# Plasma for TBI and Nebulized Nitro in Cardiac Arrest: A Fun Look Into Early Research with Dr. Peter Antevy and Bruce Hoffman

An episode of [Loud & Clear: EMS Guiding Principles - Advanced Continuing Education for Paramedics, EMTs & Prehospital Care Providers](https://invisiblenetwork.ai/podcast/1500168983), 26 Oct 2026, 52 min.

Audio: https://mcdn.podbean.com/mf/web/g3kimpqx2apxrv9g/LoudAndClear_142_BruceHoffman_PeterAntevy_mixdownac167.mp3

Your severe head injury patient is altered and hypertensive. Do they need fluid at all, and if so, which one? And in cardiac arrest, are you only restarting the heart, or is getting blood to the brain just as important? Matt talks with Dr. Peter Antevy about why plasma may help rebuild the glycocalyx, the protective lining of blood vessels that sheds after trauma, and why he believes the earliest place to give it is EMS. Then Ross talks with Bruce Hoffman about a swine study testing whether nebulized nitroglycerin during CPR can improve blood flow to the brain. This episode also covers syndecan, cerebral edema and crystalloid, the EPIC TBI study, plasma versus whole blood, point-of-care TBI biomarkers, pulmonary vascular resistance during cardiac arrest, and why EMS clinicians need a seat at the research table. In this episode, you’ll learn: • Why Dr. Antevy's agencies are moving toward running plasma in slowly for TBI • How plasma alone may bridge some bleeding patients who don't need red cells • Why carotid blood flow dropped after epinephrine in the nitroglycerin study • The new questions raised about vasopressors and flow to the brain 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. Nebulized Nitroglycerin Improves Carotid Blood Flow During Cardiopulmonary Resuscitation in a Swine Model of Cardiac Arrest (Kelly et al., Prehospital Emergency Care, 2025) EPIC TBI study results (Spaite et al., JAMA Surgery, 2019) Guests: Dr. Peter Antevy, MD, EMS Medical Director and Founder and Chief Medical Officer of Handtevy Bruce Hoffman, MSN, RN, CFRN, FP-C, Critical Care Transport Nurse with FlightBridgeED

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.