Trauma is already having a pretty shitty day. Then the patient gets cold, acidotic, stops clotting properly, and apparently the human body decides three problems aren't enough and throws low calcium into the mix.

Welcome to the lethal triad. Or, because medicine can never leave well enough alone, the lethal diamond.

In this episode of That Paramedic Podcast, Jay and Courtney break down what actually happens when trauma wrecks the body's ability to clot. We start with platelets, fibrin, and the clotting cascade before following the patient into the vicious feedback loop of hypothermia, acidosis, and coagulopathy. Then we add hypocalcemia during massive transfusion and somehow make the whole situation even worse.

Along the way, we talk damage-control resuscitation, warming patients, blood products, calcium, TXA, why drowning someone in cold crystalloid isn't particularly helpful, and why stopping visible bleeding doesn't necessarily mean you've stopped the physiological disaster happening underneath.

There are garden hoses. Sandbags. Concrete. Anti-lock brakes. Surprise vampires. An alarming amount of musical theatre. And more spontaneous singing than any discussion of traumatic coagulopathy has ever required.

Come for the clotting cascade.

Stay for Clotting Factors in Your Fucking Face.

A normal blood pressure does not always mean your patient is okay. In this Medic Minute, we look at how the body compensates during shock, the subtle warning signs that appear before hypotension, and why trends in heart rate, respirations, skin, mental status, and perfusion matter more than one reassuring number. Because your patient may be compensating beautifully, right up until they fucking aren’t.

Nitroglycerin is a medication used to treat chest pain, reduce cardiac workload, and manage acute pulmonary edema. It is also, somewhat inconveniently, an actual explosive.

In this episode of That Paramedic Podcast, we explore how nitroglycerin went from blowing things up to becoming one of the most recognizable medications in emergency medicine. We break down what nitro does to the cardiovascular system, including its effects on preload, afterload, coronary blood flow, and myocardial oxygen demand.

We also discuss common indications, dosing considerations, contraindications, adverse effects, and the clinical situations where nitroglycerin can be extremely helpful or spectacularly unhelpful. Along the way, we examine hypotension, right ventricular infarctions, PDE-5 inhibitors, pulmonary edema, and why giving nitro involves considerably more thought than simply asking whether the patient has chest pain.

It is cardiovascular physiology, explosives, questionable humour, and practical prehospital medicine, all packed into one episode.

DKA is way more than “the sugar is high.”

In this episode of That Paramedic Podcast, we break down diabetic ketoacidosis from the ground up: what causes it, why ketones and acidosis develop, why patients pee out half their circulating volume, and why potassium is the quiet psychopath nobody should ignore.

We also get into Kussmaul respirations, why a DKA patient’s crazy respiratory rate may be the thing keeping them alive, what makes intubation so dangerous, and how Alberta EMS approaches these patients in the prehospital setting.

Plus, we take a trip back to the good old days of medicine when treatment for diabetes included starvation diets, bicarbonate, and a healthy dose of “well… hopefully this works.”

Expect physiology, EMS pearls, dark humour, old-timey medicine, and several reminders not to steal anyone’s emotional-support tachypnea.

Educational only. Follow your local protocols and medical direction.

Your patient is acidotic. Fantastic. Now comes the slightly more important question: why?

In this episode of That Paramedic Podcast, we dive into the wonderfully unpleasant world of respiratory and metabolic acidosis. We break down how the body regulates pH, the roles of the lungs and kidneys, and how to determine whether the problem is caused by too much carbon dioxide, too little bicarbonate, or the human body simply deciding that chemistry is now optional.

We explore the common causes and clinical presentations of both types of acidosis, including respiratory failure, COPD, hypoventilation, shock, sepsis, diabetic ketoacidosis, renal failure, and other situations in which the patient’s internal environment has become medically described as pHucked.

We also discuss compensation, why the respiratory rate matters, how capnography and blood gases can help, and why silencing a patient’s compensatory breathing without understanding what is happening can turn a bad situation into a very short case review.

So take a deep breath, unless you are retaining carbon dioxide, and join us as we attempt to make acid-base balance slightly less confusing and considerably more inappropriate.

From humble electrolyte to killer of cardiac conduction, this episode has it all.

Capnography, ETCO2, and what that squiggly little bastard is trying to tell you.

In this special episode: Salbutamol! The tiny blue puffer, surprisingly huge story. We unpack how this famous beta‑2 agonist opens airways, shifts potassium, and earned a spot in nearly every paramedic drug bag. From asthma history and spacer-versus-nebulizer debates to lactic acidosis, changing treatment guidelines, and an unexpected Tour de France cameo, discover why salbutamol is lifesaving—but sometimes little more than a “big blue Band-Aid.” Expect practical medicine, questionable jokes, and plenty of facts to help you breathe easier.