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Podcast 185 - Eating Disorders w Hanna Thompson

In this episode, Tyler sits down with Hanna Thompson (Flight Paramedic @ Life Link III) to discuss a critical yet often overlooked topic in EMS—eating disorders. Drawing from personal experience and clinical insight, they explore how these conditions present both medically and behaviorally, especially in prehospital and interfacility transport settings.


They break down the subtle physical signs that EMS providers can look for—such as Russell's sign, lanugo, unexplained bradycardia, and electrolyte disturbances—and emphasize the importance of sensitive history taking. The conversation also dives into the dangers of refeeding syndrome, slow correction strategies, fluid choice, and the clinical significance of thiamine, magnesium, and phosphate replacement.


What You’ll Learn:

  • How eating disorders can manifest in EMS calls

  • Why you may be treating the consequences, not the disorder itself

  • Red flags like bradycardia, lanugo, and Russell’s sign

  • How to handle refeeding syndrome safely

  • Why dextrose, fluids, and electrolyte replacement should be approached cautiously

  • The connection between electrolyte shifts and seizures or arrhythmias


Key Takeaway:Patients with eating disorders are medically and psychologically fragile. In EMS, we often encounter them through the effects of the disorder—not the diagnosis itself. Recognizing subtle clues and avoiding aggressive interventions could save a life.


Resources Mentioned:

  • Hannah's blog on EMS considerations in eating disorders https://www.foamfrat.com/post/fading-away-eating-disorders

  • Data on post-COVID spikes in eating disorder incidence

  • Guidelines for electrolyte correction and refeeding syndrome

  • The questionnaire mentioned by Sam

    Morgan JF, Reid F, Lacey JH. The SCOFF questionnaire: a new screening tool for eating disorders. West J Med. 2000 Mar;172(3):164-5. doi: 10.1136/ewjm.172.3.164. PMID: 18751246; PMCID: PMC1070794.


Disclaimer: This podcast is for educational purposes only and not a substitute for clinical protocols or medical direction. Always consult your agency’s guidelines and medical control.



 
 
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