Pre-Hospital Care Podcast

In this conversation, we will examine the role of TRiM (Trauma Risk Management). This is a trauma-focused peer support system designed to assist individuals who have experienced traumatic or potentially traumatic events. In the UK Armed Forces, TRiM is based on the principle of "active monitoring," where trained non-medical personnel, known as TRiM Practitioners, keep a watchful eye on those exposed to trauma. These practitioners are not counsellors or therapists but are trained to understand the effects of trauma, maintain confidentiality, and provide practical advice. They are skilled in spotting signs of distress, conducting TRiM assessments and planning meetings, and directing individuals to appropriate support if needed.   To do this I am joined by Lucy Gough. Lucy is no stranger to the podcast and has joined me previously to talk about her experiences through the pandemic as an Emergency Medical Dispatcher. Lucy is a senior LINC worker and trained TRiM practitioner as well as an Emergency Medical dispatcher. In this episode, we explore Lucy’s role as a senior LINC worker and TRiM facilitator for EMS staff. We discuss mental health challenges, support strategies, and the implementation of TRiM after traumatic events. We also discuss the stigma around seeking help, success stories, and the future of mental health support for frontline workers in high-stress environments. To learn more about TRiM, see here: https://en.wikipedia.org/wiki/Trauma_risk_management

Today, we're diving into a crucial tool that has recently been released by GWAAC for emergency personnel: the STAB5 mnemonic. This simple yet powerful framework is designed to guide staff through the complex and often chaotic scenarios of penetrating trauma they face in prehospital care. The STAB5 pneumonic helps ensure that nothing is overlooked within penetrating torso injury, and that care is delivered as effectively and efficiently as possible with the reduction of time on scene also in focus. In this episode, we’ll break down each component of the STAB5 mnemonic, exploring its real-world application and hearing from the authors who have designed it. From scene safety to haemorrhage control, we’ll uncover how this mnemonic can be a lifesaver—not just for patients but for the pre-hospital teams that work tirelessly to save them. Please find the tool here: https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-05048-1

In this episode, we explore the evolution and achievements of Scotland's Emergency Medical Retrieval Service (EMRS), a lifeline for critically unwell patients in rural and remote areas. The EMRS, established in 2004, has transformed emergency care in Scotland, expanding its reach nationally in 2010 and opening a second base in Aberdeen in 2019. This service operates within the Scottish Specialist Transport and Retrieval (ScotSTAR) division of the Scottish Ambulance Service, providing vital pre-hospital critical care and retrieval services. Our discussion today centres around a comprehensive retrospective cohort study covering the first decade of the EMRS’s national service. We'll examine key findings, including the significant number of taskings, the crucial role of geospatial modelling in reducing transfer times, and the service’s targeted support for socio-economically deprived areas. We will delve into the critical factors associated with clinical deterioration and pre-hospital mortality and learn how the EMRS addresses these challenges. We'll also explore the future directions for the service and its ongoing efforts to improve emergency medical care and address health inequalities across Scotland. The paper that Ryan mentions in the interview on: Equity in the provision of helicopter emergency medical services in the United Kingdom: a geospatial analysis using indices of multiple deprivation can be found here: https://sjtrem.biomedcentral.com/articles/10.1186/s13049-024-01248-4

Part 3 in the Trauma Series: In this session, consultant neurosurgeon Mark Wilson discusses the fundamentals of head injury, focusing on brain injury, primary and secondary injury, venous drainage, and optimising pre-hospital management. Mark, a specialist in acute brain injury at Imperial College and an Air Ambulance doctor, shares insights from his extensive experience, including work overseas and co-founding GoodSAM, an emergency alert platform. The episode covers TBI vs. NTBI pathology, the accuracy of pre-hospital diagnoses, the role of doctor/paramedic teams, pre-hospital anaesthesia, and the importance of early intervention. Mark also shares a seminal case and key take-home messages. 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 podcast episode, we explore critical topics that significantly impact maternal and neonatal outcomes, with insights shared by Camella Main, a Consultant Midwife with over 12 years of experience. Camella has extensive experience in both hospital and pre-hospital settings, managing high-risk pregnancies and deliveries. She serves as the Lead Midwife for the London Ambulance Service and a Consultant Midwife for East Midlands Ambulance services, emphasising evidence-based practices and improving outcomes. Key discussion points include the latest guidelines and best practices for neonatal care, especially in rural and remote settings. Emerging trends and strategies to optimise neonatal care are also covered. Camella addresses various challenges in providing pre-hospital care to pregnant women and newborns, highlighting the importance of proper thermal care for newborns immediately after delivery. Recommended techniques and equipment for neonatal thermal care are discussed. Further, the podcast delves into recognising key signs and symptoms indicating active labour and imminent birth, effective maternal positions for delivery, and critical steps to care for both mother and newborn immediately after delivery. Camella also discusses the importance of escalating care to critical care teams, considerations for the safe transportation of pregnant women and newborns, and collaboration between pre-hospital services and hospitals to optimise care. Emerging trends and research areas in pre-hospital maternal and neonatal care that show promise for improving outcomes are also explored.

This is the second in the four-part series on anatomical trauma with some of the world's leading experts in specialist pre-hospital care. In this episode, we are examining pelvic trauma. In this discussion, I speak with Ash Vasireddy, a fellowship-trained Orthopaedic Trauma Surgeon at King’s College Hospital, London, specialising in complex fractures. We explore the critical nature of pelvic trauma, covering topics such as pre-hospital prevalence, injury classification, and management strategies, including REBOA's potential in air ambulance services. In the conversation, Ash shares insights from his extensive experience, including training at major trauma centres in the UK and the US. We also discuss pre-hospital assessment, common issues in orthopaedic trauma, and lessons from practice, concluding with key take-home messages and a review of pelvic fracture classifications.  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 chat with Alex Mair, a paramedic who qualified in 2022 after studying in Australia. Alex discusses her journey of starting her career in Australia and continuing it in the UK, far from her home and support systems, and goes on to share insights into the challenges she has faced both clinically and holistically. She highlights the key differences between pre-hospital ambulance paramedicine practices in the UK and Australia, offering valuable lessons she has learned from both systems. Alex reflects on the balance between support and autonomy for newly qualified paramedics (NQPs) in the UK and whether it is conducive to their development. She shares her most profound personal reflections from working in the UK and suggests improvements to address burnout in pre-hospital care. We delve into Alex's podcasting journey as the host of the Student Paramedic Podcast. She reveals what inspired her to start the podcast, how it has evolved, and how managing it has enriched her paramedic practice. Please check out her fantastic podcast here: https://podcasts.apple.com/us/podcast/the-student-paramedic-podcast/id1538672787 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/⁠

This is the first in the four-part series on anatomical trauma with some of the world's leading experts on specialist pre-hospital care. In today's episode, we delve into the complexities of assessing and treating thoracic injuries in pre-hospital care. We'll cover a range of topics, including pneumothorax, haemothorax, and flail chest. Our discussion will span the primary and secondary survey, airway management considerations, and the efficacy and evolution of modern interventions such as needle decompression. To bring these concepts to life, we'll examine real-life cases that highlight the challenges faced by healthcare professionals in the field. Joining me is Geoff Healey, a distinguished Prehospital and Retrieval Physician with Sydney HEMS. Geoff also serves as a Consultant Anaesthetist at Royal North Shore Hospital in Sydney and the Deputy Medical Manager for Sydney HEMS. With extensive experience in Australia's and the UK's Prehospital and Retrieval Systems, Geoff brings invaluable insights into our conversation. Additionally, he is an active member of the NSW Taskforce Urban Search and Rescue Team and has been deployed on numerous humanitarian missions worldwide. We unpack the intricacies of thoracic trauma management in pre-hospital settings, guided by Geoff's expert knowledge and frontline experiences.

In today's episode, we'll explore some of the key resources around breaking bad news and innovative approaches to building compassionate systems and individuals. Our guest shares her insights on the latest trends and best practices in breaking bad news and treatment of PTSD. We also explore some of the key resources available on EmergencyResilience.com, including Alex's organic story, breaking bad news and the fundamental elements of how to do this well. We also examine PTSD and the use of ketamine therapy based on Alex's PhD thesis. Alexandra Jabr is an accomplished emergency medical professional, educator, and advocate for mental health and resilience among first responders. With a career spanning over two decades, Alexandra has dedicated her life to the service of others, specialising in EMS and paramedic training. Her extensive experience in the field, coupled with a Master's degree in Mental Health and Wellness with an emphasis on Grief and Bereavement in first responders. Her PhD focussed on the use of Ketamine integrative therapy to treat PTSD in Firefighters. In addition to her fieldwork, Alexandra is a passionate educator, teaching numerous EMS courses that prepare the next generation of emergency responders with practical, real-world knowledge. She is also a prolific writer and speaker, contributing regularly to industry publications and websites like EmergencyResilience.com. Her work emphasises the importance of resilience, not just in physical preparedness but also in mental health and emotional endurance. 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/⁠

Tracy Nicholls, Chief Executive of the College of Paramedics, joins us in this episode. With over 25 years of experience, Tracy has significantly influenced the evolution of Paramedicine, from her early days as a paramedic to becoming the first registered paramedic on an NHS Trust Board of Directors. This conversation delves into the advancement of paramedicine over the last decade, the College of Paramedics' journey toward Royal College status, and the pressing issue of handover delays. We also explore the Paramedic Wellness Programme, the importance of International Paramedics Day, and the College's relationship with the HCPC. Mental health, especially its increasing focus in recent years, is also a key topic. Join us as we explore the past, present, and future of the paramedic profession.