Pre-Hospital Care Podcast

In this episode, we focus on the critical topic of frailty and fall assessment in elderly patients. Frailty is a complex condition that affects many older adults, making them more vulnerable to injuries and complications. Falls, one of the most common emergencies among this population, can have life-altering consequences, including fractures, loss of independence, and even death. For healthcare providers, managing these challenges requires skill, sensitivity, and collaboration.We also explore the barriers pre-hospital and hospital teams face in effectively communicating and coordinating care for frail elderly patients. We’ll discuss the tools and criteria used to assess frailty in emergencies and the key elements of a successful handover to hospital teams. Real-world examples will highlight the importance of seamless transitions in achieving positive outcomes. We’ll also examine how pre-hospital teams can work with hospital staff to develop proactive care pathways, prevent recurrent falls, and identify environmental or personal risk factors. Finally, we’ll touch on the importance of joint training and feedback systems to enhance skills and improve patient outcomes.To do this we’re joined by Iain Wilkinson and James Adams. Iain is a Consultant Geriatrician and Clinical Director at Surrey and Sussex Healthcare NHS Trust. As Clinical Lead for the Ageing Well Group, MDTea podcast host, Vice President (Education and Training) for the British Geriatrics Society, and educator with Health Education England, Iain has a wealth of invaluable expertise.James is a leader in frailty care and service transformation. As Chief of Service for Frailty and Community Services, he has pioneered workforce development, quality improvement, and national policy influence. His insights encompass the future of care for older people and the integration of innovative, multi-professional strategies.The Rockwood Frailty Scale / Clinical Frailty score mentioned in the episode can be found here:https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2022/02/rockwood-frailty-scale_.pdfThe MDTea podcast that Iain produces can be found here: https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746The British Geriatric Society e-learning mentioned in the episode can be found here: https://www.bgs.org.uk/bgs-elearningA framework of core capabilities for Frailty can be found here:https://skillsforjustice.org.uk/frameworks/frailty-a-framework-of-core-capabilities#:~:text=This%20framework%20aims%20to%20identify,review%20and%20development%20of%20staff.

In this episode of the Pre-Hospital Care Podcast, we had the privilege of speaking with Dr. Johannes Strobel, a leading figure in Pre-hospital Critical Care and a key driver of clinical innovation within Germany’s renowned EMS system.Reflecting on his journey, Dr. Strobel shared the challenges and rewards of shaping EMS systems across diverse settings, offering invaluable lessons learned from years at the forefront of high-pressure pre-hospital emergency medicine. His experiences provided a compelling look into the evolution of Prehospital Care, from technology integration to education and training advancements.One of the key themes of this conversation was the role of AI, telemedicine, and simulation training in transforming pre-hospital care. Johannes offers insights into how these innovations are not just improving clinician decision-making but also shaping the future of prehospital emergency care in Germany.This podcast is sponsored by PAX.Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:⁠https://www.pax-bags.com/en/⁠

In this episode, we’re delving into one of the most complexand critical topics in pre-hospital care, that of ethical and legal decision-making. Whether respecting a patient’s autonomy, determining capacity, or navigating complex end-of-life care scenarios, these decisions often come withhigh stakes and no easy answers. Balancing the duty to act with the need to respect patients’ rights can be especially challenging in unpredictable environments.We’ll explore key issues such as managing refusal oftreatment, honouring advanced directives, and addressing conflicts between ethical obligations and legal requirements. Using real-world case studies, we’ll discuss practical approaches to tackling these dilemmas while safeguarding patients and providers.In this episode, we’re joined by Steve Bell. Steve is an NHSConsultant Paramedic and Consultant HEMS Paramedic with extensive experience in pre-hospital care across ambulance trusts and HEMS. Steve is also a published researcher and educator.This podcast is sponsored by PAX.Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range, please click here:⁠https://www.pax-bags.com/en/⁠

In this episode, we discuss the role of interprofessional teams within pre-hospital care and examine the latest research published on this topic. Over the past three decades, the role of physicians in pre-hospital care has grown significantly. In this episode, we are joined by Dr Mike Christian. Beginning his career as a paramedic, Mike is now a critical care physician, researcher, and educator in PHEM. He specialises in interprofessional team care for critically ill patients in Canada. He has held leadership positions in PHEM and hospital systems in the UK and in Canada. Mike’s research demonstrates the transformative impact of inter-professional teams, which bring together physicians, paramedics, and other specialists to enhance care delivery and improve patient outcomes. This episode explores the evidence behind these teams, shedding light on their ability to reduce mortality and improve survival for critically ill and injured patients. We’ll discuss the benefits, challenges, and future potential of these teams, touching on the training, logistical, and systemic considerations that shape their implementation. The research can be found here: Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis https://link.springer.com/article/10.1186/s13049-024-01298-8   Interprofessional Learning in Multidisciplinary Healthcare Teams Is Associated With Reduced Patient Mortality: A Quantitative Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/37921751/ A link to the Canadian Critical Care Conference presentation mentioned by Mike in the interview can be found here: https://youtu.be/MVDHaYaZRSI. This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠https://www.pax-bags.com/en/⁠

In this episode, we dive into the intricate legal landscape that pre-hospital care providers must navigate daily. From understanding fundamental duty of care to managing mandatory reporting requirements, we explore how every decision in the field carries legal weight. Our discussion covers essential scenarios pre-hospital teams frequently encounter, including suspected abuse cases, mass casualty incidents, and maintaining patient confidentiality at crime scenes. We break down practical strategies for balancing legal obligations with optimal patient care, offering actionable insights for providers at all levels. Key topics include protecting yourself from negligence claims, understanding when and how to report suspected abuse, and maintaining professional boundaries while collaborating with law enforcement. Whether you're a seasoned paramedic or new to pre-hospital care, this episode provides crucial knowledge for managing legal risks while delivering excellence in patient care. The link mentioned in the episode to the NARU document can be found here: https://naru.s3.eu-west-2.amazonaws.com/wp-content/uploads/2021/09/03212218/DutyofCareBreifingNoteApril21.pdf

In this episode, we delve into NATO’s medical readiness for large-scale conflicts, addressing pressing questions about preparedness and challenges in the face of hybrid and cyber threats. Also, how NATO adapts its strategies to meet these complex needs of contemporary warfare. We’ll address lessons from recent conflicts—Ukraine, Afghanistan, and Iraq—and how these experiences have shaped NATO’s unified approach to combat medicine. From mass casualty management to the integration of cutting-edge innovations like telemedicine, robotics, and AI, we discuss the systems and technologies that underpin NATO's ability to respond effectively. The importance of collaboration and interoperability takes centre stage as we explore how NATO trains medics and aligns medical equipment across diverse member nations. Additionally, we examine how NATO balances military medical readiness with supporting civilian populations in conflict zones, leveraging partnerships with civilian healthcare systems to enhance preparedness. Finally, we tackle ethical and humanitarian considerations, shedding light on psychological resilience, the mental health of medical teams, and the challenges of providing care to both allies and adversaries. To do this I have Tim Hodgetts with me. Tim was the recently serving Surgeon General of the United Kingdom Armed Forces, the Master General of the Army Medical Services, and the elected Chair of the Committee of Chiefs of Military Medical Services in NATO. His clinical background is a Professor of Emergency Medicine amongst many other hats. Links that Tim mentions in the episode can be found here: Transferable military medical lessons from the Russo-Ukraine war https://pubmed.ncbi.nlm.nih.gov/37402486/ The novel 8Ds approach to demand management in Mass Casualty and other situations of extreme demand/capacity mismatch https://www.researchgate.net/publication/374617576_A_simple_research_framework_will_improve_Mass_Casualty_responses Frontlines and Lifelines: Collected Poems from an Army Doctor in Crisis and War (English Edition) https://www.amazon.com/Frontlines-Lifelines-Collected-Doctor-Crisis-ebook/dp/B0DCS1DFMH This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠https://www.pax-bags.com/en/⁠

In this episode, we’re diving into a critical topic for all pre-hospital providers: Documentation and Communication—Protecting Patients and Providers. In the increasingly complex world of pre-hospital care, accurate documentation and effective communication are more than just administrative tasks—they are key to ensuring patient safety, defending clinical decisions, and protecting providers from legal challenges. Every action and decision made in the field must be carefully recorded, as inadequate documentation can expose providers to significant legal risk and impact patient care. In this episode, we’ll explore best practices for pre-hospital record-keeping, the legal implications of incomplete or inaccurate documentation, and how clear communication during handovers to hospital teams can make or break a case. We’ll also examine real-world case studies, highlighting situations where discrepancies in documentation or poor communication led to legal issues or adverse outcomes. This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠https://www.pax-bags.com/en/⁠

In this episode of the Pre-Hospital Care Podcast, we explore why decision-making is a cornerstone of effective pre-hospital care. Using a compelling case study from a high-pressure environment, we examine how clinicians navigate complex decisions and decisions within decisions. We dive into key theories of decision-making, including Miller’s Magic Number 7, which highlights the limits of working memory, and heuristics, the mental shortcuts we use under pressure. We also discuss inattention bias—how critical details can be overlooked—and the importance of metacognition in reflecting on and improving decisions. Discover common pitfalls, such as over-reliance on intuition or cognitive overload, and the emerging role of artificial intelligence as a supportive tool in pre-hospital care decision-making. With AI's potential to analyse data rapidly and provide guidance, how can it complement the human element of judgment and compassion? Finally, we share practical tools and strategies to navigate decision-making challenges, and how clinicians can make sound, timely, and patient-focused choices in dynamic situations. Join us for this insightful episode as we break down the anatomy of decision-making in pre-hospital care. More information on the case study of Dan Richards can be found here: https://www.facebook.com/watch/?v=649646908762720 This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠https://www.pax-bags.com/en/⁠

In this first episode of the new year, we speak with Noah, whose life changed dramatically in 2016. While exercising at school in North London, Noah suffered a cardiac arrest caused by a primary arrhythmia, resulting in ventricular fibrillation. That day brought the adage "it takes a system to save a life" sharply into focus. Noah shares his firsthand experience of the cardiac arrest, the events leading up to it, and how it has become a defining moment in his life. We are also joined by Noah’s father, Erran, who recounts the sequence of events from his perspective—both on that fateful day in 2016 and throughout the emotional roller coaster of Noah's rehabilitation. Together, we explore Noah’s life before the incident, what both Noah and Erran remember about the day, and the detailed timeline of events that unfolded. We delve into Noah’s recovery journey, the profound shift in perspectives on life that resulted, and the lessons they have both taken from the experience. This episode offers a deeply personal insight into resilience, family support, and the critical role of pre-hospital systems in saving lives, along with powerful take-home messages from Noah and Erran. This podcast is sponsored by PAX. Whatever kind of challenge you have to face - with PAX backpacks you are well-prepared. Whether on water, on land or in the air - PAX's versatile, flexible backpacks are perfectly suitable for your requirements and can be used in the most demanding of environments. Equally, PAX bags are built for comfort and rapid access to deliver the right gear at the right time to the right patient. To see more of their innovative designed product range please click here: ⁠https://www.pax-bags.com/en/⁠

In this session, we reflect on the experiences, challenges, and growth that define a career in Paramedicine. Paramedics have the privilege of caring for individuals during some of the most vulnerable and difficult moments of their lives—a privilege that carries profound meaning but also significant emotional demands. This episode explores the essence of resilience: what it truly means, whether our current definitions are sufficient, and how we can better frame it to support those working on the front lines of care. We also examine the cumulative impact of vicarious trauma, the toll of witnessing human suffering over time, and how these experiences shape those in the profession. Importantly, this conversation is not just about challenges—it’s about growth. We discuss the concept of post-traumatic growth, exploring how adversity and trauma can lead to profound personal transformation and a renewed sense of purpose. Guests Keir Rutherford and Lisa Burrell share their journeys, offering insights into the emotional landscape of emergency care. Happy new year from the PHCP and we will see you in 2025!