Birth of APRV APRV is not new. It traces back to the work of Dr. John Downs, a University of Florida anesthesiologist, in the mid to late 1980s. Downs was intensely focused on respiratory physiology and had already influenced prehospital care through the development of early CPAP systems, such as the Downs Flow Generator. APRV evolved naturally from that same CPAP mindset. At its core, APRV was designed as an alternative to inverse-ratio pressure-control ventilation for patients with acute...

In this episode of the FOAMfrat Podcast, Dr. Harrison Brookeman (@hbrookeman) joins the discussion to examine methemoglobinemia and the emerging prehospital threat of sodium nitrite ingestion. Often viewed as a rare toxicology concept, this condition is appearing more frequently and can progress rapidly with devastating consequences if it is not recognized early. The episode focuses on what matters most to EMS clinicians in the field: the physiology of methemoglobinemia, why these patients...

A little over a year ago, I made a short reel discussing ventilating a patient in a severe metabolic acidosis. In the video, I mentioned...