Pre-Hospital Care Podcast

In this session we will be interviewing flight paramedic Paul Swinton, to talk about how to optimise the RSI in the pre-hospital environment. We will unpack some of the nuances, challenges, and approaches that Paul has found from being both a pre-hospital practitioner and in innovating the layout and design for an RSI in creating the SCRAM bag. SCRAM™ (Structured CRitical Airway Management) is an innovative solution for enhancing the performance of emergency airway management. It involves the systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM. Paul has been a paramedic for the past 20 years. He joined the Scottish Ambulance Service Special Operations Response Team, based in Glasgow, in 2010, after re-locating from the West Midlands Ambulance Service. He is currently an Air Ambulance Paramedic for the Scottish Air Ambulance Division, involved in critical care and retrieval medicine, working alongside the trauma teams and medical retrieval services of Scotland (ScotSTAR). He is originally from South Africa, where he qualified and worked as a paramedic on the road, in Emergency Departments and as a flight paramedic. This podcast is brought to you in collaboration with Scottish Health Innovations Limited, also known as SHIL, who work in partnership with NHS Scotland to identify, protect, develop and commercialise healthcare innovations to improve patient care. SHIL uses specialised knowledge to help bring new ideas and innovations from healthcare professionals to life, with a multidisciplinary team providing expert services including intellectual property advice and protection, regulatory expertise, project management, idea incubation, funding advice, development, commercialisation, and post-commercialisation monitoring.  You can follow SHIL’s work on Twitter, @ScotHealthInno You can find out more about SHIL here: https://www.shil.co.uk/ You can find SHILs products here: https://www.shil.co.uk/browse/products This podcast is also brought to you in association with Openhouse. Openhouse take a unique approach to creating products in focussing on a ‘Fit For Purpose’ end product. Their focus on creating truly bespoke products along with the best possible purchasing experience which means they have strong working relationships with customers from all sectors of industry.  Openhouse products can be found here: openhouseproducts.com You can follow Openhouse on twitter @OHproducts You can find out more about Openhouse here: https://www.openhouseproducts.com/about-us/ You can see the SCRAM range as mentioned in the episode here: https://www.openhouseproducts.com/?s=SCRAM&post_type=product You can find out more about the guest here: https://paulswinton.com I hope you enjoy this episode with an engaging and insightful guest. 

In this session we will examine the epidemiology of OHCA. We will look at the frequency and trends of OHCA together with the causes and risk factors. We will examine the concept of a registry of cardiac arrest and appreciation of baselines to work from. We will also look at the current mitigation strategies that are available to prevent OHCA such as policy, and Public Access Defibrillation (PAD) amongst others. We will also look at our guest's PhD (Dr Katherine Pemberton) and how that both informs the current climate and the future of how we tackle OHCA. We examine: The current statistical climate - in Wales and Queensland Main contributing factors/risk factors around incidence Patterns between the two areas both in disease prevalence and problematic rate-limiting steps in decreasing OHCA. Cornerstones of policy that need/require adaptation PAD/Public Access Defibrillation and the importance of community engagement Social demographics and how OHCA maps onto social deprivation  Iterative solutions (no magic bullet concept)  These are links to Dr Pemberton's literature review: https://ajp.paramedics.org/index.php/ajp/article/view/752 https://ajp.paramedics.org/index.php/ajp/article/view/753 These are the pubmed links.  https://pubmed.ncbi.nlm.nih.gov/31352680/ https://pubmed.ncbi.nlm.nih.gov/31352690/ https://pubmed.ncbi.nlm.nih.gov/33219108/ Please enjoy this episode with two insightful and engaging guests 

The best of the 'Restore Podcast 2021' is here. This conversation features accounts with Consultant psychologists, psychiatrists, special forces operatives, professional rugby stars turned drug addicts turned pastors, inspirational leadership coaches, accounts on NLP, Neuroplastic Somatic Practice, EMDR therapy, CBT, and much, much more. The mandate is…raw and inspirational conversations with the application of deep understanding and revelation. In the world of memes and brief captions that sound good in the moment, we need real, raw, and deep accounts and tools to navigate one of the most difficult segments of time in life. Instead of falling for a brief caption that means nothing and lasts only a moment, instead try leaning into these life accounts of how people have turned around their lives from truly testing times. Wisdom is the life application of knowledge. It is found in a deep understanding and fostered through narrative and tools most of which don’t lay within our own capacity and rely on us being willing to hear others survive and thriving through adversity. My thanks to all the guests that have featured across the podcast in 2021. I look forward to taking you with me into 2022 for more inspirational conversations and truly revelationary accounts.

In this episode we look at the debrief in its entirety; why we debrief, when, how and where. We examine the evidence behind debriefing and the institutions that use debrief such as the military, pre-hospital practitioners, ward based staff, sports teams, athletes and others. We then look at the types of debrief such as the hot & cold debrief, Schwartz rounds, Critical Incident Stress Debriefing, the After Action Review amongst others. We then examine 6 tools of debriefing that can be used in practice. We briefly also touch on the disparity of evidence around mitigation of psychiatric pathology such as PTSD.  Here are some of the tools mentioned: TAKESTOCK https://www.rcemlearning.co.uk/foamed/take-stock-hot-debrief/ STOP5 https://www.stemlynsblog.org/wp-content/uploads/2018/10/Hot-Debrief-Poster-V2-April-2018.pdf PLUS DELTA https://fhop.ucsf.edu/sites/fhop.ucsf.edu/files/custom_download/ACPS_Plus_Delta_Template.pdf MODIFIED PLUS DELTA https://leanconstruction.org/media/learning_laboratory/Plus_Delta/Plus-Delta.pdf ITRUST Debrief https://www.bmsc.co.uk/course/itrust-debriefing/ PEARL debrief https://debrief2learn.org/pearls-debriefing-tool/ I hope you enjoy this episode 

In this episode, we are going to examine a story of one of the key innovations in pre-hospital care in the last 20 years and how it came into existence. We will look at the Cycle Response Unit or CRU that see’s Paramedics respond to emergency calls via mountain bikes across the nation. To do this we have the creator and founder of the CRU Tom Lynch MBE, MStJ. Tom Lynch has channeled his excellent cycling and coaching skills, his self-belief, and his competitive spirit to develop and deliver the CRU.traveled the world as a BMXer, won numerous trophies and titles several times over, appeared on the front page of magazines, had fans on every continent and lived a life people can only dream of. In 1999 Tom got the go-ahead for a trial to set up the Ambulance Cycle Response Unit (C.R.U.) to answer 999 calls in the West End of London. He still had friends in the bike industry from BMX days and he made sure he got the best equipment available. The bike was fitted with the latest pre-hospital equipment and the all-important lightweight defibrillator. This marked the beginning of a legacy of paramedics on mountain bikes, but it wasn’t always an easy ride. we examine the history and background, Tom’s struggles and battles to get the project off the ground, some of the seminal cases in which the CRU has been involved, and some of Tom’s best moments. In the conversation we examine: Tom Lynch's background growing up History & inception of the CRU Demographics served across London and wider teams across the UK Advantages over other vehicles over time and environment Seminal cases that the CRU have attended/made a difference to CRU Awards achieved Some of the battles and struggles Tom has faced and overcome What it gives back to both the community and the clinician. Some of the key takeaways  I hope you enjoy this episode with two fascinating guests.

In this session we will examine the recently published in the Journal of Paramedic Practice on 'Focused ultrasound in out-of- hospital cardiac arrest by Advanced Paramedics'. To do this I have Advanced Paramedic Practitioner, author and lecturer Nick Brown.  In the episode we discuss why ultrasound is used, what device is used and what APPs use it for. We also discuss the primary and secondary outcomes of the study, the population the study focusses on (OHCA) and the problem/question they are seeking to address (cardiac arrest management/termination). We also explore the study's methodology, the differentiation of results, the conclusion, the clinical relevance to practice, what Nick took from performing the audit and the salient take home messages from the study.  The research article can be found here: https://www.magonlinelibrary.com/doi/abs/10.12968/jpar.2021.13.1.26 Please enjoy this episode and feel free to rate and review the podcast. 

In this episode we will examine the various ways in which paramedic education has evolved over the past 20 years both conceptually and the skills taught within the profession. Alan Rice and Lisa Burrell join me in this conversation,  Alan is the lead for post-registration paramedic education at St Georges University, London. His role is predominately designing and organising the delivery of education for specialist and advanced paramedic roles in both urgent and critical care. He also oversee’s the work force development of all qualified paramedics that are studying towards a higher education award. Alan also works as a consultant paramedic advising ambulance trusts. Lisa Burrell is both an Advanced Paramedic Practitioner in London and a senior lecturer at St Georges university. Lisa teaches on both the post and undergraduate cohorts and spends time teaching CCPs from different services. She has also spent over 8 years as a flight paramedic within London and has split her time between teaching and critical care. In the episode we talk about: ·  The concept of critical thinking & analysis - a central concept of education.  ·  The diversity of care pathways and how this has changed over 20 years. ·  Non-technical skills taught and emphasised throughout the curriculum and course. ·  Mentoring - the importance of this. ·  Monitoring and the use of monitors within pre-hospital care.  ·  Engagement with technology for current practitioners.  ·  Skills that have evolved – USS, thrombolysis for VTE, prescribing, Abx, ·  Anecdotal thoughts on evolution of both the profession and the paramedic practice curriculum.  The undergraduate Paramedic Science course at St Georges University London can be found here: https://www.sgul.ac.uk/study/courses/paramedic-science Please enjoy this conversation with two fantastic guests. 

In this episode we will examine the various pathologies related to psychosis and neurosis in mental health that clinicians can see within practice. We also examine some of the key aspects of these pathologies so that clinicians can construct both meaningful and targeted treatment to this extremely difficult cohort of patients. To do this am am joined by Anna Basquil, a special mental health practitioner who joined the ambulance service in January 2020, seconded by her mental health trust to provide and help embed the 'dual assessment model' on patients. She works on the 'Mental Health Joint Response Unit' together with a Paramedic. Prior to this Anna was working in an 'early intervention service' with patients experiencing their first episode of psychosis. Anna worked in patients early years of diagnosis to help them both integrate and cope with their symptoms to help normalise and stabilise their lives.  In the interview we discuss:  Some of the fundamental differences between psychoses and neuroses. The demographics of each pathology Deep dive into Psychoses – definition, types, signs and symptoms. Examine schizophrenia as the most common type of psychosis. Brief look at prodromal phase, acute phase and recovery phase of psychotic episodes. Deep dive into Neuroses – definition, types, signs and symptoms. Examine depression and anxiety as the most common types of neuroses. Brief look at triggers for neuroses. Managing episodes of neurosis Managing psychotic episodes More information on the 'Mental Health Joint Response Unit' can be found here: https://aace.org.uk/initiatives/mental-health-joint-response-car/ I hope you enjoy this episode with an engaging and informative guest. 

In this session we will examine some of the prevailing educational learning from a colleague who has just qualified as a critical care paramedic in London. We will unpack some of the revelations, nuances, and comparisons that critical care has brought from their perspective from other roles. In the episode we dig into Adam’s background and why the Advanced Paramedic Practitioner in critical care career pathway was appealing to him. We also examine what has it brought Adam from a wider perspective and the nuances in care compared to standard paramedic practice. We then unpack Adam's personal revelations that were previously unknown and what he took from the mentoring aphase of his critical care training. We finish off by looking a few seminal cases and how that both inspired him and helped him learn along the way.  I hope you enjoy this episode with both an honest and insightful guest. 

In this session we will examine the varied pathology of Transient Loss of Consciousness (TLOC), the definition, the causes, the sequalae, and the management. I wanted to also examine some of the key aspects of TLOC that are red flags and should be examined further within clinical practice. To do this I have Consultant Cardiologist and Honorary Senior Lecturer, Dr Nicholas Gall with me.  In the episode we look at an established definition of TLOC, Nick's efforts to start a blackout pathway, the fundamental problem of TLOC in unpacking why undifferentiated TLOC can be a clinical minefield. We then examine the aetiology of TLOC and the diagnostic tools with which to differentiate the pathology (USS and ECG nuances). We then look at red flags warning signs and subtle information cues with TLOC, treatment of TLOC patients (broad take home messages) and clinical examples from practice. I hope you enjoy this episode with a fascinating and insightful guest.