Pre-Hospital Care Podcast: Recent Episodes
Eoin Walker
This podcast is designed to have engaging and inspirational conversations with some of the worlds leading experts in or relating to pre-hospital care. We hope you take a lot from the conversations both from a technical and non-technical perspective. Please rate and review the show as feedback helps ensure that the best information gets back to you throughout the project.
In pre-hospital care, paramedics regularly encounter patients with a wide range of mental health conditions. From anxiety and depression to psychosis and self-harm, the ability to quickly assess and manage these conditions is crucial in ensuring the best possible outcome for the patient. But how do paramedics navigate the complexities of mental health?In the field, where resources are limited and time is critical.
In this episode, we explore the most encountered mental health pathologies in pre-hospital care, focusing on how paramedics assess, manage, and provide care for these patients under high-pressure circumstances. From acute anxiety attacks to bipolar disorder episodes, we discuss the unique challenges paramedics face when dealing with patients experiencing severe psychological distress.
We’ll also delve into the importance of collaboration between paramedics, mental health crisis teams, and other emergency responders (Multi-Disciplinary Team/MDT approaches). How do these teams work together to ensure a seamless care pathway for patients who may need urgent mental health support?
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
This is the second installment from Ryan Atkinson's blog post, "Let's talk about climate hypocrisy and carbon democracy…," which addresses the common accusation of hypocrisy faced by environmental activists.
Ryan, a filmmaker focusing on conservation, acknowledges his own air travel, which contributes to global CO2 emissions, yet argues it is necessary for communicating and effecting systemic change. He frames such criticism as a personal attack designed to shut down debate, suggesting that living a perfectly non-hypocritical life within a carbon-dependent society is nearly impossible for those seeking to make an impact. Instead, he advocates for embracing perceived hypocrisy as a starting point for dialogue about climate change and the pervasive influence of the carbon economy.
Ultimately, the blog champions the idea that individual actions, even imperfect ones, can contribute to larger structural change if they serve a greater purpose. You can read the blog post here: https://ryanatkinson.tv/2020/03/02/lets-talk-about-climate-hypocrisy-and-carbon-democracy/
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
Today, we are joined by Dr Celestine Weegenaar, the first female PHEM trainee at Great Western Air Ambulance Charity (GWAAC). Originally from Amsterdam and now firmly rooted in the South West of England, Celestine brings a wealth of experience from emergency departments across the region – and even from the skies of Australia, where she flew with LifeFlight.
We talk about her journey into pre-hospital emergency medicine, what drew her to the field, and how she’s navigating the challenges and rewards of her current role. From the adrenaline of high-acuity pre-hospital care to the quiet moments of learning and growth alongside GWAAC’s critical care team, Celestine reflects on the reality of life as a trainee in this dynamic and demanding specialty.
As the new Chair of the Pre-Hospital Emergency Medicine Trainees’ Association (PHEMTA), she also shares her vision for increasing inclusivity in the field, breaking down barriers, and supporting more women to pursue careers in PHEM. Whether you're an aspiring critical care clinician or simply interested in the people behind the patch, this episode offers a personal and inspiring look into the life and values of a rising leader in pre-hospital care.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
Ryan Atkinson's "Local Loss in a Global Crisis" explores the disconnect between Western perceptions of climate change and its tangible effects on vulnerable communities, specifically in the Langtang Valley of Nepal. Ryan reflects on his personal carbon footprint and the ethical implications of his travels while witnessing the devastation caused by the 2015 earthquake, exacerbated by climate change.
Ryan highlights the resilience and enduring spirit of the local people, who face immense challenges despite having contributed little to the global crisis. The piece ultimately underscores the profound impact of global environmental issues on local lives, compelling Ryan to advocate for these stories. You can read the blog post here: https://ryanatkinson.tv/2020/02/22/local-loss-in-a-global-crisis/
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
Every year, thousands of lives are lost to suicide, and emergency responders are often the first line of support during these critical moments. In this episode, we explore the vital role that the London Ambulance Service (LAS) plays in suicide prevention and risk assessment. From the moment a call comes into the control room to the interaction on the frontline, paramedics are trained to recognise the signs of suicidal ideation and act quickly to prevent harm.
We’ll dive into the clinical and operational aspects of suicide risk management, discussing how paramedics assess high-risk patients and work alongside police, mental health crisis teams, and hospitals to ensure the best possible care. You’ll learn about the collaborative efforts that help create a seamless response for those in the most vulnerable states, as well as the challenges involved in coordinating care across various agencies.
This episode offers a candid look at the realities of suicide prevention in pre-hospital care and the steps that can be taken to save lives.
In this episode, we reflect on the article “Asking Why. Telling Stories. Owning Accountability” and its lessons for both the diving community and pre-hospital care. The piece explores how adverse events are too often met with blame and silence, when what’s needed is open storytelling, systemic accountability, and visible learning. Drawing on three academic theses, the author argues for a shift from backward-looking, individual blame towards forward-looking, relational accountability approaches that foster trust, resilience, and safer systems.
Barriers such as fear of reputational harm and legal concerns frequently stifle honest reflection. Yet, the article suggests that structured, context-rich narratives can create a culture of genuine learning and justice, allowing organisations to adapt and prevent future harm.
For pre-hospital care, the parallels are striking. Just like in diving, providers face high-stakes environments where “first stories” may oversimplify, overlooking the complex contexts in which clinicians operate. Whether in remote environments, critical incidents, or everyday EMS work, learning requires moving past blame and toward systems thinking. Transparent communication, structured debriefs, and the courage to challenge norms are as vital to paramedics and pre-hospital teams as they are to divers and expedition leaders.
By embracing this approach, telling richer stories, strengthening feedback loops, and redefining accountability, we can better support both patients and providers in the moments when things go wrong. Read the blog post here: https://www.thehumandiver.com/blog/asking-why-telling-stories-and-owning-accountability-lessons-for-diving
You can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025
Today, we’re exploring some of the complexities of real-life palliative care cases that frontline staff have faced in practice. Joining me are four members of the London Ambulance Service’s dedicated Palliative and End-of-Life Care Team: Karina Catley, Natalie Nabunya, Rowena Rickson, and Jodie Grace. Together, we’ll examine real-life case studies that illustrate the unique challenges of caring for patients and their families during their final moments.
From managing uncontrolled seizures in the community to supporting a family’s cultural and spiritual wishes after death, these stories highlight the difficulties of decision-making when time is limited, documentation is incomplete, and emotions are intense. Along the way, we’ll explore key principles such as the doctrine of double effect, the role of shared decision-making, and the importance of recognising dying in the field. We’ll also discuss how clinicians can communicate compassionately, respect cultural values, and navigate the legal and public health frameworks that guide this care.
This is a conversation about dignity, humanity, and the privilege of supporting people at the end of their lives, offering lessons for all of us working in pre-hospital care.
This episode dives into a critical article arguing that the diving industry too often fails to learn effectively from fatalities, not because of individual mistakes, but due to systemic shortcomings. It distinguishes between “first stories”, simple narratives that assign blame, and “second stories”, deeper explorations into context, drift from safety standards, and the normalisation of deviance.
The tragic death of Linnea Mills is used as a case study, showing how multiple factors, equipment incompatibility, insufficient supervision, and the challenges of a remote location, aligned to create a disaster. Rather than focusing only on compliance or individual error, the article calls for a systems-based approach to safety: stronger feedback loops, better emergency preparedness, and a culture where speaking up about risks is encouraged.
For divers, instructors, and responders, this also underscores the importance of effective pre-hospital care. Here are key resources:
- Divers Alert Network: First Aid & Emergency Care
- WHO: Prehospital Trauma Care Systems
- NAEMT: Prehospital Trauma Life Support (PHTLS)
- EMS World: Best Practices in Prehospital Care
By combining systemic safety improvements with robust pre-hospital care readiness, the industry can better prepare for emergencies and reduce the likelihood of preventable tragedies.
You can read the blog post here: https://www.thehumandiver.com/blog/we-don-t-learn-from-diving-fatalities-and-here-s-why
You can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025
Mental health crises are one of the most complex and sensitive challenges faced in pre-hospital care. The London Ambulance Service (LAS) plays a critical role in responding to these emergencies, from the moment a 999 call is made to frontline crews delivering urgent interventions. But how does the system work as a whole? How are these calls assessed in the control room, and what role do specialist paramedics and mental health professionals play in shaping patient outcomes?
In this episode, we dive deep into Pre-Hospital Mental Health Response, exploring how the LAS manages real-time mental health incidents, the operational and clinical decision-making that happens behind the scenes, and the challenges of coordinating care across multiple agencies. We’ll hear about the evolving role of mental health-trained paramedics, case studies of successful interventions, and the key lessons learned from high-risk situations.
Joining us are colleagues from the London Ambulance Service Mental Health Team, who will share their experiences from both the frontline and the Emergency Operations Centre (EOC), giving us a full picture of how pre-hospital mental health care is delivered in one of the busiest ambulance services in the world.
This episode is a deep dive into how mental health services are integrated and embedded within an ambulance service as a fundamental part of emergency care service delivery to the population.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
This blog is a personal reflection from Advanced Paramedic Wayne Auton, who shares how he has recently embraced what he describes as a “position of yes.” This mindset involves being open and willing to accept opportunities as they arise, often at short notice, and focusing on the positive potential that each opportunity may bring. Wayne acknowledges that it is a fortunate position to be in, but one that has significantly transformed his outlook and boosted his overall positivity.
For many years, Wayne found himself caught in a cycle of negative thinking. He often focused on what might go wrong, rather than what could go right. This tendency led to decreased confidence, increased caution, and a general reluctance to take risks. It was a mindset he found restrictive and disheartening.
He reflects on how he used to default to worst-case scenarios, frequently overlooking the possible benefits of a situation. Research supports this pattern; negative events tend to be more intense and memorable because they require greater mental effort to process (Taylor, 1991). Recognising this has helped Wayne shift his focus. By choosing to say yes more often, he has created space for growth, confidence, and optimism.
You’ll also hear an AI-narrated summary of this blog, bringing Wayne’s reflections to life through audio. You can read the blog here: https://wayneauton.blogspot.com/2021/03/say-yes-to.html
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
Today, we're diving into the high-stakes intersection of tactical medicine, crisis negotiation, and pre-hospital care with Eric Acevedo, a seasoned professional operating at the front lines of some of Virginia's largest emergency response operations. Eric brings a rare blend of experience across tactical EMS, hostage negotiation, and field-based crisis response, offering a unique perspective on how communication, psychology, and calmness under pressure can save lives.
In this episode, we'll explore the foundational principles of crisis and the wider art of negotiation and how those same tools can be applied by EMS providers in their daily work, especially when it comes to de-escalating tense situations, communicating effectively with patients in distress, or persuading someone to accept lifesaving treatment.
We’ll also look at the human side of this work: emotional regulation, interdisciplinary collaboration, and lessons learned from real-world case studies where negotiation and medicine intersected in critical moments.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
In this special series, we’re bringing insightful and thought-provoking blog posts to life in audio form, exploring the human side of pre-hospital and emergency care. Today’s piece reflects on Esprit de Corps, the pride, loyalty, and belonging that exists within high-performing teams, and how it is built, tested, and lived out in some of the most demanding environments.
Wayne Auton reflects on a career spent in small, high-performing teams, from the Royal Marines to Search and Rescue to the Emergency Medical Retrieval Service (EMRS) in Scotland. Across these roles, one constant has been trust: the ability to rely on teammates, get the job done, and know that everyone has each other’s backs.
When asked recently about Esprit de Corps, it prompted reflection. Often associated with the military, it is more broadly defined as “a feeling of pride and mutual loyalty shared by the members of a group.” For the author, it is about belonging.
As a Royal Marine, that sense of belonging was immediate. From day one of training, recruits inherit over 350 years of history and pride. The Corps was more than a job; it was a culture and a way of life. Paradoxically, it also provided psychological safety, acceptance, trust, and respect within a close-knit family.
These bonds often form in vulnerability, particularly under threat. Research shows such conditions can strengthen Esprit de Corps across dangerous professions. The author recalls a helicopter mission where a suspected tail rotor failure forced the crew into emergency decision-making. They landed safely, closer than ever. That experience captured the essence of Esprit de Corps: resilience, unity, and unshakable trust forged in challenge.
You can read the blog post here: https://wayneauton.blogspot.com/2021/03/espirit-de-corps.html
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at https://www.pax-bags.com/en/
In this episode of the Pre-Hospital Care Podcast, we’re joined by Critical Care Practitioner Mike Palmer to explore the evolving role of ultrasound in trauma care outside the hospital setting.
We dive into the realities of training, drawing on insights from a bespoke HEMS hybrid ultrasound program that bridges classroom learning with frontline application. Our discussion covers the translation of emergency ultrasound skills into the unpredictable pre-hospital environment, with a focus on simulation training, image recognition, logbook development, and internal image review.
We explore how services are addressing the challenges of competency, governance, and quality assurance when deploying ultrasound in the field. We also tackle the practical and operational hurdles, how to obtain clear, actionable images in chaotic or resource-limited environments, manage the risks of false positives and missed diagnoses, and use ultrasound findings to guide critical decisions around triage and treatment.
Finally, we hear personal and professional reflections from years of frontline experience. From the traditional model of “see one, do one, teach one” to knowing when it’s better to keep the probe in your pocket, this episode offers real-world insights into the benefits, limitations, and evolving role of ultrasound in pre-hospital emergency care.
This episode is brought to you by IndieBase.
IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.
Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.
IndieBase EPR made simple, wherever you are.
Find out more at https://indiebase.net/
In this episode, we speak with Carl, one of our podcast co-hosts, about his deeply reflective article, ‘Normal or numb – that is the question, but what is the answer!’ Carl shares the personal experience that inspired the piece, attending a call to a deceased patient, which triggered a cascade of questions about emotional detachment, coping strategies, and the long-term impact of repeated exposure to trauma in paramedicine.
We unpack the central dilemma: are we becoming resilient or simply numb? Carl reflects on the gradual shift in his emotional responses and the silent build-up of stress that so many frontline clinicians experience. We explore how this detachment can protect us in the short term but risks leading to burnout, fractured personal lives, and professional disengagement.
The conversation also delves into the importance of early recognition, peer support, and thoughtful leadership responses. Carl’s reflections have also been transcribed into an AI-narrated blog post so that you can listen to his story word-for-word.
This is a powerful and honest conversation about the emotional cost of the job and an urgent call to reflect before the pressure boils over.
This episode is brought to you by IndieBase.
IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.
Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.
IndieBase EPR made simple, wherever you are.
Find out more at https://indiebase.net/
In this episode, we explore the expanding role of ultrasound in pre-hospital trauma care. Once limited to hospital settings, ultrasound is now a vital tool in frontline emergency response, helping clinicians make rapid, informed decisions on scene. We begin by unpacking the physics of ultrasound, how concepts like frequency and resolution influence what can be detected, from internal bleeding to lung collapse.
Next, we get hands-on with practical applications. We’ll cover probe selection and key sonographic indicators for conditions such as pneumothorax, haemothorax, and haemoperitoneum. Real-life case studies, including stab wounds, hangings, and traumatic cardiac arrests, highlight how ultrasound shapes critical interventions in the field.
We’ll also address essential questions around training: What level of skill is needed? How can we ensure ongoing competency? As pre-hospital ultrasound becomes more common, we must confront these challenges head-on.
Finally, we’ll examine the ethical and operational dilemmas posed by point-of-care imaging. When ultrasound findings support high-stakes decisions like performing a thoracotomy or ceasing resuscitation, what responsibilities do clinicians carry?
Join us as we delve into the promises and complexities of ultrasound in pre-hospital trauma care.
This episode is brought to you by IndieBase.
IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.
Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.
IndieBase EPR made simple, wherever you are.
Find out more at https://indiebase.net/
CarlBetts, a co-host of this podcast, authored a reflective piece titled "Where Critical Analysis Becomes Critically Unhealthy," published in 2023 in the College of Paramedics’ Hindsight magazine. In this episode, we delve into Carl’s motivations for writing the article and examine its central themes. The piece discusses how critical analysis, while an essential skill, can become counterproductive when it slips into harsh self-appraisal, leading to emotional disequilibrium and eroding clinician confidence.
We unpack how debriefs and reflective practices must be thoughtfully structured to include both challenge and affirmation, creating space for growth without causing harm. Using real clinical examples, Carl helps illustrate where reflection can go wrong and how to avoid those pitfalls.
We also discuss the importance of reframing difficult experiences to support a net positive impact on clinicians, and how critical feedback, whether from oneself or others, can be damaging if not delivered constructively. The episode outlines practical strategies, including reframing techniques, to make reflection a healthier, more sustainable process.
To bring Carl’s insights to life, we’ve transcribed his original article into an AI-narrated blog post, allowing you to listen to the word-for-word reflections from his piece, offering another way to engage deeply with his message.
This episode is brought to you by IndieBase.
IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.
Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.
IndieBase EPR made simple, wherever you are.
Find out more at https://indiebase.net/
Today’s episode dives into lived experience with cystic fibrosis through the remarkable journey of Paul Butler. Diagnosed at two and warned he wouldn’t reach twenty. Paul’s childhood revolved around twice-daily chest physiotherapy, three-daily nebulisers, and a mass of hospital admissions for infections that chipped away at his fragile lungs.
By his late teens, the odds felt fixed: average life expectancy for CF hovered around 30, and Paul’s lung capacity was already tumbling. Yet everything changed the day he cradled his newborn daughter, Amelia. Faced with a future he refused to miss, Paul overhauled his life, embracing rigorous medication adherence, evidence-informed nutrition, and a training regimen that turned a patient into a personal trainer who now deadlifts triple his body weight.
At 45, Paul hasn’t been hospitalised in seven years and views fitness not as vanity but as respiratory medicine performed in a gym. In this conversation, we ask:
- What mindset shifts sustain adherence when statistics feel fatalistic?
- And what can pre-hospital professionals learn about goal-setting, communication, and empathy from someone who quite literally trains to breathe?
You can find Paul Butler on Instagram here: https://www.instagram.com/paulbutler.coach/?hl=en
You can find Paul's website here: https://paulspeakphysique.co.uk/given-just-weeks-to-live
You can find the inspiration for this interview on the Grind Diaries Podcast here: https://podcasts.apple.com/gb/podcast/episode-16-paul-butler-the-personal-trainer-living/id1736072345?i=1000682838118
This episode is brought to you by IndieBase.
IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.
Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.
IndieBase EPR made simple, wherever you are.
Find out more at https://indiebase.net/
In this episode, we dive into The PITT, a powerful new medical drama that lays bare the raw, unfiltered reality of life in the emergency department. This conversation serves as a commentary on an AI-generated adaptation of Dr. Sarah Spelsberg’s original blog post, and it began with an interview. We first sat down with Sarah to gain deeper context and personal insight behind the post, ensuring that the AI-generated version remained true to her voice, values, and lived frontline experience.
Sarah, a seasoned wilderness medic and co-host at World Extreme Medicine, shares how The PITT resonates with emergency clinicians by portraying the often-overlooked struggles of ED life, boarding crises, staff shortages, burnout, and the layers of bureaucracy that hinder care.
Unlike polished hospital dramas like Grey’s Anatomy or House, The PITT hits closer to home. It reflects the chaos and moral weight providers carry daily, and helps the public understand what really happens behind the scenes. Sarah explains how this visibility can build empathy, reduce aggression toward staff, and shift public expectations.
She also reflects on how wilderness medicine re-centers her purpose, offering a stark contrast to hospital bureaucracy. Ultimately, this episode is both a tribute and a call to action for better systems, better support, and honest storytelling in healthcare. You can read the blog here: https://roguemed.medium.com/the-pitt-a-lifeline-for-emergency-medicine-providers-7ba1f8b2b045
The PITT offers a raw and authentic look at the challenges confronting healthcare professionals in today's America, told through the experiences of frontline workers at a contemporary hospital in Pittsburgh, Pennsylvania. Watch The PITT here: https://www.primevideo.com/detail/The-Pitt/0ORZ2LIN9JTFLLUK8UKR33DZPX
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
Today’s episode explores one of the most profound and humbling themes in medicine: what the dying and those who’ve been brought back to life can teach us about living.
Dr. Matt Morgan is an intensive care consultant, researcher, and author of A Second Act, a book inspired by the hundreds of patients he’s met who have crossed the threshold of death and returned. People like Ed, struck by lightning and left without a pulse, are revived through rapid, decisive pre-hospital action. These are the individuals Dr. Morgan believes we should be listening to, not influencers or business gurus, but those who’ve faced the thin margins between life and death and emerged with new clarity about what truly matters.
In this conversation, we’ll reflect on the emotional and ethical challenges of working in the fog between life and death, the importance of listening to survivors, and the critical role pre-hospital teams play in offering second chances. We’ll also ask: how do we carry the weight of this work without losing our humanity?
This is a powerful episode about perspective, purpose, and the lessons that only the brink of death can reveal. Matt's book 'A Second Act' can be found here: https://www.simonandschuster.co.uk/books/A-Second-Act/Matt-Morgan/9781398532335
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
In this series, we are bringing blog posts to life by interviewing the authors. Also, by generating AI audio conversations of the blog to make them accessible in audio format. I then summarise the audio in conclusion.
We begin this episode by interviewing Dr. Sarah Spelsberg to add context and personal insight behind an AI‑generated adaptation of her latest RogueMed post, “Emergency Medicine and PTSD.” Through her reflections, we explore how repeated exposure to trauma profoundly affects emergency clinicians.
Dr. Spelsberg describes how witnessing death, severe injury, suicides, resuscitations, violence, and patient suffering can lead to chronic stress and PTSD. She highlights that up to 14.6 % of emergency personnel experience PTSD symptoms, higher than rates in police or firefighters. The pressure of balancing life-or-death decision-making with systemic constraints crowded EDs, insufficient staffing, and administrative burdens amplifies emotional strain.
Our discussion focuses on the emotional toll of moral injury, guilt, burnout, hypervigilance, flashbacks, insomnia, and emotional exhaustion that haunt providers long after their shifts end. Dr. Spelsberg emphasises that PTSD in emergency medicine isn’t rare it’s predictable under these circumstances and requires culturally appropriate recognition and care.
We explore evidence-backed strategies: trauma-informed debriefs, peer support networks, access to psychological therapies like cognitive behavioural therapy and EMDR, and cultivating a culture that normalises seeking help. Dr. Spelsberg underscores that organisational change revamping shift patterns, enhancing supervision, and providing mental health resources is as crucial as individual resilience.
By sharing lived experience and actionable solutions, this episode reframes PTSD not as a weakness but as an expected response needing compassion, systemic support, and meaningful action. You can access the blog this podcast is based on here: https://roguemed.medium.com/emergency-medicine-and-ptsd-e0841f945d55
My thanks to Sarah Spelsberg for this interview as a co-host of The World Extreme Medicine podcast.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
In this episode of the Pre-hospital Care Podcast, we explore a cutting-edge innovation that’s transforming how HEMS clinicians are trained for high-stakes, life-saving procedures, such as thoracotomy, resuscitative hysterotomy, and other HALO interventions. We’re joined by Jamie, founder of Maxres, and Lily, a Critical Care Doctor, to discuss how immersive headset training is being introduced into clinical education, starting with the Thames Valley Air Ambulance.
Jamie brings a unique perspective from his time as a pilot and helicopter flight instructor in the Royal Air Force, where he experienced first-hand the value of scenario-based, immersive learning. Combined with Lily’s background as a prehospital critical care doctor, their expertise is helping shape a new frontier in clinical preparedness for the most complex and time-critical interventions.
Together, we unpack how the MaxRes system works, the science behind its development, and the real-world impact it’s having on clinical performance, confidence, and decision-making. We also look to the future, exploring how this technology could revolutionise pre-hospital education, expand into new clinical domains, and deliver highly realistic, repeatable, and effective training experiences.
Whether you’re a critical care paramedic, HEMS doctor, educator, or healthcare innovator, this episode offers an exciting look at where pre-hospital training is heading and how technology developed for the skies is now making a difference on the ground. Further information on MaxRes can be found here: https://maxres.ai/
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
In this episode of the Pre-hospital Care Podcast, we delve into the origins and current structure of the Hazardous Area Response Team (HART), a specialist unit within UK pre-hospital care. We explore why the HART model was specifically chosen in the UK and how it compares to Urban Search and Rescue (USAR) counterparts internationally. The conversation offers insights into the unique day-to-day role of a HART team member and how the team integrates with the wider emergency medical services, particularly during high-risk or complex incidents.
We also reflect on the evolution of HART, how the model has grown from its early foundations into a sophisticated and responsive service that plays a crucial role in emergency preparedness and response. The episode explores the learning mechanisms and governance structures built into HART to ensure continuous development and safe practice.
Additionally, we examine how change management and cultural integration have been essential to embedding HART within the wider healthcare and emergency response ecosystem. This includes addressing the 'hearts and minds' aspect, how to build trust, acceptance, and collaboration between specialist teams and frontline responders to ensure effective teamwork and optimal patient care.
Whether you're familiar with HART or new to the concept, this episode offers a deep dive into one of the UK's most technically demanding emergency response capabilities and how it continues to shape the landscape of pre-hospital care.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life. PAX – built to perform, made to last.
Learn more at pax-bags.com
In Part 3 of The Dying Patient: Palliative and End of Life Care, we delve into the complexities ambulance clinicians face when supporting patients in their final days and hours. Often the first to recognise when someone is dying, paramedics work within a system where community engagement may be limited, making their role crucial in identifying signs such as terminal agitation, unconsciousness, and other common symptoms. The episode discusses the importance of anticipatory medications and proactive advance care planning , especially in situations involving carer breakdown or when patients change their minds about where they wish to die.
We explore why ambulance services are frequently called during end-of-life stages, whether due to uncontrolled symptoms, sudden deterioration, or emotional distress within families. Paramedics not only offer symptom relief, both pharmacological and non-pharmacological, but also provide vital emotional support to those navigating grief, denial, or fear. Challenges include differentiating between reversible conditions and active dying, managing care when anticipatory medications are unavailable, and coordinating with wider healthcare teams.
Breaking bad news is another critical area discussed, with a focus on using frameworks such as Ask-Tell-Ask and adapting communication to the emotional needs of the moment. Lastly, the episode reflects on cultural considerations in a city as diverse as London. From language barriers and different expressions of grief to religious rituals and care after death, ambulance clinicians must remain adaptable and compassionate, ensuring that care is respectful, inclusive, and sensitive to the needs of every individual and their family. Some of the links to information mentioned in the episode can be found here: These are some of the resources mentioned in the episode:
- Breaking Bad News: https://www.sth.nhs.uk/clientfiles/File/Breaking%20bad%20news%20Reflection%20on%20the%20process.pdf
- Good Grief - understanding the grief journey in more detail: https://good-grief.org/resources/
- Hospice UK, an excellent place for further resources: https://www.hospiceuk.org/our-campaigns/dying-matters/dying-matters-awareness-week
- UK National Guidelines on Diabetes and End of Life Care: https://www.diabetes.org.uk/sites/default/files/2025-03/EoL_TREND_2024_v11-1.pdf
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
In Part 3 of our Decision Making series, we explore the power of "slow time" thinking with Detective Superintendent Ahenkora Bediako of the Metropolitan Police. With a distinguished career managing high-risk public protection departments and international investigations, Ahenkora brings deep insight into how intentional, non-biased decisions are made under pressure.
We unpack how leaders can resist reactive impulses in crisis moments and instead lean into deliberate, evidence-informed strategies, especially when the stakes are high. Drawing on his experience as an Accredited Major Crime Senior Investigating Officer (PIP3), Ahenkora shares lessons from frontline policing, complex safeguarding, and professional standards.
We also touch on his commitment to evidence-based policing, including randomised control trials, and how these approaches improve outcomes in child protection, community engagement, and organisational equity. If you're interested in high-performance leadership, decision integrity, and building inclusive, accountable systems, this episode is for you.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
Today, we’re diving into a critical yet often overlooked subject: rehabilitation for pre-hospital staff. The physical and mental demands of frontline work are relentless. Paramedics, HEMS crews, and pre-hospital teams operate in high-stress environments, managing unpredictable situations, heavy workloads, and repeated exposure to trauma. But what happens when the body or mind says, “I can’t keep going”? How do we help our colleagues recover and return, not just functioning, but stronger, healthier, and more resilient?
I’m joined by Mike Palmer, a highly experienced critical care clinician with lived experience of injury and recovery. Together, we’ll unpack the scale of injury across pre-hospital care, identify gaps in current rehabilitation practices, and explore why a structured, personalised approach is essential for long-term sustainability in this field. We’ll also take a personal look at Mike’s own journey, how he navigated his recovery, the obstacles he encountered, and the insights he gained along the way.
But this conversation goes beyond rehabilitation, it’s about reimagining how we care for those who care for others. Whether you're on the frontline, leading a team, or simply passionate about well-being in emergency medicine, this episode offers valuable perspectives on how we can better support, rehabilitate, and retain our pre-hospital workforce.
Useful links that Mike mentions in the episode can be found here:
https://pubmed.ncbi.nlm.nih.gov/31537564/
https://www.sciencedirect.com/science/article/pii/S0925753524000092
https://pubmed.ncbi.nlm.nih.gov/33492279/
https://pubmed.ncbi.nlm.nih.gov/35000895/
https://pubmed.ncbi.nlm.nih.gov/26371071/
https://pubmed.ncbi.nlm.nih.gov/34972683/
https://pubmed.ncbi.nlm.nih.gov/26371071/
https://pubmed.ncbi.nlm.nih.gov/26281820/
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.
Learn more at pax-bags.com
Today, we explore the collective experience of trauma among NHS ambulance personnel during the COVID-19 pandemic, a period that tested the resilience and identity of clinicians like never before.
In the episode, we’ll uncover the inspirations behind this research, examining how social identity processes provide a profound lens to understand how ambulance teams navigate trauma. Our guest will walk us through their methodology, highlighting the value of a longitudinal qualitative approach and the unique hurdles of conducting research during a global crisis.
Jo guides us through her methodology, highlighting the importance of longitudinal qualitative approaches and the challenges of conducting research amid a global crisis. We unpack how group membership shaped emotional and behavioural responses during the pandemic, revealing the cultural forces at play within NHS ambulance services and how these dynamics contributed to collective resilience.
We also explore the long-term psychological impact of the pandemic, comparing individual and team-based coping strategies, and discuss what this tells us about building solidarity under extreme strain.
Finally, Jo shares practical, evidence-based strategies for leaders in emergency services to foster resilience, mitigate trauma, and apply these learnings to other high-stakes professions.
Dr. Jo Mildenhall is a paramedic with over 20 years of experience in operational and leadership roles within ambulance services. She holds a master’s degree in Occupational Trauma Psychology from the University of Nottingham and earned her Doctorate from the University of York, focusing on trauma experienced by NHS ambulance staff during the pandemic. Jo is the National Paramedic Mental Health & Wellbeing Lead for the College of Paramedics and was awarded a Churchill Fellowship in 2019 to study paramedic mental health initiatives in Australasia. You can access Jo's research here: https://etheses.whiterose.ac.uk/id/eprint/35774/
In our previous episode, we explored the meaning and importance of end-of-life care, particularly during the final 12 months of life. We discovered how difficult it is to predict this timeline, especially for ambulance clinicians who often see patients at critical points without a full picture of their medical history.
In this episode, we take a closer look at what that final year can involve, focusing on the pre-hospital setting. We’ll explore the unique challenges ambulance clinicians face in making rapid, high-stakes decisions, and how existing documentation—such as care plans or advance directives—can provide valuable guidance in those moments.
We'll also discuss the role of shared decision-making and how ambulance services can help balance specialist and generalist palliative care needs. Alongside this, we’ll highlight how the NHS Long Term Plan and other key initiatives aim to improve care coordination and ensure more consistent, compassionate care.
Lastly, we’ll examine the barriers to effective advance care planning. These range from cultural sensitivities to systemic and logistical obstacles. Throughout, we’ll consider how we can better support ambulance clinicians to deliver thoughtful, person-centred care during some of life’s most vulnerable and uncertain moments. Please find links to the SPICT Tool that is mentioned in the episode:
https://www.spict.org.uk/#:~:text=Supportive%20%26%20Palliative%20Care%20Indicators%20Tool,is%20a%20plain%20language%20version.
In this episode, we dive into a critical challenge: how to embed meaningful, lasting change within ambulance services. With increasing demand, stretched resources, and ongoing operational pressures, creating improvements that truly stick is no easy task.
To unpack this, I’m joined by Carl Betts, an expert in quality improvement, leadership, and change management within the ambulance sector. Carl has been instrumental in transforming clinical practices, enhancing patient care, and fostering a culture of continuous improvement at Yorkshire Ambulance Service and beyond. Aspects we cover in the episode include:
🔹 The challenges of implementing change in high-pressure environments
🔹 Engaging frontline staff to drive meaningful improvements.
🔹 Moving beyond short-term fixes to create sustainable change.
🔹 Overcoming resistance to change and managing change fatigue.
🔹 The role of innovation and technology in shaping the future of pre-hospital care.
Welcome back to the Pre-Hospital Care Podcast. In this episode, I’m joined by Stephen Wood, emergency nurse practitioner, educator, and host of Tac Medic Whiskey: The Tactical Medicine Podcast. Steve brings a wealth of experience from pre-hospital care, the emergency department, and the tactical environment, and he’s become a prominent voice in the evolving landscape of high-threat medicine. His podcast dives deep into the challenges and innovations of tactical pre-hospital care, blending clinical insight with real-world operational experience.
In our conversation, we explore everything from the use of TXA and calcium chloride in trauma to the nuanced decisions between needle decompression and finger thoracostomy. We’ll talk about the importance of team cohesion, the mental toll of working in high-stress environments, and how to build resilience in the field. We also examine emerging technologies, training innovations, and what the future might hold for tactical medics across the globe.
Whether you're on the frontline, training the next generation, or just curious about the realities of medicine in hostile or austere environments, this episode offers invaluable insights from an educator and Nurse Practitioner, Steve Wood. You can find the Tac Medic Whiskey Podcast here: https://podcasts.apple.com/il/podcast/tac-medic-whiskey-the-tactical-medicine-podcast/id1777426233
This podcast is for information purposes only and should not replace clinical guidelines or your local service policies.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range, please click here:
https://www.pax-bags.com/en/
In today’s episode, we’re honoured to be joined by John Martin, a trailblazer whose career is a testament to innovation, leadership, and an unwavering dedication to patient care.
John’s journey began at just 18 in a microbiology lab, but his passion for healthcare quickly led him to the world of emergency medicine. Today, he serves as the Chief Executive of South Western Ambulance Service NHS Foundation Trust (SWASFT). With a wealth of experience across ambulance, acute, and community healthcare settings, John has also been the President of the College of Paramedics, advocating for the advancement of the paramedic profession. As a Visiting Professor in Paramedic Science, he’s helping shape the future of paramedic education and training.
In this episode, we’ll dive into John’s leadership transition from London Ambulance Service to SWASFT, the biggest challenges facing pre-hospital care, and the role of technology in modernising emergency response. We’ll also touch on the importance of mental health, interdisciplinary collaboration, and John’s forward-thinking vision for the future of paramedic practice. A link that John mentions in the interview to the Harvard Business School Negotiation Mastery course can be found here: https://tinyurl.com/2f8pdbkc
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, I’m joined by Marc Watson, a distinguished pharmaceutical physician and passionate advocate for mental health. Marc’s journey spans from working as a frontline GP to holding senior leadership roles in pharmacovigilance and global medical affairs, where he has been instrumental in ensuring patient safety, meeting regulatory demands, and supporting the launch of transformative medicines. Yet, behind these professional achievements lies a deeply personal story: Marc’s own experience of managing a bipolar diagnosis while navigating high-pressure, high-stakes environments.
We’ll explore his shift from clinical practice to the pharmaceutical sector, the emotional toll of leadership, and the practical tools he uses to safeguard his mental well-being. Marc also opens up about his drive to raise mental health awareness, offering honest reflections from his life.
This episode is a candid conversation about leadership, resilience, and the power of vulnerability. It highlights the urgent need to normalise mental health discussions, especially in professions where the pressure is relentless. Whether in healthcare, leading teams, or seeking perspective on mental wellness, this episode offers meaningful insight. You can read more on Marc's mental health journey here: https://www.fpm.org.uk/blog/from-surviving-to-thriving-with-my-mental-health/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode of the Pre-Hospital Care Podcast, we explore the evolving role of ambulance clinicians in palliative and end-of-life care. We’re joined by a dedicated team working to improve how prehospital services support patients in their final months, ensuring care is compassionate, coordinated, and patient-centred.
We introduce the team and their roles before breaking down the key concepts of palliative and end-of-life care. We discuss the differences between generalist and specialist palliative care, the challenges of identifying patients in the last year of life, and the critical role ambulance services play in this journey.
The conversation then moves to the service gaps and educational challenges identified within prehospital care. We examine referral pathways, tools like SPICT for early identification, and how technology shapes advanced care planning (ACP) to help inform decision-making. The team also highlights the importance of education in building clinician confidence when navigating these complex cases.
Looking ahead, we discuss the future of prehospital palliative care, including the role of simulation training, national collaboration, and addressing healthcare inequalities. We also explore opportunities for joint learning, debriefs, and improved care pathways to strengthen the connection between ambulance services and specialist palliative care teams.
The SPICT tool can be found here: https://www.spict.org.uk/the-spict/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range, please click here:
https://www.pax-bags.com/en/
Today, we're honoured to host Professor Deborah Harding, a distinguished figure in the field of advanced clinical practice. Professor Harding serves as the Supervision Lead for the NHS England for Advancing Practice, where she has been instrumental in developing supervision frameworks that support advanced practitioners across various healthcare disciplines.
With a rich background as a registered speech and language therapist, Professor Harding has extensive experience in multi-professional management and leadership within the NHS. Her academic pursuits led her to complete a PhD focusing on supervision for allied health professions, culminating in a constructivist grounded theoretical perspective on the subject.
In her role at City St George's University of London, Professor Harding has led curriculum development for the MSc and integrated degree apprenticeship in advanced clinical practice. Her work emphasises the importance of clinical supervision in supporting the development of advanced clinical practitioners, ensuring they are equipped to navigate the complexities of modern healthcare environments.
In this episode, we'll explore the critical role of supervision in advanced practice, discuss the challenges practitioners face in pre-hospital care, and gain insights from Professor Harding's extensive research and experience. Stay tuned for an enlightening conversation that sheds light on the future of advanced practice in pre-hospital care. See and read more here:
https://advanced-practice.hee.nhs.uk/
And here:
https://thepermeablepractitioner.com/
In this episode, we explore the challenges and contrasts of implementing innovation across the NHS and the private healthcare sector with expert guest Hannah Browning. As the founder of Beyond Excellence, Hannah brings a rare dual-sector insight, having held senior leadership roles in major private providers including Nuffield Health, Spire Healthcare, and HCA, as well as leading on transformative projects like the £120m development of KIMS Hospital.
Innovation within the NHS often grapples with structural rigidity, limited funding, and bureaucratic hurdles, whereas the private sector—while faster-moving and more agile—must navigate investor expectations, profitability, and intense market competition. Hannah discusses how both sectors have unique strengths: the NHS offers scale, consistency, and population-wide data, while the private sector excels in responsiveness, customer-centric models, and speed of delivery.
She reflects on what each can learn from the other: the NHS could benefit from private-sector pace and accountability, while the private sector might adopt some of the NHS’s commitment to equity and long-term population health outcomes. With real-world examples, including her strategic role in the acquisition and launch of Sevenoaks Medical Centre, Hannah brings a grounded, commercial, and compassionate view on how healthcare systems can evolve—together—for better patient care.
You can read more of Hannah's consultancy business here:
https://www.alphahealthpartners.co.uk
https://www.getbide.co.uk
In this episode of the Pre-Hospital Care Podcast, we explore the rapidly evolving role of artificial intelligence in trauma care, focusing on the AI Risk Prediction and Decision Support System (AI-TRiPS)—a cutting-edge AI tool designed to enhance decision-making in high-pressure trauma settings.
AI-TRiPS is built on Bayesian networks for clinical decision support, bridging the gap between AI development and real-world application. But how do we ensure AI tools are accurate, usable, and trusted by frontline clinicians? We cover:
🔹 How AI-TRiPS is being trialled in London’s Major Trauma Centres & Air Ambulance Services
🔹 The impact of AI-TRiPS on clinician performance and cognitive load in trauma care
🔹 Can AI-driven decision support improve outcomes in stroke, sepsis, and cardiac arrest?
🔹 The challenges of integrating AI into pre-hospital care and the resuscitation bay
Join us as we discuss the potential of AI to revolutionise trauma care and what this means for the future of pre-hospital medicine. You can read more about AI-TRiPS here: https://www.londonsairambulance.org.uk/news-and-stories/charity-news/bold-step-forward-our-patients-new-ai-study
In this episode of the Pre-Hospital Care Podcast, we’re joined by Sarah Edwards to explore the most frequently encountered paediatric emergencies seen in the field. Sarah Edwards is a Consultant in Adult and Paediatric Emergency Medicine and the RCEM Learning Chair. She is Senior Editor for the Emergency Medical Journal, RCEM Learning Chair and Honorary Secretary for ASME. She also teaches on the Master's of Medical Education course at the University of Sunderland.
In this wide-ranging conversation, we examine respiratory infections to asthma exacerbations to gastroenteritis, dehydration, febrile illnesses, and seizures. We unpack the presentations that paramedics and pre-hospital teams face on a daily basis together with some of the red flags for each disease.
We’ll discuss how to identify and prioritise care for these conditions in the often-challenging pre-hospital environment, using practical strategies to deliver safe and effective interventions. Sarah shares key insights into assessing sick children, highlighting subtle clinical signs, red flags, and common pitfalls in decision-making under pressure.
We also examine trauma in children, including how injury patterns vary across age groups and what immediate management steps are most critical. Finally, the episode touches on the vital role of caregivers and parents in the assessment process.
Some useful links that Sarah mentions in the episode include: https://spottingthesickchild.com/
The Westley Croup Score: https://handbook.bcehs.ca/clinical-resources/clinical-scores/westley-croup-severity-score/
The Big 6 The Most Common Conditions That Children Present With For Urgent Care:
https://www.improvingme.org.uk/media/1141/childurgentcaredocument2020.pdf
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
The person-centred approach to counselling is built on the foundation of empathy, authenticity, and unconditional positive regard. Developed by Carl Rogers, this approach shifts the focus from the therapist as an expert to the client as the central figure in their own healing journey. Rather than directing or diagnosing, the counsellor provides a non-judgmental, supportive space, allowing the individual to explore their thoughts and emotions freely.
At its core, this method recognises that each person has the capacity for growth, self-awareness, and healing when given the right environment. The role of the counsellor is to listen deeply, reflect, and validate, helping clients to find their own solutions rather than imposing advice.
In pre-hospital and emergency care, where professionals often witness distress and trauma, adopting person-centred communication can make a profound difference. Whether supporting patients in crisis, speaking with families, or debriefing colleagues, approaching conversations with genuine empathy, active listening, and emotional presence fosters trust and resilience.
On today’s episode, we’ll explore how this approach applies to medicine, emergency response, and mental health, and how we can all integrate person-centred principles into our professional and personal interactions.
Chris Molyneux has spent more than a decade as a counsellor working alongside people who are rediscovering their frame of reference after trauma, and supervising other counsellors who do the same. Chris brings great authenticity through his work and has already had a hugely powerful impact for many healthcare workers. Chris's work can be found here: https://www.youtube.com/watch?v=kwrbmKtOAGY
Chris The Counsellor on YouTube www.youtube.com/christhecounsellor and reach out to Chris on the following email chris@chrismolyneux.co.uk
This is a paid advertisement from BetterHelp
In the demanding field of pre-hospital care, having reliable support is crucial. Whether you're a first responder, healthcare professional, or simply facing life's everyday stresses, therapy can equip you with strategies to manage pressure, strengthen resilience, and enhance your mental health.
BetterHelp, the world’s largest online therapy platform, connects individuals with licensed therapists via video, phone, or messaging—available anytime, anywhere. With more than 5,000 therapists in the UK, it’s easy to find the right match for your needs. Strengthen your support network with BetterHelp.
Listeners receive 10% off their first month at betterhelp.com/CAREPOD
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face, with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we continue our deep dive into decision-making under pressure with Olly Sapsford, a Firefighter and Commander as well as a Lecturer in Disaster & Emergency Management at Coventry University.
We explore the mental models, training, and strategies that support effective decision-making in extreme environments. How do emergency responders manage stress, maintain clarity, and strike the right balance between experience and instinct?
Olly shares insights into leadership, teamwork, and the ethical dilemmas professionals face in high-stakes situations. From navigating risk and resource limitations to post-incident reflection, we examine how decision-making frameworks from firefighting can be applied in paramedicine—and vice versa.
With a research focus on human factors, socio-cognitive influences, and fast decision-making, Olly sheds light on the role of intuition and expertise in high-pressure environments. Drawing from his talk at the College of Paramedics Emergency and Critical Care Conference, titled ‘From the Fireground: Demystifying Extreme Decision Making for Emergency Responders’, Olly brings a fresh perspective on how responders can refine their approach to critical decision-making when every second counts.
Join us as we unpack the strategies that can make the difference between a good decision and a great one in emergency settings.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode of the Pre-Hospital Care Podcast, we are focusing on the vital topic of paediatric assessment in the pre-hospital phase of care. Assessing and managing a sick or injured child is one of the most challenging scenarios for pre-hospital teams. Our guest breaks down the key components of paediatric assessment with the subtle red flags that may indicate a child is critically unwell. We’ll also explore practical approaches to airway management, assessing breathing and circulation, and understanding neurological status in children of all ages.
Beyond the clinical side, we discuss the softer skills required when working with paediatric patients, like engaging with caregivers, managing a child’s fear, and staying calm under pressure. Whether you’re new to pre-hospital care or an experienced provider looking to refine your skills, this episode will provide valuable insights and actionable takeaways.
Anna Dobbie is a consultant in emergency medicine at The Royal London Hospital and the lead clinician with London’s Air Ambulance. With a special interest in paediatrics and teaching, Anna plays a key role in advancing pre-hospital care. In this episode, we explore her journey, insights, and experiences in emergency and pre-hospital paediatric medicine.
- Please note, the content of this podcast is for information purposes only. Please stay within your scope of practice and services operating practices at all times *
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we take an in-depth look at one of the world’s leading HEMS services—London’s Air Ambulance (LAA) Charity. This conversation centres around the lesser-known challenges of sustaining and growing a top-tier HEMS service within the UK. From community engagement strategies to high-impact fundraising and marketing campaigns, we uncover what it takes to raise over £16 million to fund two new helicopters. We also go behind the scenes to examine the efforts that brought these aircraft into service, the obstacles the charity faces, and the vital role public support plays in its mission.
Joining us is Jayne Clarke, Director of Fundraising and Marketing at London’s Air Ambulance Charity. With a strong background in strategic leadership across the charity sector, Jayne brings expertise in marketing, advertising, and ethical banking. She previously worked with McCann Worldgroup before transitioning to purpose-driven roles, including leading major campaigns at the RNLI and serving as Director of Income Generation at St Peter’s Hospice. Now, as she steers the charity into an exciting new chapter in 2025, Jayne shares her insights on what it takes to keep this lifesaving service in the air. To see more of LAA's work, engagement and fundraising, see here: https://www.londonsairambulance.org.uk/
Out-of-hospital cardiac arrest remains a critical challenge despite advances in pre-hospital care, with survival rates heavily influenced by early intervention, high-quality CPR, and coordinated response systems.
In this episode, we’re joined by Mark Faulkner, a leading expert in resuscitation and emergency care, to explore the key factors that impact survival. We’ll discuss the importance of bystander CPR and public access defibrillation in the crucial early minutes and the benefits of high-performance CPR and effective post-ROSC care. Mark will also share insights into the latest evolving role of the impact of system-wide strategies, from improved community education to better integration between emergency services and hospitals. What steps can be taken to enhance survival rates, and how can healthcare systems work together to drive meaningful change?
Join us for this discussion as we discuss system-wide and service-level changes that can make a real difference in patient outcomes.
In this episode of the Pre-Hospital Care Podcast, we dive into the crucial role of shared learning within the pre-hospital setting. Learning from past experiences, both successes and challenges, is vital for improving patient outcomes and advancing best practices. We’ll explore key moments where shared learning has led to real changes in practice and examine the importance of having a strong central community to ensure that knowledge reaches as many professionals as possible.
To explore this topic, we're joined by Sara Orritt, who brings a wealth of experience in emergency medical services and communication. Sara manages the communications and social media for The European Association of Emergency Medical Services (EMS Europe), supports the EMS Europe board in business administration, and helps organise the International EMS Congress. She also works as an Executive Support Officer for Yorkshire Ambulance Service and has previous experience with South East Coast Ambulance Service. Before her career in emergency medical services, Sara worked in television production, including roles with the BBC.
Join us as we discuss how shared learning drives change, the role of digital platforms in spreading knowledge, and how EMS professionals can stay connected to a broader learning community. EMS Europe can be found here: https://emseurope.org/
The 2025 EMS congress can be found here: https://www.emscongress2025.org/
Please find a link to the paper mentioned in the episode here: https://www.linkedin.com/posts/european-ems_earlier-this-year-the-european-association-activity-7110352516667592704-8Kxb?utm_source=share&utm_medium=member_ios&rcm=ACoAAAP50dMB5y9DijwQUZNfWmSnqRRiXV2b9mU
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we’re joined by Paramedic Adam Desmond, an experienced paramedic who has been on the frontline of some of the UK’s most devastating major incidents, including the Brixton nail bombing on 17th April 1999, the Soho nail bombing on 30th April 1999, the Ladbroke Grove rail crash on 5th October 1999, the London terror attacks on 7th July 2005, commonly known as 7/7, and the Westminster Bridge terror attack on 22nd March 2017.
With 30 years of experience in pre-hospital emergency care, Adam will take us through the evolving landscape of major incident response, unpacking the differences in injury patterns from traditional road traffic collisions to modern blast injuries. We’ll explore the human factors that influence decision-making under pressure, the importance of shared situational awareness, and the critical lessons learned from past events that continue to shape emergency response today.
Additionally, we explore the psychological impact of responding to mass casualty incidents, examining how trauma, imposter syndrome, and mental resilience affect the lives of ambulance staff. Through Adam’s insights, we’ll unpack the balance between policy and real-world decision-making.
*Trigger Warning***
Adam recollects some detailed accounts of suffering from major incidents in this episode that some listeners may find distressing.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
Today, we’re diving into one of the most challenging and high-stakes procedures in trauma medicine—prehospital resuscitative thoracotomy (RT) for traumatic cardiac arrest (TCA).
Joining me is Dr Mike Christian, the senior author of a recent study published in JAMA Surgery, which examines the impact of prehospital RT in London’s Air Ambulance (LAA) system over two decades. TCA is often seen as a condition with a poor prognosis but for select patients—particularly those suffering from cardiac tamponade—prehospital RT has been shown to improve survival rates when performed within minutes of arrest. This study is the largest of its kind, analysing over 600 cases and shedding light on the effectiveness of RT, the critical time windows, and the factors that influence outcomes.
In this episode, we’ll explore the study’s key findings, discuss the operational and ethical challenges of performing RT in the field, and consider what this means for the future of prehospital trauma care. The paper can be found here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2830622
A review and appraisal of the paper can be found here: https://www.stemlynsblog.org/laa-resuscitative-thoracotomy/
This is an advertisement from BetterHelp.
Stress and anxiety affect all of us—whether it’s the daily pressures of work, life, or the unexpected moments that throw us off balance. As pre-hospital professionals, we see firsthand how mental health can impact lives, yet we often neglect our well-being.
Anxiety can manifest in ways we don’t always recognise—headaches, sleepless nights, or even feeling constantly on edge. In a world that demands more, sometimes the best thing you can do is pause, reflect, and seek support. Therapy isn’t just for those in crisis—it’s about learning coping strategies, setting boundaries, and becoming the best version of yourself.
BetterHelp is the world’s largest online therapy platform, connecting you with professionals specialising in anxiety and more. Take control of your mental health today. Our listeners get 10% off their first month at BetterHelp.com/CAREPOD
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
This is the second in a short mini-series focusing on vehicle-borne attacks having transitioned from a relatively rare method used by Terrorist Vehicle-Borne (TVB) attacks to becoming one of the most lethal forms of terrorism.
In Western countries, by 2016, TVB has resulted in just over half of all terrorism-related deaths. Their effectiveness and simplicity make vehicle ramming attacks an increasingly popular option for lone individuals who are three times more likely to stage a successful attack by groups of two or more. According to the global terrorism index, 2024 saw an overall 63% increase in terrorist attacks in the West, with terrorism conducted by lone individuals sharply on the rise. So, how much have we learned from the past the public report published in the United Kingdom in 2013?
A 2022 systematic review focusing on lessons learned from terror attacks from 2001 to 2018 found that despite the differences in methods countries social and political systems and casualties involved many of the lessons an issues identified with similar however these lessons continue to repeat themselves time again it concluded that the lessons identified did not appear to be sufficiently acted upon the failure to learn was further highlighted in volume 2 of the Manchester Arena public inquiry which focused on the response by the emergency services it identified the organisations involved in the response to the incident had failed to capture or learn lessons from previous multi-agency exercises it reported that there had been a failure to learn embedded key lessons from exercises. This was most relevant in the areas of shared situational awareness and joint understanding of risk and co-location identified key lessons, that subsequently reoccurred during the multi-agency response on the night of the attack.
On the afternoon of August 17, 2017, Barcelona was subjected to a vehicle terrorist attack, the 22-year-old assailant drove his van some 550 metres along the famous La Rambla, killing 14 people and injuring 125. We are 8 years on now from the attack. However, the lessons identified and reflections taken from the emergency service response are still as relevant today as they were at the time. Today, we are joined by Doctor Jorge Morales Alvarez, the Medical Director of the Catalan Medical Emergency System. To read more about the attack, see here: https://en.wikipedia.org/wiki/2017_Barcelona_attacks
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In 2016, ISIS encouraged vehicle attacks through its online magazine, targeting crowded outdoor events. Rather than large-scale attacks using weapons of mass destruction, terrorism has shifted towards smaller, lone-actor incidents due to increased security measures. Online radicalisation has facilitated this change, inspiring attacks with easily accessible vehicles requiring minimal skill or preparation.
Following the publication, vehicle-borne attacks increased, with one of the deadliest occurring in Nice, France, during Bastille Day, killing 87 and injuring 458. Victims commonly suffered exsanguinating pelvic fractures. While these attacks are primarily linked to Islamist terrorism, vehicles have also been used in far-right, far-left, and criminal incidents. Between May 27 and September 5, 2020, 104 vehicle attacks were recorded at U.S. protests. However, jihadist-linked attacks tend to be more lethal due to sustained acceleration and higher kinetic energy, causing severe head, spinal, pelvic, and lower extremity injuries.
Emergency response to these incidents is complex, often spanning large areas, such as the one-mile-long scene in Nice. Additional threats like explosives and weapons further challenge responders, as seen in attacks at London Bridge and Barcelona.
Recent months have seen a rise in such attacks across Europe and the U.S., mostly linked to Islamist terrorism. Today, we are joined by Bill Salmeron, Chief of EMS for New Orleans, to discuss the New Year's Eve terrorist attack on Bourbon Street and the EMS response. To read more on the precise location and details of the incident, see here: https://en.wikipedia.org/wiki/2025_New_Orleans_truck_attack
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we’ll explore the communication barriers that clinicians encounter in delivering coordinated care for geriatric patients, including the role of sensory impairments like hearing or vision loss. We’ll uncover best practices for engaging families in decision-making, addressing complex geriatric syndromes, and managing conflicts around patient autonomy. Finally, we’ll discuss the importance of collaborative training and measurable models to improve communication and outcomes across healthcare systems.
In this episode, we’re joined by Georgie Gill, a Trainee Advanced Paramedic Practitioner working in South East England. After working as a Paramedic in an NHS Ambulance Service she moved to work as a Teaching Fellow for the Department of Elderly Medicine, balancing contributing to MDTea podcast, teaching multidisciplinary teams, and serving on the front door frailty team in the emergency department, bringing insight and expertise to paramedic practicein this area. Following this, she moved to a Community Frailty Practitioner Service undertaking advanced care planning with older adults residing in community settings, before moving back to pre-hospital care to undertake the Trainee Advanced Paramedic Practitioner role and ACP MSc.
We are also joined by Iain Wilkinson. Iain is a Consultant Geriatrician and Clinical Director at Surrey and Sussex Healthcare NHS Trust. As Clinical Lead for the Ageing WellGroup, MDTea podcast host, Vice President (Education and Training) for the British Geriatrics Society, and educator with Health Education England, Iain has a wealth of invaluable expertise.
MDTea podcast can be found here: https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we will delve into the latest advancements and innovations in XR technology - the world of Extended Reality and its groundbreaking applications in medical training and how it might shape the future of medical training in practice. From real-time communication with patients, integrating emotional intelligence for a more empathetic interaction, enhancing clinical guidance through AI-driven doctors, simulating injuries and diseases with high accuracy, and providing realistic responses to medications through advanced pharmacology simulations, this platform is set to transform the future of medical education. Join us as we unpack the potential, challenges, and future of this technology.
To do this, we’re speaking with Martien Strik. Martien is a critical care nurse with more than 13 years of experience in the clinical and prehospital field, and 8 years of VR experience in TactileVR. The CEO of Tactile VR, Will Kirkpatrick is also a critical care nurse with 5 years of experience and is the Founder/CEO of TactileVR. You can find the product here:https://tactilevr.com/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
Delirium is a common and often under-recognised condition among older adults, particularly during emergencies.It can be triggered by a range of factors, including infections, dehydration, medications, or underlying chronic conditions, and presents significant challenges for pre-hospital and hospital providers alike.
In this episode, we’ll explore the unique hurdles faced when caring for elderly patients experiencing cognitive changes. From understanding the impact of sensory impairments on communication to distinguishing between delirium, dementia, and other states of confusion, we’ll discuss practical strategies to improve assessment and care delivery. We’ll also highlight the critical role empathy plays in building trust with patients and their families during these vulnerable moments. We’ll dive into how pre-hospital and hospital teams can align to address the root causes of delirium and ensure continuity of care. Ethical dilemmas and family dynamics will also be explored, as well as proactive measures to prevent delirium in at-risk patients. Join us as we unpack these challenges and uncover solutions that prioritise dignity, safety, and quality of life for elderly patients.
To do this we’re joined Iain Wilkinson and James Adams. Iain is a Consultant Geriatrician and Clinical Director at Surrey and Sussex Healthcare NHS Trust. As Clinical Lead for the Ageing Well Group, MDTea podcast host, Vice President (Education and Training) for the British Geriatrics Society, and educator with Health Education England, Iain has a wealth of invaluable expertise.
James is a leader in frailty care and service transformation. As Chief of Service for Frailty and Community Services, he has pioneered workforce development, quality improvement, and national policy influence. His insights encompass the future of care for older people and the integration of innovative, multi-professional strategies.
Links to Validation Theory can be found here:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001394/abstract
Links to the GRIFT Triple Assessment can be found here: https://sean9n.wordpress.com/2023/05/23/a-short-story-of-geriatric-medicine-cfs-4at-news/
This is a paid advertisement from BetterHelp.
In the high-pressure world of pre-hospital care, having a strong support system is essential. Whether you're a frontline responder, medical professional, or someone navigating life’s challenges, therapy can provide valuable tools to help manage stress, build resilience, and improve mental well-being.BetterHelp is the world’s largest therapy service, connecting people with licensed mental health professionals through video, phone, and messaging—accessible anytime, anywhere. With over 5,000 therapists available in the UK, you can find the right support for your needs.Build your support system with BetterHelp.Our listeners get 10% off their first month at BetterHelp.com/CAREPOD
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
Today, we dive into the concept of how Artificial Intelligence is revolutionising how we train for critical scenarios and indeed critical skills such as CPR. Traditional simulation-based training has long been plagued by challenges such as limited realism, high costs, and barriers to accessibility. But now, advancements in AI, particularly through ChatGPT's new Advanced Voice Mode (AVM), are offering transformative solutions. By simulating patient interactions with emotional depth and natural conversational flow, AVM promises to bring an unprecedented level of realism and inclusivity to medical training.
In this episode, we’ll explore the technology's potential to modernise education for both trained and untrained medical responders. We'll discuss how AVM can enhance older manikins, relieve trainers from multitasking, and deliver just-in-time learning opportunities. We’ll also tackle challenges like minimising AI errors and mastering prompt engineering.
Join us as we unpack how tools like ChatGPT are shaping the future of medical simulation, making training more dynamic, equitable, and effective for healthcare providers worldwide. Please find the attached; Shaping the future of simulator interactions: The role of ChatGPT’s Advanced Voice Mode: https://www.resuscitationjournal.com/article/S0300-9572(24)00827-X/fulltext
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we focus on the critical topic of frailty and fall assessment in elderly patients. Frailty is a complex condition that affects many older adults, making them more vulnerable to injuries and complications. Falls, one of the most common emergencies among this population, can have life-altering consequences, including fractures, loss of independence, and even death. For healthcare providers, managing these challenges requires skill, sensitivity, and collaboration.
We also explore the barriers pre-hospital and hospital teams face in effectively communicating and coordinating care for frail elderly patients. We’ll discuss the tools and criteria used to assess frailty in emergencies and the key elements of a successful handover to hospital teams. Real-world examples will highlight the importance of seamless transitions in achieving positive outcomes. We’ll also examine how pre-hospital teams can work with hospital staff to develop proactive care pathways, prevent recurrent falls, and identify environmental or personal risk factors. Finally, we’ll touch on the importance of joint training and feedback systems to enhance skills and improve patient outcomes.
To do this we’re joined by Iain Wilkinson and James Adams. Iain is a Consultant Geriatrician and Clinical Director at Surrey and Sussex Healthcare NHS Trust. As Clinical Lead for the Ageing Well Group, MDTea podcast host, Vice President (Education and Training) for the British Geriatrics Society, and educator with Health Education England, Iain has a wealth of invaluable expertise.
James is a leader in frailty care and service transformation. As Chief of Service for Frailty and Community Services, he has pioneered workforce development, quality improvement, and national policy influence. His insights encompass the future of care for older people and the integration of innovative, multi-professional strategies.
The Rockwood Frailty Scale / Clinical Frailty score mentioned in the episode can be found here:https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2022/02/rockwood-frailty-scale_.pdf
The MDTea podcast that Iain produces can be found here: https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746
The British Geriatric Society e-learning mentioned in the episode can be found here:
https://www.bgs.org.uk/bgs-elearning
A framework of core capabilities for Frailty can be found here:
https://skillsforjustice.org.uk/frameworks/frailty-a-framework-of-core-capabilities#:~:text=This%20framework%20aims%20to%20identify,review%20and%20development%20of%20staff.
In this episode of the Pre-Hospital Care Podcast, we had the privilege of speaking with Dr. Johannes Strobel, a leading figure in Pre-hospital Critical Care and a key driver of clinical innovation within Germany’s renowned EMS system.
Reflecting on his journey, Dr. Strobel shared the challenges and rewards of shaping EMS systems across diverse settings, offering invaluable lessons learned from years at the forefront of high-pressure pre-hospital emergency medicine. His experiences provided a compelling look into the evolution of Prehospital Care, from technology integration to education and training advancements.
One of the key themes of this conversation was the role of AI, telemedicine, and simulation training in transforming pre-hospital care. Johannes offers insights into how these innovations are not just improving clinician decision-making but also shaping the future of prehospital emergency care in Germany.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we’re delving into one of the most complexand critical topics in pre-hospital care, that of ethical and legal decision-making. Whether respecting a patient’s autonomy, determining capacity, or navigating complex end-of-life care scenarios, these decisions often come withhigh stakes and no easy answers. Balancing the duty to act with the need to respect patients’ rights can be especially challenging in unpredictable environments.
We’ll explore key issues such as managing refusal oftreatment, honouring advanced directives, and addressing conflicts between ethical obligations and legal requirements. Using real-world case studies, we’ll discuss practical approaches to tackling these dilemmas while safeguarding patients and providers.
In this episode, we’re joined by Steve Bell. Steve is an NHSConsultant Paramedic and Consultant HEMS Paramedic with extensive experience in pre-hospital care across ambulance trusts and HEMS. Steve is also a published researcher and educator.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:
https://www.pax-bags.com/en/
In this episode, we discuss the role of interprofessional teams within pre-hospital care and examine the latest research published on this topic. Over the past three decades, the role of physicians in pre-hospital care has grown significantly. In this episode, we are joined by Dr Mike Christian. Beginning his career as a paramedic, Mike is now a critical care physician, researcher, and educator in PHEM. He specialises in interprofessional team care for critically ill patients in Canada. He has held leadership positions in PHEM and hospital systems in the UK and in Canada.
Mike’s research demonstrates the transformative impact of inter-professional teams, which bring together physicians, paramedics, and other specialists to enhance care delivery and improve patient outcomes. This episode explores the evidence behind these teams, shedding light on their ability to reduce mortality and improve survival for critically ill and injured patients. We’ll discuss the benefits, challenges, and future potential of these teams, touching on the training, logistical, and systemic considerations that shape their implementation. The research can be found here:
Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
https://link.springer.com/article/10.1186/s13049-024-01298-8
Interprofessional Learning in Multidisciplinary Healthcare Teams Is Associated With Reduced Patient Mortality: A Quantitative Systematic Review and Meta-analysishttps://pubmed.ncbi.nlm.nih.gov/37921751/
A link to the Canadian Critical Care Conference presentation mentioned by Mike in the interview can be found here: https://youtu.be/MVDHaYaZRSI.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we dive into the intricate legal landscape that pre-hospital care providers must navigate daily. From understanding fundamental duty of care to managing mandatory reporting requirements, we explore how every decision in the field carries legal weight.
Our discussion covers essential scenarios pre-hospital teams frequently encounter, including suspected abuse cases, mass casualty incidents, and maintaining patient confidentiality at crime scenes. We break down practical strategies for balancing legal obligations with optimal patient care, offering actionable insights for providers at all levels.
Key topics include protecting yourself from negligence claims, understanding when and how to report suspected abuse, and maintaining professional boundaries while collaborating with law enforcement. Whether you're a seasoned paramedic or new to pre-hospital care, this episode provides crucial knowledge for managing legal risks while delivering excellence in patient care. The link mentioned in the episode to the NARU document can be found here:
https://naru.s3.eu-west-2.amazonaws.com/wp-content/uploads/2021/09/03212218/DutyofCareBreifingNoteApril21.pdf
In this episode, we delve into NATO’s medical readiness for large-scale conflicts, addressing pressing questions about preparedness and challenges in the face of hybrid and cyber threats. Also, how NATO adapts its strategies to meet these complex needs of contemporary warfare.
We’ll address lessons from recent conflicts—Ukraine, Afghanistan, and Iraq—and how these experiences have shaped NATO’s unified approach to combat medicine. From mass casualty management to the integration of cutting-edge innovations like telemedicine, robotics, and AI, we discuss the systems and technologies that underpin NATO's ability to respond effectively. The importance of collaboration and interoperability takes centre stage as we explore how NATO trains medics and aligns medical equipment across diverse member nations. Additionally, we examine how NATO balances military medical readiness with supporting civilian populations in conflict zones, leveraging partnerships with civilian healthcare systems to enhance preparedness.
Finally, we tackle ethical and humanitarian considerations, shedding light on psychological resilience, the mental health of medical teams, and the challenges of providing care to both allies and adversaries.
To do this I have Tim Hodgetts with me. Tim was the recently serving Surgeon General of the United Kingdom Armed Forces, the Master General of the Army Medical Services, and the elected Chair of the Committee of Chiefs of Military Medical Services in NATO. His clinical background is a Professor of Emergency Medicine amongst many other hats.
Links that Tim mentions in the episode can be found here:
Transferable military medical lessons from the Russo-Ukraine war
https://pubmed.ncbi.nlm.nih.gov/37402486/
The novel 8Ds approach to demand management in Mass Casualty and other situations of extreme demand/capacity mismatch
https://www.researchgate.net/publication/374617576_A_simple_research_framework_will_improve_Mass_Casualty_responses
Frontlines and Lifelines: Collected Poems from an Army Doctor in Crisis and War (English Edition)
https://www.amazon.com/Frontlines-Lifelines-Collected-Doctor-Crisis-ebook/dp/B0DCS1DFMH
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we’re diving into a critical topic for allpre-hospital providers: Documentation and Communication—Protecting Patients and Providers.
In the increasingly complex world of pre-hospital care, accurate documentation and effective communication are more than just administrative tasks—they are key to ensuring patient safety, defending clinical decisions, and protecting providers from legal challenges. Every action and decision made in the field must be carefully recorded, as inadequate documentation can expose providers to significant legal risk and impact patient care.
In this episode, we’ll explore best practices for pre-hospital record-keeping, the legal implications of incomplete or inaccurate documentation, and how clear communication during handovers to hospital teams can make or break a case. We’ll also examine real-world case studies, highlighting situations where discrepancies in documentation or poorcommunication led to legal issues or adverse outcomes.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode of the Pre-Hospital Care Podcast, we explore why decision-making is a cornerstone of effective pre-hospital care. Using a compelling case study from a high-pressure environment, we examine how clinicians navigate complex decisions and decisions within decisions.
We dive into key theories of decision-making, including Miller’s Magic Number 7, which highlights the limits of working memory, and heuristics, the mental shortcuts we use under pressure. We also discuss inattention bias—how critical details can be overlooked—and the importance of metacognition in reflecting on and improving decisions.
Discover common pitfalls, such as over-reliance on intuition or cognitive overload, and the emerging role of artificial intelligence as a supportive tool in pre-hospital care decision-making. With AI's potential to analyse data rapidly and provide guidance, how can it complement the human element of judgment and compassion?
Finally, we share practical tools and strategies to navigate decision-making challenges, and how clinicians can make sound, timely, and patient-focused choices in dynamic situations. Join us for this insightful episode as we break down the anatomy of decision-making in pre-hospital care.
More information on the case study of Dan Richards can be found here: https://www.facebook.com/watch/?v=649646908762720
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this first episode of the new year, we speak with Noah, whose life changed dramatically in 2016. While exercising at school in North London, Noah suffered a cardiac arrest caused by a primary arrhythmia, resulting in ventricular fibrillation. That day brought the adage "it takes a system to save a life" sharply into focus.
Noah shares his firsthand experience of the cardiac arrest, the events leading up to it, and how it has become a defining moment in his life. We are also joined by Noah’s father, Erran, who recounts the sequence of events from his perspective—both on that fateful day in 2016 and throughout the emotional roller coaster of Noah's rehabilitation.
Together, we explore Noah’s life before the incident, what both Noah and Erran remember about the day, and the detailed timeline of events that unfolded. We delve into Noah’s recovery journey, the profound shift in perspectives on life that resulted, and the lessons they have both taken from the experience.
This episode offers a deeply personal insight into resilience, family support, and the critical role of pre-hospital systems in saving lives, along with powerful take-home messages from Noah and Erran.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this session, we reflect on the experiences, challenges, and growth that define a career in Paramedicine. Paramedics have the privilege of caring for individuals during some of the most vulnerable and difficult moments of their lives—a privilege that carries profound meaning but also significant emotional demands.
This episode explores the essence of resilience: what it truly means, whether our current definitions are sufficient, and how we can better frame it to support those working on the front lines of care. We also examine the cumulative impact of vicarious trauma, the toll of witnessing human suffering over time, and how these experiences shape those in the profession.
Importantly, this conversation is not just about challenges—it’s about growth. We discuss the concept of post-traumatic growth, exploring how adversity and trauma can lead to profound personal transformation and a renewed sense of purpose. Guests Keir Rutherford and Lisa Burrell share their journeys, offering insights into the emotional landscape of emergency care. Happy new year from the PHCP and we will see you in 2025!
In this episode, we speak with Zoe Hitchcock, whose life took a dramatic turn 11 years ago in 2013. While walking along Oxford Street in London, Zoe experienced a cardiac arrest caused by a cardiac myopathy, resulting in ventricular fibrillation. That day, the saying "it takes a system to save a life" became strikingly evident.
Zoe shares her firsthand account of the cardiac arrest, the events leading up to it, and how that moment became a pivotal turning point in her life. We explore what Zoe remembers from that day, the role her husband played in the circumstances leading her to Oxford Street, and the critical challenges faced by the pre-hospital team on the pavement.
We’ll also discuss the involvement of the HEMS team, her transfer to St. Mary’s, and the recovery process that followed. Zoe reflects on how her perspective on life and family has shifted since that day and shares key take-home messages for listeners.
This conversation highlights the resilience of the human spirit and the importance of pre-hospital care systems in saving lives. For more insights, listen to Zoe’s original account in the linked episode: S02E01 - Zoe Hitchcock, Cardiac Arrest Survivor.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
As we wrap up 2024, this special year-in-review episode of the Pre-Hospital Care Podcast feels particularly personal. It’s been a year full of challenges, breakthroughs, and moments that tested and redefined what staff can achieve.
This episode isn’t just a summary of achievements or struggles—it’s about the real stories and the people behind them. From reflections to fresh approaches to training to the emotional toll on the workforce, 2024 has been a journey of resilience and adaptation.
For us, this is a chance to celebrate the human side of pre-hospital care—the ingenuity, the teamwork, and the quiet but profound moments of care that often go unseen. It’s also a moment to acknowledge that while progress has been made, there’s still so much work to do. I hope this episode offers you a meaningful perspective on 2024 from the hosts at the PHCP.
In this episode, we explore the deeply personal and often overlooked journey of cardiac arrest recovery. Joining us is Paul Swindell, a cardiac arrest survivor, advocate, and co-founder of Sudden Cardiac Arrest UK.
In 2014, Paul’s life changed in an instant when he experienced a sudden cardiac arrest. While he was fortunate to survive, his recovery brought challenges that went beyond the physical. Today, we’ll delve into Paul’s experience, exploring the physical, emotional, and psychological hurdles he faced. We’ll discuss the role of pre-hospital care, gaps in support systems for survivors, and the mission of Sudden Cardiac Arrest UK to provide a sense of community for others navigating this journey. You can find their website here: https://suddencardiacarrestuk.org/
The 10 Years Together Event can be found here:
https://suddencardiacarrestuk.org/10-years-together/
This podcast is sponsored by Wel Medical: Wel Medical, is a leading provider of life-saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency. Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organizations are well-prepared for any emergency. With a strong focus on customer support, they are passionate about helping people feel confident in saving lives. Tune in to learn how Wel Medical is making a difference in emergency preparedness.
For more information, visit welmedical.com and discover how you can make your environment and workplace safer today.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we explore Professor Will Broughton’s inaugural lecture, Beyond the Sirens: The Unique and Evolving Nature of Paramedicine. As the UK’s second-ever “Paramedic Chair,” Professor Broughton challenges the outdated perception of paramedics as mere “ambulance drivers,” instead highlighting the profession’s evolution into one of sophisticated clinical expertise.
He discusses the broadening role of paramedics, from complex medical interventions to their increasing involvement in community health. His insights shed light on how paramedicine has progressed since the days of "urban mobile resuscitation" in 1976, and the future potential of the field.
Tune in as Professor Broughton shares his journey from his early experiences with the Red Cross to founding the UK’s first student paramedic conference, and how his time with the London Ambulance Service prepared him for his roles in education and research. We also hear his thoughts on the shifting gender dynamics within paramedicine and how technology will shape its future.
In a lighthearted moment, Professor Broughton recounts an unexpected New Year’s Eve shift where he found himself acting as an emergency plumber, illustrating the flexibility paramedics must now possess. Additionally, he reflects on the importance of asking, “What is our brand?” and the key research areas that will continue to propel Paramedicine forward.
In this conversation, we will examine the prevalence, causes,types and critical issues of violence against paramedics. Justin Mausz shares his insights on the growing prevalence of violence in the pre-hospital environment, examining the kinds of violence paramedics face, including verbal, physical, and emotional abuse. He highlights the contributing factors and offers practical strategies for mitigating these risks, drawing from his extensive research. We also explore how to protect paramedics while maintaining care delivery in high-risk environments.
To do this I am joined by Dr Justin Mausz. Justin is anaccomplished professional in paramedicine and healthcare research. He serves as a research scientist at the University of Toronto, with a focus on improving paramedic education and patient care systems. Justin’s research interests include clinical decision-making, prehospital care, and performance optimisation for emergency services. A dedicated academic, he contributes to advancing paramedicine by combining his practical experience as a former paramedic with rigorous scholarly research to drive improvements in healthcare delivery. His work has significantly impacted the academic and practical fields of pre-hospital care. You can find some of his research here:
https://pubmed.ncbi.nlm.nih.gov/36928257/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we're diving into the critical topic ofmajor trauma networks in the UK. These networks have revolutionised trauma care, significantly improving patient outcomes since their inception. We'll explore the positives and challenges faced by these networks, with insightsinto their impact on patient survival rates, and the integration of advanced technologies.
To do this I am joined by Dr Ash Vasireddy, Ash is a TraumaSurgeon at King’s College Hospital. He is also works as a HEMS (Air Ambulance) Pre-hospital Care Doctor. As part of the trauma lead at Kings College Ash also ensures the MTCs function effectively from an Orthopaedic perspective andfosters relationships with network partners in facilitating orthopaedic trauma care. Please find an informative review on Trauma Networks here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732139/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we will examine the fundamentals oftraining and education of high-performing teams. We discuss the role of real-world scenarios and high-fidelity training simulations in better-preparing trainees. We'll also discuss the role of high-fidelity simulation in enhancing the learning experience and the metrics used to evaluate training effectiveness. We will share strategies for continuously improving training programs and offer take-home points on harnessing those crucial one percent improvements in training.
To do this we have Dr. Clare Richmond with us. Clare is a Retrieval Specialist and the Director of Emergency Medicine Training at Sydney HEMS. She also serves as a State Retrieval Consultant for NSW Ambulance and as an Emergency Physician VMO at Royal Prince Alfred and Canterbury Hospitals. A graduate of Sydney University, Dr. Richmond trained in Emergency Medicine at Royal Prince Alfred Hospital and completed a fellowship at the Sydney Clinical Skills and Simulation Centre. She has taught and worked in PHEM in diverse locations including Sydney, Alice Springs, and London. Clare mentions a number of resources in the interview, this is the podcast on debriefing that she mentions:
https://debrief2learn.org/blended-approaches/
Sydney HEMS publish a debrief podcast that can be found here:
https://sydneyhems.com/category/podcasts/
More can also be found here:
https://sydneyhems.com/
Podcast Recommendation:
Join Steve Wood on the Tac Medic Whiskey Podcast. The Podcast is for up-to-date information on all things Tactical Medicine, Pre-Hospital Medicine and more. The podcast explores life-saving techniques, and real-world experiences, and discusses strategies for handling high-pressure situations. Whether you're a seasoned professional, an aspiring tac medic, or just curious about this critical field, this podcast offers expert insights, practical tips, and stories from the front lines. Listen here:
https://www.podbean.com/pu/pbblog-v4wd8-12cb369
This is the third and final part of the PTSD series looking at the empirically proven talking therapies. In this episode we examine CBT with Seth Gillihan. Seth J. Gillihan is a clinical psychologist, best-selling author, podcast host, and creator of the Think Act Be Online School. He specialises in mindfulness-centered Cognitive Behavioural Therapy (CBT). In this episode, we define what CBT is, and examine anxiety both from its origins and common patterns. We also look at some of the fundamental components of CBT to offset anxiety and restoration of equilibrium. We speak about the power of being present and living a content life with uncertainty. We look at some of the cognitive distortions and thinking errors that can occur in our day-to-day lives and how we can address these. We finish by looking at some anecdotal experiences and cases from Seth’s perspective and what he's learnt as a consequence.
We take the examples from Seth's new book: The CBT Deck for anxiety, rumination and & worry - where he gives 108 strategies to tackle the practical issues of worry. I hope you enjoy the episode as much as I enjoyed speaking with Seth as he is both insightful and engaging as a guest and author.
Seth's new book can be found here:
https://sethgillihan.com/books/the-cbt-deck-for-anxiety-rumination-worry/
More on Seth can be found here:
https://sethgillihan.com/
In this conversation, we will examine the important andoften overlooked aspect of paramedicine—caring for elderly patients in care homes. As the population ages, more and more paramedics are being called to care homes to respond to complex medical emergencies involving frail, elderlypatients. These scenarios present unique clinical, ethical, and logistical challenges that demand specialised skills and approaches. In this episode, we'll be talking to Lance A. Slatton about the specific issues paramedics face in care homes, including effective communication with care staff, managing chronic conditions, and the ethical complexities surrounding end-of-life care. We'll also explore best practices and discuss how we can improve the pre-hospital experience for both paramedics and elderly patients in these settings.
As the population ages, paramedics are increasingly called to these settings, facing unique challenges that demand specialised skills and approaches. In our discussion, we explored the specific issues paramedics encounter, such as effective communication with care staff, managing chronic conditions, and the ethical complexities of end-of-life care.
Lance A. S. , the host of the Award-Winning podcast and YouTube show All Home Care Matters, shared invaluable insights based on his role as a senior case manager at Enriched Life Home Care Services in Livonia, MI. His remarkable achievements, including being named a 50 under 50 for 2023 and recognition as the 'Top Influencer for Healthcare and Advocacy for 2024', underscore his expertise in the field. Together, we explored best practices to enhance the pre-hospital experience for paramedics and elderly patients in care home settings.
Today, we’re joined by explorer, writer, and presenter WillMillard, whose incredible adventures have taken him to some of Earth's most remote and uncharted territories. From living with Indigenous tribes in Papua New Guinea to navigating the wild rivers of West Africa, Will has always sought to push the boundaries of exploration.
But behind the thrill of discovery lies a more personal story, a story of how the pressures and isolation of his extreme travels culminated in a diagnosis of PTSD. In this episode, we’ll dive into the emotional and mental toll of a life on the edge, and how Will has navigated his journey towardhealing. We’ll discuss the unique challenges that come with extreme exploration, the impact it had on his mental health, and the lessons he’s learned about resilience, survival, and recovery.
Check out his content here:
https://www.willmillard.com/
https://en.wikipedia.org/wiki/Will_Millard
https://www.bbc.co.uk/programmes/profiles/Q24JrQYWGQTxswrrFCygBQ/will-millard
Will's fantastic blogs can be found here:
https://willmillardblog.wordpress.com/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en
In this conversation, we will explore the critical topic of selecting prehospital clinicians for high-stakes environments. We explore the traditional methods used in clinician selection and why they may fall short in the unpredictable world of pre-hospital care. We'll discuss the need to re-define performance criteria to better suit high-pressure situations and identify which mental and physical attributes are key indicators of reliable performance in challenging settings.
We will touch on the role of personality inventories andwhether it's more advantageous to choose clinicians with diverse personalities or specific traits. We will also look at effective teamwork as an essential pre-requisite in prehospital care, how to assess a clinician's potential for collaboration and whether prioritising leadership or followership—or a balance of both, yields the best results.
To do this I have Dr Chris Denny with me. Chris is anEmergency Medicine Specialist at the Auckland City Hospital. Additionally, he holds key roles as Medical Director of Northern Rescue (Auckland Rescue Helicopter Trust) and he is a member of the New Zealand Medical Assistance Team (WHO Emergency Medical Team). Chris has expertise spanning acute care, leadership, and education, and has been helping to advance both emergency medicine and prehospital and retrieval medicine (PHRM) in New Zealand. To see more of Chris's work please see here: https://codachange.org/on-the-selection-of-prehospital-clinicians
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This podcast is sponsored by Wel Medical.
Wel Medical, is a leading provider of life-saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency. Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organisations are well-prepared for any emergency.
For more information, visit welmedical.com and discover how to make your environment and workplace safer today.
In this episode, we talk with Dr. Abigail Pamich, an experienced clinical psychologist with over 20 years of experience in therapy and mental health. Dr. Abigail runs a private practice in the UK, leading a team of 12 skilled therapists who offer remote therapy to clients nationally and internationally. She also has a growing YouTube channel where she explores different types of therapy, making mental health support more accessible to a wider audience.
One of the therapeutic approaches Dr. Abigail and her team offer is EMDR (Eye Movement Desensitisation and Reprocessing) therapy. In our conversation, we explore exactly what EMDR therapy is and why it has become an important tool in addressing trauma and anxiety. Dr. Abigail breaks down some of the fundamental components of EMDR, including the process of bilateral stimulation, and explains how it can be effectively applied both in the consultation room and remotely.
We also discuss how Dr. Abigail discovered EMDR and examine its empirical support within research. Throughout the episode, she compares EMDR with other therapeutic methods, highlighting its unique effectiveness. Dr. Abigail shares compelling case studies and her own experiences with EMDR, offering insights into the profound impact it can have on mental health. Enjoy the episode. Here are links to Abigails work:
Private Practice Clinic
www.malvernhillsprivatepractice.co.uk
contact@malvernhillsprivatepractice.co.uk
Accepting self-referrals via our online form
Dr Abigail Pamich, Consultant Clinical Psychologist
www.doctorabigail.co.uk
abigail@doctorabigail.co.uk
YouTube Channel - Dr Abigail Pamich
https://www.youtube.com/channel/UCammqAR04gMcZ2zxjFj4lPw
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine and explore thecomplex dynamics of teamwork in UK healthcare. Effective teamwork is crucial for delivering safe, high-quality patient care, yet numerous factors can either enable or hinder its success. In this episode, we delve into the findings of a comprehensive study commissioned by the General Medical Council (GMC), uncovering the key enablers, such as effective communication, leadership, and a positiveculture, as well as the barriers, including hierarchies, workload pressures, and lack of role clarity.
We examine the unique challenges faced by different healthcare professionals, including junior doctors, international medical graduates, and those in emerging roles. Join us as we explore strategies to foster supportive, cohesive teams across the UK health systems. I am joined by the authors of the study, Paul Crampton and Millie Kehoe. You can read the study here: https://www.gmc-uk.org/about/what-we-do-and-why/data-and-research/research-and-insight-archive/teamworking---understanding-barriers-and-enablers-to-supportive-teams-in-uk-health-systems
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This podcast is sponsored by Wel Medical.
Wel Medical, is a leading provider of life-saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency. Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organisations are well-prepared for any emergency.
For more information, visit welmedical.com and discover how to make your environment and workplace safer today.
In this episode, we explore the history and development of ECG algorithms with a leading expert in the field. We'll cover the early days of ECG interpretation, the hurdles in creating automated algorithms, and how this essential technology has evolved. Our guest, with decades of experience, will discuss his role in establishing an ECG Core Laboratory for clinical trials and epidemiological studies. We'll also look at the globally used Glasgow ECG algorithm, which aids thousands of clinicians in interpreting 12 lead ECGs.
Joining me is Professor Peter Macfarlane, Emeritus Professor and Honorary Senior Research Fellow at the University of Glasgow. His team's work, including the Glasgow ECG interpretation program, is renowned worldwide. Peter's research has focused on ECG variations across age, gender, and ethnicity, influencing international guidelines for diagnosing acute myocardial infarction. He founded an ECG Core Laboratory for both national and international clinical trials and studies. A Fellow of the Royal Society of Edinburgh, Macfarlane received a DSc in 2000, the 1998 Rijlant International Prize in Electrocardiology, and a CBE in January 2014 for his contributions to healthcare. to see more on the Glasgow ECG Program Research, see here:
https://www.gla.ac.uk/schools/healthwellbeing/research/robertsoncentreforbiostatistics/electrocardiology/glasgowecgprogram/
Some of the publications mentioned in the interview can be seen here:
https://www.sciencedirect.com/science/article/abs/pii/S0022073606000628
https://www.gla.ac.uk/schools/healthwellbeing/research/robertsoncentreforbiostatistics/electrocardiology/publications/#clinicaltrialsandstudies
This podcast is sponsored by Wel Medical.
Wel Medical are a leading provider of life saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency.
Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organizations are well-prepared for any emergency. With a strong focus on customer support, they are passionate about helping people feel confident in saving lives. Tune in to learn how Wel Medical is making a difference in emergency preparedness. For more information, visit welmedical.com and discover how you can make your environment and workplace safer today.
In this conversation, we will examine the concept andskill of Front of Neck Access (FONA)and also theSuction Assisted Laryngoscopy and Airway Decontamination (SALAD) technique. Join us as we dive into this high-stakesprocedure with pre-hospital retrieval specialist Cliff Reid. We'll explore the indications, complications, and potential risks of FONA. Cliff will talk us through the innovative SALAD technique, which mitigates complications andimproves success rates. Real-life case studies will illustrate the challenges and decision-making involved in pre-hospital FONA. Whether you're a seasoned provider or a trainee, we want to offer insights into mastering one of the most crucial pre-hospital procedures in a critical care situation.
To do this I have Cliff Reid with me. Cliff has over twodecades of experience as a physician in air ambulance and critical care transport services, he has developed extensive expertise in advanced airway management techniques. As an educator, he has trained numerous pre-hospital professionals worldwide, sharing his knowledge and advocating for best practices in airway management. You can find more by Cliff here: https://rise.articulate.com/share/74lr2fXfmxfHRyL3ncKM00TuD31ij4HE#/
In this conversation, we will examine the second part ofthe conversation with Krissie Stiles. In this episode, we look at the pain management, cooling, and safe transportation of burns. We then examine the complications, prevention strategies, coordination with burn centres, psychological impacts on patients and families, and continued care andrehabilitation in the conversation. We finally look at the training requirements, quality improvement processes, and memorable or challenging cases that our guest have treated and attended. As we delve into various aspects of pre-hospital burn care, from initial management to long-term outcomes, highlighting best practices, advancements, and real-world experiences.
To do this I am joined by Kristina Stiles. Kristina is anurse with burns and plastic surgery qualifications since 2003 and an MSc in Burn Care since 2019. She has led quality improvement projects developing Clinical Practice Guidelines and patient information initiatives. Kristinafounded the British Burn Association’s Pre-Hospital Special Interest Group, collaborating across various specialities. Her award-winning projects include "The Burns Game," "Family Oops and Burns First Aid," and the "Saving Lives is Not Enough" report. An advocate for patient voices, she has received awards for "Outstanding Patient Care," "Innovation in Care," and "Effective Burn Care," and is an Ambassador of the Children's Burns Trust.
Here are the links to the burns charities:
- https://katiepiperfoundation.org.uk/https://dansfundforburns.org/https://cbtrust.org.uk/
- For support for burn survivors:https://adultburnsupportuk.org/
- Family Oops book:https://youtu.be/n7aDyugYJOM?si=l-h2d2dhdVB80g66https://cbtrust.org.uk/learning-zone/the-family-oops-and-burns-first-aid-ebook/ - Available for free on request from info@cbtrust.org.uk, but Krissie appreciates a donation in return.
- EMSB Course:https://www.britishburnassociation.org/emsb-courses/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will explore the key aspects of burn care, beginning with the prevalence, causes, and classification of burn severities. We'll dive into understanding the physiological responses to burns and the potential complications that can arise, ranging from infections to organ failure. Emphasising evidence-based management, we will discuss the critical priorities in burn care, including initial assessment, fluid resuscitation, airway management, pain control, and cooling, followed by safe transportation to specialised facilities.
As we move forward, we'll examine the potential complications that burn patients face, such as shock, infections, and long-term scarring. We'll also highlight prevention strategies to reduce the occurrence of burns and the importance of coordinated care with burn centres. The psychological impacts on patients and their families, which can be profound and long-lasting, will also be a focus, as well as the continuum of care that extends from the acute phase to rehabilitation and reintegration into daily life.
Additionally, we'll discuss the training requirements for healthcare providers in burn care, and the ongoing quality improvement processes in this field, and reflect on memorable or particularly challenging cases that our guest, Kristina Stiles, has encountered in her extensive career.
Kristina Stiles, who joins us for this conversation, is a highly experienced nurse specialising in burns and plastic surgery since 2003, with an MSc in Burn Care attained in 2019. Kristina has played a pivotal role in developing Clinical Practice Guidelines and patient information initiatives aimed at improving the quality of care. She is the founder of the British Burn Association’s Pre-Hospital Special Interest Group, where she has worked collaboratively across various specialities to enhance pre-hospital burn care practices.
Her contributions to the field are noteworthy, including award-winning projects such as "The Burns Game" and the "Saving Lives is Not Enough" report, both of which have had a significant impact on burn care practices and patient outcomes. Kristina is a staunch advocate for patient voices in healthcare and has received numerous accolades, including awards for "Outstanding Patient Care," "Innovation in Care," and "Effective Burn Care." In addition to her professional achievements, Kristina serves as an Ambassador of the Children's Burns Trust, further demonstrating her commitment to improving the lives of burn patients and their families.
Through this discussion, we aim to provide a comprehensive overview of pre-hospital burn care, from initial management strategies to long-term outcomes, while also highlighting best practices, recent advancements, and real-world experiences that shape the field today.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we delve into the surge in alcohol consumption during the pandemic, the rise of digital health innovations in addiction treatment, and the crucial role of medication in supporting recovery. Alcohol misuse costs the NHS in England approximately £3.5 billion annually, covering hospital admissions, treatments, and A&E visits related to alcohol-related issues.
With over 1.1 million hospital admissions yearly linked to alcohol consumption, emergency services face a significant strain. Alcohol-related liver disease stands as a major cause of mortality, with substantial NHS spending on treatment. The burden extends to mental health services treating co-occurring conditions, while indirect costs like productivity losses are estimated at £7 billion annually. Public health campaigns and social care services further compound the financial load on the NHS and society.
Join us as we welcome Jonathan Hunt-Glassman, a leading advocate for innovative approaches to treating alcohol use disorder. As the Chief Executive Officer & Co-Founder of Oar Health, Jonathan champions medication-assisted treatment and the concept of moderation as a legitimate recovery goal. Through his personal journey and professional insights, Jonathan offers a fresh perspective on managing alcohol misuse and exploring paths beyond traditional sobriety. His expertise and experience promise valuable information and inspiration for anyone invested in understanding and addressing alcohol use disorder. You can find more resources on Alcohol Use Disorder (AUD) see here: https://www.oarhealth.com/resources/alcohol-misuse-and-alcohol-use-disorder
Oar health can be found here: https://www.oarhealth.com/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode, we review the historical literature around spinal trauma, the actual prevalence of spinal trauma, and guidelines from RCSEd, NICE, NEXUS, and Canadian C spine rules. Critical Care Paramedic Jim Walmsley, with 19 years of experience at South East Coast Ambulance Service NHS Foundation Trust, joins us to discuss the cultural and clinical evolution of spinal immobilisation.
Topics include pre-hospital assessment, treatment decisions, and the latest recommendations. We also examine key cases demonstrating the effective application and share final thoughts and key takeaways. The guidelines and recommendations we discuss can be found here:
FPHC: https://fphc.rcsed.ac.uk/media/1764/pre-hospital-spinal-immobilisation.pdf
NEXUS Guidelines: https://radiopaedia.org/articles/nexus-criteria
Canadian C Spine rules: https://emedicine.medscape.com/article/2172522-overview?form=fpf
NICE Guidelines: https://www.nice.org.uk/guidance/ng41/chapter/recommendations
The EXIT Project: https://theexitprojectcouk.wordpress.com/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine the role of TRiM(Trauma Risk Management). This is a trauma-focused peer support system designed to assist individuals who have experienced traumatic or potentially traumaticevents. In the UK Armed Forces, TRiM is based on the principle of "active monitoring," where trained non-medical personnel, known as TRiM Practitioners, keep a watchful eye on those exposed to trauma. These practitioners are not counsellors or therapists but are trained to understandthe effects of trauma, maintain confidentiality, and provide practical advice. They are skilled in spotting signs of distress, conducting TRiM assessments and planning meetings, and directing individuals to appropriate support if needed.
To do this I am joined by Lucy Gough. Lucy is nostranger to the podcast and has joined me previously to talk about her experiences through the pandemic as an Emergency Medical Dispatcher. Lucy is a senior LINC worker and trained TRiM practitioner as well as an Emergency Medical dispatcher. In this episode, we explore Lucy’s role as a senior LINC worker and TRiM facilitator for EMS staff. We discuss mental health challenges, support strategies, and the implementation of TRiM after traumatic events. We also discuss the stigma around seeking help, success stories, and the future of mental health support for frontline workers in high-stress environments. To learn more about TRiM, see here: https://en.wikipedia.org/wiki/Trauma_risk_management
Today, we're diving into a crucial tool that has recently been released by GWAAC for emergency personnel: the STAB5 mnemonic. This simple yet powerful framework is designed to guide staff through the complex and often chaotic scenarios of penetrating trauma they face in prehospital care.
The STAB5 pneumonic helps ensure that nothing is overlooked within penetrating torso injury, and that care is delivered as effectively and efficiently as possible with the reduction of time on scene also in focus. In this episode, we’ll break down each component of the STAB5 mnemonic, exploring its real-world application and hearing from the authors who have designed it. From scene safety to haemorrhage control, we’ll uncover how this mnemonic can be a lifesaver—not just for patients but for the pre-hospital teams that work tirelessly to save them. Please find the tool here: https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-05048-1
In this episode, we explore the evolution and achievements of Scotland's Emergency Medical Retrieval Service (EMRS), a lifeline for critically unwell patients in rural and remote areas. The EMRS, established in 2004, has transformed emergency care in Scotland, expanding its reach nationally in 2010 and opening a second base in Aberdeen in 2019. This service operates within the Scottish Specialist Transport and Retrieval (ScotSTAR) division of the Scottish Ambulance Service, providing vital pre-hospital critical care and retrieval services.
Our discussion today centres around a comprehensiveretrospective cohort study covering the first decade of the EMRS’s national service. We'll examine key findings, including the significant number of taskings, thecrucial role of geospatial modelling in reducing transfer times, and the service’s targeted support for socio-economically deprived areas. We will delve into the critical factors associated with clinical deterioration and pre-hospital mortality and learn how the EMRS addresses these challenges. We'll also explore the future directions for the service and its ongoing efforts to improve emergency medical care and address health inequalities across Scotland. The paper that Ryan mentions in the interview on: Equity in the provision of helicopter emergency medical services in the United Kingdom: a geospatial analysis using indices of multiple deprivation can be found here: https://sjtrem.biomedcentral.com/articles/10.1186/s13049-024-01248-4
Part 3 in the Trauma Series:
In this session, consultant neurosurgeon Mark Wilson discusses the fundamentals of head injury, focusing on brain injury, primary and secondary injury, venous drainage, and optimising pre-hospital management. Mark, a specialist in acute brain injury at Imperial College and an Air Ambulance doctor, shares insights from his extensive experience, including work overseas and co-founding GoodSAM, an emergency alert platform. The episode covers TBI vs. NTBI pathology, the accuracy of pre-hospital diagnoses, the role of doctor/paramedic teams, pre-hospital anaesthesia, and the importance of early intervention. Mark also shares a seminal case and key take-home messages.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this podcast episode, we explore critical topics that significantly impact maternal and neonatal outcomes, with insights shared by Camella Main, a Consultant Midwife with over 12 years of experience. Camella has extensive experience in both hospital and pre-hospital settings, managing high-risk pregnancies and deliveries. She serves as the Lead Midwife for the London Ambulance Service and a Consultant Midwife for East Midlands Ambulance services, emphasising evidence-based practices and improving outcomes.
Key discussion points include the latest guidelines and best practices for neonatal care, especially in rural and remote settings. Emerging trends and strategies to optimise neonatal care are also covered. Camella addresses various challenges in providing pre-hospital care to pregnant women and newborns, highlighting the importance of proper thermal care for newborns immediately after delivery. Recommended techniques and equipment for neonatal thermal care are discussed.
Further, the podcast delves into recognising key signs and symptoms indicating active labour and imminent birth, effective maternal positions for delivery, and critical steps to care for both mother and newborn immediately after delivery. Camella also discusses the importance of escalating care to critical care teams, considerations for the safe transportation of pregnant women and newborns, and collaboration between pre-hospital services and hospitals to optimise care. Emerging trends and research areas in pre-hospital maternal and neonatal care that show promise for improving outcomes are also explored.
This is the second in the four-part series on anatomical trauma with some of the world's leading experts in specialist pre-hospital care.
In this episode, we are examining pelvic trauma. In this discussion, I speak with Ash Vasireddy, a fellowship-trained Orthopaedic Trauma Surgeon at King’s College Hospital, London, specialising in complex fractures. We explore the critical nature of pelvic trauma, covering topics such as pre-hospital prevalence, injury classification, and management strategies, including REBOA's potential in air ambulance services.
In the conversation, Ash shares insights from his extensive experience, including training at major trauma centres in the UK and the US. We also discuss pre-hospital assessment, common issues in orthopaedic trauma, and lessons from practice, concluding with key take-home messages and a review of pelvic fracture classifications.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
In this episode of the Pre-Hospital Care Podcast, we chat with Alex Mair, a paramedic who qualified in 2022 after studying in Australia. Alex discusses her journey of starting her career in Australia and continuing it in the UK, far from her home and support systems, and goes on to share insights into the challenges she has faced both clinically and holistically. She highlights the key differences between pre-hospital ambulance paramedicine practices in the UK and Australia, offering valuable lessons she has learned from both systems.
Alex reflects on the balance between support and autonomy for newly qualified paramedics (NQPs) in the UK and whether it is conducive to their development. She shares her most profound personal reflections from working in the UK and suggests improvements to address burnout in pre-hospital care.
We delve into Alex's podcasting journey as the host of the Student Paramedic Podcast. She reveals what inspired her to start the podcast, how it has evolved, and how managing it has enriched her paramedic practice. Please check out her fantastic podcast here: https://podcasts.apple.com/us/podcast/the-student-paramedic-podcast/id1538672787
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This is the first in the four-part series on anatomical trauma with some of the world's leading experts on specialist pre-hospital care.
In today's episode, we delve into the complexities of assessing and treating thoracic injuries in pre-hospital care. We'll cover a range of topics, including pneumothorax, haemothorax, and flail chest. Our discussion will span the primary and secondary survey, airway management considerations, and the efficacy and evolution of modern interventions such as needle decompression. To bring these concepts to life, we'll examine real-life cases that highlight the challenges faced by healthcare professionals in the field.
Joining me is Geoff Healey, a distinguished Prehospital and Retrieval Physician with Sydney HEMS. Geoff also serves as a Consultant Anaesthetist at Royal North Shore Hospital in Sydney and the Deputy Medical Manager for Sydney HEMS. With extensive experience in Australia's and the UK's Prehospital and Retrieval Systems, Geoff brings invaluable insights into our conversation. Additionally, he is an active member of the NSW Taskforce Urban Search and Rescue Team and has been deployed on numerous humanitarian missions worldwide. We unpack the intricacies of thoracic trauma management in pre-hospital settings, guided by Geoff's expert knowledge and frontline experiences.
In today's episode, we'll explore some of the key resources around breaking bad news and innovative approaches to building compassionate systems and individuals. Our guest shares her insights on the latest trends and best practices in breaking bad news and treatment of PTSD. We also explore some of the key resources available on EmergencyResilience.com, including Alex's organic story, breaking bad news and the fundamental elements of how to do this well. We also examine PTSD and the use of ketamine therapy based on Alex's PhD thesis.
Alexandra Jabr is an accomplished emergency medical professional, educator, and advocate for mental health and resilience among first responders. With a career spanning over two decades, Alexandra has dedicated her life to the service of others, specialising in EMS and paramedic training. Her extensive experience in the field, coupled with a Master's degree in Mental Health and Wellness with an emphasis on Grief and Bereavement in first responders. Her PhD focussed on the use of Ketamine integrative therapy to treat PTSD in Firefighters.
In addition to her fieldwork, Alexandra is a passionate educator, teaching numerous EMS courses that prepare the next generation of emergency responders with practical, real-world knowledge. She is also a prolific writer and speaker, contributing regularly to industry publications and websites like EmergencyResilience.com. Her work emphasises the importance of resilience, not just in physical preparedness but also in mental health and emotional endurance.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
Tracy Nicholls, Chief Executive of the College of Paramedics, joins us in this episode. With over 25 years of experience, Tracy has significantly influenced the evolution of Paramedicine, from her early days as a paramedic to becoming the first registered paramedic on an NHS Trust Board of Directors.
This conversation delves into the advancement of paramedicine over the last decade, the College of Paramedics' journey toward Royal College status, and the pressing issue of handover delays. We also explore the Paramedic Wellness Programme, the importance of International Paramedics Day, and the College's relationship with the HCPC. Mental health, especially its increasing focus in recent years, is also a key topic. Join us as we explore the past, present, and future of the paramedic profession.
In this episode, we will speak with two distinguishedguests who are leaders in critical care. Joining us from Cardiff University is Sharon Norman, the course lead for the Masters in Critical Care program at the Russell Group University. Sharon is a senior nurse by backgroundand has been instrumental in shaping the curriculum and ensuring it meets the evolving demands within critical care. From across the Atlantic, we have Adam Greene, Adam is the director of Critical Care at the British Columbia Emergency Health Services (BCEHS) in Canada. Adam brings a wealth of practical experience and insights from his extensive educational background and critical care careerspanning over 15 years.
In this episode, we will explore the intricacies of theMasters in Critical Care program, discuss the integration of technology and interdisciplinary learning and examine the career opportunities that await graduates. We'll also tackle the current challenges and future trends in critical care, offering valuable advice for those considering this demanding yet rewarding field. To find out more about the University of Cardiff's online MSc in Critical Care please see here:
https://www.cardiff.ac.uk/study/postgraduate/taught/courses/course/critical-care
This episode continues our series on traumatic bleeding, focusing on the use of blood transfusions in prehospital settings. While blood transfusions are life-saving for haemorrhagic shock, evidence on prehospital blood use is mixed. Civilian and military studies show improved outcomes with prehospital blood, but the 2022 RePHILL trial found no superiority over sodium chloride for trauma-related hemorrhagic shock - https://www.thebottomline.org.uk/summaries/icm/rephill/. Despite this, haemostatic resuscitation has evolved to be the standard care for bleeding-induced shock in the UK. Currently, only physicians in HEMS systems can administer prehospital blood under UK paramedic guidelines, with paramedics limited to using sodium chloride.
The 2007 Manchester Arena bombing inquiry considered frontline ambulances carrying blood products but deemed it infeasible for clinical and logistical reasons. It recommended that specialist teams, such as the Hazardous Area Response Team (HART), carry freeze-dried plasma. Southwestern Ambulance Service HART has since trialed Lyoplas.
This episode discusses paramedic-administered blood products outside of HEMS systems, featuring Dr. Peter Chesney, Lt. Col. (retired) Randy Shaffer, and Dr. Chesney, a pediatric emergency physician and medical director in South Florida. Lt. Col. Shaffer, a former Emergency and Trauma nurse in the U.S. Army, established prehospital programs and walking blood banks during her deployments and has since worked on regional blood coalition initiatives. Dr. Chesney, a seasoned trauma surgeon, has received numerous accolades, including the Outstanding Clinical Research Achievement Award, and co-founded the international damage control resuscitation educational program.
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This podcast is sponsored by the University of Hertfordshire.
The University of Hertfordshire’s MSc Advanced Paramedic Practice offers flexible, part-time study with some online options. Students can choose between two pathways: Primary and Urgent Care or Emergency and Critical Care. The program includes modules in leadership, coaching, and independent prescribing. Expert, research-active staff with national and international profiles deliver innovative teaching using online, VR, and simulation technology. With over 25 years of heritage, the program promises excellent career prospects and opportunities for further research through Masters by research and PhDs. Please see here for further details:
https://www.herts.ac.uk/courses/postgraduate-masters/msc-advanced-paramedic-practice2?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
In this episode, we will look at the innovative Walking BloodDonor program as a collaborative effort between the Canadian Armed Forces and Canadian Blood Services. This program has revolutionised the way blood is provided to troops deployed in remote and austere environments. Today's guest will take us behind the scenes, explaining how troops are pre-screened and readied to become walking blood donors. We'll delve into the intricate logistics of collecting, processing, and administering whole blood transfusions in the field.
To do this I am joined by Lieutenant Colonel AndrewBeckett, MD. Andrew is a highly experienced trauma surgeon and critical care physician in the Royal Canadian Medical Services. He has served on multiple overseas military missions, providing lifesaving care in austere environments. Andrew’s research interests include massive transfusion, combat casualty data management, and military simulation training. Currently an assistant professorof surgery at McGill University, he plays a vital role in advancing battlefield medicine and ensuring optimal care for wounded soldiers. To read more on this program please see here: https://www.blood.ca/en/stories/blood-war-zones-canadas-contributions-and-ongoing-support-soldiers-who
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This podcast is sponsored by the University of Hertfordshire.
The University of Hertfordshire’s MSc Advanced Paramedic Practice offers flexible, part-time study with some online options. Students can choose between two pathways: Primary and Urgent Care or Emergency and Critical Care. The program includes modules in leadership, coaching, and independent prescribing. Expert, research-active staff with national and international profiles deliver innovative teaching using online, VR, and simulation technology. With over 25 years of heritage, the program promises excellent career prospects and opportunities for further research through Masters by research and PhDs. Please see here for further details:
https://www.herts.ac.uk/courses/postgraduate-masters/msc-advanced-paramedic-practice2?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
In this episode, we'll delve into the organisational culture of ambulance services; and the unwritten rules, beliefs, and behaviours that shape how we work. From KPIs to mission statements to crew room dynamics, to the disparate social work hours of pre-hospital care. We unpack the insights of what truly makes this unique workplace tick. Joining me is Carl Betts, a fellow co-host of the Pre-Hospital Care Podcast and the Quality Improvement lead for a UK Ambulance Service. We hope you find this conversation both informative and helpful.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This podcast is sponsored by the University of Hertfordshire.
The University of Hertfordshire’s MSc Advanced Paramedic Practice offers flexible, part-time study with some online options. Students can choose between two pathways: Primary and Urgent Care or Emergency and Critical Care. The program includes modules in leadership, coaching, and independent prescribing. Expert, research-active staff with national and international profiles deliver innovative teaching using online, VR, and simulation technology. With over 25 years of heritage, the program promises excellent career prospects and opportunities for further research through Masters by research and PhDs. Please see here for further details:
https://www.herts.ac.uk/courses/postgraduate-masters/msc-advanced-paramedic-practice2?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
In this episode, we examine the upcoming Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP), a stepped wedge randomised trial evaluating the use of the National Institutes of Health Stroke Scale (NIHSS) for stroke screening by paramedics in ambulances. The study aims to enhance early stroke identification and triage, potentially improving outcomes through faster, more accurate prehospital diagnosis and treatment initiation. By training paramedics to utilise the NIHSS, the project seeks to streamline the care pathway, ensuring stroke patients receive timely and appropriate care, thereby reducing the time to treatment and improving overall patient prognosis.
To do this we have Dr. Maren Ranhoff with us. Maren is a consultant physician in neurology at Oslo University Hospital and an associate professor. She spearheads the Acute Brain Programme, a critical initiative aimed at enhancing neurological care. This programme is designed to streamline the entire process of neurological emergency care, from dispatch to on-scene assessment, triage, and seamless communication during patient handovers. Maren's leadership has been instrumental in fostering a multidisciplinary approach that improves patient outcomes and sets new standards in neurological emergency and pre-hospital management.
In addition to her work with the Acute Brain Programme, Maren is deeply involved in stroke research and innovation. Her research focuses on developing advanced diagnostic tools and therapeutic strategies to improve the treatment and recovery of stroke patients. Dr. Maren's innovative work in stroke care includes the development of rapid response protocols and the integration of cutting-edge technology to enhance the precision of stroke diagnosis and treatment.
In this podcast, we will delve into the team’s remarkable achievements and the profound impact of Maren's work in the field of neurology and pre-hospital care together with the ParaNASPP study. For more information see here:
https://pubmed.ncbi.nlm.nih.gov/35120559/
This podcast is sponsored by the University of Hertfordshire.
The University of Hertfordshire’s MSc Advanced Paramedic Practice offers flexible, part-time study with some online options. Students can choose between two pathways: Primary and Urgent Care or Emergency and Critical Care. The program includes modules in leadership, coaching, and independent prescribing. Expert, research-active staff with national and international profiles deliver innovative teaching using online, VR, and simulation technology. With over 25 years of heritage, the program promises excellent career prospects and opportunities for further research through Masters by research and PhDs. Please see here for further details:
https://www.herts.ac.uk/courses/postgraduate-masters/msc-advanced-paramedic-practice2?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
In this episode, we delve into the Ten Second TriageTool (TST) to understand its performance in action. We explore the development and impact of the NHSE Major Incident Triage Tools (MITT & TST), designed to prioritise life-saving interventions quickly and effectively. Our guest provides insights into how these tools are transforming emergency response, training for responders, and real-world applications. Discover how these advancements are setting new standards in trauma care and emergency preparedness.
Joining us is Dr. Philip Cowburn, Consultant in Emergency Medicine, Medical Director for South Western Ambulance Service, and co-author of the new 10-second triage tool for mass casualty incidents. Phil is a consultant in Emergency Medicine working at both Trusts in Bristol and co-founded the Great Western Air Ambulance service. With over a decade of experience in ambulance service medical directorate roles, he also serves as the medical advisor for the National Ambulance Resilience Unit. Dr. Cowburn hasbeen instrumental in implementing clinical practice changes from the Manchester Arena Inquiry recommendations and is active in the Faculty of Pre-Hospital Care in both Immediate Medical Care and Major Incident Management examinations.
Here is an excellent episode from the Resus Room team on Major Incident Triage featuring Phil Cowburn: https://podcasts.apple.com/gb/podcast/major-incident-triage/id1090433226?i=1000659333727
TST resources can be found here:
https://naru.s3.eu-west-2.amazonaws.com/wp-content/uploads/2023/05/03211731/naru-tst-non-clinical-responders-supplementary-information.pdf
This podcast is sponsored by The University of Hertfordshire:
The University of Hertfordshire offers both undergraduate and postgraduate courses in Paramedic Science, emphasising specialist teaching spaces, innovative simulation technology, and a dedicated paramedic teaching team. Students benefit from ambulance placements with LAS and EEAST ambulance services and the university's proximity to London and major transport links. The research-active staff, boasting national and international profiles, enhance the learning experience. The program, with over 25 years of heritage, uses cutting-edge online, VR, and simulation technology to support learning. Career prospects for graduates are excellent, with opportunities to pursue Masters by research and PhDs also available. Please see here for further details:
https://www.herts.ac.uk/courses/undergraduate/paramedic-science
https://www.herts.ac.uk/courses/postgraduate-masters/msc-paramedic-science-pre-reg
In this episode, we delve into The EXIT Project, an initiative founded by Tim Nutbeam and Rob Fenwick, aimed at improving spinal care, indications for spinal immobilisation and patient outcomes in road traffic incidents and other axial load injuries. The project employs scientific rigour and trial methodology to develop effective strategies for emergency medical services. By collaborating with a range of professionals, including researchers, medical practitioners, and emergency responders, The EXIT Project focuses on both research and practical applications to enhance road safety, clinical guidelines and ultimately clinical practice.
Tim discusses the innovative approaches the project takes to tackle the complex challenges of post-collision care. This includes the implementation of advanced triage systems, the use of data analytics to identify patterns and improve response times, and the development of training programs for emergency personnel. The project’s findings have led to significant improvements in the way road traffic incidents are managed, ultimately saving lives and reducing the severity of injuries.
Tim and Lisa also explore the broader impact of The EXIT Project's work, highlighting how their research and methodologies are being adopted by emergency services worldwide. The discussion provides insights into the importance of integrating scientific research with practical emergency response strategies, emphasising the project's role in shaping the future of road safety and emergency medical care.
For more details, visit The EXIT Project.
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This podcast is sponsored by the University of Hertfordshire:
The University of Hertfordshire offers both undergraduate and postgraduate courses in Paramedic Science, emphasising specialist teaching spaces, innovative simulation technology, and a dedicated paramedic teaching team. Students benefit from ambulance placements with LAS and EEAST ambulance services and the university's proximity to London and major transport links. The research-active staff, boasting national and international profiles, enhance the learning experience. The program, with over 25 years of heritage, uses cutting-edge online, VR, and simulation technology to support learning. Career prospects for graduates are excellent, with opportunities to pursue Masters by research and PhDs also available. Please see here for further details:
Undergraduate Paramedic Science: https://www.herts.ac.uk/courses/undergraduate/paramedic-science?utm_campaign=ug_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
MSc Paramedic Science Pre-Reg: https://www.herts.ac.uk/courses/postgraduate-masters/msc-paramedic-science-pre-reg?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
This special edition of the PHCP podcast for International Paramedic Day explores the diverse and evolving landscape of the paramedic field. Our hosts delve into the growth of roles, changes in triage systems, community engagement, interdisciplinary collaboration, technological advancements, mental health support, and future predictions.
This comprehensive discussion aims to highlight the essential role of paramedics in healthcare and the continuous evolution of the profession. We hope you enjoy. More information on International Paramedics Day can be found here: https://www.internationalparamedicsday.com/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This podcast is sponsored by the University of Hertfordshire:
The University of Hertfordshire offers both undergraduate and postgraduate courses in Paramedic Science, emphasising specialist teaching spaces, innovative simulation technology, and a dedicated paramedic teaching team. Students benefit from ambulance placements with LAS and EEAST ambulance services and the university's proximity to London and major transport links. The research-active staff, boasting national and international profiles, enhance the learning experience. The program, with over 25 years of heritage, uses cutting-edge online, VR, and simulation technology to support learning. Career prospects for graduates are excellent, with opportunities to pursue Masters by research and PhDs also available. Please see here for further details:
Undergraduate Paramedic Science: https://www.herts.ac.uk/courses/undergraduate/paramedic-science?utm_campaign=ug_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
MSc Paramedic Science Pre-Reg: https://www.herts.ac.uk/courses/postgraduate-masters/msc-paramedic-science-pre-reg?utm_campaign=pg_maincycle24&utm_medium=pre_hosp_care_podcast&utm_source=podcast&utm_id=paramedic
In this conversation, we will examine and explore the anatomy of work that a Sydney HEMS Registrar sees within their time at one of the most progressive and dynamic Air Ambulance services in the southern hemisphere. We dig into the day-to-day life, the clinical governance, the case mix and indeed the debrief that occurs within the Sydney HEMS team. We also examine some of the most significant challenges that our guest has experienced as part of that team, a team that is striving to improve and foster innovation and safer patient care. To do this we have Sam Bulford with us, Sam is a Sydney HEMS Registrar and indeed the host of the Sydney HEMS debrief podcast. You can listen to the Sydney HEMS debrief podcast here: https://podcasts.apple.com/no/podcast/podcasts-greater-sydney-area-hems/id602038154
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here:
https://www.pax-bags.com/en/
This episode is sponsored by the International Critical Care Paramedic Group (ICCPG):
The ICCPG are dedicated to advancing global Paramedicine through knowledge sharing and improved communication. Join their second conference on January 30, 2025, following the success of their 2022 event, which united over 600 paramedics worldwide. This virtual event will feature detailed case studies and in-depth clinical, training, leadership, and research discussions. Don't miss this opportunity to connect with peers and learn from international experts. For more details, contact Christian Wiggin at christian.wiggin@collegeofparamedics.co.uk
This week we are talking with Dr. Brian Burns about therange of Pre-hospital cases seen in NSW Australia. In the episode, we will explore the prevalence of trauma versus acute medical pathology, the types and patterns of injury encountered, the range and efficacy of interventions in pre-hospital care delivered and the utility of each. We will also examine the challenges of cases that are unique to Australia and also the trends that are seen within the country around blunt versus penetrating traumatic disease. We will also examine some of the challenging cases that Brian has encountered and the interplay between skills required in the pre-hospital and hospital environment.
Brian Burns is a Trauma Consultant at Royal North ShoreHospital, a clinical professor at the University of Sydney and Macquarie University and an Honorary Senior Lecturer at Queen Mary University London. Importantly, Brian is a Staff Specialist in Prehospital and Retrieval Medicine in Aeromedical Operations, NSW Ambulance.
Join me as I speak with Rob Pupelis, CEO of Spectros Medical Devices, about the latest advancements in tissue oximetry and the future of this medical technology. Rob is a leader in the development of non-invasive sensing and remote monitoring in healthcare, with a focus on shedding light on tissue health and diseases related to vascular performance.
During our discussion, we cover a range of topics, including Rob's background and involvement in this area of innovation, the current problems and leverage points in the industry, and how modern clinical practice informs future priorities regarding tissue oximetry monitoring. We also delve into Rob's innovations within tissue oximetry and how they might advance clinical and critical care, as well as the results and themes that emerged in the data when looking at tissue oxygenation.
Rob also unpacks the T-Stat Tissue Oximeter and explains why it is both more sensitive and real-time in its readings. We explore the main domains of medicine served by Spectros Medical Devices and how they could impact critical care transfers and high acuity transfers in pre-hospital care. Finally, Rob shares some take-home points that he advocates in regard to tissue oximetry monitoring. Don't miss out on this insightful conversation about the future of medical technology. To find out more about the T-Sat Tissue Oximeter see here:
https://www.spectros.com/#:
In this conversation, the author of Designing for Healthcare: The human-centred Approach, Craig Joseph joins us to discuss design processes, workflows, operations, and technologies around the person-to-person interaction which fundamentally lies at the heart of healthcare and human factors.
Craig states that currently chronic disease management,medical bankruptcy, and equitable outcomes are just a few areas that need a major overhaul within healthcare (within the US). Craig posits that a human-centred approach to managing health, preventing disease, and treating illness can create a more effective and equitable system. In the conversation, we also examine the in-built biases that we can carry through to our decision-making, as well as 6 key principles that Craig advocates to enable safer patient care and mitigate human factors. You can find the book here:
https://www.nordicglobal.com/what-we-think/insights/designing-for-health
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
This Podcast is now live on YouTube, please find the interview here:
https://www.youtube.com/channel/UCLAvKkahY34gXTJ5JjLw7DA
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine the percentage andgrowth of females in Pre-Hospital Emergency Medicine (PHEM). We also examine the diversity within the UK context and how this has slowly but surely grown and affected the workforce for the better within pre-hospitalcare. We also discuss the hierarchy of competence, barriers to entry and some of the covert and overt challenges that women have faced to enter PHEM.
To do this I have Ffyon Davis with me. Ffyon is an emergency medicine registrar and expedition doctor with a special interest in PHEM. She is also a World Extreme Medicine (WEM) faculty member and avid explorer. The empirical paper mentioned within the episode on outcome data can be found here: https://pubmed.ncbi.nlm.nih.gov/37647075/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
To watch this episode on YouTube please see here: https://youtu.be/R6MIhCFYfYg
In this episode, I will be speaking with Ani Naqvi. Ani is an Executive Transformation Expert and Mentor who guides leaders towards productivity, self-care, and finding purpose. Her remarkable experiences, including surviving the 2004 tsunami, have shaped her holistic approach to personal and professional growth. Ani's remarkable personal experiences of battling cancer, and surviving a tsunami, combined with her expertise in Executive Transformation, offer a unique perspective on finding purpose, cultivating resilience, and fostering positive intelligence. To find more about Ani's work, please see here:
https://ultimateresultsgroup.com/
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
This Podcast is now live on YouTube, please find the interview here:
https://youtu.be/1CexnsxEY9g
In this conversation, we will examine the utility andinnovation of virtual reality training as a tool for paramedic practice. We will examine the engagement with VR technology, which areas of education it can support, the reflections from students, Virtual Reality versus reality in an academic sense, the assessment process online and much more.
To do this I’m speaking with Sam Willis. Sam is a seniorparamedic lecturer at Charles Darwin University and the lead for VR-related educational concepts. Sam is also conducting his PhD in this area. You can find out more about this innovative project here: https://www.cdu.edu.au/news/vr-experience-gets-paramedicine-students-connected
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
This Podcast is now live on YouTube, please find the interview here:
https://youtu.be/9CfaMMHBQ_w
In this episode, we have the privilege of interviewing Jack Mannings, the Spinal Injury Association (SIA) support coordinator for London. Jack shares his authentic story of having a spinal cord transection at C5 from a road traffic incident that left him tetraplegic. He speaks from his experience both pre and post-injury, shedding light on his rehabilitation journey and involvement in the SIA network.
It's inspiring to see Jack's resilience and dedication to helping others who have gone through similar experiences. We encourage you to check out the excellent work that the SIA does by visiting their website: https://spinal.co.uk/
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
This Podcast is now live on YouTube, please find the interview here:
https://youtu.be/Z-AbysOl5zM
Preventing dementia and Alzheimer’s disease is apriority for many. According to the World Health Organisation (WHO) there are currently more than 55 million people suffering from dementia worldwide, and nearly 10 million new cases each year. It is also currently the seventh leading cause of death and one of the major causes of disability and dependency among older people globally.
To speak about this I’m speaking withthe Vice Presidentof Clinical and Medical Affairs for Cognivue, Dr Ernest Fung. Ernest is committed to Alzheimer's prevention through cognitive health promotion and early detection. Cognivue provides cognitive assessment tools to healthcare providersfor the early detection of cognitive impairment, allowing patients to address modifiable risk factors sooner. With a background in molecular diagnostics and life sciences, Ernest Fung is a board-certified clinical neuropsychologist and a diplomate of the American Board of Clinical Neuropsychology. With a career spanning over a decade, Dr. Fung has collaborated with physicians from multipledisciplines to assess and treat individuals with central nervous system (CNS) disorders. To find out more about the rapid 10-minute tests see here:
https://cognivue.com/
PHCP Question Time: We are collecting your questions to discuss on upcoming episodes. Please use this email to email the show and we will discuss your questions:
Prehospitalcarepodcast@hotmail.com
This Podcast is now live on YouTube, please find the interview here:
https://youtu.be/Ea8ZWy5LRHQ
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine what is involvedwith the application and benefits of becoming a University Ambulance NHS Trust. As of the start of April of this year, the Trust is now known as the Welsh Ambulance Services University NHS Trust. The sought-after status has beengranted by the Welsh Government in recognition of WAST’s commitment to develop its current and future workforce and to drive research and innovation.
To do this I have Jason Killens with me. Jason is theChief Executive of the Welsh Ambulance Services University NHS Trust, which is the national provider of 999, 111 and non-emergency patient transport services for Wales. Please enjoy this wide ranging conversation about the progressive steps of this academic innovation. To read more on this please see here:
https://ambulance.nhs.wales/news/nhs/2024/welsh-ambulance-service-awarded-university-trust-status/
We are also on YouTube. You can also watch this episode on YouTube here:
https://youtu.be/PrVv7Y_3CvQ?si=e4vaamkF7peO0RG1
In this episode, we dig into the life of a fast jet pilot with Paul Heasman. Paul speaks candidly about Crew Resource Management (CRM), the line between training and instinct, OODA loops, decision making, and much more.
Paul joined the Air Force in 1999 and went through training through various aircraft types. Paul then flew the Tornado F3 from RAF Leeming for three years before being selected for instructional duties. He progressed to RAF Valley on Anglesey, spending eleven years flying the Hawk Trainer, initially the Hawk T1 before being selected to bring the Hawk T2 into service. It was at this time Paul became interested in human performance and became an RAF aircrew performance coach. Recently, with Draken, Paul became a CAA CRM instructor for the business and facilitated CRM discussions as part of aircrew routine training. To follow Paul, please see his Instagram here: www.instagram.com/this_is_air2air
In this conversation, we will examine the role of AIwithin pre-hospital care. We will also look at how AI is being embedded within the systems and processes from dispatch algorithms to diagnostics to demand profiling. We also look at the future of AI and where it might support patientcare.
To do this I have Nico Preston with me, Nico is ascientist and paramedic with a background in health, technology, and innovation. He has 15 years of experience with complex emergencies, emergency medicine, infectious disease, natural disasters, supply chains, and toxic drugsand a career spanning non-profit, academic, government, and corporate sectors.
In this conversation, we will examine Patient Liaisonand follow-up. Pre-hospital clinicians are often just the first point of medical contact, so checking in throughout the rehabilitation allows clinicians and patients to close the loop on any unanswered questions and often is a chance to learn about things from the patient’s perspective. This fosterscontinuous improvement by identifying strengths, weaknesses, and areas for improvement. Additionally, ongoing liaison both humanises patients and builds trust & rapport with clinicians and can bring closure for EMS personnel who often only witness the initial phase of patient care. Knowing patient outcomes and recovery status can improve job satisfaction.
To do this we have Stuart Plumbley and Sarita Taneja withme. Stu is the Patient and Family Aftercare lead at Kent Surrey and Sussex (KSS) Air Ambulance Trust, Emeritus HEMS Paramedic, & Critical Care Paramedic (SECAmb). Sarita is the Patient and Family Aftercare Manager at KSS and was awarded Charity Staff Member of the Year at the Air Ambulances UK Awards of Excellence in 2022. KSS as a service can be found here:
https://aakss.org.uk/
Join me in this episode where I speak with Mike Donal. We unpack his journey through growing up, dropping out of school, drug use, mental health, self-harm, suicidal attempts, steroid use, sex, and mental health section in a hospital, all before 21 years old. We also look at Mike’s journey through the gym, alcohol, relationships, tattoos, and steroids.
Mike shares his 180-degree turn to cleaning everything up and influencing others for the better as well as his current revelations on health, faith, and a balanced mindset. We discuss the theme of selfishness and where that comes from, mental health issues such as addiction to pain and torment, self-harming, the gym, self-loathing and coping mechanisms, steroids, and the second-order effects of steroids.
Mike also talks about his children, Amber and Ezra, and how they played a significant role in his change. Join us as we unpack Mike's story and take-home messages.
In this episode, we speak with Professor Mark Wilson about the forthcoming SIS trial. This randomised study aims to compare the safety and patient outcomes of the current spinal immobilisation practice versus a more flexible "movement minimisation" approach for suspected spinal injury patients. The findings could inform future clinical guidelines.
The main concepts of the trial include assessing if "movement minimisation" is no worse than the current standard "triple spinal immobilisation" for patients suspected of spinal injury in pre-hospital and emergency settings. Current practice of triple spinal immobilisation (rigid board, straps, neck collar) may have potential harms like breathing difficulties, skin/brain injury. Movement minimisation allows more flexibility and comfort, but its safety/efficacy compared to triple immobilisation is unknown. Around 8,316 patients will be randomly assigned to either movement minimisation or triple immobilisation groups. Their neurological function, complications, and long-term well-being will be assessed. The study involved spinal injury and trauma patient groups (ASPIRE, Imperial Trauma PPI) in design, emphasising the need for research before guideline changes.
Results will be shared internationally with patients, the public, paramedics, doctors, and nurses through conferences, social media, reports, and publications to inform future NHS guidelines. More information on the trial can be found here: https://warwick.ac.uk/fac/sci/med/research/ctu/trials/sis/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will look at the relationship between Paramedic theory and practice with Vince Clarke. We will dig intoVince’s doctorate in Education on the subject, various frameworks for the acquisition of skills through simulation, reflective models of learning, the progression from novice to expert, directive versus facilitative learning, theory/practice conceptual frameworks, and finally, student views and where they perceive learning originates.
To do this I have Vince Clarke with me, Vince has been a paramedic since 1998, progressing on to an IHCD tutor. As well as completing an undergraduate degree in Paramedic Science, he has completed a master’s degree in health law and ethics in Practice and a Doctorate in Education. He is currently the principal lecturer at Hertfordshire University Paramedic Science Program, the trustee for education with the College of Paramedics, and an external advisor to several organisations. Vince's thesis can be found here:
https://uhra.herts.ac.uk/bitstream/handle/2299/21089/99008890%20Clarke%20Vince%20final%20version%20of%20submission.pdf?isAllowed=y&sequence=1
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will look at the life of an Advanced Clinical Practitioner (ACP). We will dig into what the training looks like, the autonomy involved, the various specialisms you can take, what Dan has learnt along the way and much more. As more and more alternative career pathways are opening, we explore if this one is an attractive option. We also look at the alignment to the Royal College of Emergency Medicine (RCEM) curriculum and how this shapes Dan's practice, skills and clinical decision making. ACPs play a vital role in the delivery of emergency care across the UK. They now make up over 10% of the college membership. There are over one thousand ACP members and this number is rapidly increasing. ACPs are represented on all major RCEM Committees.
We also examine some of the educational expectations outside of the RCEM curriculum to fulfil the role as an ACP and also some of the various clinical backgrounds that ACPs come from. To find out more about the ACP role you can visit the RCEM website, menu, - training / careers/ Advanced Clinical Practitioner https://rcem.ac.uk/emergency-care-advanced-clinical-practitioners/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this episode, I will be speaking with Jay Baldwin. At 26 Jay had suffered bilateral leg amputations from an IED whilst serving in the British army in Afghanistan. He was medically discharged from the UK military at 28, divorced at 32 and battled and won cancer at 33. Since being medically discharged from the Army, the dad of six has learned to walk on prosthetic limbs, has retrained as a fitness instructor and has truly inspired many. He is currently the UK’s only double amputee personal trainer. You can find Jay on social media @
https://twitter.com/NoLeggedNinja1
Join us for an insightful conversation with Robbie Maiden, a lifeboat coxswain, as he shares his journey from being embedded in a culture from a young age to becoming a leader in the austere lifeboat setting. With no formal leadership training, Robbie has developed his skills through experiential learning and personal growth. Robbie has held the position of coxswain for 27 years but has life boating in his blood.
In today’s episode, we will discuss what skill set you need to lead volunteer crews in the austere environment of the North Sea when the chips are down and how previous experiences have formed and morphed Robbie’s leadership style and skill set over the years. Robbie's storytelling skills shine through as he offers listeners words of wisdom from his experiences, both good and bad.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation we discuss the future of pre-hospital maternity care with three leading consultant midwives from UK NHS ambulance services. Dawn Kerslake, Stephanie Heys, and Camella Main are experts in their field and will provide valuable insights into this critical area of pre-hospital care.
During the podcast we explore the education and training of paramedics in maternal care, current governance systems, and patient follow-up and support mechanisms in place. We also discuss the necessity and dearth of pre-hospital maternity research. This is an excellent opportunity to learn from the best and gain insights into the future of pre-hospital maternity care. The educational resources and research that are mentioned in the episode can be found here:
https://pubmed.ncbi.nlm.nih.gov/36531803/
https://www.promptmaternity.org/pre-hospital-prompt
https://www.ncbi.nlm.nih.gov/books/NBK525996/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine human performance,some of the fundamental components of performance, models of performance, and how we train versus how we perform. We will also examine the importance of psychological safety, and the interplay between performance, standards, and behaviour. We also speak around the concept of culture as an enabler for performance.
To do this I have Tom Hurst with me. Tom is the MedicalDirector of London’s Air Ambulance (LAA), he is also a Consultant in Intensive Care Medicine (Critical Care) at King's College Hospital London. He is also a Consultant in Pre-Hospital Emergency Medicine at London HEMS, Bart's Health. Tom’s practice covers a wide range of general critical care as well as neurosciences, cardiovascular, major trauma and ECMO.
To learn more about LAA and its people, please see here: https://www.londonsairambulance.org.uk/
To donate to their cause and work please see here: https://www.londonsairambulance.org.uk/donate
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will unpack the International Journal of Paramedicineand the original vision for the journal. We willalso look at the reach of the journal and the different sections of the journal yet to launch. We also examine the interaction with the journal as it looks to create discussion and research ideas and how people can get involved in the journal team amongst much more.
To do this I have Mic Gunderson with me. Mic has been involved in EMS since 1975 in various clinical, teaching, leadership, and consulting roles. He is currently the President of the Center for Systems Improvement, the EMS Quality Academy, and the Chief Strategy Officer for the Cambridge Consulting Group. Mic also serves as the Editor-In-Chief of the International Journal of Paramedicine, which is published by the National EMS Management Association in the United States. The journal can be found here:
https://internationaljournalofparamedicine.com/index.php/ijop/index
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this episode we are speaking with London HEMS Paramedic Keiren Rodwell. We dig into Keiren's background from working as a paramedic student in New South Wales, to working for the London Ambulance Service LAS in north east London. Keiren joined London Ambulance Service straight out of university in February 2018. We speak about the death of two of Keiren’s extended family whilst protecting their family from the wild fires in Australia. We dig into what a typical day looks like in London's Air Ambulance (LAA) and also Kerien's journey to this point. We also examine the fundamental differences between pre-hospital care in Australia to the UK.
Around 25 per cent of LAS paramedics are Australian. The Service first began a recruitment campaign to attract Australian paramedics in 2014. At the time a national shortage of paramedics in the UK meant that the LAS looked to Australia because alignment of skills and training to UK practice.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation we will examine the current stateof play within UK military medicine, the demographics of modern military capability; that of deployable role 1, 2 and 3 hospitals within the field. We will also examine the lessons learnt from recent conflicts and how they might inform the military medicine of the future. We look at analogues of comparison from the last major British involvement in conflict within Iraq and how innovative aero-medical retrieval (MERT) and damage control surgery from seminal cases such as Camp Bastien can inform future care. We look at the increase in trended patterns of non-combatant injury from drone and missile strikes (that of blastinjuries), the ever-present risk of IED insult and injury and finally how we might leverage near-term adaptations of pre-hospital/MERT capabilities for future deployment.
To do this we have Major General Tim Hodgetts with us. Timis the current serving Surgeon General of the United Kingdom Armed Forces, the Master General of the Army Medical Services, and the elected Chair of the Committee of Chiefs of Military Medical Services in NATO. His clinical background is a Professor of Emergency Medicine. Originally qualifying from Westminster Medical School, commissioned in the Royal Army Medical Corps,through to his present-day role of Surgeon General, and is the senior technical authority for all clinical matters in defence.
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we speak with Australian emergency physician Dr. Ben Mckenzie. Ben has developed the AMAx4 algorithm as a streamlined approach to recognising and treating anaphylaxis after the tragic death of his 15-year-old son Max Mckenzie. Ben has helped standardise best practices for this life-threatening emergency. Promptly following the AMAx4 steps is vital for patient survival in the initial minutes of anaphylaxis until emergency medical services arrive.
Anaphylaxis is a severe, potentially fatal allergic reaction that requires prompt adrenaline to optimise survival outcomes. AMAx4 emphasises key steps that should be taken as soon as anaphylaxis is identified. The simplified, structured sequence helps reduce treatment delays, improves outcomes, and has been endorsed by major allergy organisations as an evidence-based protocol.
*** Please note, that you should adhere to local guidelines and protocols and remain compliant to these when practising pre-hospital care. Only practice the above algorithm with the support of your institution.'
For more information please find the protocol here: https://litfl.com/amax4-algorithm/
And here:
https://www.amax4.org/
This podcast is sponsored by PAX.
Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid-access to deliver the right gear at the right time to the right patient. To see more of their innovatively designed product range please click here:
https://www.pax-bags.com/en/
In this conversation, we will examine how trauma is both managed and reported on throughout Scotland. The Scottish Ambulance Service (SAS) receives over 1.5 million calls a year and responds to over 500,000 emergency incidents per year. In the episode, we will discuss The Scottish Trauma Audit Group (STAG) as a national audit group within the Scottish National Audit Programme of Public Health Scotland. STAG measures and is tasked to improving the quality of care, overall experience, and long-term outcome of patients with significant injuries throughout Scotland. We will also examine the Advanced Practitioner in Critical Care scheme in Scotland and how it has developed, how it is managedand some of the recent adaptations according to need throughout Scotland. We will also look at the need for key interventions when critical care is not available.
To do this I am speaking with Martin Esposito. Martin is a Consultant Paramedic for Major Trauma within SAS. In this role, he is the lead for all the major trauma work within SAS and also line manages the Advanced Practitioners in Critical Care. As well as trauma, is has a special interest in Pain Management and is the SAS lead for pain management as well as an Honorary Tutor at Cardiff University.More information on STAG can be found here: https://www.stag.scot.nhs.uk/
We look forward to seeing you in 2024. Happy New Year!
Eoin
This is a selection of 10 of the most downloaded episodes of 2023. In this episode, we hear from:
- Major Incident Management with Keir Rutherford and Alec Wilding.
- The future state of Pre-Hospital Care with Jason Killens.
- Safe Sedation of Acute Behavioural Disturbance with Tim Edwards.
- Addiction part 3 with Dr Brian Hall.
- Paramedic Burnout with Liz Thyer
These conversations were the last 5 of the ten most downloaded episodes of 2023. Needless to say, I learnt a lot from every guest on the podcast and feel privileged to have interviewed some great clinicians, guests and professionals on the podcast. Please feel free to reach out to me with feedback on the podcast and also feel free to rate, review and subscribe to the podcast wherever you get your podcasts. My thanks again for a great year and all the engagement along the way. If you have any feedback, suggestions and/or comments, please feel free to reach out to be at eoinwalker@hotmail.com
Happy 2024!
Eoin
6ntc23zu
This is a selection of 10 of the most downloaded episodes of 2023. In this episode we hear from:
- The UKISAR deployment to the Turkey earthquake disaster with Deb Swann.
- The Ten Second Triage Tool (TST) with Claire Park.
- The Pre-Hospital Airway with John Chatterjee.
- Pelvic Trauma with Ash Vasireddy.
- High-Fidelity Training with Neel Bhandari.
These conversations were 5 of the ten most downloaded episodes of 2023. Needless to say, I learnt a lot from every guest on the podcast and feel privileged to have interviewed some great clinicians, guests and professionals on the podcast. Please feel free to reach out to me with feedback on the podcast and also feel free to rate, review and subscribe to the podcast wherever you get your podcasts. My thanks again for a great year and all the engagement along the way. If you have any feedback, suggestions and/or comments, please feel free to reach out to be at eoinwalker@hotmail.com
Merry Christmas to everyone!
Eoin
In this conversation, we will examine some of the contemporary reflections on the Ukraine crisis with David and Shawn. We will examine what it is currently like on the ground, some of the emerging needs and how David and Shawn believe they can be met. We will also dig into David and Shawn’s background in Ukraine and how this has evolved. We will look at our guest's anecdotal reflections on the conflict currently and some of the main factors that have changed and some that have remained over time such as the Ukrainian resiliency and mindset.
To support Medics 4 Ukraine please see here: https://worldextrememedicine.com/blog/humanitarian-medicine-posts/medics4ukraine-fundraising-appeal/
In this conversation, we will be looking at the currentguidelines on the pre-hospital management of drowning and the academic research that underpins these principles. We will explore the epidemiology of drowning and examine patient outcomes as a group. We will also discuss the important wider efforts in public awareness and prevention.
To do this, we have Mike Tipton with us. Mike is a householdname in the surf lifesaving community and is one of the leading UK academics on drowning. He currently leads the extreme environmental laboratory at the University of Portsmouth. He has spent over 40 years working in thermoregulation, environmental and occupational physiology. This includes as a survival and thermal medicine consultant to the RAF and UK Sport. He has been heavily involved in the RNLI for many years, as a consultant advisor to the medical directorate. In 2018 he was awarded an MBE for services to physiological research in extreme environments.
In this conversation, we will explore some of the lessons learned through years of major incident attendance in Scotland from theEmergency Medical Retrieval Services (EMRS). We examine the Scottish Trauma Network, the demographics of healthcare in Scotland, and some of the recent and seminal major incidents that have informed EMRS’s approach. We also includesome of the lessons learnt through the Manchester bombings – that of paediatric triage and treatment in Mass Casualty incidents. We examine some of the lessons learnt through using CSCATTT, METHANE, activation and tasking, communicationsboth remotely and at site, preferred triage tools and much more.
To do this I have John Paul Loughrey with me. JP is a Consultant in Emergency Medicine at the QEUH in Glasgow and has worked with EMRS in a variety ous roles since 2011. He is the Major Incident lead for ScotSTAR and is Vice-President of the Royal College of Emergency Medicine. In addition, his other main professional interests include major trauma care, teaching and training and organising large-scale CPD events and conferences.
Reflex Medical
This podcast is sponsored by Relex Medical. Whether you need syringes and steri-strips or Littmann stethoscopes and advanced life support training manikins, Reflex Medical are here to help. When you’re restocking your ambulance or checking your paramedic equipment list there is only one place you need to go for your medical supplies – Reflex Medical. To see more of their innovative diagnostics and medical devices please click here:
https://reflexmedical.co.uk/
Discount Code: PHCP10
The above code will give you 10% off Reflex Medical web prices, this excludes sales items and can't be used in conjunction with other discounts.
Celox Medical
This podcast is sponsored by Celox Medical. Since 2006 when Celox granules were first introduced, Celox trauma products have been used to save the lives of soldiers and civilians alike. In 2008, the third-generation haemostat Celox Gauze became the UK MoD product of choice and was used to save lives in the recent conflicts in Iraq, Afghanistan and Ukraine.
Now Celox Rapid Gauze takes over as the product of choice and will be used on the front line by all branches of the armed forces. To see more of their innovative haemorrhage control products please click here: https://www.celoxmedical.com/
In this conversation, we will examine the concept andthe reality of psychological burnout among Paramedics. The effects of burnout are estimated to cost over $300 billion annually, with the WHO forecasting a burnout pandemic in the next decade. Within pre-hospital organisations, burnout can generate reduced quality, high absenteeism, increased turnover rates and substandard productivity. In the conversation, we examine the definition of burnout, the factors that increase the risk of burnout, models of burnout, the symptoms of burnout, possible mitigation strategies to avoid burnout, some of the emergent themes from the research and much more. To do this I have Liz Thyer with me. Liz is an Associate Professor in the WSU Paramedicine program and Associate Dean (Learning and Teaching) for the School of Health Sciences. She was an advanced life support paramedic with Ambulance Victoria for 11 years including roles as a clinical instructor and peer support officer. She has previously worked at Victoria University with the Paramedic programs and at Deakin University in Learning Futures. She is an active member of the Australasian College of Paramedicine and is the inaugural chair of the ACP Professional Standards Committee. Liz Thyer's work can be found here:
Review article: Prevalence of burnout in paramedics: A systematic review of prevalence studies
https://onlinelibrary.wiley.com/doi/abs/10.1111/1742-6723.13478
Stefan De Hart's work can be found here:
Burnout in Healthcare Workers: Prevalence, Impact and Preventative Strategies
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604257/Reflex Medical
This podcast is sponsored by Relex Medical. Whether you need syringes and steri-strips or Littmann stethoscopes and advanced life support training manikins, Reflex Medical are here to help. When you’re restocking your ambulance or checking your paramedic equipment list there is only one place you need to go for your medical supplies – Reflex Medical. To see more of their innovative diagnostics and medical devices please click here:
https://reflexmedical.co.uk/
Discount Code: PHCP10
The above code will give you 10% off Reflex Medical web prices, this excludes sales items and can't be used in conjunction with other discounts.
Celox Medical
This podcast is sponsored by Celox Medical. Since 2006 when Celox granules were first introduced, Celox trauma products have been used to save the lives of soldiers and civilians alike. In 2008, the third-generation haemostat Celox Gauze became the UK MoD product of choice and was used to save lives in the recent conflicts in Iraq, Afghanistan and Ukraine.
Now Celox Rapid Gauze takes over as the product of choice and will be used on the front line by all branches of the armed forces. To see more of their innovative haemorrhage control products please click here: https://www.celoxmedical.com/
*Attention: Products shown on the podcast may not be available in all markets and product indication claim(s) may vary between markets.
In the conversation, we examine the definition of addiction,the meta-substances (stimulants, sedatives, opioids), the time horizon of an addicted person (instant gratification), the triggers of addiction, the diagnosis of dependence, what dependence means, and the types of addictions (work, sex, drugs, diet, exercise). We explore two of the most addictive substances, alcohol and tobacco, and their second-order effects on health, family, and relationships. We will also look at the complications of addiction and lastly, the modern treatments and monitoring post-treatment that can be beneficial to the individual.
To do this I have Consultant Psychiatrist Dr Brian Wellswith me, Brian specialises in Substance Disorders and has an international scope of clients. He leads a bespoke, discreet, service that works closely with most of the 'quality' addiction treatment facilities globally. His specialities include addictive disorders and medical and surgical referrals where appropriate.
A fantastic lecture on addiction from Brian can be found here: http://www.youtube.com/watch?v=VDgNj7x6FSsDr Wells can be contacted here for his services and consultation:
drbrianwells@gmail.comMy thanks to Dr Wells for a fascinating and engaging interview.
Reflex Medical
This podcast is sponsored by Relex Medical. Whether you need syringes and steri-strips or Littmann stethoscopes and advanced life support training manikins, Reflex Medical are here to help. When you’re restocking your ambulance or checking your paramedic equipment list there is only one place you need to go for your medical supplies – Reflex Medical. To see more of their innovative diagnostics and medical devices please click here:
https://reflexmedical.co.uk/
Discount Code: PHCP10
The above code will give you 10% off Reflex Medical web prices, this excludes sales items and can't be used in conjunction with other discounts.
Celox Medical
This podcast is sponsored by Celox Medical. Since 2006 when Celox granules were first introduced, Celox trauma products have been used to save the lives of soldiers and civilians alike. In 2008, the third-generation haemostat Celox Gauze became the UK MoD product of choice and was used to save lives in the recent conflicts in Iraq, Afghanistan and Ukraine.
Now Celox Rapid Gauze takes over as the product of choice and will be used on the front line by all branches of the armed forces. To see more of their innovative haemorrhage control products please click here: https://www.celoxmedical.com/
Attention: Products shown on the podcast may not be available in all markets and product indication claim(s) may vary between markets.
In this conversation, we will explore some of the nuances and challenges of Exercise Associated Collapse (EAC) with Luca Carenzo. The basis of this interview was the recent publication in the Journal of Science and Medicine in Sport of An Unusual Case of Marathon-related Exercise-associated Collapse: Case Report and Some Considerations for Medical Care at Endurance Mass Participation Events. We will explore the case and some empirically proven treatments that form the mainstay of treatment within EAC. We will also visit some of the reflections on the case and how it has changed Luca’s thinking on the list of differentials within EAC. We also examine patient-focused research, intra-speciality collaboration and EAC collated databases.
To do this I have Luca Carenzo with me. Luca is an Anaesthetic and Critical Care consultant from Milan, Italy. He previously worked at The Royal London Hospital Adult Critical Care Unit and has taken part in some mission work with Doctors without Borders. He is also a World Extreme Medicine faculty member. He currently works in theIstituto Clinico Humanitas IRCCS Humanitas · Department of Anaesthesia and Intensive Care Medicine in Milan. He also works for i-Help, a critical care mass gathering provider.
The paper in the episode can be found here:
An unusual case of Marathon-related exercise-associated collapse: Case report and some considerations for medical care at endurance mass participation eventshttps://pubmed.ncbi.nlm.nih.gov/37919145/#:~:text=This%20article%20presents%20a%20unique,immediately%20with%20CPR%20and%20AED.
This paper is also mentioned in the episode:
Sudden cardiac arrest in a marathon runner. A case report
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484937/
In this conversation, we will examine whether point-of-care ultrasound is a reliable predictor of outcome during Traumatic Cardiac Arrest (TCA). We will dig into the recently published systematic review on the topic with Tim Harris, who is one of the authors of the paper. We will examine why the authors decided to look at TCA and POCUS, the number of studies and patients examined, the type of Mechanism Of Injury (MOI) leading to TCA, what the results showed, and how this is relevant to practice. We also look at the other adjunctive markers in the pre-hospital domain to inform the Termination Of Resuscitation (TOR) based on the results found in this paper. We will also dig into another recently published paper related to the diagnostic performance of POCUS in resuscitative outcomes published in April of this year on a systematic review and meta-analysis of 3265 patients and outcomes with POCUS.
To do this I have Tim Harris with me. Tim is a Professor of Emergency Medicine and Programme Director for the Emergency and Resuscitation Medicine programme at the Blizard Institute, Queen Mary University of London. He has trained extensively overseas, training in Emergency Medicine and Intensive Care Medicine in the UK, Australia, Africa, India and Samoa. The papers we examine include:
Is point-of-care ultrasound a reliable predictor of outcome during traumatic cardiac arrest? A systematic review and meta-analysis from the SHoC investigators:https://www.sciencedirect.com/science/article/abs/pii/S0300957221003270
Diagnostic performance of point-of-use ultrasound of resuscitation outcomes: A systematic review and meta-analysis of 3265 patients:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129265/
My thanks to Tim for an engaging and insightful interview.
In this conversation, we will look at the research examining methods of safe sedation by Advanced Paramedic Practitioners within London and examine the research published on this looking at sedation of Acute Behavioural Disturbance (ABD). We will examine; what the retrospective cohort study of pre-hospital agitation management showed regarding the sedation of the ABD patient. Also, the origins of ABD according to the paper, the Sedation Assessment Tool used to measure pre- and post-intervention, the approaches that senior clinicians can take to sedate patients and more.
To do this I have Tim Edwards with me, Tim is a Consultant Paramedic with the London Ambulance Service NHS Trust and a visiting lecturer at the University of Hertfordshire. Tim has been a paramedic since 2000 and has undertaken various roles including working as a flight paramedic, senior lecturer, and advanced paramedic practitioner and is currently working as a Consultant Paramedic in London.
The study that the conversation is based on can be found here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9730188/#bibr_10
Many thanks to Tim for this conversation.
In this episode, we will explore why Thrombectomy is considered a leading stroke intervention and can contribute to the early rehabilitation and treatment of ischemic stroke. This is especially important if recognised within pre-hospital care. This is due to its effectiveness in rapidly restoring blood flow to the brain and improving patient outcome. In the episode we will explore how this intervention can restore of cerebral blood flow, the time sensitivity of the intervention, the functional recovery of patients undergoing thrombectomy, the minimally invasive approach thrombectomy takes, the collaborative care and finally the positive clinical trials showing it effectiveness.
To do this I have Kunle Ogungbemi with me.Kunle is theClinical Lead of interventional Neuroradiology at St George's University Hospitals in London. He has also a named author on a paper examining the Hub-and-spoke model for thrombectomy service in UK NHS practice. So the data suggests that for every 9-minute delay in onset to reperfusion, 1/100 patients will have more severe disability at 90 days. In the hub-and-spoke model, proposes that patients with suspected stroke are initially taken to the nearest hyperacute stroke centre (spoke). Patients with confirmed stroke caused by LVO are then transferred to the thrombectomy centre (hub) with thrombolysis started if appropriate.
In this conversation, we will examine the complex and challenging environment of toxic drug and substance misuse on the streets of Vancouver and across British Columbia. We will explore the issues of concomitant drug ingestion, the use of fentanyl, the complications of mental health and the cyclical pattern of pre-hospital presentation. We will also explore the challenges of bias towards this patient group and how that can both affect care and outcomes.
Jen Bolster is an Advanced Care Paramedic in British Columbia. She is also a Paramedic Practice Leader (PPL) within BCEHS. She has a portfolio which examines and engages with paramedic-led research into mental health, substance use and the toxic drug crisis. She advocates that paramedics are uniquely positioned to offer patients alternatives to the emergency department. Jen’s research interests include paramedic mental health and resilience, contemporary vs non contemporary leadership styles, women studies, and non-technical skills.
In this episode, we will explore reverse mentoring and challenging the status quo in quality improvement with Carl Betts. We will look at Carl’s reflections on mentorship and reverse mentorship of Quality Improvement fellows within an Ambulance service setting. We dig into how Carl leads these QI fellows but also how they lead him in innovation and ideas. The focus of reverse mentoring is to increase the mentee’s inclusion competencies; however, mentors are simultaneously provided with the opportunity to learn from their mentee’s experience, knowledge and skills so it can be considered as a career development opportunity for both parties. Reverse mentoring is an effective way to build genuine awareness of the barriers faced by ethnically diverse employees and different perceptions of leadership from the mentee’s perspective. We also dig into the assessment process for the fellowship and how Carl has flipped this on its head.
Carl Betts is the Quality Improvement lead for the Yorkshire Ambulance Service (YAS) and has been a Paramedic for over 10 years. He currently leads the fellowship program for his service. Please enjoy this wide-ranging conversation with Carl Betts, a regular contributor and guest on the podcast.
In this podcast, we will look at the benefit and utility of Methoxyflurane, more commonly known as Penthrox. Penthrox is a volatile, self-administered inhaled analgesic indicated for short-term pain relief. Penthrox is a portable, lightweight, non-invasive inhaler for self-administration of the Methoxyflurane vapour. Penthrox provides analgesia when inhaled at low concentrations giving analgesic therapeutic doses, but can also reduce and mitigate even severe pain yet has a short half-life. We will examine its use and limitations within the expedition environment and how and when it can be optimally used as either a sole adjunctive pain relief agent or as part of a larger pain relief strategy. We also get Will's reflections from use in practice and where and when Penthrox is useful.
Joining me is Dr Will Duffin, Will is the co-medical director of World Extreme Medicine and is an NHS GP. He is also an expedition, TV/film doctor and father of two. He lectures around the UK for NB Medical Education and is a digital host of the World Extreme Medicine podcast. Many thanks to World Extreme Medicine for kindly agreeing to the use of this audio.
You can find more on Penthrox here:
https://penthrox.co.uk/healthcare/simple-to-use/?
You can find more on World Extreme Medicine here:
https://worldextrememedicine.com
In this episode, we examine how to approach systems strengthening in clinical practice within the context of Sierra Leone with Aneesah Peersaib. We will look at her recent deployment to support Continued Professional Development at local, regional and national level and her role in leadership development whilst in post in Sierra Leone. We will examine how she disseminated education & training, policy, and governance and how she approached cultural change from the ground up. Finally, we will examine how she built and maintained safe systems of practice, and how you can embody a culture of educational leadership and empower coproduced with in-country clinicians to provide solutions to wider systems development work.
To do this, I'm speaking with Aneesah Peersaib. Aneesah has recently held the post of Nursing Education Advisor to Chief Nursing and Midwifery in Freetown, Sierra Leone. She collaborates across NGOs to work with the Sierra Leone Ministry of Health and Sanitation to standardise nursing education and support national strategic delivery. She has been a senior Nurse both inside and outside of the UK NHS working for Health Education England as a clinical lead and clinical advisor supporting education and workforce development across London. Aneesah is an Emergency nurse by trade and has experience leading central London Emergency departments before going on to wider systems leadership roles.
If you want to reach out to Aneesah about the episode please contact her through LinkedIn here: https://www.linkedin.com/in/aneesah-peersaib-9153725a/?originalSubdomain=uk
In this next period, we will be recording a mini-series on addiction starting with this first episode with Specialist Addiction Therapist Mark Dempster. In 2013, the Centre for Social Justice determined that the level of addiction in the UK made it the “addiction capital of Europe.” This includes the use of legal substances, mainly alcohol, and the use of Class A drugs, which include heroin, cocaine, meth, and hallucinogens. £36 billion is spent by the nation every year on treatment relating to drug and alcohol abuse. At the time of filing their report, titled 'No Quick Fix', the UK had the highest rate of addiction to opioids and the highest lifetime use of amphetamines, cocaine, and ecstasy across Europe. Many view addiction as something that only affects the users themselves but, in reality, casualties from substance abuse are taxing entire communities and society as a whole. Addiction in the UK affects everyone from loved ones to clinicians and the everyday public.
In the conversation, we examine the five stages of addiction, common cognitive pitfalls, habit Vs. addiction, and Mark's organic story through his lived experience with addiction. We also look at the 12-step process of Narcotics Anonymous (NA). Mark is a specialist addiction therapist and a recovery coach within a Harley Street Counselling Practice. He has witnessed chemical and behavioural addictions both personally and within his circle of family and friends.
Learning the practice of psychotherapy for addiction helped Mark reach out to all types of addicts, from programmes working with prisoners, helping at homeless shelters, and to wealthy bankers from Canary Wharf. According to Mark, the addict’s circumstances varied but their addictions had a lot in common. In the conversation, we also cover:
- Defining Addiction & UK stats - The health burden & impact on the individual and extended families
- Origins – how people become addicted (habit Vs addiction)
- Dual diagnosis
- The 5 stages of addiction
- The NA & AA 12-step model (origins and application)
- Common cognitive pitfalls
- Breaking the cycle – different types of therapy (CBT, DBT, ACT, +/- PET for PTSD)
- Anecdotal experiences and cases from Mark’s perspectives
You can find out more about Mark here:
https://markdempstercounselling.com/about/
You can find out more about Narcotics Anonymous here:
https://ukna.org
You can find out more about Alcoholics Anonymous here:
https://www.alcoholics-anonymous.org.uk
In this conversation, we will examine the various types of trauma scores that feature both out-of-hospital and in-hospital to measure trauma – those of anatomical, physiological and combined trauma scores. We will look at why these are important, the three broad types of trauma scores, the origins, reliability and sensitivity of these. We will also examine the pros and cons of the GCS together with the history behind the GCS. We will examine the trauma score, revised trauma score, APACHE and CRAMS scales, Abbreviated Injury Score, Injury severity score, New Injury Severity Score (NISS), TRISS (Trauma and Injury Severity Score), and finally the ASCOT (A Severity characterisation of trauma). We will also examine the limitations to these scores and also some of the more long-term reasons for use.
Mark Faulkner is a Consultant Paramedic and associate medical director with the London Ambulance Service NHS Trust, Mark is also the clinical advisor for Major Trauma within the LAS and as such sits on the Pan London Trauma Steering Group, as well as number of national trauma groups. Mark has been involved in major trauma for over 12 years, since the inception of the London Trauma System and has developed and refined the London Trauma Triage Tool. In the conversation, we examine:
-
Why we look at and create these scores.
-
The three broad types
-
The GCS – origins, sensitivity/specificity & the limitations
-
Trauma Score & revised trauma score
-
APACHE & CRAMS scales
-
AIS
-
ISS
-
NISS & TRISS score
-
ASCOT
-
Final thoughts
My thanks to Mark for an insightful and engaging conversation.
In this conversation, we will examine the current state of NHS ambulance service delivered care and how we can approach this with a different perspective. We will examine the current models of operation and how over the next 10 to 20 years this needs to be flipped on its head. We will explore the numbers of See, treat and convey versus see, treat and refer, versus telephone consult and close and how this can be flipped on its head. We will also explore how the adage of modern technology can we can meet these needs througg technology and how the progressive Paramedic Career Framework supports this through advanced urgent care practitioners & more pathways to refer patients to. We will also explore some of the innovations that Jason has initiated to work toward this goal.
Jason Killens is the Chief Executive of the Welsh Ambulance Services NHS Trust, which is the national provider of 999, 111 and non-emergency patient transport services for Wales. Jason has spent his career working in Ambulance Services in the UK and Australia. He progressed through the ranks in London Ambulance Service from an Emergency Medical Technician to Executive Director of Operations. He was appointed as the Chief Executive of the South Australia Ambulance Service in 2015 before joining the Welsh Ambulance Service as Chief Executive in September 2018. In the conversation, we examine:
- Jason’s journey through healthcare
- The current state of activity
- The future state of activity
- Why hear and treat has come to the fore.
- Risks of this proposed model
- How modern tech supports this vision
- The Paramedic Career Framework and how this also supports future state operations (urgent care ambassadors)
- New innovations that Jason is looking at
- What happens if we don’t adopt this flipped model of care?
- Final thoughts
My thanks to Jason for his reflections and thoughts on this topic. To see more of the inverted pyramid of care, please see here:
https://www.linkedin.com/posts/jasonkillens_nhs75-teamwast-activity-7082261899463028736-DDTJ?utm_source=share&utm_medium=member_desktop
In this conversation, we will examine the challenges of exposure to high-stress situations, the principle of ‘psychological stunning’ and how to deal with the concepts of ‘amygdala highjack’. We will reflect with Tash on a seminal case that she experienced and her reflections on it. We will also reflect on how to harness and control these psychological and physiological stressors in practice to get the best out of yourself in a situation such as this. We will also look at the cognitive switches that Tash uses to de-escalate from the stress of the shift and finally how she approaches self-care within her practice.
Natasha Adams is a Senior Critical Care Paramedic (CCP) with the Queensland Ambulance Service, working on the Woodridge CCP POD and with the High Acuity Response Unit (HARU). Her clinical interests include progressive out-of-hospital care clinical education, and leadership development. Natasha is currently working on a project with graduate paramedic induction programs but will soon progress into a full review of Queensland Ambulance Services' clinical education and operational areas. In the conversation, we examine:
- The case & reflections on the case
- Why and how a ‘state of startle & overwhelm’ occurs.
- The senses that shut down – hearing, vision, spatial awareness, concept of time
- Mental imagery and rehearsal
- Metacognition on the scene (thinking about thinking and mental awareness on the scene)
- The trajectory of the HPT when the rails are coming off
- Cognitive triggers (end of shift cognitive switching – going home mindset)
- The hot debrief – contextualising the scene and emotions – permission to exhale
- Nuances of NTS – permission to fail/miss information (self and crew)
- Reflection on care and Self-care
My thanks to Tash for an engaging and insightful interview.
In this conversation, we will examine the utility and functions of ultrasound within air ambulance services. We look at how the aggregation of data and familiarity with ultrasound is narrowing down and assisting time to intervention and time to definitive care. We look at the scans of preference and some of the data around pneumothoraces, tamponade and positive findings under ultrasound in the critical care patient. Importantly we will get Dan’s perspective on where ultrasound is affecting patient care and where he sees the future of ultrasound going within pre-hospital care.
Dan Nevin is a PHEM consultant with London’s Air Ambulance and an Anaesthetist with Barts and the Royal London NHS Trust. Dan has years of experience working in pre-hospital care in both South Africa, where he originally trained, and in the UK. His special interests include trauma, critical care anaesthesia and PHEM. Dan is also the ultrasound lead for LAA and has been leading the use of POC ultrasound within the service. In the conversation we exam:
- Why ultrasound has become a useful tool in trauma.
- Data collected on scans and relationship with intervention (surgical or otherwise).
- The protocol that LAA prescribe to in practice.
-
The governance around image acquisition and decision -making.
-
USS within Standard Operating Procedures (SOPs) and where it should sit in practice.
- KPIs and frequency of scanning.
- Where ultrasound is going and the future of USS within critical care.
- Take home messages
My thanks to Dan for an insightful and engaging interview.
In this conversation we will examine the anatomy of the Advanced Paramedic Practitioner in Urgent Care (APPUC) scheme as it currently stands within London. We will examine the discharge to the community rate, Alternative Care Pathway referral rates and where they are being referred to, commonly seen pathology for the group, advances in the scheme (innovation and where they are looking to innovate), and finally aligned training that the scheme receives.
Kate Hardy is an advanced paramedic practitioner in urgent care working in London. She gives us insights into what the anatomy of work looks like, the types of pathology, and the Multi-Disciplinary Team (MDT) approach that the scheme takes. The range of topics in the conversation include:
- The concept of Urgent Care Advanced Paramedics
- What a day in the life of an APPUC looks like
- The discharge rate of the scheme
- Commonly seen pathologies for the scheme
- Training that the Advanced Paramedics receive.
- Master’s level training and what that brings in terms of critical thinking ability.
- Clinical governance and how that looks on an individual and collective level.
- How Kate has changed as a clinician through the scheme.
- Alignment with the Multi-professional framework for advanced clinical practice in England
Please find a link to the Multi-professional framework for advanced clinical practice in England here:
https://www.hee.nhs.uk/sites/default/files/documents/multi-professionalframeworkforadvancedclinicalpracticeinengland.pdf
My thanks to Kate for an engaging and insightful interview.
In this conversation we will examine the recent recommendations and development of a national out-of-hospital transfusion protocol for critical care services. We will unpack the recent modified RAND Delphi study that sets out the guidance of clinical governance and recommendations for out of hospital transfusion services. We will dig into the recommendations on the initiation of transfusion, the types of blood components and products, the delivery and monitoring of out of hospital transfusion, the Indications for and use of transfusion adjuncts and finally the resuscitation targets to halt ongoing transfusion.
Adam Greene is a Unit Chief and Critical Care Paramedic working at British Columbia Emergency Health Service. He is also an honorary lecturer at Cardiff University on the Masters in Critical Care. He amongst others has recently published the Development of a national out-of-hospital transfusion protocol: a modified RAND Delphi study which will form the basis of our discussion.
The study can be found here: https://www.cmajopen.ca/content/11/3/E546
Adam's contact details can be found here: Adam.Greene@bcehs.ca
This is the second instalment of the conversation on the approach to major incidents with Keir Rutherford & Alec Wilding. We examine triage tools which have just come into practise which is around the TST - 10 second triage algorithm and the MITT - major incident triage tool and also look at enhanced levels of care on scene and what should be done in the casualty clearing station. We also examine at how we manage our emotions as senior clinicians both on scene and retrospectively and work we work with interdisciplinary teams around the fire brigade and the police on scene.
Here are more resources from the conversation:
London Bridge article: https://www.magonlinelibrary.com/doi/abs/10.12968/jpar.2017.9.12.512
Ten second triage: A novel and pragmatic approach to major incident triage: https://t.co/LXdO1MFRX4
New NHS Prehospital Major Incident Triage Tool: from MIMMS to MITT: https://emj.bmj.com/content/39/11/800.long
NARU app: https://naru.org.uk/jesip-launched-free-app-emergency-responders/
Jesip aid memoir : https://jesip.org.uk/uploads/media/pdf/Aide_Memoires/JESIP_Aide_Memoire_2022.pdf
In this conversation we will examine some of the lessons learnt from anecdotal experiences in major incidents, together with the reflections from previous recommendations in major incident enquiries such as the Manchester bombings. We will examine the differentiation of terrorist attacks at point of call from an otherwise normal RTC or ‘typical’ incident. We also look at the initial approach to triage, who and how this should be done as well as the integration and relationship of the Ten Second Triage (TST) algorithm, the Major Incident Triage Tool (MITT) and levels of enhanced care at the scene. Also, the concept of casualty clearing and when and how this should be performed. We also examine the level/ceiling of intervention that is beneficial from the empirical research in such events and how this should be approached. We also examine inter-disciplinary working with other services such as police responders and fire brigade.
Keir Rutherford is an Advanced Paramedic Practitioner in Critical Care and also a flight paramedic with London’s Air Ambulance. Alec is also an Advanced Paramedic Practitioner in Critical Care and the Emergency Planning Resilience and Response (EPRR) lead for Festival Medical Services, who are a charity providing event medical cover including at Glastonbury and also a Specialist Paramedic for Hampshire Isle of Wight Air Ambulance.
To read more on some of the information referred to in the Manchester Bombing inquiry please see here: https://manchesterarenainquiry.org.uk/
This is part 1 of a 2 part conversation as we felt there was too much to include in just one episode.
In this conversation we will examine the latest in non-invasive ventilation via the helmet interface. Recent empirical research has shown that ventilation via helmet can mean faster recovery time, shortening an ICU stay, reduces the need to intubate, lowers ICU mortality, and can result in minimal or no sedation of the patient.
Aurika Savickaite is a registered based in Chicago and was involved in the successful testing of the helmet ventilator in the ICU at the University of Chicago during a three-year trial study. Aurika has worked as a registered nurse and patient care manager at the University of Chicago Medical Centre, Medical Intensive Care Unit, and as a staff nurse at Vilnius University Hospital, in the intensive care unit. She earned a Bachelor of Rehabilitation and Nursing at Vilnius University Faculty of Medicine in 2001.
Aurika is a recognized expert innoninvasive ventilation via the helmet interface and has garnered widespread respect within the medical community for her passionate work in this area. She was involved in a successful three-year trial study at the University of Chicago Medical Center that tested the effectiveness of helmet-based ventilation in the ICU. Drawing on this experience, Aurika founded HelmetBasedVentilation.com, a website that has become a valuable resource for medical professionals seeking to learn more about the benefits of helmets and their use in treating patients with respiratory distress. In the episode we cover:
- The story of exploration into NIV for Aurika and what did the covid pandemic reinforce?
- The benefits of NIV in general.
- What are the benefits of helmet ventilation over NIV mask ventilation (greater alveolar recruitment).
-
The study - Effect of Non-invasive Ventilation Delivered by Helmet vs Face Mask on the Rate of Endotracheal Intubation in Patients with Acute Respiratory Distress Syndrome - A Randomized Clinical Trial.
-
Commonly seen pathologies that benefit from NIV and the onward benefit.
- What are some of the pre-hospital benefits in transport and retrieval.
- The indications and contraindications of NIV.
- What the masters program taught Aurika (level of critical analysis)
The paper that Aurika refers to in the interview can be found here: https://jamanetwork.com/journals/jama/fullarticle/2522693
In this conversation we will examine the principles of coagulopathy and novel approaches to coagulopathy within pre-hospital care. We will examine the utility of fibrinogen concentrate, the distinct features of fibrinogen concentrate with cryoprecipitate, its longevity of use compared to other blood products, how you constitute fibrinogen concentrate for use in the pre-hospital environment amongst other topics.
To do this I have Ross Davenport with me, Ross is a Consultant Trauma & Vascular Surgeon at the Royal London hospital in the UK. He is also a Senior Lecturer in Trauma Sciences and has previously worked in prehospital care for both London and Essex & Herts Air Ambulance. His research has focused on trauma-induced coagulopathy, acute response to injury and the treatment of major trauma haemorrhage. His work in traumatic coagulopathy and massive transfusion, inflammation and organ dysfunction has had international renown. In the episode we examine:
· Coagulation and the pre-hospital evidence
· Are we getting a handle on hypothermic induced coagulopathy
· What is fibrinogen concentrate and its mechanism of action?
· How it differs from cryoprecipitate and whether we still need cryoprecipitate.
· What the initial empirical research shows from CRYOSTAT 2 research.
· It’s robustness within pre-hospital environments and how you reconstitute it for pre-hospital use.
· Current trials with Fibrinogen concentrate and early indications of effectiveness.
· ROTEM/thromboelastometry markers of effectiveness
· When to give it in the patient journey?
Please enjoy this episode.
In this conversation we will examine the concept of the performance pizza. This is a concept which examines three main domains of performance within pre-hospital care; the predictable routine, the predictable emergencies and the unpredictable emergencies. We will dig into each of these domains and examine what each constitutes, how you train for each state and how to navigate each.
To do this I have Stephen Hearns with me. Stephen is a consultant in emergency and aeromedical retrieval medicine. He works with Scotland’s Emergency Medical Retrieval Service (EMRS). This aeromedical retrieval service delivers pre-hospital critical care for major trauma patients, rural hospital secondary retrievals and major incident responses. Inspired by experience gained working on London’s air ambulance and in Queensland Australia, Stephen led the establishment of this team from a small voluntary service in 2004 to what is now a fully government funded aeromedical retrieval organisation with an international reputation. In the episode we discuss:
· The three performance domains – how did Steve come to rest on these domains and how do they look in practice.
· The predictable routine – Patients and/or skills that are executed everyday and are commonplace within practice.
· The predictable emergencies – The High Acuity High Occurrence skills or patient presentations (RSI for example)
· The unpredictable emergencies – the High Acuity Low Occurrence (HALO) skills that might fall into the unpredictable spectrum (Surgical Airway)
· Putting it all together in training and how simulation and case review plays into this.
· How Core Cognition seeks to educate these areas within high performance teams.
You can find more on Steve's Core Cognition website here: https://corecognition.co.uk/
The performance pizza can be seen here:
https://corecognition.co.uk/performance-infographics/performance-pizza
My thanks to Steve for an insightful and educational discussion.
In this conversation we will examine the career progression of Vicki Brown, who is an Advanced Practitioner in Critical Care, and is the first person in the country to get on the Faculty of Pre Hospital Care (FPHC) Register of Consultant Practitioners by qualifying from a purely paramedic background. We will trace her career pathway and the steps that have been taken by her to achieve such a pivotal role within pre-hospital critical care.
Vicki joined the ambulance service in 2002. And has had roles in management, learning and development and working on HEMS. She became the first ACP-CC for SWAST in 2020 and the first person to register as a Consultant (Level 8) Practitioners in Pre-Hospital Emergency Medicine in 2021.
· The start of Vicki's career – 2002 and what Vicki was doing previously to Paramedic Practice.
· What Vicki learnt on the road as a Paramedic
· What management taught her and she carried through
· How training and education played a role in her progression
· The adage of learning every-day
· The educational pathway (DIMC, higher education, FIMC)
· What working at GWAAC has taught her
· How governance looks within the team at GWAAC.
· What responsibilities Vicki undertakes now as an Advanced Practitioner in Critical Care.
· How she has changed over the years through her positions.
· Where the profession is going, the pillars of advanced practice within the UK.
To see more on Vicki please see here:
https://greatwesternairambulance.com/apcc-vicki-brown-breaks-barriers/
To see more on GWAAC please see here: https://greatwesternairambulance.com/
This episode is sponsored by MEQU.
THE °M WARMER SYSTEM is a portable blood and IV fluid warming system. °MEQU has developed an IV-blood warmer for emergency transfusions. It’s a portable fluid warmer which warms up blood from cold to body temperature within seconds. The set-up time is less than 30 seconds, and the user-friendly design ensures that the °M Warmer System cannot be assembled incorrectly. Blood and other infusion fluids can be heated from 5°C to 37°C at flowrates up to 150 ml/min. One charged battery can heat up to 2 liters of cold fluids (5°C) or 4 liters of fluids at room temperature (21°C) to body temperature.
The °M Warmer System has a compact design and weighs only 760 grams making it portable and ideal for prehospital use. The single-use warmer’s small size (10cm x 5cm x 2cm) allows it to be attached to the patient close to the infusion site, using its integrated adhesive pad. This secures infusion site and reduces heat loss in the tubing. The °M Warmer System is approved for use in ambulances, helicopters and fixed wing air frames. Please see here for further details:
https://mequ.dk/product/?gclid=Cj0KCQjwy9-kBhCHARIsAHpBjHjgsgSlJ0bzKpZmNAs_OFdOEgYeeFKj0-Q-5XDJU5v-D5G15r23o_8aAoddEALw_wcB
This is a repost of an episode I recorded back in the early years of podcasting. It remains the most downloaded episode of the entire podcast. Steve Rashford is the medical director of The Queensland Ambulance Service (QAS) with 5,000 staff and 1,300 response vehicles. In the episode Steve gives some of his perspectives of a pre-hospital careers spanning over 20 years in duration within multiple services. QAS has a contemporary approach to clinical service delivery and innovation in prehospital trauma care. It also operates a tiered system of pre-hospital care with Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs) and a smaller cohort of HARU Paramedics.
In this episode we discuss a variety of topics:
- High Acuity Response Unit (HARU) both its inception and the clinical remit for the HARU.
- Governance around the HARU program and provider quality assurance for some of the procedures (RSI, on-call advice, blood products and the bleeding patients).
- Quality improvement and where the program is heading
- The lessons learnt building the HARU and ICP schemes in QLD.
I hope you enjoy this episode as I found it both insightful and helpful to look at how other systems approach high performing teams and continuous improvement.
Please feel free to reach out to me at eoinwalker@hotmail.com as I always welcome feedback.
In this conversation we will examine the fundamentals of human factors within tasks with Jim Walmsley. We will focus on Human factors from a task perspective refer to the ways in which the design of a task or activity can affect the safety and performance of the individuals performing it. We will examine the concept of task complexity, task variability, task duration and demands, feedback mechanisms in place to learn from, clearly defined goals, and finally task design. We will also discuss some of the mitigation factors involved in environmental design, training and skill development, task analysis to error trap, and teamwork and communication.
To do this I have Jim Walmsley with me, Jim is a specialist paramedic in critical care. He has led expeditions for various Non-Governmental Organisations (NGOs) in and around Europe since 1996, and in 2001 he obtained his carnet as an International Mountain Leader, alongside additional outdoor qualifications in climbing, kayaking, and the rope access industry. As a qualified Critical Care Paramedic, he’s spent the last nineteen years specialising in pre-hospital critical care, after initially training and working in Sheffield. Having completed an MSc in clinical research and a PgDip in critical care, he now resides the Southeast of England. In the conversation we examine:
· What is human factors from Jim’s perspectives
· How task human factors have affected Jim in the past - A case that is seminal and typifies the importance of human factors
· The classic offenders - unfamiliarity with the task, inexperience, a shortage of time, inadequate checking, poor procedures.
· Task complexity & variability
· Task duration and demands.
· Feedback mechanisms in practice
· Defined and clear goal setting
· Design flow to mitigate
· Training skill and development
· Task analysis to error trap
· Teamwork and comms
I hope you enjoy this final episode in the series on human factors within practice.
In this conversation we will examine the concept of flash teams with Ben Watts. We will focus on why they can pose such a challenge in highly stressful situations. We examine the concepts and issues of ego, lack of team ethos, lack of shared understanding/clear plan, poor communications, name use, active listening issues, poor followship, anchoring and much more. We also examine when things are working well and some of the core fundamental components of this including collaboration, use of checklists, feedback mechanisms, closed loop communication, affirmation, shared mental models and overt followship and leadership. We also look at one of the key fundamental tenets of flash teams, that of consistently calm cadence of communication.
To do this I have Ben Watts with me, Ben is no stranger to the podcast and has spoken with me on a number of episodes, most recently around the bleeding patient. Ben is a critical care retrieval practitioner working with the Emergency Medical Retrieval Service (EMRS) in Scotland and also works as a World Extreme Medicine (WEM) faculty member. In the conversation we examine:
· The concept of flash teams
· When it goes right – what this looks like from a flow of communication
· When it goes wrong and how can we correct it
· The importance of effective communication
· Feedback mechanisms to course correct for future performance
· Error detection – Ben’s approach to error trapping
· Distraction and environmental factors - signal versus noise
· Decision making paralysis and the concept of ‘overwhelm’.
· Correcting poor teams when they are going wrong.
· Training and education around flash teams
My thanks to Ben for an engaging and interesting conversation
In this session I am speaking with Clare Fitchett as we explore the fundamentals of human factors and the interplay of leadership. In the conversation we examine what human factors mean to Clare and how they affect her practice. We also look at leadership and how Clare perceives leadership can affect human factors for the better. We finally examine the concept and strategies of human factors mitigation and how we can offset the patent safety issues that human factors brings with it.
Clare graduated as a paramedic in 2011 having undertaken her student paramedic training with South Central Ambulance Service. She commenced her Specialist Paramedic (Critical Care) training in 2018 with Thames Valley Air Ambulance (TVAA) and holds the Diploma in Immediate Medical care (DipIMC) from the Royal College of Surgeons in Edinburgh and is completing an MSc in Advanced Clinical Practice. Clare also volunteers as an Expedition Medic with the British Exploring Society and is also a faculty member of World Extreme Medicine. She currently works for Hampshire and the Ilse of Wight Air Ambulance. In the conversation we explore:
- Overview of HF- why it is important to Clare and holistically
- How leadership can affect HF - the interplay between human factors and leadership
- Seminal leadership points that are useful/attributes of a good leader
- How we support more junior clinicians to lead in critical care circumstances
- Peer review and/or shared mental models
- Some of the mistakes and misconceptions that people make when relying on their own memory versus checklists
- Aspects of Clare's leadership that has changed over time
- Managing stressful environmental human factors on scene
- Some of the great leaders Clare has learnt the most from in regard to human factors mitigation
- Examples cases; seminal cases from Clare’s experience - 2 cases, one which went well and one which was challenging and valuable learning.
Please find some valuable empirical research that underpins Clare's perspectives:
Interventions to improve team effectiveness within health care: a systematic review of the past decade
https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-019-0411-3
A standardised approach to pre-hospital RSI in the UK; utility, governance and content of current pre-induction checklists
https://link.springer.com/article/10.1186/1757-7241-23-S2-A16
My thanks to Clare for an insightful and engaging interview
In this session, I am speaking with Neel Bhanderi on the advantages of high-fidelity training within clinical practice. In the conversation, we examine the concepts of analogs of reality and how it has multifactorial benefits through the integration of handover simulation, debriefing, stress inoculation, skill acquisition under stress, communication under applied stress, and much more. To do this I have Dr. Neel Bhanderi with me. Neel is the Head of Education and Training at MedSTAR retrieval HEMS service based in Adelaide. He is also a Consultant in Emergency Medicine at the Royal Adelaide Hospital. Neel trained as an Emergency Physician and worked as a Consultant at St George’s Hospital Major Trauma Centre in London for several years and for Kent Surrey and Sussex (KSS) Air Ambulance. In 2016, Neel emigrated to Australia where he works as an Emergency Specialist at the Townsville Hospital in North Queensland and is currently the head of education for MedSTAR retrieval service.In the conversation, we examine:
• Why high-fidelity simulation is useful & Neels approach to multi-modal simulation. • What components of training do MedSTAR focus on (Skills based, assessment-based, comms based or all three) – templates of training outcomes used. • How Neel approaches the training debrief.• How Neel creates incremental training stressors within the operational teams. • Environmental stress training methods (operational Task and environmental noise).• Approach to micro versus macro tasks • Comms under pressure within the training environment • Handover and how MedStar simulates this (filming, use of the checklist, analyzing) • Training relationship with case review (identifying training needs from case review). • How Neel is changing training in the short term (other elements such as personality and characterological traits).
Please enjoy this wide-ranging conversation with a fantastic guest. For more on MedSTAR and the work they do please see here:
https://saambulance.sa.gov.au/work-with-us/who-we-employ/medstar-emergency-medical-retrieval/
- We will resume with the human factors series next week
In this conversation we will examine the fundamentals of human factors with Matt Edwards. We will focus on Human factors from an individual perspective. We will examine some of the seminal cases that Matt has experienced in practice and the concept of routine versus crisis from a checklist perspective. We will also examine how human interactions in healthcare change outcomes, from civility to risk aversion and the concept of trust. We will also examine the mitigation strategies that exist around the way an individual understands their environment can affect their ability to detect and respond to hazards from attention and perception. Also the mitigation of distraction, how to avoid decision-making paralysis, the limitations of memory, the regular attenders of stress and fatigue, and finally the effects of communication on the individual, task and team.
To do I'm speaking with Matt Edwards, Matt is a consultant in Adult and Paediatric Emergency Medicine at Kings College Hospital, London and the lead for major trauma and education in Kings. He is also a HEMS Physician with Kent Surrey Sussex (KSS) Air Ambulance and the Polar Medicine course director for World Extreme Medicine. He has held positions as a HEMS Registrar with London’s Air Ambulance, a Flight Physician with AMREF Flying Doctors, Nairobi, and a Medical Officer with the British Antarctic Survey. In the conversation we examine:
· What are human factors from Matt’s perspective
· How task and individual human factors have affected Matt in the past
· How checklists work - routine vs crisis & the limitations of short term memory.
· Trust as a concept in healthcare teams and organisations - how human interactions in healthcare change outcomes - civility to risk aversion.
· Fatigue, the regular attender in every clinicians journey
· Distraction and how that affects performance
· Decision making paralysis and how to break this
· Teamwork and communication
Please enjoy this wide ranging conversation with Matt.
In this episode we kick off a mini-series on human factors in practice. I will be speaking with a cross section of clinicians on what human factors means to them and the impact it can and has had on their practice. In this episode I discuss the fundamentals of human factors including; a working definition of human factors, why human factors are important, the history of human factors, the main domains of human factors, Individual Human factors & mitigation, task human factors & mitigation, environmental/System human factors F& mitigation, NASA's approach to human factors and finally three seminal cases in human factors.
Medical errors can have significant costs both in terms of patient health outcomes and financial costs. While it is difficult to estimate the precise global costs of medical errors, studies have suggested that they can be substantial. In the United States alone, medical errors have been estimated to cost between $17 billion and $29 billion annually in direct costs, such as additional medical expenses, lost income, and disability. This figure does not include the indirect costs associated with lost productivity or quality of life. A study in the UK estimated that preventable medical errors cost the National Health Service (NHS) around £1 billion each year. On a global scale, a report by the World Health Organization (WHO) estimated that 10% of hospital admissions worldwide result in adverse events, and around half of these are due to errors. These errors are estimated to cause between 6 and 10% of hospital admissions in developed countries, and up to 20% of admissions in developing countries. The report also estimated that medication errors alone affect at least 1.5 million people globally each year, resulting in 100,000 deaths annually.
Here are the links mentioned in the episode:
- REMOTE MEDICAL EMERGENCIES RGS - https://www.rgs.org/CMSPages/GetFile.aspx?nodeguid=6643dce6-a321-4002-b117-28d26897ab59⟨=en-GB
- https://www.youtube.com/watch?v=5C59910SWyw To err is human documentary
-
https://emcrit.org/wp-content/uploads/ElaineBromileyAnonymousReport.pdf – Elaine Bromiley report
- https://www.theverge.com/2019/5/2/18518176/boeing-737-max-crash-problems-human-error-mcas-faa - The Boeing 737 human factors https://sma.nasa.gov/sma-disciplines/human-factors https://www.dmp.wa.gov.au/Documents/Safety/MSH_TB_HOF_Woodside_HOFOilnGas.pdf
Please feel free to reach out to me on eoinwalker@hotmail.com for future content and feedback
In this episode I am speaking with Debs Swann on her recent deployment to the Turkey Earthquake disaster. It is the deadliest earthquake in what is present day Turkey since the 526 Antioch earthquake, making it the deadliest natural disaster in its modern history. As of 20 March 2023, more than 57,300 deaths were confirmed: more than 50,000 in Turkey, and more than 7,200 in Syria. In Turkey alone there were at least 50,096 deaths and 107,204 injured across 11 provinces of Turkey. By 23 February 2023, the Ministry of Environment, Urbanization and Climate Change conducted damage inspections for 1.25 million buildings; revealing 164,000 buildings were either destroyed or severely damaged. A further 150,000 commercial infrastructure were at least moderately damaged. At least 15.73 million people and 4 million buildings were affected. About 345,000 apartments were destroyed. More than 2 million residents in the affected provinces were evacuated to nearby provinces including Mersin, Antalya, Mardin, Niğde and Konya. More than 20 percent of Turkey's agriculture production was damaged. The United Nations said crops, livestock, fisheries, aquaculture and rural infrastructure were also heavily damaged. The international organisation for migration estimated about 2.7 million people were made homeless.
In the conversation we examine her anecdotal experience of deploying with the UK international Search and Rescue Team near the cities of Nurdağı and Gaziantep in Gaziantep Province, just outside the regional capital. We examine the reflection on cases she witnessed, the pattern of injuries, the use of search and rescue dogs, the hot and cold brief of the group, the near death experiences that she had and much more. Debs Swann is an Advanced Clinical Practitioner (ACP) working in the Cambridge area, she is also a PHEM practitioner working with the Birmingham care teams. Debs is also a World Extreme Medicine faculty member and is an active member of the UKISAR team. In the episode she reflects on her time both within the deployment and her reflections afterward. She also reflects on her near death experiences and how that translates to her perspectives on time horizons.
My thanks to Debs for this candid and honest interview and her overall insights.
In this conversation we will examine the recent changes in spinal immobilisation within pre-hospital practice. We will look at the historic literature, prevalence of spinal injury in reality, the RCSEd recommendations, and other international guidelines and also the current practice of C-spine collars and extrication advice. To do this I have Jim Walmsley with me, Jim is a Critical Care Paramedic at South East Coast Ambulance Service NHS Foundation Trust. Jim has a 19-year history with the ambulance service and has focussed his career on clinical practice, research, under-graduate teaching, as well as managerial duties.In the episode we discuss: •The culture and historic research of spinal immobilisation.•Pre-hospital prevalence & cultural shift •What are the main considerations in the pre-hospital phase of care •Pre-hospital assessment (sensitive? Valid?) main information to take note of (MOI & other factors)•Immediate treatment options – to immobilise or not immobilise •Latest recommendations •Seminal cases where the application of the above has worked well•Final thoughts & take-home messages.
Some of the references that Jim referred to can be found here:
https://fphc.rcsed.ac.uk/media/1757/pre-hospital-spinal-immobilisation.pdf
Canadian C spine rules:
https://www.sira.nsw.gov.au/resources-library/motor-accident-resources/publications/for-professionals/whiplash-resources/SIRA08109-Canadian-C-Spine-Rule1117-396476.pdf
NEXUS guidelines:
https://www.ebmedicine.net/media_library/files/Trauma-Imaging-Resuscitation-CD.pdf
Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3494329/
My thanks to Jim for an engaging and insightful interview.
In this conversation we will examine the immediate, mid-term and long-term effects of sexual assault. We will also examine the short-term treatment that pre-hospital clinicians should consider. We will also examine some of the long-term support that is available for victims of sexual assault. We will also examine elements of safeguarding, care pathways, and forensics that work on a co-aligned basis with psychological support mechanisms. To do this I have Jayne Butler with me. Jayne is the CEO of Rape Crisis and an experienced voluntary sector leader with a strong background in frontline service delivery. Jayne has worked in social justice-focused organisations for almost 20 years. These include organisations working on asylum and immigration, mental health, child sexual exploitation and access to justice. Before moving into infrastructure and influencing work, Jayne was involved in designing, fundraising for and managing a range of frontline services. She has worked strategically as a consultant in a range of voluntary sector organisations, and as a staff member or trustee in a number of membership and infrastructure organisations. These include The Comfrey Project, North East Law Centre, Relate Northumberland and Tyneside, Newcastle United Foundation and The Children’s Society. Prior to joining RCEW, Jayne was Head of Income and Development for Law Centres Network, the national membership body for Law Centres. During her time there, she led on the Network's response to the Covid-19 pandemic. Jayne is a Fellow of the RSA. In the conversation we discuss:
•The need for psychological support as an immediate intervention •The pre-hospital prevalence •What are the main considerations in the pre-hospital phase of care •Pre-hospital assessment when a patient has been sexually assaulted •Forensic assessment •Immediate treatment options, midterm, and long term •Safeguarding needs of this patient group •Care pathways available for these patients •Example case of when services work well together. •Final thoughts & take-home messages from Jayne.
Services that Jayne sign posts to in the episode includes:
24/7 help line: https://247sexualabusesupport.org.uk/
Rape Crisis website: https://rapecrisis.org.uk/
Statistics on sexual assault & rape: https://rapecrisis.org.uk/get-informed/statistics-sexual-violence/
My thanks to Jayne for an informative and insightful interview.
In this conversation we will examine the prevalence, types, and challenges of pelvic trauma. We will also look at some of the pre-hospital and Emergency Department management of pelvic trauma and why it can be such a critical injury to treat. To do this I am speaking with Ash Vasireddy. Ash is a fellowship-trained Orthopaedic Trauma Surgeon specialising in the management of complex upper limb, lower limb, pelvic and acetabular fractures. He works at King’s College Hospital (Major Trauma Centre) in London. He completed further specialist Orthopaedic Trauma training at The Royal London Hospital, as well as Orthopaedic Trauma Fellowships at Queen’s Medical Centre in Nottingham and King’s College Hospital in London. In addition, Ash has also completed travelling fellowship visits to multiple major trauma centres in America, including the Shock Trauma Centre in Baltimore and Harborview Medical Centre in Seattle. Ash also has extensive experience in Emergency Medicine, Intensive Care and Anaesthesia. He is also a Consultant at Essex and Herts Air Ambulance (EHAAT) and research lead for EHAAT. In the conversation we examine:
- Why a pelvic fracture is so critical
- The pre-hospital prevalence
- What are the main types / classifications
- The spectrum of injury – pain to life threatening blood loss
- Pre-hospital assessment of the pelvis
- Some of the common issues seen as an Orthopaedic Trauma Surgeon
- IR vs OR
- Possibilities of REBOA within the Air Ambulance Service
- Lessons learnt from practice (pre-hospital and in-hospital)
- Seminal cases
- Final thoughts & take-home messages.
In the conversation Ash mentions the two common types of Pelvic classification, these are:
TILE: https://litfl.com/classification-of-pelvic-fractures/
Young and Burgess classification of pelvic ring fractures: https://radiopaedia.org/articles/young-and-burgess-classification-of-pelvic-ring-fractures?lang=gb
My thanks to Ash for an insightful and engaging interview.
In this session I am speaking with Robbie Lendrum on the Myocardial Hypoperfusion & injury in Trauma. We examine the Windkessel concept of pulsatile flow to constant flow, reservoir pressure as an analogue of diastolic pressure, coronary perfusion in diastole. We also explore blood pressure targeted intervention, the disparity between NIBP and IBP, the precision of diagnostics versus intervention, and individually patient centred intervention. We finally fundamentally drill down into the true importance of diastolic blood pressure in trauma care and how this is a succinct shift in mindset and teaching to traditional systolic blood pressure measurements and cut offs.
To do this I have Robbie Lendrum with me. Robbie is a consultant in cardiac anaesthesia and critical care. He is also a consultant in Pre-Hospital Care working with London’s Air Ambulance. Robbie is an honorary senior lecturer at Queen Mary university London and an Endovascular Resuscitation Researcher within the UK. Within the conversation we also examine:
- Cardiac hypoperfusion – pathophysiology
- The Windkessel concept – converting pulsatile flow into constant flow, the generation of pressure.
- Reservoir pressure equal to diastolic pressure
- Coronary perfusion in diastole and the fundamental importance of diastole in trauma
- Arterial injury and respective diastolic hypotension – wide pulse pressures - Effect on coronary perfusion pressure & flow
- CVD – Cardiovascular Dysfunction with early death/72 hour boundary.
- Physiological targets (targeted intervention)
- Why should we move on from blood transfusion and drive faster to hospital.
- The secondary effects on the heart & essentially outcome.
- Arterial shock and the proximal thoracic aorta.
- The two main types of patient and how we approach these (Tamponade and exsanguination)
My thanks to Robbie for this interview. This is a fundamental shift in teaching and mindset and is seminal in how we see and approach trauma care in the future. The key pieces of research that Robbie mentions in the interview includes:
Importance of the aortic reservoir in determining the shape of the arterial pressure waveform. The forgotten lessons of Frank. https://www.sciencedirect.com/science/article/abs/pii/S187293120700155X
The Underlying Cardiovascular Mechanisms of Resuscitation and Injury of REBOA and Partial REBOA
https://pubmed.ncbi.nlm.nih.gov/35615678/
Trauma Laparotomy in the UK: A Prospective National Service Evaluation
https://pubmed.ncbi.nlm.nih.gov/34015456/
My thanks to Robbie for his insights and reflections.
In this session I am speaking with Mark Hannaford, Luca Alfatti, and Alione Hlivco around the current logistical aid efforts, implementation, climate and anecdotal reflections in Ukraine. We also want to dig into the cadence of change in the current climate from an infrastructural perspective, logistical effort and the real need on the ground from the guest’s experience. Our guests include Mark Hannaford, Mark is the CEO and founder of World Extreme Medicine. Since its inception WEM has trained over 20,000 medics in extreme medicine and has a global platform that also hosts the first MSc in extreme medicine at Exeter University in the UK. Welcome Mark to the podcast. We also have Alione Hlivco, Alione is a former MP in Ukraine. She is a regular contributor at Chatham House, Monocle24, CapX and is a TEDx Speaker. Finally, Luca Alfatti. Luca is the Head of Operations for #Medics4Ukraine, who has delivered over 1.7 million pounds worth of medical aid to Ukraine, as well as several trauma medical courses to frontline soldiers and medics. He is also an advanced paramedic in the UK. Aspects of the conversation include:
· The current climate & significant elements of recent change
· Multi-factorial risk profile of the country currently
· The existing and emergent needs as seen by the guests
· Cross section of clinical cases
· Recent education delivered & aspirations
· Recent activity within the #Medics4Ukraine initiative within the UK
· Information governance
· Aspirations within the next few months (broad & not area specific)
· Logistical challenges
· Diversity of medical distribution
World Extreme Medicine can be found here: https://worldextrememedicine.com/
The Medics4Ukraine initiative can be found here https://www.gofundme.com/f/medics4ukraine
This episode is published with kind permission from World Extreme Medicine
In this session we will examine the latest perspectives and insights into recreational drug toxicology with Dima Abdulrahim. I wanted to unpack some of the recreational drug toxicology with reference to drugs that seem to be in favour with youth and have pre-hospital touch points from an acute perspective. Dima Abdulrahim has been working in the field of substance use treatment for 30 years. She is currently the Quality Lead in the Addictions department of CNWL NHS Trust. Dima was the Principal Researcher and Programme Manager of the NEPTUNE Project, based in the Club Drug Clinic. She is the author of two books on novel psychoactive substances and club drugs and other publications and has developed as a series of e-learning and mobile-learning modules, with co-author Owen Bowden-Jones. Dima was a council member of the Advisory Council for the Misuse of Drugs (ACMD) for many years. Topics covered include a deep dive into:
• Some of the most addictive recreational substances Dima has seen in practice
• Poly-pharmacy and the associated incremental risk profile to the user
• The combined use of sildenafil with other drugs within the chem-sex context
• GHB addiction and profile and the narrow therapeutic window and GABA-B stimulation/sedation (and over sedation) in overdose
• The half-life of GHB
• Serotonin linked harms and syndromes, mainly within MDMA and ecstasy
• The incumbent fentanyl crisis (unwarranted and unregulated cutting of drugs with fentanyl)
• The false economy of safety around drugs bought online
• The contemporary issue around fake ketamine distribution
• The circulation of fake pregabalin and benzodiazepines and the related deaths
• Take home Naloxone campaigns
• Other emergent synthetic recreational drugs seen within the clinic
Resources that Dima has written include:
Books:
Abdulrahim D and Bowden-Jones O: Textbook of Clinical Management of Club Drugs and Novel Psychoactive Substances Cambridge University Press Medicine. October 2022 (book)
Bowden-Jones and Abdulrahim: Club Drugs and Novel Psychoactive Substances. The Clinical Handbook. Cambridge University Press Medicine. November 2020 (book)
Resources (available free of charge)
NEPTUNE e-learning modules on club drugs and novel psychoactive substances
http://neptune-clinical-guidance.co.uk/e-learning/
Neptune guidelines and resources http://neptune-clinical-guidance.co.uk/
ATOMIC- Addiction to Medication: Improving Care. Mobile-learning modules on the harms and management of non-medical prescription drug use. https://addiction-to-medication.org/atomic/
My thanks to Dima for an engaging and insightful interview.
In this session I will be talking with Neil Jeffers on CRM or Crew Resource Management. We will examine a working definition of CRM, why it’s of fundamental importance to Neil, the history of CRM, the symbiotic link between human factors and CRM, and the detrimental aspects of collective agreement. In the conversation we will also examine some of the theory, threat and error management, CRM tools that Neil uses and advocates, and finally how debrief can be a fundamental tool to improving CRM.
Neil has been a Pilot with London’s Air Ambulance for 16 years and has been Chief Pilot for the last 8 years. Neil has flown over 8,000 hours since he started flying in 1997 and has over a 5,000-hour track record in instructing and examining. Neil was also an experienced crew resource management instructor and a certified first responder and has been a volunteer emergency responder with London Ambulance Service for 5 years. In the interview we cover:
- A working definition of CRM
- Why CRM is so fundamental to high performing teams
- Brief history of CRM from aviation into medicine
- Flash points within a scene that mandate good CRM
- The linkage between CRM and Human Factors
- Deep dive on the hierarchy of CRM in order of importance - Decision Making, Leadership & Management, Situational awareness, communication (Closed loop, chunked, tone & intonation).
- Negative aspects of collective agreement
- Threat and error management
- Dunning Kruger effect
- CRM tools that Neil deploys and recommend
- Debriefing; The utility of debriefing
Some of the concepts that Neil mentions includes:
Threat/error management: https://www.easa.europa.eu/en/downloads/22642/en
Dunning-Kruger effect: https://thedecisionlab.com/biases/dunning-kruger-effect
Cognitive Dissonance: https://www.verywellmind.com/what-is-cognitive-dissonance-2795012
My thanks to Neil for an insightful and engaging interview.
In this session we will examine the fundamentals of the pre-hospital airway from airway assessment all the way through to the difficulties posed in practice. We will also look at the management from a stepwise concept all the way through to the use of invasive surgical techniques to manage the airway. We will also examine some of the optimal methods used to monitor the respiratory effort and when and when not to intervene. We will also examine the current utility and debate around Direct Laryngoscopy (DL) and Video Laryngoscopy (VL) and whether VL is around to stay within practice.
To do this I have with me John Chatterjee. John is a consultant anaesthetist with an interest in pre-hospital care and difficult airway, thoracic and high-risk anaesthesia. He has worked with and educated clinicians around the world in various ambulance and hospital services including places like New Zealand, Sydney, Liberia, Ethiopia, Ukraine and in the UK where he has worked with HEMS and BASICS. John is as an anaesthetist at Guys and St Thomas', and a Consultant with London's Air Ambulance at the Royal London. In the episode we examine:
- The challenges of the pre-hospital airway
- How to assesses the difficulty of an airway from sight and brief assessment
- Declaration of the findings and plan
- VL vs DL and where VL is going from a SOP and utilisation tool.
- Stepwise management and understanding where to come in on the management plan.
- Assessment of respiratory effort
- Thoughts on RSI compared to retrospective practice.
- Tips on surgical airways
- Seminal airway research in the last 10 years – Impact Brain Apnoea
- Seminal cases that John has learnt a lot from
- Final thoughts from John and take-home messages.
John mentions these two papers within the conversation:
Difficult Airway Society (DAS) 2015 guidelines for management of unanticipated difficult intubation in adults:
https://aimeairway.ca/userfiles/26556848_Difficult_Airway_Society_2015_guidelines_for_management_of_unanticipated_difficult_intubation_in_adults.pdf
Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients by pre-hospital physicians
https://academic.oup.com/bja/article/113/2/220/1745948
My thanks to John for an insightful and engaging conversation.
In this session I am speaking with Claire Park on a new primary triage tool developed by Claire and a research team. It has been accepted and agreed by NHS England for use by all UK ambulance services and prospectively by National Police and Fire Services. It has also been adopted by the UK MOD to roll out across all UK military personnel internationally.
Claire Park is a Consultant in Pre-hospital Emergency Medicine for London HEMS, and Anaesthesia and Critical Care Medicine at Kings College Hospital in London. She also is an army consultant with over 20 years of deployed military experience. Claire is the medical adviser to the Specialist Firearms teams of the Metropolitan Police Service (MPS), and has worked closely with all of the emergency services in London on developing the joint response to high threat incidents, in particular following the attacks of 2017. She is also the Chief Investigator on a UK nationally funded research grant looking at evidence for improving patient outcomes in the hot zone in major incidents and has developed relationships in this area with many members of the Committee Tactical Emergency Casualty Care CTECC over the last 4 to 5 years. In the conversation we examine:
-
Definition of triage as a fundamental baseline.
-
Why need for change - Current standards (START and SMART triage) and the existing and emergent needs from a triage tool.
-
Empirical literature
-
Changes to current practices - Challenges in design/Physiology or not physiology/Bleeding not bleeding/talking/breathing.
-
Design considerations and the inclusion of penetrating injury.
-
Testing of the tool
-
Adoption - Adoption of the tool by various institutions.
-
Improvements expected to be seen on the ground.
-
What’s next - Future projects for Claire.
The new TST tool can be found here: https://twitter.com/seanharris999/status/1582382980902723584
My thanks to Claire and the team for this insightful interview.
In this episode we are examining the recent strikes and pay freeze that frontline paramedics have been experiencing. This is on the background of increased cost of living and operational pressures across the emergency care system. We will focus both on Carl’s recent reflections of the issue and also the sense of community within the current strikes. We will also examine how this strike is different to others and indeed how the climate of the NHS is vastly different to that ever seen before.
Carl Betts is no stranger to the podcast, he has been a paramedic for over 10 years and currently working in Quality Improvement. He has also written a recent blog on his reflections of the strike action, the sense of unity and the multi-factorial climate of pressures that paramedics work in within the UK.
This was an episode recorded for World Extreme Medicine (WEM) and aired with kind permission from WEM. World Extreme Medicine are providers of specialist environment and expedition medical education and can be found here: https://worldextrememedicine.com/
In this session I am speaking with Andrew Pearce on the concept of the trauma handover. We examine the definition of the handover, the commonly expected barriers to effective handover, and the recall of handover information. We will also examine where the handover occurs, standards and recommendations, tools and templates, how we can measure effectiveness, and finally whether it works in practice. We will also dig into some of the empirical literature to examine some of the evidence behind the handover.
Andrew Pearce is an Emergency Physician and pre-hospital retrieval medicine specialist. He is currently the Clinical Director and a Medical Retrieval Consultant coordinator at MedSTAR Emergency Medical Retrieval Service based in Adelaide, Australia. In the episode we examine:
-
Definition of the clinical handover.
-
Commonly expected barriers to information handover.
-
Recall of information and some of the errors in recall.
-
Empirical findings on handover from the literature.
-
Where the handover occurs and bias attached to handover information.
-
Current standards & recommendations (Standard 6, ACSQHC)
-
Templates and Tools used and advocated.
-
Measuring effectiveness/quality assurance of handover.
-
Summary from Andrew.
Some of the empirical papers and standards mentioned in this episode can be found here:
Clinical handover in the trauma setting: a qualitative study of paramedics and trauma team members
https://pubmed.ncbi.nlm.nih.gov/20702445/
Expectations differ between senders and receivers of patients in transition - Joint commission centre for Transforming Healthcare 2017
https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_58_hand_off_comms_9_6_17_final_(1).pdf?db=web&hash=5642D63C1A5017BD214701514DA00139&hash=5642D63C1A5017BD214701514DA00139
Clinical handovers between prehospital and hospital staff: literature review
https://emj.bmj.com/content/32/7/577.short
Australian Commission on safety and quality in healthcare: Standard 6: Clinical Handover
https://www.safetyandquality.gov.au/sites/default/files/migrated/Standard6_Oct_2012_WEB.pdf
My thanks to Andrew for an engaging and insightful interview.
In this session I am speaking with Aggie Rice on the concept and tool of Schwartz rounds and her journey of implementation within the NHS. Schwartz rounds can be described as a structured forum where all staff, clinical and non-clinical, come together regularly to discuss the emotional and social aspects of working in healthcare. In the session we wanted to explore the purpose of Schwartz Rounds and some of the potential benefits to staff that participant in them. We also wanted to look at the evidence and staff feedback as to their utility and ability to flatten the hierarchies of management within an organisation. The underlying premise for Rounds is that the compassion shown by staff can make all the difference to a patient care, but also in turn, make staff feel supported in their work. We want to dig into this principle and get the thoughts from Aggie who is implementing them at a local and national level.
Aggie Rice is a mentor and trainer on the Schwartz Rounds and Team Time programmes. After working for the Point of Care Foundation for a few years as an Associate, Aggie joined the Foundation in this full-time role in 2021. Aggie has worked on the Schwartz Round programmes since 2016 and has a keen interest in organisational culture, storytelling and the emotional wellbeing of health and social care staff.
In the episode we cover:
-
Why Schwartz rounds are important in the contemporary healthcare climate.
-
The power of narrative and the anatomy of the Schwartz round
-
The principle of psychological safety
-
Whether they can be used as a surrogate for counselling
-
Opening up and flattened hierarchy
-
Adoption and rate limiting steps/barriers to participation
-
Progress within the Ambulance Service versus other healthcare settings
10.Take home messages
You can learn more about Schwartz Rounds here:
https://www.pointofcarefoundation.org.uk/our-programmes/staff-experience/
You can learn more about Aggie Rice here:
https://www.pointofcarefoundation.org.uk/about-us/people/aggie-rice/
I hope you enjoy this episode with an insightful and engaging guest.
In this session we will examine the latest research to emerge from Zane Perkins and Mike Christian around Resuscitative Thoracotomy (RT). The research has been led by Zane and Mike examined over 600 retrospective thoracotomy cases from the LAA database spanning 20 years, looking at the survivors, the pathology (exsanguination versus tamponade), the pre-arrest rhythms, the morbidity and mortality, the time of intervention versus outcome as well as other markers. I wanted to explore the results of this research and the potential implications on practice.
Zane Perkins is a consultant Trauma and General Surgeon at the Royal London Hospital, a consultant Physician for London's Air Ambulance, and an Honorary Senior Lecturer at the Centre for Trauma Sciences, Queen Mary’s University London.
- Current thinking on Thoracotomy practice
- Examine the research in more detail from primary & secondary outcomes
- Survival rates - Who are the current survivors?
- What are the main domains of pathology
- Exsanguination: Results of outcome and pre-arrest rhythms
- What it shows around intervention and decisions around exsanguination
- Tamponade: results of outcome and pre-arrest rhythms
- What it shows around intervention and decisions around tamponade
- Differentiated decision making and prospective changes to SOP
- Final thoughts and take-home messages.
The study has yet to be published but we will publish the results as they are published. My thanks to Zane for an engaging and insightful interview.
This is the second part of the lecture series on building effective teams and dealing with difficult people. The concepts taught here involve models of teamwork (Action centred Leadership, the five dysfunctions of a team), trust - both as a concept and a pre-requisite, culture, homeostatic teams and finally tools and techniques for fostering good team work.
In the second half of the podcast we examine dealing with difficult people from the perspective of understanding the triggers, root cause analysis, rapport building, the energy investment model, the ELCR framework, self awareness, humility and insight. Some of the resources and models can be found here:
Energy investment model: https://careerresilience.wordpress.com/2021/06/03/how-are-you-investing-your-energy-in-times-of-change/
Action Centred Leadership: https://www.businessballs.com/leadership-styles/action-centred-leadership-john-adair/
The Five Dysfunctions of a team: https://tomorrowsleadership.nl/how-to-overcome-the-5-dysfunctions-of-virtual-teams/
Empathic communication: https://hbr.org/2022/08/4-ways-to-communicate-with-more-empathy
I hope you get something from this episode that you can use either within clinical practice or within general work-based situations. I'm always keen for feedback on sessions, please feel free to reach out to me at eoinwalker@hotmail.com - please also rate, review and subscribe to the podcast. This episode will be aired across the Pre-hospital Care Podcast and Restore Podcast platforms.
Many thanks,
Eoin
In this session we will examine Exertional Heat Injury (EHI) within individuals undertaking endurance races, military exercises, or extreme activity. We will draw contrast and parallels to acute behavioural disturbance, what is happening both at the physiological level and some of the autonomic positive feedback mechanisms within EHI. To do this I have Harvey Pynn with me, Harvey is a Lieutenant colonel within the British Military and an Emergency Medicine and air ambulance consultant with GWAAC. In the episode we examine:
· Definitions, spectrum of disease – EHI as a broad definition and spectrum of states
· How are thinking has changed on heat illness and what is happening on a physiological level
· Incidence of EHI; anecdotal and empirical
· The hierarchy of ‘exercise-state’ heat loss – evaporative, convective, conduction, then radiation.
· Heat acclimatisation: Salt concentration (aldosterone mediated), sweating initiation and rate.
· Risk factors (individual, environmental)- concomitant disease or drugs (dehydration, alcohol, co-morbid disease, medication)
· Subtle and not so subtle prodromal signs and symptoms of heat injury & why urine colour isn’t a great marker (lack of micturition during dehydration).
· Preventative measures and treatment modalities in severe EHI
· Analogues of comparison and symptomatology – ABD, drug induced hyperthermia.
· Differential diagnosis and an anecdotal case from Harvey
Please find some related research produced by Harvey pertaining to measuring dehydration and the sequlae of EHI:
https://www.researchgate.net/publication/327822126_The_Compensatory_Reserve_Index-potential_uses_in_a_military_context
Please also see relevant empirical literature that is congruent with the podcast:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819979/
Please enjoy this episode with an engaging and informative guest.
In this episode I examine the art of active listening. It is a slightly different episode and one of a number to come where I give a series of lectures. In this episode I wanted to do two things:
-
Build awareness of the factors that affect our listening ability.
-
Build and create the conditions that can produce good listening habits.
One of the main problems is caused by the fact that we think much faster than we talk. The average rate of speech for most of us is around 125 words per minute. In contrast we process and think at about 800 words a minute. This is a fundamental mis-match which can cause a deficit in receiving information. The human brain is made up of more than 13 billion cells and operates in such a complicated but efficient manner that it makes any comparison to computers seem insignificant. It might seem logical to slow down our thinking when we listen so as to coincide with the 125-word-per-minute speech rate, but slowing down thought processes seems to be a very difficult thing to do. When we listen, therefore, we continue thinking at high speed while the spoken words arrive at low speed. In the act of listening, the differential between thinking and speaking rates means that our brain works with hundreds of words in addition to those that we hear, assembling thoughts other than those spoken to us. The latency of this mis-match is often taken up by internal dialogue rather than integration of the spoken, but more importantly inferred meaning behind words. In this episode I examine:
- The definition of active listening.
- The 'classic' example - one which we all fall prey to.
- The anatomy of the received message.
- The why and what of ‘Active Listening’.
- Triple A listening (what triple A listening actually is).
- Kinesthetics of listening – what it feels like to be heard amongst other aspects.
- Models of active listening: Four ears of communication, the communication triangle.
- The power of silence
- The quality of listening - The hierarchy of active listening
- Chunking information as an adjunct to active listening
- Closed loop communication
- The power of agreement
Please let me know what you think of the content at eoinwalker@hotmail.com and also feel free to recommend future topics. Please also feel free to rate and review the podcast and I always welcome feedback.
In this session we will examine one of the common greatest human factors challenges within pre-hospital care, that of acute fatigue within clinical practice. The ambulance services are trying out different ways of working to help staff feel less tired at work and safer on scene, but these actions are often localised and have no empirical underpinning, and also we don’t know whether they are making working environments safer.
Kristy is investigating whether patient and staff outcomes can be improved through development and implementation of a fatigue risk management system (FRMS), as is done in other safety-critical industries like aviation and transport. The evidence suggests individual components of a FRMS which may be effective, Kristy is currently investigating the optimal packaging of these interventions. Kristy believes that FRMS adoption in the NHS needs local tailoring and understanding of barriers and facilitators. Kristy is looking at a way to integrate a comprehensive fatigue risk management system for the UK NHS ambulance sector that is acceptable, feasible, and likely to improve patient outcomes and staff wellbeing and experience.
Within the episode we will examine:
-
Kristy’s research approach toan agreed set of evidence-based and emerging components of a FRMS for the UK ambulance sector that are considered feasible and acceptable.
-
The wider CATNAPS study and its wide ranging primary and secondary outcomes.
-
The components of a comprehensive FRMS that are in use and why.
-
The ways in which front-line staff and patients experience current fatigue actions and potential to improve safety culture and reporting.
-
Development and usability testing of the FRMS and its implementation guide that allows tailoring to organisational and local context and is underpinned by a new theory of change and logic model.
-
The 12 hour day and and night shift, both pros and cons of this pattern of working.
-
Fatigue mitigation and how the FRMS may serve to support this.
-
Second and third order effects of fatigue.
More on CATNAPS and Kristy's research can be found here: https://arc-eoe.nihr.ac.uk/research-implementation/research-themes/mental-health-over-life-course/catnaps-fighting-fatigue-nhs
Please enjoy this episode with an engaging guest.
In this session we will examine the bleeding patient in the tactical and combat environment. We will dig into some of the fundamental education that has changed practice in recent years, we will also look at the sequential approach to bleeding control, second and third generation haemostatics, pharmacological agents, tourniquets, neck zones and injuries, blunt injury and junctional wounds, hypotensive management and finally pain management in the combat arena. We also examine the utility and success of highly interventional skills at or near point of wounding such as REBOA. Finally we will examine Traumatic Cardiac Arrest (TCA) and the utility (or not) of an algorithmic approach to management.
To do this, Ed Barnard joins me. Ed is an emergency medicine consultant within Cambridge University hospital and has undergone sub-specialty training in pre-hospital EM, working in more than five EMS systems, educating and mentoring medical students and doctors in training, giving national and international lectures, delivering a national research and clinical innovation meeting, completing a PhD from a top-100 research university, publishing over 30 journal articles, receiving five national-level research awards, and being appointed as a Senior Lecturer for the military.
Topics covered:
- Sequential approach to arresting bleeding
- Look at second/third/fourth generation haemostatic compounds (celox, quik-clot)
- Utility of tourniquets (origins, usage and types)
- Neck zones and wounds
- Blunt injury and junctional wounds
- Hypotensive mx - utility of this
- Critical Hypovolaemia and tx modality
- Interventions at point of wounding - REBOA
- TCA management and algorithmic approaches
- Ed's reflections and perspectives over the past 5 years on bleeding
Some of the concepts and evidence that Ed mentions in the episode can be found here:
- A comparison of Selective Aortic Arch Perfusion and Resuscitative Endovascular Balloon Occlusion of the Aorta for the management of hemorrhage-induced traumatic cardiac arrest: A translational model in large swine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526509/
- The outcome of patients in traumatic cardiac arrest presenting to deployed military medical treatment facilities: data from the UK Joint Theatre Trauma Registry https://militaryhealth.bmj.com/content/164/3/150.abstract
- Prehospital determinants of successful resuscitation after traumatic and non-traumatic out-of-hospital cardiac arrest
- Epidemiology and aetiology of traumatic cardiac arrest in England and Wales — A retrospective database analysis https://www.sciencedirect.com/science/article/abs/pii/S030095721630538X
Please enjoy this episode with an insightful and engaging guest.
In this session I will be talking with Carl Betts on the anatomy of quality improvement and some of the pitfalls that occur along the way. Carl is a Paramedic for over 10 years and is a quality improvement lead based in Sheffield working for the ambulance service. In this conversation we will look at the pitfalls we can fall into when examining improvement. We will also look at some of the bias’s that can preclude improvement. We will also be talking about how root cause analysis occurs, data collection, pre and post implementation analysis, some of the quality improvement projects on workflow and hospital delays and how that might translate in practice. In the conversation we examine:
- The overview of QI.
- Pitfalls to improvement
- Bias: The WW2 story
- Bias at work
- RCA – why it’s important and make it relevant to hospital delays
- Why data collection is important
- Why pre and post implementation analysis are important
- Project on hospital delays & ideas that have come from them
- Final thoughts from Carl and take-home messages.
Below is a link to plan, do, study, act cycles that Carl made reference to in the interview.
https://www.england.nhs.uk/wp-content/uploads/2022/01/qsir-pdsa-cycles-model-for-improvement.pdf
Please enjoy this episode with an engaging and insightful guest.
In this episode we will examine how the evolution of public health is migrating through to ambulance services and creating future opportunities within this field of practice. In May of last year AACE (the association of Ambulance Chief Executives) published a discussion paper around developing a public health approach within the ambulance sector. This paper starts by denoting that every 24 hours, the NHS has contact with over a million people, and the ambulance sector is at the fore front of these interactions. So we also know that ill health maps across social deprivation and indeed constitutes a high percentage of pre-hospital work, so I want to dig into all of the above with Dr Andrew Furber.
Andrew has been the Regional Director for Public Health England (Northwest) and Regional Director of Public Health NHS NW since May 2020. He was previously Centre Director for Public Health England (PHE) in Yorkshire and Humber. He has worked as a Director of Public Health from 2007 to 2018 and is a past President of the Association of Directors of Public Health UK (ADPH). He was awarded an OBE for services to public health in the Jubilee Birthday Honours List.
In this episode we examine:
- The necessity of taking a population perspective and approach to public health.
- What the data is telling us about pre-hospital public health.
- Potential preventative strategies.
- Looking at the wider, societal determinants of health and wellbeing and focusing on reducing inequalities.
- The challenge of working in partnership across health systems.
- Future opportunities for Paramedics in the domain of public health.
- Final take home points from Andrew.
Please find more information here: https://aace.org.uk/wp-content/uploads/2021/05/Single-pages-Public-Health-Approach-Ambulance-Sector.final_.pdf
Finger Tips - Public Health https://healthierlives.phe.org.uk/
Please enjoy this episode with an insightful guest.
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy.
One of their most innovative recent products is the D heart: D-Heart is the first portable ECG device that is simple to use, clinically reliable, affordable and makes use of a smartphone. It allows anyone to perform a hospital-level ECG in total autonomy with the option to send the results to the 24/7 tele-cardiology service or to your trusted doctor. D-Heart allows you to track your heart health, explain possible unclear symptoms or to monitor the efficacy of medication. D-Heart will allow you to become an engaged partner in the management of your health. You can record an ECG whenever you have symptoms and share it with your trusted physician and to establish a shared decision-making process. The image-processing and artificial intelligence will guide you to the correct electrode placement by showing you an image of your own chest with virtual marks placed where you should apply the electrodes.
More information on the D heart can be found here: https://www.bha-medical.com/d-heart-ecg-mobile-device
More information on BHA medical can be found here: https://www.bha-medical.com/
In this session we will examine the bleeding patient in the tactical and combat environment. We will dig into some of the fundamental education that has changed practice in recent years, we will also examine the SWIFT Study which is a study of Whole blood In Frontline Trauma A multi-centre randomised controlled trial of the clinical and cost-effectiveness of pre-hospital whole blood administration versus standard care for traumatic haemorrhage.
To do this I am speaking with Surgeon Capt Jason Smith. Jason is currently the Defence Professor of Emergency Medicine at the Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham. He was also appointed Royal College of Emergency Medicine Professor in 2013, and is an Honorary Professor at Plymouth University Peninsula Schools of Medicine and Dentistry. He was Consultant Advisor in Emergency Medicine to the Medical Director General (Navy) from 2010-2014. He is a Fellow of the Royal College of Emergency Medicine, the Royal College of Physicians of London, and the Royal Geographical Society. He undertook a doctorate in the management of patients with blast lung injury, and his current research interests include the treatment of pain in emergency patients and the management of traumatic cardiac arrest.
In the episode we examine:
- Sequential approach to arresting bleeding
- The utility of TXA
- Pharmacological agents - TXA, FFP, FDP, blood, cryo-p, RePHILL
- TheRePHILL trial
- Pain mx and preferential agents
- Freeze Dried Plasma and Fresh Frozen Plasma and part of the array of intervention
- The SWIFT trial
To find more on the SWIFT trial please see here: https://www.nhsbt.nhs.uk/clinical-trials-unit/current-trials-and-studies/swift/
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the latest solutions that BHA medical offer is the iMed end-to-end Covid-19 testing and monitoring solution. NPH iMed is an end-to-end Covid-19 testing and monitoring solution, developed in partnership with BHA Medical Limited to assist in collating and managing test results, reopen travel, leisure, events and entertainment. One of the first independent online test verification systems in the world, NPH iMed is a leading solution for testing, managing and monitoring all of your Covid-19 needs.
NPH Group has simplified the process of reporting test result data for you through our online platform which makes capturing the required data for submission easy, while easily recalling individuals for repeat testing and submissions. NPH have created a fully compliant and automatic upload capability, so you don’t have to worry about it, with a cost-effective solution. More can be found here:
https://bha-medical.com
https://www.bha-medical.com/imed-self-testing-monitoring-covid-19-app
In this session we will be talking with Zoe Hitchcock. Zoe, 9 years ago in 2013 had a seminal event whilst walking on Oxford St in London. Zoe suffered a cardiac arrest from a cardiac myopathy causing a VF cardiac arrest. The adage that it takes a system to save a life truly came into focus that day. In this episode we will hear from Zoe’s first-hand experience of that cardiac arrest and the events leading up to incident and how it has been a turning point in her life.
- What Zoe remembers about that day
- The wider picture around Zoe’s husband and reason she was in Oxford St
- The incident on the pavement and challenges for pre-hospital team
- HEMS team and transfer to St Marys
- The recovery and life now
- The perspective change to life and family
- Take homes messages
The episode below is the initial conversation I had with Zoe to give you more details of the incident and the surrounding conditions:
https://podcasts.apple.com/gb/podcast/s02e01-zoe-hitchcock-cardiac-arrest-survivor/id1441215901?i=1000437344052
Please enjoy this episode with a true legend.
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the latest solutions that BHA medical offer is the iMed end-to-end Covid-19 testing and monitoring solution. NPH iMed is an end-to-end Covid-19 testing and monitoring solution, developed in partnership with BHA Medical Limited to assist in collating and managing test results, reopen travel, leisure, events and entertainment. One of the first independent online test verification systems in the world, NPH iMed is a leading solution for testing, managing and monitoring all of your Covid-19 needs.
NPH Group has simplified the process of reporting test result data for you through our online platform which makes capturing the required data for submission easy, while easily recalling individuals for repeat testing and submissions. NPH have created a fully compliant and automatic upload capability, so you don’t have to worry about it, with a cost-effective solution. More can be found here:
https://bha-medical.com
https://www.bha-medical.com/imed-self-testing-monitoring-covid-19-app
In this episode we will examine the true story of the tragic death of a Search and Rescue medic Dave VanBuskirk. On the evening of the 22nd of July, 2013 Dave fell approximately 200 ft to his death whilst on a winching mission to save another person at Mt Charleston in the Las Vegas region of the US. To tell the story I interview SAR pilot Dave Callan.
Dave Callen is a retired Sergeant from the Las Vegas Metropolitan Police Department. He spent most of his career in the Air Support unit, where he flew patrol, search and rescue, surveillance, short haul/long line and tactical missions. Dave is certified as a rescue pilot a variety of airframes and holds an airplane and helicopter instrument rating with over 4,000 hours of flying experience. Dave unpacks the incident back in 2013, its wide-ranging impacts on the wider team and some of the lasting lessons learnt from the tragedy.
In the episode we examine:
- The anatomy of the Las Vegas Police Police Dept – The service Dave VanBuskirk was flying in.
- What regular operations would look like and the span of area covered by the service.
- Who Dave VanBuskirk was as a person and professional.
- The immediate impacts of the death on Dave Callen and the wider team.
- Dynamic rollout – what it is, why lips on winch hooks can pose a risk.
- The risk mitigation strategies Dave has taken from the incident
- Dave VanBuskirk’s principle of getting a little bit better everyday and commitment to excellence.
- Safety audits – the principles and lessons learnt.
- Final thoughts and take-home messages.
To learn more about Dave VanBuskirk, see here: https://sr3rescueconcepts.com/about
To learn more about SR3 Rescue Concepts please see here: https://sr3rescueconcepts.com/
This podcast is brought to you in association with BHA Medical.
https://bha-medical.com/about-us/
BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. There most recent product is the Vitalstream:
https://bha-medical.com/medical-products/vitalstream/
The Vitalstream is the world’s most innovative wireless non-invasive patient monitor, using a simple disposable finger cuff to measure Continuous Beat-by-Beat Blood Pressure “CNIBP,” Heart Rate, Respiration Rate, and other physiological parameters. This unique technology enables safe, secure, and accurate patient monitoring from virtually anywhere, including remote patient monitoring from a secure cloud portal. This solution provides real time data, enabling healthcare staff to provide early intervention and rapid response to a patient’s changing health conditions. Using a low-cost, disposable finger cuff, the VitalStream patented Pulse Decomposition Analysis (“PDA”) algorithms process the arterial pulse waveform to derive CNIBP, Heart Rate, Respiration Rate, and other hemodynamic parameters.
Please also check out further devices and services offered by BHA medical here:
https://bha-medical.com
I hope you enjoy this episode with an insightful and engaging guest.
In this session we will examine a new pathway which is emerging within Scotland and north of England. The Chronic Obstructive Pulmonary Disease (COPD) pathway has been designed to both specialise treatment and expedite specialist care to this cohort of patients. NHS data shows that in 2020/21, approximately 1.17 million people in England have been diagnosed with COPD, which is around 1.9% of the population.
To host the conversation I have Jonathon Will with me. Jonathon is a registered Paramedic working with the Scottish Ambulance Service (SAS), he has also worked as an Emergency Care Paramedic within various Emergency Department Resuscitation units. His last two years has been spent working as the Clinical Effectiveness Lead within SAS and a National improvement Advisor for urgent and unscheduled care within NHS Scotland. Tom Fardon is a Respiratory Consultant within NHS Tayside, with a specialist interest in airways disease (COPD, Asthma and Bronchiectasis). Tom is also the clinical lead for the managed clinical network within Tayside and the chair of the national advisory group for respiratory medicine, also the lead for respiratory care action plan within NHS Scotland. He also leads the Scottish Respiratory advisory committee to initiate the recommendations within the respiratory care action plan. In the conversation we talk about:
-
The pathology of COPD; what’s going on with these patients and how these patients normally present to the ambulance service.
-
Physiological tolerance and adaptation over time.
-
Why this pathway has been designed? (what is the current problem)
-
How the key clinicians and specialisms have been brought together * End points that the pathway serves
-
Improvements to the current services
-
What tiers of patients this pathway serves
-
What happens to the life-threatening COPD patients
-
What a patient could expect when they go through the pathway.
-
What the future holds
-
Take homes messages
Please find more about the pathway here: https://www.consultantconnect.org.uk/copd-pathway-tayside/
Consultant Connect are partly responsible for supporting this pathway and can be found here: https://www.consultantconnect.org.uk/
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of their most innovative recent products is the D heart: D-Heart is the first portable ECG device that is simple to use, clinically reliable, affordable and makes use of a smartphone. It allows anyone to perform a hospital-level ECG in total autonomy with the option to send the results to the 24/7 tele-cardiology service or to your trusted doctor. D-Heart allows you to track your heart health, explain possible unclear symptoms or to monitor the efficacy of medication. D-Heart will allow you to become an engaged partner in the management of your health. You can record an ECG whenever you have symptoms and share it with your trusted physician and to establish a shared decision-making process. The image-processing and artificial intelligence will guide you to the correct electrode placement by showing you an image of your own chest with virtual marks placed where you should apply the electrodes.
More information on the D heart can be found here: https://www.bha-medical.com/d-heart-ecg-mobile-device
More information on BHA medical can be found here: https://www.bha-medical.com/
In this interview we will examine the emerging research priorities within pre-hospital care from the perspective of priority and importance. I will be speaking with Sarah McLaughlin – a senior research fellow with affiliations with Essex & Herts Air Ambulance (EHAAT) and Anglia Ruskin University. I will also be speaking with Lisa Ramage, Lisa is a PHEM trainee in the East of England and the chair of PHOTON. PHOTON is a group of non-consultant grade, pre-hospital, doctors with an ambition to expand the quality and reach of research within pre-hospital care. In this conversation we are going to examine a national Delphi study which is defining the national research priorities within pre-hospital care in the contemporary climate. We will also:
- Examine what is a Delphi study
- Why is it an important time for empirical research and audit at the moment within pre-hospital care
- Sarah’s EHAAT Delphi study as an analogue of the national PHOTON study
- The process of a Delphi study in terms of rounds and refinement of the questions.
- How does it achieve consensus?
- What are the advantages to a Delphi study?
- Ethical approval (the panel and process)
- Topics that have emerged from the process
- Why is it important to study end points that don’t always involve mortality (look at 30 day outcome, CPC neurological outcome, discharge data, and patient centred outcomes)
- How does this inform national strategic direction and focus
- Final thoughts from Sarah and Lisa & take-home messages.
You can find out more about PHOTON and Lisa Ramage here: https://fphc.rcsed.ac.uk/about/photon-group
You can find out more about EHAAT here: https://www.ehaat.org/about-us/our-people/
You can find the EHAAT Delphi study that is mentioned in the interview here: https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00835-z
You can find some of Sarah McLaughlin's publications here: https://www.researchgate.net/profile/Sarah-Mclachlan-5
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the latest solutions that BHA medical offer is the iMed end-to-end Covid-19 testing and monitoring solution. NPH iMed is an end-to-end Covid-19 testing and monitoring solution, developed in partnership with BHA Medical Limited to assist in collating and managing test results, reopen travel, leisure, events and entertainment. One of the first independent online test verification systems in the world, NPH iMed is a leading solution for testing, managing and monitoring all of your Covid-19 needs.
NPH Group has simplified the process of reporting test result data for you through our online platform which makes capturing the required data for submission easy, while easily recalling individuals for repeat testing and submissions. NPH have created a fully compliant and automatic upload capability, so you don’t have to worry about it, with a cost-effective solution. More can be found here:
https://bha-medical.com
https://www.bha-medical.com/imed-self-testing-monitoring-covid-19-app
Please enjoy this episode with two insightful and engaging guests
In this session we will examine the latest research and approaches to traumatic cardiac arrest with Richard Lyon. We will examine the demographics and diversity of pathology that clinicians see day to day within TCA. We will also examine survival rates, empirical research, blood products, the utility of high-fidelity simulation, and the importance of governance & debrief. We will also examine the usefulness of ultrasound and application in practice.
Richard Lyon is a Consultant in Emergency Medicine and Pre-hospital Care at the Royal Infirmary of Edinburgh and Clinical Lead for the Medic One team. He is a HEMS Consultant and Director of Research for Kent, Surrey & Sussex Air Ambulance. He studied at Edinburgh University where he developed close research links with the Scottish Ambulance Service. He undertook a unique doctorate thesis on out-of-hospital cardiac arrest, a project that has developed into a national strategy for cardiac arrest in Scotland.
In the episode we examine:
- A working definition of TCA
- Current thinking / acceptance of TCA algorithm differentiation
- Survival rates - Who are the survivors?
- Current empirical research
- What are the main domains of pathology
- Blood products in TCA
- High fidelity training.
- Internal governance and debrief.
- HF & Team dynamics within TCA
- Utility of USS
- Seminal cases.
- Final thoughts and take-home messages.
These are some of the latest algorithms related to TCA:
https://www.resus.org.uk/sites/default/files/2020-05/G2015_Traumatic_Cardiac_Arrest_Treatment.pdf
https://rcem.ac.uk/wp-content/uploads/2021/10/RCEM_Traumatic_Cardiac_Arrest_Sept2019_FINAL.pdf
https://fphc.rcsed.ac.uk/media/2577/tca-submission-oct-2018.pdf
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of their most innovative recent products is the D heart:
D-Heart is the first portable ECG device that is simple to use, clinically reliable, affordable and makes use of a smartphone. It allows anyone to perform a hospital-level ECG in total autonomy with the option to send the results to the 24/7 tele-cardiology service or to your trusted doctor. D-Heart allows you to track your heart health, explain possible unclear symptoms or to monitor the efficacy of medication. D-Heart will allow you to become an engaged partner in the management of your health. You can record an ECG whenever you have symptoms and share it with your trusted physician and to establish a shared decision-making process.
The image-processing and artificial intelligence will guide you to the correct electrode placement by showing you an image of your own chest with virtual marks placed where you should apply the electrodes. More information on the D heart can be found here:
https://www.bha-medical.com/d-heart-ecg-mobile-device
More information on BHA medical can be found here:
https://www.bha-medical.com/
Please enjoy this episode with both an insightful and fascinating guest.
In this interview we will examine some of the prevailing issues and incremental rise of Alzheimer’s disease within the global healthcare system. Cognitive decline is a major concern of the aging population. Already, Alzheimer’s disease affects approximately one in 14 people over the age of 65, rapidly becoming the third leading cause of death in the UK behind cardiovascular disease and cancer.
To do this I have with me Jennifer Bute. Jennifer was a GP in a large clinical practice, whose patients included those with dementia. Then she began to notice symptoms in herself and was finally given a diagnosis of young-onset dementia in 2009. After resigning as a GP, she resolved to explore what could be done to slow the progress of dementia. Jennifer has written a new book titled ‘Dementia from the inside’ and in this interview we will dig into some of the concepts form the book and speak around the wider aspects of the disease.
Jennifers website and book can be found here: https://www.gloriousopportunity.org/resources.php
More from Jennifer can be found here: https://www.gloriousopportunity.org/
Concepts she advocates including Japanese Memory Groups can be found here: https://www.gloriousopportunity.org/japanese-memory-groups.php
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the latest solutions that BHA medical offer is the iMed end-to-end Covid-19 testing and monitoring solution. NPH iMed is an end-to-end Covid-19 testing and monitoring solution, developed in partnership with BHA Medical Limited to assist in collating and managing test results, reopen travel, leisure, events and entertainment. One of the first independent online test verification systems in the world, NPH iMed is a leading solution for testing, managing and monitoring all of your Covid-19 needs.
NPH Group has simplified the process of reporting test result data for you through our online platform which makes capturing the required data for submission easy, while easily recalling individuals for repeat testing and submissions. NPH have created a fully compliant and automatic upload capability, so you don’t have to worry about it, with a cost-effective solution. More can be found here:
https://bha-medical.com
https://www.bha-medical.com/imed-self-testing-monitoring-covid-19-app
In this conversation I talk with Carl Betts about his reflections on paramedic retention in contemporary practice. Carl is a paramedic and quality improvement lead based in Sheffield working for the ambulance service. He has been a paramedic for 10 years and also has a 10-year extensive history of expeditions across the globe. We examine this article, Carl’s motivations for writing it, and pull out some of the salient learning points from his reflection in this interview. We examine some of the metaphorical warning lights that Carl describes (demand, resourcing, external management pressure), the spill over of GP work, e-consult and exponential rise of primary care. We also examine current hospital handover times, the central pivot and reason for staying in the role (patients) & the frustration seesaw that clinicians find themselves on. We also explore what the ‘outs’ and opportunities there are at the moment for paramedics, we also look at mental burnout and how should things change to avoid frustration and burn out, and finally a seminal case in reference to the conversation from Carl's experience.
The reflection can be found here:
https://wordpress.com/page/prehospitalcarepodcast335905859.wordpress.com/3
The rotational paramedic proposals can be found here:
https://www.hee.nhs.uk/our-work/paramedics/rotating-paramedics
https://www.hee.nhs.uk/sites/default/files/documents/Feasability%20Study%20of%20the%20Rotating%20Paramedics%20Pilot%20-%20Final.pdf
The future proposals from AACE can be found here:
http://aace.org.uk/wp-content/uploads/2015/09/Ambulance-2020-and-beyond-the-AACE-vision.pdf
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of their most innovative recent products is the D heart:
*D-Heart is the first portable ECG device that is simple to use, clinically reliable, affordable and makes use of a smartphone. It allows anyone to perform a hospital-level ECG in total autonomy with the option to send the results to the 24/7 tele-cardiology service or to your trusted doctor. D-Heart allows you to track your heart health, explain possible unclear symptoms or to monitor the efficacy of medication. D-Heart will allow you to become an engaged partner in the management of your health. You can record an ECG whenever you have symptoms and share it with your trusted physician and to establish a shared decision-making process.
The image-processing and artificial intelligence will guide you to the correct electrode placement by showing you an image of your own chest with virtual marks placed where you should apply the electrodes. More information on the D heart can be found here:*
https://www.bha-medical.com/d-heart-ecg-mobile-device
More information on BHA medical can be found here:
https://www.bha-medical.com/
In this session we will be talking with Noah Baron Cohen. Noah, now 22, 6 years ago in 2016 had a seminal event whilst exercising at The Jewish Community Secondary School in North London. Noah suffered a cardiac arrest from a primary arrhythmia causing a VF cardiac arrest. The adage that it takes a system to save a life truly came into focus that day. In this episode we will hear from Noah’s first-hand experience of that cardiac arrest and the events leading up to incident and how it has been a turning point in his life. Erran is Noah’s father and will also tell the sequence of events as he experienced it, both on that day in 2016 and the consequential roller coaster ride of Noah's rehabilitation.
We talk about Noah’s life before the incident, what Noah & Erran remember about that day, we run through sequentially timeline of events. We also speak about the recovery journey that Noah embarked on, the consequential shift in perspectives on life that it has given rise to, and finally take home message from Noah and Erran.
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the latest solutions that BHA medical offer is the iMed end-to-end Covid-19 testing and monitoring solution. NPH iMed is an end-to-end Covid-19 testing and monitoring solution, developed in partnership with BHA Medical Limited to assist in collating and managing test results, reopen travel, leisure, events and entertainment. One of the first independent online test verification systems in the world, NPH iMed is a leading solution for testing, managing and monitoring all of your Covid-19 needs.
NPH Group has simplified the process of reporting test result data for you through our online platform which makes capturing the required data for submission easy, while easily recalling individuals for repeat testing and submissions. NPH have created a fully compliant and automatic upload capability, so you don’t have to worry about it, with a cost-effective solution. More can be found here:
https://bha-medical.com
https://www.bha-medical.com/imed-self-testing-monitoring-covid-19-app
Please enjoy this episode with an inspiring pair of guests.
In this session we will examine the recent viral Monkeypox (MPV) outbreak with Professor Kelechi Nnoaham. We dig into the anatomy of the virus, the possibility of local transmission of the virus, the origins of the current outbreak, current prevalence, symptomatology, known transmission pathways, viral genetic adaptation, the R rate, Case Fatality Rate, containment (ring vaccination strategies), whether the MSM data is outlier data, and finally, surveillance of MPV.
Professor Kelechi is the Executive Director of Public Health and lead for Research & Development, Innovation and Value-Based Health for Cwm Taf Morgannwg University Health Board, Wales. Kelechi has held Honorary Professorships in Public Health and Epidemiology at Plymouth University (since 2015) and Cardiff University (since 2021) medical schools and previously worked as the Director of Public Health for Plymouth and Bristol City Councils. He has subsequently worked throughout leadership roles in public health and healthcare leadership across the UK. Kelechi has an MPH in Global Health Science (with Distinction) at Oxford University and followed that up with a PhD in Public Health & Epidemiology at Oxford University in 2011.
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy.
BHA’s latest innovation is a Monkeypox Lateral Flow Antigen Rapid Test.
The product is a lateral flow detection of monkeypox virus antigen in human whole blood, serum, plasma, rash exudate, or nasal swab. The product uses a double antibody sandwich method. During the test, a specimen is dropped into the specimen hole, the specimen is superimposed under the capillary effect. If the specimen contains monkeypox virus, a colour band appears in the test area (T) indicating a positive result for monkeypox virus. If the specimen does not contain the corresponding substance, there will be no colour bands in the test area (T), and the result will be negative. The Performance Characteristics show that the positive and negative coincidence rates are 100%
Please see the show notes for further details and how to order kits:
https://www.bha-medical.com/monkeypox-virus-antigen-rapid-test-kit
https://www.bha-medical.com
Please enjoy this wide ranging episode with an insightful guest.
In this session we will examine the importance and art of dispatch with Jerry Overton. Jerry Overton serves as the President of the International Academies of Emergency Dispatch, the organisation charged with setting standards, establishing curriculum, and conducting research for public safety dispatch worldwide.
Established in 1988, the International Academies of Emergency Dispatch (IAED) is the international standard setting and certification body for emergency dispatch. Currently, its protocols are in use in over 2800 dispatch centres in 38 countries. As the President of the IAED, Jerry leads the Academy, which allows advanced call taking, clinical assessment, and patient management by evidenced based telephone algorithms. Jerry has established international relationships for IAED and assists in the development of EMS systems worldwide.
- The importance of dispatch as a concept and model.
- Origins of targeted dispatch and how far we’ve come.
- Modelling – dispatch systems support tools (MPDS, ProQA).
- The four historical priority symptoms - chest pain; difficulty breathing; change in level of consciousness; serious haemorrhage.
- Importance of compliance to pre-arrival instructions.
- Paramedic/CCP additional dispatch – Silent interrogation, active interrogation, crew requests, advice to crews on the ground.
- Pre-arrival dispatch instructions (importance and nuances of these).
- Breathing diagnostic tools and the integration of software into the call taking script.
- Take Home Massages and reflections from Jerry
This podcast is brought to you in association with BHA Medical. BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. One of the most recent devices they sell is the D-Heart; D-Heart is the first smartphone ECG device that is simple to use, clinically reliable, portable and affordable. It allows anyone to perform a hospital-level ECG in total autonomy and to send the results to the 24/7 telecardiology service or to your trusted doctor.
· The app guides you to perform a professional ECG
· Bluetooth ECG streaming in real time
· Medical grade ECG (12 to 60 seconds of recording)
· Telecardiology service available 24/7
· Charge the device directly in the case
· Italian design and manufacturing
The D heart ECG device can be found here: https://bha-medical.com/medical-products/d-heart/
For further information on BHA medical please see here: https://bha-medical.com
Please enjoy this wide ranging conversation with an insightful and engaging guest.
In this session we will examine the fundamentals of head injury with consultant neurosurgeon Mark Wilson. We will dig into the details of brain injury, primary and secondary injury, the importance of venous drainage, and optimising the pre-hospital management.
Mark is a Consultant Neurosurgeon and Pre-Hospital Care Specialist working at both Imperial College (mainly St Mary's Major Trauma Centre) and as an Air Ambulance doctor. He is also a Clinical Professor specialising in Brain Injury at Imperial and Honorary Professor of Pre-Hospital Care (the Gibson Chair) at the Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh. Marks’ specialist areas are acute brain injury (mostly traumatic brain injury) and its very early management. He is also co-director of the Imperial Neurotrauma Centre and co-founder of GoodSAM, a revolutionary platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them. He has worked extensively overseas (India, Nepal, South Africa, as a GP in Australia, Researcher for NASA and as an expedition doctor on Arctic and Everest expeditions).
In the episode we examine:
- Incidence of brain injury
- TBI Vs NTBI pathology
- Doctor/Paramedic teams within neurological injuries
- Accuracy of our pre-hospital diagnoses with head injury
- Do we triage patients to the right places.
- Pre-hospital Anaesthesia and transfer to neurological units
- The importance of the basics done well even before formative PHC.
- Pupils and wider, lesser-known symptomatology
- Seminal case from Marks experience.
- Final thoughts from Mark and take-home messages.
This podcast is brought to you in association with BHA Medical.
https://bha-medical.com/about-us/
BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. There most recent product is the Vitalstream:
https://bha-medical.com/medical-products/vitalstream/
The Vitalstream is the world’s most innovative wireless non-invasive patient monitor, using a simple disposable finger cuff to measure Continuous Beat-by-Beat Blood Pressure “CNIBP,” Heart Rate, Respiration Rate, and other physiological parameters. This unique technology enables safe, secure, and accurate patient monitoring from virtually anywhere, including remote patient monitoring from a secure cloud portal. This solution provides real time data, enabling healthcare staff to provide early intervention and rapid response to a patient’s changing health conditions. Using a low-cost, disposable finger cuff, the VitalStream patented Pulse Decomposition Analysis (“PDA”) algorithms process the arterial pulse waveform to derive CNIBP, Heart Rate, Respiration Rate, and other hemodynamic parameters.
Please also check out further devices and services offered by BHA medical here:
https://bha-medical.com
I hope you enjoy this episode with an insightful and engaging guest.
In this session we will examine the fundamentals of Mountain Rescue with Paramedic Jamie Patterson and Emergency Nurse Practitioner Ben Cooper. This will include a look at the demographics and diversity of rescues within the Mountain Rescue Team (MRT). We will also examine the different specialist domains that constitute being a member of the MRT such as navigation, search strategies, team dynamics, Immediate Medical Care (IMC), casualty evacuation and much more. Finally, we will examine some seminal cases where all of Ben and Jamie’s training has come to use. Both World Extreme Medicine colleagues examine the following topics:
- Why is the MRT a fundamental part of an emergency response out on the hill?
- What a MRT comprises of (the size, the diversity of background and profession)?
- Domains of practice that are relevant
- What the education and training looks like from the inside.
- Internal governance and debrief.
- Risk management and mitigation
- Search strategies
- Importance of team dynamics
- The immediate medical care and ceilings of care on scene.
- Casevac
- Seminal cases from both guests
Further resources recommended by the guests include:
Go outside. Sit down. Wait.
https://dmbins.com/blog/go-outside-sit-down-wait/
Mountain Rescue Doctor: Wilderness Medicine in the Extremes of Nature
https://www.amazon.co.uk/Mountain-Rescue-Doctor-Wilderness-Medicine-ebook/dp/B000V770NC
Mountain Rescue: History and Development in the Peak District 1920s-Present Day
https://www.amazon.co.uk/Mountain-Rescue-Development-1920s-Present-1920s-2007/dp/0752440918
Cairngorm John: A Life in Mountain Rescue
https://www.amazon.co.uk/Cairngorm-John-Allen/dp/1905207573
Call-out: A climber's tales of mountain rescue in Scotland
https://www.amazon.co.uk/Call-out-climbers-mountain-rescue-Scotland/dp/1911342215
World Extreme Medicine - Fundamentals of Search & Rescue | Northumberland | October 2022
https://worldextrememedicine.com/products/search-rescue/sar/
If you have any specific Mountain Rescue questions, Jamie Patterson is available to take these at: jamie.pattison90@gmail.com
I hope you find this episode both engaging and insightful.
In this session I will be talking with Allistair MacSorley around his journey through pre-hospital care as a paramedic and then a day in 2018 that changed his life forever and left him paralysed from the waist down. We will also be examining his tenacity, drive and attributes that separate him from the crowd. He is currently still working as a registered Paramedic and part of the maternity team within London Ambulance Service. He is also part of the Irish paracycling development squad in hand cycling. He is training for and focussed on the next hand cycling World Cup in May in Belgium, aiming towards ParaOylpmics Paris 2024 and then the LA games 2028. He has adapted and employed a coach from September 2021 which has fundamentally changed his training program and diet. The carbon fibre cycle bike is a £15,000 specialised bike with adaptations and enables Ali to compete at elite level.
In the conversation we discuss:
- The introduction to Alistair’s life growing up
- His father’s influence and motorbikes
- His training as a Paramedic
- What he took his training and facets of his career
- The career break and what he learned whilst away
- The incident and injuries sustained
- The recovery
- The adaptations to life
- His current role (LAS and cycling)
Ali's story can also be found here:
https://www.irishnews.com/news/northernirelandnews/2019/07/29/news/-flying-doctor-left-paralysed-after-motorcycle-crash-returns-to-circuit-a-year-later-to-complete-lap-1672238/
https://www.bbc.co.uk/sport/motorsport/49140461
Please enjoy this episode with a truly inspiring professional and friend.
In this session we examine the importance of governance and the main facets that constitute robust governance. This includes a look at why governance is important, the different domains that constitute good governance and finally how it is applied in practice. We will also look at the fundamentals of risk management within governance and the symbiotic relationship between the two. To do this I have Intensive Care, Anaesthetic and Pre-hospital care consultant Pete Sherren with me. In the conversation we unpack:
- What is governance and why it is a vitally important feature of a culture of improvement.
- The facets of good governance and cultural commitment.
- Education and Training.
- Clinical audit.
- Clinical effectiveness.
- Research and development.
- Openness
- Information Management
- Finally Risk management and how this is important for the patient clinician, and institution.
Links to the Delphi study that we mention in the conversation can be found here:
Consensus on research priorities for Essex & Herts Air Ambulance: a Delphi study: https://sjtrem.biomedcentral.com/track/pdf/10.1186/s13049-021-00835-z.pdf
Please enjoy this conversation with an engaging and insightful guest.
I'm pleased to release this recently recorded episode with ED consultant Dr Amy Hughes. Amy has launched the 'Portfolio Medical Careers' Podcast which details interesting narratives and career paths from various medical careers. This series will cover doctors, paramedics, nurses, and other allied healthcare professionals with different stories and paths within and outside of the National Health Service (NHS). She has some fantastic interviews lined up and really gets to the heart of emphasising the 'journey and not just the destination'. The podcast also denotes that various experiences can feed into the wider clinician and person and give more rounded and diverse experience from which to draw.
This month we join Paramedic Eoin Walker. Eoin has been a practising paramedic for over 20 years and journied through a fascinating career including the LAS cycle response unit, Physician Response Unit, London's Air Ambulance (HEMS), LAS Advanced Paramedic Practitioner, Expedition Medicine and, most recently, a role with the International Committee of the Red Cross (ICRC).
The podcast can be found here:
https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQwMDc3NS9yc3M/episode/YTlhYTI3NjktYWFkNS00MDBlLWEzODctM2FhZjIwZjBjNGUz?hl=en-HU&ved=2ahUKEwjMi4nizsX2AhXUiP0HHY46DecQjrkEegQIBhAF&ep=6
In this session we will examine some of the prevailing issues and difficulties of paediatric pain management. To do this I have Will Broughton, an associate professor of paramedic science at Buckinghamshire New University, Paramedic with specialist interest in Paediatric Emergency Medicine and Paramedic Education. He continues to practice clinically with London Ambulance Service (LAS) and South Central Ambulance Service (SCAS).
We will unpack some of the nuances, challenges, and evidenced based approaches that Will has found from being both a pre-hospital practitioner and studying his MSc in this domain of practice. In the conversation we discuss:
- Definitions of pain and what it means to children.
- Physiological consequences of pain in paediatrics
- Difficulties of pain management in Paediatrics
- Pain relief routes available and advocated (NICE)
- Pain assessment - Wong and Baker, visual analogue scales.
- The utility of the FLACC score
- Monitoring difficulties and challenges
- Human factors with Pain - Parents, stressful environment
- Tx/Pain Mx strategies - NICE, preferences, nuances.
- Take homes messages.
Resources that are mentioned in the episode include:
CRIES pain scale http://geriatricphysio.yolasite.com/resources/CRIES%20Scale%20for%20Neonatal%20Postoperative%20Pain%20Assessment.pdf
WHO pain ladder https://professionals.wrha.mb.ca/old/professionals/files/PDTip_AnalgesicLadder.pdf
Children in painhttps://rcem.ac.uk/wp-content/uploads/2021/11/Pain_in_Children_2017_18_National_Report_Oct_2018.pdf
Wong and Baker faces https://wongbakerfaces.org
I hope you enjoy this episode with a fantastic guest. Will Broughton can be reached on Twitter at @WilBroughton
In this session we will be interviewing flight paramedic Paul Swinton, to talk about how to optimise the RSI in the pre-hospital environment. We will unpack some of the nuances, challenges, and approaches that Paul has found from being both a pre-hospital practitioner and in innovating the layout and design for an RSI in creating the SCRAM bag. SCRAM™ (Structured CRitical Airway Management) is an innovative solution for enhancing the performance of emergency airway management. It involves the systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM.
Paul has been a paramedic for the past 20 years. He joined the Scottish Ambulance Service Special Operations Response Team, based in Glasgow, in 2010, after re-locating from the West Midlands Ambulance Service. He is currently an Air Ambulance Paramedic for the Scottish Air Ambulance Division, involved in critical care and retrieval medicine, working alongside the trauma teams and medical retrieval services of Scotland (ScotSTAR). He is originally from South Africa, where he qualified and worked as a paramedic on the road, in Emergency Departments and as a flight paramedic.
This podcast is brought to you in collaboration with Scottish Health Innovations Limited, also known as SHIL, who work in partnership with NHS Scotland to identify, protect, develop and commercialise healthcare innovations to improve patient care. SHIL uses specialised knowledge to help bring new ideas and innovations from healthcare professionals to life, with a multidisciplinary team providing expert services including intellectual property advice and protection, regulatory expertise, project management, idea incubation, funding advice, development, commercialisation, and post-commercialisation monitoring.
You can follow SHIL’s work on Twitter, @ScotHealthInno
You can find out more about SHIL here: https://www.shil.co.uk/
You can find SHILs products here: https://www.shil.co.uk/browse/products
This podcast is also brought to you in association with Openhouse. Openhouse take a unique approach to creating products in focussing on a ‘Fit For Purpose’ end product. Their focus on creating truly bespoke products along with the best possible purchasing experience which means they have strong working relationships with customers from all sectors of industry.
Openhouse products can be found here: openhouseproducts.com
You can follow Openhouse on twitter @OHproducts
You can find out more about Openhouse here: https://www.openhouseproducts.com/about-us/
You can see the SCRAM range as mentioned in the episode here: https://www.openhouseproducts.com/?s=SCRAM&post_type=product
You can find out more about the guest here: https://paulswinton.com
I hope you enjoy this episode with an engaging and insightful guest.
In this session we will examine the epidemiology of OHCA. We will look at the frequency and trends of OHCA together with the causes and risk factors. We will examine the concept of a registry of cardiac arrest and appreciation of baselines to work from. We will also look at the current mitigation strategies that are available to prevent OHCA such as policy, and Public Access Defibrillation (PAD) amongst others. We will also look at our guest's PhD (Dr Katherine Pemberton) and how that both informs the current climate and the future of how we tackle OHCA.
We examine:
- The current statistical climate - in Wales and Queensland
- Main contributing factors/risk factors around incidence
- Patterns between the two areas both in disease prevalence and problematic rate-limiting steps in decreasing OHCA.
- Cornerstones of policy that need/require adaptation
- PAD/Public Access Defibrillation and the importance of community engagement
- Social demographics and how OHCA maps onto social deprivation
- Iterative solutions (no magic bullet concept)
These are links to Dr Pemberton's literature review:
https://ajp.paramedics.org/index.php/ajp/article/view/752
https://ajp.paramedics.org/index.php/ajp/article/view/753
These are the pubmed links.
https://pubmed.ncbi.nlm.nih.gov/31352680/
https://pubmed.ncbi.nlm.nih.gov/31352690/
https://pubmed.ncbi.nlm.nih.gov/33219108/
Please enjoy this episode with two insightful and engaging guests
The best of the 'Restore Podcast 2021' is here. This conversation features accounts with Consultant psychologists, psychiatrists, special forces operatives, professional rugby stars turned drug addicts turned pastors, inspirational leadership coaches, accounts on NLP, Neuroplastic Somatic Practice, EMDR therapy, CBT, and much, much more.
The mandate is…raw and inspirational conversations with the application of deep understanding and revelation. In the world of memes and brief captions that sound good in the moment, we need real, raw, and deep accounts and tools to navigate one of the most difficult segments of time in life. Instead of falling for a brief caption that means nothing and lasts only a moment, instead try leaning into these life accounts of how people have turned around their lives from truly testing times. Wisdom is the life application of knowledge. It is found in a deep understanding and fostered through narrative and tools most of which don’t lay within our own capacity and rely on us being willing to hear others survive and thriving through adversity.
My thanks to all the guests that have featured across the podcast in 2021. I look forward to taking you with me into 2022 for more inspirational conversations and truly revelationary accounts.
In this episode we look at the debrief in its entirety; why we debrief, when, how and where. We examine the evidence behind debriefing and the institutions that use debrief such as the military, pre-hospital practitioners, ward based staff, sports teams, athletes and others. We then look at the types of debrief such as the hot & cold debrief, Schwartz rounds, Critical Incident Stress Debriefing, the After Action Review amongst others. We then examine 6 tools of debriefing that can be used in practice. We briefly also touch on the disparity of evidence around mitigation of psychiatric pathology such as PTSD.
Here are some of the tools mentioned:
- TAKESTOCK https://www.rcemlearning.co.uk/foamed/take-stock-hot-debrief/
- STOP5 https://www.stemlynsblog.org/wp-content/uploads/2018/10/Hot-Debrief-Poster-V2-April-2018.pdf
- PLUS DELTA https://fhop.ucsf.edu/sites/fhop.ucsf.edu/files/custom_download/ACPS_Plus_Delta_Template.pdf
- MODIFIED PLUS DELTA https://leanconstruction.org/media/learning_laboratory/Plus_Delta/Plus-Delta.pdf
- ITRUST Debrief https://www.bmsc.co.uk/course/itrust-debriefing/
- PEARL debrief https://debrief2learn.org/pearls-debriefing-tool/
I hope you enjoy this episode
In this episode, we are going to examine a story of one of the key innovations in pre-hospital care in the last 20 years and how it came into existence. We will look at the Cycle Response Unit or CRU that see’s Paramedics respond to emergency calls via mountain bikes across the nation. To do this we have the creator and founder of the CRU Tom Lynch MBE, MStJ.
Tom Lynch has channeled his excellent cycling and coaching skills, his self-belief, and his competitive spirit to develop and deliver the CRU.traveled the world as a BMXer, won numerous trophies and titles several times over, appeared on the front page of magazines, had fans on every continent and lived a life people can only dream of. In 1999 Tom got the go-ahead for a trial to set up the Ambulance Cycle Response Unit (C.R.U.) to answer 999 calls in the West End of London. He still had friends in the bike industry from BMX days and he made sure he got the best equipment available. The bike was fitted with the latest pre-hospital equipment and the all-important lightweight defibrillator. This marked the beginning of a legacy of paramedics on mountain bikes, but it wasn’t always an easy ride. we examine the history and background, Tom’s struggles and battles to get the project off the ground, some of the seminal cases in which the CRU has been involved, and some of Tom’s best moments.
In the conversation we examine:
- Tom Lynch's background growing up
- History & inception of the CRU
- Demographics served across London and wider teams across the UK
- Advantages over other vehicles over time and environment
- Seminal cases that the CRU have attended/made a difference to
- CRU Awards achieved
- Some of the battles and struggles Tom has faced and overcome
- What it gives back to both the community and the clinician.
- Some of the key takeaways
I hope you enjoy this episode with two fascinating guests.
In this session we will examine the recently published in the Journal of Paramedic Practice on 'Focused ultrasound in out-of- hospital cardiac arrest by Advanced Paramedics'. To do this I have Advanced Paramedic Practitioner, author and lecturer Nick Brown.
In the episode we discuss why ultrasound is used, what device is used and what APPs use it for. We also discuss the primary and secondary outcomes of the study, the population the study focusses on (OHCA) and the problem/question they are seeking to address (cardiac arrest management/termination). We also explore the study's methodology, the differentiation of results, the conclusion, the clinical relevance to practice, what Nick took from performing the audit and the salient take home messages from the study.
The research article can be found here: https://www.magonlinelibrary.com/doi/abs/10.12968/jpar.2021.13.1.26
Please enjoy this episode and feel free to rate and review the podcast.
In this episode we will examine the various ways in which paramedic education has evolved over the past 20 years both conceptually and the skills taught within the profession. Alan Rice and Lisa Burrell join me in this conversation, Alan is the lead for post-registration paramedic education at St Georges University, London. His role is predominately designing and organising the delivery of education for specialist and advanced paramedic roles in both urgent and critical care. He also oversee’s the work force development of all qualified paramedics that are studying towards a higher education award. Alan also works as a consultant paramedic advising ambulance trusts.
Lisa Burrell is both an Advanced Paramedic Practitioner in London and a senior lecturer at St Georges university. Lisa teaches on both the post and undergraduate cohorts and spends time teaching CCPs from different services. She has also spent over 8 years as a flight paramedic within London and has split her time between teaching and critical care.
In the episode we talk about:
· The concept of critical thinking & analysis - a central concept of education.
· The diversity of care pathways and how this has changed over 20 years.
· Non-technical skills taught and emphasised throughout the curriculum and course.
· Mentoring - the importance of this.
· Monitoring and the use of monitors within pre-hospital care.
· Engagement with technology for current practitioners.
· Skills that have evolved – USS, thrombolysis for VTE, prescribing, Abx,
· Anecdotal thoughts on evolution of both the profession and the paramedic practice curriculum.
The undergraduate Paramedic Science course at St Georges University London can be found here:
https://www.sgul.ac.uk/study/courses/paramedic-science
Please enjoy this conversation with two fantastic guests.
In this episode we will examine the various pathologies related to psychosis and neurosis in mental health that clinicians can see within practice. We also examine some of the key aspects of these pathologies so that clinicians can construct both meaningful and targeted treatment to this extremely difficult cohort of patients. To do this am am joined by Anna Basquil, a special mental health practitioner who joined the ambulance service in January 2020, seconded by her mental health trust to provide and help embed the 'dual assessment model' on patients. She works on the 'Mental Health Joint Response Unit' together with a Paramedic. Prior to this Anna was working in an 'early intervention service' with patients experiencing their first episode of psychosis. Anna worked in patients early years of diagnosis to help them both integrate and cope with their symptoms to help normalise and stabilise their lives.
In the interview we discuss:
- Some of the fundamental differences between psychoses and neuroses.
- The demographics of each pathology
- Deep dive into Psychoses – definition, types, signs and symptoms.
- Examine schizophrenia as the most common type of psychosis.
- Brief look at prodromal phase, acute phase and recovery phase of psychotic episodes.
- Deep dive into Neuroses – definition, types, signs and symptoms.
- Examine depression and anxiety as the most common types of neuroses.
- Brief look at triggers for neuroses.
- Managing episodes of neurosis
- Managing psychotic episodes
More information on the 'Mental Health Joint Response Unit' can be found here: https://aace.org.uk/initiatives/mental-health-joint-response-car/
I hope you enjoy this episode with an engaging and informative guest.
In this session we will examine some of the prevailing educational learning from a colleague who has just qualified as a critical care paramedic in London. We will unpack some of the revelations, nuances, and comparisons that critical care has brought from their perspective from other roles. In the episode we dig into Adam’s background and why the Advanced Paramedic Practitioner in critical care career pathway was appealing to him. We also examine what has it brought Adam from a wider perspective and the nuances in care compared to standard paramedic practice.
We then unpack Adam's personal revelations that were previously unknown and what he took from the mentoring aphase of his critical care training. We finish off by looking a few seminal cases and how that both inspired him and helped him learn along the way.
I hope you enjoy this episode with both an honest and insightful guest.
In this session we will examine the varied pathology of Transient Loss of Consciousness (TLOC), the definition, the causes, the sequalae, and the management. I wanted to also examine some of the key aspects of TLOC that are red flags and should be examined further within clinical practice. To do this I have Consultant Cardiologist and Honorary Senior Lecturer, Dr Nicholas Gall with me.
In the episode we look at an established definition of TLOC, Nick's efforts to start a blackout pathway, the fundamental problem of TLOC in unpacking why undifferentiated TLOC can be a clinical minefield. We then examine the aetiology of TLOC and the diagnostic tools with which to differentiate the pathology (USS and ECG nuances). We then look at red flags warning signs and subtle information cues with TLOC, treatment of TLOC patients (broad take home messages) and clinical examples from practice.
I hope you enjoy this episode with a fascinating and insightful guest.
In this session I speak with Professor Kelechi Nnoaham. We examine the prevailing themes of public health within the contemporary pandemic. We examine some of the key aspects of public health necessary to overcome one of the most challenging public health issues since the inception of the NHS. We dissect some of the fundamental principles of public health, the info-demic war of information, the contemporary evidence-based research, decentralised leadership and more.
Professor Kelechi is the Executive Director of Public Health and lead for Research & Development, Innovation and Value-Based Health for Cwm Taf Morgannwg University Health Board, Wales. Kelechi has held Honorary Professorships in Public Health and Epidemiology at Plymouth University (since 2015) and Cardiff University (since 2021) medical schools and previously worked as the Director of Public Health for Plymouth and Bristol City Councils. He has subsequently worked throughout leadership roles in public health and healthcare leadership across the UK. Kelechi has an MPH in Global Health Science (with Distinction) at Oxford University and followed that up with a PhD in Public Health & Epidemiology at Oxford University in 2011. In the conversation we examine:
- The current public health climate – acute versus chronic needs, secondary infection rates.
- Collaboration – joined up working versus independent initiative
- The information war – The ‘info-demic’
- ‘Press release’ medicine – effectiveness and impact.
- The principles of public health - The big 5 - population health management, prevention, population health research, knowledge mobilisation and collaborative working with communities.
- The 4, 4, 54 principles within a public health context
- Empirical research in the current climate; disaggregation of data (lack of sub-group analysis), action with absence of published data, equity of authorship, retraction of papers, robustness of evidence, retraction of studies, increase in corrections in 2020, decrease in RCTs & Meta analysis, decrease in ethics and consent.
- Decentralised ownership of health (internal locus of control).
Professor Kelechi can be contacted through the following platforms;
• Twitter - @CwmTaf_DPH, @KelechiNnoaham
• LinkedIn - linkedin.com/in/kelechi-nnoaham-1649937
Please enjoy this interview with an insightful and fascinating guest.
In this episode I speak with Dr David Stehlik on leadership, followership and organisations. Dr Stehlik is the programme director for the Keith Bussey School of Business and entrepreneurial leadership at the University of St Francis in Fort Wayne in the US. He is also the the founder of a strategy and business education consultancy ‘Fourscene’ related to the field of strategic foresight. He is a strategist, an educator and team developer, he has also published a book called ‘Integrated delivery - innovating leadership for outstanding healthcare outcomes’ that was released at the beginning of 2021.
In this episode we speak about what constitutes ‘great leaders’, and then dissecting the antithesis of this in the anatomy of failing leaders. We also examine:
- Self-awareness and tools to help get there (SWOT analysis, Johari’s window)
- Great followers and failing followers
- The consequences model & Role-playing model & conflict resolution
- The AI model
- Great organisations & failing organisations
You can contact David at https://www.foursceneventures.com/about.html
You can also read the article that the interview is based on here: https://www.regent.edu/acad/global/publications/jpc/vol5iss1/3-stehlik.pdf
I hope you enjoy this episode with a fantastic guest.
In this session we will examine a recent publication by Clinical Practice Development Manager of the Advanced Paramedic Practitioner for critical care scheme in London Ambulance Service, Mark Faulkner, which is featured in the Scandinavian Journal of Trauma, resuscitation and emergency medicine. The case study involved the resuscitation of a VF cardiac arrest in a 3-month-old infant.
The link to the case report can be found in the show notes and in this episode, we will be speaking with Mark (one of the authors) to both explore the case and some of the essential learning points that surround cases like this.
We explore the following themes:
- The current statistical climate of cardiac arrest and infant cardiac arrest
- Prodromal symptoms of sick infants
- The utility of sense checks with a clinician in the control room
- Use of standard and extended diagnostics to recognise ROSC such as USS
- Deviation from protocol (post shock pause) for good reason
- Differentiating recurrent from refractory VF from the download
- Underlying causes of structural and electrical abnormalities and cardiac myopathies
- The utility of a HOT debrief in these cases as an intrinsic benefit.
The article from the interview can be found here:
https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00871-9
References to articles that Mark mentions throughout the interview can be found here:
https://pubmed.ncbi.nlm.nih.gov/19913971/
https://www.sciencedirect.com/science/article/pii/S1521689620301087
https://www.magonlinelibrary.com/doi/full/10.12968/jpar.2021.13.6.232
I hope you find this episode insightful and useful.
In this session, we interview Gaynor Prince. Gaynor is an emergency physician based in New Zealand and has developed a subspecialty interest in ultrasound in ED. We take a look at point of care ultrasound, its utility and its limitations. We will be especially focussing on the EFAST and how it has been adaptive and progressive in point of care treatment in the past 5 years. We also take a look at ultrasound probes and the positive and negative interaction with tissue. Gaynor unpacks some of the fundamental advantages and disadvantages of POCUS and how it has been adapted, been made portable and democratised amongst clinicians in recent years.
We unpack the principles of EFAST, what we are looking for, when to look and where. We examine the difference image representations of fluid, blood, ascites, urine, intestinal contents, lungs, air. Gaynor them looks at the anatomical variations and how to optimise the view, interplay with clinical questioning, repetition of scans and preferential windows to see the anatomy. We go sequentially through the EFAST and look at tips and tricks from Gaynor's practice and how these can be related to everyone's ultrasound practice and decision making.
We finally look at a prime example of when USS has been really useful to Gaynor's practice in one of the remotest and most extreme environments - Antarctica. She recalls a story of when ultrasound greatly assisted her decision making, illustrating some of the unique examples of this modality in remote and austere locations.
You can see more from Gaynor here: https://www.wem.academy/videos/extreme-medicine-research/ultrasoundinextremeenvironments/
This episode has been kingly re-shared from WEMcast. World Extreme Medicine provide courses, resources, training and conferences and can be found at: https://worldextrememedicine.com
Please enjoy the episode.
Caroline Philips is back for the fourth instalment of the maternity mini series. Caroline is joined by Stacey Robinson the LAS practice lead midwife and Sarah Brown the LAS practice lead paramedic. In this episode they focus the on management of various pathologies, including bleeding, cord prolapse, shoulder dystocia, and all types of other maternal emergencies and treatment modalities seen within the pre-hospital environment.
They dig into the technical and non-technical elements of care for the above pathologies and some of the different manoeuvres that optimise the mother and baby’s health in difficult deliveries. In this final episode we hear from these two specialists as they draw upon their experience, knowledge and oversight to relay some of the most essential aspects of care in maternal emergencies.
Our thanks goes to London Ambulance Service for allowing these professional perspectives to be shared and for being a forerunner in recruiting midwives and specialist paramedics with a maternal pre-hospital care focus to support the wider frontline staff. We hope you enjoy this episode with two fantastic clinicians.
In this episode Caroline Philips speaks with Stacey Robinson, prehospital midwife about challenges and emergencies of early pregnancy. They discuss bleeding, termination of pregnancy, and miscarriage. Stacey addresses why bleeding occurs and how to assess for it in the first trimester; inclusive of the subjective terms of 'light' and 'heavy' bleeding. They also discuss the potential risks and the atypical presentations that can occur within the first trimester. Stacey discusses some of the nuisances of care that can be provided to this cohort of patients, together with the hidden signs of bleeding.
Stacey also discusses the psychosocial aspects of care around bereavement and loss which can occur around this pathology. Stacey reinforces the importance of psychological reassurance and care which are vitally important to this patient group.
Relevant links that are useful for this episode can be found here:
https://www.miscarriageassociation.org.uk/wp-content/uploads/2019/08/Ambulance-Crews-first-responders-Good-Practice-Gude.pdf
https://www.miscarriageassociation.org.uk/information/for-health-professionals/e-learning/
https://nbcpathway.org.uk/professionals
We hope you find this interview valuable with an insightful and engaging guest.
To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team.
https://www.medics.academy/courses/medics-academy-fellowship-programme-application
You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases:
· skill training and learning,
· skill development
· skill application
The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment.
As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
In this episode Caroline Philips interviews Stacey Robinson; pre-hospital midwife, on a variety of maternity and newborn topics that pre-hospital providers might face on scene. Having embedded herself within an ambulance service, Stacey gives a unique and insightful perspective on common myths, unique presentations, and healthy fundamental baselines of maternal and newborn care.
This is a four part series, in this episode Stacey unpacks her role, the 'normal labour' scenario and deviation in physiology to be expected in pregnancy. They look at why physiology changes and some of the important details around history and examination. They also examine some of the non-pharmacological methods of optimising birth (skin to skin, micturition, non-technical skills, drying).
Here are some useful links for this mini series:
https://cprguidelines.eu/assets/guidelines/RESUS-8907-NLS.pdf
https://nbcpathway.org.uk/professionals
https://www.miscarriageassociation.org.uk/information/for-health-professionals/e-learning/
https://www.miscarriageassociation.org.uk/wp-content/uploads/2019/08/Ambulance-Crews-first-responders-Good-Practice-Gude.pdf
https://www.tommys.org/baby-loss-support
Please enjoy this episode with a truly insightful guest and experienced midwife.
To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team.
https://www.medics.academy/courses/medics-academy-fellowship-programme-application
You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases:
· skill training and learning,
· skill development
· skill application
The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment.
As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
This session will be the first of a mini-series examining the first-hand accounts of clinicians at some of the most well-known major incidents in the past 20 years. We will start the series by looking at the London bombings from both my perspective and a paramedic Team Leader now Critical Care Paramedic Ken Murphy. We will examine from our anecdotal experience how the scene unfolded and how it became apparent that 3 other bombs had detonated in quick succession. We will walk through some of the thoughts, recollections and structural components and just how it felt to be part of the largest coordinated terrorist attack that the UK has ever seen.
In the episode we examine:
- Our day up until that point
- The initial call to Kings Cross for a reported power surge
- The confirmation down in Aldgate East
- Arrival on scene and what met us
- The triage and extrication
- CSCATTT and closer look at the 3 Ts
- Transfer of patients to the Royal London Hospital
- Kings Cross – the casualty clearing station and transfer of patients
I hope you enjoy this first hand account that examines the difficulties and realities of major incidents.
To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team.
https://www.medics.academy/courses/medics-academy-fellowship-programme-application
You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases:
· skill training and learning,
· skill development
· skill application
The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment.
As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
In this episode I speak with GP Natalie Taylor and Paramedic Jamie Patterson on Expedition Medicine. We examine the skills, schemes, teams and courses that are helpful to prepare you for this dynamic environment. We will dive into our guests experiences to see what has worked for them and how they have navigated previous expedition trips. A special thanks goes out to World Extreme Medicine as we all met through this platform and have indeed all worked for WEM throughout our careers.
We take a look at:
- The diversity of experience of both guests
- Main themes of expedition medicine – % of non-medical issues, Human Factors, self-care, self admin, primary care
- Group / team dynamics and how psychological health also plays a part
- Trauma on expedition
- Education and experience needed to go on the trips
- Rate limiting steps on all expeditions and things to be minded of as a clinician
- The casevac - nuances and tips
- Some of Nat and Jamie’s most amazing highlights from expedition
I hope you enjoy the episode.
You can find more from World Extreme Medicine, courses and everything expedition here:
https://worldextrememedicine.com
To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team.
https://www.medics.academy/courses/medics-academy-fellowship-programme-application
You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases:
· skill training and learning,
· skill development
· skill application
The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment.
As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
In this episode I examine critical care communication and why this is so important within clinical practice. I look at definitions & statistics, the communication problem, the anatomy of communication, the patient, team and individual, leadership communication, empathetic communication, conflict management communication and finally crisis communication. I examine the approach to individual communication that can optimise both sent and received communication, the main facets of non-verbal, verbal and tonality that is needed to confer vital information.
I also look at a number of theories that have deconstructed the problem of communication, these are; communication theory, Millers Magic number 7, The communication triangle, signal detection theory, and finally meta-cognition. I break down some of the central concepts of the main aspects of critical care communication that are used on a day-to-day basis, that of, leadership, empathy, conflict and crisis. I hope you enjoy this topic. We are going to start mixing up the content on the podcast and feature more educational content, lecture sets as well as more traditional interviews and conversations with experts within their field of practice.
To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team.
https://www.medics.academy/courses/medics-academy-fellowship-programme-application
You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases:
· skill training and learning,
· skill development
· skill application
The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment.
As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
In this session we examine some of the ways in which we have seen paramedics diversify through a multitude of roles within the healthcare economy. We chat with Gary Strong; Paramedic and CPD lead from the College of Paramedics and Caroline Phillips; my co-host, Paramedic and Palliative care Paramedic. The session is intended to unpack, examine our roles and journey through pre-hospital care and finally give insight into some of the positive and challenging aspects of diversification we have seen within paramedic practice in the contemporary climate.
In the episode we discuss:
- The variety of roles that are open to Paramedics & ways in which Paramedicine is changing.
- We examine Gary’s path through Paramedicine, how he has got to where he is now and what got him there (education, roles and reflections).
- Caroline’s path through Paramedicine, from education, roles and reflections on current and past job titles within paramedic practice.
- My own (Eoin’s) path through Paramedicine, how I have got to where I am now and what got me there (education, roles, reflections)
- Final thoughts on pathways, education and the future of diversity and the role of a paramedic itself.
As we see the diversity of roles within our expansive field of practice we reflect on where the profession has come from and how quickly it has adapted to new eco-systems of healthcare. We also reflect on some of the fundamental traits of paramedics around adaptability and flexibility as the DNA of what makes a paramedic so integrated and embedded within various domains of practice.
I hope you enjoy this wider ranging conversation on the evolution of the 'paramedic'.
In this episode Caroline Philips interviews Sarah Aldington; a Consultant Emergency Physician in Sydney, she is also a pre-hospital & retrieval specialist with Sydney HEMS. Sarah formerly worked in respiratory medicine in the UK before studying her PhD in New Zealand focusing on the prevalence of cannabis smoking induced COPD and lung cancer. Whilst in Wellington Sarah established a choir for COPD patients called 'Sing Your Lungs Out (SYLO)'.
In this interview Sarah gives a fantastic insight into advanced lung disease and a patient focused approach to this life limiting illness. Sarah recounts this amazing initiative that took on a life of its own and instilled a community of like minded sufferers. Sarah and Caroline share insightful perspectives on what truly matters to patients and how this initiative changed Sarah's perspectives on her approach to medicine.
Please enjoy this episode with a fantastic guest.
More on the choir they speak about can be found here:
https://pubmed.ncbi.nlm.nih.gov/27650768/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294022/
https://pcnnz.co.nz/wp-content/uploads/2016/05/Health-Happiness-Community-Gayle-Williams.pdf
https://givealittle.co.nz/org/sylo#:~:text=The%20Sing%20Your%20Lungs%20Out,living%20with%20chronic%20lung%20disease.&text=Neighbourhoods%20Fun%20Awareness-,The%20Sing%20Your%20Lungs%20Out%20(SYLO)%20Choir%20is%20a%20community,of%20life%20and%20lung%20function.
In this session Caroline Philips interviews two of the advanced paramedics in urgent care. The conversation includes; their role on a day to day basis, this structure of the scheme and how there time is spent. They also examine how previous pre-hospital roles (such as clinical advise, team leader/manager roles) have helped with the senior clinical role as an APPUC. Nikki and Andrew also catalogue the variety of patients that they see and the in-depth patient focussed history taking and nuanced risk/benefit analysis undertaken. They also discuss some of the skills that the scheme supports such as wound care assessment and closure methods, point of care tests, additional medications and utilisation of alternative referral pathways. Nikki and Andrew also denote the adjunctive education and skills that have been fostered within the APPUC scheme.
As the prevailing percentage of demand within pre-hospital care are medical pathologies, this scheme has had bilateral benefit of supporting frontline paramedics and managing patients in the community and avoiding the transfer through to the emergency department where possible. They also denote the change in communication skills that Nikki and Andrew have both witnessed within their practice.
Please enjoy this fantastic episode with two insightful practitioners.
Claire is a registered Nurse and Paramedic working as a frailty coordinator at Brook Green Medical Centre, London (HAFP Primary Care Network) with Dr Anna Wilson (Lead GP) and Dr Emily Eve as part of a frailty team. She also sits on the College of Paramedics Committee for primary and urgent care specialist interest group. Claire works as a part community matron as well as a registered paramedic and receives referrals to both support and link the patient into appropriate care pathways.
In this episode Claire and Caroline discuss the definition of frailty, contributing factors and the sequelae of neurological disorders contributing to frailty. Clare also discusses baselines of health and the phenotype model and the cumulative deficit model. Caroline also talks about the fall decision tool and frailty syndrome.
Please enjoy this episode with an insightful guest.
For more on frailty please see the links below:
https://www.bgs.org.uk/ British Geriatric Society
https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746 MDTea Podcast
https://www.rcem.ac.uk/ Royal College of Emergency Medicine
Tony Underwood is a former English Rugby Union professional who played as a winger for both country and at club level. He made his England debut in October 1992 against Canada, and went on to win a total of 27 English performances/caps. Having trained as an airline pilot, went on to fly for Easy jet, Virgin Atlantic and Emirates.
In this conversation we talk about resilience, high performing teams, relationship with failure and success, continual improvement & feedback mechanisms, transitioning & adaptation to change, meta-programs, co-aligned lessons with aviation and medicine and finally human factor mitigation. I hope you enjoy this interview with an insightful and interesting guest.
To find out more about Tony please head to:
wordplaygroup.com
Twitter: @underwood_tony
In this conversation with Ben Watts we look at the sequential approach to arresting bleeding. We also examine the second/third generation haemostatic compounds (celox, quik-clot), pharmacological agents such as TXA, FFP, FDP, blood, cryoprecipitate. We also examine the utility of tourniquets (origins, usage and types), neck zones and wounds, Blunt injury and junctional wounds, Hypotensive management and Pain management modalities and preferential agents.
Ben is a specialist retrieval practitioner/CCP working in Scotland and previously as a CCP in the Thames Valley and before this in South West of England. He also has an extensive history of expedition work in various international locations, I first met Ben whilst working for World Extreme Medicine as a fellow paramedic and he has been a contributor to both WEMcast and to the College of Paramedics podcast.
I hope you enjoy this wider ranging conversation as much as we did.
Mark Dempster is an addiction specialist working with patients with drug addiction, gambling addiction, sex addiction, alcohol addiction, internet addiction, and more. He is a counsellor dedicated to helping people regain control and turn their lives around. In the conversation we look at some of the statistics around the health burden & impact on the individual and extended families, how people become addicted (habit Vs addiction), the 5 stages of addiction, common cognitive pitfalls and finally breaking the cycle. We also explore some of therapies that are evidence based and are commonly practised such as CBT, DBT, ACT, and PET.
In 2013, the Centre for Social Justice determined that the level of addiction in the UK made it the “addiction capital of Europe.” This includes the use of legal substances, mainly alcohol, and the use of Class A drugs, that include heroin, cocaine, meth, and hallucinogens. £36 billion is spent by the nation every year on treatment relating to drug and alcohol abuse. At the time of filing their report, titled No Quick Fix, the UK had the highest rate of addiction to opioids and the highest lifetime-use of amphetamines, cocaine, and ecstasy across Europe.
Many view addiction as something that only affects the users themselves but, in reality, casualties from substance abuse are taxing on entire communities, the NHS and society as a whole. It has a direct affect on healthcare workers and on the frontline of the emergency services on a daily basis.
Please enjoy this interview with Mark, his clinic and work can be found here:
http://markdempstercounselling.com/
In this interview I interview Johannes von Vopelius-Feldt, Johannes is an emergency physician currently working in South West England. He has written and undertaken extensive research into the utility and demographics of critical care teams. He has also empirically examined the impact of critical care within certain patient presentations to examine the benefit that these teams can bring.
In the conversation we examine; the overall proven benefit of critical care versus standard care within pre-hospital care. We also examine skill mix versus intervention, intervention versus outcome, the wider utility to critical care outside of cardiac arrest and some of the prospective studies which may benefit transparency into the usefulness of CCTs. We also examine the shift in mindsets and underlying concepts that are now well known and accepted around human factors and mitigation strategies compared to 10 years ago.
Johannes' research can be found below - please enjoy this conversation with an insightful and engaging guest as he brings an inquisitive and research based perspective to the domain of critical care.
J von Vopelius-Feldt, JR Benger - European Journal of Emergency Medicine 20 (6), 382-386 45, 2013
Who does what in prehospital critical care? An analysis of competencies of paramedics, critical care paramedics and prehospital physicians
J von Vopelius-Feldt, J Benger - Emergency Medicine Journal 31 (12), 1009-1013 40, 2014
Critical care paramedics: where is the evidence? A systematic review
J von Vopelius-Feldt, J Wood, J Benger Emergency Medicine Journal 31 (12), 1016-1024, 18 2014
Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest
J von Vopelius-Feldt, J Brandling, J Benger - Resuscitation 114, 40-46 17 2017
The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest
J von Vopelius-Feldt, A Coulter, J Benger Resuscitation 96, 290-295 15 2015
Critical care paramedics in England: a national survey of ambulance services
J von Vopelius-Feldt, J Benger - European Journal of Emergency Medicine 21 (4), 301-304 13 2014
Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis
J von Vopelius-Feldt, J Powell, R Morris, J Benger - BMC emergency medicine 16 (1), 1-7 11 2016
Should physicians attend out-of-hospital cardiac arrests?
J von Vopelius-Feldt, JR Benger - Resuscitation 108, A6-A7 4 2016
Response to: influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation
In this session we interview Lucy Grimwade who works as an Advanced Clinical Practitioner (ACP) and Matron in an Emergency Department in Manchester. Lucy gives a fantastic perceptive on the current climate within the emergency department throughout the first and second spike of Covid-19. She gives an honest and insightful first hand recollection of her clinical and personal experiences around the effects in patients physical and mental health. She also provides an insightful commentary on the mental health of the shared ED community and habits that have served her well during the lockdown period.
Please enjoy this interview providing a unique cross-section of life on the frontline of the NHS during the greatest health crisis it has ever faced.
In this episode I talk with Bram Connolly. Bram is former special forces operative with the Australian Special Forces with 20 years of experience on the frontline. Bram was was awarded the Distinguished Service Medal for leadership in the Australia Day awards 2012. Bram is the Managing Director and founder of Hindsight Leadership and Resilience. He is the author of "The Fighting Season" and "Off Reservation" and the leadership book "The Commando Way" published in 2020.
In the conversation we talk about:
Resilience, leadership, values and optimisation. We explore various facets of the book 'The Commando Way' and dig into some of the 20 years experience that taught Bram the lessons he depicts in the book. I hope you enjoy this interview with an inspirational leader. Bram also has a podcast:
https://podcast.warrioru.com.au/podcasts/
Hi book 'The Commando Way' can be found here:
https://www.amazon.co.uk/s?k=the+commando+way&adgrpid=55975240794&gclid=Cj0KCQiA0-6ABhDMARIsAFVdQv-06UsRi2ZQL-Obrchizx8P0WYzCaepcjXf-70TtIPFVkJAksF7S0IaAtPbEALw_wcB&hvadid=259062984695&hvdev=c&hvlocint=9046009&hvlocphy=21468&hvnetw=g&hvqmt=e&hvrand=11852429682160879921&hvtargid=kwd-302016437038&hydadcr=24402_1816050&tag=googhydr-21&ref=pd_sl_39q7xnnmde_e
In this episode we speak with Lloyd Evans a GP in Wales around his experiences of the second wave of the pandemic. We explore some of the fundamental issues that have led to a rise in demand and stress both within the general population and the frontline NHS staff. We explore some of the second and third order effects of the covid pandemic, together with the unintended positive aspects that it has incurred.
I hope you enjoy this episode with an insightful and honest practitioner as it gives a rounded cross-section of accounts from the frontline of the largest health crisis that has befallen the NHS since its inception in 1948.
In this mini-series I talk to Alec Wilding who is an Advanced Paramedic Practitioner (APP) on the frontline of the healthcare system within the UK. Alec gives me an honest and transparent perspective of life tackling the second wave of the covid pandemic and his thoughts on how it is impacting the mental and physical health of both the population and the staff.
Alec gives an honest and insightful recollection into the incremental effects of the pandemic and is the second of four accounts from the frontline - I hope you get as much out of it as I have.
In this mini-series I talk to a cross section of individuals at the frontline of the healthcare system within the UK. In this episode I speak with friend and colleague Lucy Gough. Lucy is an Emergency Medical Dispatcher (EMD) within London. She gives me an honest and transparent perspective of life in the Emergency Control Room and her thoughts on the contemporary demand profile within the pandemic in London.
Lucy is both honest and insightful into the unique challenges that she and colleagues face on a day-to-day basis and the overall challenge that the ambulance service faces in response to the largest health demand since the creation and inception of the NHS.
This is the first of four accounts from the frontline - I hope you get as much out of it as I have.
This has been a unique and challenging year for everyone. It has been a real privilege to have over a 100 conversations on various podcasts and platforms (PHCP, Restore and WEM). I have included this recording of the best of Restore as mental health has taken a central spotlight in this pandemic and has been an inescapable facet to manage for all of us as things have become difficult in work and personal lives.
My hope for 2021 is that a continued narrative both encourages you and gives everyone listening to these podcasts a sense of hope in a time that has required every clinician to engage with difficult times. I hope to help encourage every healthcare professional in this time of demand and great need, these conversations are designed to hopefully give back to you - I sincerely hope they serve this function at this time.
My thanks also goes out to everyone that has contributed to the PHCP in 2020, platforms like this will always benefit from a plenary of perspectives rather than just individual ones.
Eoin
In this episode we explore the initiative of pre-hospital co-responding mental health nurses working alongside paramedics within London, UK. We look at the prevalence of mental health within the capital and how Anna and Dan have seen the initiative add benefit to pre-hospital assessment, management and the resultant access to healthcare.
We look at some of the current prevailing mental health statistics (MIND 2020), such as:
- 1 in 4 people experience mental health issues each year.
- 792 million people are affected by mental health issues worldwide.
- At any given time, 1 in 6 working-age adults have symptoms associated with mental ill health.
- Mental illness is the second-largest source of burden of disease in England. Mental illnesses are more common, long-lasting and impactful than other health conditions.
- Men aged 40-49 have the highest suicide rates in the UK.
We also look at anecdotal commonalities in acute MH presentations within the community and the interplay between the Mental Health Act and the Mental Capacity Act in assessment and treatment of mental health patients. Lastly, we look at case studies to understand the dual assessment model that Anna and Dan use to assess patients within the pre-hospital environment.
I hope you enjoy the episode.
In this episode I chat to Jason Fox about his new book ‘Life Under Fire’ for those of you that aren’t familiar with Jason, he is a former Royal Marine Commando and Special Forces Sergeant. Joining at 16 and serving for 20 years; Jason passed the grueling selection process for the Special Forces in 2001, serving with the Special Boat Service till 2012. Jason has planned and led operations including hostage rescue, counter terrorism, counter insurgency, maritime counter terrorism, surveillance, body guarding and counter narcotic missions. He currently features in the channel 4 program - SAS: Who Dares Wins.
The book is split into two parts, the first part the battle mind looks at his journey to a resilient life and mental approach. The second part - Strength and Guile looks at the lessons learned from his 20 years as an operator and royal marines commando and inferred learning to the reader. Concepts we explore include:
The concept of graded exposure to training. The sense of community and brotherhood from war. Jason's struggles with PTSD and the emotional combat indicators that signify it. The ‘cigar moment’ and how it calms the central nervous system down. Awareness of your own vulnerabilities and how it can help protect you. The preferential mode of de-escalation over aggression (grey man, passive use of the weapon). High performing teams ability to self regulate rather than externally regulate. Reframing negative events and what it can teach us about resilience. The power of debrief also known as Sensitive Site Exploitation/SSE. The concept that there is a flattened hierarchy and everyone can contribute a game changing piece of information. Not resting in the aftermath of success and using failure as a teacher.
I hope you enjoy the episode. You can find 'Life under fire' by Penguin books here:
https://www.penguin.co.uk/books/111/1119268/life-under-fire/9781787633193.html
In this episode Julia Samuel and Caroline Phillips discuss grief and the process of bereavement. We discuss important skills for breaking bad news, bereavement by exposure and ways in which we can support our own resilience as healthcare professionals.
Julia Samuel is a psychotherapist who has spent the last thirty years working with bereaved families. She has worked both in private practice and in the NHS at St Mary’s Hospital Paddington where she pioneered the role of maternity and paediatric psychotherapist. In 1994 she worked to launch and establish Child Bereavement UK as its Founder Patron, where she played a central role until September 2019. Julia was awarded an MBE in the 2015 New Year’s Honours list for services to bereaved children. She is the author of two books: Grief Works and This Too Shall Pass.
We hope you enjoy the episode.
Further reading:
-
Child Bereavement UK https://www.childbereavementuk.org/?gclid=Cj0KCQjw2or8BRCNARIsAC_ppyYXJ4jJ5kW2226C30UnEuOOBqUA8vUbrBPiCuZFHmJ4sh1L8HHhydIaAjssEALw_wcB
-
Information about Julia Samuel’s books, ‘Grief Works’ and ‘This too shall pass’ can be found here, as well as her ‘Pillars of Strength’ tips - https://juliasamuel.co.uk
-
Cruse Bereavement UK has practical resources and information for personal and professional use - https://www.cruse.org.uk
This episode explores advanced neurological conditions with Palliative Nurse Consultant Diane Laverty. Diane has over 30 years experience in palliative care and spent time in her doctorate exploring informal carers needs when looking after those with progressive neurological conditions.
Motor Neurone, Parkinson’s and Multiple Sclerosis conditions are discussed, common symptoms and potential exacerbations are covered and the wider social implication on family and carers are discussed.
Further reading:
-
Motor Neurone Disease Association https://www.mndassociation.org
-
Parkinson’s Foundation
https://www.parkinson.org
- Multiple Sclerosis Society
https://www.mssociety.org.uk/about-ms/what-is-ms
- Oxford Handbook of Palliative Medicine (2019)
We hope you enjoy the episode.
I just wanted to do a house keeping episode to let you know what to expect in this season. We are half way through the mini series on End of Life Care and had 'recognising the dying phase' with Dr Emma Hall and 'oncological emergencies' with Merel a cancer clincial nurse specialist.
- We have two more instalments of EOLC and these are around advanced neurological disease with Diane Laverty and Grief and bereavement with Julia Samuel MBE. Caroline Philips has done a fantastic job at cataloging some of these essential conversations and really helping us appreciate some of the deeper facets of end of life care.
- We will have some skill based episodes with myself and Nick Brown. These are looking at the skills undertaken by clinicians and everything that the text books don’t tell you around experiential learning and reflections of performing these on a daily/weekly basis - we will look at IO, splintage, intubation, IV access and other skills.
- We will look at pain management with a pain specialist and some of the types and methods of acute and chronic pain management that we might face in the pre-hospital environment.
- We will do a deep dive into one of the prolific drugs in society and that we interact with on a daily basis - that of alcohol. We will look at chronic alcoholism and how it changes physiology. We will also look at acute intoxication and why these patients can be so difficult to look after.
- We will start with a mini case review series as well - dissecting some challenging cases and what we can learn from these cases.
- We will also look at urgent care with a GP and urgent care advanced paramedic in more detail and some of the subtitles that we can learn to pick up as clinicians.
- Finally we will look at some of the diverse range of pre-hospital career options that are available for clinicians (paramedics, doctors and nurses) in the current climate.
We hope you enjoy the season.
In end of life care we are mindful of respecting patient’s wishes, including those relating to conveyance to acute care settings. However there are some presentations, specifically in relation to cancer, which we need to be aware of and rapidly refer onto either acute or specialist colleagues.
In this episode we explore these reversible oncological emergencies based on cases seen in Merel’s clinical experience as a Cancer Clinical Nurse Specialist in a specialist cancer centre in The Netherlands.
We review Neutropenic Sepsis, Superior Vena Cava Obstruction, Metastatic Spinal Cord Compression and Hypercalcaemia.
Further reading:
-
AACE JRCALC Clinical Guidelines (2019) – End of Life Care
-
NICE Guidelines - Metastatic spinal cord compression in adults: risk assessment, diagnosis and management
-
NICE Guidelines - Neutropenic sepsis: prevention and management in people with cancer
-
Oxford Handbook of Palliative Medicine (2019)
We hope you enjoy the episode.
In this episode Caroline Phillips hosts Dr Emma Hall, Palliative Care Consultant and discusses the signs of the final few days and hours of life. We discuss the challenges of recognising the dying phase, the importance of shared decision making and the positive aspects of shared learning between prehospital and palliative care professionals.
This is part of a mini series on the Pre-hospital Care Podcast where we will start to look into topics in more depth and involve some of the subject specialists to share their experience.
We hope you enjoy the episode.
Further reading:
- Kathryn Mannix – With the End in Mind
- Oxford Handbook of Palliative Medicine (2019)
- AACE JRCALC Clinical Guidelines (2019) – End of Life Care
In this episode we explore some of the fundamental the components what makes a good debrief. The concept of debrief effects everyone within pre-hospital care whether formal or informal. Involvement in a debrief exercise can help to make sense of events and offer the opportunity for learning that can be applied in the future. It’s power, in part, is that it takes place when the events are fresh in the mind and that all experiencers are able to contribute.
In this episode we dig a little into the broad benefits of debriefing and what makes for a successful debrief exercise (as well what doesn’t) within the context of prehospital care. How can we optimise the setting and structure in which a productive conversation can be had in order to maximise the outcomes from a debrief? Also, is shared reflection just for those ‘big jobs’ or can we apply it to any experience?
We look at:
- Definitions of debrief.
- What do we think debriefing is/what purpose it serves.
- What debriefing is not.
- How we can optimise the setting for a successful debrief.
- How to structure a debrief.
- Relevant content in the context of pre-hospital care.
- Some of the issues/pitfalls/barriers involved in debriefing.
The models we refer to in the episode are here:
Gibbs cycle:
https://www.mindtools.com/pages/article/reflective-cycle.htm
The 3D model of debriefing:
https://www.semanticscholar.org/paper/The-3D-model-of-debriefing%3A-defusing%2C-discovering%2C-Zigmont-Kappus/7b63a9876c39340398dedd25b48eddc5f08096b8
Other insightful resources include the book 'Never fly solo' by Rob Waldman:
http://www.neverflysolo.com/about-book.html
Debriefing tools:
https://www.nds.org.au/images/resources/wa-safer-services/Debriefing-Tool.pdf
We hope you enjoy this wide ranging conversation.
This is a wide ranging conversation on club drugs, illegal highs and Novel Psycho-active Substances (NPS) with Dr Owen Bowden Jones. Owen is a Consultant Psychiatrist with over 20 years' experience in general and substance misuse psychiatry in both the NHS and private practice. In 2010 he founded the Club Drug Clinic, offering treatment specifically for those using 'club' drugs such as cocaine, ketamine, MDMA, GHB/GBL and novel psychoactive substances.
In the conversation we discuss:
- The definition of Club drugs and illegal highs/Novel Psychoactive substances
- Define the problem by age and top 5 commonly seen drug presentations (differentiate between prevalence and problem – i.e. seeking help)
- Examine traditional vs emergent drug trends
- Look at groupings of drugs – Sedatives/dissociates, stimulants, synthetic cannabinoids, hallucinogens
- Examples of each and on common presentations & adjunctive use (concomitant use of these drugs)
- Ask about sourcing & trends in where people acquire drugs presently
- Look at first line staff engagement – who sees these groups of patients first (not always acute presentations)
- Examine new harms & clinical challenges
- Reference project Neptune – Novel Psycho-active Treatment Uk Network
There is free e-learning on club drugs, illegal highs and NPS that Owen has put together, please find it at:
http://neptune-clinical-guidance.co.uk/e-learning/
Feel free to reach out to Dr Bowden-Jones here:
Owen.bowdenjones@nhs.net
•
Clubdrugclinic.cnwl@nhs.net
•
www.clubdrugclinic.com
•
@ClubDrugClinic
@OwenBowdenJones
www.neptune-clinical-guidance.co.uk
In this wide ranging conversation with Will Duffin - a passionate GP, educator, adventurer, innovator and polymath we define the current problem around depression and then examine different states of depression. We also look at why people get caught in the cycle of depression and current modalities of treatment for depression (chemical intervention, groups, social prescribing, referral pathways).
We then look at the concept of micro-adventure & the benefits of these together with Will’s perspective on optimising mental health and balance (work/life). We look at how do Will achieve's balance in his life and regimes that works for him. We also examine ways in which he has changed his mindset and approach to mental health over the past 10 years both as a GP and as an adventurer.
We dig down into some of the statistics on Mental Health and why this is such an important topic - such as (Figures from MIND and MHFA England 2020):
- 1 in 4 people experience mental health issues each year
- 792 million people are affected by mental health issues worldwide
- At any given time, 1 in 6 working-age adults have symptoms associated with mental ill health
- Mental illness is the second-largest source of burden of disease in England.
- Mental illnesses are more common, long-lasting and impactful than other health conditions
- Men aged 40-49 have the highest suicide rates in the UK
- 70-75% of people with diagnosable mental illness receive no treatment at all
- Half of mental ill health starts by age 15 and 75% develops by age 18
I hope you enjoy this conversation with an insightful and thoughtful colleague and friend.
In this wide ranging conversation with Critical Care Paramedic Ben Watts and ED Consultant Iain Edgar we look at an overview of the TVAA service in providing critical care to the community. We also look at how expedition and military domains that they both practice can be used within the pre-hospital critical care environment. Other aspects of the conversation includes:
- The patient target group and demographics of the service.
- Examine traditional vs emergent pre-hospital presentations that Iain and Ben have seen over their time in pre-hospital care.
- Interventions and decision-making and how these are approached within TVAA.
- Critical care training approaches, quality assurance and quality improvement within the service.
- Frontline staff engagement and how the service both encourage and incorporate them within the scheme.
- Innovations that the scheme has embedding and medium to long-term innovations that may improve the program
- Non-technical aspects of care Vs technical skills & utilisation rates
- Incremental gains when orchestrating flash teams
- Personal learnings over the last >2 years
I hope you enjoy the last of these critical care service review sessions with two insightful friends and colleagues.
In this episode we explore conflict resolution with Ray Goodall. Ray is an accomplished ex-military senior officer who is skilled in developing cohesive teams and has a vast operational background. He is Internationally acclaimed War College Faculty and a military institute instructor. He is also a liaison and advisor to Presidents, Ambassadors and Generals in complex multinational combat environments. Ray has extensive Combined Joint Force and Air Component Crisis Planning experience. He is an internationally recognized expert of the Command and Control of Air Power.
In this wide ranging conversation we explore:
· The definition of Conflict resolution
· Leadership in conflict situations (enemy and colleague conflict)
· Models of conflict resolution - Strategy of Conflict and Game theory
· De-escalation techniques used (aviation/inter-personal)
· Optimisation of physiology - whether you use breathing techniques or tools to focus
· Mentoring Vs Coaching
· Rapid Decision making under stress and/or incomplete information
· Failure (anecdotal examples of how you've learnt through failure)
· Debrief & how to harness the best out of the debrief
I hope you enjoy this episode with an extremely insightful and interesting guest.
Karim is a Professor of Trauma Sciences in the Blizzard Institute, Barts and the London School of Medicine & Dentistry, and Consultant Trauma & Vascular Surgeon at Barts Health NHS Trust. He is also the director of the pan London trauma system.
In this episode we look at:
- Monitoring modalities and diagnostics (the advent of pre-hospital and in-hospital US, in-hospital CT & MRI) that have led to an improvement in outcome.
- Whether front loading pre-hospital critical care teams with more interventions had a net positive impact on survival to discharge.
- The benefit of numerical targets for physiology such as blood pressure in resuscitation or more organic end-points such as mentation/AVPU or pallor/diaphoresis/respiratory rate are more useful?
- The adverse effects of complex interventional involvement in pelvic blunt injury (such as REBOA or ECMO) are worth the investment at point of injury or whether they are better placed in centres of specialism?
- What we can do to prevent penetrating trauma as the upward trend in penetrating disease continues?
- Look at the advances in rehabilitation services Vs impact on survival to discharge in comparison to pre-hospital, & surgical intervention?
- Some of the more common injury patterns that exist more-so now compared to when Karim first started as a surgeon.
- The recent challenges faced within the Pan London Trauma Networks.
- The advent of Acute Traumatic Coagulopathy (ATC) in the early 2000’s and its consequential impact on survival since.
- Where Karim sees the largest gains that can be made in pre-hospital care?
- What Karim looks for potential in other junior clinicians
- Advice that Karim would pass on to someone starting their medical career.
- Aspects of mindset and approach that have changed in Karim's practice over the last 10 years
I hope you enjoy the episode.
This is a wide ranging conversation with Mark Faulkner - the clinical development manager for critical care (advanced practice) within the London Ambulance Service NHS Trust, Mark is also the clinical advisor for Major Trauma within the LAS and as such sits on the Pan London Trauma Steering Group, as well as number of national trauma groups. In this episode we examine a variety of topics that encompass decision making, experience & empirical background, additional clinical interventions, leadership & non-technical skills and support/pastoral functionalities of advanced practice.
We discuss:
- Overview of the APPCC Scheme
- The patient target group & demographics
- Added value of interventions Vs decision making.
- Training, quality assurance and quality improvement within the scheme.
- First line staff engagement – who sees these groups of patients first
- Innovations that the scheme has just embedding and medium to long-term innovations that have improved the program
- Non-technical aspects of care Vs technical skills & utilisation rates
- Incremental gains when orchestrating flash teams
- Personal learnings over the last >6 years
I hope you enjoy the episode
In this conversation I talk with Tim Archer. Tim is a former Group Captain, he held a number of senior appointments in the RAF during which time he gained an MA in Leadership Studies from the Centre for Leadership Studies at Exeter University, a Post Grad Certificate in Executive Coaching from Lancaster University Business School and was awarded a full-time 12-month Fellowship back at the Centre for Leadership Studies.
After a spell as Director Public Sector at the Leadership Trust in the UK, he moved to the United Arab Emirates for 8 years where he was a government advisor during which time he developed, designed and taught experiential leadership development and coaching programmes. He currently works for Cardiff University developing their leadership modules for the MSc in Public Health.
We have a wide ranging conversation that touches on:
The definition of leadership Mission command - military doctrine (what to do, not how to do it - no disseminated responsibility) myth of military leadership - Constructive decent Vs destructive concept The OODA loop (Observe, Orient, Decide, Act) Leadership Vs Management (Kotter) Trust and cohesion – Peak rapport Homeostatic leadership Compassionate Leadership Situational leadership Leadership in conflict Leader as a coach Systems leadership - NHS Model - leading when not in charge
I hope you enjoy this episode with a fascinating guest and friend.
This has been the most downloaded episode of all time on the Restore Podcast and very relevant to the pre-hospital community. I have decided to re-post it on the PHCP as it affects every aspect of life and of blue light personnel.
In this episode I interview a senior Detective Inspector within the police who works within the Modern Slavery and Child Exploitation Unit in London. English born and raised, of African decent and operating for 14 years within the police through the hierarchy of leadership he has a unique perspective into the contemporary climate. I first met Henk as a friend about 8 years ago and have valued his perspectives and insights as a friend and colleague battling shift-work, the reality of London and everything in-between.
We discuss some of the fundamental assumptions, biases and racism within society and aspects of law that need to be re-considered. We also discuss his standing as a leader within the institution and how we can all model progress and address the bias and racism. We also talk about representation of black and ethnic minorities within the emergency services and how this can be addressed. We also talk about the institution of the police and how the concepts of trust and of 'Non-maleficence' (do no harm) needs to be restored from the community towards the police.
I hope you enjoy this episode.
In this episode I talk to Wayne Auton and Tom Archer who work respectively for the Scottish and Welsh Air Ambulances (EMRS & EMRTS). Wayne is a former Royal Marine and currently a Specialist Paramedic in retrieval and transfer medicine as well as pre-hospital critical care. Tom is a Critical Care Practitioner & lecturer on the Critical Care MSc in Cardiff University. In this episode I talk with Wayne and Tom about innovation within the domain, advice to aspiring critical care colleagues, top tips in leadership & group dynamics. I also ask then about how they have navigated the past 6 months both personally and as a service.
The Emergency Medical Retrieval Service (EMRS) provides critical care and transfer to definitive treatment for patients in remote healthcare locations across Scotland. They provide Consultant and Retrieval Practitioner delivered aeromedical retrieval from rural health care facilities throughout Scotland and well as pre-hospital critical care of major trauma patients, telemedicine advice to rural health care colleagues, rural facility outreach training and research in pre-hospital medicine and major incident support across the country.
The Emergency Medical Retrieval and Transfer Service (EMRTS) Cymru is an aeromedical retrieval service that provides Consultant and Critical Care Practitioner-delivered pre-hospital critical care across Wales. It was launched at the end of April 2015 and is a partnership between Wales Air Ambulance Charity, Welsh Government and NHS Wales. EMRTS provide pre-hospital critical care for all age groups (i.e. any intervention/decision that is carried outside standard paramedic practice) and undertake time-critical, life or limb-threatening adult and paediatric transfers from peripheral centres (inc. Emergency Departments, Medical Assessment Units, Minor Injury Units) for patients requiring specialist intervention at the receiving hospital.
I hope you enjoy the episode with these two great friends.
You can find out more about them both here:
Wayne:
https://www.wayneauton.com/blog-1/https/wwwwayneautoncom/blog-page-url/new-post-title
Tom:
https://www.linkedin.com/in/tom-archer-857b2354/?originalSubdomain=uk
In this conversation I talk with Andrew Latimer. Andrew is an Acting Assistant Professor in the the Department of Emergency Medicine. He is involved with quality improvement, education, and clinical and operations research in Emergency Medical Services including involvement with Seattle Fire Medic One, King County EMS, and Airlift Northwest. His research interests are in the pre-hospital care of critically ill and injured patients, pre-hospital airway management, and air medical retrieval medicine.
In this episode we look at the concepts of 'measure and improve' which have proven to make Seattle one of the world's leading institutions on cardiac arrest survival. Their main domains of practice around out-of-hospital cardiac arrest and advanced airway management (inclusive of drug-assisted intubation).
The Medic One Program began in 1970 when the first group of firefighters were trained as paramedics in cooperation with Harborview Medical Center and the University of Washington. Since then, the Medic One Program has gained notoriety due to the training and pre-hospital emergency patient care paramedics deliver within the community. Medic One provides the community with Advanced Life Support (ALS) activities that, in the past, could only be performed by physicians. In addition to responding to medical emergencies, medic units respond to all working fires, hazardous materials and rescue responses.
I hope you enjoy this episode with a fascinating clinician & individual.
Stephen left the military in 2012 after serving 14 years in the Royal Marines and the SBS. At the age of 27 Stephen was awarded the Military Cross (MC) by Her Majesty the Queen for his work in Afghanistan in 2008. The MC is granted in recognition of "an act or acts of exemplary gallantry during active operations against the enemy on land" to all members of the British Armed Forces of any rank. Since 2015 he has mentored youth in schools, executives, budding sports stars, professional athletes and delivered the Limitless Programme to diverse audiences, veterans charities and public services.
In this conversation we have an honest talk about his challenges with mental health through his military service and beyond. Stephens honest and open recital of his challenges with self harm and victim mindset and how he broke this are both insightful and refreshingly honest. Through his revelations of seeking like minded community he recently started an online community (10,000) of military and blue light personnel to support, encourage and offer opportunities to like minded individuals.
His story is both encouraging and a voice of hope that despite the depths of suffering you can overcome any level of adversity with healthy community and a healthy mindset.
Please find the charity that is fundamental to Stephen's story here:
rock2recovery.co.uk
The online community of OpSpartan can be found here:
https://www.opspartan.com
More on Stephen can be found here:
https://www.wioh.co.uk/about
In this episode we interview Matt Masson ex-extreme sports and ski instructor. In November 2011 Matt sustained a life changing head injury when he fell 26 ft through a plastic roof onto his head. He has had to re-build his life completely from re-learning to talk, to walk, to ski amongst many other things. Matt's inspirational story is a true testament to his mental determination, engagement with rehabilitation and timely pre-hospital care.
His story and YouTube video can be found here:
https://www.thewobblyjourno.com
and
https://youtu.be/xnJExrygdSk
We re-unite him with Mike Nolan the Flight Paramedic on the night (a friend and colleague) who walks him through his injury load, the sequential interventions and his initial presentation on the night. Matt is just about to release his first book together with his Mother titled 'Road to the top of the mountain'. Please enjoy this truly inspirational story told in first person.
Our thanks also goes out to the Nurse liaison team at the Royal London Hospital that initially put both Mike and Matt in contact.
In this conversation I chat to Ben Meadley. Ben has extensive experience in prehospital critical care, and is an operational Intensive Care Flight Paramedic (MICA) with Air Ambulance Victoria. Ben has a keen interest in prehospital critical care, advanced clinical assessment, pre-hospital critical care interventions and developing clinical judgement in critical care practitioners. MICA paramedics’ training goes beyond practical skill precision to include more detail in anatomy, physiology, pathophysiology and pharmacology to greater increase capacity to make independent complex clinical decisions and interventions. MICA paramedics operate either as part of a two person crew or as a single responder.
We look at many facets of the MICA system and the differentiation between land MICA and flight MICA systems. We dig down into Ben's experience and empirical knowledge and look at the fundamentals of high performance within the MICA system, why they exist and how they continually improve.
I hope you enjoy this conversation.
Steve is the medical director of The Queensland Ambulance Service (QAS) with 5,000 staff and 1,300 response vehicles. QAS has a contemporary approach to clinical service delivery and innovation in prehospital trauma care. It also operates a tiered system of pre-hospital care with Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs) and a smaller cohort of HARU Paramedics.
In this episode we discuss a variety of topics:
- High Acuity Response Unit (HARU) both its inception and the clinical remit for the HARU.
- Governance around the HARU program and provider quality assurance for some of the procedures (RSI, on-call advice, blood products and the bleeding patients).
- Quality improvement and where the program is heading
- The lessons learnt building the HARU and ICP schemes in QLD.
I hope you enjoy this episode as I found it both insightful and helpful to look at how other systems approach high performing teams and continuous improvement.
Eoin
In this conversation with Piers Carter we examine the fundamentals of high performing individuals - the birth place of high performing teams. Piers has an eclectic background. Since 1997 he has been working with businesses; coaching, facilitating and helping them have better conversations – as individuals, teams and leaders.
Prior to this, he was paid by the government to throw petrol bombs at the Police – as a riot control, Public Order & self defence instructor. Piers then began expedition-leading, giving him some incredible experiences all over the world working with adults and young people in developing countries and challenging environments. I have always found Piers to be an inspirational character with insight into some of the foundational pearls of wisdom that has changed my world on a day-to-day basis.
In this conversation we talk about the power of choice, paying attention to somatic signals, how we gain better insight into personal triggers, the concept of centring, broadening our exposure to failure and many other things. I hope you enjoy this episode with a true legend and friend.
You can find out more about Piers here:
http://pierscarter.co.uk/
For more content from the Restore Podcast please head over to:
https://anchor.fm/eoin-walker1/episodes/Episode-11-High-Performing-Individuals-with-Piers-Carter-ee9u7p
In this episode I interview Karim Ahmed the clinical lead for the emergency department of the Royal London Hospital (RLH) in Whitechapel. We examine the impact of MTCs across the health economy and why they can add a survival benefit to the patient. We also look at the utility of overlaying fundamental and essential patterns of care to complex scene's and how this deconstructs some extremely challenging pathology. We also examine the social deprivation that tracks trauma & some of the outliers that can present to the RLH.
We also get some pearls of wisdom from Karim in relation to trauma and the wider population of undifferentiated trauma patients that constitute the case load seen on any given day in London.
I hope you enjoy this episode with an insightful friend and colleague.
In this episode I chat to Jason Fox - a former Royal Marine Commando and Special Forces Sergeant. Joining at 16 and serving for 20 years; Jason passed the grueling selection process for the Special Forces, serving with the Special Boat Service. Jason has planned and led operations including hostage rescue, counter terrorism, counter insurgency, maritime counter terrorism, surveillance, body guarding and counter narcotic missions. He currently features in the channel 4 program - SAS: Who Dares Wins.
We look at the similarities between the Special Forces (SF) and critical care (paramedic) practice. We examine the principles of high performing teams, relationship with failure, and communication amongst other aspects. We also look at self care and what it means on a practical level and the power of not taking yourself too seriously. I have always found Jason to be honest and open person which is why having conversations with him is so refreshingly real.
This episode will feature on the Restore Podcast (self-care non-clinical) and the Pre-hospital Care Podcast (clinical conversations) as it relates to both.
I hope you enjoy this episode.
In this episode Nick Brown and Jo Shaw deconstruct the definitions, challenges and nuances of research within pre-hospital care. They examine the history of research and the differences between research, audit and service evaluation. They look some of the results of the contemporary bigger research studies that have recently been published & also the origins of funding through the national governmental bodies such as the National Institute of Health Research (NIHR).
They also differentiate some of the various methodologies within empirical research and make reference to how this can affect the outcome data and inference to the clinical bottom line. This episode illustrates that it is important to be driven by the data especially in an information light environment when on scene with patients.
We hope you enjoy the episode
In this episode myself and Mark Falkner look at the origins of the trauma tree & why it was created. We also look at the origins and utility of GCS, heart rate and respiratory rate. We also discuss the mapping of social deprivation onto trauma & the exposure that paramedics see in regards to trauma. We also look at some of the outliers within trauma that don't fit the historical picture of trauma. We also look at the most useful vital sign - that of respiratory rate.
I hope you enjoy the episode.
For more content by me head over to the Restore Podcast with Eoin Walker:
https://podcasts.apple.com/gb/podcast/restore-with-eoin-walker/id1505391534
In this episode I interview Mark Falkner the Critical Care Scheme lead in London. We look at a cross section of critical care concepts from Traumatic Brain Injury to which are the most essential vital signs to pay attention to. We also look at some of the empirical literature of the above topics and examine the trauma tree in relation to this. I hope this episode imparts some key take home messages for you all as clinicians in the pre-hospital domain of practice.
Please also find more content from me around inspiring stories in mental health and well-being from a whole cross section of society on the Restore Podcast with Eoin Walker here:
https://anchor.fm/eoin-walker1/episodes/Episode-3---Reboot-your-life-with-Dan-Richards-ec8ep2
I hope you enjoy the episode
In this episode we explore the various domains of medicine away from an ambulance or hospital setting. Roger Alcock is an Emergency Medicine and Paediatric Emergency Medicine consultant in Scotland and was involved in the 2014 UK response to the West Africa ebola crisis. Myself and Roger explore the facets of humanitarian and expedition medicine that can add to your career and add depth and breath to experience as a pre-hospital clinician. We explore some of the details of Roger's Sierra Leone deployment for the ebola crisis and some of his expedition endeavours all of which have added to his career and perspectives.
We also examine some of the non-technical skills that these deployments and expeditions can foster which both add to resourcefulness and situational awareness of clinical demand and innovation in low resource settings.
I hope you enjoy the episode.
This episode focuses on a vital part of pre-hospital care; that of end of life care. Dan Davis explores this area with Caroline Philips, Diane Laverty, Georgina Murphy Jones. As all three guests work in various capacities for Macmillan they explore both the similarities and variations of palliative and EoLC and the subtle changes in approach to these patients. They look at the mindset change of approach to these patents in de-emphasising resuscitation and focusing on rapport building, supporting documented wishes and multi-agency engagement to facilitate the best care in the last period of a patient's life.
- Diane Laverty works as a Macmillan Nurse Consultant and is passionate about specialist palliative care and EoLC patients having a voice and receiving high quality care across all domains of practice.
- Caroline Philips and Georgina Murphy Jones work as paramedic clinical tutors and Macmillan specialist clinicians helping embed both EoLC training and practice across London and to fellow colleagues.
They examine the difficulty of not having prior rapport with these patients & families and some of the variations we would expect to see when looking at the physiology and clinical findings. This episode is especially important in the current climate and Dan brings this into focus talking about his own experiences with EoLC with his own father.
Please enjoy this episode which discusses this relevant and important narrative within pre-hospital care.
In this episode Dan Davis explores the wider aspects of TBI with Alice Kershberg, a clinical nurse specialist in traumatic brain injury. Alice plays a vital role in not only looking after patients who have suffered a traumatic brain injury, but acts as the bridge between the hospital and the community and between the neurosurgery team and the family. In this episode we explore many facets of the pathology but also shine a light on the pastoral role of acting as a liaison supporting patients and family after surgery, helping them to navigate their recovery in what can be a life changing injury.
Alice's role is fundamentally key to linking medicine to the lives of those affected in the community and gives an insight into the patient journey after pre-hospital care has passed the baton onto the hospital and into rehabilitation - we hope you enjoy the episode.
In this episode Nick Brown examines a cross section of perspectives from staff that have recently qualified to staff that have progressed through to fully qualified. We get their thoughts on education and mentoring through various routes into pre-hospital care. We also look at some of the support mechanisms for clinicians and the diverse range of presentations that pre-hospital care throws at you.
It is a fascinating insight into various levels of experience, clinical grades & thoughts through fresh eyes in what can sometimes be one of the most challenging roles within the NHS.
In this episode we take a look at the components of high performing teams and what differentiates these from teams that fail to perform. We examine the concepts of ownership, humility, checklists, communication and non-technical skills. We also look clinicians relationship with failure and how that can either be a tool for positive change or compound the failure and associated implications. We take examples across domains and relate them back to pre-hospital care - looking at themes of successful teams from a technical and non-technical perspective. We hope you enjoy the episode.
At the recording of this podcast episode, the world is in the midst of the coronavirus pandemic. Eoin welcomes a special guest to go through the facts of the global crisis with Will Duffin, education lead and content director at the World Extreme Medicine.
In this episode of the pre-hospital care podcast, we welcome Mark Faulkner, an advanced paramedic practitioner, to unpack the often daunting legal world that paramedics are exposed to.
You never know when that "nightmare job" or patient is going to appear and put you to the test. As clinicians, we should be always attempting to push our push our skills closer to perfection. In this episode, Ben Clarke shares his insights into deliberate practice, in-time learning, and meta-cognition.
In part 1 of our conversation with Ben Clarke (Assistant medical director of London Ambulance Service), we talk about leadership in pre-hospital care. What's more important - a good leader, or a good team willing to follow? Can you teach leadership or does it only come from experience? Can you be born a leader? How do you empower different types of staff on-scene? Join us as we explore the nature of leadership in pre-hospital care.
Have you ever been working, and all sense of time and self melts away, and you find yourself in perfect sync with what you’re doing? There’s a word for that. It’s called the Flow State.
In part 2 of our conversation with Dr Esther Murray, we explore Flow and how to put yourself in hyper productive mindsets more often using specific techniques anyone can implement in their work.
Dr Murray is a Senior Lecturer in Health Psychology and an expert in the subject of moral injury and self-care.
In part 1 (of 2) of our conversation with Dr Esther Murray, we explore the concept of a moral injury, and how paramedics can spot warning signs that they've suffered one, as well as tips on how to restore a good mental state. Dr Murray is a Senior Lecturer in Health Psychology and an expert in the subject of moral injury and self-care.
In this episode, we welcome Victoria Lebrec, who fights for road safety in London after losing her leg being run over by a skip lorry in 2014. Others have lost limbs on the same section of road since her incident, and it is only one of many places in London where accident rates are disproportionately high. Victoria’s work is focused on raising awareness for the need for improvements for cyclist safety across London.
Meet Dan Richards, an ex-patient of Eoin’s who lost his right arm and shoulder in a traffic accident 9 years ago. His story of recovery and his imperturbable attitude is inspiring. He summed it up perfectly with, “…whatever you want in life, you must work hard for it. Even if you don’t get it, you can still hold your head high and say, ‘Well, at least I did not give up,’ and while there is no shame in giving up, there is no success in it either.”
Update: Due to a technical hiccup, this episode was cut short by about 15 minutes during the first day of it's being published. It's now updated, so If you listened to it then and would like to catch the rest of this conversation, you can re-download the episode now. Thank you for your patience.
We're back with the second season of the Pre-Hospital Care podcast! Our first episode is a fascinating conversation with a cardiac arrest survivor and long friend of Eoin's, Zoe Hitchcock. They met when Zoe suffered a heart attack and Eoin happened to be sent out to treat her. Tune in for a fascinating and unique perspective on pre-hospital healthcare from the patient's perspective.
We end the first season of The Pre-Hospital Care Podcast by finishing up Eoin and Rich’s conversation with Dan Davis as they talk about dealing with the emotional trauma that is, unfortunately, part and parcel of pre-hospital care.
Thanks so much for being a part of this journey into healthcare podcasting. Keep an eye out for season 2! It’ll be out before you know it.
The paramedic field is much more fast-tracked than it once was. It's such an established path that many new paramedics have come straight from the classroom, and are being thrown into situations that a professional of any seniority would find it difficult to handle.
Perhaps it's no surprise, then, that the mental health of people working in emergency healthcare is getting worse over time. What can be done?
On this episode of Pre Hospital Care Podcast, Eoin and Rich continue their discussion with Nick Brown to tackle the non-technical skills necessary in controlling a tragic and highly emotional scene. In 96% of cardiac arrest cases, the patient doesn’t make it. When that happens, they are not the only patient.
Losing a loved one is traumatic and a genuine health risk over time. If we take our oath as clinicians seriously, therefore, we must be well prepared and skilled in not adding any further stress and trauma, as well as set up avenues for ongoing help and support.
Medics.Academy is dedicated to educating health professionals on every aspect of medicine, both technical and non-technical.
Go to www.Medics.Academy to browse our library of healthcare education.
On this episode of Pre Hospital Care Podcast, Eoin and Rich talk tackle perhaps the toughest topic in pre-hospital care. Delivering bad news to family members. Health professionals are not usually well taught about how to deliver the news of the death of a patient in a suitable and tactful way. This episode explains the four stages of delivering bad news, words to avoid, and how to remain professional but give support as much as you and your team can. Medics.Academy is dedicated to educating health professionals on every aspect of medicine, both technical and non-technical. Go to www.Medics.Academy to browse our large library of CPD-ready courses.
In this week’s podcast, we continue to discuss the crucial topic of pre-hospital airway management. How can we maximise the chances of patients with airway problems when time and circumstance are not on our side?
Eoin Walker and Rich McGirr walk through different procedures and both technical and non-technical aspects of managing the airway in the field.
For CPD-relevant content about pre-hospital care and many other healthcare fields, sign up at www.Medics.Academy.
Eoin Walker and Rich McGirr are back to discuss the ever growing evidence base and controversial topic of airway management in the pre-hospital setting.
How does the reality of managing this urgent, life-or-death part of the body differ from what is taught in the classroom? What are the essential steps in dealing with the prehospital airway? What are the pros and cons of each method?
Eoin Walker and Rich McGirr are back with special guest Martin Mist to talk more about the unique challenges that present themselves to paramedics when dealing with crises brought on by ingestion of illegal substances.
When will you need to resort to physical restraint? Why part of a paramedic’s job is to be a detective. How to do proper research on new. What the top 5 hard-hitter drugs are and key nuggets for dealing with each.
All this and more on the latest episode of the Pre-Hospital Care Podcast.
Paramedics are constantly in the middle of life and death situations. In the first full episode of the Medics.Academy Pre Hospital Care podcast, paramedics Owen Walker, Richard McGirr, and Martin Mist discuss Club Drugs and Non-Legal Highs and their effects on patients. As paramedics, they’re the first medical professionals to assess a situation before getting them to physicians at the hospital. They see the patients at their lowest point, suffering from anything from a cardiac arrest, a severe allergic reaction or a psychotic episode. Among many other topics, this episode covers the common and uncommon presentations of patients after drug overdoses and what paramedics look for and how to assess the situations.
This podcast is presented by Eoin Walker and Rich McGirr and is a Medics Academy podcast. The purpose of this podcast is to provide paramedics an easy-to-access set of resources and educational materials wherever they are. Feel free to take a look at the description in the footnotes of the podcast. Sign up to Medics Academy today to find out even more about what we do and just how much content we put out there for your education.