Pre-Hospital Care Podcast

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 distinguished

In this episode, we will explore the intricacies of the

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 [email protected]

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 Blood

To do this I am joined by Lieutenant Colonel Andrew

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 [email protected]

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 [email protected]

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.

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 Triage

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 has

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 [email protected]

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