Join the journey through the highs and lows of prehospital critical care. Discover the nuances of decision-making under pressure and learn to prioritize tasks effectively. Leadership evolves through emotional intelligence and team dynamics, enhancing collaboration in critical scenarios. Explore how guidelines and evidence-based practices shape quick, informed interventions. Plus, reflect on the balance of self-reflection and its potential pitfalls in clinical growth. This insightful conversation is rich in strategies for both new and seasoned clinicians.

A really strong line up of papers to bring this year's evidence round up to a close! First up we take a look at a paper evaluating the utility of pulse oximetry (along with several other diagnostic tests) in identifying vascular injury following trauma, a really interesting look at an approach we didn't know much about. Next up we run through PARAMEDIC-3, a huge RCT looking at the best vascular access strategy for patients in cardiac arrest, will the result of this paper change our approach? And finally we look at a paper focussing on intubation success rate in US EMS services according to intubation rate. Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Motor vehicle collisions or road traffic collisions are a massive problem worldwide. Data from the World Health Organisation reports that there are around 1.2 million deaths every year and this is the leading cause of death internationally for children and young adults aged 5-29 years.  In the UK there are around 1,500 deaths annually and also around 60,000 patients with significant and life changing injuries, which is 7 patients every hour!! So anything we can do to improve patient care following an MVC is definitely a worthwhile venture. We’ve looked at Extrication here on the podcast before but we’re back on it again because today the Faculty of Pre Hospital Care have released their Consensus Statement on Extrication Following a Motor Vehicle Collision.  The statement builds on the work from the EXIT project and the research that has helped inform our understanding of multiple factors of extrication. The statement will inform a change of practice for both clinicians and non-medical responders and in this episode we run through the statement with two of it’s authors and discuss the practical applications. Make sure you take a look at the new Consensus Statement itself and the background evidence which is all linked to on the website. Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

Dive into the latest research on post-resuscitation pneumothorax, revealing that around 11% of patients may be affected after CPR. Explore the complexities of diagnosing vertigo with a new clinical risk score that aims to improve patient assessment in the emergency department. Lastly, the discussion tackles the challenges of pre-alerts and the need for better communication between emergency services and departments, highlighting the importance of streamlined processes for optimal patient care.

Dive into the intriguing world of adrenal insufficiency and crises! Discover how cortisol regulates our wellbeing and the complexities of diagnosing adrenal issues. The conversation sheds light on recent guidance to improve awareness and management, as well as practical strategies like 'sick day rules' for those on steroids. Learn about critical management steps in emergencies, including key interventions for hypotension and the importance of collaboration with endocrinology teams. This is a must-listen for anyone interested in enhancing patient care!

Tom Roberts, an Emergency Medicine Registrar and collaborator on the SHED study, dives into the critical world of subarachnoid hemorrhage diagnosis. He discusses how non-invasive blood pressure readings can mislead in pre-hospital settings, raising important clinical questions. The conversation also explores the SHED study's findings on CT scan accuracy for SAH detection and the vital role of naloxone in improving outcomes during out-of-hospital cardiac arrests. It's a captivating blend of research insights and practical implications for emergency medicine.

Dive into the critical world of pulmonary embolisms, where early recognition can save lives. Discover the complexities of diagnosis, including risk factors and the intricate role of scoring systems like PERC and WELL. Learn how to navigate treatment options in emergencies and address unique challenges, such as those faced by pregnant patients. The podcast also highlights the importance of ongoing management and prevention strategies that ensure effective patient care. Join the hosts as they unravel the fascinating evidence behind pulmonary embolism!

This month's discussion dives into groundbreaking research on dual sequential defibrillation, focusing on how shock interval timings can improve outcomes for patients with refractory ventricular fibrillation. The hosts also tackle the best prognostication tools for upper GI bleeds, analyzing their effectiveness in clinical settings. Lastly, the potential risks associated with tranexamic acid use in trauma patients are evaluated, highlighting concerns over venous thromboembolism and the discrepancies in clinical practices across countries.

The discussion kicks off with insights on the UK REBOA trial, diving into its questionable benefits for trauma patients compared to standard care. There’s an intriguing look at dual sequential defibrillation methods for treating refractory VF, especially in obese patients, and how they stack up against traditional techniques. Finally, the potential of video livestreaming from medical scenes is explored, examining how it might improve dispatch accuracy and resource allocation in emergency situations. It's a blend of science and innovation!

Exploring the complexities of Acute Kidney Injury (AKI) from anatomy and physiology, etiologies, diagnosis, and management. Emphasizing the importance of clear definitions, fluid management, and comprehensive care. Decision-making for catheterization and strategies for treating AKI in hospitals are also discussed. A valuable episode bringing clarity to a complicated topic.