Today, we're diving into one of the most challenging scenarios any EMS provider faces: paediatric cardiac arrest. The figures are challenging, with only a 4.9% survival rate for infants and neurologically intact survival rates as low as 1-4% nationally. These calls have long been considered to have poor outcomes.

But what if I told you that one fire department completely rewrote the playbook and achieved neurologically intact survival rates of 46%? What if they did it by breaking conventional rules and staying on scene longer, not shorter?

Today, we're joined by Medical Director Paul Banerjee from Polk County Fire Rescue in Florida, where they've transformed paediatric cardiac arrest outcomes through changing the protocols that challenge everything we thought we knew about pre-hospital resuscitation. From their "NO/NO/GO" dispatch system to permissive hypercarbia post-intubation, from mechanical CPR to aggressive on-scene airway management, Polk County has proven that with the right approach, we can dramatically improve outcomes in this patient cohort.

*** Please note, this podcast is for information purposes only. You must stay within your scope and remit of practice and service SOPs at all times ***

This podcast is sponsored by BlueRoomXR

When lives are on the line, training needs to feel real. That’s where BlueRoom comes in, the world’s most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.

With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.

Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn’t the future of training; it’s training transformed.

👉 For truly immersive training, step inside the BlueRoom. Visit ⁠BlueRoomXR.com⁠ to request your demo today.

This is the second audio blog, written by Dr. Will Duffin, detailing medical considerations and avoidance techniques for leeches, bullet ants, and mosquitoes, which are common threats in tropical environments.

This guide provides practical advice on managing bites and highlights the importance of malaria prophylaxis and insect repellent for effective expedition planning. You can read the blog here:

https://worldextrememedicine.com/blog/jungle-medicine-posts/jungle-survival-guide/

World Extreme Medicine has given kind permission to use this blog post.

This podcast is sponsored by BlueRoomXR

When lives are on the line, training needs to feel real. That’s where BlueRoom comes in, the world’s most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.

With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.

Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn’t the future of training; it’s training transformed.

👉 For truly immersive training, step inside the BlueRoom. Visit ⁠BlueRoomXR.com⁠ to request your demo today.

This week, we’re shining a spotlight on an incredible initiative from the student paramedics at Liverpool John Moores University.

The LJMU Paramedic Society is bringing back their award-winning 24-hour CPR Marathon — raising awareness of lifesaving skills and vital funds for the North West Air Ambulance Charity.

From 6pm Friday the 24th, to 6 pm Saturday the 25th of October, teams will perform continuous CPR for 24 hours straight inside the Student Life Building — alongside CPD sessions, emergency service demonstrations, and free CPR training open to everyone.

Last year, they raised over £3,000, and this year they’re aiming to do it again, supporting a charity that receives no government or NHS funding but delivers advanced critical care across the North West every single day.

If you’d like to help keep the Air Ambulance flying, you can donate here: https://www.justgiving.com/page/ljmu-paramedic-society-3?utm_medium=FR&utm_source=CL

💛 The LJMU CPR Marathon, 24 hours, one lifesaving mission.

In today’s episode, we’re exploring the evolving role of women in Helicopter Emergency Medical Services (HEMS) and pre-hospital critical care, inspired by insights from Critical Care Doctor Sophie MacDougall. Sophie highlights both the unique challenges and the incredible rewards that come with working in this demanding, fast-paced environment, one that remains largely male-dominated but is gradually becoming more diverse.

We’ll hear from guests who share their journeys into HEMS and air ambulance work, reflecting on what the job gives back to them every day and how they have navigated their career paths within GWAAC. From overcoming barriers and difficult moments to the importance of mentors, whether male or female, our guests reveal the critical lessons they’ve learned along the way.

This episode also delves into the steps needed to encourage more women to join HEMS teams, breaking down stereotypes and showing that this field is not just a “men’s world.” We’ll discuss how initiatives like the GWAAC ‘Fem in PHEM’ event are making a difference and how ongoing support and visibility can inspire the next generation of female critical care professionals.

Whether you’re a clinician, a student, or simply curious about pre-hospital care, this conversation offers valuable perspectives on resilience, aspiration, and inclusion in one of healthcare’s most challenging specialties.

This podcast is sponsored by BlueRoomXR

When lives are on the line, training needs to feel real. That’s where the BlueRoom Simulator comes in, the world’s most advanced mixed-reality medical simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the side of a cliff, BlueRoom delivers pressure-filled environments without real-world risk.


With a Mission Control dashboard, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.
Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn’t the future of training; it’s training transformed.


👉 For truly immersive training, step inside the BlueRoom. Visit ⁠www.blueRoomxr.com⁠ to request your demo today.

This week, we’re shining a spotlight on an incredible initiative from the student paramedics at Liverpool John Moores University.

The LJMU Paramedic Society is bringing back their award-winning 24-hour CPR Marathon — raising awareness of lifesaving skills and vital funds for the North West Air Ambulance Charity.

From 6pm Friday the 24th, to 6 pm Saturday the 25th of October, teams will perform continuous CPR for 24 hours straight inside the Student Life Building — alongside CPD sessions, emergency service demonstrations, and free CPR training open to everyone.

Last year, they raised over £3,000, and this year they’re aiming to do it again, supporting a charity that receives no government or NHS funding but delivers advanced critical care across the North West every single day.

If you’d like to help keep the Air Ambulance flying, you can donate here: https://www.justgiving.com/page/ljmu-paramedic-society-3?utm_medium=FR&utm_source=CL

💛 The LJMU CPR Marathon, 24 hours, one lifesaving mission.

This blog post, written by Dr Will Duffin, addresses the benefits of in-situ wilderness simulation training for medical professionals working in remote environments.

Written by Dr. Will Duffin, this blog post unpacks his experience providing medical cover for the TV show Survivor to illustrate how practicing emergency scenarios on-site helps teams improve emergency management skills, foster team bonding, and 'battle test' equipment and processes before real incidents occur. The article explicitly links this training methodology to the World Extreme Medicine organisation, highlighting their range of specialised medical courses and academic programs focused on various extreme and remote settings like polar, space, and ocean medicine.

Ultimately, the blog is an informative piece advocating for low-stakes, context-specific simulation training while simultaneously serving as a promotional tool for the organisation's educational offerings and conferences. You can read the blog here: https://worldextrememedicine.com/blog/extreme-medicine-posts/train-hard-fight-easy-the-benefits-of-in-situ-wilderness-simulation-training/

World Extreme Medicine has given kind permission to use this blog post.

This podcast is sponsored by BlueRoomXR

When lives are on the line, training needs to feel real. That’s where BlueRoom comes in, the world’s most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.

With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.

Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn’t the future of training; it’s training transformed.

👉 For truly immersive training, step inside the BlueRoom. Visit ⁠BlueRoomXR.com⁠ to request your demo today.

In pre-hospital care, paramedics regularly encounter patients with a wide range of mental health conditions. From anxiety and depression to psychosis and self-harm, the ability to quickly assess and manage these conditions is crucial in ensuring the best possible outcome for the patient. But how do paramedics navigate the complexities of mental health?In the field, where resources are limited and time is critical.

In this episode, we explore the most encountered mental health pathologies in pre-hospital care, focusing on how paramedics assess, manage, and provide care for these patients under high-pressure circumstances. From acute anxiety attacks to bipolar disorder episodes, we discuss the unique challenges paramedics face when dealing with patients experiencing severe psychological distress.

We’ll also delve into the importance of collaboration between paramedics, mental health crisis teams, and other emergency responders (Multi-Disciplinary Team/MDT approaches). How do these teams work together to ensure a seamless care pathway for patients who may need urgent mental health support?

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/⁠

This is the second installment from Ryan Atkinson's blog post, "Let's talk about climate hypocrisy and carbon democracy…," which addresses the common accusation of hypocrisy faced by environmental activists.

Ryan, a filmmaker focusing on conservation, acknowledges his own air travel, which contributes to global CO2 emissions, yet argues it is necessary for communicating and effecting systemic change. He frames such criticism as a personal attack designed to shut down debate, suggesting that living a perfectly non-hypocritical life within a carbon-dependent society is nearly impossible for those seeking to make an impact. Instead, he advocates for embracing perceived hypocrisy as a starting point for dialogue about climate change and the pervasive influence of the carbon economy.

Ultimately, the blog champions the idea that individual actions, even imperfect ones, can contribute to larger structural change if they serve a greater purpose. You can read the blog post here: https://ryanatkinson.tv/2020/03/02/lets-talk-about-climate-hypocrisy-and-carbon-democracy/

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/⁠

Today, we are joined by Dr Celestine Weegenaar, the first female PHEM trainee at Great Western Air Ambulance Charity (GWAAC). Originally from Amsterdam and now firmly rooted in the South West of England, Celestine brings a wealth of experience from emergency departments across the region – and even from the skies of Australia, where she flew with LifeFlight.

We talk about her journey into pre-hospital emergency medicine, what drew her to the field, and how she’s navigating the challenges and rewards of her current role. From the adrenaline of high-acuity pre-hospital care to the quiet moments of learning and growth alongside GWAAC’s critical care team, Celestine reflects on the reality of life as a trainee in this dynamic and demanding specialty.

As the new Chair of the Pre-Hospital Emergency Medicine Trainees’ Association (PHEMTA), she also shares her vision for increasing inclusivity in the field, breaking down barriers, and supporting more women to pursue careers in PHEM. Whether you're an aspiring critical care clinician or simply interested in the people behind the patch, this episode offers a personal and inspiring look into the life and values of a rising leader in pre-hospital care.

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/⁠

Ryan Atkinson's "Local Loss in a Global Crisis" explores the disconnect between Western perceptions of climate change and its tangible effects on vulnerable communities, specifically in the Langtang Valley of Nepal. Ryan reflects on his personal carbon footprint and the ethical implications of his travels while witnessing the devastation caused by the 2015 earthquake, exacerbated by climate change.

Ryan highlights the resilience and enduring spirit of the local people, who face immense challenges despite having contributed little to the global crisis. The piece ultimately underscores the profound impact of global environmental issues on local lives, compelling Ryan to advocate for these stories. You can read the blog post here: https://ryanatkinson.tv/2020/02/22/local-loss-in-a-global-crisis/

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 year, thousands of lives are lost to suicide, and emergency responders are often the first line of support during these critical moments. In this episode, we explore the vital role that the London Ambulance Service (LAS) plays in suicide prevention and risk assessment. From the moment a call comes into the control room to the interaction on the frontline, paramedics are trained to recognise the signs of suicidal ideation and act quickly to prevent harm.

We’ll dive into the clinical and operational aspects of suicide risk management, discussing how paramedics assess high-risk patients and work alongside police, mental health crisis teams, and hospitals to ensure the best possible care. You’ll learn about the collaborative efforts that help create a seamless response for those in the most vulnerable states, as well as the challenges involved in coordinating care across various agencies.

This episode offers a candid look at the realities of suicide prevention in pre-hospital care and the steps that can be taken to save lives.

In this episode, we reflect on the article “Asking Why. Telling Stories. Owning Accountability” and its lessons for both the diving community and pre-hospital care. The piece explores how adverse events are too often met with blame and silence, when what’s needed is open storytelling, systemic accountability, and visible learning. Drawing on three academic theses, the author argues for a shift from backward-looking, individual blame towards forward-looking, relational accountability approaches that foster trust, resilience, and safer systems.

Barriers such as fear of reputational harm and legal concerns frequently stifle honest reflection. Yet, the article suggests that structured, context-rich narratives can create a culture of genuine learning and justice, allowing organisations to adapt and prevent future harm.

For pre-hospital care, the parallels are striking. Just like in diving, providers face high-stakes environments where “first stories” may oversimplify, overlooking the complex contexts in which clinicians operate. Whether in remote environments, critical incidents, or everyday EMS work, learning requires moving past blame and toward systems thinking. Transparent communication, structured debriefs, and the courage to challenge norms are as vital to paramedics and pre-hospital teams as they are to divers and expedition leaders.

By embracing this approach, telling richer stories, strengthening feedback loops, and redefining accountability, we can better support both patients and providers in the moments when things go wrong. Read the blog post here: https://www.thehumandiver.com/blog/asking-why-telling-stories-and-owning-accountability-lessons-for-diving

You can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025