PHEMCAST

By Tim Nutbeam and Clare Bosanko

What's PHEMCAST about?

A UK Prehospital Emergency Medicine Podcast.

This podcast and associated website aims to:

- Share knowledge and expertise in the field of prehospital medicine with specific reference to the UK working environment

- Make this content relevant to all professional prehospital practitioners

Download our free app to listen on your phone

PHEMCAST episodes:

04.27.2023
Vasopressors in Trauma
Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1. The European guideline...
11.28.2022
TXA – an update
Read more about the Cochrane injuries group: https://injuries.cochrane.org/about-us-0 Have a listen to the earlier TXA podcast here: https://phemcast.co.uk/2018/01/18/episode-26-tranexamic-acid/ Do you want to revise your clotting pathways and the mechanism of action of TXA?! Here are some links to the excellent...
09.15.2022
Extrication
Road traffic collisions are a leading cause of death and injury. Following a road traffic collision many patients will remain trapped in their vehicle. Extrication is the process by which injured or potentially injured people are removed from their vehicle...
04.11.2022
Pain (& analgesia)
This is the book Jon quotes, “Pain is a symphony…” The International Association for the Study of Pain’s revised definition of pain is available here. If you’d like to read more about ‘nocebo’ i.e. the non-pharmacological adverse effects of an...
03.29.2022
RePHILL
Before you listen to this new podcast, we encourage you to go back and have a listen to Episode 16: Blood which we released in 2017 outlining the available evidence about prehospital blood, and the background to the RePHILL trial....
02.07.2022
Cold Injury
This podcast is dedicated to the memory of Emmanuel Cauchy. George’s adventures! Grading frostbite The GELOX study The Hyperbaric oxygen study described by Carron is now in print and available here. Guidelines The guidelines mentioned by Chris can be found...
07.27.2021
Ultrasound
Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound...
06.27.2021
Acute behavioural disturbance
Definitions UK definition (RCEM): It describes the sudden onset of aggressive and violent behaviour and autonomic dysfunction, typically in the setting of acute on chronic drug abuse or serious mental illness. Australian definition (NSW Health): Behaviour that puts the patient...
05.10.2021
The Jungle
This was a joint podcast with our friends & colleagues at WEMCast – to hear more from them, have a look at their podcast back catalogue, and there’s more information on the World Extreme Medicine website. Mosquito born disease Malaria...
04.21.2021
Intubation
Guidance documents College of Paramedics Statement on Intubation, available here. AAGBI Safer Prehospital Anaesthesia 2017, available here. Positioning Recommended Rich Levitan resources Airway axes Epiglottoscopy Bimanual Laryngoscopy Further resources https://www.resus.com.au/apnoeic-oxygenation-resuscitation-time/ https://anaesthetists.org/Home/Resources-publications/Guidelines/Safer-pre-hospital-anaesthesia Click here to hear what our friends over at...
03.18.2021
Altitude
From: https://www.bbc.co.uk/news/uk-wales-46441129 From: https://www.ultimatekilimanjaro.com/blog/should-i-use-supplemental-oxygen-on-kilimanjaro/ Want to know more? This is one of the organisations Lucy mentions: British Exploring And this is the Global Health MSc The Wilderness Society Guidelines are available here. This is the link to the Wilderness Medical...
02.25.2021
Drowning
Some facts Drowning is important: 1,000 people drown every day, 2 every 3 minutes, 41 per hour. It is the world’s 3rd leading cause of accidental death: 3.6 million people over 10 years. Disease of youth 64% < 30 years old...
05.03.2020
Episode 36: COVID-19
Case definition Current case definition for COVID-19 can be accessed here. Risk stratification This is the Emergency Medicine Specialty guide we discussed in the podcast, which includes use of the NEWS and 40 step test (edit: since recording the podcast...
09.25.2019
Episode 35: The collapsed infant
A: Optimal airway position for infants Note how a rolled towel is placed under the baby’s shoulders to allow space for the occiput and avoid flexion of the neck and airway. ‘B’ assessment Video links to examples of children with...
07.12.2019
Episode 34: Back pain
So, where is the Cauda Equina? From Core EM How does a herniated disc cause CES? This fab infographic summarising the key points about the CES guidance was produced by @DrLindaDykes and @saspist. Here is the full guideline from The...
03.31.2019
Episode 33: Psychosomatic Illness
Many thanks to Suzanne O’Sullivan for her time in putting this podcast together. Her excellent books “It’s all in your head” and “Brainstorm” are well worth a read. It is certainly one of the PHEMcast recordings which is going...
03.03.2019
Episode 32: Ketamine
Huge thanks to the team at World Extreme Medicine and WEM Cast for sharing the interview with Richard Harris. Dosing These are a guide only, each patient will need a bespoke approach depending on their pre-existing condition,...
01.22.2019
Episode 31: Stroke & Dizziness
The Danish mnemonic to help remember the elements of a cerebellar neurological examination: There are lots of Youtube videos to demonstrate these signs, here are a few which I thought were particularly helpful: Disdiadochokinesis Ataxia Nystagmus Intention tremor If you...
10.29.2018
Episode 30: Head injury
Quite a few of our previous podcasts include content which is relevant to this Head Injury one. Why not go back and have a listen to: Episode 3: Hyperoxia Episode 20: End Tidal Carbon Dioxide Episode 28: LOST (Low Output...
07.04.2018
Episode 29: Major Incidents
Another invitation to the Trauma Care Conference this year inspired us to combine two of the excellent speakers into this podcast considering major incidents. Thanks to both our speakers for sharing their talks from the conference. Trauma Care offer...
04.16.2018
Episode 28: LOST
Cardiac arrest is the end point, it is the symptom, not the diagnosis. The pathophysiological process varies, and this is particularly relevant in trauma vs medical. In medical cardiac arrest, the pathological processes tend to affect the heart’s ability to pump:...
02.09.2018
Episode 27: Checklists
We recommend reading Atul Gawande’s book ‘The Checklist Manifesto’. It’s a well written, fascinating story about the introduction of the WHO Safer Surgery checklist and the impact it had. This link will take you straight to Amazon if you want...
01.18.2018
Episode 26: Tranexamic Acid
The paper which we discuss in the interview is available open access here How does tranexamic acid work? Critical appraisal aids To understand more about hierachy of evidence and how a systematic review fits into this please have a look...
12.01.2017
Episode 25: Tension pneumothorax 2
Where can you undertake decompression of a pneumothorax? Be particularly careful when using the 2nd intercostal space mid-clavicular line that you are sufficiently lateral. For example, here are the locations identified as ‘2nd ICS mid clavicular line’ amongst 25 EM...
12.01.2017
Episode 24: Tension pneumothorax 1
Firstly, go and read Simon and Tim Harris’ great 2005 paper on the subject which we reference repeatedly in the podcast. It is available free open access here. A pneumothorax exists when air accumulates in the potential space between the...
11.14.2017
Episode 23: Intraosseus access
The various devices which Tony discusses are: This video shows the rapidity of infusion entering the circulation from a humeral IO. This is the paper mentioned by Tony, which shows the stepwise improvement in mortality amongst combat casualties from military conflict...
11.07.2017
Episode 22: BASICS & FPHC Conference 2017 – Part 2
10.06.2017
Episode 21: BASICS & FPHC Conference 2017 – Part 1
09.06.2017
Episode 20: End Tidal Carbon Dioxide
Guest contributor: Lauren Weekes What is ETCO2? % or partial pressure of carbon dioxide measured somewhere near the mouth at the end of a normal exhalation (hence end tidal, end of tidal volume breath) To get a measurement the following...
07.06.2017
Episode 19: Surgical Airway
The West Midlands surgical skills course offers cadaveric training for PHEM and EM practitioners on rare life saving procedures. Click here to go straight to their page. Anatomy The Guidelines Difficult Airway Society 2015 guidelines for management of unanticipated difficult...
06.04.2017
Episode 18: The Ventilator Part 2
Many apologies for the delay in the release of this podcast! A second apology is due for the sound quality – it was recorded at a ‘live’ HEMS base – this has led to lots of background noise I am...
03.28.2017
Episode 17: Broken? Impact on the rescuer
This episode has been compiled over a year – many thanks to our four contributors, who have shared their stories and knowledge. They were interviewed at TraumaCare 2016, TraumaCare 2017 and the BASICS/FPHC Conference 2016. If you ever need to...
02.23.2017
Episode 16: “Blood”
There is the potential for significant controversy in this month’s episode – and we would really appreciate the feedback of the prehospital community on this one. We have held the ‘no clear fluids’ mantra close to our hearts for most...
01.04.2017
Episode 15: Paediatric Trauma & How to Do Sim
Paediatric Trauma TARN report: Severe Injury in Children Simulation ATACC:The Anaesthesia Trauma and Critical Care course Thanks to Mark Forrest (@ObiDoc) for sharing these videos: References Spurr J, Gatward J, Joshi N, Carley SD. Top 10 (+1) tips to get...
12.12.2016
Episode 14: Thoracotomy
Details of the surgical skills course mentioned in the podcast can be found here: https://wmstc.co.uk/portfolio/phem-ess/ The Sydney HEMS Traumatic Cardiac arrest operating procedure can be viewed on their website, and there are a number of useful references within the document:...
12.02.2016
Episode 13: The Ventilator
Ventilation – a dark art. Difficult to be a master, easy to be average (or terrible)! This is “part 1”, which includes some of the basic (and not very basic) concepts behind ventilation. We recorded over 60 minutes of excellent...
09.19.2016
Episode 12: Breaking Bad News
YouTube videos: From the police officer’s perspective: https://www.youtube.com/watch?v=toaA_TNwcxg From the mother’s perspective: https://www.youtube.com/watch?v=0KJZXOKStao The paper about watching resuscitation is this one: http://www.nejm.org/doi/full/10.1056/NEJMoa1203366#t=article This is a section taken from the London Ambulance Service clinical bulletin, from 2011, which includes the SPIKES mnemonic: The...
07.14.2016
Episode 11: Gentle Patient Handling
The paper we mentioned by Jonathan Benger and Jules Blackham can be accessed here: https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-17-44 Stable versus unstable spinal injury The location of an injury and involvement of different structures defines the stability of a spinal injury. Anterior column: anterior longitudinal ligament...
06.13.2016
Episode 10: Stress Inoculation
Big thanks to Anand Swaminathan @EMSwami, Chris Nickson @precordialthump, Jesse Spurr @Inject_Orange, Chris Hicks @HumanFact0rz, and Tom Evens @doctomevens Their pre-workshop reading/listening recommendations: http://stemlynsblog.org/englishman-south-africa-robert-lloyd-st-emlyns/ http://emcrit.org/podcasts/toughness-michael-lauria-i/ Bandwidth Visualisation tips:
06.06.2016
Episode 9: Maternal Collapse
Apologies for the quality of the sound – we recorded in a very echo-ey office! The Royal College of Obstetricians and Gynaecologists (RCOG) green top guideline is accessible here: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_56.pdf We have talked about ramping previously, in Episode 6: Oxygenation....
04.19.2016
Episode 8: Chemical Suicide
The recent resurgence in this method of suicide has put emergency responders at a significant increase of serious injury and death. This podcast discussed the current most frequent methods of attempted and successful inhalational suicide – keep safe. ...
04.10.2016
Episode 7: Sepsis
We hope you enjoyed our sepsis podcast. It is obviously a huge topic and there is lots of information to cover; a couple of other recently released podcasts are available which are produced with the Emergency Medicine community in mind,...
03.17.2016
Episode 6: Oxygenation
To provide a bit of balance following our earlier hyperoxia podcast, this episode we are discussing circumstances when we want to deliver extra oxygen to patients and ways to do this effectively, including an interview with Sydney HEMS Consultant Yash...
02.02.2016
Episode 5: Amputation
Welcome to PHEMCAST episode 5: Amputation One of the things we never want to have to do, but need to be prepared for. Have a listen, consider your kit, your top-cover arrangements, and when and how you may need to...
01.06.2016
Episode 4: Chemical incidents
We hope you enjoyed this PHEMCast. Please feedback your comments via the blog, twitter or email us on [email protected]. The NARU video we mention in the podcast can be accessed here: http://naru.org.uk/videos/ior-nhs/ And the paper we discuss is: Chilcott RP....
12.06.2015
Episode 3: Hyperoxia
Hello and welcome to our next episode – we hope you enjoy it. This episode concentrates on hyperoxia – the delivery of lots (often too much) oxygen and the harms it may cause our patients. We both had colds –...
11.05.2015
Episode 2: The Pelvic Binder
Sorry for the slight delay releasing our “October” podcast – but here it is (note how it is cunningly labelled Episode 2)! This month we are reviewing the evidence for the pelvic binder and discussing scenarios in which it should...
08.11.2015
Podcast: September 2015: The LMA
Here it is – our very first podcast, and guess what – it is on supraglottic airways! This first episode reviews the history of the laryngeal mask airway and we discuss the relative benefits and risks of supraglottic airway devices....

What's PHEMCAST about?

Download our free app to listen on your phone

PHEMCAST episodes:

Vasopressors in Trauma

TXA – an update

Extrication

Pain (& analgesia)

RePHILL

Cold Injury

Ultrasound

Acute behavioural disturbance

The Jungle

Intubation

Altitude

Drowning

Episode 36: COVID-19

Episode 35: The collapsed infant

Episode 34: Back pain

Episode 33: Psychosomatic Illness

Episode 32: Ketamine

Episode 31: Stroke & Dizziness

Episode 30: Head injury

Episode 29: Major Incidents

Episode 28: LOST

Episode 27: Checklists

Episode 26: Tranexamic Acid

Episode 25: Tension pneumothorax 2

Episode 24: Tension pneumothorax 1

Episode 23: Intraosseus access

Episode 22: BASICS & FPHC Conference 2017 – Part 2

Episode 21: BASICS & FPHC Conference 2017 – Part 1

Episode 20: End Tidal Carbon Dioxide

Episode 19: Surgical Airway

Episode 18: The Ventilator Part 2

Episode 17: Broken? Impact on the rescuer

Episode 16: “Blood”

Episode 15: Paediatric Trauma & How to Do Sim

Episode 14: Thoracotomy

Episode 13: The Ventilator

Episode 12: Breaking Bad News

Episode 11: Gentle Patient Handling

Episode 10: Stress Inoculation

Episode 9: Maternal Collapse

Episode 8: Chemical Suicide

Episode 7: Sepsis

Episode 6: Oxygenation

Episode 5: Amputation

Episode 4: Chemical incidents

Episode 3: Hyperoxia

Episode 2: The Pelvic Binder

Podcast: September 2015: The LMA