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
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Hypothermia Rescue: Cardiac Arrest in a Tree Well [not-audio_url] [/not-audio_url]

Duration: 39:59
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When The Anatomy Is Gone: Facial Trauma Airway Management [not-audio_url] [/not-audio_url]

Duration: 24:21
What do you do when the anatomy you've memorized simply doesn't exist anymore? When a patient's entire face is gone, and your standard airway management tools won't work? This is where training meets reality. Critical ca…
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Duration: 25:14
Discover the difference between resistance (your daily shield built through sleep, nutrition, relationships, and spiritual wellness) and resilience (the anaerobic sprint you can't maintain forever). Recorded on-site at F…
What If They Find Out I'm A Fraud? - Imposter Syndrome in EMS [not-audio_url] [/not-audio_url]

Duration: 23:02
Ever cried in the ambulance because you felt completely overwhelmed? Sophie Fuller has—and she's done something powerful with that experience. In this raw discussion, the Life and Sirens podcast host shares her most vuln…