That Paramedic Podcast

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.

In this episode of That Paramedic Podcast, Jay and Courtney dive into ketamine—from its surprising origins and battlefield use to its modern role in sedation, pain management, behavioural emergencies, and mental health treatment. They explore how it works, its benefits and risks, evolving research, and practical considerations for paramedics—all with plenty of humour and real-world insight.

In this episode, we unpack midazolam—how it slips into the brain, turns up GABA’s “calm down” signal, and helps manage everything from seizures and severe agitation to procedural sedation. Along the way, we explore dosing, respiratory risks, surprising history, and real-world calls where Versed saved the day—or met a patient determined to remain a grumbly bear. Educational, practical, and only mildly sedating.