The First 60 Seconds After ROSC: How To Prevent Re-Arrest

The First 60 Seconds After ROSC: How To Prevent Re-Arrest

Author: Ross Orpet, Paramedic turned EMS Physician September 7, 2026 Duration: 35:52
The First 60 Seconds After ROSC: How To Prevent Re-Arrest How do you improve your resuscitation systems beyond the ACLS algorithm? Will talks with Ian Blanchard, Senior Scientist for Alberta’s provincial EMS system about the “frame of survival” and why rehearsing equipment placement and vector change can make critical actions nearly automatic when the call comes in. Then, Ross talks with Mike Humphrey of Lethbridge Fire and Emergency Services about what happened when his team reviewed their cardiac arrests and discovered a recurring pattern: post-ROSC hypotension followed by a near 50% re-arrest rate. Their response was to redesign post-ROSC care around the first 60 seconds to prevent life-sustaining therapies from disappearing during the transition of care.In this episode, you’ll learn: What “doing reps in the clinical gym” looks like when you don’t have access to a high-fidelity simulator Why moving a cardiac-arrest patient too early can undermine CPR quality and make resuscitation worse What 1 minute blood pressure reassessments can reveal that a single “good” post-ROSC pressure may miss Why a vasopressor-dependent patient should stay on the EMS stretcher  The best time to prepare for vector change, pit-crew roles, and post-ROSC care   Resources:Want more? Sign up for our weekly newsletter, The Confidence Dispatch. Want individualized coaching and mentorship? Check out The Loud & Clear Fellowship. Just have a question and want some personalized help? Book a free coaching call with us. Canadian Resuscitation Outcomes ConsortiumResuscitation AcademyInternational Liaison Committee on ResuscitationEpisode 133: Post-ROSC Care & Pacing: Prove the PerfusionGuests:Ian Blanchard, former paramedic and Senior Scientist for Alberta’s provincial EMS system Mike Humphrey, Lethbridge Fire and Emergency Services

Stepping out of the classroom and into the rig is where the real learning begins, but that transition often leaves even seasoned providers with a lingering doubt. Loud & Clear: EMS Guiding Principles addresses that gap directly, moving past the basic protocols to explore the foundational reasoning that makes for excellent prehospital care. Hosted by Ross Orpet, a paramedic who now practices as an EMS physician, this podcast digs into the "why" behind the algorithms. It’s built on the understanding that no textbook can possibly cover every unique scenario you’ll encounter on the road. Instead of just listing steps, each episode examines the core principles that guide critical decisions when the situation doesn't fit a neat checklist. You’ll hear discussions that bridge the gap between field experience and medical rationale, focusing on the adaptive thinking required for complex emergencies. This is advanced continuing education designed for paramedics, EMTs, and all prehospital providers who feel that standard training was just the beginning. The conversations in this series aim to solidify your clinical judgment, helping you build confidence through comprehension. By tuning in, you gain access to a deeper level of professional development, where the objective is to think clearer and act more decisively, no matter how many days you have on the job. This podcast serves as a vital resource for those committed to mastering their craft beyond the basics.
Author: Language: English Episodes: 50

Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers
Podcast Episodes
Pediatric Sepsis with Dr. Peter Antevy [not-audio_url] [/not-audio_url]

Duration: 32:50
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Duration: 1:37:52
Most EMS skills training creates an illusion of competence. You drill a procedure, check a box, and move on. But what does the research actually show about competency and retention? Dr. Jason Hine (EM physician, SimKit f…
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Duration: 16:18
Stephanie Suzadail's favorite word is "fail." She'll tell you why and how we should embrace it. In this episode she walks through the difference between failure that builds you and failure that breaks you. Why Sisyphus i…
Great Mentors Shape Better Clinicians [not-audio_url] [/not-audio_url]

Duration: 19:33
Don't Be A Field Training Officer Be A Field Training Mentor. Field training is about more than teaching skills, it shapes culture, standards, and the kind of clinician someone becomes. In this episode, Ross sits down wi…
Frozen Fingers, Time Is Tissue: The Prehospital Approach to Frostbite [not-audio_url] [/not-audio_url]

Duration: 1:00:06
Frostbite is more dangerous than it looks and easier to make worse than you think. In this episode, Ross and Will sit down with Dr. Greg Doctor, a wilderness medicine specialist and emergency physician practicing in the…
Wired to Fail: The Science of Human Error in EMS [not-audio_url] [/not-audio_url]

Duration: 11:17
What if the mistake wasn't your fault... but it's still your responsibility? That's the tension Shay Montgomery sits with every time she talks about the day she flew to a scene without the drug bag. Shay is a flight nurs…