The PREMED Podcast

'ello!    This time round we were sadly unable to meet face-to-face and produce all those funny little videos you love but we did have a good chat about BP monitoring, triage, and clinical assessment of neurological presentations.     Thank you to our case contributor Jay, and to everyone who got involved on SoMe with the #MysteryDiagnosis.    Have YOU got a case? We want to read about it! Please submit to: podcast@prem-ed.com   Also, if you have a second, would you like / rate / subscribe please? It means more to us than money itself (well, maybe not).   J&S x   References:  NICE: Major trauma: assessment and initial management The London Major Trauma Triage Decision Tool Spoiler alert! 1 Spoiler alert! 2   * explicit content * Hosted on Acast. See acast.com/privacy for more information.

Oh hello there, and thanks for coming back!    This week we were joined by Marcus the HART Hero (we named him that, not him) as we discussed hypoxia, agitation, restraint, anxiolysis, and Rupert Murdoch.    Thank you to our case contributor, and to everyone who got involved on SoMe with the #MysteryDiagnosis.    If you want to submit a case for a future episode, or have any questions, concerns, or feedback, please get in touch at podcast@prem-ed.com   J&S x   References:  MHRA Schedule 17 drugs Paramedics and medicines: legal considerations (England, 2016) The Mental Capacity Act and use of proportionate restraint (in the UK)   * explicit content * Hosted on Acast. See acast.com/privacy for more information.

Its here! The podcast you've all been waiting for but didn't know it!    Thank you to our anonymous case contributor, and to everyone who got involved on SoMe with the #MysteryDiagnosis.    If you want to submit a case for a future episode, or have any questions, concerns, or feedback, please get in touch at podcast@prem-ed.com   J&S x   References:  STE in aVR (LITFL) S1Q3T3 pattern (LITFL) Aortic Stenosis and cardiac auscultation NICE guidelines: VTE The 2017 ESC STEMI Guidelines   * explicit content * Hosted on Acast. See acast.com/privacy for more information.

Hello all!    Following a festive hiatus we're back, but things are going to be a bit different from now on...   Join Silas and Jonny as they chat, argue, and reflect on all things prehospital, resuscitation and emergency medicine!    * explicit content * Hosted on Acast. See acast.com/privacy for more information.

Lieutenant Colonel Ross Moy (Twitter: @ross_moy) is a consultant in Emergency and Pre-Hospital Medicine in the British Army. During training he undertook Fellowships in Critical Care, Aeromedical Retrieval and Pre-Hospital medicine. He has deployed overseas several times, including operational tours of Iraq and Afghanistan. He is now an EM Consultant at the Queen Elizabeth University Hospital, Glasgow and EMRS Scotland. He is also the Clinical Director of MERT Training and has clinical interests in austere care, human factors and ethics.   He is married to Pauline, with two enthusiastic sons, and a lazy Labrador. He is a dreadful guitarist, and reasonable runner. He also enjoys hillwalking, skiing and whisky. (Nb. Ross' words, I'm not being judgemental!)   I really enjoyed talking to Ross about his career, trauma care, human factors, medical education, and much more.    I hope you enjoy listening and let us know what you think!    -- Silas.     Plugs!  Ross on Twitter Army Medical Services recruitment PhEDECs™ ECG Course   References Meet MERT MERT overview REPHILL trial   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

PHEM Feedback is a project which assists ambulance and air ambulance staff with patient follow up.   I was lucky enough to catch up with two of the minds behind the project – Sinead Keane and Dr Gio Cracolici – about its origins, how it works, and how it helps with clinician's learning and patient outcomes.    Check it out!    -- Silas.     References PHEM Feedback   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

A bit later than usual but better late than never, right?!    This episode contains the second half of my conversation with consultant midwife Dawn Kerslake about maternity emergencies in prehospital care. We discussed ante- and postpartum haemorrhage, pre-eclampsia and eclampsia.    As always, please get in touch with any feedback and feel free to leave us a review (5 stars optional but ideal...)   -- Silas. Hosted on Acast. See acast.com/privacy for more information.

Dawn is back!   In this episode I was pleased to speak to Dawn Kerslake again, consultant midwife at South East Coast Ambulance Service, about the normal birth and some of the potential maternity emergencies that may occur in the prehospital environment.    Hopefully you've heard the episode on maternity emergencies by The Resus Room (if not, I highly recommend) and my discussion with Dawn will go some way to complimenting that.    Enjoy!   -- Silas Hosted on Acast. See acast.com/privacy for more information.

Hello again!   Welcome to part 2 of my discussion with chief paramedic officer Justin Thomas. In this episode we discussed RSI, research, Justin's journey to becoming a PhD student, and how to move to South Africa as a paramedic.   Enjoy!     -- Silas   References Health Professions Council of South Africa (2018). ‘Clinical Practice Guidelines'. [Online]. Unknown (2017). ‘Pre-hospital medicine: South Africa vs. the United Kingdom'. Int Journal Paramedic Practice. [Online]. College of Paramedics (2018). ‘Post-registration Career Framework'. [Online]. Petter, J (2012). ‘Raising educational standards for the paramedic profession'. Journal of Paramedic Practice. [Online]. General Medical Council (2020). ‘Bringing physician associates and anaesthesia associates into regulation'. [Online]. Ebben et al (2017). ‘A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review'. Scand J Trauma Resusc Emerg Med. [Online]. Brown, M (2015). ‘The Paramedic Series'. Mental Health Cop (blog). [Online].   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Hello 2021!   We're back with season two of The Prehospital Podcast and to kick it off I spoke to Justin Thomas, Chief Paramedic Officer in Saudi Arabia and PhD student.   We had a really interesting chat (I think so anyway...) about paramedic education in South Africa, paramedic practice in Saudi Arabia, the ethics of prehospital decision making, and much more.   Have a listen and let us know what you think, part two dropping in a few weeks.    -- Silas   References Health Professions Council of South Africa (2018). ‘Clinical Practice Guidelines'. [Online]. Unknown (2017). ‘Pre-hospital medicine: South Africa vs. the United Kingdom'. Int Journal Paramedic Practice. [Online]. College of Paramedics (2018). ‘Post-registration Career Framework'. [Online]. Petter, J (2012). ‘Raising educational standards for the paramedic profession'. Journal of Paramedic Practice. [Online]. General Medical Council (2020). ‘Bringing physician associates and anaesthesia associates into regulation'. [Online]. Ebben et al (2017). ‘A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review'. Scand J Trauma Resusc Emerg Med. [Online]. Brown, M (2015). ‘The Paramedic Series'. Mental Health Cop (blog). [Online].   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Hello again!    Here is the second half of my conversation with Dr Joanna Poole about the intricacies of ventilation.   We had a really interesting discussion about physiology, pathophysiology, hyperventilation, tension disease, and loads more. Let me know your thoughts, enjoy!    -- Silas   References Lung volumes and capacities (MedBullets, 2019): Tension pneumothorax – time for a rethink? (Leigh-Smith and Harris, 2005) West's zones of the lung (Yartsev, 2019): The Iron Lung (The Science Museum, 2018): SECAmb pioneering new protocol for spinal injury patients (Sanders, 2020) High Flow Nasal Cannula (HFNC) – Part 1: How It Works (Lodeserto, 2018) #REBELEM Patent foramen ovale (Aggarwal and Singh, 2018) #BMJbestpractice Novel Tips for Airway Management (Rogers, 2014) The Oxford Head Elevating Laryngoscopy Pillow (Alma Medical, no date) ERC and ESICM Guidelines for Post-resuscitation Care (Nolan et al, 2015)   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Hello!    Sorry for the delay on this one but its here! In this episode, I spoke with Dr Joanna Poole about the intricacies of ventilation.   We had a really interesting discussion about physiology, pathophysiology, hyperventilation, tension disease, and loads more! In fact, we discussed so much I've split it into two parts.    So hopefully you find it as interesting as I did... Let us know your thoughts!    -- Silas   References Lung volumes and capacities (MedBullets, 2019): Tension pneumothorax – time for a rethink? (Leigh-Smith and Harris, 2005) West's zones of the lung (Yartsev, 2019): The Iron Lung (The Science Museum, 2018): SECAmb pioneering new protocol for spinal injury patients (Sanders, 2020) High Flow Nasal Cannula (HFNC) – Part 1: How It Works (Lodeserto, 2018) #REBELEM Patent foramen ovale (Aggarwal and Singh, 2018) #BMJbestpractice Novel Tips for Airway Management (Rogers, 2014) The Oxford Head Elevating Laryngoscopy Pillow (Alma Medical, no date) ERC and ESICM Guidelines for Post-resuscitation Care (Nolan et al, 2015)   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Happy October friends!    In this episode I spoke to Lance Gray, paramedic and all round good guy, about his move from Australia and time as a critical care outreach practitioner. It was really interesting to hear Lance's experience of working as a paramedic in-hospital, as well as what it was like to be on the 'frontline' with the early COVID-19 pandemic. And for the international listeners, Lance had a few tips about moving to the UK as a paramedic.    Danke,   -- Silas   References Australian paramedic graduates transitioning into UK NHS ambulance services: what are the potential challenges? (Devenish et al, 2015) Cardiovascular complications in COVID-19: A systematic review and meta-analysis (Kunutsor and Laukkanen, 2020) COVID-19 and Cardiology (ESC, 2020) Critical Care Outreach teams (NICE, 2018)  Guidance for the role and use of non-invasive respiratory support in adult patients with COVID- 19 (confirmed or suspected) (NICE, 2020)   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Sorry for the delay friends, but I'm sure it was worth the wait (hopefully)... This time round I spoke with Jace Mullen, paramedic and all round great guy based in Colorado, Denver.   We intended to discuss the differences between UK and USA practice but ended up chatting more about the similarities! Topics included EMS roles, education and training, specialties, referral and discharge, medications, the law, and (of course) cardiac arrest.   Feedback welcome as always,   -- Silas   References National Registry of Emergency Medical Technicians #USA The Human Medicines Regulations 2012 #UK Medicine Entitlements (HCPC, 2018) #UK Paramedics and medicines: legal considerations (England, 2016) #UK EMS, Medical oversight of systems (Baker and Cole, 2019) #USA   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Aaaaand we're back!    In this episode I was excited to speak to Dawn Kerslake, one of just two ambulance service consultant midwives in the country. We had a really interesting discussion about physiological births, complications, Dawn's experiences, and baby loss.    Despite extra training, maternity cases are still stressful for me and so I found the content of this episode especially useful! I hope you do to.   Enjoy,   -- Silas   References Maternity Marmite Series – Breech Birth (Mansfield, 2016) #webinar Maternity Marmite Series – Cord Prolapse (Mansfield, 2016) #webinar Maternity Care for Paramedics (e-LfH, 2018) #e-learning Royal College of Obstetricians & Gynaecologists 'Green Top' guidelines Baby Loss Awareness Mariposa Trust (for patients) Sands | Stillbirth and neonatal death charity (for patients) Sands training (for healthcare staff) Resuscitation and support of transition of babies at birth (Wyllie et al, 2015) #RCUKGuidelines   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Hello friends!   Sorry for the delay on this one, I needed a bit of a break after the COVID episode... But I'm back, and in this episode I had a chat with my mate Andy about the mysterious world of HART. We discussed the genesis of HART, their additional capabilities, tips for effective teamwork at incidents, and how paramedics can get involved if they're interested.   I hope you find the episode useful, please share and subscribe.   Until next time,   -- Silas   References The National Ambulance Resilience Unit (NARU) Education Centre Ambulance HART website Paramedic Insight: the training to become a HART paramedic (Clark, 2017) How to become a HART paramedic: Hannah's story   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Episode three already! And a bit of a longer one this time... In a bit of a one-off, I got in touch with Ben Paul, student Critical Care Paramedic and Senior Lecturer, about COVID-19 in pre-hospital critical care. You're probably sick of hearing about it, but on the off-chance you're not we put together this episode to try and provide some clarity to those of us working outside of hospital. To be clear... Neither of us are experts and clearly the knowledge of COVID-19 is changing daily but we have managed to muddle through the wealth of literature out there to bring a summary of what we think is useful for people to know. Our discussion encompassed R-nought, pathophysiology, diagnosis, treatment of respiratory failure and OHCA, and (of course) PPE.  Hopefully you find this useful. And if you do, please subscribe / rate / share - you know the drill!  Thanks,  -- Silas   References Background and pathophysiology: Coronavirus Disease 2019 (COVID-19) overview (Medscape, 2020) COVID-19 risk factors (NHS, 2020) COVID-19 Insights: cytokine storm / massive immunomodulation (Drbeen, 2020) COVID-19 (Internet Book of Critical Care, 2020) #Pulmcrit Innate vs adaptive immunity (Khan Academy) Cytokine storm and sepsis disease pathogenesis (Chousterman et al, 2017) Berlin Criteria for Acute Respiratory Distress Syndrome (MDCalc) Diagnosis: COVID-19: guidance for ambulance trusts (Public Health England, 2020) Anosmia in COVID-19 (ENT UK, 2020) COVID:Diabetes (Diabetes UK, 2020) Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes (Yang et al, 2010) Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area (Richardson et al, 2020) Aerosol Generating Procedures: TBC Treatment (respiratory failure): CPAP for COVID-19 (NHS England / Improvement, 2020) Guidance for Prone Positioning of the Conscious COVID Patient (Intensive Care Society, 2020) Treatment of ARDS With Prone Positioning (Scholten et al, 2017) Prone Position and Mechanical Ventilation (Nickson, 2020) #LITFL Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome (Richard et al, 2006) Endocrinology in the time of COVID-19: Management of adrenal insufficiency (European Society of Endocrinology, 2020) Treatment (cardiac arrest): Resuscitation Council UK Statements on COVID-19 (Coronavirus), CPR and Resuscitation (RCUK, 2020)   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

We're back!    Thank you all so much for listening, and for your kind feedback. Its really encouraging to see so much engagement and I'm looking forward to sharing some more meaningful conversations with you in the future.   In part two of my discussion with Critical Care Paramedic Scott Hardy, we spoke about the management of foreign body airway obstruction, airway management in trauma patients, out-of-hospital cardiac arrest, and paramedic intubation. Scott is such a knowledgeable practitioner and it was great to hear his thoughts on the nuances of these topics.   I hope you find this episode useful. Please do subscribe, leave us a quick review, and feel free to get in touch with any comments, opinions, or feedback.     Peace!     --   Silas   References Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? (Glouberman and Zimmerman, 2002) Iatrogenic intracranial placement of nasopharyngeal airway after trauma (Swanson, Nickele, and Kuo, 2015) Busting Top Trauma Myths (Collopy et al, 2015) Rapid Sequence Intubation (Lafferty, 2020) The AIRWAYS-2 Trial (Benger et al, 2018) The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis (Crewdson et al, 2017) Prehospital endotracheal intubation: elemental or detrimental? (Pepe, Roppolo, and Fowler, 2015) Advanced airway management during adult cardiac arrest: A systematic review (Granfeldt et al, 2019) International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (Soar et al, 2019) A Critical Reassessment of Ambulance Service Airway Management in Pre-Hospital Care (JRCALC Airway Working Group, 2008) Airway management policy and procedure (London Ambulance Service, 2018) Paramedic Intubation Consensus Statement (College of Paramedics, 2018) The PART Trial (Wang et al, 2018)   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Where better to start than with airway management?  In this episode I speak to Scott Hardy. Scott is a Critical Care Paramedic and medical educator with over ten years experience in the speciality. He has a professional interest in airway management and teaches on the Difficult Airway Course.  We actually ended up chatting for a bit longer than expected so I've broken the episode down into two parts. In this first part we spoke about the goal of airway management and ways we can maximise our success. I really hope you enjoy the episode. Please do subscribe, leave us a quick review, and feel free to get in touch with any comments, opinions, or feedback.  Cheers!  -- Silas   References Can an airway assessment score predict difficulty at intubation in the emergency department? (Reed, Dunn, and McKeown, 2005) Direct Laryngoscopy and Tracheal Intubation (Bannister and MacBeth, 1944) Anatomic Insights and Practice Changing Concepts (Levitan, 2012) The "Ear-Sternal Notch" Line-How Should You Lie? (Rahiman and Keane, 2017) The Difficult Airway Society Guidelines The Vortex Approach 'EVLI' Airway Incrementalization (Kovacs, 2018) #EMCrit Kovacs Kata to Optimize a Failing Laryngoscopy Attempt (Weingart, 2019) #EMCrit   Sound recordist Jack Neuman Hosted on Acast. See acast.com/privacy for more information.

Hello everyone, It's been a long time in the making but we have finally got round to starting The Prehospital Podcast!  This prologue just gives a brief introduction to the podcast, and some information about how it will pan out in the future.  Please get in touch with feedback, we're always keen to hear your thoughts and suggestions about episodes so far, and content you'd like us to include in the future.  Don't forget to subscribe, it would be great to build a bit of an audience!  -- Silas. Hosted on Acast. See acast.com/privacy for more information.