Pre-Hospital Care Podcast

Steve is the medical director of The Queensland Ambulance Service (QAS) with 5,000 staff and 1,300 response vehicles. QAS has a contemporary approach to clinical service delivery and innovation in prehospital trauma care. It also operates a tiered system of pre-hospital care with Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs) and a smaller cohort of HARU Paramedics.  In this episode we discuss a variety of topics: High Acuity Response Unit (HARU) both its inception and the clinical remit for the HARU. Governance around the HARU program and provider quality assurance for some of the procedures (RSI, on-call advice, blood products and the bleeding patients). Quality improvement and where the program is heading  The lessons learnt building the HARU and ICP schemes in QLD. I hope you enjoy this episode as I found it both insightful and helpful to look at how other systems approach high performing teams and continuous improvement. Eoin  

In this conversation with Piers Carter we examine the fundamentals of high performing individuals - the birth place of high performing teams. Piers has an eclectic background. Since 1997 he has been working with businesses; coaching, facilitating and helping them have better conversations – as individuals, teams and leaders. Prior to this, he was paid by the government to throw petrol bombs at the Police – as a riot control, Public Order & self defence instructor. Piers then began expedition-leading, giving him some incredible experiences all over the world working with adults and young people in developing countries and challenging environments. I have always found Piers to be an inspirational character with insight into some of the foundational pearls of wisdom that has changed my world on a day-to-day basis. In this conversation we talk about the power of choice, paying attention to somatic signals, how we gain better insight into personal triggers, the concept of centring, broadening our exposure to failure and many other things. I hope you enjoy this episode with a true legend and friend. You can find out more about Piers here: http://pierscarter.co.uk/ For more content from the Restore Podcast please head over to:  https://anchor.fm/eoin-walker1/episodes/Episode-11-High-Performing-Individuals-with-Piers-Carter-ee9u7p

In this episode I interview Karim Ahmed the clinical lead for the emergency department of the Royal London Hospital (RLH) in Whitechapel. We examine the impact of MTCs across the health economy and why they can add a survival benefit to the patient. We also look at the utility of overlaying fundamental and essential patterns of care to complex scene's and how this deconstructs some extremely challenging pathology. We also examine the social deprivation that tracks trauma & some of the outliers that can present to the RLH. We also get some pearls of wisdom from Karim in relation to trauma and the wider population of undifferentiated trauma patients that constitute the case load seen on any given day in London.  I hope you enjoy this episode with an insightful friend and colleague. 

In this episode I chat to Jason Fox - a former Royal Marine Commando and Special Forces Sergeant. Joining at 16 and serving for 20 years; Jason passed the grueling selection process for the Special Forces, serving with the Special Boat Service. Jason has planned and led operations including hostage rescue, counter terrorism, counter insurgency, maritime counter terrorism, surveillance, body guarding and counter narcotic missions. He currently features in the channel 4 program - SAS: Who Dares Wins. We look at the similarities between the Special Forces (SF) and critical care (paramedic) practice. We examine the principles of high performing teams, relationship with failure, and communication amongst other aspects. We also look at self care and what it means on a practical level and the power of not taking yourself too seriously. I have always found Jason to be honest and open person which is why having conversations with him is so refreshingly real. This episode will feature on the Restore Podcast (self-care non-clinical) and the Pre-hospital Care Podcast (clinical conversations) as it relates to both. I hope you enjoy this episode.

In this episode Nick Brown and Jo Shaw deconstruct the definitions, challenges and nuances of research within pre-hospital care. They examine the history of research and the differences between research, audit and service evaluation. They look some of the results of the contemporary bigger research studies that have recently been published & also the origins of funding through the national governmental bodies such as the National Institute of Health Research (NIHR).  They also differentiate some of the various methodologies within empirical research and make reference to how this can affect the outcome data and inference to the clinical bottom line. This episode illustrates that it is important to be driven by the data especially in an information light environment when on scene with patients.  We hope you enjoy the episode

In this episode myself and Mark Falkner look at the origins of the trauma tree & why it was created. We also look at the origins and utility of GCS, heart rate and respiratory rate. We also discuss the mapping of social deprivation onto trauma & the exposure that paramedics see in regards to trauma. We also look at some of the outliers within trauma that don't fit the historical picture of trauma. We also look at the most useful vital sign - that of respiratory rate. I hope you enjoy the episode. For more content by me head over to the Restore Podcast with Eoin Walker: https://podcasts.apple.com/gb/podcast/restore-with-eoin-walker/id1505391534

In this episode I interview Mark Falkner the Critical Care Scheme lead in London. We look at a cross section of critical care concepts from Traumatic Brain Injury to which are the most essential vital signs to pay attention to. We also look at some of the empirical literature of the above topics and examine the trauma tree in relation to this. I hope this episode imparts some key take home messages for you all as clinicians in the pre-hospital domain of practice. Please also find more content from me around inspiring stories in mental health and well-being from a whole cross section of society on the Restore Podcast with Eoin Walker here:  https://anchor.fm/eoin-walker1/episodes/Episode-3---Reboot-your-life-with-Dan-Richards-ec8ep2 I hope you enjoy the episode 

In this episode we explore the various domains of medicine away from an ambulance or hospital setting. Roger Alcock is an Emergency Medicine and Paediatric Emergency Medicine consultant in Scotland and was involved in the 2014 UK response to the West Africa ebola crisis. Myself and Roger explore the facets of humanitarian and expedition medicine that can add to your career and add depth and breath to experience as a pre-hospital clinician. We explore some of the details of Roger's Sierra Leone deployment for the ebola crisis and some of his expedition endeavours all of which have added to his career and perspectives. We also examine some of the non-technical skills that these deployments and expeditions can foster which both add to resourcefulness and situational awareness of clinical demand and innovation in low resource settings.  I hope you enjoy the episode.

This episode focuses on a vital part of pre-hospital care; that of end of life care. Dan Davis explores this area with Caroline Philips, Diane Laverty, Georgina Murphy Jones. As all three guests work in various capacities for Macmillan they explore both the similarities and variations of palliative and EoLC and the subtle changes in approach to these patients. They look at the mindset change of approach to these patents in de-emphasising resuscitation and focusing on rapport building, supporting documented wishes and multi-agency engagement to facilitate the best care in the last period of a patient's life. Diane Laverty works as a Macmillan Nurse Consultant and is passionate about specialist palliative care and EoLC patients having a voice and receiving high quality care across all domains of practice.  Caroline Philips and Georgina Murphy Jones work as paramedic clinical tutors and Macmillan specialist clinicians helping embed both EoLC training and practice across London and to fellow colleagues. They examine the difficulty of not having prior rapport with these patients & families and some of the variations we would expect to see when looking at the physiology and clinical findings. This episode is especially important in the current climate and Dan brings this into focus talking about his own experiences with EoLC with his own father.  Please enjoy this episode which discusses this relevant and important narrative within pre-hospital care.

In this episode Dan Davis explores the wider aspects of TBI with Alice Kershberg, a clinical nurse specialist in traumatic brain injury.  Alice plays a vital role in not only looking after patients who have suffered a traumatic brain injury, but acts as the bridge between the hospital and the community and between the neurosurgery team and the family. In this episode we explore many facets of the pathology but also shine a light on the pastoral role of acting as a liaison supporting patients and family after surgery, helping them to navigate their recovery in what can be a life changing injury. Alice's role is fundamentally key to linking medicine to the lives of those affected in the community and gives an insight into the patient journey after pre-hospital care has passed the baton onto the hospital and into rehabilitation - we hope you enjoy the episode.