Guest: Dr. Maia Dorsett
Favorite Quotes by Maia:
“The vomiting center: It sounds like a place you never want to visit.”
“My husband could eat a fish taco on a roller coaster and not get sick.”
“Rocuronium really does help vomiting, because you physically can’t.”
“Babies haven’t proven that they are put together correctly.”
The Thinking Series turns the paramedic core curriculum on its head. The conventional design of initial EMS education is structured by dividing the content into body systems. If you are an EMT or paramedic student, you likely have a course schedule & corresponding textbook chapters organized by body systems: GI, Neuro, Cardiac, etc. The curriculum has to sit within a framework; The body-system design makes sense for initial education, but it does offer challenges.
Where would education about vomiting normally occur in the curriculum? It’s customary, and maybe intuitive, to tuck that topic into the GI bucket. But vomiting caused by a neurological condition like hemorrhagic stroke with increasing ICP is far more concerning than vomiting caused by gastroenteritis.
The Thinking Series solves this problem: Instead of starting with a body system, we start with the patient complaint – the way patients actually present to us in the field.
In this episode, you will hear Maia talk about pediatrics, geriatrics, pregnancy, substance-use disorders. Again, all are topics that have historically been siloed as a “special population” topic.
By centering on the chief complaint, the conversation mirrors how working paramedics actually think about differential diagnosis.
Learning Objectives:
- Describe the major physiological mechanisms that cause vomiting.
- Generate a differential diagnosis for vomiting using physiologically based reasoning.
- Identify clinical indications of a potentially life-threatening cause of vomiting.
- Apply clinical reasoning strategies to prehospital vomiting presentations.
- Prioritize assessment and management actions for a vomiting patient in the field.
- Describe the mechanism of action of medications used to treat nausea and vomiting.
Medic Mindset 