Life and Sirens Podcast

Life and Sirens Podcast |Behind & On The Scene|
Truth, education, and growth—on every level.
|A Platform For EMS Professionals|
💌P.O. Box 1137 Murfreesboro, TN 37130

Tomorrows Episode! We talk true crime and ethical lessons!
02/22/2026

Tomorrows Episode! We talk true crime and ethical lessons!

02/20/2026

Fierce patient advocacy is what paramedicine is all about. Meeting patient’s where they are and ensuring they get the best care possible.

Join us Monday as we break down a true crime case as it relates to ethics, advocacy, and fallacies of authority.

02/18/2026

Edema doesn’t always mean “don’t give fluids.” Sometimes the sickest-looking patients are actually intravascularly depleted — and missing that can cost them perfusion.

An edematous patient may still need fluids or blood when:
🚨 They are in hemorrhagic shock
Trauma patients can appear swollen from injury or third spacing while actively bleeding. Blood products remain the priority — not diuretics.

🚨 They have distributive shock (like sepsis)
Capillary leak pushes fluid into the tissues, but the vascular space is empty. Early fluid resuscitation is associated with improved perfusion and outcomes.

🚨 They are hypoalbuminemic
Low oncotic pressure allows fluid to shift into interstitial spaces while circulating volume drops. These patients can look overloaded but be profoundly volume depleted.

🚨 They show signs of poor perfusion
Think beyond appearance:
• Altered mental status
• Narrow pulse pressure
• Delayed cap refill
• Rising lactate
• Hypotension

Treat the hemodynamics — not just the optics.

In EMS, this is where clinical judgment matters most:
👉 Puffy does NOT always equal plenty.



Sources:
• Surviving Sepsis Campaign Guidelines, 2021
• American College of Surgeons — ATLS 10th Edition
• Guyton & Hall Textbook of Medical Physiology (Fluid Dynamics & Capillary Exchange)
• Journal of Trauma and Acute Care Surgery — Damage Control Resuscitation



Discretionary Statement:
This content is for educational purposes only and should not replace local protocols, medical direction, or clinical judgment. Always treat according to your service guidelines and patient presentation.

This is a method-driven clinical episode that gives EMS a repeatable decision model for fluids, CPAP, nitrates, and bloo...
02/16/2026

This is a method-driven clinical episode that gives EMS a repeatable decision model for fluids, CPAP, nitrates, and blood products.

This episode teaches how to differentiate hypovolemia, cardiogenic pulmonary edema, sepsis, and hemorrhage-so medics stop flooding drowning patients and starving shocked ones.

Episode show notes: https://.www.lifeandsirenspodcast.com/episode-guide/ep-67-dry=vs-drowning-managing-fluid-depleted-and-fluid-overloaded-patients

For more Life & Sirens content, visit www.lifeandsirenspodcast.com

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To submit your stories, questions, or experiences to be featured on the show, follow this link: https://www.lifeandsirenspodcast.com/radioreports

02/15/2026

We talk a lot about fluid replacement and not a lot about fluid evacuation— this episode covers both!!

One of the most common ways EMS accidentally harms patients?Treating physiology on autopilot.A liter isn’t always the an...
02/15/2026

One of the most common ways EMS accidentally harms patients?

Treating physiology on autopilot.

A liter isn’t always the answer.
And neither is a diuretic.

In this episode, we give you a repeatable call flow you can use on every critically ill patient:

✔ Identify what is failing first
✔ Sort the physiology (Pump, Pipes, Fluid)
✔ Choose the correct branch
✔ Reassess early
✔ Know when evacuation is the intervention

Because great prehospital medicine isn’t about memorizing treatments.

It’s about understanding the problem you’re solving.

🎧 Dry vs. Drowning — available now.

Send this to your partner.
Your preceptee.
Your crew.

Better clinicians build better systems.

02/14/2026

Refractory Hypotension in Hemorrhagic Shock:
• Situation: A trauma patient remains hypotensive despite fluid resuscitation, and blood products are unavailable.
• Consideration: Routine use of vasopressors in hemorrhagic shock is not supported and may be harmful. However, in exceptional cases where all other measures fail, and transport times are prolonged, vasopressors might be used cautiously.

Key Takeaways
• First-Line Treatment: Always prioritize fluid resuscitation and hemorrhage control.
• Vasopressors as a Last Resort: Consider only when hypotension is refractory to fluids, and the patient’s condition insists.
• Monitor Closely: Be vigilant for potential complications, such as tissue ischemia from extravasation.



📚 References
• Orpet RE, Barrett WJ, Kaucher KA, et al. Prehospital Trauma Compendium: Vasopressors in Trauma – a Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care. 2024.
• Lee J. Understanding prehospital vasopressors: dopamine, epinephrine, or norepinephrine. EMS1. 2025.



Remember, each patient scenario is unique. Always follow your local protocols and consult medical control when in doubt. For educational purposes only.

This Valentine’s Day, we’re talking about the relationship we’re all in: EMS. From the parts of the job we love - the pu...
02/14/2026

This Valentine’s Day, we’re talking about the relationship we’re all in: EMS. From the parts of the job we love - the purpose, the people, the adrenaline - to the parts that quietly wear on us, this episode is an honest look at what keeps us here and what makes it complicated. A little heart, a little humor, and a lot of truth about life and sirens. 🩵

02/13/2026

Valentine’s Special:
EMS LOVE ME, LOVE ME NOT

Self sacrifice is not the key that opens doors… as a paramedic… or in life.

EMS is like a box of chocolates…and dispatch definitely mixed them up.Some are chaotic.Some are confusing.Some are surpr...
02/13/2026

EMS is like a box of chocolates…
and dispatch definitely mixed them up.

Some are chaotic.
Some are confusing.
Some are surprisingly wholesome.
And some absolutely should have come with a warning label.

But somehow — shift after shift — we keep opening the box.

Tag your partner who has survived these chocolates with you ❤️🚑

Happy (early) Valentine’s Day from Life & Sirens.

02/12/2026

Valentines Spcial:
🩵We LOVE EMS, here is why.🩵

The Sacred Work of Showing UpAn Open Letter to EMS Providers | Life & SirensTo the provider reading this — whether you’r...
02/12/2026

The Sacred Work of Showing Up
An Open Letter to EMS Providers | Life & Sirens

To the provider reading this — whether you’re sitting in the front seat of the truck, halfway through a long shift, or finally catching your breath after a difficult call — this letter is for you.

There is something sacred about the work you do.

Not because it is glamorous. Not because it is easy. But because when someone calls for help, you go. You walk into uncertainty for the sake of someone else, bringing skill, steadiness, and compassion into moments that often feel overwhelming.

Never let that become ordinary.

What you carry is more than equipment — it is presence. The ability to think clearly when seconds matter. The willingness to care for strangers on what may be the hardest day of their lives. The quiet strength to show up again and again, often without recognition.

And I want you to hear this clearly:

What you do matters.
Even on the calls that feel routine.
Especially on the ones that stay with you.

But let’s speak honestly — this profession is heavy. There will be shifts that drain you, calls you replay in your mind, and seasons where fatigue feels louder than purpose.

If you are in one of those seasons, please remember: feeling the weight does not mean you are weak. It means you are human in a profession that requires immense heart.

Take care of yourself with the same seriousness you bring to patient care. Rest when you need to. Lean on your partners. Talk about the calls. Longevity in EMS is not accidental — it is intentional.

And as you grow in this career, do not confuse excellence with hardness. The strongest providers are not the ones who feel the least — they are the ones who never lose their humanity. Be skilled and decisive, but remain kind. Extend patience to the new provider finding their rhythm, and remember that mentorship is how this profession moves forward.

Because gratitude in EMS isn’t about loving every shift. It is about recognizing the privilege of being trusted in moments that truly matter — advocating for patients, calming fear, and bringing clarity into chaos.

So wherever this letter finds you, I hope you pause long enough to remember why you started. Beneath the long hours, the system frustrations, and the exhaustion… there is still purpose here.

Let this career make you wiser, not colder. Stronger, not hardened. More compassionate, not detached.

At its core, this work has always been about people — about showing up fully when it matters most.

And that will always be sacred work.

To every provider reading this: thank you for continuing to answer the call, for stepping forward when others step back, and for carrying the responsibility of this role with quiet courage.

This profession is better because you are in it.

Stand steady. Care deeply. And never become numb to the privilege of serving others.

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Nashville, TN

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