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Just Jared and Mike this time, but fear not more guests are in the works! Please keep your questions coming! If your question wasn't answered this time we haven't forgotten you, don't worry. The die hard fans can also find us on YouTube with video!

1) You have an employee not meeting clinical expectations, consistently. Knowledge of the protocols are no where near adequate. Operationally, they’re awful. And their standards are what I would call… subpar. How do I as a team lead/shift leader approach this? I should add that they are super reliable in other parts of the job.

2) I work for an ALS non-transport service and was treating a patient that I believed was primarily experiencing flash pulmonary edema secondary to CHF. Has a history of emphysema, CHF, hypertension, and hyperlipidemia. Is taking meds appropriate for history. Complaining of acute SOB and is found tachypneic with marked increased work of breathing, tachycardia and markedly hypertensive (240’s/120’s) lung sounds present bilaterally with wheezes in the upper lobes and rales in the lower lobes. I started the patient on CPAP and a duo-neb through the CPAP. The transporting unit arrived and the paramedic on that unit freaked out that the albuterol was going to kill this person. Is that really a thing or urban myth? Thoughts?

3) I am working on a patient that has been in and out of traumatic brady PEA arrest and is now in sustained arrest. How important is TXA in the treatment of this patient?

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