The 10-8 Show

About The 10-8 Show

The Inflection Point is the podcast that brings paramedics, EMS providers, and healthcare professionals the latest in prehospital medicine, critical care, cardiac and trauma management, pharmacology, and system design. Jakob Rodger and Ryan Cichowski dive deep into the intricacies of frontline care—combining clinical expertise, research, human factors, leadership, and interdisciplinary collaboration to help you think differently and perform at a higher level. We aim to take a holistic approach to sharing high-quality information that supports paramedics and healthcare professionals.

Publisher

Ryan Cichowski and Jakob Rodger.

Category

health & fitness

Language

en

Explicit

No

First episode

16 Feb 2025

Latest episode

5 Oct 2026

Latest episodes

83 episodes in the feed.

1. 

   5 Oct 2026

   Bradyarrhythmias: When a Patient Is Approaching Cardiac Arrest | Class Professional

   Symptomatic bradycardia can be one of the most nuanced and high-risk emergencies paramedics manage. In this episode, we work through a case of unstable complete heart block and break down the clinical decisions that matter when a patient is deteriorating. How do you recognize when bradycardia is actually causing instability? When should you consider fluids or atropine? When is it time to move to transcutaneous pacing? And where does dopamine fit when the patient is approaching cardiac arrest? We explore the physiology, ECG interpretation, treatment options, and escalation decisions behind symptomatic bradycardia, with a focus on practical pre-hospital decision-making. We discuss: • Recognizing unstable symptomatic bradycardia • Complete and high-grade AV block • Third-degree heart block ECG findings • Sinus bradycardia, vagal tone, and right-sided MI • Fluids and preload • Atropine and its limitations • Transcutaneous pacing • Electrical vs. mechanical capture • Analgesia and sedation during pacing • Fentanyl, midazolam, and ketamine • Dopamine vs. pacing • Escalating care toward cardiac arrest CHAPTERS 00:00 Why symptomatic bradycardia is nuanced 01:51 Unstable bradycardia after a fall 03:28 Assessing the unstable patient 05:49 Complete heart block 08:02 Third-degree heart block ECG 10:50 Bradycardia, vagal tone, and right-sided MI 13:40 First- and second-degree AV blocks 17:41 Type I vs. Type II second-degree block 19:23 Treatment options 21:03 Fluids and preload 24:16 Atropine, pacing, and next steps 28:19 Pacing in high-grade block 30:32 Electrical vs. mechanical capture 32:47 Pain control and sedation 36:01 Ketamine, fentanyl, and midazolam 37:06 Dopamine vs. pacing 41:37 Practical bradycardia framework 44:52 Final takeaways 45:32 Educational disclaimer MATERIAL FEATURED IN THIS EPISODE The ECG concepts and case-based learning featured in this episode are supported by Clinical ECGs in Paramedic Practice, published by Class Professional. This full-colour guide takes paramedics from cardiac electrophysiology and foundational rhythm recognition through systematic 12-lead ECG interpretation, with clinical cases and more than 100 practice ECGs. Clinical ECGs in Paramedic Practice: https://www.classprofessional.co.uk/books-ebooks/paramedic-emergency-care/paramedic-textbooks/clinical-ecgs-in-paramedic-practice/ (https://www.classprofessional.co.uk/books-ebooks/paramedic-emergency-care/paramedic-textbooks/clinical-ecgs-in-paramedic-practice/) We also reference Critical Care Paramedicine: A Case-Based Approach, a Class Professional resource exploring assessment and management of critically ill patients across pre-hospital and critical care practice. Class Professional: https://www.classprofessional.co.uk/ (https://www.classprofessional.co.uk/) Canadian website: https://www.classprofessional.ca/ (https://www.classprofessional.ca/) Listener discount code: InflectionPoint10 SPONSORED BY CLASS PROFESSIONAL This episode is proudly sponsored by Class Professional, creators of evidence-informed books, digital tools, and educational resources for paramedics and healthcare professionals. Podcasts and author conversations: https://www.classprofessional.co.uk/podcasts/ (https://www.classprofessional.co.uk/podcasts/) Instagram: https://www.instagram.com/classprofessional/ (https://www.instagram.com/classprofessional/) Canadian Instagram: https://www.instagram.com/classprofessional_canada/ (https://www.instagram.com/classprofessional_canada/) YouTube: https://www.youtube.com/@class.professional (https://www.youtube.com/@class.professional) LinkedIn: https://www.linkedin.com/company/class-professional/ (https://www.linkedin.com/company/class-professional/) Facebook: https://www.facebook.com/ClassProfessionalPublishing/ (https://www.facebook.com/ClassProfessionalPublishing/) X: https://x.com/classprofession (https://x.com/classprofession) Threads: https://www.threads.net/@classprofessional (https://www.threads.net/@classprofessional) DISCLAIMER This content is intended for educational and informational purposes only. It is not medical advice and should not be used to diagnose, treat, or manage any medical condition or emergency. Always follow current evidence, local medical directives, organizational policies, clinical guidelines, and medical oversight. IMAGE AND MATERIAL CREDITS All ECG images, rhythm strips, and medical illustrations of the heart featured in this episode are reproduced from Clinical ECGs in Paramedic Practice with permission from Class Professional.

2. 

   14 Sept 2026

   External Violence Against Paramedics: Beyond Zero Tolerance | Mandy Johnston

   Paramedics respond when people need help. But when they experience violence, who protects them, and what happens after they report it? Mandy Johnston returns for her second episode of The Inflection Point to discuss external violence against paramedics and what it takes to move beyond a zero-tolerance policy. Mandy is the epitome of a leader and a trailblazer in protecting others. Her work in paramedic safety and violence prevention connects policy, reporting, education, and collaboration across agencies. Her approach demonstrates change management in practice: listening to paramedics, building trust, reducing barriers, securing resources, and turning frontline concerns into organizational action. In this episode, we explore Peel’s External Violence Incident Report (EVIR), how reporting data can drive meaningful change, and how that data supported council approval of $1.25 million for ALERT, a 12-hour reality-based training program. We discuss conflict avoidance, tactical communication, stress responses, documentation, and the difficult decisions surrounding disengagement and unavoidable force. Mandy also shares the emotional weight of realistic simulation, why experienced paramedics need this training, and how developing instructors can strengthen leadership across an organization. Not all violence can be prevented. Protecting paramedics requires a comprehensive program and leaders willing to follow through. WATCH MANDY’S FIRST EPISODE https://www.youtube.com/watch?v=ht9xPIpiaFA (https://www.youtube.com/watch?v=ht9xPIpiaFA) EPISODE CHAPTERS 00:00 Can We Prevent Violence Against Paramedics? 00:33 Making Zero Tolerance Meaningful 01:49 Building EVIR Reporting 03:16 What Motivates Paramedics to Report? 05:27 Removing Reporting Barriers 10:51 Turning Reports Into Action 12:03 Funding Change With Data 13:09 Inside ALERT Training 14:15 Stress Responses and Realistic Scenarios 16:33 Documentation After Using Force 19:18 Why Experienced Paramedics Need This Training 22:50 Moral Dilemmas in Training 24:08 From Victim to Empowered 27:27 Designing Realistic Scenarios 31:56 The Details That Make Simulation Feel Real 34:14 Handling Emotional Critiques 35:02 Tracking the Emotional Impact 35:48 Why Simulation Matters 37:59 Powerful Participant Feedback 39:31 Instructor Debriefs and Consolidating Learning 42:06 Instructor Lessons and Team Growth 44:15 Scaling the Program Across Ontario 45:46 Tactical Communication Under Stress 49:10 Legal Documentation and Criminal Charges 56:28 Building Culture Through Leadership 01:01:36 Mandy’s Hardest Leadership Lesson 01:05:36 Why Violence Prevention Takes an Entire System IMAGE CREDITS All photographs and images featured in the video version of this episode are from Peel Regional Paramedic Services. Thank you to Peel for providing these visuals. Thank you for listening to The Inflection Point. Follow the podcast and share this episode with a colleague, educator, or leader. EDUCATIONAL DISCLAIMER This episode is for educational and informational purposes. It does not replace accredited training, medical or legal advice, or your service’s policies and procedures. Follow applicable legislation, local medical directives, protocols, and authorized guidance. Views expressed are those of the hosts and guest and do not necessarily represent their employers or affiliated organizations.

3. 

   7 Sept 2026

   Sinus Tachycardia or SVT? How Paramedics Can Tell in Seconds | Class Professional

   A regular narrow-complex tachycardia at 180 bpm: sinus tachycardia or SVT? We break down the clinical and ECG features that help paramedics distinguish a compensatory sinus tachycardia from a true re-entry rhythm without relying on heart rate alone. The episode begins with a 34-year-old experiencing sudden palpitations and a regular narrow-complex tachycardia at approximately 180 bpm. From there, we work through the findings that can change the differential: • Sudden versus gradual onset • Clinical context and underlying causes • Patient appearance and perfusion • Rate and rhythm regularity • Respiratory variation • P-wave morphology and placement • SVT, atrial flutter and atrial fibrillation • Stable versus unstable presentations TIMESTAMPS 00:00 SVT case introduction 01:02 Assessing sudden-onset tachycardia 03:21 Reading the ECG: narrow-complex rhythms 04:30 Sinus tachycardia vs. SVT 07:19 AVNRT and re-entry pathways 08:57 What “supraventricular” really means 10:08 SVT triggers and patient history 11:13 Stable vs. unstable tachycardia 12:55 Why SVT can impair cardiac output 14:34 A practical ECG learning resource 17:16 Vagal manoeuvres and the modified Valsalva 20:04 When to establish IV access 21:21 Adenosine: how it works and how to give it 23:29 Preparing patients for adenosine 25:02 Adenosine dosing and contraindications 27:21 Managing borderline blood pressure 30:11 Sedation and cardioversion 31:15 Wolff-Parkinson-White explained 32:57 Atrial fibrillation with WPW: key risks 35:17 Assessing accessory-pathway risk 35:53 Closing notes and disclaimer MATERIAL FEATURED IN THIS EPISODE The ECG concepts and case-based learning featured in this episode are supported by Clinical ECGs in Paramedic Practice, published by Class Professional. This concise, full-colour guide takes paramedics from cardiac electrophysiology and foundational rhythm recognition through systematic 12-lead ECG interpretation. It combines practical explanations, clinical cases and more than 100 practice ECGs to strengthen interpretation, clinical reasoning and decision-making. Explore Clinical ECGs in Paramedic Practice: https://www.classprofessional.co.uk/books-ebooks/paramedic-emergency-care/paramedic-textbooks/clinical-ecgs-in-paramedic-practice/ (https://www.classprofessional.co.uk/books-ebooks/paramedic-emergency-care/paramedic-textbooks/clinical-ecgs-in-paramedic-practice/) Explore Class Professional’s clinical education resources: https://www.classprofessional.co.uk/ (https://www.classprofessional.co.uk/) Class Professional Canada: https://www.classprofessional.ca/ (https://www.classprofessional.ca/) SPONSORED BY CLASS PROFESSIONAL This episode is proudly sponsored by Class Professional, creators of trusted, evidence-informed books, digital tools and educational resources for paramedics and healthcare professionals. Listen to their podcasts and author conversations: https://www.classprofessional.co.uk/podcasts/ (https://www.classprofessional.co.uk/podcasts/) FOLLOW CLASS PROFESSIONAL Instagram: https://www.instagram.com/classprofessional/ (https://www.instagram.com/classprofessional/) Canadian Instagram: https://www.instagram.com/classprofessional_canada/ (https://www.instagram.com/classprofessional_canada/) YouTube: https://www.youtube.com/@class.professional (https://www.youtube.com/@class.professional) LinkedIn: https://www.linkedin.com/company/class-professional/ (https://www.linkedin.com/company/class-professional/) Facebook: https://www.facebook.com/ClassProfessionalPublishing/ (https://www.facebook.com/ClassProfessionalPublishing/) X: https://x.com/classprofession (https://x.com/classprofession) Threads: https://www.threads.net/@classprofessional (https://www.threads.net/@classprofessional) ABOUT THE INFLECTION POINT The Inflection Point explores the decisions, systems and human factors shaping healthcare, paramedicine, leadership and patient safety. IMAGE CREDITS All ECG images, rhythm strips and medical illustrations of the heart featured in this episode are reproduced from Clinical ECGs in Paramedic Practice with permission from Class Professional. DISCLAIMER This content is intended for education only. Always follow current evidence, local medical directives, organizational policies and best-practice guidelines. #SVT #SinusTachycardia #ECG #ECGInterpretation #Paramedic #Paramedicine #Adenosine #Cardiology #EmergencyMedicine #ClassProfessional @class.professional

Who has been a guest on The 10-8 Show

Names identified in recent episode analyses. Showing up to five guests.

• Paige Mason
• Mandy Johnston
• Dr Andrew Petrosoniak
• Dr Aws Almufleh
• Kimmo Murto

Reach and audience

Public platform figures. Ratings count people who left a rating, not total listeners.

Spotify

5.0 / 5

6 ratings

Podcast Authority Score: 35 / 100

A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.

Quality

70

Social presence

0

YouTube

0

Engagement

0

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