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Welcome back! In this episode, we're diving deep into something we all think we know, the Glasgow Coma Scale. The GCS has been a fundamental part of assessing patients with altered consciousness for over 50 years. You'll find it in trauma scores, neurology exams and practically every prehospital and ED handover. But here's the thing, is it as reliable and useful as we think? In this episode, we'll explore the origins of the scale, what it was designed for and how it's been used (and maybe misused...) since. We take a look at how reproducible it really is, particularly when different clinicians score the same patient. Spoiler alert: it's not always as consistent as you might hope! We'll also unpack the individual components; eyes, voice, motor and ask if they all carry equal weight, or are some more prognostically useful than others? Because a GCS of 4 isn't always the same GCS of 4, depending on how you get there… We'll be looking at real-world implications, how we make decisions around airway management, imaging, and referral, all based on that one number. So whether you're in prehospital care, the ED, or intensive care - stick with us as we try to answer the question: is the GCS still doing what we need it to, or is it time to move on? Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Opioid toxicity is a major and growing challenge across the UK and beyond, with nearly 10 deaths every day from opioid overdose and over a million adults using Class A drugs annually, the impact on emergency services is enormous. In this episode, we're diving deep into the recognition and management of acute opioid toxicity in the emergency setting, including the reversal using naloxone. We'll run through; The scale of the problem, including the rise of novel synthetic opioids like fentanyl and nitazenes. A breakdown of opioid pharmacology, including receptor types, potencies, and onset of action. How to identify classic and mixed presentations of opioid overdose. Best practice on naloxone dosing, routes of administration, and when to start infusions. The risk of acute withdrawal and how to manage it with care. How to approach mixed overdoses, cardiac arrests involving opioids, and nebulised naloxone. And finally, the importance of holistic care, safeguarding, and onward referral to support recovery. Whether you're in ED, prehospital care, or just want to sharpen your tox knowledge, this episode's packed with take-home learning. Oh, and yes... Gangs of London gets a shout-out too. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Welcome back to The Resus Room! This time, we're diving into the fascinating and often overlooked world of electrical injuries. From household mishaps and workplace accidents to tasers and even lightning strikes, electrical injuries can range from minor shocks to life-threatening cardiac arrests. As always, we'll be taking you through the full spectrum of care, from first contact at the roadside to critical management in resus. And let's be honest, there's a real lack of clear guidance out there when it comes to managing these cases. So, we've done the legwork, scoured the literature, and we're here to make sense of it all. In this episode, we'll cover: Pathophysiology; how electricity interacts with the body and why not all shocks are created equal. Classification; what makes a low-voltage injury different from a high-voltage one, and why that matters. Prehospital & ED Management; who needs an ECG, who needs admission, and what to do with those tricky "seemingly fine" patients. Special cases; tasers, lightning strikes, and the unique challenges they pose. One of the big questions we'll be tackling: Does everyone who gets an electric shock need to go to hospital? We've all seen them, the patient that has a shock at work, but they feel fine. So, do they need a work-up, or can they safely go home? So, grab a coffee (or maybe a non-conductive beverage of choice), and let's get stuck in to Electrical Injuries! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
We are pleased to speak to the Ven. Dr. Rob James (which he said we could shorten to Rob), about his latest publication, 50 New Testament Stories for Storytellers, a new illustrated, beautifully illustrated we might add, children's Bible. Rob is an Associate Professor and the Director of Anglican Studies and Formation at the Vancouver School of Theology. He also holds six degrees from five universities and has many years of experience as an Anglican perish priest. Rob speaks to us about his approach to telling biblical stories to kids (and adults) through the lens of storytelling, incorporating visuals and participation as he goes. There are important questions to be asked about how we speak to children about faith and how we tell kids the stories of the Bible. Often this telling has been experienced as reductionist or moralizing. Rob does neither of these things. He helps to bridge the gap between biblical scholarship and storytelling in this book and is a resource that we heartily recommend for those wanting to find hopeful, new, and interesting ways to bring the stories of the Bible to children. 50 New Testament Stories for Storytellers is available now. A quick recording note, you may notice that our interview with Rob has a distinct cathedral-like echo. Unfortunately, we did not record our conversation with Rob in a cathedral, although that would have been cool, but we hope it isn't a distraction as you listen. Enjoy!
Take the next step in your OCD recovery with my course - Use the Promo Code 'BREAKFREE' at Checkout for 50% off: OCD Course - OCD Elements: Foundations for Freedom Book your free discovery call directly, visit: www.robertjamescoaching.com In this episode of the OCD and Anxiety Podcast, we delve into the complexities of managing OCD when you're not feeling your best due to illness. Discover practical strategies to cope with anxiety symptoms that may feel intensified by physical sickness like the flu or COVID. Rob James shares personal insights on the unique challenges faced when regular coping mechanisms are disrupted by illness. From adjusting expectations to implementing passive diffusion techniques, learn how to maintain resilience and regain control over intrusive thoughts, even when energy is low. Join us as we explore simple, yet effective self-care practices that can make a significant difference in managing OCD during times of physical sickness. Whether it's recognizing small wins or taking micro-steps, this episode offers valuable advice for anyone grappling with anxiety under the weather Disclaimer: Robert James Pizey (of Robert James Coaching) is not a medical professional and is also not providing therapy or medical treatment. Robert James Pizey recommends that anyone experiencing anxiety or OCD to seek professional medical help straight away to get a medical opinion and rule out other conditions or illnesses. The comments and opinions as written on this site are simply that and are not to be taken as professional medical opinions. Robert James Pizey provides coaching, education, accountability and peer support around Anxiety through his own personal experiences.
In 1978, Naomi James became the first woman to sail single-handedly around the world via Cape Horn.At the time, Naomi had had only six weeks of sailing experience and had never been on her own on a boat. She also suffered seasickness, and struggled with navigation.But with the encouragement of her husband Rob James, a professional sailor, she set off from Dartmouth, England, in her yacht, the Express Crusader.During the 43,000km journey, the boat capsized and she had to sail through a hurricane. But after 272 days, she arrived back in Dartmouth to a hero's welcome. In 1979, she was given a damehood. She tells Jane Wilkinson about her epic adventure.Eye-witness accounts brought to life by archive and testimony. Sporting Witness is for those fascinated by sporting history. We take you to the events that have shaped the sports world through the eyes of the people who were there. For nine minutes, you become a fan in the stands as we take you back in time to examine memorable victories and agonising defeats from all over the world. You'll hear from people who have achieved sporting immortality, or those who were there as incredible sporting moments unfolded.Recent episodes explore the forgotten football Women's World Cup, the plasterer who fought a boxing legend, international football's biggest ever beating and the man who swam the Amazon river. We look at the lives of some of the most famous F1 drivers, tennis players and athletes as well as people who've had ground-breaking impact in their chosen sporting field, including: the most decorated Paralympian, the woman who was the number 1 squash player in the world for nine years, and the first figure skater to wear a hijab. You can learn all about fascinating and surprising stories, such as the tennis player who escaped the Nazis, how a man finally beat a horse in a race, and how the FIFA computer game was created.(Photo: Naomi James checks the rigging. Credit: Evening Standard/Getty Images)
Cardiac Arrest in pregnancy affects around 1: 12-30,000 women in the developed world. As you'd expect the risk of death for mother and child is extremely high, but some causes of arrest are reversible and we can make a real impact with our care and treatment of these cases Now it goes without saying that these are some of the most emotive, complex and technically challenging Resuscitations that you could think to be involved in; by definition young female arrest with unborn babies involved. Thankfully this is not going to be a case that many of us see, but with the stakes so high and potential to impact on the outcome of two patients, it's an area that's worth real consideration, preparation and mental rehearsal in case we are one of the few that may need to deal with it! In this episode we're going to run through all the same stuff that you'd expect; pathophysiology of pregnancy, aetiology and the way in which we should approach these arrests. But then we're lucky enough to be joined by Caroline Leech, an EM and Prehospital doctor who's an expert in the area having just published a key paper that's prompted loads of discussion in crew room and online on the topic of maternal arrest and Resuscitative Hysterotomy which will really challenges our perception on survival for both mum and the unborn baby if a RH is indicated. So we'll be running through that paper with some really valuable insights from Caroline and wrap up with some questions to her exploring experience from cases, along with potential strategies for how approach and manage these cases for those working both in prehospital and in-hospital settings. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Happy Year of the Lions! Leones de León won the 2025 LBPN, Nicaraguan Winter League, Serie Final after coming back down 3 – 1 vs Tren del Norte who did their best Icarus impression; (11:28) Leones del Escogido won the 2025 LIDOM, Dominican Winter League, Serie Final after almost losing a 3 -2 lead vs Tigres del Licey the defending back-to-back champions; and (18:39) Rob James, Partner at Pillsbury, talks Common Law and the San Francisco Giants. Drink: Cabernet Sauvignon (2020) from Markham Vineyards in Napa Valley, California. Rob James website: https://www.attenuatedsubtleties.com/ Last Call Baseball T-Shirts: https://lastcallbaseball.creator-spring.com/ Last Call Baseball Instagram: https://www.instagram.com/lastcallbaseball/ Last Call Baseball Twitter: https://x.com/LastCall4040 Intro and Outro Music: DeCarlo Podcast Logo Artist Instagram: https://www.instagram.com/regan_vasconcellos/
Stephen, Philip and Josh join David via Zoom for a look back at the highlights of 2024. We look and listen to extracts from interviews with Alexia Davis and her journey to become her authentic self, Tony and Pank discuss prison reform, Rob James and Mark Ward discus the infected blood scandal and Stephen talks about Shadowed Dreamer.
Welcome back to the first Roadside to Resus episode for 2025!! In this episode, we're diving into a seasonally appropriate, and really paediatric common presentation for anyone involved in emergency care….Bronchiolitis. Now although it's one of the most common respiratory illnesses affecting kids, bronchiolitis can easily cause confusion and concern around the severity of illness, whether to convey/admit/discharge, and also which treatments are indicated and which aren't, including the perennially hot topic of bronchodilators. In this episode we're going to and delve into all of those aspects & explore the evidence and guidelines that are out there for bronchiolitis, including the NICE guidelines on the topic. So, whether you're on the frontlines of paediatric emergency medicine or just brushing up on your knowledge, this episode…hopefully…will be packed with practical insights to enhance your care in those patients with bronchiolitis or even the differentials! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Give to help Chris continue Truce It all started with a meeting over fancy donuts. Paige Patterson and a friend met together to plot the fundamentalist takeover of the Southern Baptist Convention. Before that time, the SBC had been more theologically diverse (though, not necessarily racially diverse due to its founding as a group that desired slavery). But if this group of fundamentalists was going to get a whole denomination to turn their way, they'd have to be clever. It would take time. Their scheme involved getting fundies elected into high office who could then turn committees and sub-committees to their side. It's a story of a minority group gaining control of a large organization, and steering it toward their vision of what it means to be a Christian. Sources The Fundamentalist Takeover of the Southern Baptist Convention – by Rob James, Gary Leazer The Evangelicals by Frances Fitzgerald Christianity Today article about Paige Patterson's allegations Religion News article about Patterson Tennesseean article about Patterson Article about early Baptists Church History in Plain Language by Bruce Shelley Cornell's article about the separation of church and state Frances Shaeffer and the Shaping of Evangelical America by Barry Hankins Johnson Archives about SBC Johnson Archives SBC Resolutions Certified Pastry Aficianatro article about beignets Discussion Questions The episode starts with a discussion of accusations about Paige Patterson. What was your reaction to that story and why? Is it possible for a spouse to be a part of the salvation of their husband or wife? Where are the lines? When were you baptized? Did you do it as an adult, child, or both? Why? What do you think is the "right" way to baptize someone? Why? What are your thoughts on inerrancy? Learn more about your ad choices. Visit podcastchoices.com/adchoices
Motor vehicle collisions or road traffic collisions are a massive problem worldwide. Data from the World Health Organisation reports that there are around 1.2 million deaths every year and this is the leading cause of death internationally for children and young adults aged 5-29 years. In the UK there are around 1,500 deaths annually and also around 60,000 patients with significant and life changing injuries, which is 7 patients every hour!! So anything we can do to improve patient care following an MVC is definitely a worthwhile venture. We've looked at Extrication here on the podcast before but we're back on it again because today the Faculty of Pre Hospital Care have released their Consensus Statement on Extrication Following a Motor Vehicle Collision. The statement builds on the work from the EXIT project and the research that has helped inform our understanding of multiple factors of extrication. The statement will inform a change of practice for both clinicians and non-medical responders and in this episode we run through the statement with two of it's authors and discuss the practical applications. Make sure you take a look at the new Consensus Statement itself and the background evidence which is all linked to on the website. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
AI takes a huge amount of energy to run and could make it harder to fight climate change. On the other hand, AI could help make our energy systems more sustainable, efficient and safer. Three experts talk all things AI and energy with a live audience. The talk was part of a daylong symposium titled “Policy Leadership in the Age of AI”, hosted by the LBJ School of Public Affairs at The University of Texas at Austin.Meet the panelists:Michael Pyrcz is a professor in UT's Cockrell School of Engineering and the Jackson School of Geosciences, who researches and teaches about ways to apply data analytics and machine learning to improve the exploration and safe production of minerals, groundwater and conventional energy, a.k.a. oil and gas. He also shares educational content on YouTube and elsewhere under the alias GeoStatsGuy.Varun Rai is a professor in UT's LBJ School, who studies the spread of clean energy technologies and how real-world factors – from economics to politics to regulation to social behaviors – drive the adoption of these technologies.Rob James is an attorney at the law firm Pillsbury, who leads a number of energy and infrastructure projects for the firm in Texas and California. Those projects have included AI data centers and zero-emission power generation and storage.Dig DeeperThe A.I. Power Grab, NYTimes (Oct. 2024)A bottle of water per email: the hidden environmental costs of using AI chatbots, Washington Post (Sep. 2024)Four ways AI is making the power grid faster and more resilient, MIT Technology Review (Nov. 2023)Microsoft deal would reopen Three Mile Island nuclear plant to power AI, Washington Post (Sep. 2024)Extreme Weather Is Taxing Utilities More Often. Can A.I. Help?, New York Times (Sep. 2024)Fixing AI's energy crisis, Nature (focused on reducing computer hardware's power consumption - Oct. 2024)A.I. Needs Copper. It Just Helped to Find Millions of Tons of It., New York Times (July 2024)AI is poised to drive 160% increase in data center power demand, Goldman Sachs (May 2024)Photos from Policy Leadership in the Age of AI Symposium (Oct. 2024)Episode CreditsOur co-hosts are Marc Airhart, science writer and podcaster in the College of Natural Sciences and Casey Boyle, associate professor of rhetoric and director of UT's Digital Writing & Research Lab.Executive producers are Christine Sinatra and Dan Oppenheimer. Sound design and audio editing by Robert Scaramuccia. Theme music is by Aiolos Rue. Interviews are recorded at the Liberal Arts ITS recording studio.The cover photo for this episode is by Thomas Meredith, courtesy of LBJ School of Public Affairs. About AI for the Rest of UsAI for the Rest of Us is a joint production of The University of Texas at Austin's College of Natural Sciences and College of Liberal Arts. This podcast is part of the University's Year of AI initiative. The opinions expressed in this podcast represent the views of the hosts and guests, and not of The University of Texas at Austin. You can listen via Apple Podcasts, Spotify, Amazon Podcasts, RSS, or anywhere you get your podcasts. You can also listen on the web at aifortherest.net. Have questions or comments? Contact: mairhart[AT]austin.utexas.edu
In this episode we're going to be running through adrenal presentations; both Adrenal insufficiency and Adrenal Crisis. There are some parts of these that aren't completely understood and a lack of a universal definition of Adrenal Crisis, but both insufficiency and a crisis are similar problems at different points on a spectrum and solid understanding of the endocrinology and physiology can really help to improve care in this area. There is huge potential for improving current morbidity and mortality. We'll run through both primary and central adrenal insufficiency, describe how this leads to different effects on mineralocorticoids and glucocorticoids and the signs and symptoms that will occurs as a result. Many of the patients presenting to the department will be unknown to have adrenal insufficiency and we'll run through those who are at higher risk, including a huge group due to ongoing medication, who may be those on steroid doses much lower than you would previously have considered as significant. NICE published their most recent guidance on Adrenal Insufficiency in August this year and we'll be referring to a lot of this as we run through the episode. We'll finish up looking at the critical presentation of Adrenal Crisis and the emergency and ongoing management, along with how we support patients with insufficiency to prevent a crisis occurring. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
PE's (or Pulmonary Emboli) are a key part of Emergency Care, something that many of us will consider as a differential diagnosis multiple times of a daily basis, in a similar way to acute coronary syndrome, so we need to be absolute experts on the topic! A PE normally occurs when a Deep Vein Thrombosis shoots off to the pulmonary arterial tree, occurring in 60-120 per 100,000 of the population per year The inhospital mortality is 14% and the 90 day mortality is around 20%. But this is proportional to its size, and risk stratifying PE's once we've got the diagnosis is really important. PE is a real diagnostic challenge and less than 1 in 10 who are investigated for a PE end up with the diagnosis, so knowing the risk factors, associated features and thresholds for work up are really important. There are some key concepts in risk stratification and particularly in test thresholds that we'll cover in this episode that are applicable to all of our practice…..we're excited! Getting these right helps us to avoid missing the diagnosis and equally importantly ensure we aren't ‘over testing' & ‘over diagnosing' because investigation and treatment for a PE isn't without it's own risks. In the episode we'll talk in depth about factors associated with presentation, risk factors, investigations and finally onto treatments, covering the whole spectrum from low risk PE's up to those with massive PE's and cardiac arrest. The evidence base behind the work up and treatments is truly fascinating and we hope you find this episode as eye-opening as we did to prepare for! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
While much of my interview with Rob James includes information about visiting the annual Robin Hood Festival in Sherwood Forest, if you don't anticipate being able to make that particular trip, the episode also includes discussion about promoting wildlife diversity in Sherwood, the importance of the Robin Hood legend for the local community, and more!To learn more about the Robin Hood Festival go to: visitsherwood.co.uk/home/robin-hood-festival-2024/Or simply visitsherwood.co.uk for planning a trip any other time of year or for learning more about what remains of this ancient oak forest.For more from Into the Greenwood:instagram.com/intogreenwoodtwitter.com/intogreenwoodthreads.net/@intogreenwoodfacebook.com/intogreenwoodyoutube.com/@intothegreenwoodpodcast6559To support the podcast go to:patreon.com/IntoGreenwoodorbuymeacoffee.com/intogreenwoodOur selected charity: Trees, Water & PeopleSupport the Show.
Acute Kidney Injury is common, complicated and holds significant morbidity and mortality. But...if we recognise it, we can make a real difference to our patients' outcomes. In this episode we run through the anatomy, physiology and aetiologies. We have a think about the multitude of definitions of AKI and then take each of the pre renal, renal and post renal categories and think about the ways we can optimise our care in each. We also have a think about who needs to be admitted and who can be safely managed in the community. This was a hugely valuable episode for us all to research and bring clarity to a complicated topic, we hope it does the same for you too! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
So this month we're looking at major incidents and specifically the triage process that is now coming into play in the UK and further afield that you need to know about! We normally stick pretty strongly to clinical topics; they're pretty easy to focus on because you can imagine how extra knowledge in a certain clinical area could make a difference to presentations that we see pretty commonly. And being brutally honest, making the effort to prepare and rehearse what we might do, on the off chance that we ever come across a major incident, can be difficult to motivate yourself to do. But this is probably an area that investing a bit of time in, really thinking about how you would act in a major incident, could make a phenomenal difference to what may be one of the most, if not the most challenging clinical days of your career. In the episode we run through Ten Second Triage (TST) and the Major Incident Triage Tool (MITT). They replace the previous triage methodologies and are to be implemented by the end of this month. We also cover some other aspects of planning and approach for being the first responder at a major incident, and we were lucky enough to gain some insights to the new triage process from Phil Cowburn, an EM & PHEM consultant who was involved in their development. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
Rob's been a commentator over the years (can you tell?), and he loves a good story, so we're only just shifting into second gear in this chat! Discover how Herridge jumped into rallying on a whim, convinced he was world champion material on the very first transport stage! Learn about the Datsun 1600 that started it all, his near switch to Mitsubishi, and the ultimate move to Subaru, sparking a partnership that's lasted for decades. We recorded this episode in the workshop, surrounded by cars Rob has worked on and won in. The attachment to some of them is understandable, especially when you hear the story of how Rob clinched his second Australian title before officially receiving the first. Despite a lengthy and draining court battle, he never gave up. Special thanks to Rob James and Adelaide Hawkins from Motorsport Australia, who assisted with this episode while filming a TV story for an upcoming round of the Australian Rally Championship. Head to Rusty's Facebook, Twitter or Instagram and give us your feedback and let us know what you want to hear about on Rusty's Garage. WIN 1 of 5 $100 Vouchers: Just help us out by completing our inaugural Rusty's Garage survey here.See omnystudio.com/listener for privacy information.
This Saturday, Craig talks to Rob James. Between 2000 and 2018 Rob James was almost certainly the busiest close-up magician in the UK often performing at 25 proper paying high fee close-up gigs a month. In 2018 after becoming both burnt out and financially secure, he quit.
Lower back pain is a really common cause for patients to present to primary care, urgent care and emergency care. Thankfully many of these cases are self limiting, but somewhere in the region of 1:300 patients with back pain in the ED will have Cauda Equina Syndrome. Cauda Equina Syndrome is something that is challenging for all clinicians because many patients with simple lower back pain may have many similar symptoms, but if we miss it, or if there is a delay to surgery that can lead to potentially avoidable long-term disability for our patients and on top of that its a major cause of healthcare litigation. And we're not talking about a delay in weeks being a problem here, we're talking about hours to days, with big potential complications like impaired bowel/bladder/sexual dysfunction or lower limb paralysis - so you can see why litigation is a big part of some missed cases. In this episode we run through the the signs, symptoms, investigations and treatment with a strong reference back to the underlying anatomy and disruption. We also cover the recently published national Cauda Equina Pathway, which is a great resource but poses some real challenges in it's implementation! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
End Tidal CO2, or ETCO2 for short, is something that's talked about pretty often in Emergency and Critical Care and that's because it's used a lot in the assessment and treatment of patients! It's got a big part to play in airway management, resuscitation, sedation and is also increasingly used in other situations. Some of these applications have some pretty strong evidence to back them up but others are definitely worth a deeper thought, because without a sound understanding of ETCO2 we can fall foul of some traps… ETCO2 is a non-invasive measurement of the partial pressure of CO2 in expired gas at the end of exhalation. Ideally we'd like to know what's really going on arterially with the partial pressure of arterial CO2 but we can use the end tidal because that's an easy reading to get from exhaled breath, when it will most closely resemble the alveolar CO2 concentration. Its value is reflective of ventilation but also really importantly is affected by the circulation, the circuit and how it's applied. In the podcast we run through all of these aspects, its application to clinical care and also some of its pitfalls. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
As we all know, rapid and effective resuscitation makes a huge difference to the chance of survival from a cardiac arrest. If you're going to pick a rhythm to have as the patient or as the Resuscitationist, then it's going to be a shockable rhythm, so VF or pulseless VT as they hold the greatest chance of survival. You'll find an initial shockable rhythm in around 20% of cases & defibrillation alone may lead to a ROSC. So it's absolutely imperative to get the immediate management spot on! Whilst current practice is good, there are some aspects of care that we can improve on and make a real difference to outcomes in these patients, with those first on scene or at the bedside in a phenomenally important position to deliver life saving care. In this episode we'll be talking predominantly about refractory VF but the strategy will transfer to how we can also deal with refractory VT cardiac arrests. We'll be running through all of the following; VF incidence Mechanisms behind VF Refractory and recurrent VF Defibrillation strategies Pharmacological strategies PCI in arrest ECMO Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
We know it's the festive season but we thought we'd try and cover an issue from which there appears to be no escape and is a particular problem at this time of year, queuing! Whether we like it or not, this has become a factor for all of us working in emergency care, whether its delays getting your patient into the department, queueing down the corridor into ED, a prolonged stay in ED for an appropriate ward, or even in a physical queue to get out of the ED and onto an appropriate bed! We are looking after our patients for significantly longer than we're used to and this pushes the patient and the clinician into an area of care in which we have limited experience and comfort. Rather than accepting delays and ignoring their inevitable impact on patient care, we need to move towards equipping ourselves with the skills and knowledge to fill that care vacuum and ensure that excellence in patient care continues throughout their time with the ambulance service. So with that in mind, in this episode we're going to think about some of the considerations and interventions that are required to ensure our patients remain safe and comfortable throughout their queueing experience. And to do that we're going to draw on the concept of prolonged field care. An article by Aehbric O'Kelley and Tom Mallinson recently authored a paper published in Journal of paramedic practice entitled “Prolonged field care principles in UK paramedic practice”. That article really provided the idea and stimulus for this episode, so thanks to them for all of the hard work and once you've listened to us waffle on you should head across to their paper for a far more eloquent explanation of it all! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
The world of F1 Podcasting is a small space - luckily, we share it with some absolute legends. In this episode, James is joined by one of them, Box of Neutrals' Rob James. ---
Blood gases are really commonly used in ED, Critical Care, Respiratory Medicine and Prehospitally. In fact, you'd do well to walk 10 meters in an ED without being given one to sign off! But it's for good reason, because they give you additional information about what's going on from a respiratory and metabolic perspective in the patient. And it's probably worth mentioning at this point, this episode is going to be pretty ‘science-heavy', there should be something in here for everyone; from the clinician that's been looking at these things for the last 30 years, to those that haven't started interpreting gases. So arterial blood gases can tell you about the efficacy of the patients ventilation in terms of their partial pressures of oxygen and carbon dioxide levels and also from a metabolic perspective about other disorders of their acid-base balance. In the episode we'll be covering the following; -Overview of blood gases -Respiratory & metabolic sides of the gas -Acidaemia -Alkalaemia -Bicarbonate or base excess? -Compensation -Oxygenation -Anion gaps -System of interpretation -Venous gases -Clinical application & examples of interpretation We'll be referring to the equation listed on our webpage, so make sure you go and have a look at that and all the references listed. Once you've listened to the podcast make sure you run through the quiz below to consolidate the concepts covered with some more gas examples and of course get you free CPD certificate for your TheResusRoom portfolio! Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
HOST: Steve Elkins. Rob James in hour 2 and your calls.
HOST: Steve Elkins. Rob James in hour 2 and your calls.
HOST: Steve Elkins. Guest: Orlean Koehle discusses her new book on the Maui Fires, (anomalies). Rob James co-host in hour 2 discusses all the issues that concern us.
HOST: Steve Elkins. Guest: Orlean Koehle discusses her new book on the Maui Fires, (anomalies). Rob James co-host in hour 2 discusses all the issues that concern us.
HOST: Steve Elkins. Guest: Orlean Koehle discusses her new book on the Maui Fires, (anomalies). Rob James co-host in hour 2 discusses all the issues that concern us.
HOST: Steve Elkins. Guest: Orlean Koehle discusses her new book on the Maui Fires, (anomalies). Rob James co-host in hour 2 discusses all the issues that concern us.
Host Jen Miller speaks with Rob James, Chair of the Avon Lake Charter Review Commission, who gives an overview of the Commission, and explains Issue 28, the Proposed Charter Amendment that will appear on this November's ballot. Upcoming events happening in Avon Lake: October 27, 9:00 AM-12:00 PM: Holy Spirit Ladies Guild Garage and Bake Sale at Holy Spirit Parish's Fr. Mosovsky Hall October 27, 6:00-7:30 PM: Trick-or-Treating at Towne Center Community Campus Main Street Care Center October 28, 9:00 AM-1:00 PM: Shred Day at the Ellen Trivanovich Aquatic Center Parking Lot October 31, 6:00-7:30 PM: HalloweenTrick-or-Treating November 3: Deputy Clerk of Council Application Deadline November 6, 7:00 PM: Collective Committee Meeting November 7, 6:30 AM-7:30 PM: Election Day November 10: Human Resources Director Application Deadline For information about these and future events/meetings in Avon Lake, please visit www.AvonLake.org/Events.
Mike Rivero special guest in hour 1. Middle East Powder Keg. Rob James is my guest host in hour 2 guest, and your questions.
Mike Rivero special guest in hour 1. Middle East Powder Keg. Rob James is my guest host in hour 2 guest, and your questions.
Mike Rivero special guest in hour 1. Middle East Powder Keg. Rob James is my guest host in hour 2 guest, and your questions.
Mike Rivero special guest in hour 1. Middle East Powder Keg. Rob James is my guest host in hour 2 guest, and your questions.
In this episode we're going to cover the ‘atraumatic' or ‘spontaneous' pneumothoraces and focus on some new key guidelines from the British Thoracic Society which came out in July this year and also look at the relevant evidence on the topic. There are pretty significant changes in the BTS guidance, it's no longer about finding a pneumothorax, working out if it's primary or secondary and then acting dependant on the size. It's now moved more towards looking at how the patient is clinically, taking into account the symptomatology, any big risk characteristics, whether it's primary or secondary and then thinking about the patients wishes and priorities and nuancing the management plan towards those. This episode builds on some of the concepts we discussed in our Traumatic Pneumothorax podcast, so make sure you give that one a listen before clicking play on this one! We'll be looking at the presentation, evidence, management and follow up, along with some trials that you can get involved in to help develop practice even further. Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
HOST: Steve Elkins. NIR hosts Steve Elkins, Rob James and Steve Stars respond on how to handle the Gaza attacks and the dire predictions of what comes next? Was this
HOST: Steve Elkins. NIR hosts Steve Elkins, Rob James and Steve Stars respond on how to handle the Gaza attacks and the dire predictions of what comes next? Was this
Delivering excellent End of Life Care in the Emergency Care is a real challenge but also a huge privilege and has formed some of the most rewarding parts of our careers to date. We've been really keen to End of Life Care as a topic for a while now. Many, if not all of you, will have been out to these patients or received them in your ED. They aren't simple cases to manage, with lots of issues around scope of practice, lack of alternative care pathways, confusion surrounding legal documentation and many studies have identified a lack of education around palliative care. In this episode we'll do our best to demystify those medico-legal terms, talk about care pathways and options that may be available to us, have a think about how we can talk with patients about death and then go on to discuss the clinical care we might need to deliver and the wider holistic nature of caring for these patients and their loved ones. We're lucky enough to be joined by Ed Presswood, who's a palliative care consultant and clearly an expert on the topic. We gained a massive amount from this episode and we hope you find it really useful too. You'll find the hyperlinks to some fantastic resources on the topic over on the webpage at TheResusRoom. Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
HOST: Steve Stars. Hour 2. Rob James joins Steve Stars who is substituting for Steve Elkins to continue the quest for justice. How do we openly address the crimes against
Welcome back to the podcast, coming to you all the way from Australia! Rob and James were fortunate enough to be invited to deliver the keynote and an airway masterclass at this year's Australian College of Paramedicine International Conference. At what was an amazing meeting, they were lucky enough to be able to catch up with some of the fantastic speakers to hear the key parts of their talks. In this episode you'll hear from; Richard Armour, Mobile Intensive Care Ambulance Paramedic at Ambulance Victoria and PhD Candidate at Monash University; Identifying patients requiring chest compressions at overdose prevention sites Nick Roder, MICA Flight Paramedic Educator, Ambulance Victoria and Teaching Associate, Monash University; Intubation in the setting of airways and inhalation burns Dr Tegwyn McManamny, Intensive Care Paramedic and Lead Patient Review Specialist, Ambulance Victoria; Care of the Older Person - Delirium and Paramedic Detective Olivia Hedges, Palliative Care Connect Lead, Ambulance Victoria; Palliative Care Connect Program Chelsea Lanos, Advanced Care & Community Paramedic Researcher; Organ donation after out-of-hospital cardiac arrest in Canada - a potential role for paramedics A huge thanks to ACP for the invite, Zoll for the support of the podcast and conference and to the fantastic speakers for giving ip their time to talk to us. We'll be back with another Roadside to Resus episode for you next week on End of Life Care. Once again we'd love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom and we'll see you back in September! Rob & James
HOST: Steve Elkins. Rob James and calls.
So in this episode we're going to run though the primary survey in trauma. This clinical assessment helps us identify and treat life threatening injuries and to rapidly intervene and correct them, so getting it right really matter1. How this is done is hugely dependant upon the setting (either pre or in-hospital) as it is affected by the access to the patient, the number of people there to contribute to care and the challenges that the scene or hospital environment might hold. We run through a model of primary survey that looks to gain as much information as possible in a rapid and effective pattern and discuss the slightly different approaches we all take, along with rationale behind them. Finally we cover the communication of the primary survey to the team, strategies that we can undertake to achieve this and how this can affect the momentum and onwards care of the patient. We found this a really useful topic to consider in some depth and we hope it's of use to you too! Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
This is the first of two episodes looking at pneumothoraces. In this episode we're going to start out by taking a look at traumatic pneumothoraces. Traumatic pneumothoraces are present in about a fifth of multiple trauma patients, so it's not infrequent to come across them and they can obviously occur in those with isolated chest injury too. Thoracic trauma occurs in around two thirds of multi-trauma cases and is classified as the primary cause of death in a quarter of trauma patients. The clinical assessment carries with it a fair amount of dogma, including looking for tensions with tracheal deviation, so we'll be running through what the signs we should look for actually mean. Then we'll move on to a detailed discussion about investigation strategies before finally looking at the guidelines and evidence on the topic, including which we have to intervene with, which we probably shouldn't and those in which there is much uncertainty... Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James ps; if you're interested in getting your site involved with the CoMITED Trial then email comited-trial@bristol.ac.uk
The last time we took a good look at head injuries was back in 2018 in our Roadside to Resus episodes and for all of the foundational stuff on incidence, assessment, management and loads more make sure you go and check that episode out. But this episode is one of our new UPDATES episodes, because we're pretty old now… and whilst we've been having a go at this for a while evidence and guidelines will have progressed, which clearly have implications on how we manage certain cases and that's where these come in! So they'll focus mainly on the last 5 years of practice. The new NICE head injury guidance has just been released and it's the first major overhaul since 2014. Now we know it's a UK guideline, but there's some really key practice updates and evidence in there that's relevant irrespective of where you find yourself listening this! So in this episode we're going to be having a look at the most recent TXA evidence, with in terms of indications, timing and dosing. We'll be having a look at the risk of intracerebral injury with regards to anticoagulants and antiplatelet agents and a few other bits and pieces that can help us inform and improve our care. Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
This episode is a discussion of the Coastal Studies & Society Journal with co-editors Isaac Land, Professor of History at Indiana State University, and Rob James, senior lecturer in History at the University of Portsmouth, UK.
Being in a situation of being unable to intubate and unable to oxygenate is an absolute time critical emergency. Focus needs to be paid to the techniques and strategy to deal with this situation. But we also need to consider steps to ensure it occurs at a low frequency and our decision making and recognition of the situation happens quickly and simply. In the episode we're going to be talking about a number of other aspects that are relevant for all emergency providers, irrespective of whether you intubate or not, along with how those aspects translate into everyday practice. We'll be covering bits around patient positioning, optimising simple ventilation via a BVM & supraglottics, all the way through to needle cricothyroidotomy and surgical airways. Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James
Sherwood Forest in the County of Nottinghamshire lays claim to a world famous tree, The Major Oak. It may well have harbored Robin Hood and his merry men, or perhaps people like them. Admirers from all over the world visit the beloved English oak, drawn by the legend. Two guests from the Sherwood Forest National Nature Reserve help describe why the tree is so special. One is Paul Cook, the Warden tasked with maintaining the woodland and the landscape. The other is the Sheriff of Nottingham, or, that is, Richard Townsley, a tour guide and local authority on Robin Hood. There's an aura around this tree thanks to the legend, but the allure and lasting popularity of England's arboreal icon has become about so much more. GuestsPaul CookWardenSherwood Forest National Nature Reserve, RSPBRichard TownsleyTour Guide - Sheriff of NottinghamSherwood Forest National Nature Reserve, RSPBConsulting EditorDavid Still, IIReader Nigel Holmesnigelholmes.com(excerpts from The Merry Adventures of Robin Hood by Howard Pyle, edited by Jonathan Kelley, The Townsend Press, Inc.)Recorder MusiciansDavid BorKim WassRecorder Music"Light of love," Anonymous"When that I was and a little tiny boy," anonymous Shakespearean stage tune"When lo, by break of morning," Thomas Morley, 1595"It was a lover and his lass," Thomas Morley, 1600"Tres douce dame que j'aour," Guillaume de Machaut, 14th c."We Be Soldiers Three," Thomas Ravenscroft, 1609Special thanks to:Rob James, Sherwood ForestPhoto creditSherwood Forest National Nature Reserve, RSPBTheme MusicDiccon Lee, www.deeleetree.comArtworkDahn Hiuni, www.dahnhiuni.com/homeWebsitethisoldtree.showTranscripts available.Follow onFacebook or Instagram We want to hear about the favorite tree in your life! To submit a ~3 or 4 minute audio story for consideration for an upcoming episode of "Tree Story Shorts" on This Old Tree, record the story on your phone's voice memo app and email to:doug@thisoldtree.netThis episode was written in part at LitArts RI, a community organization and co-working space that supports Rhode Island's creators. litartsri.org