Pre-Hospital Care

In this episode, we explore “Leaving Room for Rougher Edges in EMS” by Radu Venter, a powerful reflection on perfectionism in paramedicine. Radu is a Flight Paramedic based in Canada. He challenges the unrealistic pursuit of flawless performance in an unpredictable, high-pressure environment and asks when “good enough” should truly be enough. We discuss how flexibility, honesty, and self-compassion can replace self-criticism, and how embracing imperfection can actually strengthen team culture and patient care. Join us as we explore the realities of being human in emergency medicine.Read the full article here: https://substack.com/home/post/p-116881333This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

In this episode, we delve into one of the most universal and often misunderstood experiences: grief. Whether it's supporting families after a sudden loss, witnessing trauma firsthand, or coping with personal emotional impacts, grief is an ever-present companion in pre-hospital care.Joining us is Liz Gleeson, a highly respected psychotherapist, educator, and specialist in grief. Liz is the creator of the internationally acclaimed Shapes of Grief podcast and training program, and she lectures widely on grief and loss. With a background in somatic therapies and a PhD in progress on Forest Therapy and bereavement, Liz brings a compassionate, embodied, and deeply informed perspective to the conversation.We'll explore key models of grief, including Kübler-Ross's Five Stages, the Dual Process Model, Attachment Theory, and Continuing Bonds. We'll also discuss the art of listening, cultural competence, caregiver compassion and burnout, and ethical challenges in grief support. This conversation is for anyone navigating the emotional complexities of pre-hospital work and seeking ways to respond with presence, professionalism, and care in moments of profound human vulnerability. You can find Liz's podcast "Shapes of Grief' podcast here: https://podcasts.apple.com/gb/podcast/shapes-of-grief/id1450116449This is Liz's website, where further training on grief can be found: https://shapesofgrief.com/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life. PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

In this audio blog, Carl Betts employs the analogy of a traditional dry stone wall to explain the principles of healthcare improvement. Carl suggests that just as these walls rely on the careful placement and interconnection of unique stones without mortar, healthcare systems depend on the relationships between processes, people, and policies. A key point is that a single failure or "slippage" in either the wall or the system can cause a cascading disruption. The blog advocates for a thoughtful approach to improvement, stressing that rebuilding requires assessment and learning rather than simply replacing components. Ultimately, the source frames the dry stone wall as a blueprint for success in healthcare, emphasising connection, resilience, and the value of incremental progress.This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

In this episode, we're diving into the journey of Zoe Boswell, a dedicated paramedic, mother, and community volunteer with the Great Western Air Ambulance Charity (GWAAC). Zoe brings over a decade of experience as a road paramedic, all while balancing the demands of family life and volunteering with the GWAAC Heartstarters program.Zoe's story is a powerful example of resilience, progression, and passion within the pre-hospital care world. Her ability to manage complex clinical challenges on scene, train at an advanced level, and still give back to the community through CPR education speaks volumes about her commitment to the profession.In our conversation, we explore her motivations, her aspirations from road to critical care paramedic, the emotional impact of high-acuity cases, and the unique perspective she brings as a parent working on the front line. Whether you're a student paramedic, a seasoned clinician, or just curious about the realities of life on the HEMS pathway, Zoe's insights are both inspiring and deeply grounded in the realities of modern pre-hospital care. Let's dive into this episode with Zoe Boswell.This episode is brought to you by IndieBase.IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

This blog podcast unpacks an article titled "Beyond the Summit: Why Human Factors and Crew Resource Management Matter in Expeditions," written by Ryan Atkinson on 22 September 2025. Ryan asserts that while competence and experience are crucial for expeditions, human factors (HF), the psychological, social, and organisational influences on performance are often the difference between success and disaster. Ryan highlights that stressors like fatigue, ambition, and cognitive biases like Groupthink and Social Proof amplify risk in extreme environments, citing the Tunnel Creek avalanche as an example. To mitigate these risks, the author advocates for the adoption of Crew Resource Management (CRM), an aviation-inspired safety framework focusing on practices like closed-loop communication, checklists, shared situational awareness, and flattened authority gradients. Ultimately, successful expedition teams must evolve from fragile flash teams into structured evolved teams that prioritise collective safety through understanding human limitations and working together. You can read Ryan's blog here: https://ryanatkinson.tv/2025/09/22/beyond-the-summit-why-human-factors-and-crew-resource-management-matter-in-expeditions/

Today, we're diving into one of the most challenging scenarios any EMS provider faces: paediatric cardiac arrest. The figures are challenging, with only a 4.9% survival rate for infants and neurologically intact survival rates as low as 1-4% nationally. These calls have long been considered to have poor outcomes.But what if I told you that one fire department completely rewrote the playbook and achieved neurologically intact survival rates of 46%? What if they did it by breaking conventional rules and staying on scene longer, not shorter?Today, we're joined by Medical Director Paul Banerjee from Polk County Fire Rescue in Florida, where they've transformed paediatric cardiac arrest outcomes through changing the protocols that challenge everything we thought we knew about pre-hospital resuscitation. From their "NO/NO/GO" dispatch system to permissive hypercarbia post-intubation, from mechanical CPR to aggressive on-scene airway management, Polk County has proven that with the right approach, we can dramatically improve outcomes in this patient cohort. *** Please note, this podcast is for information purposes only. You must stay within your scope and remit of practice and service SOPs at all times ***This podcast is sponsored by BlueRoomXRWhen lives are on the line, training needs to feel real. That's where BlueRoom comes in, the world's most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn't the future of training; it's training transformed.

This is the second audio blog, written by Dr. Will Duffin, detailing medical considerations and avoidance techniques for leeches, bullet ants, and mosquitoes, which are common threats in tropical environments. This guide provides practical advice on managing bites and highlights the importance of malaria prophylaxis and insect repellent for effective expedition planning. You can read the blog here: https://worldextrememedicine.com/blog/jungle-medicine-posts/jungle-survival-guide/World Extreme Medicine has given kind permission to use this blog post.This podcast is sponsored by BlueRoomXRWhen lives are on the line, training needs to feel real. That's where BlueRoom comes in, the world's most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn't the future of training; it's training transformed.

In today's episode, we're exploring the evolving role of women in Helicopter Emergency Medical Services (HEMS) and pre-hospital critical care, inspired by insights from Critical Care Doctor Sophie MacDougall. Sophie highlights both the unique challenges and the incredible rewards that come with working in this demanding, fast-paced environment, one that remains largely male-dominated but is gradually becoming more diverse.We'll hear from guests who share their journeys into HEMS and air ambulance work, reflecting on what the job gives back to them every day and how they have navigated their career paths within GWAAC. From overcoming barriers and difficult moments to the importance of mentors, whether male or female, our guests reveal the critical lessons they've learned along the way.This episode also delves into the steps needed to encourage more women to join HEMS teams, breaking down stereotypes and showing that this field is not just a “men's world.” We'll discuss how initiatives like the GWAAC ‘Fem in PHEM' event are making a difference and how ongoing support and visibility can inspire the next generation of female critical care professionals.Whether you're a clinician, a student, or simply curious about pre-hospital care, this conversation offers valuable perspectives on resilience, aspiration, and inclusion in one of healthcare's most challenging specialties.This podcast is sponsored by BlueRoomXRWhen lives are on the line, training needs to feel real. That's where the BlueRoom Simulator comes in, the world's most advanced mixed-reality medical simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the side of a cliff, BlueRoom delivers pressure-filled environments without real-world risk.
With a Mission Control dashboard, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.
Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn't the future of training; it's training transformed.


This blog post, written by Dr Will Duffin, addresses the benefits of in-situ wilderness simulation training for medical professionals working in remote environments. Written by Dr. Will Duffin, this blog post unpacks his experience providing medical cover for the TV show Survivor to illustrate how practicing emergency scenarios on-site helps teams improve emergency management skills, foster team bonding, and 'battle test' equipment and processes before real incidents occur. The article explicitly links this training methodology to the World Extreme Medicine organisation, highlighting their range of specialised medical courses and academic programs focused on various extreme and remote settings like polar, space, and ocean medicine. Ultimately, the blog is an informative piece advocating for low-stakes, context-specific simulation training while simultaneously serving as a promotional tool for the organisation's educational offerings and conferences. You can read the blog here: https://worldextrememedicine.com/blog/extreme-medicine-posts/train-hard-fight-easy-the-benefits-of-in-situ-wilderness-simulation-training/World Extreme Medicine has given kind permission to use this blog post. This podcast is sponsored by BlueRoomXRWhen lives are on the line, training needs to feel real. That's where BlueRoom comes in, the world's most advanced mixed-reality training simulator. No bulky controllers or gimmicks, just your hands, your kit, and a level of immersion that places you straight into the mission. From the cockpit of a Blackhawk to the chaos of a combat zone, BlueRoom delivers pressure-filled environments without real-world risk.With Mission Control, instructors can shift conditions, change patient vitals, and dial up intensity instantly. And thanks to Garmin biometrics, the system even responds to your physiology in real time, adapting as your stress and heart rate rise.Born in Australia and now trusted across five continents, BlueRoom is redefining readiness for military, medical, and frontline professionals. This isn't the future of training; it's training transformed.

In pre-hospital care, paramedics regularly encounter patients with a wide range of mental health conditions. From anxiety and depression to psychosis and self-harm, the ability to quickly assess and manage these conditions is crucial in ensuring the best possible outcome for the patient. But how do paramedics navigate the complexities of mental health?In the field, where resources are limited and time is critical. In this episode, we explore the most encountered mental health pathologies in pre-hospital care, focusing on how paramedics assess, manage, and provide care for these patients under high-pressure circumstances. From acute anxiety attacks to bipolar disorder episodes, we discuss the unique challenges paramedics face when dealing with patients experiencing severe psychological distress.We'll also delve into the importance of collaboration between paramedics, mental health crisis teams, and other emergency responders (Multi-Disciplinary Team/MDT approaches). How do these teams work together to ensure a seamless care pathway for patients who may need urgent mental health support? This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

This is the second installment from Ryan Atkinson's blog post, "Let's talk about climate hypocrisy and carbon democracy…," which addresses the common accusation of hypocrisy faced by environmental activists. Ryan, a filmmaker focusing on conservation, acknowledges his own air travel, which contributes to global CO2 emissions, yet argues it is necessary for communicating and effecting systemic change. He frames such criticism as a personal attack designed to shut down debate, suggesting that living a perfectly non-hypocritical life within a carbon-dependent society is nearly impossible for those seeking to make an impact. Instead, he advocates for embracing perceived hypocrisy as a starting point for dialogue about climate change and the pervasive influence of the carbon economy. Ultimately, the blog champions the idea that individual actions, even imperfect ones, can contribute to larger structural change if they serve a greater purpose. You can read the blog post here: https://ryanatkinson.tv/2020/03/02/lets-talk-about-climate-hypocrisy-and-carbon-democracy/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Today, we are joined by Dr Celestine Weegenaar, the first female PHEM trainee at Great Western Air Ambulance Charity (GWAAC). Originally from Amsterdam and now firmly rooted in the South West of England, Celestine brings a wealth of experience from emergency departments across the region – and even from the skies of Australia, where she flew with LifeFlight.We talk about her journey into pre-hospital emergency medicine, what drew her to the field, and how she's navigating the challenges and rewards of her current role. From the adrenaline of high-acuity pre-hospital care to the quiet moments of learning and growth alongside GWAAC's critical care team, Celestine reflects on the reality of life as a trainee in this dynamic and demanding specialty.As the new Chair of the Pre-Hospital Emergency Medicine Trainees' Association (PHEMTA), she also shares her vision for increasing inclusivity in the field, breaking down barriers, and supporting more women to pursue careers in PHEM. Whether you're an aspiring critical care clinician or simply interested in the people behind the patch, this episode offers a personal and inspiring look into the life and values of a rising leader in pre-hospital care.This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Ryan Atkinson's "Local Loss in a Global Crisis" explores the disconnect between Western perceptions of climate change and its tangible effects on vulnerable communities, specifically in the Langtang Valley of Nepal. Ryan reflects on his personal carbon footprint and the ethical implications of his travels while witnessing the devastation caused by the 2015 earthquake, exacerbated by climate change. Ryan highlights the resilience and enduring spirit of the local people, who face immense challenges despite having contributed little to the global crisis. The piece ultimately underscores the profound impact of global environmental issues on local lives, compelling Ryan to advocate for these stories. You can read the blog post here: https://ryanatkinson.tv/2020/02/22/local-loss-in-a-global-crisis/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

Every year, thousands of lives are lost to suicide, and emergency responders are often the first line of support during these critical moments. In this episode, we explore the vital role that the London Ambulance Service (LAS) plays in suicide prevention and risk assessment. From the moment a call comes into the control room to the interaction on the frontline, paramedics are trained to recognise the signs of suicidal ideation and act quickly to prevent harm.We'll dive into the clinical and operational aspects of suicide risk management, discussing how paramedics assess high-risk patients and work alongside police, mental health crisis teams, and hospitals to ensure the best possible care. You'll learn about the collaborative efforts that help create a seamless response for those in the most vulnerable states, as well as the challenges involved in coordinating care across various agencies.This episode offers a candid look at the realities of suicide prevention in pre-hospital care and the steps that can be taken to save lives.

In this episode, we reflect on the article “Asking Why. Telling Stories. Owning Accountability” and its lessons for both the diving community and pre-hospital care. The piece explores how adverse events are too often met with blame and silence, when what's needed is open storytelling, systemic accountability, and visible learning. Drawing on three academic theses, the author argues for a shift from backward-looking, individual blame towards forward-looking, relational accountability approaches that foster trust, resilience, and safer systems.Barriers such as fear of reputational harm and legal concerns frequently stifle honest reflection. Yet, the article suggests that structured, context-rich narratives can create a culture of genuine learning and justice, allowing organisations to adapt and prevent future harm.For pre-hospital care, the parallels are striking. Just like in diving, providers face high-stakes environments where “first stories” may oversimplify, overlooking the complex contexts in which clinicians operate. Whether in remote environments, critical incidents, or everyday EMS work, learning requires moving past blame and toward systems thinking. Transparent communication, structured debriefs, and the courage to challenge norms are as vital to paramedics and pre-hospital teams as they are to divers and expedition leaders.By embracing this approach, telling richer stories, strengthening feedback loops, and redefining accountability, we can better support both patients and providers in the moments when things go wrong. Read the blog post here: https://www.thehumandiver.com/blog/asking-why-telling-stories-and-owning-accountability-lessons-for-divingYou can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025

Today, we're exploring some of the complexities of real-life palliative care cases that frontline staff have faced in practice. Joining me are four members of the London Ambulance Service's dedicated Palliative and End-of-Life Care Team: Karina Catley, Natalie Nabunya, Rowena Rickson, and Jodie Grace. Together, we'll examine real-life case studies that illustrate the unique challenges of caring for patients and their families during their final moments. From managing uncontrolled seizures in the community to supporting a family's cultural and spiritual wishes after death, these stories highlight the difficulties of decision-making when time is limited, documentation is incomplete, and emotions are intense. Along the way, we'll explore key principles such as the doctrine of double effect, the role of shared decision-making, and the importance of recognising dying in the field. We'll also discuss how clinicians can communicate compassionately, respect cultural values, and navigate the legal and public health frameworks that guide this care. This is a conversation about dignity, humanity, and the privilege of supporting people at the end of their lives, offering lessons for all of us working in pre-hospital care.

This episode dives into a critical article arguing that the diving industry too often fails to learn effectively from fatalities, not because of individual mistakes, but due to systemic shortcomings. It distinguishes between “first stories”, simple narratives that assign blame, and “second stories”, deeper explorations into context, drift from safety standards, and the normalisation of deviance.The tragic death of Linnea Mills is used as a case study, showing how multiple factors, equipment incompatibility, insufficient supervision, and the challenges of a remote location, aligned to create a disaster. Rather than focusing only on compliance or individual error, the article calls for a systems-based approach to safety: stronger feedback loops, better emergency preparedness, and a culture where speaking up about risks is encouraged.For divers, instructors, and responders, this also underscores the importance of effective pre-hospital care. Here are key resources:Divers Alert Network: First Aid & Emergency CareWHO: Prehospital Trauma Care SystemsNAEMT: Prehospital Trauma Life Support (PHTLS)EMS World: Best Practices in Prehospital CareBy combining systemic safety improvements with robust pre-hospital care readiness, the industry can better prepare for emergencies and reduce the likelihood of preventable tragedies.You can read the blog post here: https://www.thehumandiver.com/blog/we-don-t-learn-from-diving-fatalities-and-here-s-whyYou can contact Gareth Lock here: https://www.thehumandiver.com/contact-us-2025

Mental health crises are one of the most complex and sensitive challenges faced in pre-hospital care. The London Ambulance Service (LAS) plays a critical role in responding to these emergencies, from the moment a 999 call is made to frontline crews delivering urgent interventions. But how does the system work as a whole? How are these calls assessed in the control room, and what role do specialist paramedics and mental health professionals play in shaping patient outcomes?In this episode, we dive deep into Pre-Hospital Mental Health Response, exploring how the LAS manages real-time mental health incidents, the operational and clinical decision-making that happens behind the scenes, and the challenges of coordinating care across multiple agencies. We'll hear about the evolving role of mental health-trained paramedics, case studies of successful interventions, and the key lessons learned from high-risk situations.Joining us are colleagues from the London Ambulance Service Mental Health Team, who will share their experiences from both the frontline and the Emergency Operations Centre (EOC), giving us a full picture of how pre-hospital mental health care is delivered in one of the busiest ambulance services in the world.This episode is a deep dive into how mental health services are integrated and embedded within an ambulance service as a fundamental part of emergency care service delivery to the population. This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

This blog is a personal reflection from Advanced Paramedic Wayne Auton, who shares how he has recently embraced what he describes as a “position of yes.” This mindset involves being open and willing to accept opportunities as they arise, often at short notice, and focusing on the positive potential that each opportunity may bring. Wayne acknowledges that it is a fortunate position to be in, but one that has significantly transformed his outlook and boosted his overall positivity.For many years, Wayne found himself caught in a cycle of negative thinking. He often focused on what might go wrong, rather than what could go right. This tendency led to decreased confidence, increased caution, and a general reluctance to take risks. It was a mindset he found restrictive and disheartening.He reflects on how he used to default to worst-case scenarios, frequently overlooking the possible benefits of a situation. Research supports this pattern; negative events tend to be more intense and memorable because they require greater mental effort to process (Taylor, 1991). Recognising this has helped Wayne shift his focus. By choosing to say yes more often, he has created space for growth, confidence, and optimism.You'll also hear an AI-narrated summary of this blog, bringing Wayne's reflections to life through audio. You can read the blog here: https://wayneauton.blogspot.com/2021/03/say-yes-to.htmlThis episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

Today, we're diving into the high-stakes intersection of tactical medicine, crisis negotiation, and pre-hospital care with Eric Acevedo, a seasoned professional operating at the front lines of some of Virginia's largest emergency response operations. Eric brings a rare blend of experience across tactical EMS, hostage negotiation, and field-based crisis response, offering a unique perspective on how communication, psychology, and calmness under pressure can save lives.In this episode, we'll explore the foundational principles of crisis and the wider art of negotiation and how those same tools can be applied by EMS providers in their daily work, especially when it comes to de-escalating tense situations, communicating effectively with patients in distress, or persuading someone to accept lifesaving treatment.We'll also look at the human side of this work: emotional regulation, interdisciplinary collaboration, and lessons learned from real-world case studies where negotiation and medicine intersected in critical moments. This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

In this special series, we're bringing insightful and thought-provoking blog posts to life in audio form, exploring the human side of pre-hospital and emergency care. Today's piece reflects on Esprit de Corps, the pride, loyalty, and belonging that exists within high-performing teams, and how it is built, tested, and lived out in some of the most demanding environments.Wayne Auton reflects on a career spent in small, high-performing teams, from the Royal Marines to Search and Rescue to the Emergency Medical Retrieval Service (EMRS) in Scotland. Across these roles, one constant has been trust: the ability to rely on teammates, get the job done, and know that everyone has each other's backs.When asked recently about Esprit de Corps, it prompted reflection. Often associated with the military, it is more broadly defined as “a feeling of pride and mutual loyalty shared by the members of a group.” For the author, it is about belonging.As a Royal Marine, that sense of belonging was immediate. From day one of training, recruits inherit over 350 years of history and pride. The Corps was more than a job; it was a culture and a way of life. Paradoxically, it also provided psychological safety, acceptance, trust, and respect within a close-knit family.These bonds often form in vulnerability, particularly under threat. Research shows such conditions can strengthen Esprit de Corps across dangerous professions. The author recalls a helicopter mission where a suspected tail rotor failure forced the crew into emergency decision-making. They landed safely, closer than ever. That experience captured the essence of Esprit de Corps: resilience, unity, and unshakable trust forged in challenge. You can read the blog post here: https://wayneauton.blogspot.com/2021/03/espirit-de-corps.htmlThis episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at https://www.pax-bags.com/en/

In this episode of the Pre-Hospital Care Podcast, we're joined by Critical Care Practitioner Mike Palmer to explore the evolving role of ultrasound in trauma care outside the hospital setting.We dive into the realities of training, drawing on insights from a bespoke HEMS hybrid ultrasound program that bridges classroom learning with frontline application. Our discussion covers the translation of emergency ultrasound skills into the unpredictable pre-hospital environment, with a focus on simulation training, image recognition, logbook development, and internal image review. We explore how services are addressing the challenges of competency, governance, and quality assurance when deploying ultrasound in the field. We also tackle the practical and operational hurdles, how to obtain clear, actionable images in chaotic or resource-limited environments, manage the risks of false positives and missed diagnoses, and use ultrasound findings to guide critical decisions around triage and treatment.Finally, we hear personal and professional reflections from years of frontline experience. From the traditional model of “see one, do one, teach one” to knowing when it's better to keep the probe in your pocket, this episode offers real-world insights into the benefits, limitations, and evolving role of ultrasound in pre-hospital emergency care.This episode is brought to you by IndieBase.IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

In this episode, we speak with Carl, one of our podcast co-hosts, about his deeply reflective article, ‘Normal or numb – that is the question, but what is the answer!'  Carl shares the personal experience that inspired the piece, attending a call to a deceased patient, which triggered a cascade of questions about emotional detachment, coping strategies, and the long-term impact of repeated exposure to trauma in paramedicine.We unpack the central dilemma: are we becoming resilient or simply numb? Carl reflects on the gradual shift in his emotional responses and the silent build-up of stress that so many frontline clinicians experience. We explore how this detachment can protect us in the short term but risks leading to burnout, fractured personal lives, and professional disengagement.The conversation also delves into the importance of early recognition, peer support, and thoughtful leadership responses. Carl's reflections have also been transcribed into an AI-narrated blog post so that you can listen to his story word-for-word.This is a powerful and honest conversation about the emotional cost of the job and an urgent call to reflect before the pressure boils over.This episode is brought to you by IndieBase.IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers.Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

In this episode, we explore the expanding role of ultrasound in pre-hospital trauma care. Once limited to hospital settings, ultrasound is now a vital tool in frontline emergency response, helping clinicians make rapid, informed decisions on scene. We begin by unpacking the physics of ultrasound, how concepts like frequency and resolution influence what can be detected, from internal bleeding to lung collapse.Next, we get hands-on with practical applications. We'll cover probe selection and key sonographic indicators for conditions such as pneumothorax, haemothorax, and haemoperitoneum. Real-life case studies, including stab wounds, hangings, and traumatic cardiac arrests, highlight how ultrasound shapes critical interventions in the field.We'll also address essential questions around training: What level of skill is needed? How can we ensure ongoing competency? As pre-hospital ultrasound becomes more common, we must confront these challenges head-on.Finally, we'll examine the ethical and operational dilemmas posed by point-of-care imaging. When ultrasound findings support high-stakes decisions like performing a thoracotomy or ceasing resuscitation, what responsibilities do clinicians carry? Join us as we delve into the promises and complexities of ultrasound in pre-hospital trauma care. This episode is brought to you by IndieBase. IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers. Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

CarlBetts, a co-host of this podcast, authored a reflective piece titled "Where Critical Analysis Becomes Critically Unhealthy," published in 2023 in the College of Paramedics' Hindsight magazine. In this episode, we delve into Carl's motivations for writing the article and examine its central themes. The piece discusses how critical analysis, while an essential skill, can become counterproductive when it slips into harsh self-appraisal, leading to emotional disequilibrium and eroding clinician confidence.We unpack how debriefs and reflective practices must be thoughtfully structured to include both challenge and affirmation, creating space for growth without causing harm. Using real clinical examples, Carl helps illustrate where reflection can go wrong and how to avoid those pitfalls.We also discuss the importance of reframing difficult experiences to support a net positive impact on clinicians, and how critical feedback, whether from oneself or others, can be damaging if not delivered constructively. The episode outlines practical strategies, including reframing techniques, to make reflection a healthier, more sustainable process.To bring Carl's insights to life, we've transcribed his original article into an AI-narrated blog post, allowing you to listen to the word-for-word reflections from his piece, offering another way to engage deeply with his message. This episode is brought to you by IndieBase. IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers. Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

Today's episode dives into lived experience with cystic fibrosis through the remarkable journey of Paul  Butler. Diagnosed at two and warned he wouldn't reach twenty. Paul's childhood revolved around twice-daily chest physiotherapy, three-daily nebulisers, and a mass of hospital admissions for infections that chipped away at his fragile lungs. By his late teens, the odds felt fixed: average life expectancy for CF hovered around 30, and Paul's lung capacity was already tumbling. Yet everything changed the day he cradled his newborn daughter, Amelia. Faced with a future he refused to miss, Paul overhauled his life, embracing rigorous medication adherence, evidence-informed nutrition, and a training regimen that turned a patient into a personal trainer who now deadlifts triple his body weight.At 45, Paul hasn't been hospitalised in seven years and views fitness not as vanity but as respiratory medicine performed in a gym. In this conversation, we ask: What mindset shifts sustain adherence when statistics feel fatalistic? And what can pre-hospital professionals learn about goal-setting, communication, and empathy from someone who quite literally trains to breathe? You can find Paul Butler on Instagram here: https://www.instagram.com/paulbutler.coach/?hl=enYou can find Paul's website here: https://paulspeakphysique.co.uk/given-just-weeks-to-liveYou can find the inspiration for this interview on the Grind Diaries Podcast here: https://podcasts.apple.com/gb/podcast/episode-16-paul-butler-the-personal-trainer-living/id1736072345?i=1000682838118This episode is brought to you by IndieBase. IndieBase is the smart, simple, and budget-friendly Electronic Patient Record (EPR) system designed specifically for the demands of HEMS and pre-hospital care. Whether you're responding solo, working within a flexible team, or managing care across a larger organisation, IndieBase is built to support you. It runs seamlessly on laptops, tablets, or smartphones, and crucially, it operates offline, ensuring you can document care wherever you are, even in the most remote environments. Developed from the proven platform of HEMSbase by Medic One Systems, IndieBase offers a familiar, intuitive interface with the rock-solid reliability clinicians need. It's ready for everything from festival medical cover to high-acuity critical care transfers. Key features include full integration with all major pre-hospital monitors, case review, and clinical governance modules, making it an ideal solution for teams preparing for CQC registration. A patient feedback module also helps drive service improvement and meaningful engagement. For clinicians working across multiple organisations, IndieBase provides a personal logbook that combines your data and links directly with your existing HEMSbase logbook.IndieBase EPR made simple, wherever you are.Find out more at https://indiebase.net/

In this episode, we dive into The PITT, a powerful new medical drama that lays bare the raw, unfiltered reality of life in the emergency department. This conversation serves as a commentary on an AI-generated adaptation of Dr. Sarah Spelsberg's original blog post, and it began with an interview. We first sat down with Sarah to gain deeper context and personal insight behind the post, ensuring that the AI-generated version remained true to her voice, values, and lived frontline experience.Sarah, a seasoned wilderness medic and co-host at World Extreme Medicine, shares how The PITT resonates with emergency clinicians by portraying the often-overlooked struggles of ED life, boarding crises, staff shortages, burnout, and the layers of bureaucracy that hinder care.Unlike polished hospital dramas like Grey's Anatomy or House, The PITT hits closer to home. It reflects the chaos and moral weight providers carry daily, and helps the public understand what really happens behind the scenes. Sarah explains how this visibility can build empathy, reduce aggression toward staff, and shift public expectations.She also reflects on how wilderness medicine re-centers her purpose, offering a stark contrast to hospital bureaucracy. Ultimately, this episode is both a tribute and a call to action for better systems, better support, and honest storytelling in healthcare. You can read the blog here: https://roguemed.medium.com/the-pitt-a-lifeline-for-emergency-medicine-providers-7ba1f8b2b045The PITT offers a raw and authentic look at the challenges confronting healthcare professionals in today's America, told through the experiences of frontline workers at a contemporary hospital in Pittsburgh, Pennsylvania. Watch The PITT here: https://www.primevideo.com/detail/The-Pitt/0ORZ2LIN9JTFLLUK8UKR33DZPXThis episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

Today's episode explores one of the most profound and humbling themes in medicine: what the dying and those who've been brought back to life can teach us about living.Dr. Matt Morgan is an intensive care consultant, researcher, and author of A Second Act, a book inspired by the hundreds of patients he's met who have crossed the threshold of death and returned. People like Ed, struck by lightning and left without a pulse, are revived through rapid, decisive pre-hospital action. These are the individuals Dr. Morgan believes we should be listening to, not influencers or business gurus, but those who've faced the thin margins between life and death and emerged with new clarity about what truly matters.In this conversation, we'll reflect on the emotional and ethical challenges of working in the fog between life and death, the importance of listening to survivors, and the critical role pre-hospital teams play in offering second chances. We'll also ask: how do we carry the weight of this work without losing our humanity? This is a powerful episode about perspective, purpose, and the lessons that only the brink of death can reveal. Matt's book 'A Second Act' can be found here: https://www.simonandschuster.co.uk/books/A-Second-Act/Matt-Morgan/9781398532335This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

In this series, we are bringing blog posts to life by interviewing the authors. Also, by generating AI audio conversations of the blog to make them accessible in audio format. I then summarise the audio in conclusion. We begin this episode by interviewing Dr. Sarah Spelsberg to add context and personal insight behind an AI‑generated adaptation of her latest RogueMed post, “Emergency Medicine and PTSD.” Through her reflections, we explore how repeated exposure to trauma profoundly affects emergency clinicians.Dr. Spelsberg describes how witnessing death, severe injury, suicides, resuscitations, violence, and patient suffering can lead to chronic stress and PTSD. She highlights that up to 14.6 % of emergency personnel experience PTSD symptoms, higher than rates in police or firefighters. The pressure of balancing life-or-death decision-making with systemic constraints crowded EDs, insufficient staffing, and administrative burdens amplifies emotional strain.Our discussion focuses on the emotional toll of moral injury, guilt, burnout, hypervigilance, flashbacks, insomnia, and emotional exhaustion that haunt providers long after their shifts end. Dr. Spelsberg emphasises that PTSD in emergency medicine isn't rare it's predictable under these circumstances and requires culturally appropriate recognition and care.We explore evidence-backed strategies: trauma-informed debriefs, peer support networks, access to psychological therapies like cognitive behavioural therapy and EMDR, and cultivating a culture that normalises seeking help. Dr. Spelsberg underscores that organisational change revamping shift patterns, enhancing supervision, and providing mental health resources is as crucial as individual resilience.By sharing lived experience and actionable solutions, this episode reframes PTSD not as a weakness but as an expected response needing compassion, systemic support, and meaningful action. You can access the blog this podcast is based on here: https://roguemed.medium.com/emergency-medicine-and-ptsd-e0841f945d55My thanks to Sarah Spelsberg for this interview as a co-host of The World Extreme Medicine podcast. This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

In this episode of the Pre-hospital Care Podcast, we explore a cutting-edge innovation that's transforming how HEMS clinicians are trained for high-stakes, life-saving procedures, such as thoracotomy, resuscitative hysterotomy, and other HALO interventions. We're joined by Jamie, founder of Maxres, and Lily, a Critical Care Doctor, to discuss how immersive headset training is being introduced into clinical education, starting with the Thames Valley Air Ambulance.Jamie brings a unique perspective from his time as a pilot and helicopter flight instructor in the Royal Air Force, where he experienced first-hand the value of scenario-based, immersive learning. Combined with Lily's background as a prehospital critical care doctor, their expertise is helping shape a new frontier in clinical preparedness for the most complex and time-critical interventions.Together, we unpack how the MaxRes system works, the science behind its development, and the real-world impact it's having on clinical performance, confidence, and decision-making. We also look to the future, exploring how this technology could revolutionise pre-hospital education, expand into new clinical domains, and deliver highly realistic, repeatable, and effective training experiences.Whether you're a critical care paramedic, HEMS doctor, educator, or healthcare innovator, this episode offers an exciting look at where pre-hospital training is heading and how technology developed for the skies is now making a difference on the ground. Further information on MaxRes can be found here: https://maxres.ai/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

In this episode of the Pre-hospital Care Podcast, we delve into the origins and current structure of the Hazardous Area Response Team (HART), a specialist unit within UK pre-hospital care. We explore why the HART model was specifically chosen in the UK and how it compares to Urban Search and Rescue (USAR) counterparts internationally. The conversation offers insights into the unique day-to-day role of a HART team member and how the team integrates with the wider emergency medical services, particularly during high-risk or complex incidents.We also reflect on the evolution of HART, how the model has grown from its early foundations into a sophisticated and responsive service that plays a crucial role in emergency preparedness and response. The episode explores the learning mechanisms and governance structures built into HART to ensure continuous development and safe practice.Additionally, we examine how change management and cultural integration have been essential to embedding HART within the wider healthcare and emergency response ecosystem. This includes addressing the 'hearts and minds' aspect, how to build trust, acceptance, and collaboration between specialist teams and frontline responders to ensure effective teamwork and optimal patient care.Whether you're familiar with HART or new to the concept, this episode offers a deep dive into one of the UK's most technically demanding emergency response capabilities and how it continues to shape the landscape of pre-hospital care.This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life. PAX – built to perform, made to last.Learn more at pax-bags.com

In Part 3 of The Dying Patient: Palliative and End of Life Care, we delve into the complexities ambulance clinicians face when supporting patients in their final days and hours. Often the first to recognise when someone is dying, paramedics work within a system where community engagement may be limited, making their role crucial in identifying signs such as terminal agitation, unconsciousness, and other common symptoms. The episode discusses the importance of anticipatory medications and proactive advance care planning , especially in situations involving carer breakdown or when patients change their minds about where they wish to die.We explore why ambulance services are frequently called during end-of-life stages, whether due to uncontrolled symptoms, sudden deterioration, or emotional distress within families. Paramedics not only offer symptom relief, both pharmacological and non-pharmacological, but also provide vital emotional support to those navigating grief, denial, or fear. Challenges include differentiating between reversible conditions and active dying, managing care when anticipatory medications are unavailable, and coordinating with wider healthcare teams.Breaking bad news is another critical area discussed, with a focus on using frameworks such as Ask-Tell-Ask and adapting communication to the emotional needs of the moment. Lastly, the episode reflects on cultural considerations in a city as diverse as London. From language barriers and different expressions of grief to religious rituals and care after death, ambulance clinicians must remain adaptable and compassionate, ensuring that care is respectful, inclusive, and sensitive to the needs of every individual and their family. Some of the links to information mentioned in the episode can be found here: These are some of the resources mentioned in the episode:Breaking Bad News: ⁠⁠https://www.sth.nhs.uk/clientfiles/File/Breaking%20bad%20news%20Reflection%20on%20the%20process.pdf⁠⁠Good Grief - understanding the grief journey in more detail: ⁠⁠https://good-grief.org/resources/⁠⁠Hospice UK, an excellent place for further resources: ⁠⁠https://www.hospiceuk.org/our-campaigns/dying-matters/dying-matters-awareness-weekUK National Guidelines on Diabetes and End of Life Care: https://www.diabetes.org.uk/sites/default/files/2025-03/EoL_TREND_2024_v11-1.pdfThis episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

In Part 3 of our Decision Making series, we explore the power of "slow time" thinking with Detective Superintendent Ahenkora Bediako of the Metropolitan Police. With a distinguished career managing high-risk public protection departments and international investigations, Ahenkora brings deep insight into how intentional, non-biased decisions are made under pressure.We unpack how leaders can resist reactive impulses in crisis moments and instead lean into deliberate, evidence-informed strategies, especially when the stakes are high. Drawing on his experience as an Accredited Major Crime Senior Investigating Officer (PIP3), Ahenkora shares lessons from frontline policing, complex safeguarding, and professional standards.We also touch on his commitment to evidence-based policing, including randomised control trials, and how these approaches improve outcomes in child protection, community engagement, and organisational equity. If you're interested in high-performance leadership, decision integrity, and building inclusive, accountable systems, this episode is for you. This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

Today, we're diving into a critical yet often overlooked subject: rehabilitation for pre-hospital staff. The physical and mental demands of frontline work are relentless. Paramedics, HEMS crews, and pre-hospital teams operate in high-stress environments, managing unpredictable situations, heavy workloads, and repeated exposure to trauma. But what happens when the body or mind says, “I can't keep going”? How do we help our colleagues recover and return, not just functioning, but stronger, healthier, and more resilient?I'm joined by Mike Palmer, a highly experienced critical care clinician with lived experience of injury and recovery. Together, we'll unpack the scale of injury across pre-hospital care, identify gaps in current rehabilitation practices, and explore why a structured, personalised approach is essential for long-term sustainability in this field. We'll also take a personal look at Mike's own journey, how he navigated his recovery, the obstacles he encountered, and the insights he gained along the way.But this conversation goes beyond rehabilitation, it's about reimagining how we care for those who care for others. Whether you're on the frontline, leading a team, or simply passionate about well-being in emergency medicine, this episode offers valuable perspectives on how we can better support, rehabilitate, and retain our pre-hospital workforce. Useful links that Mike mentions in the episode can be found here:https://pubmed.ncbi.nlm.nih.gov/31537564/https://www.sciencedirect.com/science/article/pii/S0925753524000092https://pubmed.ncbi.nlm.nih.gov/33492279/https://pubmed.ncbi.nlm.nih.gov/35000895/https://pubmed.ncbi.nlm.nih.gov/26371071/https://pubmed.ncbi.nlm.nih.gov/34972683/https://pubmed.ncbi.nlm.nih.gov/26371071/https://pubmed.ncbi.nlm.nih.gov/26281820/This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup. PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at pax-bags.com

Today, we explore the collective experience of trauma among NHS ambulance personnel during the COVID-19 pandemic, a period that tested the resilience and identity of clinicians like never before. In the episode, we'll uncover the inspirations behind this research, examining how social identity processes provide a profound lens to understand how ambulance teams navigate trauma. Our guest will walk us through their methodology, highlighting the value of a longitudinal qualitative approach and the unique hurdles of conducting research during a global crisis.Jo guides us through her methodology, highlighting the importance of longitudinal qualitative approaches and the challenges of conducting research amid a global crisis. We unpack how group membership shaped emotional and behavioural responses during the pandemic, revealing the cultural forces at play within NHS ambulance services and how these dynamics contributed to collective resilience.We also explore the long-term psychological impact of the pandemic, comparing individual and team-based coping strategies, and discuss what this tells us about building solidarity under extreme strain.Finally, Jo shares practical, evidence-based strategies for leaders in emergency services to foster resilience, mitigate trauma, and apply these learnings to other high-stakes professions.Dr. Jo Mildenhall is a paramedic with over 20 years of experience in operational and leadership roles within ambulance services. She holds a master's degree in Occupational Trauma Psychology from the University of Nottingham and earned her Doctorate from the University of York, focusing on trauma experienced by NHS ambulance staff during the pandemic. Jo is the National Paramedic Mental Health & Wellbeing Lead for the College of Paramedics and was awarded a Churchill Fellowship in 2019 to study paramedic mental health initiatives in Australasia. You can access Jo's research here: https://etheses.whiterose.ac.uk/id/eprint/35774/

In our previous episode, we explored the meaning and importance of end-of-life care, particularly during the final 12 months of life. We discovered how difficult it is to predict this timeline, especially for ambulance clinicians who often see patients at critical points without a full picture of their medical history.In this episode, we take a closer look at what that final year can involve, focusing on the pre-hospital setting. We'll explore the unique challenges ambulance clinicians face in making rapid, high-stakes decisions, and how existing documentation—such as care plans or advance directives—can provide valuable guidance in those moments.We'll also discuss the role of shared decision-making and how ambulance services can help balance specialist and generalist palliative care needs. Alongside this, we'll highlight how the NHS Long Term Plan and other key initiatives aim to improve care coordination and ensure more consistent, compassionate care.Lastly, we'll examine the barriers to effective advance care planning. These range from cultural sensitivities to systemic and logistical obstacles. Throughout, we'll consider how we can better support ambulance clinicians to deliver thoughtful, person-centred care during some of life's most vulnerable and uncertain moments. Please find links to the SPICT Tool that is mentioned in the episode: https://www.spict.org.uk/#:~:text=Supportive%20%26%20Palliative%20Care%20Indicators%20Tool,is%20a%20plain%20language%20version.

In this episode, we dive into a critical challenge: how to embed meaningful, lasting change within ambulance services. With increasing demand, stretched resources, and ongoing operational pressures, creating improvements that truly stick is no easy task.To unpack this, I'm joined by Carl Betts, an expert in quality improvement, leadership, and change management within the ambulance sector. Carl has been instrumental in transforming clinical practices, enhancing patient care, and fostering a culture of continuous improvement at Yorkshire Ambulance Service and beyond. Aspects we cover in the episode include:

Welcome back to the Pre-Hospital Care Podcast. In this episode, I'm joined by Stephen Wood, emergency nurse practitioner, educator, and host of Tac Medic Whiskey: The Tactical Medicine Podcast. Steve brings a wealth of experience from pre-hospital care, the emergency department, and the tactical environment, and he's become a prominent voice in the evolving landscape of high-threat medicine. His podcast dives deep into the challenges and innovations of tactical pre-hospital care, blending clinical insight with real-world operational experience.In our conversation, we explore everything from the use of TXA and calcium chloride in trauma to the nuanced decisions between needle decompression and finger thoracostomy. We'll talk about the importance of team cohesion, the mental toll of working in high-stress environments, and how to build resilience in the field. We also examine emerging technologies, training innovations, and what the future might hold for tactical medics across the globe. Whether you're on the frontline, training the next generation, or just curious about the realities of medicine in hostile or austere environments, this episode offers invaluable insights from an educator and Nurse Practitioner, Steve Wood. You can find the Tac Medic Whiskey Podcast here: https://podcasts.apple.com/il/podcast/tac-medic-whiskey-the-tactical-medicine-podcast/id1777426233** This podcast is for information purposes only and should not replace clinical guidelines or your local service policies. **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 innovatively designed product range, please click here:⁠https://www.pax-bags.com/en/⁠

In today's episode, we're honoured to be joined by John Martin, a trailblazer whose career is a testament to innovation, leadership, and an unwavering dedication to patient care.John's journey began at just 18 in a microbiology lab, but his passion for healthcare quickly led him to the world of emergency medicine. Today, he serves as the Chief Executive of South Western Ambulance Service NHS Foundation Trust (SWASFT). With a wealth of experience across ambulance, acute, and community healthcare settings, John has also been the President of the College of Paramedics, advocating for the advancement of the paramedic profession. As a Visiting Professor in Paramedic Science, he's helping shape the future of paramedic education and training.In this episode, we'll dive into John's leadership transition from London Ambulance Service to SWASFT, the biggest challenges facing pre-hospital care, and the role of technology in modernising emergency response. We'll also touch on the importance of mental health, interdisciplinary collaboration, and John's forward-thinking vision for the future of paramedic practice. A link that John mentions in the interview to the Harvard Business School Negotiation Mastery course can be found here: https://tinyurl.com/2f8pdbkcThis 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 innovatively designed product range, please click here:⁠https://www.pax-bags.com/en/⁠

In this episode, I'm joined by Marc Watson, a distinguished pharmaceutical physician and passionate advocate for mental health. Marc's journey spans from working as a frontline GP to holding senior leadership roles in pharmacovigilance and global medical affairs, where he has been instrumental in ensuring patient safety, meeting regulatory demands, and supporting the launch of transformative medicines. Yet, behind these professional achievements lies a deeply personal story: Marc's own experience of managing a bipolar diagnosis while navigating high-pressure, high-stakes environments.We'll explore his shift from clinical practice to the pharmaceutical sector, the emotional toll of leadership, and the practical tools he uses to safeguard his mental well-being. Marc also opens up about his drive to raise mental health awareness, offering honest reflections from his life.This episode is a candid conversation about leadership, resilience, and the power of vulnerability. It highlights the urgent need to normalise mental health discussions, especially in professions where the pressure is relentless. Whether in healthcare, leading teams, or seeking perspective on mental wellness, this episode offers meaningful insight. You can read more on Marc's mental health journey here: https://www.fpm.org.uk/blog/from-surviving-to-thriving-with-my-mental-health/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 explore the evolving role of ambulance clinicians in palliative and end-of-life care. We're joined by a dedicated team working to improve how prehospital services support patients in their final months, ensuring care is compassionate, coordinated, and patient-centred.We introduce the team and their roles before breaking down the key concepts of palliative and end-of-life care. We discuss the differences between generalist and specialist palliative care, the challenges of identifying patients in the last year of life, and the critical role ambulance services play in this journey.The conversation then moves to the service gaps and educational challenges identified within prehospital care. We examine referral pathways, tools like SPICT for early identification, and how technology shapes advanced care planning (ACP) to help inform decision-making. The team also highlights the importance of education in building clinician confidence when navigating these complex cases.Looking ahead, we discuss the future of prehospital palliative care, including the role of simulation training, national collaboration, and addressing healthcare inequalities. We also explore opportunities for joint learning, debriefs, and improved care pathways to strengthen the connection between ambulance services and specialist palliative care teams.The SPICT tool can be found here: https://www.spict.org.uk/the-spict/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 innovatively designed product range, please click here:⁠https://www.pax-bags.com/en/⁠

Today, we're honoured to host Professor Deborah Harding, a distinguished figure in the field of advanced clinical practice. Professor Harding serves as the Supervision Lead for the NHS England for Advancing Practice, where she has been instrumental in developing supervision frameworks that support advanced practitioners across various healthcare disciplines. ​With a rich background as a registered speech and language therapist, Professor Harding has extensive experience in multi-professional management and leadership within the NHS. Her academic pursuits led her to complete a PhD focusing on supervision for allied health professions, culminating in a constructivist grounded theoretical perspective on the subject. ​In her role at City St George's University of London, Professor Harding has led curriculum development for the MSc and integrated degree apprenticeship in advanced clinical practice. Her work emphasises the importance of clinical supervision in supporting the development of advanced clinical practitioners, ensuring they are equipped to navigate the complexities of modern healthcare environments. ​In this episode, we'll explore the critical role of supervision in advanced practice, discuss the challenges practitioners face in pre-hospital care, and gain insights from Professor Harding's extensive research and experience. Stay tuned for an enlightening conversation that sheds light on the future of advanced practice in pre-hospital care. See and read more here: https://advanced-practice.hee.nhs.uk/And here: https://thepermeablepractitioner.com/

In this episode, we explore the challenges and contrasts of implementing innovation across the NHS and the private healthcare sector with expert guest Hannah Browning. As the founder of Beyond Excellence, Hannah brings a rare dual-sector insight, having held senior leadership roles in major private providers including Nuffield Health, Spire Healthcare, and HCA, as well as leading on transformative projects like the £120m development of KIMS Hospital.Innovation within the NHS often grapples with structural rigidity, limited funding, and bureaucratic hurdles, whereas the private sector—while faster-moving and more agile—must navigate investor expectations, profitability, and intense market competition. Hannah discusses how both sectors have unique strengths: the NHS offers scale, consistency, and population-wide data, while the private sector excels in responsiveness, customer-centric models, and speed of delivery.She reflects on what each can learn from the other: the NHS could benefit from private-sector pace and accountability, while the private sector might adopt some of the NHS's commitment to equity and long-term population health outcomes. With real-world examples, including her strategic role in the acquisition and launch of Sevenoaks Medical Centre, Hannah brings a grounded, commercial, and compassionate view on how healthcare systems can evolve—together—for better patient care. You can read more of Hannah's consultancy business here: https://www.alphahealthpartners.co.ukhttps://www.getbide.co.uk

In this episode of the Pre-Hospital Care Podcast, we explore the rapidly evolving role of artificial intelligence in trauma care, focusing on the AI Risk Prediction and Decision Support System (AI-TRiPS)—a cutting-edge AI tool designed to enhance decision-making in high-pressure trauma settings.AI-TRiPS is built on Bayesian networks for clinical decision support, bridging the gap between AI development and real-world application. But how do we ensure AI tools are accurate, usable, and trusted by frontline clinicians? We cover:

In this episode of the Pre-Hospital Care Podcast, we're joined by Sarah Edwards to explore the most frequently encountered paediatric emergencies seen in the field. Sarah Edwards is a Consultant in Adult and Paediatric Emergency Medicine and the RCEM Learning Chair. She is Senior Editor for the Emergency Medical Journal, RCEM Learning Chair and Honorary Secretary for ASME. She also teaches on the Master's of Medical Education course at the University of Sunderland.In this wide-ranging conversation, we examine respiratory infections to asthma exacerbations to gastroenteritis, dehydration, febrile illnesses, and seizures. We unpack the presentations that paramedics and pre-hospital teams face on a daily basis together with some of the red flags for each disease. We'll discuss how to identify and prioritise care for these conditions in the often-challenging pre-hospital environment, using practical strategies to deliver safe and effective interventions. Sarah shares key insights into assessing sick children, highlighting subtle clinical signs, red flags, and common pitfalls in decision-making under pressure.We also examine trauma in children, including how injury patterns vary across age groups and what immediate management steps are most critical. Finally, the episode touches on the vital role of caregivers and parents in the assessment process. Some useful links that Sarah mentions in the episode include: https://spottingthesickchild.com/The Westley Croup Score: https://handbook.bcehs.ca/clinical-resources/clinical-scores/westley-croup-severity-score/The Big 6 The Most Common Conditions That Children Present With For Urgent Care:https://www.improvingme.org.uk/media/1141/childurgentcaredocument2020.pdfThis 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/⁠

The person-centred approach to counselling is built on the foundation of empathy, authenticity, and unconditional positive regard. Developed by Carl Rogers, this approach shifts the focus from the therapist as an expert to the client as the central figure in their own healing journey. Rather than directing or diagnosing, the counsellor provides a non-judgmental, supportive space, allowing the individual to explore their thoughts and emotions freely.At its core, this method recognises that each person has the capacity for growth, self-awareness, and healing when given the right environment. The role of the counsellor is to listen deeply, reflect, and validate, helping clients to find their own solutions rather than imposing advice.In pre-hospital and emergency care, where professionals often witness distress and trauma, adopting person-centred communication can make a profound difference. Whether supporting patients in crisis, speaking with families, or debriefing colleagues, approaching conversations with genuine empathy, active listening, and emotional presence fosters trust and resilience.On today's episode, we'll explore how this approach applies to medicine, emergency response, and mental health, and how we can all integrate person-centred principles into our professional and personal interactions.Chris Molyneux has spent more than a decade as a counsellor working alongside people who are rediscovering their frame of reference after trauma, and supervising other counsellors who do the same. Chris brings great authenticity through his work and has already had a hugely powerful impact for many healthcare workers. Chris's work can be found here: https://www.youtube.com/watch?v=kwrbmKtOAGYChris The Counsellor on YouTube www.youtube.com/christhecounsellor and reach out to Chris on the following email chris@chrismolyneux.co.ukThis is a paid advertisement from BetterHelp In the demanding field of pre-hospital care, having reliable support is crucial. Whether you're a first responder, healthcare professional, or simply facing life's everyday stresses, therapy can equip you with strategies to manage pressure, strengthen resilience, and enhance your mental health.BetterHelp, the world's largest online therapy platform, connects individuals with licensed therapists via video, phone, or messaging—available anytime, anywhere. With more than 5,000 therapists in the UK, it's easy to find the right match for your needs. Strengthen your support network with BetterHelp.Listeners receive 10% off their first month at betterhelp.com/CAREPOD 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 continue our deep dive into decision-making under pressure with Olly Sapsford, a Firefighter and Commander as well as a Lecturer in Disaster & Emergency Management at Coventry University.We explore the mental models, training, and strategies that support effective decision-making in extreme environments. How do emergency responders manage stress, maintain clarity, and strike the right balance between experience and instinct?Olly shares insights into leadership, teamwork, and the ethical dilemmas professionals face in high-stakes situations. From navigating risk and resource limitations to post-incident reflection, we examine how decision-making frameworks from firefighting can be applied in paramedicine—and vice versa.With a research focus on human factors, socio-cognitive influences, and fast decision-making, Olly sheds light on the role of intuition and expertise in high-pressure environments. Drawing from his talk at the College of Paramedics Emergency and Critical Care Conference, titled ‘From the Fireground: Demystifying Extreme Decision Making for Emergency Responders', Olly brings a fresh perspective on how responders can refine their approach to critical decision-making when every second counts.Join us as we unpack the strategies that can make the difference between a good decision and a great one in emergency settings.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 are focusing on the vital topic of paediatric assessment in the pre-hospital phase of care. Assessing and managing a sick or injured child is one of the most challenging scenarios for pre-hospital teams. Our guest breaks down the key components of paediatric assessment with the subtle red flags that may indicate a child is critically unwell. We'll also explore practical approaches to airway management, assessing breathing and circulation, and understanding neurological status in children of all ages.Beyond the clinical side, we discuss the softer skills required when working with paediatric patients, like engaging with caregivers, managing a child's fear, and staying calm under pressure. Whether you're new to pre-hospital care or an experienced provider looking to refine your skills, this episode will provide valuable insights and actionable takeaways. Anna Dobbie is a consultant in emergency medicine at The Royal London Hospital and the lead clinician with London's Air Ambulance. With a special interest in paediatrics and teaching, Anna plays a key role in advancing pre-hospital care. In this episode, we explore her journey, insights, and experiences in emergency and pre-hospital paediatric medicine.* Please note, the content of this podcast is for information purposes only. Please stay within your scope of practice and services operating practices at all times * 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 take an in-depth look at one of the world's leading HEMS services—London's Air Ambulance (LAA) Charity. This conversation centres around the lesser-known challenges of sustaining and growing a top-tier HEMS service within the UK. From community engagement strategies to high-impact fundraising and marketing campaigns, we uncover what it takes to raise over £16 million to fund two new helicopters. We also go behind the scenes to examine the efforts that brought these aircraft into service, the obstacles the charity faces, and the vital role public support plays in its mission.Joining us is Jayne Clarke, Director of Fundraising and Marketing at London's Air Ambulance Charity. With a strong background in strategic leadership across the charity sector, Jayne brings expertise in marketing, advertising, and ethical banking. She previously worked with McCann Worldgroup before transitioning to purpose-driven roles, including leading major campaigns at the RNLI and serving as Director of Income Generation at St Peter's Hospice. Now, as she steers the charity into an exciting new chapter in 2025, Jayne shares her insights on what it takes to keep this lifesaving service in the air. To see more of LAA's work, engagement and fundraising, see here: https://www.londonsairambulance.org.uk/

Out-of-hospital cardiac arrest remains a critical challenge despite advances in pre-hospital care, with survival rates heavily influenced by early intervention, high-quality CPR, and coordinated response systems.In this episode, we're joined by Mark Faulkner, a leading expert in resuscitation and emergency care, to explore the key factors that impact survival. We'll discuss the importance of bystander CPR and public access defibrillation in the crucial early minutes and the benefits of high-performance CPR and effective post-ROSC care. Mark will also share insights into the latest evolving role of the impact of system-wide strategies, from improved community education to better integration between emergency services and hospitals. What steps can be taken to enhance survival rates, and how can healthcare systems work together to drive meaningful change?Join us for this discussion as we discuss system-wide and service-level changes that can make a real difference in patient outcomes.

In this episode of the Pre-Hospital Care Podcast, we dive into the crucial role of shared learning within the pre-hospital setting. Learning from past experiences, both successes and challenges, is vital for improving patient outcomes and advancing best practices. We'll explore key moments where shared learning has led to real changes in practice and examine the importance of having a strong central community to ensure that knowledge reaches as many professionals as possible.To explore this topic, we're joined by Sara Orritt, who brings a wealth of experience in emergency medical services and communication. Sara manages the communications and social media for The European Association of Emergency Medical Services (EMS Europe), supports the EMS Europe board in business administration, and helps organise the International EMS Congress. She also works as an Executive Support Officer for Yorkshire Ambulance Service and has previous experience with South East Coast Ambulance Service. Before her career in emergency medical services, Sara worked in television production, including roles with the BBC.Join us as we discuss how shared learning drives change, the role of digital platforms in spreading knowledge, and how EMS professionals can stay connected to a broader learning community. EMS Europe can be found here: https://emseurope.org/The 2025 EMS congress can be found here: https://www.emscongress2025.org/Please find a link to the paper mentioned in the episode here: https://www.linkedin.com/posts/european-ems_earlier-this-year-the-european-association-activity-7110352516667592704-8Kxb?utm_source=share&utm_medium=member_ios&rcm=ACoAAAP50dMB5y9DijwQUZNfWmSnqRRiXV2b9mUThis 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/⁠