In this episode, Deb Swann and Roger Alcock take us behind the scenes of humanitarian medicine, sharing their experiences of working in two very different global health emergencies: the 2023 Türkiye–Syria earthquake response and the 2014–2016 West African Ebola outbreak.

On 6 February 2023, a series of devastating earthquakes struck southern Türkiye and northern Syria. More than 59,000 people were killed, including over 53,500 in Türkiye and around 5,900 in Syria. The humanitarian medical response involved emergency trauma care, field hospitals, medical evacuations and international Emergency Medical Teams. Within the first year, 38 national and international Emergency Medical Teams from more than 25 countries carried out almost 100,000 medical consultations in Türkiye.

The episode also looks back at the West African Ebola crisis of 2014–2016: The largest Ebola outbreak since the virus was discovered in 1976. Beginning in Guinea and spreading to Liberia and Sierra Leone, the outbreak ultimately infected more than 28,600 people and caused 11,325 deaths. WHO declared it a Public Health Emergency of International Concern in August 2014.

Deb and Roger discuss what it is like to work in these extraordinary circumstances, the challenges of providing healthcare when normal systems have been overwhelmed, and the human experiences that stay with medical teams long after they return home.

In this episode:

• Humanitarian medicine in the aftermath of the 6 February 2023 earthquake
• The international medical response in TürkiyeWorking during the 2014–2016 Ebola outbreak
• The realities of working on the humanitarian frontlineThe personal experiences and human stories behind the statistics
• What these crises can teach us about emergency medical response

NEAS Specialist Capabilities Conference 2026

The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.

Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.

The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.

Other speakers include Lee Thompson, who will discuss regional critical care, alongside specialists from EPRR and HART. Dräger supports the conference and focuses on collaboration, innovation, excellence, resilience and the communities we serve.

The closing date to register your interest is 11 October 2026.

👉 Register your interest for NEAS Specialist Capabilities Conference 2026

Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, Newcastle, Gateshead

In pre-hospital care, we spend a great deal of time preparing for the moments that matter most: cardiac arrest, major trauma, difficult airways, and emotionally challenging conversations. We train, rehearse, and work hard to achieve technical excellence. But what happens after the event may be just as important as what happens during it.

Debriefing is a familiar concept in healthcare. We often think of it as a chance to review what happened, identify what went well, and consider what we could do differently next time. But for some of the world’s highest-performing teams, debriefing is much more than a learning exercise. It is a fundamental part of how they operate.

Few organisations demonstrate this better than the Blue Angels. Their debriefing culture is immediate, structured, honest, and uncompromising. Every action can be examined, every assumption challenged, and every team member is expected to contribute. The goal is not to assign blame but to understand performance, learn quickly, and get better.

So, what can healthcare learn from a team where the margin for error is measured in milliseconds? To explore that question, David and I are joined by John Hiltz, who brings firsthand experience of the Blue Angels’ debriefing culture, leadership, and approach to developing high-performing teams. John offers a unique perspective on what exceptional teams do differently, and how the principles of aviation debriefing could help pre-hospital teams build greater trust, accountability, learning, and performance.

In this episode, we explore whether debriefing is simply a tool for learning from what has already happened or one of the most powerful mechanisms we have for building better teams.

NEAS Specialist Capabilities Conference 2026

The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.

Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.

The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.

Other speakers include Lee Thompson, who will discuss regional critical care, alongside specialists from EPRR and HART. Dräger supports the conference and focuses on collaboration, innovation, excellence, resilience and the communities we serve.

The closing date to register your interest is 11 October 2026.

👉 Register your interest for NEAS Specialist Capabilities Conference 2026

Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, Newcastle, Gateshead

Every critically ill newborn represents one of the most demanding moments in healthcare. Within seconds of birth, teams may need to assess, communicate, prioritise, and intervene in an environment where the margin for error is extraordinarily small. Technical expertise is fundamental, but safe and effective resuscitation depends on much more than clinical knowledge alone. Communication, leadership, teamwork, situational awareness, and other human factors can profoundly influence how teams perform under the highest pressure.

My guest today is James Yates, Critical Care Paramedic, educator and instructor on the Advanced Resuscitation of the Newborn Infant (ARNI) programme from the Resuscitation Council UK. ARNI is a specialist two-day programme that combines advanced clinical skills with communication, human factors, structured simulation and debriefing for clinicians caring for critically ill and sick newborns.

James brings extensive experience in teaching clinicians how to perform effectively under pressure, not simply by developing technical competence, but by strengthening the non-technical skills that underpin high-performing teams.

In this episode, we explore what high-performing teams do differently, why communication can break down during complex emergencies, and how structured simulation and expert debriefing can transform both individual clinicians and the wider systems in which they work.

We discuss psychological safety, cognitive overload, shared mental models, leadership, communication, and the challenges of facilitating meaningful debriefs with experienced clinicians. Most importantly, we consider what neonatal resuscitation can teach us about team performance more broadly, and why these lessons extend far beyond the delivery room into pre-hospital medicine, HEMS, emergency care and critical care.

If you are interested in how teams develop, adapt, and perform under pressure, this episode offers lessons well beyond neonatal resuscitation.

NEAS Specialist Capabilities Conference 2026

The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.

Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.

The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.

Other speakers include Lee Thompson, discussing regional critical care, alongside specialists from EPRR and HART. The conference is supported by Dräger and focuses on collaboration, innovation, excellence, resilience and the communities we serve.

The closing date to register your interest is 11 October 2026.

👉 Register your interest for NEAS Specialist Capabilities Conference 2026

Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, Newcastle, Gateshead

Major haemorrhage remains one of the most time-critical emergencies in pre-hospital care. When a patient is bleeding to death, stopping the haemorrhage is the immediate priority, but what happens next is equally important. What are we actually replacing?

In this special compilation of The Pre-Hospital Care Podcast, we explore the evolving science and practice of blood-based resuscitation in major trauma. In Part One, Professor Ross Davenport explores the science of bleeding and coagulation in trauma, examining trauma-induced coagulopathy, fibrinogen, haemostasis, and why conventional fluid-based resuscitation may fail to address the underlying physiological problem.

In Part Two, we move from physiology to practice in Blood Administration in Haemorrhagic Shock within EMS Systems. We examine the evidence for pre-hospital blood administration, lessons from military and civilian systems, the RePHILL trial, and the practical challenges of introducing blood products into emergency medical services.

Together, these conversations explore a fundamental shift in trauma resuscitation: moving beyond simply replacing volume, towards replacing the components the patient has actually lost. Because when someone is bleeding to death, the question isn't simply “How much fluid do they need?” It is “What does this patient need us to put back?”

NEAS Specialist Capabilities Conference 2026

The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.

Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.

The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.

Other speakers include Lee Thompson, discussing regional critical care, alongside specialists from EPRR and HART. The conference is supported by Dräger and focuses on collaboration, innovation, excellence, resilience and the communities we serve.

The closing date to register your interest is 11 October 2026.

👉 Register your interest for NEAS Specialist Capabilities Conference 2026

Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, NewcastleGateshead

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 resuscitation is different. Different patients, different teams, different environments, and often very different outcomes. But one thing remains constant: every clinical encounter has the potential to teach us something. The challenge, particularly in pre-hospital and acute care, is creating the time, space, and culture needed to turn those experiences into meaningful learning and sustained improvement.

Debriefing is often viewed as something that happens after the event, a chance to review what happened, identify what went well, and consider what could have been done differently. But effective debriefing is far more than a post-event checklist or a quality improvement exercise. Done well, it can strengthen psychological safety, build trust, improve communication, and help teams develop the shared mental models and expertise needed to perform under pressure.

In this episode, David and I are joined by Dr Bridgid Joseph, whose work across resuscitation practice, in-situ simulation, and interprofessional education has given her a unique insight into how teams learn in high-stakes clinical environments. She brings a practical perspective on what makes debriefing effective, and what prevents teams from getting the most from it. Together, we explore whether debriefing is simply a way of learning from what has already happened, or something much more powerful: a mechanism for developing better teams, improving performance, and ultimately delivering better care to patients.

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/⁠

Artificial intelligence is advancing rapidly in healthcare, but what could it mean for pre-hospital care? In this compilation episode, we bring together two conversations exploring how AI could support clinicians, improve decision-making, and transform the way emergency care is delivered.

We begin with Zane Perkins, exploring AI-TRiPS, an AI Risk Prediction and Decision Support System for trauma care. We discuss how AI and Bayesian networks could support clinical reasoning, identify risk and reduce cognitive burden in high-pressure environments such as major trauma and air ambulance care.

But with that potential comes important questions around trust, cognitive bias, human factors and clinical responsibility. What happens when clinicians disagree with an algorithm? And could we become too reliant on technology?

We then broaden the discussion with Nico Preston, exploring the wider applications of AI across pre-hospital care, from dispatch and demand prediction to diagnostics, risk stratification and clinical decision support.

Across both conversations, one theme becomes clear: the future of AI in emergency care is unlikely to be about replacing clinicians. Instead, the opportunity may be to create human–AI systems that combine computational power with clinical experience, judgement and contextual awareness. But getting that balance right will be critical. Can AI make us better clinicians, and how do we ensure we use it safely?

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/⁠

The most dangerous part of an intubation is often not the moment the laryngoscope goes in; it’s the ten minutes before it ever leaves the tray.

In this episode of the Pre-Hospital Care Podcast, we focus on The Last 10 Minutes Before Intubation: the critical phase where outcomes are often decided long before airway instrumentation begins. Joining us is Cosmo Scurr, Consultant Anaesthetist, bringing extensive experience in managing critically ill patients and high-risk airway emergencies. Cosmo brings an anaesthetist’s perspective to the physiology, preparation, decision-making and team behaviours that underpin safe airway management.

This is not a discussion about laryngoscopy technique. Instead, we explore the preparation, physiology and human factors that shape success or failure before the first attempt is made.

We’ll examine how experienced clinicians approach pre-oxygenation in sick, hypoxic patients, and why seemingly small decisions can dramatically influence peri-intubation oxygen reserve. We’ll explore the physiology of induction and the pitfalls of hypotension, including why cardiovascular collapse during airway management is often predictable rather than sudden.

The conversation also examines role allocation in high-acuity environments, failed-airway planning and cognitive load management when the room is under pressure. What does good preparation actually look like? How should teams approach equipment preparation, briefing, task allocation and contingency planning? And how can we create shared mental models before the situation becomes time-critical?

Ultimately, this episode is about recognising that airway management begins before the airway is touched. The quality of those final ten minutes may determine what happens in the ten minutes that follow.

Through a case-based lens, we’ll ask: what do experienced HEMS and critical care clinicians do differently in those final minutes? What habits, checks, and assumptions separate smooth intubations from catastrophic ones?

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/⁠

High-fidelity simulation has become far more than an opportunity to practise clinical procedures in a controlled environment. For pre-hospital clinicians working in complex, unpredictable and high-stakes environments, simulation can provide something that conventional classroom teaching cannot: the opportunity to rehearse performance when the environment itself becomes part of the problem.

In this compilation episode of the Pre-Hospital Care Podcast, we bring together two conversations that explore how high-fidelity simulation can be designed, delivered and debriefed to create meaningful improvements in clinical and team performance.

We begin with Dr Neel Bhanderi, Head of Education and Training at MedSTAR Retrieval HEMS in Adelaide and Consultant in Emergency Medicine at the Royal Adelaide Hospital. Recorded in 2023, our conversation explores the concept of creating an "analogue of reality" and using simulation to introduce progressively more complex stressors into training. We discuss skills acquisition under stress, communication, handover, environmental noise, task loading, debriefing and the relationship between simulation and operational case review.

We then move to a more recent conversation with Ben King, Founder and CEO of Best Practice Medicine. Ben explores the role of high-fidelity simulation in preparing clinicians for the complexity and uncertainty of real-world pre-hospital care. We look at experiential learning, team coordination, human performance under stress, targeted debriefing and the use of video-assisted debriefing to translate simulation into measurable performance improvement.

Across both conversations, a common theme emerges: the value of simulation is not determined simply by how realistic the mannequin, environment or equipment looks. It is determined by how deliberately the simulation reproduces the cognitive, behavioural, environmental and interpersonal demands of clinical practice, and what happens during the debrief afterwards.

We explore:

• What actually makes simulation "high fidelity"?
• How can training progressively introduce stress without overwhelming learners?
• The difference between technical skills and performance in complex environments
• Communication and handover under pressure
• Environmental stressors, distraction and task loading
• Simulation as a tool for developing team performance
• How video can enhance debriefing and reflective learning
• Psychological safety during debriefing
• Using real-world case review to identify simulation and training needs
• Moving from simulation as an educational event to simulation as a performance-improvement system
• How we can better prepare clinicians for the reality of pre-hospital care

The central question is simple:

If we expect clinicians to perform under pressure, should we not train performance under pressure?

High Fidelity Simulation with Neel Bhanderi
Originally released 15 May 2023
Listen to the original episode on Apple Podcasts

High Fidelity Simulation in Pre-hospital Care: Training for Reality, Debriefing for Impact with Ben King
Originally released 27 April 2026
Listen to the original episode on Apple Podcasts

The Pre-Hospital Care Podcast brings together leading clinicians, researchers, educators and practitioners to explore the science, practice and human factors behind modern pre-hospital care.

If you enjoy the episode, please subscribe, leave a review and share it with a colleague involved in clinical education, simulation or pre-hospital care.

Resuscitation is often seen as individual performance, but cardiac arrest care is ultimately a system outcome, shaped by training, communication, leadership, feedback, and the systems supporting the team.

In this three-part debriefing series, I’m joined by David Hiltz as co-host, and in this first episode, Ann Doll from the Resuscitation Academy, to explore how high-performing systems turn resuscitation events into opportunities for learning and sustained improvement.

We explore how structured debriefing can create a feedback loop between frontline experience and organisational improvement, and how to build a culture where learning is routine rather than optional. We also examine lessons from aviation and other high-performance environments, where debriefing, safety reporting and incident analysis turn individual experiences and near misses into organisational learning.

If learning stays with one crew, the system learns very little. If it is captured, shared and translated into changes in training, processes or system design, one event can improve performance across an entire organisation.

Practical resources for debriefing and resuscitation improvement:

Resuscitation Academy — Ann Doll

The Resuscitation Academy provides a substantial library of free, practical resources for improving cardiac arrest systems and performance. Resources include e-books, toolkits, high-performance CPR materials, T-CPR resources, CARES resources, community CPR and PAD resources, as well as a free Cardiac Arrest System Self-Assessment.

ThriveIn — Bridgid Joseph

ThriveIn provides healthcare consulting and educational resources focused on quality improvement, staff education, patient safety, emergency cardiovascular care and innovation. Resources also include work relating to mock codes and improving cardiac arrest response.

360 Leadership Group — John Hiltz

The 360 Leadership Group provides resources and perspectives on high-performance teams, leadership, communication, preparation and debriefing, drawing heavily from the experience of former Blue Angels pilots and other high-performance environments.

Structured and Supported Debriefing

The Structured and Supported Debriefing Script provides a practical Gather → Analyze → Summarize approach. It includes facilitator questions designed to understand what happened, explore why it happened, identify what went well and what needs improvement, and support the team in identifying its own learning.

AHRQ TeamSTEPPS — Debriefing

The AHRQ TeamSTEPPS Debrief is one of the most immediately usable healthcare debriefing resources. It includes a debriefing checklist covering communication, roles, situational awareness, workload, resources, what went well and what could be improved. AHRQ also provides a short video demonstrating an emergency-department debrief.

FEMA — After-Action Review

The FEMA After-Action Review resources provide a more comprehensive approach to reviewing significant events. The AAR User Guide covers preparation, data collection, analysis, findings and improvement actions, alongside templates and tools for tracking whether recommended actions are completed.

NASA — Crew-Centered Debriefing

The NASA Guidelines for Facilitating Debriefings provide valuable insight from aviation human-factors research. The approach emphasises crew participation, self-discovery, effective questioning and facilitation rather than simply lecturing the team. This is particularly relevant to the idea that a facilitator's role is to help the team discover and articulate its own learning.

NASA Aviation Safety Reporting System — CALLBACK

The NASA ASRS CALLBACK provides a remarkable collection of real-world aviation lessons. Using de-identified safety reports and commentary, CALLBACK explores communication, decision-making, teamwork, human factors, and operational risk. It offers an excellent example of how individual experiences can be transformed into organisational learning.

Decision-making is one of the defining skills of pre-hospital practice. Every shift requires clinicians to interpret incomplete information, navigate uncertainty, balance competing risks, and make consequential decisions, often under intense time pressure. But does faster decision-making necessarily lead to better decisions?

In this compilation episode of the Pre-Hospital Care Podcast, we explore the anatomy of decision-making under pressure, examining the cognitive processes, mental models, and human factors that influence how emergency responders think, assess, and act.

We explore the limits of working memory through Miller’s Magic Number 7, the role of heuristics and intuition, inattention bias, cognitive overload, and the critical role of metacognition in recognising and improving our own decision-making. We also consider how stress, leadership, teamwork, experience, and limited resources shape decisions when the stakes are high.

Featuring insights from Olly Sapsford, Firefighter, Commander and Lecturer in Disaster & Emergency Management at Coventry University, alongside discussion of Radu Venter’s research into EMS decision-making, this compilation challenges the culture of constant urgency in emergency medicine and asks whether rushing decisions actually makes us better clinicians.

From the fireground to the ambulance and the clinical environment, we examine the OODA Loop, reflective practice, expertise, ethical decision-making, and the potential for technology and artificial intelligence to support, not replace, human judgement.

Ultimately, this episode asks a fundamental question: what does it take to make sound, timely, and patient-focused decisions when every decision counts? These are the individual episodes:

• The Anatomy of Decision Making Under High Pressure Situations
  Listen on Apple Podcasts
• Decision-Making Under High Pressure Situations – Part 2 with Olly Sapsford
  Listen on Apple Podcasts
• EMS Decision-Making: Rushing the OODA Loop with Radu Venter
  Listen on Apple Podcasts