Podcasts – Greater Sydney Area HEMS: Recent Episodes
Sydney HEMS Team and Friends
G'day, and welcome back.
Pre-hospital clinicians are used to working under pressure. Teams work in often austere environments, with limited resources caring for some of the most severe patient pathologies at their most undifferentiated.
Within all this, individuals and teams must perform at their peak. But this is easier said than done. So how, in this most niche of clinical areas, can an individual, a team and an organisation promote, harness and maintain peak performance?
Dr Stephen Hearns is an Emergency and Pre-Hospital Physician from Glasgow, Scotland. Stephen has spent most of his career working out-of-hospital, both in the UK and around the world. Throughout, Stephen has reflected on his own journey of peak performance, and has dedicated more recent years to the study and deep dive into what contributes to an individual and team functioning most highly in the pre-hospital space.
In this episode, we discuss Stephen's research and published work to inform this topic. Stephen has spent time with other peak-performing groups including but not limited to Armed Forces and sporting teams, and has developed a package of learning to inform daily optimal performance. We talk about communication strategies, cognitive aids, team selection and organisational leadership - all of which, and more, contribute to peak performance.
This episode is a must-listen for all pre-hospital clinicians intent on optimising their attainment, that of the team and that of their organisation.
Learn more here: https://corecognition.co.uk/
Chat soon!
Hello and welcome back.
This is part two of our chat with Dr Matt Hooper, continuing our conversation on emergency last aid.
In this episode, we discuss the hows and whens involved when informing a family of their loved one's death, as well as the setting in which to do this.
Too, we discuss the importance of maintaining space and safety for one's self and the team, and how a system can encourage psychological safety in this regard.
As with part one, please ensure this episode is the right one for you - this is a challenging and emotionally-charged topic and whilst very important, please make sure it is the right episode at the right time for you.
Chat soon.
G'day, and welcome back.
In today's episode, we are delighted and privileged to be joined by South Australia's Dr Matt Hooper.
The practice of medicine - including pre-hospital medicine - often focuses on life preservation. But, as acute care clinicians we often also find ourselves caring for patients at the end of their life. Too, we find ourselves caring for their relatives and loved ones, and the wider medical team. It can be really challenging to provide this care in such an acute, unexpected and unstable setting - so how do we do it, how do we stabilise the moment and continue to deliver compassionate care?
This is the work of Dr Matt Hooper, who together with colleagues has created the 'emergency last aid' program - designed to teach the foundational skills needed to deliver compassionate end-of-life care in high-pressure environments. Drawing on his experience as a pre-hospital, intensive care and palliative care physician, Matt talks us through his approach to these challenging, rewarding circumstances.
Before listening to this episode, please ensure it is the right episode for you: talking about death, dying and grief can be triggering for some, so please ensure that this episode is what you need, at the right time, and that you have support around you.
Part two coming soon, chat then.
G'day and welcome back.
Damage control resuscitation - what is it, why should a pre-hospital provider do it, what does it look like in real life, and what are the results.
These are but some of the questions asked in this episode of Dr Dan Nevin and Mr Zane Perkins, Consultants with London's Air Ambulance. In conversation with Sydney's Dr Ian Ferguson, we explore this approach to the care of the bleeding trauma patient, focusing on the key tenants of this method and some of the mandated actions required when a patient is declared a damage control resuscitation case.
To be clear - these are patients requiring a modified approach to even a 'code crimson/red' patient - these are the absolute most sick of all pre-hospital bleeding trauma patients.
Too, as ever we discuss the effect on the wider system of this novel approach as well as the potential associated modifications to conventional trauma care.
Thanks for listening, chat soon.
G'day and welcome back to the podcast.
ECMO....in trauma? Today, we are talking about a more general emergency medicine / intensive care medicine topic, that of advanced trauma care. It is fair to raise an eyebrow at 'advanced trauma care' and 'ECMO' in the same sentence - these patients are anatomically disrupted, prone to bleeding and suffering huge multi-system injuries. So placing them onto a heparinised ECMO circuit seems counterintuitive.
But, Chris Bishop and the team from London offer a different perspective.
Chris is a Senior Clinical Research Fellow at the Centre for Trauma Sciences at Queen Mary University of London, UK. His PhD research focuses on the potential utility of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to treat cardiac dysfunction associated with major trauma haemorrhage. Indeed, as we have discussed elsewhere in the podcast, these patients often have refractory cardiogenic shock secondary to an unfavourable metabolic storm following massive acute trauma - and it is partly this which ECMO may help bridge.
Too, we discuss with Chris the benefit of ECMO as part of a neuro-protection package of care in patients with severe lung injury who are challenging to ventilate.
This is real cutting edge medicine, and we are delighted to share with you our chat with Chris.
Speak to you soon.
G'day and welcome back into part two of our conversation with Prof Sheldon Cheskes from Toronto, Canada.
Here we continue our discussion about refractory cardiac dysrhythmias with the Sheldon, the principal investigator of 'The dose VF' study.
In this part two, we talk to Sheldon about chemical strategies to overcome these dysrhythmias, as well as ask Sheldon about this best case ever - its a cracker!
Thanks for listening, chat soon.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the HEMS debrief podcast.
We are back with part one of a two part episode with Professor Sheldon Cheskes from Toronto, Canada. Sheldon is a Professor of Emergency Medicine by trade, a clinical scientist and a medical director for ambulance services within the Canadian province of Ontario.
Perhaps, though, Sheldon is best known for his work as the principal investigator in the 'Dose VF' study, during which Sheldon and the team demonstrate the effectiveness of double sequential external defibrillation (DSED; rapid sequential shocks from two defibrillators) and vector-change (VC) in patients suffering from shock refractory ventricular fibrillation. This ground-breaking out-of-hospital trial has been the subject of great interest amongst pre-hospital and in-hospital clinicians alike, and demonstrates very promising data supporting these two defibrillation strategies.
We are delighted, then, to talk to the man himself on the podcast today. Sheldon shares with us data from the study, and talks with us about the underlying physiology and pathology of this patient cohort, as well as how a health care system needs to best accommodate this potential salvageable group of cardiac arrest sufferers.
A link to the New England Journal of Medicine paper is below, and as ever we hope you enjoy listening to this and part of of Sheldon's episode.
Chat soon!
https://www.nejm.org/doi/full/10.1056/NEJMoa2207304
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back.
Today, we continue our conversation on pre-hospital thoracotomies.
To do this, we have teamed up with Professor Ewoud Ter Avest, an Emergency Physician with the London HEMS service. Ewoud is an author on the London's recently published review paper discussing the Service's experience with pre-hospital thoracotomies over the past 20 years. In conversation with our own Dr Ian Ferguson and Chris Ennis, who are authors on a similar paper out of Sydney, we will consider the shared themes, learnings and evolutions of this acute procedure between the two services.
In so doing, we continue to discuss optimal timing of a pre-hospital thoracotomy, what constitutes signs of life, and which patient groups are most likely to most benefit from the procedure.
This is a fascinating episode and as ever, we hope you enjoy it.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back.
In this part two of our chat with Prof Laurie Morrison from Toronto, we continue our conversation around the latest ILCOR guidelines. We discuss, amongst other things, strategies to manage recurrent / refractory dysrhythmias, as well as the use of mechanical CPR devices and the administration of adrenaline.
Too, we quiz Laurie on how guidelines and written and interpreted, and the choice of the language used.
As ever, we hope you enjoy this episode - be sure to tune back in soon for more general retrieval topics, as well as more focused discussion around cardiac arrest.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back to the HEMS debrief - continuing our chats on cardiac arrest.
We are thrilled to be again joined by Prof Laurie Morrison from Toronto, Canada. Laurie is an Emergency Physician and has dedicated her career to the research and improvement of out-of-hospital cardiac arrest care. To this end, Laurie is a member of ILCOR where she has previously been named a 'Giant in Resuscitation'.
Today, join Laurie in conversation with Nat for part one of a two part episode discussing the latest 2025 ILCOR guidelines.
These guidelines are packed - with concern given to CPR modes, effective defibrillation and the use of adrenaline to name but some. Who better to discuss this than Laurie herself - who with Nat spells out the guidelines to best help us all improve our cardiac arrest care.
Be sure to tune in soon for part two of this episode, as well as for more chat on pre-hospital thoracotomies.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Debrief, another episode here of the cardiac arrest deep dive.
Today is a cracker - we have our very own Dr Cliff Reid in conversation with Nat, discussing PEA. Now, anyone who knows Cliff will know he is passionate about many things, one of which is PEA - specifically the nomenclature around PEA and the differences between PEA patients, and thus how we treat them; not all PEAs are the same, and therefore the treatment considerations need to be equally as nuanced.
In this episode, Nat and Cliff break down different PEA cohorts, and use their own experiences to colour-in the fascinating discussion of this often over-looked subset of cardiac arrest patients.
A huge thank you to all those who listen to the podcast in NSW, Australia and beyond - we are so grateful for your continued encouragement and support.
Let's continue to get excited about cardiac arrest, as we listen to Nat and Cliff discuss all things PEA.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back to the Sydney HEMS Debrief podcast.
Today, we re-introduce some more general pre-hospital retrieval medicine matters, and what could be more retrieval medicine than a pre-hospital thoracotomy.
Joining the pod today, we have Dr Ian Ferguson and CCP Chris Ennis who together discuss their recently published research paper on this HALO procedure.
This case series reviews all cases of pre-hospital resuscitative thoracotomy undertaken from 1st Jan 2013 until 31st December 2024, within the NSW physician-CCP pre-hospital system. In concert with recently published data from the London team, Ian, Chris and Sam, discuss the nuances of this procedure - the why, the when and the unexpected survivors observed within the Sydney study cohort.
Too, we discuss the use of ultrasound in this patient cohort and the importance of the 'everything else' beyond the procedure itself.
A reference of the full text is below, and as ever please do share with your peers and network.
Chat soon.
Ennis C, Tant J, Burns B, Oliver H, Ostrowski K, Oliver M, Kruit N, Ferguson I. Pre-Hospital Resuscitative Thoracotomy Performed in New South Wales, Australia: A Case-Series. Emerg Med Australas. 2025 Dec;37(6):e70186. doi: 10.1111/1742-6723.70186. PMID: 41362072.
G'day, and thanks for tuning in to another episode of the HEMS Debrief podcast - this is our focused series on cardiac arrest.
Today we are joined by Canadian Physician-Researcher Dr Brian Grunau. Brian is an Assistant Professor at the University of British Columbia Department of Emergency Medicine and works clinically as an Emergency Physician at St. Paul’s Hospital in Vancouver, Canada. His research investigates methods to improve outcomes from out-of-hospital cardiac arrest, and in so doing he has received over $15 million in research funding and published over 190 peer-reviewed articles. Brian is a member of the International Liaison Committee on Resuscitation (ILCOR) Advanced Life Support Task Force, which creates resuscitation treatment recommendations.
In today's episode, we specifically quiz Brian on the time dependent yields of conventional resuscitation vs eCPR initiation, as well as how a system can best promote cardiac arrest research at every step of the chain of survival.
Thanks as ever for listening!
As we move deeper into 2026, the podcast will re-introduce episodes on more general Retrieval / Aeromedical topics, addressing both the technical and non-technical of this fascinating and challenging speciality. Do hit subscribe to stay up to date! And as ever, thank you for listening.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the HEMS debrief podcast.
It is 2026, and we are kicking off with an episode of the cardiac arrest mini-series dedicated to paediatric cardiac arrest.
Sadly Nat could not join, so instead Sam alone is in conversation with Dr Janice Tijssen.
Janice is a paediatric critical care physician from London, Ontario. Having trained in London (Ontario) and Toronto, Janice is now a member of the Paediatric Life Support Taskforce for the International Liaison Committee on Resuscitation (ILCOR) and is the medical director for her hospital's Paediatric Advanced Life Support (PALS) education program. Too, Janice leads her hospital's Paediatric Critical Care Outreach Team (PCCOT).
In this episode, we reflect on the changes in the recent ILCOR guidelines around paediatric cardiac arrest, as well as deep dive into some of the physiology of the arrested paediatric patient, asking both how can we prevent arrest, and how can we optimise the arrested physiology to best achieve sustained ROSC.
We sure hope you enjoy this episode, there is a lot in here for any paediatric critical care provider.
As we move deeper into 2026, the podcast will re-introduce episodes on more general Retrieval / Aeromedical topics, addressing both the technical and non-technical of this fascinating and challenging speciality. Do hit subscribe to stay up to date! And as ever, thank you for listening.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'Day and welcome back to the HEMS debrief, cardiac arrest mini-series. This is part two of our conversation with the pre-hospital ECMO team from Paris, France.
Following part one, in this part two we continue to chat with Alice and Lionel about their extended research in the out-of-hospital cardiac arrest space, including but not limited to rapid cooling and ventilation strategies.
Too, we discuss the cultural reluctance of systems to further adopt pre-hospital ECMO, as well as share some tips for those systems considering embarking on ECMO provision.
As 2025 draws to a close, thank you sincerely for listening throughout 2025, and we cannot wait to talk again in 2026.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Sydney HEMS Debrief podcast - this is our focused mini-series on Cardiac Arrest.
Today's episode is a big one. We have the absolute privilege of speaking to the Dr Alice Hutin and Prof Lionel Lamhaut from the pre-hospital ECMO team in Paris, France.
The team, part of the Service d’Aide Medical d’Urgence (aka SAMU) in Paris, have been performing pre-hospital ECMO for OOHCA since 2011. For the past 10 years, the team have been available 24/7, working in concert with the pre-hospital ICU team dispatched to cardiac arrests in the greater Paris region.
Truly ground-breaking, Alice and Lionel join us to reflect on over a decade of pre-hospital ECPR care, system implementation and challenges. Too, and perhaps most significantly, Alice and Lionel reflect on the extent to which the pre-hospital ECPR service has influenced every step of the chain of survival in the Paris system - promoting high quality basic and advanced life support at multiple levels within the pre-hospital response.
Too, Sam does not shy away from asking some tough questions around just who should be performing ECPR - high specialised, limited access services or should this therapy be adopted and delivered more widely.
This is part one of a two part episode, and is an absolute cracker.
Be sure to tune in to part two very soon!
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Sydney HEMS debrief, with our focus still firmly on cardiac arrest.
In this episode 14, Nat is joined by Dr Helen Oliver in conversation with Dr Caroline Leech from the UK. Caroline is an emergency and pre-hospital physician who's academic interest focuses on maternal cardiac arrest. Specifically, Caroline's work concerns resuscitative hysterotomy; the when, the how, and the what to do after performing this HALO procedure.
Additionally, Nat, Helen and Caroline discuss the physiology of maternal cardiac arrest and how we can best optimise our holistic resuscitation care as well as some of the ethical considerations surrounding this very challenging and confronting circumstance.
We hope you enjoy this challenging episode, and of course share widely with your network.
Chat soon.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
Welcome back, this is part two of Nat's chat with Dr PO Berve from Norway.
Continuing the conversation, Nat and PO discuss physiological markers of ALS effectiveness as well as broach how to most judiciously use adrenaline during cardiac arrest. Too, PO dives into how to use the end tidal capnogram as a marker of CPR effectiveness - and it is not how you may think!
Of course, this would not be a Sydney HEMS debrief episode without talking about eCPR and ventilation during CPR - the later being a favourite topic of Nat's for sure.
As ever, thanks for listening and chat again soon.
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
As we move our the podcast onto both Spotify and Apple Podcasts, we are re-posting this episode originally published in March 2024.
In this episode, Nat and Alex join Sam to discuss the Sydney PRECARE pre-hospital ECMO trial as it is just getting under way. Focusing on workflows and team integration, Nat and Alex share their experiences, challenges and successes in these early days for the trial.
We hope that the content here may help frame that of other episodes in this cardiac arrest series, as well as flavour future episodes as we reflect on PRECARE several years later.
Hello, and welcome back to the Sydney HEMS debrief podcast. This is our focused series on cardiac arrest.
Today we have part one of two in conversation with Dr PO Berve from Norway. PO is an Anaesthetist and Pre-Hospital physician from Oslo where he works on the physician response car of the region. PO's research has been absolutely fundamental to the modern understanding of CPR physiology and the haemodynamics of the arrested patient, and his work is rightly lauded as critical in the practice of physiology-guided resuscitation.
Have you ever wondered what happens during one chest compression? In this episode, Nat deep-dives with PO into the physiology of the arrested patient – specifically what happens, or what should happen, during one perfect chest compression. It’s a fascinating conversation not to be missed by anyone with an interest in performing high quality resuscitation tailored to a specific patient.
Part two coming soon!
We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
Welcome back to the Sydney HEMS debrief. We are up to episode 11!
Today, we are pivoting towards toxicology. Specifically, we discuss some of the more common toxidromes encountered pre-hospitally, how they cause cardiac arrest, and what providers – in particular pre-hospital providers – may do in order to best resuscitate these patients.
In addition to some broader and very applicable learning themes pertinent to any toxidrome, we discuss
- Beta-blockers
- Calcium channel blockers
- Amitriptyline
- Quetiapine
- …and more
Of course we are not doing discussing this alone. We are so luck to be joined today by a clinical toxicologist, Dr Úna.
Dr Úna Nic Ionmhain graduated from Trinity College Dublin, and subsequently trained in Emergency Medicine in Perth. She completed a Pre Hospital and Retrieval Medicine year with CareFlight NSW as well as a poisons fellowship. She is now a staff specialist FACEM at Liverpool Hospital NSW, and a clinical toxicologist with the NSW Poisons Information Centre. She has an academic interest in HIET in toxicology for cardiogenic shock, which was the focus of her masters thesis, and is a passionate educator with a particular interest in cardiotoxicity.
We sure hope you enjoy this episode, and until next time, we hope you have a great week.
ScreenshotThis is part two of our conversation with Dr Mike Lauria.
Join us as Nat and Mike continue to delve into team performance. In this episode, Nat and Mike discuss human factors gold including but not limited to how to accept imperfection and continue to deliver optimal team performance when things are going south, how to instil calm in a team whilst maintaining the momentum of care, and how to adapt and pivot whilst maintaining optimal process.
Of course, there is much much more and so we hope you enjoy this episode, and share it far and wide.
Speak soon.
ScreenshotHello, and welcome back to the Sydney HEMS debrief podcast.
Thank you for your patience – I have been taking the long way home from Canada, but am delighted to be back in Sydney and now ready to go with more episodes of our focused series on cardiac arrest.
In this part one of two episodes, we are pivoting away from the technical towards human factors and team performance. In doing this, we are thrilled to be joined by Dr Mike Lauria.
Mike is a human factors legend. Prior to becoming a Doctor, Mike served as an elite Pararescueman in the 321st Special Tactics Squadron during which time he won numerous service awards. Then, Mike became the lead instructor of a tactical training group before moving back to New Hampshire to work as a Critical Care and Flight paramedic. If that wasn’t enough, Mike then went to and graduated from Medical School before completing his residency in Emergency Medicine, as well as fellowships in EMS and Critical Care, at the University of New Mexico Health Science Center.
Currently, Mike works as an attending critical care and EMS physician at the University of Washington, and is the Associate Medical Director at Airlift Northwest.
Suffice to say, Mike brings an exceptional wealth of experience and perspective on what constitutes a high performing team and a high performing individual, and the factors required to maintain operational momentum even during unfavourable circumstances. Nat and Mike discuss this and much more in what are two episodes full of absolute gold.
I predict these episodes will become mandatory listening for human factors and team performance enthusiasts, and rightly so.
Chat soon!
ScreenshotHello and welcome back to the Sydney HEMS debrief, focus on cardiac arrest.
This week, we are very excited to deep dive into defibrillation. Join us as we talk through the physics of defibrillation, what is needed to get defibrillation as good as it can be, and what to do when defibrillation is simply not working.
We are delighted to be joined this week by Michael Heller. Michael is a paramedic by background, who now works as a medical engineer focused on defibrillation. Michael studied Rescue Engineering in Germany, and combining his clinical background is now a defining expert voice on defibrillation, and an excellent educator.
Too, we are delighted to be joined again by CCP Jackie, the educator for the Sydney pre-hospital ECMO/cardiac arrest car. In this episode, Jackie reflects on her experience backing up crews attending cardiac arrests, and how this experience has shaped her appreciation of the importance of good and judicious defibrillation, the barriers to making this happen, and how we as providers can all improve our defibrillation practice.
We hope you enjoy this episode, and as ever please send any feedback to me (Sam).
Have a great week!
ScreenshotHello and welcome back to the Sydney HEMS debrief, focus on cardiac arrest.
This week, we are joined by a Sydney local – Prof Jimmy Chien, as we talk about PE in cardiac arrest.
Jimmy is a Senior Staff Specialist (Senior Consultant) in Respiratory Medicine, with a sub-speciality focus on pulmonary embolism. Jimmy has been fundamental in the creation of the PE emergency response team at his tertiary facility in Sydney, as well as in the roll-out of similar multi-disciplinary teams across Australia. On a daily basis, Jimmy and his team encounter the most challenging PE patients – those with intermediate or high risk PE, as well as those in arrest.
In this episode, Nat, Jimmy and I unpack how a PE causes an arrest, how to ascertain if a patient has arrested secondary to a massive PE, the therapies available to those patients who have arrested due to a known or suspected PE, and the role of mechanical support including ECMO. Too, we quiz Jimmy on where the literature is taking us to help manage this cohort of patients, as well as some of the emerging post-therapy care plans.
Jimmy is a wealth of knowledge, and we sure hope you enjoy the episode as much as we did recording it.
ScreenshotHello and welcome back.
This week, we are joined by Dr Felipe Teran from New York, discussing trans-oesophageal ECHO (TOE) in arrest.
Felipe is an Associate Professor of Emergency Medicine at Weill Cornell Medical College, New York. Additionally, Felipe is a clinical scientist and educational leader specifically focused on the utility and application of TOE during cardiac arrest. Indeed, Felipe is leading the way integrating this intervention into ACLS efforts.
In this episode, myself (Sam), Nat and CCP Jackie chat with Felipe about the literature to date demonstrating the application of TOE in arrest to best optimise chest compression position to promote forward flow. In so doing, resuscitation providers can attempt to avoid a left ventricular outflow tract obstruction, and are better able to continually assess the effectiveness of ACLS – noting that the heart can change position throughout arrest.
Additionally, Nat talks about her and the team’s experience of pre-hospital TOE within the New South Wales Ambulance system, in particular how TOE can be utilised as part of a toolkit of assessment during arrest to assess the effectiveness of a resuscitation – even in the absence of placing a patient onto ECMO. Linked to this, Jackie describes the effect of live physiologic guidance and feedback to the paramedic workforce in New South Wales.
We certainly hope you enjoy this episode, and we look forward to talking with you again soon.
ScreenshotHello and welcome back.
As we continue to discuss cardiac arrest, this week we talk with Prof Laurie Morrison from Toronto about:
- How to integrate cardiac arrest research into an existing systems
- How to gather and interpret physiologic data during arrest – particularly ventilation data – and what to do with this data to optimise arrest care
- How to be a leader in this research field
Prof Morrison is an academic and Clinical Scientist in the Division of Emergency Medicine, Department of Medicine at the University of Toronto and Sunnybrook Health Sciences Centre. Her program of research focuses on the evaluation and implementation of time sensitive interventions in acute emergencies, including cardiac arrest.
Laurie is a member of ILCOR, where she has been named a ‘Giant in Resuscitation’. Outside of ILCOR, Laurie has led the way establishing ‘Rescu’ – a collaborative prehospital research network wherein investigators conduct randomised controlled trials and outcome validation studies in resuscitation research. Laurie continues to provide leadership to several committees including the network of Canadian Emergency Medicine Researchers, and she has has received honorary membership to the European Resuscitation Council for life time achievement in resuscitation science.
We hope you enjoy this episode, and as ever please send us feedback or questions.
Please remember to hit subscribe!
ScreenshotHello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest.
This is the second half of our chat with Dr Hans van Schuppen from Amsterdam as we put the P back into CPR.
In today’s episode, we discuss amongst other things:
- Lung recruitment intra-arrest
- The impact of tidal volumes during arrest
- To PEEP or not to PEEP during arrest
- How to use ventilation to prevent acidosis during arrest
Join now as we continue to pick Hans’ brain, and as ever we hope you enjoy this and subsequent episodes.
Please remember to hit subscribe!
Here is a link to the text Hans’ references concerning common terminology of ventilation during cardiopulmonary resuscitation: https://pubmed.ncbi.nlm.nih.gov/39848430/
Screenshot(Please excuse the re-post, poor editing on my part (Sam’s) means we are re-posting this episode)
Hello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest.
This is episode 3, and today it is all about ventilation during arrest. It is time to put the P back into CPR. Ventilation has been neglected in cardiac arrest management, and this two part episode focuses on how ventilation can not only help achieve a ROSC but the importance of ventilation too in achieving neurologically intact survival
- We debate 30:2 or continuous ventilation and the merits of LMA vs intubation vs BVM
- We talk about the complexities of heart lung interactions
- Where the research is heading in understanding how best to ventilate these patients
We are delighted to be joined by an absolute expert in this area, Dr Hans van Schuppen from Holland.
Hans is an anesthesiologist and HEMS physician at the Amsterdam University Medical Centre. Hans is a combined researcher, clinician and leader. He is an ERC Advanced Life Support Course Director, co-founder of the ResusNL conference, member of the expert group on national ambulance guidelines on resuscitation and is a member of the jury of the Dutch National Resuscitation Competition. As a member of the Dutch Resuscitation Council, he co-authored the national resuscitation guidelines, and helped to develop and implement a nationwide standard operating procedure for the handover of out-of-hospital cardiac arrest patients.
Currently, Hans is the chair of the Medical Committee and board member of the Dutch Resuscitation Council. His research evolved into a formal PhD with the ARREST (AmsteRdam REsuscitation STudies) group and the department of Anesthesiology, resulting in his thesis “Prehospital Advanced Life Support”. He now serves as director of resuscitation science of ARREST and works towards close collaboration between clinical care, education, research and innovation in resuscitation.
We could not stop talking to Hans, so please tune back in next week for the second half of our conversation.
ScreenshotHello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest.
In the second episode of this series, we talk to Dr Tommaso Scquizatto from Milan, Italy.
Tommaso is a Doctor, researcher and innovator in cardiac arrest, resuscitation, and emergency critical care medicine. He works in the Department of Anaesthesia and Intensive Care at IRCCS Ospedale San Raffaele in Milan, Italy, where he leads cardiac arrest research and innovation.
His clinical and research efforts focus on improving the entire chain of survival for out-of-hospital cardiac arrest, from prevention to advanced resuscitation, including the use of extracorporeal life support and novel technologies. He serves on the Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR) and the 2025 Guidelines Working Groups for BLS, ALS, and extracorporeal CPR of the European Resuscitation Council (ERC). He is also an editorial board member and social media editor for Resuscitation and Resuscitation Plus.
With Tommaso in this episode, we talk about targeted physiology in cardiac arrest included targeted diastolic blood pressure, Tommaso’s research, and how systems and workflows may adapt to incorporate new intra-ACLS interventions such as transoesophageal ECHO.
We hope you enjoy the episode, please be sure to hit subscribe and tune back in next week,
Hello and welcome back to The Sydney HEMS Debrief, episode 15!
It has been a while since our last episode, and today we are back with the Pre-Care team to discuss this world-leading trial. Joining us are Nat, Jackie, Andrew and Pete. Together, we will discuss the experiences of clinicians involved in this trial, specifically highlighting the importance of maintaining good ALS prior to the arrival of, as well as during the presence of, the pre-care team as well as how the pre-care trial is impacting attitudes towards cardiac arrest management across the greater workforce. We discuss some of the emerging practices regarding a personalised approach to cardiac arrest management, and we reflect on the broader benefits of this unique and fascinating trial.
I certainly hope you enjoy it!
Welcome back to The Sydney HEMS Debrief, now on episode 14!
Today, we are joined by Retrieval and Anaesthetic Staff Specialist Dr Jess Devlin, who talks us through one of her most challenging and rewarding cases. Using the case as a springboard, we go on to discuss some of the nuances around, and approaches towards, multi-casualty scenes and consider how to make sense of an overwhelming situation and perform effectively within it.
This episode is certainly a must listen for any clinician who may be faced with a multi-casualty, multi-agency situation, and who wants to function effectively and safely with in.
I sure hope you enjoy!
Welcome back to The Sydney HEMS Debrief, now on episode 13.
Today we are talking about the PreCare trial, currently underway here in Sydney. This feasibility trial – a first for Sydney – concerns placing patients suffering out of hospital cardiac arrest onto potentially life-saving extracorporeal membrane oxygenation (ECMO) therapy in the field, before transporting them to definitive care.
To discuss more, we are joined again by Dr Nat Kruitt, Staff Specialist here at Sydney HEMS and Specialist in Cardiac Anaesthesia and ECMO, as well as Alex Peters, one of the Sydney HEMS Critical Care Paramedics. We will discuss how and why the trial came about, the practical application and workflow considerations of placing an eligible patient onto pre-hospital ECMO, as well as some future considerations for this innovative therapy.
This episode is a must listen for other pre-hospital providers in the greater Sydney basin who may come into contact with the ECMO team, as well as those interested in eCPR and ECMO more broadly.
I hope you enjoy it!
Welcome back to The Sydney HEMS Debrief. After an extended New Year break, we return with episode 12.
We are joined this week by Sydney HEMS Staff Specialist Dr Ian Ferguson. Ian is the lead author on a recently published randomised control trial assessing the haemodynamic effects of adding fentanyl to an induction regime of ketamine and rocuronium for rapid sequence intubation in the emergency department. This multicenter study conducted in New South Wales, Australia, has yielding some thought-provoking results, and may change your in- or out-of-hospital anaesthesia practice in future.
Join us here in episode 12 to hear it live from chief investigator himself.
Below is a link to the full and free text:
Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The FAKT study-A randomized clinical trial
Ferguson I, Buttfield A, Burns B, Reid C, Shepherd S, Milligan J, Harris IA, Aneman A; Australasian College for Emergency Medicine Clinical Trials Network. Fentanyl versus placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department: The FAKT study-A randomized clinical trial.Acad Emerg Med. 2022 Jun;29(6):719-728. doi: 10.1111/acem.14446. Epub 2022 Mar 15. PMID: 35064992; PMCID: PMC9314707.
Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314707/
Welcome to episode 11 – likely our last episode of the year!
The feedback has been fantastic – thank you to all who have taken the time to let me know your thoughts, and for helping to shape the episodes into what they are.
In this end of year episode, we are joined by Sydney HEMS Staff Specialist Dr Ruby Hsu. Ruby and I sat down for a chat with no real agenda, but knowing that she had a fantastically varied and colourful pre-hospital career across several countries, I thought it valuable to hear Ruby’s thoughts on – amongst other things – safe systems, career building, and luck.
I hope you enjoy it, and speak to you in the New Year.
Sam
Join for the second part of Dr Brian Burns’ episode, as we continue to discuss mimics of shock in our trauma population.
See some show notes below for more resources.
Thanks for listening!
Show notes:
Reference on pulmonary embolism: https://emcrit.org/pulmcrit/eight-pearls-for-the-crashing-patient-with-massive-pe/
Reference on pulmonary contusion: https://pubmed.ncbi.nlm.nih.gov/30906578/
Reference on pulmonary contusion lung ultrasound: https://coreultrasound.com/pulmonary-contusions/
In the ninth episode of the Sydney HEMS Debrief series, we have the first half of a two-part episode!
Join us as Sydney HEMS Senior Staff Specialist Dr Brian Burns discusses the recognition, aetiology and treatment of different types of shock in our pre-hospital trauma patients. Whilst pre-hospital clinicians may have a natural bias towards hypovolaemic shock secondary to blood loss, Dr Burns discusses the many mimics of hypovolaemic shock, and how it is crucial we remain mindful of other causative acute and subacute pathologies.
See some show notes below for more resources.
Thanks for listening!
Show notes:
Reference on impact brain apnoea: https://pubmed.ncbi.nlm.nih.gov/27211834/
Reference on spinal cord injury: https://www.nature.com/articles/nrdp201718
Reference on blunt cardiac injury: https://www.aast.org/resources-detail/blunt-cardiac-injury
Welcome back to the Sydney HEMS debrief! In this episode 8, we are joined by the extraordinary Dr Nat Kruit. Dr Kruit is a Sydney HEMS Consultant, Cardiac Anaesthetist, and ECMO Specialist. Given the increasing global chatter around ECMO, and to give it its full name, extracorporeal membrane oxygenation is going to be the focus of this episode. Join us as Dr Kruit takes us through the physiology, patient selection, and retrieval considerations of this fascinating – and very specialised – area of medicine.
In the seventh episode of the Sydney HEMS Debrief series, Sydney HEMS CCP and Educator Jackie Buckthought shares a challenging case from her training. Jackie discusses how this case has affected her work flow, resilience, and more recently her perspective as an educator. It’s a cracker!
As ever, any feedback is welcome – please get in touch, and until the next time, have a great week.
Enjoy.
In episode six of the debrief series, NSW Aeromedical Retrieval Staff Specialist Dr Sarah Aldington discusses a formative experience, highlighting the profound impact cases may have on clinicians and the importance of a dedicated debrief.
Click to access STOP5.pdf
Welcome back to the Sydney HEMS debrief – this is episode 5. Dr Robbie Lloyd has spent his past 12 months as a Sydney HEMS Registrar, and has been intent on making quality assurance and clinical governance ‘cool’. By harnessing the learning from our daily ‘coffee and cases’ team chat, he has led a fantastic project wherein snippets of learning are disseminated widely around the organisation. Find out more on this episode, as well as the blog post linked below.
Enjoy!
Find out more about his Quality Improvement Project here.
In Episode 4 of the series, Sydney HEMS Critical Care Paramedic Sam Immens joins HEMS Physician Dr Samuel Bulford to discuss a pragmatic and practical reflection tool which has helped him navigate his clinical workflow.
Working as a Critical Care Paramedic with NSW Ambulance and the Toll Rescue Helicopter has been a lifelong personal and professional goal for Sam, who describes himself as “genuinely humbled by the professionalism and expertise displayed by the Pilots, Aircrew, Doctors, Engineers, Managers, Support Staff, and his fellow CCPs, in delivering critical care to anyone, in any place, at any time across New South Wales.”
Sam had some further reading recommendations he wanted to share here too:
- Rolfe’s adaptation to the reflective model we use in clinical practice today.
Rolfe., G et al. (2001) Critical reflection in nursing and the helping professions: a user’s guide.Basingstoke, Palgrave Macmillan
- Rolfe credits Terry Borton with the genesis of the terms and concept in his 1970 book
Borton, T. (1970). Reach, touch, and teach; student concerns and process education. New York, Mcgraw-Hill
- Thanks for the Feedback, by Stone and Heen – essential reading for those that are in the position of giving feedback and mentoring as it nicely delineates coaching, feedback, and appreciation.
Drs Natalie May, Geoff Healy, and Cliff Reid discuss missions in which the prehospital medical team is diverted to a hospital because their patient has been moved from scene to a (non-major) hospital. While one might expect these missions to … Continue reading →
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Cliff Reid, Karel Habig, and Geoff Healy discuss the approach to patients with hypoxia and obstructed airways, prior to rapid sequence induction. This is all about effective basic airway management.
Cliff Reid, Karel Habig, and Geoff Healy discuss the approach to patients with penetrating injury.
In this podcast, Cliff Reid, Karel Habig, and Geoff Healy discuss how to do a prehospital primary survey Reference: Ware S, Reid C, Burns BJ, Habig K. Helicopter emergency medical service registrars do not comprehensively document primary surveys. European Journal … Continue reading →
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In this 28 minute audio podcast recorded at the SMACC conference in 2013 Sydney HEMS physician Dr Brian Burns talks about being prepared for life, limb & sight saving procedures in the prehospital environment. http://traffic.libsyn.com/smacc2013/know-your-weapons-burns.mp3 You can download the podcast by right-clicking here Here … Continue reading →