Pre-Hospital Care Podcast

CarlBetts, a co-host of this podcast, authored a reflective piece titled "Where Critical Analysis Becomes Critically Unhealthy," published in 2023 in the College of Paramedics’ Hindsight magazine. In this episode, we delve into Carl’s motivations for writing the article and examine its central themes. The piece discusses how critical analysis, while an essential skill, can become counterproductive when it slips into harsh self-appraisal, leading to emotional disequilibrium and eroding clinician confidence.We unpack how debriefs and reflective practices must be thoughtfully structured to include both challenge and affirmation, creating space for growth without causing harm. Using real clinical examples, Carl helps illustrate where reflection can go wrong and how to avoid those pitfalls.We also discuss the importance of reframing difficult experiences to support a net positive impact on clinicians, and how critical feedback, whether from oneself or others, can be damaging if not delivered constructively. The episode outlines practical strategies, including reframing techniques, to make reflection a healthier, more sustainable process.To bring Carl’s insights to life, we’ve transcribed his original article into an AI-narrated blog post, allowing you to listen to the word-for-word reflections from his piece, offering another way to engage deeply with his message. This episode is brought to you by IndieBase. IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers. Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

Today’s episode dives into lived experience with cystic fibrosis through the remarkable journey of Paul  Butler. Diagnosed at two and warned he wouldn’t reach twenty. Paul’s childhood revolved around twice-daily chest physiotherapy, three-daily nebulisers, and a mass of hospital admissions for infections that chipped away at his fragile lungs. By his late teens, the odds felt fixed: average life expectancy for CF hovered around 30, and Paul’s lung capacity was already tumbling. Yet everything changed the day he cradled his newborn daughter, Amelia. Faced with a future he refused to miss, Paul overhauled his life, embracing rigorous medication adherence, evidence-informed nutrition, and a training regimen that turned a patient into a personal trainer who now deadlifts triple his body weight.At 45, Paul hasn’t been hospitalised in seven years and views fitness not as vanity but as respiratory medicine performed in a gym. In this conversation, we ask: What mindset shifts sustain adherence when statistics feel fatalistic? And what can pre-hospital professionals learn about goal-setting, communication, and empathy from someone who quite literally trains to breathe? You can find Paul Butler on Instagram here: https://www.instagram.com/paulbutler.coach/?hl=enYou can find Paul's website here: https://paulspeakphysique.co.uk/given-just-weeks-to-liveYou can find the inspiration for this interview on the Grind Diaries Podcast here: https://podcasts.apple.com/gb/podcast/episode-16-paul-butler-the-personal-trainer-living/id1736072345?i=1000682838118This episode is brought to you by IndieBase. IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers. Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

In this episode, we dive into The PITT, a powerful new medical drama that lays bare the raw, unfiltered reality of life in the emergency department. This conversation serves as a commentary on an AI-generated adaptation of Dr. Sarah Spelsberg’s original blog post, and it began with an interview. We first sat down with Sarah to gain deeper context and personal insight behind the post, ensuring that the AI-generated version remained true to her voice, values, and lived frontline experience.Sarah, a seasoned wilderness medic and co-host at World Extreme Medicine, shares how The PITT resonates with emergency clinicians by portraying the often-overlooked struggles of ED life, boarding crises, staff shortages, burnout, and the layers of bureaucracy that hinder care.Unlike polished hospital dramas like Grey’s Anatomy or House, The PITT hits closer to home. It reflects the chaos and moral weight providers carry daily, and helps the public understand what really happens behind the scenes. Sarah explains how this visibility can build empathy, reduce aggression toward staff, and shift public expectations.She also reflects on how wilderness medicine re-centers her purpose, offering a stark contrast to hospital bureaucracy. Ultimately, this episode is both a tribute and a call to action for better systems, better support, and honest storytelling in healthcare. You can read the blog here: https://roguemed.medium.com/the-pitt-a-lifeline-for-emergency-medicine-providers-7ba1f8b2b045The PITT offers a raw and authentic look at the challenges confronting healthcare professionals in today's America, told through the experiences of frontline workers at a contemporary hospital in Pittsburgh, Pennsylvania. Watch The PITT here: https://www.primevideo.com/detail/The-Pitt/0ORZ2LIN9JTFLLUK8UKR33DZPXThis 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 pax-bags.com

Today’s episode explores one of the most profound and humbling themes in medicine: what the dying and those who’ve been brought back to life can teach us about living.Dr. Matt Morgan is an intensive care consultant, researcher, and author of A Second Act, a book inspired by the hundreds of patients he’s met who have crossed the threshold of death and returned. People like Ed, struck by lightning and left without a pulse, are revived through rapid, decisive pre-hospital action. These are the individuals Dr. Morgan believes we should be listening to, not influencers or business gurus, but those who’ve faced the thin margins between life and death and emerged with new clarity about what truly matters.In this conversation, we’ll reflect on the emotional and ethical challenges of working in the fog between life and death, the importance of listening to survivors, and the critical role pre-hospital teams play in offering second chances. We’ll also ask: how do we carry the weight of this work without losing our humanity? This is a powerful episode about perspective, purpose, and the lessons that only the brink of death can reveal. Matt's book 'A Second Act' can be found here: https://www.simonandschuster.co.uk/books/A-Second-Act/Matt-Morgan/9781398532335This 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 pax-bags.com

In this series, we are bringing blog posts to life by interviewing the authors. Also, by generating AI audio conversations of the blog to make them accessible in audio format. I then summarise the audio in conclusion. We begin this episode by interviewing Dr. Sarah Spelsberg to add context and personal insight behind an AI‑generated adaptation of her latest RogueMed post, “Emergency Medicine and PTSD.” Through her reflections, we explore how repeated exposure to trauma profoundly affects emergency clinicians.Dr. Spelsberg describes how witnessing death, severe injury, suicides, resuscitations, violence, and patient suffering can lead to chronic stress and PTSD. She highlights that up to 14.6 % of emergency personnel experience PTSD symptoms, higher than rates in police or firefighters. The pressure of balancing life-or-death decision-making with systemic constraints crowded EDs, insufficient staffing, and administrative burdens amplifies emotional strain.Our discussion focuses on the emotional toll of moral injury, guilt, burnout, hypervigilance, flashbacks, insomnia, and emotional exhaustion that haunt providers long after their shifts end. Dr. Spelsberg emphasises that PTSD in emergency medicine isn’t rare it’s predictable under these circumstances and requires culturally appropriate recognition and care.We explore evidence-backed strategies: trauma-informed debriefs, peer support networks, access to psychological therapies like cognitive behavioural therapy and EMDR, and cultivating a culture that normalises seeking help. Dr. Spelsberg underscores that organisational change revamping shift patterns, enhancing supervision, and providing mental health resources is as crucial as individual resilience.By sharing lived experience and actionable solutions, this episode reframes PTSD not as a weakness but as an expected response needing compassion, systemic support, and meaningful action. You can access the blog this podcast is based on here: https://roguemed.medium.com/emergency-medicine-and-ptsd-e0841f945d55My thanks to Sarah Spelsberg for this interview as a co-host of The World Extreme Medicine podcast. 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 pax-bags.com

In this episode of the Pre-hospital Care Podcast, we explore a cutting-edge innovation that’s transforming how HEMS clinicians are trained for high-stakes, life-saving procedures, such as thoracotomy, resuscitative hysterotomy, and other HALO interventions. We’re joined by Jamie, founder of Maxres, and Lily, a Critical Care Doctor, to discuss how immersive headset training is being introduced into clinical education, starting with the Thames Valley Air Ambulance.Jamie brings a unique perspective from his time as a pilot and helicopter flight instructor in the Royal Air Force, where he experienced first-hand the value of scenario-based, immersive learning. Combined with Lily’s background as a prehospital critical care doctor, their expertise is helping shape a new frontier in clinical preparedness for the most complex and time-critical interventions.Together, we unpack how the MaxRes system works, the science behind its development, and the real-world impact it’s having on clinical performance, confidence, and decision-making. We also look to the future, exploring how this technology could revolutionise pre-hospital education, expand into new clinical domains, and deliver highly realistic, repeatable, and effective training experiences.Whether you’re a critical care paramedic, HEMS doctor, educator, or healthcare innovator, this episode offers an exciting look at where pre-hospital training is heading and how technology developed for the skies is now making a difference on the ground. Further information on MaxRes can be found here: https://maxres.ai/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 pax-bags.com

In this episode of the Pre-hospital Care Podcast, we delve into the origins and current structure of the Hazardous Area Response Team (HART), a specialist unit within UK pre-hospital care. We explore why the HART model was specifically chosen in the UK and how it compares to Urban Search and Rescue (USAR) counterparts internationally. The conversation offers insights into the unique day-to-day role of a HART team member and how the team integrates with the wider emergency medical services, particularly during high-risk or complex incidents.We also reflect on the evolution of HART, how the model has grown from its early foundations into a sophisticated and responsive service that plays a crucial role in emergency preparedness and response. The episode explores the learning mechanisms and governance structures built into HART to ensure continuous development and safe practice.Additionally, we examine how change management and cultural integration have been essential to embedding HART within the wider healthcare and emergency response ecosystem. This includes addressing the 'hearts and minds' aspect, how to build trust, acceptance, and collaboration between specialist teams and frontline responders to ensure effective teamwork and optimal patient care.Whether you're familiar with HART or new to the concept, this episode offers a deep dive into one of the UK's most technically demanding emergency response capabilities and how it continues to shape the landscape of 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 pax-bags.com

In Part 3 of The Dying Patient: Palliative and End of Life Care, we delve into the complexities ambulance clinicians face when supporting patients in their final days and hours. Often the first to recognise when someone is dying, paramedics work within a system where community engagement may be limited, making their role crucial in identifying signs such as terminal agitation, unconsciousness, and other common symptoms. The episode discusses the importance of anticipatory medications and proactive advance care planning , especially in situations involving carer breakdown or when patients change their minds about where they wish to die.We explore why ambulance services are frequently called during end-of-life stages, whether due to uncontrolled symptoms, sudden deterioration, or emotional distress within families. Paramedics not only offer symptom relief, both pharmacological and non-pharmacological, but also provide vital emotional support to those navigating grief, denial, or fear. Challenges include differentiating between reversible conditions and active dying, managing care when anticipatory medications are unavailable, and coordinating with wider healthcare teams.Breaking bad news is another critical area discussed, with a focus on using frameworks such as Ask-Tell-Ask and adapting communication to the emotional needs of the moment. Lastly, the episode reflects on cultural considerations in a city as diverse as London. From language barriers and different expressions of grief to religious rituals and care after death, ambulance clinicians must remain adaptable and compassionate, ensuring that care is respectful, inclusive, and sensitive to the needs of every individual and their family. Some of the links to information mentioned in the episode can be found here: These are some of the resources mentioned in the episode:Breaking Bad News: ⁠⁠https://www.sth.nhs.uk/clientfiles/File/Breaking%20bad%20news%20Reflection%20on%20the%20process.pdf⁠⁠Good Grief - understanding the grief journey in more detail: ⁠⁠https://good-grief.org/resources/⁠⁠Hospice UK, an excellent place for further resources: ⁠⁠https://www.hospiceuk.org/our-campaigns/dying-matters/dying-matters-awareness-weekUK National Guidelines on Diabetes and End of Life Care: https://www.diabetes.org.uk/sites/default/files/2025-03/EoL_TREND_2024_v11-1.pdfThis 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 pax-bags.com

In Part 3 of our Decision Making series, we explore the power of "slow time" thinking with Detective Superintendent Ahenkora Bediako of the Metropolitan Police. With a distinguished career managing high-risk public protection departments and international investigations, Ahenkora brings deep insight into how intentional, non-biased decisions are made under pressure.We unpack how leaders can resist reactive impulses in crisis moments and instead lean into deliberate, evidence-informed strategies, especially when the stakes are high. Drawing on his experience as an Accredited Major Crime Senior Investigating Officer (PIP3), Ahenkora shares lessons from frontline policing, complex safeguarding, and professional standards.We also touch on his commitment to evidence-based policing, including randomised control trials, and how these approaches improve outcomes in child protection, community engagement, and organisational equity. If you're interested in high-performance leadership, decision integrity, and building inclusive, accountable systems, this episode is for you. 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 pax-bags.com

Today, we’re diving into a critical yet often overlooked subject: rehabilitation for pre-hospital staff. The physical and mental demands of frontline work are relentless. Paramedics, HEMS crews, and pre-hospital teams operate in high-stress environments, managing unpredictable situations, heavy workloads, and repeated exposure to trauma. But what happens when the body or mind says, “I can’t keep going”? How do we help our colleagues recover and return, not just functioning, but stronger, healthier, and more resilient?I’m joined by Mike Palmer, a highly experienced critical care clinician with lived experience of injury and recovery. Together, we’ll unpack the scale of injury across pre-hospital care, identify gaps in current rehabilitation practices, and explore why a structured, personalised approach is essential for long-term sustainability in this field. We’ll also take a personal look at Mike’s own journey, how he navigated his recovery, the obstacles he encountered, and the insights he gained along the way.But this conversation goes beyond rehabilitation, it’s about reimagining how we care for those who care for others. Whether you're on the frontline, leading a team, or simply passionate about well-being in emergency medicine, this episode offers valuable perspectives on how we can better support, rehabilitate, and retain our pre-hospital workforce. Useful links that Mike mentions in the episode can be found here:https://pubmed.ncbi.nlm.nih.gov/31537564/https://www.sciencedirect.com/science/article/pii/S0925753524000092https://pubmed.ncbi.nlm.nih.gov/33492279/https://pubmed.ncbi.nlm.nih.gov/35000895/https://pubmed.ncbi.nlm.nih.gov/26371071/https://pubmed.ncbi.nlm.nih.gov/34972683/https://pubmed.ncbi.nlm.nih.gov/26371071/https://pubmed.ncbi.nlm.nih.gov/26281820/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 pax-bags.com