Pre-Hospital Care Podcast

Today, we’re diving into one of the most challenging and high-stakes procedures in trauma medicine—prehospital resuscitative thoracotomy (RT) for traumatic cardiac arrest (TCA). Joining me is Dr Mike Christian, the senior author of a recent study published in JAMA Surgery, which examines the impact of prehospital RT in London’s Air Ambulance (LAA) system over two decades. TCA is often seen as a condition with a poor prognosis but for select patients—particularly those suffering from cardiac tamponade—prehospital RT has been shown to improve survival rates when performed within minutes of arrest. This study is the largest of its kind, analysing over 600 cases and shedding light on the effectiveness of RT, the critical time windows, and the factors that influence outcomes.In this episode, we’ll explore the study’s key findings, discuss the operational and ethical challenges of performing RT in the field, and consider what this means for the future of prehospital trauma care. The paper can be found here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2830622A review and appraisal of the paper can be found here: https://www.stemlynsblog.org/laa-resuscitative-thoracotomy/This is an advertisement from BetterHelp.Stress and anxiety affect all of us—whether it’s the daily pressures of work, life, or the unexpected moments that throw us off balance. As pre-hospital professionals, we see firsthand how mental health can impact lives, yet we often neglect our well-being.Anxiety can manifest in ways we don’t always recognise—headaches, sleepless nights, or even feeling constantly on edge. In a world that demands more, sometimes the best thing you can do is pause, reflect, and seek support. Therapy isn’t just for those in crisis—it’s about learning coping strategies, setting boundaries, and becoming the best version of yourself.BetterHelp is the world’s largest online therapy platform, connecting you with professionals specialising in anxiety and more. Take control of your mental health today. Our listeners get 10% off their first month at BetterHelp.com/CAREPODThis 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/⁠

This is the second in a short mini-series focusing on vehicle-borne attacks having transitioned from a relatively rare method used by Terrorist Vehicle-Borne (TVB) attacks to becoming one of the most lethal forms of terrorism.In Western countries, by 2016, TVB has resulted in just over half of all terrorism-related deaths. Their effectiveness and simplicity make vehicle ramming attacks an increasingly popular option for lone individuals who are three times more likely to stage a successful attack by groups of two or more. According to the global terrorism index, 2024 saw an overall 63% increase in terrorist attacks in the West, with terrorism conducted by lone individuals sharply on the rise. So, how much have we learned from the past the public report published in the United Kingdom in 2013? A 2022 systematic review focusing on lessons learned from terror attacks from 2001 to 2018 found that despite the differences in methods countries social and political systems and casualties involved many of the lessons an issues identified with similar however these lessons continue to repeat themselves time again it concluded that the lessons identified did not appear to be sufficiently acted upon the failure to learn was further highlighted in volume 2 of the Manchester Arena public inquiry which focused on the response by the emergency services it identified the organisations involved in the response to the incident had failed to capture or learn lessons from previous multi-agency exercises it reported that there had been a failure to learn embedded key lessons from exercises. This was most relevant in the areas of shared situational awareness and joint understanding of risk and co-location identified key lessons, that subsequently reoccurred during the multi-agency response on the night of the attack.On the afternoon of August 17, 2017, Barcelona was subjected to a vehicle terrorist attack, the 22-year-old assailant drove his van some 550 metres along the famous La Rambla, killing 14 people and injuring 125. We are 8 years on now from the attack. However, the lessons identified and reflections taken from the emergency service response are still as relevant today as they were at the time. Today, we are joined by Doctor Jorge Morales Alvarez, the Medical Director of the Catalan Medical Emergency System. To read more about the attack, see here: https://en.wikipedia.org/wiki/2017_Barcelona_attacksThis 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 2016, ISIS encouraged vehicle attacks through its online magazine, targeting crowded outdoor events. Rather than large-scale attacks using weapons of mass destruction, terrorism has shifted towards smaller, lone-actor incidents due to increased security measures. Online radicalisation has facilitated this change, inspiring attacks with easily accessible vehicles requiring minimal skill or preparation.Following the publication, vehicle-borne attacks increased, with one of the deadliest occurring in Nice, France, during Bastille Day, killing 87 and injuring 458. Victims commonly suffered exsanguinating pelvic fractures. While these attacks are primarily linked to Islamist terrorism, vehicles have also been used in far-right, far-left, and criminal incidents. Between May 27 and September 5, 2020, 104 vehicle attacks were recorded at U.S. protests. However, jihadist-linked attacks tend to be more lethal due to sustained acceleration and higher kinetic energy, causing severe head, spinal, pelvic, and lower extremity injuries.Emergency response to these incidents is complex, often spanning large areas, such as the one-mile-long scene in Nice. Additional threats like explosives and weapons further challenge responders, as seen in attacks at London Bridge and Barcelona.Recent months have seen a rise in such attacks across Europe and the U.S., mostly linked to Islamist terrorism. Today, we are joined by Bill Salmeron, Chief of EMS for New Orleans, to discuss the New Year's Eve terrorist attack on Bourbon Street and the EMS response. To read more on the precise location and details of the incident, see here: https://en.wikipedia.org/wiki/2025_New_Orleans_truck_attackThis 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’ll explore the communication barriers that clinicians encounter in delivering coordinated care for geriatric patients, including the role of sensory impairments like hearing or vision loss. We’ll uncover best practices for engaging families in decision-making, addressing complex geriatric syndromes, and managing conflicts around patient autonomy. Finally, we’ll discuss the importance of collaborative training and measurable models to improve communication and outcomes across healthcare systems.In this episode, we’re joined by Georgie Gill, a Trainee Advanced Paramedic Practitioner working in  South East England. After working as a Paramedic in an NHS Ambulance Service she moved to work as a Teaching Fellow for the Department of Elderly Medicine, balancing contributing to MDTea podcast, teaching multidisciplinary teams, and serving on the front door frailty team in the emergency department, bringing insight and expertise to paramedic practicein this area. Following this, she moved to a Community Frailty Practitioner Service undertaking advanced care planning with older adults residing in community settings, before moving back to pre-hospital care to undertake the Trainee Advanced Paramedic Practitioner role and ACP MSc. We are also joined by Iain Wilkinson. Iain is a Consultant Geriatrician and Clinical Director at Surrey and Sussex Healthcare NHS Trust. As Clinical Lead for the Ageing WellGroup, 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.MDTea podcast can be found here: https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746This 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 will delve into the latest advancements and innovations in XR technology - the world of Extended Reality and its groundbreaking applications in medical training and how it might shape the future of medical training in practice. From real-time communication with patients, integrating emotional intelligence for a more empathetic interaction, enhancing clinical guidance through AI-driven doctors, simulating injuries and diseases with high accuracy, and providing realistic responses to medications through advanced pharmacology simulations, this platform is set to transform the future of medical education. Join us as we unpack the potential, challenges, and future of this technology.  To do this, we’re speaking with Martien Strik. Martien is a critical care nurse with more than 13 years of experience in the clinical and prehospital field, and 8 years of VR experience in TactileVR. The CEO of Tactile VR, Will Kirkpatrick is also a critical care nurse with 5 years of experience and is the Founder/CEO of TactileVR. You can find the product here:https://tactilevr.com/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/⁠

Delirium is a common and often under-recognised condition among older adults, particularly during emergencies.It can be triggered by a range of factors, including infections, dehydration, medications, or underlying chronic conditions, and presents significant challenges for pre-hospital and hospital providers alike.In this episode, we’ll explore the unique hurdles faced when caring for elderly patients experiencing cognitive changes. From understanding the impact of sensory impairments on communication to distinguishing between delirium, dementia, and other states of confusion, we’ll discuss practical strategies to improve assessment and care delivery. We’ll also highlight the critical role empathy plays in building trust with patients and their families during these vulnerable moments. We’ll dive into how pre-hospital and hospital teams can align to address the root causes of delirium and ensure continuity of care. Ethical dilemmas and family dynamics will also be explored, as well as proactive measures to prevent delirium in at-risk patients. Join us as we unpack these challenges and uncover solutions that prioritise dignity, safety, and quality of life for elderly patients. To do this we’re joined 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.Links to Validation Theory can be found here:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001394/abstractLinks to the GRIFT Triple Assessment can be found here: https://sean9n.wordpress.com/2023/05/23/a-short-story-of-geriatric-medicine-cfs-4at-news/This is a paid advertisement from BetterHelp.In the high-pressure world of pre-hospital care, having a strong support system is essential. Whether you're a frontline responder, medical professional, or someone navigating life’s challenges, therapy can provide valuable tools to help manage stress, build resilience, and improve mental well-being.BetterHelp is the world’s largest therapy service, connecting people with licensed mental health professionals through video, phone, and messaging—accessible anytime, anywhere. With over 5,000 therapists available in the UK, you can find the right support for your needs.Build your support system with BetterHelp.Our listeners get 10% off their first month at BetterHelp.com/CAREPODThis 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/⁠

Today, we dive into the concept of how Artificial Intelligence is revolutionising how we train for critical scenarios and indeed critical skills such as CPR. Traditional simulation-based training has long been plagued by challenges such as limited realism, high costs, and barriers to accessibility. But now, advancements in AI, particularly through ChatGPT's new Advanced Voice Mode (AVM), are offering transformative solutions. By simulating patient interactions with emotional depth and natural conversational flow, AVM promises to bring an unprecedented level of realism and inclusivity to medical training. In this episode, we’ll explore the technology's potential to modernise education for both trained and untrained medical responders. We'll discuss how AVM can enhance older manikins, relieve trainers from multitasking, and deliver just-in-time learning opportunities. We’ll also tackle challenges like minimising AI errors and mastering prompt engineering.Join us as we unpack how tools like ChatGPT are shaping the future of medical simulation, making training more dynamic, equitable, and effective for healthcare providers worldwide. Please find the attached; Shaping the future of simulator interactions: The role of ChatGPT’s Advanced Voice Mode: https://www.resuscitationjournal.com/article/S0300-9572(24)00827-X/fulltext 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 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/⁠