Prehospital Emergency Care Podcast

What does it really take to administer pediatric medications safely in EMS—and what can go wrong even when clinicians use cognitive aids? In this crossover episode, originally recorded for the EMS Clinical Brief podcast, Maia Dorsett interviews Bryan Harmer, a paramedic researcher and expert in pediatric medication safety whose simulation research has directly observed and characterized medication errors. His findings include two important papers recently published in Prehospital Emergency Care. Together, they unpack the often-overlooked microskills involved in pediatric medication administration, from determining weight and calculating doses to preparing, administering, and documenting medications. Drawing on Bryan's research, they explore how seemingly small errors—including incorrect use of length-based tapes, air in syringes, and errors during bedside dilution—can lead to discrepancies between the dose intended, the dose administered, and the dose documented. They also discuss why cognitive aids alone aren't enough and share practical strategies EMS systems can use to identify hidden risks and improve medication safety through simulation, equipment selection, and medication cross-checks.
References:
Hoyle Jr, J. D., Davis, A. T., Putman, K. K., Trytko, J. A., & Fales, W. D. (2012). Medication dosing errors in pediatric patients treated by emergency medical services. Prehospital emergency care, 16(1), 59-66.
Hoyle Jr, J. D., Ekblad, G., Hover, T., Woodwyk, A., Brandt, R., Fales, B., & Lammers, R. L. (2020). Dosing errors made by paramedics during pediatric patient simulations after implementation of a state-wide pediatric drug dosing reference. Prehospital Emergency Care, 24(2), 204-213.
Harmer, B. M., Hoyle Jr, J. D., Edwards, A., Fredericks, T., Wells, L., Lecznar, A., ... & Fogarty, K. (2026). Assessing the influence of a statewide dosing reference aid on prehospital pediatric medication dosing errors: a mixed-methods simulation-based investigation. Prehospital emergency care, 30(6), 848-855.
Harmer, B. M., Hoyle Jr, J. D., Wells, L., Fredericks, T., Edwards, A., Lecznar, A., ... & Fogarty, K. (2026). A Simulation-Based Root Cause Analysis of Pediatric Medication Dosing Errors in Emergency Medical Services. Prehospital emergency care, 1-9.
Dorsett, M., O'Donnell, S., Strickland, W., Cheng, W., Sensenbach, B., Cannuli, M., ... & Cushman, J. T. (2026). Improving pediatric medication safety through implementation of evidence-based guidelines. Prehospital Emergency Care, 1-8.
 
As always THANK YOU for listening.
Hawnwan Philip Moy MD (@pecpodcast)
Scott Goldberg MD, MPH (@EMS_Boston)
Jeremiah Escajeda MD, MPH (@jerescajeda)
Joelle Donofrio-Odmann DO (@PEMems)
Maia Dorsett MD PhD (@maiadorsett)
Lekshmi Kumar MD, MPH(@Gradymed1)
Greg Muller DO (@DrMuller_DO)
Ariana Weber MD (@aweberMD4)
Rebecca Cash PhD (@CashRebeccaE)
Michael Kim MD (@michaeljukim)
Rachel Stemerman PhD (@steminformatics)
Nikolai Arendovich MD

Welcome to the Prehospital Emergency Care Podcast!
In this episode, hosts Jer Escajeda, Greg Muller, and Ariana Weber discuss four more of the fourteen articles from the Prehospital Trauma Compendium.  
In 2025, the Prehospital Trauma Compendium introduced crucial guidelines and insights regarding the management of traumatic injuries in prehospital settings. This episode summarizes four significant articles that focus on special populations: pediatric, pregnant, and geriatric patients, as well as the management of entrapped patients.  If you're an EMS professional or a medical provider involved in trauma care, these insights are vital for improving patient outcomes. 
References:
Cicero MX, Adelgais K, Funaro MC, et al. Prehospital Trauma Compendium: Pediatric Severe and Inflicted Trauma - A Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. Published online February 10, 2025. doi:10.1080/10903127.2025.2457141
Maloney LM, Huff AN, Couturier K, et al. Prehospital Trauma Compendium: Management of Injured Pregnant Patients- A Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. Published online March 12, 2025. doi:10.1080/10903127.2025.2473679
Haussner WK, Breyre AM, Bascombe K, et al. Prehospital Trauma Compendium: Management of Geriatric Trauma Patients - A Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. Published online September 25, 2025. doi:10.1080/10903127.2025.2557006
Bosson N, Abo BN, Litchfield TD, et al. Prehospital Trauma Compendium: Management of the Entrapped Patient - a Position Statement and Resource Document of NAEMSP. Prehosp Emerg Care. Published online October 24, 2024. doi:10.1080/10903127.2024.2413876
 
As always THANK YOU for listening.
Hawnwan Philip Moy MD (@pecpodcast)
Scott Goldberg MD, MPH (@EMS_Boston)
Jeremiah Escajeda MD, MPH (@jerescajeda)
Joelle Donofrio-Odmann DO (@PEMems)
Maia Dorsett MD PhD (@maiadorsett)
Lekshmi Kumar MD, MPH(@Gradymed1)
Greg Muller DO (@DrMuller_DO)
Ariana Weber MD (@aweberMD4)
Rebecca Cash PhD (@CashRebeccaE)
Michael Kim MD (@michaeljukim)
Rachel Stemerman PhD (@steminformatics)
Nikolai Arendovich MD

Welcome to the Prehospital Emergency Care Podcast!
Rapid seizure termination is one of the most important priorities in pediatric prehospital care, yet establishing intravenous access can delay treatment. In this episode, Maia Dorsett and Joelle Donofrio-Odmann speak with Jonathan Mohnkern about his recent systematic review and meta-analysis comparing intranasal and intramuscular midazolam for pediatric seizures. Together, they review the available evidence, discuss the pharmacologic differences between administration routes, examine the implications for EMS protocols and medication dosing, and explore how these findings may influence future prehospital seizure management.
 
Featured Article:
Mohnkern, J. D., Khalid, A., Ibrahim, M., Dave, V., Chierighini, P. P., Riaño, A. S., ... & Martins Shehan, T. S. (2026). Intranasal versus intramuscular midazolam in pediatric seizure control: a systematic review and meta-analysis. Prehospital Emergency Care, 1-9. https://doi.org/10.1080/10903127.2026.2658592
Additional References:
Shah, M. I., Macias, C. G., Dayan, P. S., Weik, T. S., Brown, K. M., Fuchs, S. M., ... & Lang, E. S. (2014). An evidence-based guideline for pediatric prehospital seizure management using GRADE methodology. Prehospital emergency care, 18(sup1), 15-24.
Shah, M. I., Ostermayer, D. G., Browne, L. R., Studnek, J. R., Carey, J. M., Stanford, C., ... & Lerner, E. B. (2021). Multicenter evaluation of prehospital seizure management in children. Prehospital Emergency Care, 25(4), 475-486.
Remick, K., Redgate, C., Ostermayer, D., Kaji, A. H., & Gausche-Hill, M. (2017). Prehospital glucose testing for children with seizures: a proposed change in management. Prehospital Emergency Care, 21(2), 216-221.
Silbergleit, R., Durkalski, V., Lowenstein, D., Conwit, R., Pancioli, A., Palesch, Y., & Barsan, W. (2012). Intramuscular versus intravenous therapy for prehospital status epilepticus. New England journal of medicine, 366(7), 591-600.
Mohammed, M. Z., Elagouza, I., El Gaafary, M., El-Garhy, R., & El-Rashidy, O. (2024). Intranasal versus buccal versus intramuscular midazolam for the home and emergency treatment of acute seizures in pediatric patients: a randomized controlled trial. Pediatric Neurology, 158, 135-143.
 
Further Resources: 
Pediatric EMS Podcast: Managing Prehospital Pediatric Seizures: https://naemsp.org/podcast-pediatric-em/expedite-the-route-simplify-the-dose-managing-pediatric-prehospital-seizures/

Welcome to the Prehospital Emergency Care Podcast!
In this episode, Greg Muller discusses the article Promotion of Emergency Medical Services: A National Analysis of Clinician Willingness to Recommend the Profession with authors Jacob Kamholz and Ash Panchal.
This article explores a novel approach to assessing EMS workforce sentiment using the Net Promoter Score (NPS). Guests Jacob Kamholtz and Ash Panchal discuss how NPS can serve as a benchmark for EMS career advocacy, workforce sustainability, and future planning, highlighting key findings and implications for EMS leadership.
Featured Article

Kamholz JC, Gage CB, van den Bergh SL, Riel KM, Powell JR, Panchal AR. Promotion of Emergency Medical Services: A National Analysis of Clinician Willingness to Recommend the Profession. Prehosp Emerg Care. 2026 Feb 20:1-7. doi: 10.1080/10903127.2026.2619038.
 
 
As always THANK YOU for listening.
Hawnwan Philip Moy MD (@pecpodcast)
Scott Goldberg MD, MPH (@EMS_Boston)
Jeremiah Escajeda MD, MPH (@jerescajeda)
Joelle Donofrio-Odmann DO (@PEMems)
Maia Dorsett MD PhD (@maiadorsett)
Lekshmi Kumar MD, MPH(@Gradymed1)
Greg Muller DO (@DrMuller_DO)
Ariana Weber MD (@aweberMD4)
Rebecca Cash PhD (@CashRebeccaE)
Michael Kim MD (@michaeljukim)
Rachel Stemerman PhD (@steminformatics)
Nikolai Arendovich MD

Welcome to the Prehospital Emergency Care Podcast!
In this episode, hosts Jeremiah Escajeda, Greg Muller, and Ariana Weber discuss four of the sixteen articles from the Prehospital Trauma Compendium.
In 2025, the Prehospital Trauma Compendium introduced crucial guidelines and insights regarding the management of traumatic injuries in prehospital settings. This episode summarizes four significant articles that focus on the use of blood products, vasopressors, tranexamic acid, (TXA), and care for patients in traumatic cardiac arrest. If you're an EMS professional or a medical provider involved in trauma care, these insights are vital for improving patient outcomes.
 
Featured Articles

Brown, J. B., Yazer, M. H., Kelly, J., Spinella, P. C., DeMaio, V., Fisher, A. D., … Guyette, F. X. (2025). Prehospital Trauma Compendium: Transfusion of Blood Products in Trauma – A Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care, 1–10. https://doi.org/10.1080/10903127.2025.2476195


Orpet, R. E., Barrett, W. J., Kaucher, K. A., Colwell, C. B., & Lyng, J. W. (2024). Prehospital Trauma Compendium: Vasopressors in Trauma – a Position Statement and Resource Document of NAEMSP. Prehospital Emergency Care, 1–7. https://doi.org/10.1080/10903127.2024.2437656


Barrett, W. J., Kaucher, K. A., Orpet, R. E., Campion, E. M., Goodloe, J. M., Fischer, P. E., … Lyng, J. W. (2025). Prehospital Trauma Compendium: Tranexamic Acid in Trauma – A Joint Position Statement and Resource Document of NAEMSP, ACEP, and ACS-COT. Prehospital Emergency Care, 1–8. https://doi.org/10.1080/10903127.2025.2497056



Breyre, A. M., George, N., Nelson, A. R., Ingram, C. J., Lardaro, T., Vanderkolk, W., & Lyng, J. W. (2025). Prehospital Trauma Compendium: Prehospital Management of Adults with Traumatic Out-of-Hospital Circulatory Arrest – A Joint Position Statement and Resource Document of NAEMSP, ACS-COT, and ACEP. Prehospital Emergency Care, 1–15. https://doi.org/10.1080/10903127.2024.2428668

 
As always THANK YOU for listening.
Hawnwan Philip Moy MD (@pecpodcast)
Scott Goldberg MD, MPH (@EMS_Boston)
Jeremiah Escajeda MD, MPH (@jerescajeda)
Joelle Donofrio-Odmann DO (@PEMems)
Maia Dorsett MD PhD (@maiadorsett)
Lekshmi Kumar MD, MPH(@Gradymed1)
Greg Muller DO (@DrMuller_DO)
Ariana Weber MD (@aweberMD4)
Rebecca Cash PhD (@CashRebeccaE)
Michael Kim MD (@michaeljukim)
Rachel Stemerman PhD (@steminformatics)
Nikolai Arendovich MD