The St.Emlyn’s Podcast

Dive into groundbreaking research as the hosts discuss the Sub 30 feasibility study for pre-hospital ECMO, highlighting its rapid implementation challenges. They compare emergency anaesthesia practices between pre-hospital and in-hospital settings, uncovering variations in patient care. Learn about the effectiveness of physician-led pre-hospital teams and their potential impact on outcomes. The economic implications of advanced interventions in emergency care are also explored, alongside insights from the London Trauma Conference. Don't miss this eye-opening discussion!

In this special edition of the St Emlyn’s podcast, Iain Beardsell and Simon Carley review the top medical papers of 2024, originating from Simon’s talk at The Big Sick conference in Zermatt. The discussion includes a comparison of non-invasive versus arterial pressure monitoring, the association of intra-arrest arterial blood pressure with ROSC, the efficacy of serratus anterior plane blocks for rib fracture management, and the evaluation of a micro axial flow pump in cardiogenic shock. They also delve into double sequential external defibrillation in refractory out-of-hospital cardiac arrest and provide a rapid-fire review of additional critical papers discussed at the conference. Notable mentions include the HEMOTION trial, PRE OXI trial, BLING III, and PARAMEDIC-3, among others. A must-listen for those passionate about evidence-based medicine in emergency and pre-hospital care. You can read more about all the trials, including links to all the papers here (part 1) and here (part 2) 00:00 Introduction and Conference Highlights 01:51 Non-Invasive vs. Arterial Pressure Monitoring 03:28 Intra-Arrest Blood Pressure and ROSC 05:34 Serratus Anterior Plane Blocks for Rib Fractures 08:38 Micro Axial Flow Pump in Cardiogenic Shock 10:49 Double Sequential Defibrillation in Cardiac Arrest 13:17 HEMOTION Trial 15:01 PRE OXI and BLING III Trials 17:08 Fluid Management in Septic Shock 18:37 Expedited Transfer vs. On-Scene Resuscitation 20:39 Intraosseous vs. Intravenous Access 21:48 Conclusion and Final Thoughts

Peter Brindley, a physician and researcher, returns to discuss the intersections of social media, AI, and digital footprints in healthcare. He emphasizes the importance of an authentic online presence and the critical evaluation of information. Topics include the transformative role of AI in clinical decisions and the risks associated with misinformation. Brindley also introduces the intriguing concept of the Kardashian Index, highlighting the balance between public engagement and maintaining scientific integrity in today's digital landscape.

The hosts share exciting highlights from the IncrEMentuM 2025 conference, featuring innovative presentations and a vibrant atmosphere. They delve into the challenges of maintaining clinical skills, especially for rare procedures, and underscore the importance of diastolic blood pressure in effective cardiac resuscitation. Insights into resuscitative hysterotomy provide new perspectives on timing in emergencies. Additionally, they discuss the complexities of determining death in critical care settings, enhancing the understanding of vital decision-making in emergency medicine.

Richard Lyon, a distinguished emergency doctor and deputy medical director of the air ambulance service in Kent, shares his profound insights from the London Trauma Conference 2024. He delves into the vital role of structured debriefing and case reflection in improving clinical skills. Richard discusses how video recording can transform educational practices in emergency medicine, addressing ethical concerns while building trust. He also reflects on the challenges facing senior clinicians and emphasizes the importance of supportive environments for professional growth.

In a riveting discussion, Dan Dworkis, an ER physician and Chief Medical Officer at the Mission Critical Team Institute, dives into the pursuit of excellence in emergency medicine. He emphasizes the need for proactive growth, likening it to nurturing a rosebush. The talk highlights the importance of small changes that lead to big impacts on team dynamics and morale. Dan shares insights on maintaining a positive mindset under pressure and fostering resilience, making it essential for medical professionals striving for excellence.

Dr. Jeff Kerrie, an internal medicine physician specializing in dive and hyperbaric medicine, shares his expertise on the nuances of hyperbaric therapy. He explores the critical treatment protocols for decompression sickness, addressing the importance of timely intervention. The discussion covers the mechanics of hyperbaric chambers and highlights both the medical applications and the risks of unregulated uses. With a focus on patient safety, Dr. Kerrie emphasizes consulting certified professionals for effective hyperbaric treatments.

Mark Wilson, a Consultant Neurosurgeon and Air Ambulance doctor, shares his expertise at the London Trauma Conference. He discusses the impressive evolution of the GoodSAM app, initially designed for emergency responders but now utilized in various sectors, including police and public health. Mark highlights how the app employs real-time video guidance and AI to save lives during medical crises. He also covers its role during COVID-19 and invites listeners to engage in community volunteer efforts that enhance emergency response.

Caroline Leech, a Consultant in Emergency Medicine and expert in trauma care, discusses the pressing issue of moral injury in healthcare. She clarifies how moral injury differs from moral distress and outlines its three key mechanisms: acts of commission, acts of omission, and betrayal. Through compelling examples from emergency situations, Caroline highlights the emotional toll on responders and stresses the critical need for psychological support. The conversation shines a light on the healthcare system’s responsibility to address these issues for the well-being of providers.

The hosts discuss a randomized trial on early exercise for blunt chest trauma, revealing unexpected findings about recovery outcomes. They delve into new evidence regarding the long-term safety of intraosseous access in emergencies. The conversation shifts to updated imaging guidelines for pediatric trauma and the intriguing role of AI in healthcare. Key reflections on toxic alcohol poisoning and an exciting preview of upcoming medical conferences round out the discussion.