In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Simon Carley review blog posts from August and September. They reflect on their experience at the BASICs Conference, highlighting discussions on resuscitation science and new resuscitation council guidelines.

Topics covered include the physiological-targeted resuscitation, arterial line placements during cardiac arrest, the PECan abdominal trauma rule in pediatric emergency care, intra-arrest stellate ganglion blocks, hydrofluoric acid burns treatment, and pediatric status epilepticus. They also delve into the evidence trial on moving patients with refractory out-of-hospital cardiac arrest to hospitals for specialised care, and review discussions on moral injury among emergency responders. Additionally, they mention the upcoming Geckos Global Health and Emergency Care Research Summit and explore the potential future of emergency medicine by 2038.

00:00 Introduction and Conference Highlights

02:55 Arterial Line Placement During Cardiac Arrest

05:27 Pediatric Abdominal Trauma Rule

10:25 Intra-Arrest Stellate Ganglion Blocks

14:35 Moral Injury in Emergency Responders

23:22 Hydrofluoric Acid Burns Treatment

25:38 Ketamine for Pediatric Status Epilepticus

28:57 Refractory Out-of-Hospital Cardiac Arrest

33:59 Global Health and Emergency Care Research

35:09 Conclusion and Future Episodes

Episode summary

Why in‑person conferences still matter in a post‑COVID world.

What formats work now: short talks, interviews, demos, strong hosting.

How to turn “a great day out” into Monday‑morning change.

Guests

David Carr — EM physician (Toronto). Leads the Annual Update in EM at Whistler. Focus: inclusive, high‑energy, “hard‑core EM” content.

Haney Mallemat — EM & Critical Care (South Jersey/Philadelphia). Founder of ResusX; designs short, high‑engagement sessions that feel like live conversations.

Key themes

Why travel when content is online?

From lectures to experiences.

Programme design starts with the audience.

Strong hosting is part of pedagogy.

Social learning drives change.

Practical takeaways for clinicians

Arrive with intent: bring 1–2 real patient problems to solve.

Choose your format: prioritise short talks, interviews, and hands‑on if your attention is fragmented.

Make it stick on Monday: debrief with a colleague, write one practice change, set a review date. Present a short “what I learned” to your team.

Borrow authority wisely: take clear, referenced points (e.g., contrast allergy/nephropathy policies) back to local committees.

Practical takeaways for organisers

Audience first: define who you serve; let that drive length, tone, and format.

Shorten and vary: fewer bullet‑heavy lectures; more interviews, panels, and no‑slide formats when it helps educators shine.

Coach and curate: select speakers for content and delivery; build a pipeline for new voices.

Invest in hosting: treat chairs as educators; they safeguard pacing, transitions, and safety.

Design the socials: plan purposeful evening micro‑teaching and cross‑disciplinary meet‑ups.

Measure impact: mandate feedback tied to CPD; analyse themes and close the loop next year.

Risks and tensions

Edutainment vs evidence: keep the energy without losing rigour.

Access and equity: budgets, visas, disability, and caring responsibilities exclude many; amplify content post‑event.

“Too innovative?” Novel formats can struggle with recognition and funding; meet audiences halfway and iterate.

How conferences translate to patient care

Prioritise topics that solve common bottlenecks.

Put change agents on stage with take‑home resources (e.g., clear radiology guidance on contrast “allergy” and nephropathy).

Encourage attendees to form local groups to implement one change within two weeks.

Recorded at the BASICS Pre-Hospital Care Conference at Sketchley Grange, this episode explores one of the most experimental tools in civilian trauma care — the abdominal aortic and junctional tourniquet. Dr Ed Barnard joins us to discuss why this device was developed, how it works, and where it might — just might — save lives when all other options have failed.

The conversation traces the problem of non-compressible haemorrhage, the leading cause of potentially survivable trauma death. Conventional limb tourniquets, pelvic binders and packing can’t reach these deep bleeding sites. The AAJT offers a radical alternative: external aortic compression to buy a few crucial minutes until surgical control or REBOA is possible.

Ed explains the mechanism — an inflatable, ratcheted belt that can occlude the aorta or major junctional vessels — and the evidence so far. Laboratory and volunteer data show that it can stop flow, but pain and tissue ischaemia make it difficult to tolerate for long. Clinical experience remains limited to small case series, mostly in military or research settings, and no human trials yet demonstrate a survival benefit.

The discussion is candid about risk and realism. The AAJT is a last-resort device, to be used only within strict governance, with clear time limits and immediate plans for definitive haemorrhage control. It’s not something you reach for on a normal shift — it’s something you might need once in a career, and only if every other option has failed.

Ed shares insights from ongoing research, including its potential role as a bridge to REBOA, and the governance frameworks that should surround any trial use. The episode ends with a look to the future: how civilian and military collaboration might refine indications, training, and data collection for this rare but potentially life-saving intervention.

Surgeon Captain Ed Barnard

Surgeon Captain Ed Barnard is a Consultant in Emergency Medicine at Addenbrooke’s Hospital, Cambridge, and a Professor of Emergency Medicine with the Defence Medical Services. He also serves with East Anglian Air Ambulance as a HEMS doctor (having had many years as a BASICS responder). His academic work focuses on prehospital and military trauma care, with a portfolio spanning clinical trials, blood product innovation, and trauma system development.

Ed’s academic work focuses on improving survival from catastrophic bleeding, particularly non-compressible and junctional haemorrhage. He has published and presented widely on trauma resuscitation, traumatic cardiac arrest, and the evolving role of devices such as the abdominal aortic and junctional tourniquet (AAJT) and REBOA. He is a co-author of the 2025 BMJ Military Health systematic review examining the utility of the AAJT-S in military practice.

He is also an experienced educator, contributing to trauma training for BASICS, HEMS, and Defence Medical Services, and continues to combine clinical work with research aimed at translating lessons from military to civilian trauma care.

About BASICS:

In this episode of the St Emlyn's Podcast, Iain and Simon discuss the latest updates in emergency medicine during the hot UK summer. They discuss the latest research and content from the St Emlyns blog, touching on topics like serotonin syndrome, the impact of the new urgent and emergency care plan in the UK, and the use of salbutamol as an analgesic for renal colic.

They also highlight the growing issue of nitazenes, a new class of synthetic opioids, and their implications for emergency medicine. Lastly, they emphasise the importance of staying updated on toxicology to effectively manage high-acuity, low-occurrence events such as drug-induced hyperthermia.

00:00 Introduction

01:35 Upcoming Conferences

03:41 Med Pod Learn

05:09 Serotonin Syndrome Deep Dive

10:22 Urgent and Emergency Care Plan

18:04 Salbutamol for Renal Colic

22:07 Hypothermia in Toxicology Emergencies

27:04 Nitazines: A Growing Problem 

Iain and Simon  return after a brief hiatus to discuss key blog posts from April and May on the St Emlyn's Podcast. They highlight notable conferences including IncrEMentum 2025 in Spain, The Big Sick in Zermatt, and the BASICs Conference.

Discussions cover content from recent emergency medicine research, the importance of compassion and patient-centred care, and operational strategies to avoid emergency department overcrowding. Insights are also shared from fieldwork in South Africa on emergency thoracotomies and their impressive survival rates.

In this episode of the St Emlyn's Podcast, Iain Beardsell and Simon Carley revisit January's  blog posts and podcasts, covering several seminal studies relevant to emergency and pre-hospital care.

Topics include the Sub 30 Feasibility Study on pre-hospital ECMO, comparisons of pre-hospital versus in-hospital emergency anaesthesia, variations in maintenance of pre-hospital anaesthesia in trauma patients, and the effectiveness of physician-led pre-hospital teams.

They also discuss the economic implications of advanced pre-hospital interventions and highlight reviews from the London Trauma Conference.

00:00 Introduction and January Recap

01:58 Pre-Hospital ECPR Study: The Sub 30 Study

07:09 Emergency Anaesthesia: Pre-Hospital vs. Emergency Department

13:55 Maintenance of Pre-Hospital Anaesthesia: Variations in Practice

16:57 Physician-Led Pre-Hospital Teams: Do They Improve Outcomes?

22:12 Additional Insights and Upcoming Content

In this special edition of the St Emlyn’s podcast, Iain Beardsell and Simon Carley review the top medical papers of 2024, originating from Simon’s talk at The Big Sick conference in Zermatt. The discussion includes a comparison of non-invasive versus arterial pressure monitoring, the association of intra-arrest arterial blood pressure with ROSC, the efficacy of serratus anterior plane blocks for rib fracture management, and the evaluation of a micro axial flow pump in cardiogenic shock.

They also delve into double sequential external defibrillation in refractory out-of-hospital cardiac arrest and provide a rapid-fire review of additional critical papers discussed at the conference. Notable mentions include the HEMOTION trial, PRE OXI trial, BLING III, and PARAMEDIC-3, among others.

A must-listen for those passionate about evidence-based medicine in emergency and pre-hospital care.

You can read more about all the trials, including links to all the papers here (part 1) and here (part 2)

00:00 Introduction and Conference Highlights

01:51 Non-Invasive vs. Arterial Pressure Monitoring

03:28 Intra-Arrest Blood Pressure and ROSC

05:34 Serratus Anterior Plane Blocks for Rib Fractures

08:38 Micro Axial Flow Pump in Cardiogenic Shock 10:49 Double Sequential Defibrillation in Cardiac Arrest

13:17 HEMOTION Trial

15:01 PRE OXI and BLING III Trials

17:08 Fluid Management in Septic Shock

18:37 Expedited Transfer vs. On-Scene Resuscitation

20:39 Intraosseous vs. Intravenous Access

21:48 Conclusion and Final Thoughts

Join hosts Iain Beardsell and Natalie May at the London Trauma Conference as they welcome Peter Brindley back to the St Emlyn’s podcast. In this engaging episode, they delve into the nuances of social media, digital footprints, and the burgeoning influence of artificial intelligence in medicine. Brindley discusses the importance of maintaining an authentic digital presence and addresses the impact of misinformation and disinformation in the digital age. They explore the challenges and opportunities presented by AI in clinical decision-making and share insights on navigating this evolving landscape as healthcare professionals. Tune in for a thought-provoking conversation on staying relevant and responsible in a digitally-driven world.

In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley reflect on their experiences at recent conferences, including the IncrEMentuM 2025 and The Big Sick. They discuss the exceptional quality and innovative formats of presentations at IncrEMentuM, emphasizing the enthusiasm and positive atmosphere. The discussion also covers key emergency medicine topics from February's blog posts, including the maintenance of clinical skills, the importance of diastolic blood pressure in resuscitation, and a systematic review on resuscitative hysterotomy. Additionally, they explore new guidance on the diagnosis of death, particularly in intensive care settings. Special thanks to Galen Pharmaceuticals and PM Cardio for their support.