Pre-Hospital Care Podcast

In this episode, we explore the history and development of ECG algorithms with a leading expert in the field. We'll cover the early days of ECG interpretation, the hurdles in creating automated algorithms, and how this essential technology has evolved. Our guest, with decades of experience, will discuss his role in establishing an ECG Core Laboratory for clinical trials and epidemiological studies. We'll also look at the globally used Glasgow ECG algorithm, which aids thousands of clinicians in interpreting 12 lead ECGs. Joining me is Professor Peter Macfarlane, Emeritus Professor and Honorary Senior Research Fellow at the University of Glasgow. His team's work, including the Glasgow ECG interpretation program, is renowned worldwide. Peter's research has focused on ECG variations across age, gender, and ethnicity, influencing international guidelines for diagnosing acute myocardial infarction. He founded an ECG Core Laboratory for both national and international clinical trials and studies. A Fellow of the Royal Society of Edinburgh, Macfarlane received a DSc in 2000, the 1998 Rijlant International Prize in Electrocardiology, and a CBE in January 2014 for his contributions to healthcare. to see more on the Glasgow ECG Program Research, see here: https://www.gla.ac.uk/schools/healthwellbeing/research/robertsoncentreforbiostatistics/electrocardiology/glasgowecgprogram/ Some of the publications mentioned in the interview can be seen here: https://www.sciencedirect.com/science/article/abs/pii/S0022073606000628 https://www.gla.ac.uk/schools/healthwellbeing/research/robertsoncentreforbiostatistics/electrocardiology/publications/#clinicaltrialsandstudies This podcast is sponsored by Wel Medical. Wel Medical are a leading provider of life saving medical equipment. Known for their cutting-edge defibrillators, including the widely trusted iPAD SP1, Wel Medical is dedicated to making emergency tools accessible in public spaces, schools, and businesses. Their defibrillators are designed for ease of use, with clear voice prompts and visual aids, empowering anyone to help in a cardiac emergency. Wel Medical also offers a comprehensive range of first aid supplies and provides expert training, ensuring that organizations are well-prepared for any emergency. With a strong focus on customer support, they are passionate about helping people feel confident in saving lives. Tune in to learn how Wel Medical is making a difference in emergency preparedness. For more information, visit welmedical.com and discover how you can make your environment and workplace safer today.

Cliff Reid, a physician with over 20 years in air ambulance and critical care, shares his expertise on Front of Neck Access (FONA) and the SALAD technique. He discusses the complexities and risks of FONA, especially for vulnerable patients like infants. The conversation reveals practical insights on mastering SALAD for contaminated airways using specialized techniques. Reid also emphasizes the importance of teamwork, effective feedback, and mindset shifts in emergency airway management, demonstrating how real-life scenarios influence critical decision-making.

In this conversation, we will examine the second part of the conversation with Krissie Stiles. In this episode, we look at the pain management, cooling, and safe transportation of burns. We then examine the complications, prevention strategies, coordination with burn centres, psychological impacts on patients and families, and continued care and rehabilitation in the conversation. We finally look at the training requirements, quality improvement processes, and memorable or challenging cases that our guest have treated and attended. As we delve into various aspects of pre-hospital burn care, from initial management to long-term outcomes, highlighting best practices, advancements, and real-world experiences.  To do this I am joined by Kristina Stiles. Kristina is a nurse with burns and plastic surgery qualifications since 2003 and an MSc in Burn Care since 2019. She has led quality improvement projects developing Clinical Practice Guidelines and patient information initiatives. Kristina founded the British Burn Association’s Pre-Hospital Special Interest Group, collaborating across various specialities. Her award-winning projects include "The Burns Game," "Family Oops and Burns First Aid," and the "Saving Lives is Not Enough" report. An advocate for patient voices, she has received awards for "Outstanding Patient Care," "Innovation in Care," and "Effective Burn Care," and is an Ambassador of the Children's Burns Trust. Here are the links to the burns charities: https://katiepiperfoundation.org.uk/https://dansfundforburns.org/https://cbtrust.org.uk/ For support for burn survivors:https://adultburnsupportuk.org/ Family Oops book:https://youtu.be/n7aDyugYJOM?si=l-h2d2dhdVB80g66https://cbtrust.org.uk/learning-zone/the-family-oops-and-burns-first-aid-ebook/ - Available for free on request from info@cbtrust.org.uk, but Krissie appreciates a donation in return. EMSB Course:https://www.britishburnassociation.org/emsb-courses/ 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 conversation, we will explore the key aspects of burn care, beginning with the prevalence, causes, and classification of burn severities. We'll dive into understanding the physiological responses to burns and the potential complications that can arise, ranging from infections to organ failure. Emphasising evidence-based management, we will discuss the critical priorities in burn care, including initial assessment, fluid resuscitation, airway management, pain control, and cooling, followed by safe transportation to specialised facilities. As we move forward, we'll examine the potential complications that burn patients face, such as shock, infections, and long-term scarring. We'll also highlight prevention strategies to reduce the occurrence of burns and the importance of coordinated care with burn centres. The psychological impacts on patients and their families, which can be profound and long-lasting, will also be a focus, as well as the continuum of care that extends from the acute phase to rehabilitation and reintegration into daily life. Additionally, we'll discuss the training requirements for healthcare providers in burn care, and the ongoing quality improvement processes in this field, and reflect on memorable or particularly challenging cases that our guest, Kristina Stiles, has encountered in her extensive career. Kristina Stiles, who joins us for this conversation, is a highly experienced nurse specialising in burns and plastic surgery since 2003, with an MSc in Burn Care attained in 2019. Kristina has played a pivotal role in developing Clinical Practice Guidelines and patient information initiatives aimed at improving the quality of care. She is the founder of the British Burn Association’s Pre-Hospital Special Interest Group, where she has worked collaboratively across various specialities to enhance pre-hospital burn care practices. Her contributions to the field are noteworthy, including award-winning projects such as "The Burns Game" and the "Saving Lives is Not Enough" report, both of which have had a significant impact on burn care practices and patient outcomes. Kristina is a staunch advocate for patient voices in healthcare and has received numerous accolades, including awards for "Outstanding Patient Care," "Innovation in Care," and "Effective Burn Care." In addition to her professional achievements, Kristina serves as an Ambassador of the Children's Burns Trust, further demonstrating her commitment to improving the lives of burn patients and their families. Through this discussion, we aim to provide a comprehensive overview of pre-hospital burn care, from initial management strategies to long-term outcomes, while also highlighting best practices, recent advancements, and real-world experiences that shape the field today. 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 delve into the surge in alcohol consumption during the pandemic, the rise of digital health innovations in addiction treatment, and the crucial role of medication in supporting recovery. Alcohol misuse costs the NHS in England approximately £3.5 billion annually, covering hospital admissions, treatments, and A&E visits related to alcohol-related issues. With over 1.1 million hospital admissions yearly linked to alcohol consumption, emergency services face a significant strain. Alcohol-related liver disease stands as a major cause of mortality, with substantial NHS spending on treatment. The burden extends to mental health services treating co-occurring conditions, while indirect costs like productivity losses are estimated at £7 billion annually. Public health campaigns and social care services further compound the financial load on the NHS and society. Join us as we welcome Jonathan Hunt-Glassman, a leading advocate for innovative approaches to treating alcohol use disorder. As the Chief Executive Officer & Co-Founder of Oar Health, Jonathan champions medication-assisted treatment and the concept of moderation as a legitimate recovery goal. Through his personal journey and professional insights, Jonathan offers a fresh perspective on managing alcohol misuse and exploring paths beyond traditional sobriety. His expertise and experience promise valuable information and inspiration for anyone invested in understanding and addressing alcohol use disorder. You can find more resources on Alcohol Use Disorder (AUD) see here: https://www.oarhealth.com/resources/alcohol-misuse-and-alcohol-use-disorder Oar health can be found here: https://www.oarhealth.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/⁠

In this episode, we review the historical literature around spinal trauma, the actual prevalence of spinal trauma, and guidelines from RCSEd, NICE, NEXUS, and Canadian C spine rules. Critical Care Paramedic Jim Walmsley, with 19 years of experience at South East Coast Ambulance Service NHS Foundation Trust, joins us to discuss the cultural and clinical evolution of spinal immobilisation. Topics include pre-hospital assessment, treatment decisions, and the latest recommendations. We also examine key cases demonstrating the effective application and share final thoughts and key takeaways. The guidelines and recommendations we discuss can be found here: FPHC: https://fphc.rcsed.ac.uk/media/1764/pre-hospital-spinal-immobilisation.pdf NEXUS Guidelines: https://radiopaedia.org/articles/nexus-criteria Canadian C Spine rules: https://emedicine.medscape.com/article/2172522-overview?form=fpf NICE Guidelines: https://www.nice.org.uk/guidance/ng41/chapter/recommendations The EXIT Project: https://theexitprojectcouk.wordpress.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/⁠

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/⁠