mal, it finally happened.

I got a return customer who's a frequent flier!  Airport takes a minute.


Aircraft inbound with a woman experiencing dizziness and nausea.


After the steak chili we just downed for lunch at the firehouse I'm experiencing the same symptoms.  The flight number sounds familiar and the City of origin sounds familiar as well.  You see, while the rest of the EMS world gets and address, I get a story...

"Medical Emergency reported, TWA flight 101, inbound from Taipei ETA one five minutes (no one says multiple digit numbers at the airport, it's the coolest thing!) to gate G55, female in seat 27Alpha, Blue shirt, black shoes, oversized pink roller bag with a kitten on the tag...unknown medical."

No, seriously, sometimes they give us the most insane details about the person, except for the reason we're heading over there.  A few moment later we get the update that she feels like I do and before I can burp the aircraft pulls up to the gate and the doors open and...wait...did they say "pink roller bag with a kitten?"  Is this dejavu?

There she is.

The same woman I saw yesterday for the same symptoms.  Already returned from her stint overseas because, please note the quotes, "I'm too sick to fly."

Let's do the math.  14.5 hours here...deported for forged documents (claimed nausea, asked for Paramedics), 14.5 hours home, time to forge new documents and book another flight, then the next flight back, another 14.5 hours.

Woman has stamina.  And nausea.  And requests to be taken to the hospital as fast as possible before she gets sent back again.