Pre-Hospital Care Podcast

In this session I will be talking with Allistair MacSorley around his journey through pre-hospital care as a paramedic and then a day in 2018 that changed his life forever and left him paralysed from the waist down. We will also be examining his tenacity, drive and attributes that separate him from the crowd. He is currently still working as a registered Paramedic and part of the maternity team within London Ambulance Service. He is also part of the Irish paracycling development squad in hand cycling. He is training for and focussed on the next hand cycling World Cup in May in Belgium, aiming towards ParaOylpmics Paris 2024 and then the LA games 2028. He has adapted and employed a coach from September 2021 which has fundamentally changed his training program and diet. The carbon fibre cycle bike is a £15,000 specialised bike with adaptations and enables Ali to compete at elite level.  In the conversation we discuss:  The introduction to Alistair’s life growing up His father’s influence and motorbikes His training as a Paramedic What he took his training and facets of his career The career break and what he learned whilst away The incident and injuries sustained The recovery The adaptations to life His current role (LAS and cycling) Ali's story can also be found here: https://www.irishnews.com/news/northernirelandnews/2019/07/29/news/-flying-doctor-left-paralysed-after-motorcycle-crash-returns-to-circuit-a-year-later-to-complete-lap-1672238/ https://www.bbc.co.uk/sport/motorsport/49140461 Please enjoy this episode with a truly inspiring professional and friend.

In this session we examine the importance of governance and the main facets that constitute robust governance. This includes a look at why governance is important, the different domains that constitute good governance and finally how it is applied in practice. We will also look at the fundamentals of risk management within governance and the symbiotic relationship between the two. To do this I have Intensive Care, Anaesthetic and Pre-hospital care consultant Pete Sherren with me. In the conversation we unpack:  What is governance and why it is a vitally important feature of a culture of improvement.  The facets of good governance and cultural commitment.  Education and Training. Clinical audit. Clinical effectiveness. Research and development. Openness Information Management Finally Risk management and how this is important for the patient clinician, and institution. Links to the Delphi study that we mention in the conversation can be found here:  Consensus on research priorities for Essex & Herts Air Ambulance: a Delphi study: https://sjtrem.biomedcentral.com/track/pdf/10.1186/s13049-021-00835-z.pdf Please enjoy this conversation with an engaging and insightful guest. 

I'm pleased to release this recently recorded episode with ED consultant Dr Amy Hughes. Amy has launched the 'Portfolio Medical Careers' Podcast which details interesting narratives and career paths from various medical careers. This series will cover doctors, paramedics, nurses, and other allied healthcare professionals with different stories and paths within and outside of the National Health Service (NHS). She has some fantastic interviews lined up and really gets to the heart of emphasising the 'journey and not just the destination'. The podcast also denotes that various experiences can feed into the wider clinician and person and give more rounded and diverse experience from which to draw.  This month we join Paramedic Eoin Walker. Eoin has been a practising paramedic for over 20 years and journied through a fascinating career including the LAS cycle response unit, Physician Response Unit, London's Air Ambulance (HEMS), LAS Advanced Paramedic Practitioner, Expedition Medicine and, most recently,  a role with the International Committee of the Red Cross (ICRC). The podcast can be found here:  https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQwMDc3NS9yc3M/episode/YTlhYTI3NjktYWFkNS00MDBlLWEzODctM2FhZjIwZjBjNGUz?hl=en-HU&ved=2ahUKEwjMi4nizsX2AhXUiP0HHY46DecQjrkEegQIBhAF&ep=6

In this session we will examine some of the prevailing issues and difficulties of paediatric pain management. To do this I have Will Broughton, an associate professor of paramedic science at Buckinghamshire New University, Paramedic with specialist interest in Paediatric Emergency Medicine and Paramedic Education. He continues to practice clinically with London Ambulance Service (LAS) and South Central Ambulance Service (SCAS). We will unpack some of the nuances, challenges, and evidenced based approaches that Will has found from being both a pre-hospital practitioner and studying his MSc in this domain of practice. In the conversation we discuss:  Definitions of pain and what it means to children. Physiological consequences of pain in paediatrics Difficulties of pain management in Paediatrics Pain relief routes available and advocated (NICE) Pain assessment - Wong and Baker, visual analogue scales.  The utility of the FLACC score Monitoring difficulties and challenges  Human factors with Pain - Parents, stressful environment Tx/Pain Mx strategies - NICE, preferences, nuances. Take homes messages. Resources that are mentioned in the episode include:  CRIES pain scale http://geriatricphysio.yolasite.com/resources/CRIES%20Scale%20for%20Neonatal%20Postoperative%20Pain%20Assessment.pdf WHO pain ladder https://professionals.wrha.mb.ca/old/professionals/files/PDTip_AnalgesicLadder.pdf Children in painhttps://rcem.ac.uk/wp-content/uploads/2021/11/Pain_in_Children_2017_18_National_Report_Oct_2018.pdf Wong and Baker faces https://wongbakerfaces.org I hope you enjoy this episode with a fantastic guest. Will Broughton can be reached on Twitter at @WilBroughton

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.