The Shift Extension Paramedic Podcast

Welcome back to season 2 of the podcast with our new co-host Lou. Today we break down the provisional diagnosis. Do we need one? How do we make one? Are they harmful?

Matt and Nick sit down to discuss this common challenge. What do you do if your patient refuses your advice? How to provide advice and break down the barriers to refusal How to assess capacity What do documents like power of attorney and an ARP really mean?

Mr. Jordan Emery path has taken him from NSW ambulance to an NGO in New York, before landing the top job in Ambulance Tasmania. We sat down with Jordan earlier this year to talk about paramedic culture, making mistakes and the idea of heart centered leadership. 

We are back for our first episode in 2024. Time for Matt to pick Nick's brain about fast and slow dysrhythmias.  Does electrode placement matter? How do I differentiate between SVT and VT? How do I manage these fast rhythms? When should I worry about atrial fibrillation? Do I need to be able to interpret all of the slow rhythms?

Today we sit down Sean Golding, an Australian commercial airline captain, paramedic and technical dive instructor. Not long after completing Australia's first non-stop flight from New York to Sydney, Sean found himself out of work due to covid. We talk about how Sean became a paramedic, how he handles medical incidents during long haul flights and what we can learn from aviation to improve fatigue management and non-technical skills. 

Matt is back to pick Nick's brain. This time it's all about the respiratory patient.  - Should I give adrenaline to a sick COPD patient? - What is the difference between CPAP and BiPAP - How do I figure out the BVM? - How do I measure RR in an unconscious patient? - What is the point of a BVM filter?

Today we sit down with Professor Peter O'Meara. Peter has been practicing paramedicine since the early 1970's and was one of the first to complete a profession focused PhD. We talk about his early career, the inception of paramedic degrees in Australia and where the future of professionalisation will take us. 

This is the first installment of our new case study "What would I do if". Matt poses a series of clinical questions on the topic of TBI and the general management of a trauma patient following a long fall.  What should I take into a remote scene? Should I expose all of my trauma patients? Does everyone need a binder? How do I manage the agitated patient? Sedation or pain relief? How can I value add to my TBI patient?  

We sat down with paramedic, nurse, midwife, and academic Belinda Flanigan. Belinda has had an incredible career in paramedicine from ambulance officer to now the head of the first school of paramedicine in Australia.  We talk about her career, her life as a midwife, how her PhD changed practice and some advice for those looking to dip their toes into research. 

Today we sit down with Matt, a paramedic, phd candidate and lead author of "The Clinical Guidelines Manifesto". The CGM is the most up to date comparison of ambulance service CPG's across Australia and New Zealand.  We dive into the manifesto, how ambulance services create their own guidelines, and how we can improve the process of determining best practice.   The manifesto was published in The Shift Extension industry journal.  To read the manifesto head to www.theshiftextension.org 

Today we sit down with New Zealand Extended Care Paramedic and Nurse Shell Piercy. Shell has had a diverse career working in military, ambulance, mining and wilderness settings. We talk about her experiences, finding your purpose and how to make the most of your career in paramedicine. 

Dr Sandy Macquarrie is an accomplished paramedic, academic and researcher. After decades of ambulance and fire service in Canada, he migrated to Australia to teach. He completed a PhD in paramedic wellness and continues his work at Griffith University on the Gold Coast. Last year, Sandy suffered 4 cardiac arrests.  We sat down with Sandy to talk about how paramedics deal with death and dying. How do we care for family? How do we care for ourselves? What did he learn from his experiences as both a paramedic and patient. 

Today we are joined by Dustin Osbourne, a police officer from Queensland, Australia. Dustin was instrumental in the creation and delivery of the police tactical first aid program. We talk about his experiences providing medical care in the community and the role police can play.  

Today we are joined by Mark Ward, an experienced remote area paramedic from QLD. We sat down to discuss how paramedics can adapt to their ever-changing clinical practice. We look at why things change slowly, why change is important and why vinegar and box jellyfish are not your friends. 

Today Nick and Sunny talk about cardiac arrest. How do we become better at managing these in our environment and care for others when the outcome is poor. 

Today Sunny and Nick discuss the case of a 70-year-old with syncope in the presence of an ongoing infection. We talk about assessment, red flags, patient needs, and recommendation of care. 

Today we welcome Clinical Nurse Kate Carmody to the show. Kate is an experienced nurse, with military, civilian and out of hospital experience. Today we talk about the taskforce she led during the recent NSW flood disaster, providing vital medical care to isolated and vulnerable communities. 

The poem "I'm a paramedic, but no one taught me how" by  Julia Cornah teaches us that our studies can't prepare us for everything that we will encounter. That sometimes we have to be creative and think outside the box. Today Sunny and Nick reflect on some of the stranger jobs, the ones you can't learn to deal with from a textbook. 

We were fortunate to sit down with Dr Andrew Tagg, an paediatric emergency specialist from Australia. Andy is also the co-founder of the education platform, "Don't Forget the Bubbles". We had an amazing chat about how to a better clinician and how to look after yourself in the process. 

Today we sit down with Mr Darren Hodge. Darren is a MICA Flight Paramedic from Melbourne, Australia. Today he shares a case from his book "A Life on the Line". Not only did the case push Darren to his limits, but so did the aftermath. 

Today we are joined by Ekaterina (Kat) Puzanova, the author of the article "Underestimated and Underutilised - The private paramedic sector". We explore this emerging sector, challenge some misconceptions, and discuss how private paramedics can serve our profession. 

Today we sit down with Alex Mair, to talk about her highly successful podcast. The Student Paramedic Podcast has been providing fantastic insights, learnings and ideas  for students and paramedics alike. Alex tells us about where it all began, the lessons she learnt along the way, and how it helped her become a life long learner. 

We spend a lot of time developing our technical skills. But have we lost sight of the importance of the so called "soft skills"? Today we sit down with Andy Bell to discuss these skills and why they are essential to our practice.  "A patient won't remember what you said, or what you did, they will remember how you made them feel"

We recently sat down with Mitchell Trethowan, to have a chat about his recent publication "Good Grief, Bad Grief - Should family be present during cardiopulmonary resuscitation". Can being present benefit the family, or can it hinder clinical interventions? Does being present allow the family to be involved in decision making, or does it hinder communication within the team? Tune in to hear our thoughts! To read the article in full, head to Good Grief Bad Grief - Clinical Education (theshiftextension.org) 

On today's episode, Sunny and Nick explore a case of atypical anaphylaxis. 

Welcome to the first episode of The Shift Extension Paramedic Podcast. Today Sunny and Nick dive into our first case study. We have all been to the intoxicated patient who we believe is "just drunk" and thus absolutely fine. But what if there was something else contributing to their presentation, something that was subtle but dangerous.  Today we talk about serotonin syndrome.  These patients are usually young, fit and healthy, but can present with life threatening disease. We will talk about its presentation, red flags and how our bias can cloud our judgement.