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Pre-Hospital Care

Pre-Hospital Care

By Medics Academy
In this episode, we welcome Victoria Lebrec, London Traffic Justice Campaign Coordinator for RoadPeace. Victoria has been fighting for road safety in London since losing her leg after a collision with a skip lorry in 2014. Others have lost limbs on the same section of road since the incident, and it is only one of many places in London where accident rates are disproportionately high. Victoria’s work is focused on raising awareness of the need for improvements for cyclist safety across London.
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Currently playing episode

S01E01: Club Drugs & Non-Legal Highs (Part 1)

Pre-Hospital Care

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End of Life Care: Recognising the dying phase with Dr Emma Hall
In this episode Caroline Phillips hosts Dr Emma Hall, Palliative Care Consultant and discusses the signs of the final few days and hours of life. We discuss the challenges of recognising the dying phase, the importance of shared decision making and the positive aspects of shared learning between prehospital and palliative care professionals. This is part of a mini series on the Pre-hospital Care Podcast where we will start to look into topics in more depth and involve some of the subject specialists to share their experience.  We hope you enjoy the episode. Further reading: Kathryn Mannix – With the End in Mind Oxford Handbook of Palliative Medicine (2019) AACE JRCALC Clinical Guidelines (2019) – End of Life Care
1:05:44
October 23, 2020
The Pre-hospital Debrief with Nick, Caroline and Eoin
In this episode we explore some of the fundamental the components what makes a good debrief. The concept of debrief effects everyone within pre-hospital care whether formal or informal. Involvement in a debrief exercise can help to make sense of events and offer the opportunity for learning that can be applied in the future. It’s power, in part, is that it takes place when the events are fresh in the mind and that all experiencers are able to contribute. In this episode we dig a little into the broad benefits of debriefing and what makes for a successful debrief exercise (as well what doesn’t) within the context of prehospital care. How can we optimise the setting and structure in which a productive conversation can be had in order to maximise the outcomes from a debrief? Also, is shared reflection just for those ‘big jobs’ or can we apply it to any experience? We look at: Definitions of debrief. What do we think debriefing is/what purpose it serves. What debriefing is not. How we can optimise the setting for a successful debrief. How to structure a debrief. Relevant content in the context of pre-hospital care. Some of the issues/pitfalls/barriers involved in debriefing. The models we refer to in the episode are here:  Gibbs cycle: https://www.mindtools.com/pages/article/reflective-cycle.htm The 3D model of debriefing: https://www.semanticscholar.org/paper/The-3D-model-of-debriefing%3A-defusing%2C-discovering%2C-Zigmont-Kappus/7b63a9876c39340398dedd25b48eddc5f08096b8 Other insightful resources include the book 'Never fly solo' by Rob Waldman: http://www.neverflysolo.com/about-book.html Debriefing tools: https://www.nds.org.au/images/resources/wa-safer-services/Debriefing-Tool.pdf We hope you enjoy this wide ranging conversation.
1:00:58
October 8, 2020
Club drugs, illegal highs and Novel Psycho-active Substances with Owen Bowden Jones
This is a wide ranging conversation on club drugs, illegal highs and Novel Psycho-active Substances (NPS) with Dr Owen Bowden Jones. Owen is a Consultant Psychiatrist with over 20 years' experience in general and substance misuse psychiatry in both the NHS and private practice. In 2010 he founded the Club Drug Clinic, offering treatment specifically for those using 'club' drugs such as cocaine, ketamine, MDMA, GHB/GBL and novel psychoactive substances. In the conversation we discuss: The definition of Club drugs and illegal highs/Novel Psychoactive substances Define the problem by age and top 5 commonly seen drug presentations (differentiate between prevalence and problem – i.e. seeking help) Examine traditional vs emergent drug trends Look at groupings of drugs – Sedatives/dissociates, stimulants, synthetic cannabinoids, hallucinogens Examples of each and on common presentations & adjunctive use (concomitant use of these drugs) Ask about sourcing & trends in where people acquire drugs presently Look at first line staff engagement – who sees these groups of patients first (not always acute presentations) Examine new harms & clinical challenges Reference project Neptune – Novel Psycho-active Treatment Uk Network There is free e-learning on club drugs, illegal highs and NPS that Owen has put together, please find it at: http://neptune-clinical-guidance.co.uk/e-learning/ Feel free to reach out to Dr Bowden-Jones here: Owen.bowdenjones@nhs.net • Clubdrugclinic.cnwl@nhs.net • www.clubdrugclinic.com • @ClubDrugClinic @OwenBowdenJones www.neptune-clinical-guidance.co.uk
44:57
September 14, 2020
Bonus episode: Depression & Micro-adventure - Restore Podcast
In this wide ranging conversation with Will Duffin - a passionate GP, educator, adventurer, innovator and polymath we define the current problem around depression and then examine different states of depression. We also look at why people get caught in the cycle of depression and current modalities of treatment for depression (chemical intervention, groups, social prescribing, referral pathways). We then look at the concept of micro-adventure & the benefits of these together with Will’s perspective on optimising mental health and balance (work/life). We look at how do Will achieve's balance in his life and regimes that works for him. We also examine ways in which he has changed his mindset and approach to mental health over the past 10 years both as a GP and as an adventurer. We dig down into some of the statistics on Mental Health and why this is such an important topic - such as (Figures from MIND and MHFA England 2020): 1 in 4 people experience mental health issues each year 792 million people are affected by mental health issues worldwide At any given time, 1 in 6 working-age adults have symptoms associated with mental ill health Mental illness is the second-largest source of burden of disease in England. Mental illnesses are more common, long-lasting and impactful than other health conditions Men aged 40-49 have the highest suicide rates in the UK 70-75% of people with diagnosable mental illness receive no treatment at all Half of mental ill health starts by age 15 and 75% develops by age 18 I hope you enjoy this conversation with an insightful and thoughtful colleague and friend.
56:13
August 26, 2020
Thames Valley Air Ambulance (TVAA) with Ben Watts and Iain Edgar
In this wide ranging conversation with Critical Care Paramedic Ben Watts and ED Consultant Iain Edgar we look at an overview of the TVAA service in providing critical care to the community. We also look at how expedition and military domains that they both practice can be used within the pre-hospital critical care environment. Other aspects of the conversation includes: The patient target group and demographics of the service. Examine traditional vs emergent pre-hospital presentations that Iain and Ben have seen over their time in pre-hospital care. Interventions and decision-making and how these are approached within TVAA. Critical care training approaches, quality assurance and quality improvement within the service. Frontline staff engagement and how the service both encourage and incorporate them within the scheme. Innovations that the scheme has embedding and medium to long-term innovations that may improve the program Non-technical aspects of care Vs technical skills & utilisation rates Incremental gains when orchestrating flash teams Personal learnings over the last >2 years I hope you enjoy the last of these critical care service review sessions with two insightful friends and colleagues.
59:40
August 25, 2020
Conflict Resolution with Ray Goodall
In this episode we explore conflict resolution with Ray Goodall. Ray is an accomplished ex-military senior officer who is skilled in developing cohesive teams and has a vast operational background. He is Internationally acclaimed War College Faculty and a military institute instructor. He is also a liaison and advisor to Presidents, Ambassadors and Generals in complex multinational combat environments. Ray has extensive Combined Joint Force and Air Component Crisis Planning experience. He is an internationally recognized expert of the Command and Control of Air Power.  In this wide ranging conversation we explore: ·  The definition of Conflict resolution ·  Leadership in conflict situations (enemy and colleague conflict) ·  Models of conflict resolution - Strategy of Conflict and Game theory ·  De-escalation techniques used (aviation/inter-personal) ·  Optimisation of physiology - whether you use breathing techniques or tools to focus ·  Mentoring Vs Coaching ·  Rapid Decision making under stress and/or incomplete information ·  Failure (anecdotal examples of how you've learnt through failure) ·  Debrief & how to harness the best out of the debrief I hope you enjoy this episode with an extremely insightful and interesting guest.
1:04:14
August 18, 2020
Trauma with Karim Brohi
Karim is a Professor of Trauma Sciences in the Blizzard Institute, Barts and the London School of Medicine & Dentistry, and Consultant Trauma & Vascular Surgeon at Barts Health NHS Trust. He is also the director of the pan London trauma system. In this episode we look at: Monitoring modalities and diagnostics (the advent of pre-hospital and in-hospital US, in-hospital CT & MRI) that have led to an improvement in outcome. Whether front loading pre-hospital critical care teams with more interventions had a net positive impact on survival to discharge. The benefit of numerical targets for physiology such as blood pressure in resuscitation or more organic end-points such as mentation/AVPU or pallor/diaphoresis/respiratory rate are more useful? The adverse effects of complex interventional involvement in pelvic blunt injury (such as REBOA or ECMO) are worth the investment at point of injury or whether they are better placed in centres of specialism? What we can do to prevent penetrating trauma as the upward trend in penetrating disease continues? Look at the advances in rehabilitation services Vs impact on survival to discharge in comparison to pre-hospital, & surgical intervention? Some of the more common injury patterns that exist more-so now compared to when Karim first started as a surgeon. The recent challenges faced within the Pan London Trauma Networks. The advent of Acute Traumatic Coagulopathy (ATC) in the early 2000’s and its consequential impact on survival since. Where Karim sees the largest gains that can be made in pre-hospital care? What Karim looks for potential in other junior clinicians  Advice that Karim would pass on to someone starting their medical career. Aspects of mindset and approach that have changed in Karim's practice over the last 10 years  I hope you enjoy the episode.
37:53
August 10, 2020
Advanced Paramedic Practitioners (Critical Care) in London with Mark Faulkner
This is a wide ranging conversation with Mark Faulkner - the clinical development manager for critical care (advanced practice) within the London Ambulance Service NHS Trust, Mark is also the clinical advisor for Major Trauma within the LAS and as such sits on the Pan London Trauma Steering Group, as well as number of national trauma groups. In this episode we examine a variety of topics that encompass decision making, experience & empirical background, additional clinical interventions, leadership & non-technical skills and support/pastoral functionalities of advanced practice. We discuss: Overview of the APPCC Scheme The patient target group & demographics Added value of interventions Vs decision making. Training, quality assurance and quality improvement within the scheme. First line staff engagement – who sees these groups of patients first Innovations that the scheme has just embedding and medium to long-term innovations that have improved the program Non-technical aspects of care Vs technical skills & utilisation rates Incremental gains when orchestrating flash teams Personal learnings over the last >6 years I hope you enjoy the episode
32:34
August 6, 2020
Leadership with Tim Archer
In this conversation I talk with Tim Archer. Tim is a former Group Captain, he held a number of senior appointments in the RAF during which time he gained an MA in Leadership Studies from the Centre for Leadership Studies at Exeter University, a Post Grad Certificate in Executive Coaching from Lancaster University Business School and was awarded a full-time 12-month Fellowship back at the Centre for Leadership Studies. After a spell as Director Public Sector at the Leadership Trust in the UK, he moved to the United Arab Emirates for 8 years where he was a government advisor during which time he developed, designed and taught experiential leadership development and coaching programmes. He currently works for Cardiff University developing their leadership modules for the MSc in Public Health. We have a wide ranging conversation that touches on: The definition of leadership Mission command - military doctrine (what to do, not how to do it - no disseminated responsibility)  myth of military leadership  - Constructive decent Vs destructive concept The OODA loop (Observe, Orient, Decide, Act) Leadership Vs Management (Kotter) Trust and cohesion – Peak rapport Homeostatic leadership Compassionate Leadership Situational leadership Leadership in conflict Leader as a coach  Systems leadership - NHS Model - leading when not in charge I hope you enjoy this episode with a fascinating guest and friend.
1:21:01
July 8, 2020
Black Lives Matter: A conversation with senior Detective Inspector Ahenkora Bediako. Restore Podcast Collaboration
This has been the most downloaded episode of all time on the Restore Podcast and very relevant to the pre-hospital community. I have decided to re-post it on the PHCP as it affects every aspect of life and of blue light personnel.  In this episode I interview a senior Detective Inspector within the police who works within the Modern Slavery and Child Exploitation Unit in London. English born and raised, of African decent and operating for 14 years within the police through the hierarchy of leadership he has a unique perspective into the contemporary climate. I first met Henk as a friend about 8 years ago and have valued his perspectives and insights as a friend and colleague battling shift-work, the reality of London and everything in-between. We discuss some of the fundamental assumptions, biases and racism within society and aspects of law that need to be re-considered. We also discuss his standing as a leader within the institution and how we can all model progress and address the bias and racism. We also talk about representation of black and ethnic minorities within the emergency services and how this can be addressed. We also talk about the institution of the police and how the concepts of trust and of 'Non-maleficence' (do no harm) needs to be restored from the community towards the police.  I hope you enjoy this episode. 
1:16:21
June 27, 2020
EMRS & EMRTS Critical Care & Retrieval Services with Wayne Auton and Tom Archer
In this episode I talk to Wayne Auton and Tom Archer who work respectively for the Scottish and Welsh Air Ambulances (EMRS & EMRTS). Wayne is a former Royal Marine and currently a Specialist Paramedic in retrieval and transfer medicine as well as pre-hospital critical care. Tom is a Critical Care Practitioner & lecturer on the Critical Care MSc in Cardiff University. In this episode I talk with Wayne and Tom about innovation within the domain, advice to aspiring critical care colleagues, top tips in leadership & group dynamics. I also ask then about how they have navigated the past 6 months both personally and as a service. The Emergency Medical Retrieval Service (EMRS) provides critical care and transfer to definitive treatment for patients in remote healthcare locations across Scotland. They provide Consultant and Retrieval Practitioner delivered aeromedical retrieval from rural health care facilities throughout Scotland and well as pre-hospital critical care of major trauma patients, telemedicine advice to rural health care colleagues, rural facility outreach training and research in pre-hospital medicine and major incident support across the country. The Emergency Medical Retrieval and Transfer Service (EMRTS) Cymru is an aeromedical retrieval service that provides Consultant and Critical Care Practitioner-delivered pre-hospital critical care across Wales. It was launched at the end of April 2015 and is a partnership between Wales Air Ambulance Charity, Welsh Government and NHS Wales. EMRTS provide pre-hospital critical care for all age groups (i.e. any intervention/decision that is carried outside standard paramedic practice) and undertake time-critical, life or limb-threatening adult and paediatric transfers from peripheral centres (inc. Emergency Departments, Medical Assessment Units, Minor Injury Units) for patients requiring specialist intervention at the receiving hospital.  I hope you enjoy the episode with these two great friends. You can find out more about them both here:  Wayne: https://www.wayneauton.com/blog-1/https/wwwwayneautoncom/blog-page-url/new-post-title Tom: https://www.linkedin.com/in/tom-archer-857b2354/?originalSubdomain=uk
1:10:16
June 26, 2020
Medic One - Seattle Fire Department with Andrew Latimer
In this conversation I talk with Andrew Latimer. Andrew is an Acting Assistant Professor in the the Department of Emergency Medicine. He is involved with quality improvement, education, and clinical and operations research in Emergency Medical Services including involvement with Seattle Fire Medic One, King County EMS, and Airlift Northwest. His research interests are in the pre-hospital care of critically ill and injured patients, pre-hospital airway management, and air medical retrieval medicine. In this episode we look at the concepts of 'measure and improve' which have proven to make Seattle one of the world's leading institutions on cardiac arrest survival.  Their main domains of practice around out-of-hospital cardiac arrest and advanced airway management (inclusive of drug-assisted intubation). The Medic One Program began in 1970 when the first group of firefighters were trained as paramedics in cooperation with Harborview Medical Center and the University of Washington. Since then, the Medic One Program has gained notoriety due to the training and pre-hospital emergency patient care paramedics deliver within the community. Medic One provides the community with Advanced Life Support (ALS) activities that, in the past, could only be performed by physicians. In addition to responding to medical emergencies, medic units respond to all working fires, hazardous materials and rescue responses. I hope you enjoy this episode with a fascinating clinician & individual.
37:40
June 15, 2020
Life after the SBS with Stephen Burns
Stephen left the military in 2012 after serving 14 years in the Royal Marines and the SBS. At the age of 27 Stephen was awarded the Military Cross (MC) by Her Majesty the Queen for his work in Afghanistan in 2008. The MC is granted in recognition of "an act or acts of exemplary gallantry during active operations against the enemy on land" to all members of the British Armed Forces of any rank. Since 2015 he has mentored youth in schools, executives, budding sports stars, professional athletes and delivered the Limitless Programme to diverse audiences, veterans charities and public services. In this conversation we have an honest talk about his challenges with mental health through his military service and beyond. Stephens honest and open recital of his challenges with self harm and victim mindset and how he broke this are both insightful and refreshingly honest. Through his revelations of seeking like minded community he recently started an online community (10,000) of military and blue light personnel to support, encourage and offer opportunities to like minded individuals. His story is both encouraging and a voice of hope that despite the depths of suffering you can overcome any level of adversity with healthy community and a healthy mindset. Please find the charity that is fundamental to Stephen's story here: rock2recovery.co.uk The online community of OpSpartan can be found here: https://www.opspartan.com More on Stephen can be found here: https://www.wioh.co.uk/about
54:54
June 14, 2020
How to survive and thrive from a life threatening head injury: With Matt Masson and Mike Nolan
In this episode we interview Matt Masson ex-extreme sports and ski instructor. In November 2011 Matt sustained a life changing head injury when he fell 26 ft through a plastic roof onto his head. He has had to re-build his life completely from re-learning to talk, to walk, to ski amongst many other things. Matt's inspirational story is a true testament to his mental determination, engagement with rehabilitation and timely pre-hospital care. His story and YouTube video can be found here: https://www.thewobblyjourno.com and https://youtu.be/xnJExrygdSk We re-unite him with Mike Nolan  the Flight Paramedic on the night (a friend and colleague) who walks him through his injury load, the sequential interventions and his initial presentation on the night. Matt is just about to release his first book together with his Mother titled 'Road to the top of the mountain'. Please enjoy this truly inspirational story told in first person. Our thanks also goes out to the Nurse liaison team at the Royal London Hospital that initially put both Mike and Matt in contact.
57:33
June 12, 2020
The Mobile Intensive Care Ambulance (MICA) program with Ben Meadley
In this conversation I chat to Ben Meadley. Ben has extensive experience in prehospital critical care, and is an operational Intensive Care Flight Paramedic (MICA) with Air Ambulance Victoria. Ben has a keen interest in prehospital critical care, advanced clinical assessment, pre-hospital critical care interventions and developing clinical judgement in critical care practitioners. MICA paramedics’ training goes beyond practical skill precision to include more detail in anatomy, physiology, pathophysiology and pharmacology to greater increase capacity to make independent complex clinical decisions and interventions. MICA paramedics operate either as part of a two person crew or as a single responder. We look at many facets of the MICA system and the differentiation between land MICA and flight MICA systems. We dig down into Ben's experience and empirical knowledge and look at the fundamentals of high performance within the MICA system, why they exist and how they continually improve. I hope you enjoy this conversation.   
52:32
June 9, 2020
The High Acuity Response Unit (HARU) & Critical Care with Stephen Rashford
Steve is the medical director of The Queensland Ambulance Service (QAS) with 5,000 staff and 1,300 response vehicles. QAS has a contemporary approach to clinical service delivery and innovation in prehospital trauma care. It also operates a tiered system of pre-hospital care with Advanced Care Paramedics (ACPs), Intensive Care Paramedics (ICPs) and a smaller cohort of HARU Paramedics.  In this episode we discuss a variety of topics: High Acuity Response Unit (HARU) both its inception and the clinical remit for the HARU. Governance around the HARU program and provider quality assurance for some of the procedures (RSI, on-call advice, blood products and the bleeding patients). Quality improvement and where the program is heading  The lessons learnt building the HARU and ICP schemes in QLD. I hope you enjoy this episode as I found it both insightful and helpful to look at how other systems approach high performing teams and continuous improvement. Eoin  
58:15
June 1, 2020
High Performing Individuals with Piers Carter. Restore Podcast collaboration
In this conversation with Piers Carter we examine the fundamentals of high performing individuals - the birth place of high performing teams. Piers has an eclectic background. Since 1997 he has been working with businesses; coaching, facilitating and helping them have better conversations – as individuals, teams and leaders. Prior to this, he was paid by the government to throw petrol bombs at the Police – as a riot control, Public Order & self defence instructor. Piers then began expedition-leading, giving him some incredible experiences all over the world working with adults and young people in developing countries and challenging environments. I have always found Piers to be an inspirational character with insight into some of the foundational pearls of wisdom that has changed my world on a day-to-day basis. In this conversation we talk about the power of choice, paying attention to somatic signals, how we gain better insight into personal triggers, the concept of centring, broadening our exposure to failure and many other things. I hope you enjoy this episode with a true legend and friend. You can find out more about Piers here: http://pierscarter.co.uk/ For more content from the Restore Podcast please head over to:  https://anchor.fm/eoin-walker1/episodes/Episode-11-High-Performing-Individuals-with-Piers-Carter-ee9u7p
53:55
May 23, 2020
The UK's busiest Major Trauma Centre with Karim Ahmed
In this episode I interview Karim Ahmed the clinical lead for the emergency department of the Royal London Hospital (RLH) in Whitechapel. We examine the impact of MTCs across the health economy and why they can add a survival benefit to the patient. We also look at the utility of overlaying fundamental and essential patterns of care to complex scene's and how this deconstructs some extremely challenging pathology. We also examine the social deprivation that tracks trauma & some of the outliers that can present to the RLH. We also get some pearls of wisdom from Karim in relation to trauma and the wider population of undifferentiated trauma patients that constitute the case load seen on any given day in London.  I hope you enjoy this episode with an insightful friend and colleague. 
1:03:43
May 19, 2020
Special Forces Vs Critical Care (Restore Podcast collaboration)
In this episode I chat to Jason Fox - a former Royal Marine Commando and Special Forces Sergeant. Joining at 16 and serving for 20 years; Jason passed the grueling selection process for the Special Forces, serving with the Special Boat Service. Jason has planned and led operations including hostage rescue, counter terrorism, counter insurgency, maritime counter terrorism, surveillance, body guarding and counter narcotic missions. He currently features in the channel 4 program - SAS: Who Dares Wins. We look at the similarities between the Special Forces (SF) and critical care (paramedic) practice. We examine the principles of high performing teams, relationship with failure, and communication amongst other aspects. We also look at self care and what it means on a practical level and the power of not taking yourself too seriously. I have always found Jason to be honest and open person which is why having conversations with him is so refreshingly real. This episode will feature on the Restore Podcast (self-care non-clinical) and the Pre-hospital Care Podcast (clinical conversations) as it relates to both. I hope you enjoy this episode.
49:45
May 16, 2020
Fundamentals of Research
In this episode Nick Brown and Jo Shaw deconstruct the definitions, challenges and nuances of research within pre-hospital care. They examine the history of research and the differences between research, audit and service evaluation. They look some of the results of the contemporary bigger research studies that have recently been published & also the origins of funding through the national governmental bodies such as the National Institute of Health Research (NIHR).  They also differentiate some of the various methodologies within empirical research and make reference to how this can affect the outcome data and inference to the clinical bottom line. This episode illustrates that it is important to be driven by the data especially in an information light environment when on scene with patients.  We hope you enjoy the episode
32:50
May 14, 2020
Trauma Tree & Vital Signs
In this episode myself and Mark Falkner look at the origins of the trauma tree & why it was created. We also look at the origins and utility of GCS, heart rate and respiratory rate. We also discuss the mapping of social deprivation onto trauma & the exposure that paramedics see in regards to trauma. We also look at some of the outliers within trauma that don't fit the historical picture of trauma. We also look at the most useful vital sign - that of respiratory rate. I hope you enjoy the episode. For more content by me head over to the Restore Podcast with Eoin Walker: https://podcasts.apple.com/gb/podcast/restore-with-eoin-walker/id1505391534
50:37
May 4, 2020
Critical Care Concepts
In this episode I interview Mark Falkner the Critical Care Scheme lead in London. We look at a cross section of critical care concepts from Traumatic Brain Injury to which are the most essential vital signs to pay attention to. We also look at some of the empirical literature of the above topics and examine the trauma tree in relation to this. I hope this episode imparts some key take home messages for you all as clinicians in the pre-hospital domain of practice. Please also find more content from me around inspiring stories in mental health and well-being from a whole cross section of society on the Restore Podcast with Eoin Walker here:  https://anchor.fm/eoin-walker1/episodes/Episode-3---Reboot-your-life-with-Dan-Richards-ec8ep2 I hope you enjoy the episode 
21:41
May 3, 2020
Austere Medicine with Eoin & Roger Alcock
In this episode we explore the various domains of medicine away from an ambulance or hospital setting. Roger Alcock is an Emergency Medicine and Paediatric Emergency Medicine consultant in Scotland and was involved in the 2014 UK response to the West Africa ebola crisis. Myself and Roger explore the facets of humanitarian and expedition medicine that can add to your career and add depth and breath to experience as a pre-hospital clinician. We explore some of the details of Roger's Sierra Leone deployment for the ebola crisis and some of his expedition endeavours all of which have added to his career and perspectives. We also examine some of the non-technical skills that these deployments and expeditions can foster which both add to resourcefulness and situational awareness of clinical demand and innovation in low resource settings.  I hope you enjoy the episode.
58:40
April 26, 2020
End of Life Care with Dan, Georgina, Diane and Caroline
This episode focuses on a vital part of pre-hospital care; that of end of life care. Dan Davis explores this area with Caroline Philips, Diane Laverty, Georgina Murphy Jones. As all three guests work in various capacities for Macmillan they explore both the similarities and variations of palliative and EoLC and the subtle changes in approach to these patients. They look at the mindset change of approach to these patents in de-emphasising resuscitation and focusing on rapport building, supporting documented wishes and multi-agency engagement to facilitate the best care in the last period of a patient's life. Diane Laverty works as a Macmillan Nurse Consultant and is passionate about specialist palliative care and EoLC patients having a voice and receiving high quality care across all domains of practice.  Caroline Philips and Georgina Murphy Jones work as paramedic clinical tutors and Macmillan specialist clinicians helping embed both EoLC training and practice across London and to fellow colleagues. They examine the difficulty of not having prior rapport with these patients & families and some of the variations we would expect to see when looking at the physiology and clinical findings. This episode is especially important in the current climate and Dan brings this into focus talking about his own experiences with EoLC with his own father.  Please enjoy this episode which discusses this relevant and important narrative within pre-hospital care.
1:04:20
April 21, 2020
Traumatic Brain Injury - with Dan Davis & Alice Kershberg
In this episode Dan Davis explores the wider aspects of TBI with Alice Kershberg, a clinical nurse specialist in traumatic brain injury.  Alice plays a vital role in not only looking after patients who have suffered a traumatic brain injury, but acts as the bridge between the hospital and the community and between the neurosurgery team and the family. In this episode we explore many facets of the pathology but also shine a light on the pastoral role of acting as a liaison supporting patients and family after surgery, helping them to navigate their recovery in what can be a life changing injury. Alice's role is fundamentally key to linking medicine to the lives of those affected in the community and gives an insight into the patient journey after pre-hospital care has passed the baton onto the hospital and into rehabilitation - we hope you enjoy the episode. 
1:00:54
April 13, 2020
New experiences in Pre-hospital Care with Nick Brown
In this episode Nick Brown examines a cross section of perspectives from staff that have recently qualified to staff that have progressed through to fully qualified. We get their thoughts on education and mentoring through various routes into pre-hospital care. We also look at some of the support mechanisms for clinicians and the diverse range of presentations that pre-hospital care throws at you.  It is a fascinating insight into various levels of experience, clinical grades & thoughts through fresh eyes  in what can sometimes be one of the most challenging roles within the NHS.
1:12:59
April 6, 2020
High Performing Teams with Eoin & Dan
In this episode we take a look at the components of high performing teams and what differentiates these from teams that fail to perform. We examine the concepts of ownership, humility, checklists, communication and non-technical skills. We also look clinicians relationship with failure and how that can either be a tool for positive change or compound the failure and associated implications. We take examples across domains and relate them back to pre-hospital care - looking at themes of successful teams from a technical and non-technical perspective. We hope you enjoy the episode. 
1:35:52
March 31, 2020
The Facts Behind the Coronavirus Pandemic with Will Duffin
At the recording of this podcast episode, the world is in the midst of the coronavirus pandemic. Eoin welcomes a special guest to go through the facts of the global crisis with Will Duffin, education lead and content director at the World Extreme Medicine.
45:37
March 25, 2020
S02E08: Mark Faulkner: Defanging the Coroner’s Court for Paramedics
In this episode of the pre-hospital care podcast, we welcome Mark Faulkner, an advanced paramedic practitioner, to unpack the often daunting legal world that paramedics are exposed to.
30:08
August 12, 2019
S02E07: Ben Clarke Part 2: Deliberate Practice in Pre-Hospital Care
You never know when that "nightmare job" or patient is going to appear and put you to the test. As clinicians, we should be always attempting to push our push our skills closer to perfection. In this episode, Ben Clarke shares his insights into deliberate practice, in-time learning, and meta-cognition. 
19:44
July 29, 2019
S02E06: Ben Clarke Part 1: Leadership Techniques in Pre-Hospital Care
In part 1 of our conversation with Ben Clarke (Assistant medical director of London Ambulance Service), we talk about leadership in pre-hospital care. What's more important - a good leader, or a good team willing to follow? Can you teach leadership or does it only come from experience? Can you be born a leader? How do you empower different types of staff on-scene? Join us as we explore the nature of leadership in pre-hospital care. 
39:44
July 15, 2019
S02E05: Esther Murray (Part 2): The Flow State in Healthcare
Have you ever been working, and all sense of time and self melts away, and you find yourself in perfect sync with what you’re doing? There’s a word for that. It’s called the Flow State.  In part 2 of our conversation with Dr Esther Murray, we  explore Flow and how to put yourself in hyper productive mindsets more often using specific techniques anyone can implement in their work. Dr Murray is a Senior Lecturer in Health Psychology and an expert in the subject of moral injury and self-care. 
26:18
July 1, 2019
S02E04: Esther Murray (Part 1): How to Take Care of Yourself After a Moral Injury
In part 1 (of 2) of our conversation with Dr Esther Murray, we explore the concept of a moral injury, and how paramedics can spot warning signs that they've suffered one, as well as tips on how to restore a good mental state. Dr Murray is a Senior Lecturer in Health Psychology and an expert in the subject of moral injury and self-care. 
30:56
June 17, 2019
S02E03: Victoria Lebrec: Collision Survivor & Activist for Road Safety in London
In this episode, we welcome Victoria Lebrec, who fights for road safety in London after losing her leg being run over by a skip lorry in 2014. Others have lost limbs on the same section of road since her incident, and it is only one of many places in London where accident rates are disproportionately high. Victoria’s work is focused on raising awareness for the need for improvements for cyclist safety across London. 
33:08
June 3, 2019
S02E02: Dan Richards: Motorcycle Collision Survivor & Amputee
Meet Dan Richards, an ex-patient of Eoin’s who lost his right arm and shoulder in a traffic accident 9 years ago. His story of recovery and his imperturbable attitude is inspiring. He summed it up perfectly with, “…whatever you want in life, you must work hard for it. Even if you don’t get it, you can still hold your head high and say, ‘Well, at least I did not give up,’ and while there is no shame in giving up, there is no success in it either.”
49:14
May 20, 2019
S02E01: Zoe Hitchcock: Cardiac Arrest Survivor
Update:  Due to a technical hiccup, this episode was cut short by about 15 minutes during the first day of it's being published. It's now updated, so If you listened to it then and would like to catch the rest of this conversation, you can re-download the episode now. Thank you for your patience.  We're back with the second season of the Pre-Hospital Care podcast! Our first episode is a fascinating conversation with a cardiac arrest survivor and long friend of Eoin's, Zoe Hitchcock. They met when Zoe suffered a heart attack and Eoin happened to be sent out to treat her. Tune in for a fascinating and unique perspective on pre-hospital healthcare from the patient's perspective.
1:01:47
May 6, 2019
S01E08: Self-Care and Dealing with Trauma with Dan Davis (Part 2)
We end the first season of The Pre-Hospital Care Podcast by finishing up Eoin and Rich’s conversation with Dan Davis as they talk about dealing with the emotional trauma that is, unfortunately, part and parcel of pre-hospital care.  Thanks so much for being a part of this journey into healthcare podcasting. Keep an eye out for season 2! It’ll be out before you know it. 
50:19
February 27, 2019
S01E07: Self-Care and Dealing with Trauma with Dan Davis (Part 1)
The paramedic field is much more fast-tracked than it once was. It's such an established path that many new paramedics have come straight from the classroom, and are being thrown into situations that a professional of any seniority would find it difficult to handle.  Perhaps it's no surprise, then, that the mental health of people working in emergency healthcare is getting worse over time. What can be done? 
28:24
February 13, 2019
S01E06: Family Witness Resuscitation and Breaking Bad News, with Nick Brown (Part 2)
On this episode of Pre Hospital Care Podcast, Eoin and Rich continue their discussion with Nick Brown to tackle the non-technical skills necessary in controlling a tragic and highly emotional scene. In 96% of cardiac arrest cases, the patient doesn’t make it. When that happens, they are not the only patient.  Losing a loved one is traumatic and a genuine health risk over time. If we take our oath as clinicians seriously, therefore, we must be well prepared and skilled in not adding any further stress and trauma, as well as set up avenues for ongoing help and support.  Medics.Academy is dedicated to educating health professionals on every aspect of medicine, both technical and non-technical.  Go to www.Medics.Academy to browse our library of healthcare education. 
46:42
January 30, 2019
S01E05: Family Witness Resuscitation and Breaking Bad News (Part 1)
On this episode of Pre Hospital Care Podcast, Eoin and Rich talk tackle perhaps the toughest topic in pre-hospital care. Delivering bad news to family members. Health professionals are not usually well taught about how to deliver the news of the death of a patient in a suitable and tactful way. This episode explains the four stages of delivering bad news, words to avoid, and how to remain professional but give support as much as you and your team can. Medics.Academy is dedicated to educating health professionals on every aspect of medicine, both technical and non-technical. Go to www.Medics.Academy to browse our large library of CPD-ready courses. 
40:31
January 16, 2019
S01E04: The Pre-Hospital Airway (Part 2)
In this week’s podcast, we continue to discuss the crucial topic of pre-hospital airway management. How can we maximise the chances of patients with airway problems when time and circumstance are not on our side?  Eoin Walker and Rich McGirr walk through different procedures and both technical and non-technical aspects of managing the airway in the field.  For CPD-relevant content about pre-hospital care and many other healthcare fields, sign up at www.Medics.Academy.
38:47
January 2, 2019
S01E03: The Pre-Hospital Airway (Part 1)
Eoin Walker and Rich McGirr are back to discuss the ever growing evidence base and controversial topic of airway management in the pre-hospital setting. How does the reality of managing this urgent, life-or-death part of the body differ from what is taught in the classroom? What are the essential steps in dealing with the prehospital airway? What are the pros and cons of each method?
43:08
December 19, 2018
S01E02: Club Drugs & Non-Legal Highs (Part 2)
Eoin Walker and Rich McGirr are back with special guest Martin Mist to talk more about the unique challenges that present themselves to paramedics when dealing with crises brought on by ingestion of illegal substances. When will you need to resort to physical restraint? Why part of a paramedic’s job is to be a detective. How to do proper research on new. What the top 5 hard-hitter drugs are and key nuggets for dealing with each. All this and more on the latest episode of the Pre-Hospital Care Podcast.
1:03:37
December 5, 2018
S01E01: Club Drugs & Non-Legal Highs (Part 1)
Paramedics are constantly in the middle of life and death situations. In the first full episode of the Medics.Academy Pre Hospital Care podcast, paramedics Owen Walker, Richard McGirr, and Martin Mist discuss Club Drugs and Non-Legal Highs and their effects on patients. As paramedics, they’re the first medical professionals to assess a situation before getting them to physicians at the hospital. They see the patients at their lowest point, suffering from anything from a cardiac arrest, a severe allergic reaction or a psychotic episode. Among many other topics, this episode covers the common and uncommon presentations of patients after drug overdoses and what paramedics look for and how to assess the situations.
57:00
November 20, 2018
S01E00: Introduction
This podcast is presented by Eoin Walker and Rich McGirr and is a Medics Academy podcast. The purpose of this podcast is to provide paramedics an easy-to-access set of resources and educational materials wherever they are. Feel free to take a look at the description in the footnotes of the podcast. Sign up to Medics Academy today to find out even more about what we do and just how much content we put out there for your education.
08:47
November 2, 2018