Episodes

  • Black Swan Disaster Events with Helen Hynson Vettori

    Black Swan Disaster Events with Helen Hynson Vettori
    Jan 23 2026
    Helen Hynson Vettori (https://www.helenhynsonvettori.com/) is a former EMT/paramedic and retired senior medical intelligence analyst at the Department of Homeland Security. We have her on the show to share her insights and the two sci-fi thriller novels she wrote based on her experiences. Helen channeled her real-world emergency response and pandemic-planning experience into her sci-fi disaster thriller series, beginning with Black Swan Impact and followed by Black Swan Shock. A “Black Swan” event is a term used to describe a catastrophic incident that no one could have foreseen or imagined because of its unprecedented impact. Helen didn’t imagine crisis from the outside, rather she spent years preparing for biological threats, including pandemics, and then watched COVID unfold in real time. That insider perspective and her frustration with confusing messaging and federal missteps became the fuel for fiction that feels uncomfortably plausible. Dr. Joe Holley from Paragon Medical Education Group joined the podcast as well as our disaster emergency management expert Becky DePodwin and our disaster weather expert Dan DePodwin. The episode is co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Winter Storm Impact and Preparations The meeting focused on a major winter storm expected to impact large parts of the United States, with Dan providing detailed forecasts of snow, ice, and travel disruptions across multiple regions. The group discussed the storm’s potential effects on various cities, including Oklahoma City, Atlanta, and the Northeast, emphasizing the danger of ice accumulation and power outages. They also advised listeners to consider rescheduling flights and prepare for travel disruptions, particularly in the affected areas. The conversation ended with an introduction to their guest, Helen Hinson Vittori, a former EMT and intelligence analyst at the Department of Homeland Security, who will discuss her experiences during the pandemic. Emergency Response Expert’s Pandemic Novel Helen shared her extensive background in emergency response, including her work as a paramedic, her role in biothreat planning at DHS, and her experience creating pandemic response plans. She retired in 2018 but became concerned about the government’s response to COVID-19 in 2020, which led her to write a sci-fi political thriller novel called “Black Swan Impact” that explores a catastrophic pathogen event in the year 2113. The novel served as a cathartic way for her to process the chaotic response to the pandemic she had witnessed firsthand. Emergency Preparedness Through Personal Writing Helen shared her experience as an emergency manager and author, discussing how writing provided her with both peace and a mission to educate others about emergency preparedness. She emphasized that individual preparedness is crucial for both personal and community-level disasters, and highlighted a book club question in her second book, “Black Swan Shock,” that encourages readers to assess their own emergency preparedness. Federal Pandemic Planning and Leadership Helen shared her experience working on federal pandemic plans and witnessing their partial abandonment during the actual crisis, expressing disappointment in leadership’s failure to communicate effectively and adhere to established protocols. The discussion explored how better preparation and public education could improve future responses to pandemics and other disasters, with Helen emphasizing the importance of all-hazard planning that starts at the individual level. The group agreed to have Helen return for another podcast episode, and several connections were made between participants for future discussions. Wrap up and updates The team went through contact information and Joe shared that Paragon is working on a new cadaveric-based simulator for pericardial tamponade training. The team encouraged listeners to stay safe and check out Helen’s books. The group discussed the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!
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    41 mins
  • 2026 Seasonal Influenza Update with Dr. Joe Holley

    2026 Seasonal Influenza Update with Dr. Joe Holley
    Jan 19 2026
    We delve into the recent surge of Influenza cases across large swaths of the United States in recent weeks. This year is shaping up to be a particularly difficult year for health care facilities and the patients who need them for treatment. Dr. Joe Holley joins us today to discuss what he’s seeing in the Memphis, Tennessee area and what the national flu outlook is. The most common Influenza A strain right now is causing a surge in ER visits and hospital admissions across the U.S. right now. The dominant Influenza A strain for the 2025-2026 flu season is the A(H3N2) subclade K, a variant with notable mutations. The annual vaccine is moderately effective at preventing severe illness and hospitalization and the subclade K variant responds well to antivirals such as Tamiflu. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Flu Trends and Vaccination Impact Joe and Jamie discussed the recent surge in flu cases, particularly affecting unvaccinated individuals and those with underlying health conditions. Jamie shared his experience of being admitted to the ER with influenza A and noted that vaccinated individuals were more likely to be discharged. Joe confirmed that national trends showed higher hospitalization rates and deaths among the unvaccinated, elderly, and those with other medical issues. Flu Awareness for Healthcare Jamie shared his severe flu experience, which included a high fever, chills, and muscle cramps, leading him to seek emergency care. He emphasized the importance of flu awareness for healthcare professionals, noting the recent increase in flu-related deaths and pediatric deaths reported by the CDC. Healthcare Virus Transmission Prevention Jamie and Joe discussed protective measures for healthcare providers against virus transmission, emphasizing hand hygiene, respiratory protection, and avoiding confined spaces with sick individuals. Joe highlighted the risk of virus spread in confined environments like airplanes, while Jamie shared personal experiences and encouraged listeners to take transmission prevention seriously, noting its impact on their community. Post-COVID Brain Fog Symptoms Jamie described experiencing “brain fog” after recovering from COVID-19, which made mental tasks difficult and required significant mental effort. Joe explained that this could be due to increased inflammatory markers and the body’s energy expenditure in fighting the infection. Sam noted that their household member who had not been vaccinated experienced different symptoms, and both Sam and their household member took about two weeks to regain their energy levels. Influenza Symptoms and Management Joe explained that vaccination can reduce the severity of symptoms, and both Jamie and Sam experienced typical symptoms of influenza A, with Jamie noting the importance of IV fluids in managing his symptoms. Sam described severe gastrointestinal symptoms, while Jamie mentioned being prescribed Zofran despite not experiencing nausea. Joe elaborated on how dehydration and inflammatory mediators contribute to symptoms, and rehydration can help alleviate them. Winter Virus and Flu Updates Jamie shared his experience of being delayed for release from the hospital due to low blood pressure, which was unusual for him. The medical team tried various methods to increase his blood pressure, including making him angry and having him walk around. Joe explained that while having the flu is unpleasant, it leads to the development of protective antibodies. Sam noted that the flu often overshadows other winter viruses, and Joe confirmed they are still seeing a variety of other respiratory infections. Early Flu Treatment and Testing Joe and Sam discussed the importance of seeking medical attention and testing for flu symptoms, with Joe recommending early treatment with antiviral drugs like Tamiflu, which are most effective within the first 48 hours of symptoms. Sam acknowledged that healthcare professionals might be reluctant to visit doctors when they need to, possibly due to a false sense of invincibility. Jamie emphasized the significance of early testing and treatment for flu, aligning with Joe’s advice. Influenza Testing and Treatment Discussion The group discussed influenza prevention and treatment, with Joe emphasizing the importance of early diagnosis and medication, particularly given the availability of over-the-counter rapid flu tests. Jamie noted that the COVID-19 pandemic had increased access to home testing, which Sam and Joe hadn’t previously considered. They agreed that while many people might choose to tough it out, getting tested early could be ...
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    29 mins
  • Disaster Podcast 2025 Year In Review

    Disaster Podcast 2025 Year In Review
    Jan 11 2026

    We gather our podcast regulars for a look at the past year on the show with our 2025 Disaster Podcast year in review. Dr. Joe Holley joined co-hosts Sam Bradley and Jamie Davis for this episode. Kyle Nelson, Becky DePodwin, and Dan DePodwin sent in their top episode picks by email.

    Joe Holley kicks off the look back at last year with a vote for the clinical topics, especially the recent 5-episode run on head-up CPR during sudden cardiac arrest. We assembled a special page for the head up CPR topic with all 5 episodes listed.

    Joe also discussed the importance of understanding how research works and not to get caught up in a single social media post on a novel subject without really understanding the context amidst other research. His final choice was the look at K9 and USAR dog training with Kimberly Holley. Kimberly has extensive training alongside her two trained USAR dogs and the third dog she has in training.

    Kyle talked about the episode with the Combat Midwife, Jessica Arno. This was an in-depth look at maternal and pediatric disaster care. In addition, Stump Dan the weatherman was another favorite episode as host Sam Bradley used the internet to come up with some novel weather terms and try to stump our own Dan DePodwin. These episodes are an annual favorite as Dan has an amazing understanding of weather, especially winter weather.

    Investigating airline disasters with Edward Colson of Ready Northwest was one of Becky DePodwin’s favorites as we delved into aviation industry disaster planning. She also put in her vote for the Stump the weatherman episode linked above.

    Jamie added the annual look at the Winter X-Games in Aspen. Our own Kyle Nelson worked as Planning Section Chief for the incident management team before and during the event this past year and shared some of the challenges they faced making such an event as safe as possible.

    We covered many other excellent topics this past year. If you have a different favorite from the ones listed in this episode retrospective, leave your answer in the comments below.

    Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well.

    Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!
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    39 mins
  • Most Recent Clinical Research — Elevated CPR Discussion Part 5

    Most Recent Clinical Research — Elevated CPR Discussion Part 5
    Dec 12 2025
    Kurt Bramer from Advanced CPR Solutions comes back for a final look at Head-Up CPR as we pull all the pieces from the earlier four episodes together. Dr. Joe Holley is back to bring in the latest research into the process as well. We will tie all this back to the global health disaster that is sudden cardiac arrest. Recent research from across the emergency medical community has pointed to impressive improvements in both return of spontaneous circulation (ROSC) as well as survival to discharge and neurologically intact survival when compared to conventional supine CPR performance. We’ll have links below to some of those studies and papers. Research Bibliography for Head-Up CPR Studies The episode is co-hosted again by our regular hosts, Sam Bradley and Jamie Davis. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Three Elevated CPR Series Episode Four CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Head-Up CPR Research Update Jamie and Sam discussed the upcoming podcast episode, which will focus on wrapping up the last four episodes about head-up CPR and recent research. They mentioned the challenges of implementing new approaches in rural systems with volunteer staff. Sam noted that Dr. Joe and Kurt Bramer have been working on presenting the information in a way that can be applied responsibly. Joe briefly mentioned that SENA teams were activated to assist with floods in Seattle. The main focus of the episode will be on the latest data on head-up CPR, including improved physiology, survival rates, and neurological function, particularly for non-shockable rhythms like asystole. Advantages of Head-Up CPR Studies Sam, Kurt, and Joe discussed the significance of two seminal studies on head-up CPR. The 2016 preclinical animal study showed significant improvement in perfusion when compared to standard CPR, with a synergistic effect when using additional devices like the ITD and suction cup. The 2022 independent registry analysis demonstrated that head-up CPR resulted in a five times greater likelihood of neurologically intact survival compared to conventional CPR, even up to 20 minutes post-cardiac arrest. Joe explained that the bundled care approach for cardiac arrest patients involves multiple components, including appropriate ventilation, high-quality CPR, and post-resuscitation care, all of which contribute to improved outcomes. Bystander CPR System Implementation The discussion focused on the importance of proper implementation of bystander CPR, AEDs, and advanced techniques like impedance threshold devices and suction cup CPR to improve patient outcomes, particularly neurologic ones. Kurt emphasized the need for a system-wide approach, from first responders to hospital care, highlighting successful partnerships like Louisville’s, where continuity of care is prioritized. Jamie inquired about best practices for implementing this system-wide approach, to which Kurt responded with examples from different regions, noting that while ideal partnerships exist, proactive agencies can still achieve good outcomes even with less supportive hospitals. Cardiac Arrest Resuscitation Bundle Implementation The team discussed the importance of addressing multiple aspects of cardiac arrest resuscitation simultaneously, as highlighted by Joe, who emphasized that successful outcomes require implementing all elements of the care bundle equally. Jamie inquired about training approaches, to which Joe responded that effective training involves both initial instruction and ongoing feedback through quality improvement processes, stressing that successful resuscitations require adherence to the entire bundle rather than just some components. Prioritizing Tasks in Resuscitation Joe and Kurt discussed the importance of prioritizing tasks during resuscitation, emphasizing the need to focus on the overall process rather than individual steps. They highlighted the benefits of the Head-Up CPR model, which organizes priorities and reduces chaos during medical emergencies. Kurt explained that this method allows for more efficient and coordinated delivery of therapies, leading to better patient outcomes. Head-Up CPR Survival Benefits The group discussed two significant studies on CPR techniques. Kurt presented findings from a 2023 preclinical study showing that early administration of head-up CPR resulted in a 40% 24-hour survival rate compared to 9%...
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    1 hr and 2 mins
  • The Science and Physiology of Head-up CPR – Elevated CPR Discussion Part 4

    The Science and Physiology of Head-up CPR – Elevated CPR Discussion Part 4
    Dec 6 2025
    Kurt Bramer from Advanced CPR Solutions returns again this week to continue the series on Head-Up CPR and other promising sudden cardiac arrest treatments. There are three previous episodes in this series. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Three Elevated CPR Series Episode Five After the severe weather update from disaster meteorologist Dan DePodwin, the Disaster Podcast team focuses on the science and physiology of Head-Up CPR. They ask why this approach provides for better protection of neurological function during a cardiac arrest. Dr. Joe Holley does an excellent job of describing the specific concepts of pressure gradients in blood flow to and from the heart during CPR in various patient positions. Kurt outlines what he calls the Four Rules of Head-Up CPR that are essential components for successful resuscitation during cardiac arrest treatment. These rules come from Dr. Joanna Moore’s Editorial The Do’s and Don’ts of Head Up CPR: 1) Use of Suction Cup CPR and an ITD 2) A Priming Period is Needed 3) Cannot Lift the Patient Too High 4) You Cannot Lift the Patient Too Quickly CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Episode Opening segment and Weather update The meeting began with a discussion about travel weather for the country and record cold in many parts of the upper midwest and northeast with Dan DePodwin. The group then transitioned to their main topic, the physiology of CPR, with Dr. Joe Holley focusing our attention on the specific anatomy and process inside the body during CPR. Head-Up CPR Techniques Discussed Kurt and Joe discussed the importance of adhering to the “four rules” of head-up CPR, which were derived from a published editorial by Dr. Moore. They emphasized that studies showing no improved outcomes often violate these rules, highlighting the significance of proper technique. Jamie Davis, the host of the Disaster Podcast, introduced the episode, which would focus on the science and physiology of elevated CPR, while Sam and Dan briefly discussed the early winter weather conditions across the United States. Head-Up CPR Research Advances The discussion focused on head-up CPR, a novel research advancement in resuscitation aimed at improving neurologic survival. Kurt explained its origins, highlighting a case study involving a ski hill cardiac arrest patient who survived due to an elevated head position, which was later recognized as a critical factor. The conversation also touched on a study conducted in South Korea, where researchers developed a modified EMS stretcher to accommodate patients in high-rise buildings with small elevators, leading to the question of the optimal CPR position. Initial findings from animal studies suggested that a head-up position could reduce intracranial pressure, potentially improving outcomes during CPR. CPR Physiology and Blood Flow Joe explained the physiology of CPR, focusing on how differences in pressure inside the body create blood flow. He described how chest compressions increase intrathoracic pressure, pushing blood towards the brain and other areas of lower pressure. He emphasized that over-ventilation and incomplete chest recoil can be detrimental during CPR, as they prevent blood from flowing back into the heart. He also noted that patients who exhibit “guppy breathing” during resuscitation have a better chance of successful resuscitation. CPR Vacuum Technology and Physiology Joe explained the physiology of blood flow during CPR, focusing on the importance of preload and the manipulation of pressure differences between the thoracic cavity and the brain. He described how the ITD16 device creates a vacuum in the chest to enhance blood flow to the brain and reduce intracranial pressure. Joe also discussed the concept of “head-up CPR,” which combines enhanced vacuum with gravity assistance to improve blood flow and neuroprotective outcomes. Head-Up CPR Techniques and Safety Sam and Kurt discussed the importance of using proper equipment and techniques for head-up CPR, as outlined by Dr. Joanna Moore’s “four rules.” Kurt emphasized that suction cup CPR in conjunction with an ITD or rescue pod is crucial for effective and safe head-up CPR. He also stressed the need for a priming period, avoiding excessive head elevation, and slow head-up positioning to prevent blood from draining from the head faster than CPR can ...
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    55 mins
  • Changes in AHA CPR and Cardiac Arrest Guidelines Over the Years – Elevated CPR Discussion Part 3

    Changes in AHA CPR and Cardiac Arrest Guidelines Over the Years – Elevated CPR Discussion Part 3
    Nov 28 2025
    We are joined by Kurt Bramer from Advanced CPR Solutions again this week to continue the series on Head-Up CPR and other promising sudden cardiac arrest treatments. He and Dr. Joe Holley kicked off the discussion in two previous episodes. Elevated CPR Series Episode One Elevated CPR Series Episode Two Elevated CPR Series Episode Four Elevated CPR Series Episode Five We open this week’s episode with a holiday severe weather update from our disaster meteorologist, Dan DePodwin. He reports on several storm systems that will impact Thanksgiving holiday travel across the eastern half of the country. Following that update, we kick off episode 3 of our Head-Up CPR series with a look at the long history of the evolutionary changes to cardiac arrest treatment. Kurt Bramer from Advanced CPR Solutions leads off with a response to some comments to the first two episodes in this series. A few listeners worried that we might sound like we were criticizing the individual responders on cardiac arrest calls over the low survival rates for the condition. The team made a joint statement that no criticism of providers in the field was intended. We all are providers ourselves and are merely commenting on the results that everyone has been getting in response to treating cardiac arrest. Some systems do better with resource management than others, but even those areas fail to save even a simple majority of their cardiac arrest patients. CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary CPR Challenges and Future Improvements The meeting began with a discussion about travel weather for the Thanksgiving weekend, with Dan DePodwin warning of widespread lake effect snow in the eastern United States and a potential ground blizzard in the Dakotas and Minnesota. The group then transitioned to their main topic, CPR, where Joe clarified that their previous discussion about CPR’s limitations was not meant to criticize CPR providers, but rather to highlight the challenges and lack of progress in the field over the past 50 years. They planned to explore potential improvements to CPR in future episodes. Advancements in CPR Techniques Kurt Bramer, with 40 years of experience in EMS and emergency management, discussed the history of CPR, highlighting its evolution from mouth-to-mouth resuscitation to modern techniques. He emphasized the need for better tools and more effective methods for emergency responders, as current practices are often based on outdated or insufficiently tested techniques. The group acknowledged that while responders are doing their best with limited tools, recent research may lead to positive changes in CPR practices. They also touched on the introduction of high-performance CPR in the 2010s, which aimed to maximize the effectiveness of current technologies and minimize detrimental pauses during resuscitation efforts. Mechanical CPR Guidelines Review The discussion focused on the American Heart Association’s recent guidelines regarding mechanical CPR, which recommend against routine use but allow for exceptions like transport scenarios. Kurt and Joe highlighted that the guidelines lump together different types of mechanical compressors, ignoring their unique physiological effects and training limitations. They emphasized that current research primarily focuses on patient survival as an endpoint, which may not fully capture the benefits of mechanical CPR, such as improved blood flow and reduced pauses during resuscitation. The conversation also touched on the importance of considering neurological outcomes beyond mere survival and the need for better training on integrating mechanical devices into overall cardiac arrest management. Bundle Care Approach in Resuscitation The group discussed the bundle of care approach in resuscitation, focusing on the use of multiple therapies simultaneously to improve patient outcomes. Kurt and Joe highlighted the success of the ITD (Impedance Threshold Device) when used with high-quality CPR, leading to a 50% increase in one-year survival. They also noted that only a small percentage of resuscitation guidelines are supported by randomized control trials, emphasizing the challenges in interpreting research data. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the ...
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    1 hr and 1 min
  • Flawed Approaches to Sudden Cardiac Arrest Research – Elevated CPR Discussion Part 2

    Flawed Approaches to Sudden Cardiac Arrest Research – Elevated CPR Discussion Part 2
    Nov 21 2025
    Kurt Bramer from Advanced CPR Solutions comes back on the show this week to continue the series on Head-Up CPR and other promising sudden cardiac arrest treatments. He and Dr. Joe Holley kicked off the discussion in a previous episode. Elevated CPR Series Episode One Elevated CPR Series Episode Three Elevated CPR Series Episode Four Elevated CPR Series Episode Five In this second episode installment of the sudden cardiac arrest and CPR series Kurt and Dr. Joe Holley discuss some key flaws in approaching cardiac arrest research like other medical diseases and treatments. The large number of unknown and uncontrollable variables surrounding sudden cardiac arrest make it hard for randomized control trials to effectively pinpoint positive treatment modalities. CARES Registry for Cardiac Arrest Stats Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Challenges in Resuscitation Research Funding Kurt discussed the paradox between resuscitation research and orphan drugs, highlighting how both lack funding despite their importance. He explained that orphan drugs target rare conditions, making research and development challenging due to limited market potential, similar to the situation in cardiac arrest resuscitation, which is a leading cause of death worldwide but receives limited research funding. Joe agreed, noting that complacency and insufficient focus contribute to the lack of high-quality research and implementation of new techniques in cardiac arrest resuscitation. Sam questioned the reliance on randomized control trials as the gold standard for evaluating resuscitation therapies, suggesting a need to explore alternative research paradigms. Propensity Score Matching in Research Kurt explained the concept of propensity score matching, a statistical analysis tool that allows for patient-to-patient comparisons using control groups not part of randomized trials, by matching variables such as age, downtime, and bystander CPR. Joe elaborated on the challenges of conducting cardiac arrest resuscitation research, highlighting the difficulty of patient participation in randomized trials and the need for large patient numbers to account for numerous impactful details. Jamie questioned the acceptance of different statistical analyses, to which Kurt responded that the issue is primarily one of unfamiliarity, as propensity score matching is widely used in other industries but not yet fully embraced in medicine. Improving CPR Techniques and Trials Joe and Kurt discussed the challenges of conducting randomized controlled trials for cardiac arrest, noting the difficulty in controlling variables and the high cost associated with large-scale studies. They highlighted the importance of using large numbers of patients to account for variables and the need for funding, which is often scarce. Sam brought up the discovery of the ITD and the plunger concept, leading to the suggestion of placing a thumb over the end of the ET tube to enhance pressure differentials and improve blood flow during CPR. Joe explained the hydrodynamic principles behind this technique, emphasizing the role of pressure differentials in creating flow and enhancing cardiac output. Counterintuitive CPR Physiology Insights The group discussed counterintuitive aspects of CPR physiology, including how preventing air from entering the lungs during chest compressions can actually improve blood flow. Kurt shared that many of these discoveries were made serendipitously while studying the body’s response to cardiac arrest. The discussion touched on the challenges of rural emergency response and the importance of data collection in EMS agencies. The participants agreed to continue the series with future episodes focusing on heads-up CPR and various therapies, with Kurt promising to share survival stories in the next installment. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, and don’t forget to subscribe to the Disaster Podcast for weekly insights from leaders in disaster response and research!
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    28 mins
  • The Global Disaster of Sudden Cardiac Arrest — Elevated CPR Discussion Part 1

    The Global Disaster of Sudden Cardiac Arrest — Elevated CPR Discussion Part 1
    Nov 14 2025
    Kurt Bramer from Advanced CPR Solutions comes on the show this week with Dr. Joe Holley. Kurt has a background in EMS since 1979 and worked as an emergency manager in Minneapolis. He currently works for Advanced CPR Solutions as a clinical educator. Sudden cardiac arrest is a global disaster that rivals the recent viral pandemic in scope. Cardiac arrest is by far the number one killer worldwide according to every public health agency of note. Over the years, treatment of this problem has a less than 4 or 5 percent survival rate with only minor incremental changes to treatment modalities. CARES Registry for Cardiac Arrest Stats Episode 2 of Elevated CPR Series Episode 3 of Elevated CPR Series Episode 4 of Elevated CPR Series Episode 5 of Elevated CPR Series The regular treatment updates that go out every five years feature only relatively minor adjustments to treatments that aren’t all that effective. Part of the problem is that it’s nearly impossible to accurately study the effects of various treatments on cardiac arrest victims due to the wide variety of variables present. Follow up on more of these segments as we continue to look at the current research trends in future episodes and what is on the horizon for the future. The episode was co-hosted by Sam Bradley and Jamie Davis. Scroll down for Podcast Discussion Summary Thank you as always to Paragon Medical Education Group for their long-term support of the Disaster Podcast. Dr. Joe Holley and the team at Paragon continue to provide excellent and customized disaster response training to jurisdictions around the U.S. and internationally as well. Podcast Discussion Summary Advancing Cardiac Arrest Survival Strategies Jamie, Sam, and Kurt discussed the global disaster of sudden cardiac arrest, highlighting its prevalence and the low survival rate despite advancements in CPR. Kurt explained the distinction between evolutionary and revolutionary changes in resuscitation, emphasizing the need for significant innovations like public access defibrillation and rescue CPR. The group planned to explore these topics further in upcoming episodes, aiming to engage both EMS professionals and emergency managers in addressing this critical issue. CPR Practices and Research Evolution The group discussed the evolution of CPR practices and the impact of scientific research on patient outcomes. Kurt and Jamie shared their experiences with skepticism and complacency among emergency responders regarding cardiac arrest cases, noting that previous protocol changes often had limited effectiveness. The conversation highlighted the importance of evidence-based practices and the potential for new techniques, like active compression and decompression, to improve survival rates. Cardiac Arrest Survival Rates Challenges The group discussed the challenges and limited success rates in resuscitating cardiac arrest patients, with Joe noting that despite advancements, survival rates remain around 10-11%, equivalent to a 90% failure rate. Kurt explained that while the Cardiac Arrest Registry for Enhanced Survival (CARES) data shows a 10% overall survival rate, the rate for neurologically intact survival has remained below 9% since 2013. The discussion highlighted the difficulties in conducting research on cardiac arrest due to variables like CPR quality, EMS response models, and patient characteristics, leading Kurt to suggest that randomized control trials may not be the most effective research paradigm for this field. Challenges in Pre-Hospital RCTs The group discussed challenges in conducting randomized controlled trials (RCTs) for pre-hospital resuscitation, with Joe highlighting significant variability in CPR quality and ventilation techniques. Kurt mentioned Peter Safar’s work and his belief that high-quality animal studies are needed before deploying therapies in uncontrolled EMS environments. The discussion also touched on the American Heart Association’s guidelines, with Joe noting that while these represent the state of science, local factors and resource constraints must be considered when implementing recommendations. Advancing CPR Techniques for Survival The meeting focused on a series discussing cardiac arrest as a global disaster, with a particular emphasis on improving CPR techniques. Kurt Bramer shared a case study from a ski slope where a patient’s recovery was attributed to the use of a rescue pump and the gravitational effect of being in an inclined position. The group discussed the potential of “head-up CPR” as a promising technique, and Jamie Davis announced upcoming episodes in the series. The participants agreed to continue exploring these topics in future discussions. The group discussed the importance of disaster preparedness and the role of specialized training, with Jamie highlighting the sponsorship of the Disaster Podcast by Paragon Medical Education Group. Catch the full episode using the player above or on your favorite podcast platform, ...
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    35 mins