The St.Emlyn’s Podcast

In the March 2025 episode of the St. Emlyn's podcast, Iain Beardsell and Simon Carley discuss a variety of topics covered in their latest blog posts and podcasts. Key discussions include the implications of cannabis edibles in emergency departments, expert viewpoints on pre-hospital resuscitative thoracotomy for traumatic cardiac arrest, and the use of ketamine for opioid-dependent patients. Highlights from recent conferences such as The Big Sick, IncrEMentuM 2025, and the Royal College of Emergency Medicine (RCEM) conference in Birmingham are shared. The episode also delves into department culture, addressing resilience, risk management, and other critical topics in emergency medicine. The podcast concludes with a recommendation of Matt Morgan’s book "A Second Act: What Nearly Dying Teaches About Really Living." 00:00 Introduction and March 2025 Roundup 01:45 Cannabis Edibles in the Emergency Department 05:25 Pre-Hospital Resuscitative Thoracotomy 12:38 Ketamine for Opioid Users in Acute Pain 15:17 Conference Highlights and Reflections 27:13 Matt Morgan's Inspirational Talk 30:50 Conclusion and Farewell

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.

00:00 Introduction and Welcome 01:40 Understanding Digital Footprint 03:53 Navigating Information and Misinformation 05:41 The Role of AI in Information Search 08:45 AI in Clinical Decision Making 15:28 The Kardashian Index and Social Media Influence 17:39 Conclusion and Final Thoughts

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.

00:00 Introduction and Recent Conferences 00:42 Highlights from IncrEMentuM 2025 04:47 Emergency Medicine Blog Posts Overview 05:10 Maintaining Competency in Rare Procedures 11:23 Diastolic Blood Pressure in Resuscitation 15:37 Resuscitative Hysterotomy Insights 20:43 Understanding Death Criteria 24:48 Conclusion and Acknowledgements

In this episode of the St Emlyn's Podcast, Iain Beardsell and Natalie May speak with Richard Lyon, an emergency doctor and deputy medical director of the air ambulance service at Kent, Surrey, and Sussex. Recorded at the London Trauma Conference 2024 in Kensington, Richard shares experiences and lessons from his talk on five critical cases that shaped him as a clinician and human being. Discussion topics include the importance of case debriefing, the impact of video recording in clinical practice, overcoming the challenges of self-reflection, and the evolving culture of pre-hospital emergency medicine. Richard emphasizes the significance of supportive and structured debriefing processes and offers insights on integrating video reviews into emergency practices for improved education and reflection. 00:00 Introduction and Guest Welcome 00:37 Richard Lyon's Background and Talk Overview 01:00 The Importance of Case Learning and Debriefing 02:12 Challenges and Strategies in Case Learning 04:24 The Power of Video Recording in Clinical Practice 07:30 Implementing Video Recording: Practical Steps 08:24 Addressing Concerns and Building Trust 12:56 Senior Clinicians and Vulnerability 17:33 Supporting Pre-Hospital Clinicians 20:35 Conclusion and Final Thoughts The Guest - Richard Lyon Professor Lyon is an active UK NHS Consultant in Emergency Medicine and Pre-hospital Care in Edinburgh and Deputy Medical Director for Air Ambulance, Kent Surrey & Sussex. A globally recognised leader in pre-hospital and emergency medical care, Prof Lyon works for multiple world class organisations, helping to develop current and future state-of-the art medical devices, systems and concepts aiming to save lives across the globe. A respected clinical leader and senior medical advisor to both governments and global corporations, with a track record of delivering high quality output and success across clinical, academic, research and innovation. Prof Lyon was made a Member of the Most Excellent Order of the British Empire (MBE) by HM The Queen in the 2017 Honours, for Services to Emergency Healthcare, after he established a programme of work on out-of-hospital cardiac arrest for Scotland. Prof Lyon holds a personal Chair of Pre-hospital Emergency Care at the University of Surrey and has an established research portfolio in pre-hospital resuscitation and trauma care, with an extensive publication record. Prof Lyon is a current member of the Faculty of Pre-hospital Care and author of several international guidelines. Prof Lyon is a Physician with the UK International Search & Rescue Team.

In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe welcome Dan Dworkis, an ER doctor from Los Angeles and host of the Emergency Mind podcast. Dan shares his expertise on optimizing team and individual performance in high-stress medical environments.

The discussion delves into the concept of excellence beyond merely avoiding negative outcomes, using a rosebush metaphor to illustrate the need for proactive growth. They explore how teams can benchmark and improve performance, the importance of creating a culture of continuous improvement, and strategies to maintain positivity and energy even in challenging conditions. Dan also highlights the Mission Critical Team Institute and its role in supporting teams in life-or-death situations.

This episode is essential listening for medical professionals committed to pushing the boundaries of excellence in their practice.

00:00 Introduction and Guest Welcome

01:06 Defining Excellence in Medicine

02:29 Measuring and Achieving Team Performance

06:13 Small Changes for Big Impact

10:03 Maintaining Positivity and Energy

15:30 Mission Critical Team Institute

16:33 Conclusion and Farewell

The Guest - Dan Dworkis

Dan Dworkis, MD, PhD, FACEP is the Chief Medical Officer at the Mission Critical Team Institute, the founder of The Emergency Mind Project, a board-certified emergency medicine physician, and an assistant professor at the Keck School of Medicine at USC.

His work focuses on the optimal development of mission critical teams in and out of emergency departments. He completed the Harvard Affiliated Emergency Medicine Residency at Massachusetts General Hospital / Brigham Health, and also earned an MD and PhD in molecular medicine from Boston University School of Medicine. Dr. Dworkis is the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure.

In this episode of the St. Emlyn's podcast, hosts Iain Beardsell and Natalie May discuss hyperbaric medicine at the London Trauma Conference with Dr. Jeff Kerrie, an internal medicine physician from Canada. Dr. Kerrie provides insights into dive and hyperbaric medicine, covering the basics of hyperbaric therapy, its applications, and key practices for emergency departments when treating patients with decompression illness. The conversation also touches on misconceptions and unregulated uses of hyperbaric chambers, emphasizing the importance of consulting certified medical professionals.

00:00 Introduction to the Podcast and Guests

00:58 Understanding Hyperbaric Medicine 0

1:33 Dive Medicine and Decompression Illness

04:15 Emergency Response and Treatment Protocols

07:26 Hyperbaric Chamber Mechanics

10:05 Beyond Dive Medicine: Other Uses of Hyperbaric Therapy

11:43 Challenges and Misuses of Hyperbaric Therapy

12:38 Conclusion and Final Thoughts

The Guest

For the last three years, Jeff Kerrie has served as the Island Health Medical Director of Quality, Safety, and Ethics. Dr. Kerrie has a master’s degree in clinical bioethics from Clarkson University/Icahn School of Medicine at Mt. Sinai in New York. Over the last six years, Dr. Kerrie helped build the Island Health ethics program, where he has provided ethics consultations and teaching to staff, patients, and families.

Dr. Kerrie underwent medical training at the University of Manitoba before completing residency in Internal Medicine at UBC. He practices as a general internist in Victoria, and is an Assistant Clinical Professor with the University of British Columbia and the University of Victoria. Other medical work has included medicine in atypical environments (including dive/hyperbaric medicine, ski patrol, and high altitude environments), obesity medicine, and international health. Dr. Kerrie is also a graduate of the Physician Quality Improvement program at Island Health.

In his spare time Dr. Kerrie enjoys aviation, skiing, and SCUBA diving.

In this episode, Iain Beardsell and Natalie May speak with neurosurgeon Mark Wilson at the London Trauma Conference. Mark provides an in-depth look at the evolution of the GoodSAM app over the past decade. Initially designed to alert off-duty trained individuals to assist in emergencies, particularly for cardiac arrests and impact brain apnoea, the app has grown to include applications in police services, public health during COVID-19, and community volunteer efforts. It employs advanced technology, such as real-time video guidance and AI, to offer immediate assistance and improve outcomes in medical emergencies and other crises. Mark's insights shed light on how this innovative platform is saving lives and transforming emergency and public response systems worldwide. 00:00 Introduction and Reunion 00:47 The GoodSAM App: A Decade of Evolution 01:52 GoodSAM's Impact on Cardiac Arrests 02:09 Expanding GoodSAM: Police and Community Involvement 02:35 How GoodSAM Works 05:54 GoodSAM's Role During COVID-19 13:42 The Future of GoodSAM: AI and Community Support 15:04 How to Get Involved with GoodSAM 16:26 Conclusion and Final Thoughts The Guest

Mark is a Consultant Neurosurgeon and Pre-Hospital Care Specialist working at both Imperial College (mainly St Mary's Major Trauma Centre) and as an Air Ambulance doctor.

He am a Clinical Professor specialising in Brain Injury at Imperial and Honorary Professor of Pre-Hospital Care (the Gibson Chair) at the Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh.

His specialist areas are acute brain injury (mostly traumatic brain injury) and its very early management. He is co-director of the Imperial Neurotrauma Centre and am co-founder of GoodSAM, a revolutionary platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them.

Mark have worked extensively overseas (India, Nepal, South Africa, as a GP in Australia, Researcher for NASA and as an expedition doctor on Arctic and Everest expeditions). He also wrote The Medics Guide to Work and Electives Around the World. His research is mainly into the brain in trauma and in hypoxia (using it as an injury model) in humans.

In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe welcome back Caroline Leech, a emergency medicine consultant with extensive pre-hospital care experience. Caroline discusses the concept of moral injury, delving into its distinction from moral distress. She introduces three mechanisms of moral injury: acts of commission, acts of omission, and betrayal. Caroline provides insightful examples from emergency medicine to illustrate these concepts, emphasizing the importance of identifying and addressing moral injury to support healthcare professionals. The discussion highlights the emotional and cognitive distress faced by emergency responders and the necessity for professional psychological support when moral distress accumulates into moral injury. 00:00 Introduction and Welcome 00:23 Introducing Caroline Leech 01:10 Defining Moral Injury and Distress 03:42 Acts of Commission 07:12 Acts of Omission 12:30 Betrayal in Healthcare 15:00 Conclusion and Final Thoughts The Guest - Caroline Leech

Caroline Leech is Deputy Clinical Lead of The Air Ambulance Service and has 25 years of prehospital clinical experience. She is a Consultant in Emergency Medicine at University Hospital Coventry, the West Midlands Trauma Network Director, and the Trauma Lead for the Institute for Applied & Translational Technologies in Surgery (IATTS). Caroline is currently undertaking a NIHR funded Clinical Research Scholarship with Warwick University. Her research interests include maternal out-of-hospital cardiac arrest, calcium in traumatic haemorrhage, and frailty in major trauma. She is committed to improving equality and diversity in PHEM, and promoting strategies for supporting the wellbeing and psychosocial care of prehospital responders.