For over a decade after a large study showed a mortality benefit, this drug remained controversial. David and James look at the TXA saga.

Clinical conversations is back. But where have we been, what have we been doing and what do we have planned for the future?

We’re all familiar with the concept of STEMI. But the definition is built around a single ECG sign – not the underlying problem itself. Is that the best way to do it? Should we be thinking about this in a totally different way? Is Occlusive Myocardial Infarction (OMI) the new STEMI? Notes

OMI Manifesto

Amal Mattu on YouTube

Subtle STEMI iOS app

The Ancient Scholar

Capnography plays a crucial role in the treatment of a range of life-threatening conditions. Its central role following intubation is undeniable and it's also an important part of our approach to cardiac arrest and sedated patients of all kinds. Yet it is not always as straightforward as it might seem. In this episode, David and James speak with Matt Humar (intensive care paramedic, acting patient safety review lead at Ambulance Victoria, and secretary of the safe airway society) about matters capnographic. 

Further reading

• https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%20414/difference-between-end-tidal-and-arterial-pco2
• https://www.capnography.com/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231274/

Shock is the quintessential critical illness. Bread and butter for everyone involved in prehospital and critical care. But do we really understand it? Could we be doing better for these patients?

James is joined by Assoc. Prof. David Anderson, intensivist and Ambulance Victoria Medical Director, for a... shocking discussion. 

People experiencing acute behavioral disturbance are some of the most vulnerable patients we treat. It’s a deeply distressing situation for the patient and extremely confronting for clinicians and carers. In this episode, we speak with psychiatrist Dr Alison Taylor about important changes we're making to improve care for these patients.

Family violence is a deeply confronting and serious problem that occurs across all ages, genders, and socioeconomic groups. It has a profound impact on the health and well-being millions of people across the globe. How can we identify family violence? How should we respond to a disclosure of family violence? How can we help victim survivors? Ambulance Victoria Safe Guarding Care Lead Amber Smith joins James and David to discuss this important issue.

MARAM Family violence practice guide

The decision to withhold or cease resuscitation is one of the most impactful and also one of the more confronting decisions that paramedics make in the field. AV Medical Director Associate Professor David Anderson discuss Dr Natalie Anderson, PhD discuss the decision making process and how to better approach these difficult cases.   

MyGriefToolbox - Great Canadian resource for all paramedics, with helpful modules covering decision-making, patient death and grief.

Breaking bad news in the ED - Notifying family members of a death in the emergency department.

Ambulance Victoria recently introduced intranasal ketamine for the treatment of moderate and severe pain. It has proven to be effective but we have identified opportunities to do better.

Clinical Practice Development Specialist James Oswald and Medical Director David Anderson discuss the new Clinical Practice Guideline and some of the lessons we've learned along the way.