Pre-Hospital Care Podcast
By Eoin Walker
This podcast is designed to have engaging and inspirational conversations with some of the worlds leading experts in or relating to pre-hospital care. We hope you take a lot from the conversations both from a technical and non-technical perspective. Please rate and review the show as feedback helps ensure that the best information gets back to you throughout the project.
Head injuries with consultant neurosurgeon Mark Wilson
In this session we will examine the fundamentals of head injury with consultant neurosurgeon Mark Wilson. We will dig into the details of brain injury, primary and secondary injury, the importance of venous drainage, and optimising the pre-hospital management. Mark is a Consultant Neurosurgeon and Pre-Hospital Care Specialist working at both Imperial College (mainly St Mary's Major Trauma Centre) and as an Air Ambulance doctor. He is also a Clinical Professor specialising in Brain Injury at Imperial and Honorary Professor of Pre-Hospital Care (the Gibson Chair) at the Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh. Marks’ specialist areas are acute brain injury (mostly traumatic brain injury) and its very early management. He is also co-director of the Imperial Neurotrauma Centre and co-founder of GoodSAM, a revolutionary platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them. He has worked extensively overseas (India, Nepal, South Africa, as a GP in Australia, Researcher for NASA and as an expedition doctor on Arctic and Everest expeditions). In the episode we examine: Incidence of brain injury TBI Vs NTBI pathology Doctor/Paramedic teams within neurological injuries Accuracy of our pre-hospital diagnoses with head injury Do we triage patients to the right places. Pre-hospital Anaesthesia and transfer to neurological units The importance of the basics done well even before formative PHC. Pupils and wider, lesser-known symptomatology Seminal case from Marks experience. Final thoughts from Mark and take-home messages. This podcast is brought to you in association with BHA Medical. https://bha-medical.com/about-us/ BHA medical source, supply and implement innovative medical technology and solutions across the globe. BHA provide market leading services in covid 19 testing kits, medical products, smart technology and consultancy. There most recent product is the Vitalstream: https://bha-medical.com/medical-products/vitalstream/ The Vitalstream is the world’s most innovative wireless non-invasive patient monitor, using a simple disposable finger cuff to measure Continuous Beat-by-Beat Blood Pressure “CNIBP,” Heart Rate, Respiration Rate, and other physiological parameters. This unique technology enables safe, secure, and accurate patient monitoring from virtually anywhere, including remote patient monitoring from a secure cloud portal. This solution provides real time data, enabling healthcare staff to provide early intervention and rapid response to a patient’s changing health conditions. Using a low-cost, disposable finger cuff, the VitalStream patented Pulse Decomposition Analysis (“PDA”) algorithms process the arterial pulse waveform to derive CNIBP, Heart Rate, Respiration Rate, and other hemodynamic parameters. Please also check out further devices and services offered by BHA medical here: https://bha-medical.com I hope you enjoy this episode with an insightful and engaging guest.
May 20, 2022
The fundamentals of Mountain Rescue with Ben Cooper and Jamie Patterson
In this session we will examine the fundamentals of Mountain Rescue with Paramedic Jamie Patterson and Emergency Nurse Practitioner Ben Cooper. This will include a look at the demographics and diversity of rescues within the Mountain Rescue Team (MRT). We will also examine the different specialist domains that constitute being a member of the MRT such as navigation, search strategies, team dynamics, Immediate Medical Care (IMC), casualty evacuation and much more. Finally, we will examine some seminal cases where all of Ben and Jamie’s training has come to use. Both World Extreme Medicine colleagues examine the following topics: Why is the MRT a fundamental part of an emergency response out on the hill? What a MRT comprises of (the size, the diversity of background and profession)? Domains of practice that are relevant What the education and training looks like from the inside. Internal governance and debrief. Risk management and mitigation Search strategies Importance of team dynamics The immediate medical care and ceilings of care on scene. Casevac Seminal cases from both guests Further resources recommended by the guests include: Go outside. Sit down. Wait. https://dmbins.com/blog/go-outside-sit-down-wait/ Mountain Rescue Doctor: Wilderness Medicine in the Extremes of Nature https://www.amazon.co.uk/Mountain-Rescue-Doctor-Wilderness-Medicine-ebook/dp/B000V770NC Mountain Rescue: History and Development in the Peak District 1920s-Present Day https://www.amazon.co.uk/Mountain-Rescue-Development-1920s-Present-1920s-2007/dp/0752440918 Cairngorm John: A Life in Mountain Rescue https://www.amazon.co.uk/Cairngorm-John-Allen/dp/1905207573 Call-out: A climber's tales of mountain rescue in Scotland https://www.amazon.co.uk/Call-out-climbers-mountain-rescue-Scotland/dp/1911342215 World Extreme Medicine - Fundamentals of Search & Rescue | Northumberland | October 2022 https://worldextrememedicine.com/products/search-rescue/sar/ If you have any specific Mountain Rescue questions, Jamie Patterson is available to take these at: email@example.com I hope you find this episode both engaging and insightful.
April 20, 2022
‘From Ruin to Recovery’ with Allistair MacSorley
In this session I will be talking with Allistair MacSorley around his journey through pre-hospital care as a paramedic and then a day in 2018 that changed his life forever and left him paralysed from the waist down. We will also be examining his tenacity, drive and attributes that separate him from the crowd. He is currently still working as a registered Paramedic and part of the maternity team within London Ambulance Service. He is also part of the Irish paracycling development squad in hand cycling. He is training for and focussed on the next hand cycling World Cup in May in Belgium, aiming towards ParaOylpmics Paris 2024 and then the LA games 2028. He has adapted and employed a coach from September 2021 which has fundamentally changed his training program and diet. The carbon fibre cycle bike is a £15,000 specialised bike with adaptations and enables Ali to compete at elite level. In the conversation we discuss: The introduction to Alistair’s life growing up His father’s influence and motorbikes His training as a Paramedic What he took his training and facets of his career The career break and what he learned whilst away The incident and injuries sustained The recovery The adaptations to life His current role (LAS and cycling) Ali's story can also be found here: https://www.irishnews.com/news/northernirelandnews/2019/07/29/news/-flying-doctor-left-paralysed-after-motorcycle-crash-returns-to-circuit-a-year-later-to-complete-lap-1672238/ https://www.bbc.co.uk/sport/motorsport/49140461 Please enjoy this episode with a truly inspiring professional and friend.
April 15, 2022
Governance within High Performing Teams with Pete Sherren
In this session we examine the importance of governance and the main facets that constitute robust governance. This includes a look at why governance is important, the different domains that constitute good governance and finally how it is applied in practice. We will also look at the fundamentals of risk management within governance and the symbiotic relationship between the two. To do this I have Intensive Care, Anaesthetic and Pre-hospital care consultant Pete Sherren with me. In the conversation we unpack: What is governance and why it is a vitally important feature of a culture of improvement. The facets of good governance and cultural commitment. Education and Training. Clinical audit. Clinical effectiveness. Research and development. Openness Information Management Finally Risk management and how this is important for the patient clinician, and institution. Links to the Delphi study that we mention in the conversation can be found here: Consensus on research priorities for Essex & Herts Air Ambulance: a Delphi study: https://sjtrem.biomedcentral.com/track/pdf/10.1186/s13049-021-00835-z.pdf Please enjoy this conversation with an engaging and insightful guest.
March 20, 2022
Portfolio Medical Careers Podcast, an interview with Eoin Walker
I'm pleased to release this recently recorded episode with ED consultant Dr Amy Hughes. Amy has launched the 'Portfolio Medical Careers' Podcast which details interesting narratives and career paths from various medical careers. This series will cover doctors, paramedics, nurses, and other allied healthcare professionals with different stories and paths within and outside of the National Health Service (NHS). She has some fantastic interviews lined up and really gets to the heart of emphasising the 'journey and not just the destination'. The podcast also denotes that various experiences can feed into the wider clinician and person and give more rounded and diverse experience from which to draw. This month we join Paramedic Eoin Walker. Eoin has been a practising paramedic for over 20 years and journied through a fascinating career including the LAS cycle response unit, Physician Response Unit, London's Air Ambulance (HEMS), LAS Advanced Paramedic Practitioner, Expedition Medicine and, most recently, a role with the International Committee of the Red Cross (ICRC). The podcast can be found here: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5saWJzeW4uY29tLzQwMDc3NS9yc3M/episode/YTlhYTI3NjktYWFkNS00MDBlLWEzODctM2FhZjIwZjBjNGUz?hl=en-HU&ved=2ahUKEwjMi4nizsX2AhXUiP0HHY46DecQjrkEegQIBhAF&ep=6
March 15, 2022
Paediatric pain management with Will Broughton
In this session we will examine some of the prevailing issues and difficulties of paediatric pain management. To do this I have Will Broughton, an associate professor of paramedic science at Buckinghamshire New University, Paramedic with specialist interest in Paediatric Emergency Medicine and Paramedic Education. He continues to practice clinically with London Ambulance Service (LAS) and South Central Ambulance Service (SCAS). We will unpack some of the nuances, challenges, and evidenced based approaches that Will has found from being both a pre-hospital practitioner and studying his MSc in this domain of practice. In the conversation we discuss: Definitions of pain and what it means to children. Physiological consequences of pain in paediatrics Difficulties of pain management in Paediatrics Pain relief routes available and advocated (NICE) Pain assessment - Wong and Baker, visual analogue scales. The utility of the FLACC score Monitoring difficulties and challenges Human factors with Pain - Parents, stressful environment Tx/Pain Mx strategies - NICE, preferences, nuances. Take homes messages. Resources that are mentioned in the episode include: CRIES pain scale http://geriatricphysio.yolasite.com/resources/CRIES%20Scale%20for%20Neonatal%20Postoperative%20Pain%20Assessment.pdf WHO pain ladder https://professionals.wrha.mb.ca/old/professionals/files/PDTip_AnalgesicLadder.pdf Children in painhttps://rcem.ac.uk/wp-content/uploads/2021/11/Pain_in_Children_2017_18_National_Report_Oct_2018.pdf Wong and Baker faces https://wongbakerfaces.org I hope you enjoy this episode with a fantastic guest. Will Broughton can be reached on Twitter at @WilBroughton
March 02, 2022
‘Designing the RSI’ with Paul Swinton
In this session we will be interviewing flight paramedic Paul Swinton, to talk about how to optimise the RSI in the pre-hospital environment. We will unpack some of the nuances, challenges, and approaches that Paul has found from being both a pre-hospital practitioner and in innovating the layout and design for an RSI in creating the SCRAM bag. SCRAM™ (Structured CRitical Airway Management) is an innovative solution for enhancing the performance of emergency airway management. It involves the systemisation, standardisation, cognitive offloading, human factors and good governance are core principles to the design and philosophy of SCRAM. Paul has been a paramedic for the past 20 years. He joined the Scottish Ambulance Service Special Operations Response Team, based in Glasgow, in 2010, after re-locating from the West Midlands Ambulance Service. He is currently an Air Ambulance Paramedic for the Scottish Air Ambulance Division, involved in critical care and retrieval medicine, working alongside the trauma teams and medical retrieval services of Scotland (ScotSTAR). He is originally from South Africa, where he qualified and worked as a paramedic on the road, in Emergency Departments and as a flight paramedic. This podcast is brought to you in collaboration with Scottish Health Innovations Limited, also known as SHIL, who work in partnership with NHS Scotland to identify, protect, develop and commercialise healthcare innovations to improve patient care. SHIL uses specialised knowledge to help bring new ideas and innovations from healthcare professionals to life, with a multidisciplinary team providing expert services including intellectual property advice and protection, regulatory expertise, project management, idea incubation, funding advice, development, commercialisation, and post-commercialisation monitoring. You can follow SHIL’s work on Twitter, @ScotHealthInno You can find out more about SHIL here: https://www.shil.co.uk/ You can find SHILs products here: https://www.shil.co.uk/browse/products This podcast is also brought to you in association with Openhouse. Openhouse take a unique approach to creating products in focussing on a ‘Fit For Purpose’ end product. Their focus on creating truly bespoke products along with the best possible purchasing experience which means they have strong working relationships with customers from all sectors of industry. Openhouse products can be found here: openhouseproducts.com You can follow Openhouse on twitter @OHproducts You can find out more about Openhouse here: https://www.openhouseproducts.com/about-us/ You can see the SCRAM range as mentioned in the episode here: https://www.openhouseproducts.com/?s=SCRAM&post_type=product You can find out more about the guest here: https://paulswinton.com I hope you enjoy this episode with an engaging and insightful guest.
February 21, 2022
The epidemiology of cardiac arrest with Katherine Pemberton and Tom Archer
In this session we will examine the epidemiology of OHCA. We will look at the frequency and trends of OHCA together with the causes and risk factors. We will examine the concept of a registry of cardiac arrest and appreciation of baselines to work from. We will also look at the current mitigation strategies that are available to prevent OHCA such as policy, and Public Access Defibrillation (PAD) amongst others. We will also look at our guest's PhD (Dr Katherine Pemberton) and how that both informs the current climate and the future of how we tackle OHCA. We examine: The current statistical climate - in Wales and Queensland Main contributing factors/risk factors around incidence Patterns between the two areas both in disease prevalence and problematic rate-limiting steps in decreasing OHCA. Cornerstones of policy that need/require adaptation PAD/Public Access Defibrillation and the importance of community engagement Social demographics and how OHCA maps onto social deprivation Iterative solutions (no magic bullet concept) These are links to Dr Pemberton's literature review: https://ajp.paramedics.org/index.php/ajp/article/view/752 https://ajp.paramedics.org/index.php/ajp/article/view/753 These are the pubmed links. https://pubmed.ncbi.nlm.nih.gov/31352680/ https://pubmed.ncbi.nlm.nih.gov/31352690/ https://pubmed.ncbi.nlm.nih.gov/33219108/ Please enjoy this episode with two insightful and engaging guests
February 17, 2022
The Best of 2021 - The Restore Podcast with Eoin Walker
The best of the 'Restore Podcast 2021' is here. This conversation features accounts with Consultant psychologists, psychiatrists, special forces operatives, professional rugby stars turned drug addicts turned pastors, inspirational leadership coaches, accounts on NLP, Neuroplastic Somatic Practice, EMDR therapy, CBT, and much, much more. The mandate is…raw and inspirational conversations with the application of deep understanding and revelation. In the world of memes and brief captions that sound good in the moment, we need real, raw, and deep accounts and tools to navigate one of the most difficult segments of time in life. Instead of falling for a brief caption that means nothing and lasts only a moment, instead try leaning into these life accounts of how people have turned around their lives from truly testing times. Wisdom is the life application of knowledge. It is found in a deep understanding and fostered through narrative and tools most of which don’t lay within our own capacity and rely on us being willing to hear others survive and thriving through adversity. My thanks to all the guests that have featured across the podcast in 2021. I look forward to taking you with me into 2022 for more inspirational conversations and truly revelationary accounts.
January 29, 2022
The 'power of the debrief', types and tools for debrief
In this episode we look at the debrief in its entirety; why we debrief, when, how and where. We examine the evidence behind debriefing and the institutions that use debrief such as the military, pre-hospital practitioners, ward based staff, sports teams, athletes and others. We then look at the types of debrief such as the hot & cold debrief, Schwartz rounds, Critical Incident Stress Debriefing, the After Action Review amongst others. We then examine 6 tools of debriefing that can be used in practice. We briefly also touch on the disparity of evidence around mitigation of psychiatric pathology such as PTSD. Here are some of the tools mentioned: TAKESTOCK https://www.rcemlearning.co.uk/foamed/take-stock-hot-debrief/ STOP5 https://www.stemlynsblog.org/wp-content/uploads/2018/10/Hot-Debrief-Poster-V2-April-2018.pdf PLUS DELTA https://fhop.ucsf.edu/sites/fhop.ucsf.edu/files/custom_download/ACPS_Plus_Delta_Template.pdf MODIFIED PLUS DELTA https://leanconstruction.org/media/learning_laboratory/Plus_Delta/Plus-Delta.pdf ITRUST Debrief https://www.bmsc.co.uk/course/itrust-debriefing/ PEARL debrief https://debrief2learn.org/pearls-debriefing-tool/ I hope you enjoy this episode
November 24, 2021
The story of the Cycle Response Unit (CRU) with Tom Lynch MBE, MStJ & Tom Baverstock
In this episode, we are going to examine a story of one of the key innovations in pre-hospital care in the last 20 years and how it came into existence. We will look at the Cycle Response Unit or CRU that see’s Paramedics respond to emergency calls via mountain bikes across the nation. To do this we have the creator and founder of the CRU Tom Lynch MBE, MStJ. Tom Lynch has channeled his excellent cycling and coaching skills, his self-belief, and his competitive spirit to develop and deliver the CRU.traveled the world as a BMXer, won numerous trophies and titles several times over, appeared on the front page of magazines, had fans on every continent and lived a life people can only dream of. In 1999 Tom got the go-ahead for a trial to set up the Ambulance Cycle Response Unit (C.R.U.) to answer 999 calls in the West End of London. He still had friends in the bike industry from BMX days and he made sure he got the best equipment available. The bike was fitted with the latest pre-hospital equipment and the all-important lightweight defibrillator. This marked the beginning of a legacy of paramedics on mountain bikes, but it wasn’t always an easy ride. we examine the history and background, Tom’s struggles and battles to get the project off the ground, some of the seminal cases in which the CRU has been involved, and some of Tom’s best moments. In the conversation we examine: Tom Lynch's background growing up History & inception of the CRU Demographics served across London and wider teams across the UK Advantages over other vehicles over time and environment Seminal cases that the CRU have attended/made a difference to CRU Awards achieved Some of the battles and struggles Tom has faced and overcome What it gives back to both the community and the clinician. Some of the key takeaways I hope you enjoy this episode with two fascinating guests.
November 14, 2021
'Focused ultrasound in out-of- hospital cardiac arrest by Advanced Paramedics', with Nick Brown
In this session we will examine the recently published in the Journal of Paramedic Practice on 'Focused ultrasound in out-of- hospital cardiac arrest by Advanced Paramedics'. To do this I have Advanced Paramedic Practitioner, author and lecturer Nick Brown. In the episode we discuss why ultrasound is used, what device is used and what APPs use it for. We also discuss the primary and secondary outcomes of the study, the population the study focusses on (OHCA) and the problem/question they are seeking to address (cardiac arrest management/termination). We also explore the study's methodology, the differentiation of results, the conclusion, the clinical relevance to practice, what Nick took from performing the audit and the salient take home messages from the study. The research article can be found here: https://www.magonlinelibrary.com/doi/abs/10.12968/jpar.2021.13.1.26 Please enjoy this episode and feel free to rate and review the podcast.
November 01, 2021
The evolution of Paramedic education with Lisa Burrell and Alan Rice
In this episode we will examine the various ways in which paramedic education has evolved over the past 20 years both conceptually and the skills taught within the profession. Alan Rice and Lisa Burrell join me in this conversation, Alan is the lead for post-registration paramedic education at St Georges University, London. His role is predominately designing and organising the delivery of education for specialist and advanced paramedic roles in both urgent and critical care. He also oversee’s the work force development of all qualified paramedics that are studying towards a higher education award. Alan also works as a consultant paramedic advising ambulance trusts. Lisa Burrell is both an Advanced Paramedic Practitioner in London and a senior lecturer at St Georges university. Lisa teaches on both the post and undergraduate cohorts and spends time teaching CCPs from different services. She has also spent over 8 years as a flight paramedic within London and has split her time between teaching and critical care. In the episode we talk about: · The concept of critical thinking & analysis - a central concept of education. · The diversity of care pathways and how this has changed over 20 years. · Non-technical skills taught and emphasised throughout the curriculum and course. · Mentoring - the importance of this. · Monitoring and the use of monitors within pre-hospital care. · Engagement with technology for current practitioners. · Skills that have evolved – USS, thrombolysis for VTE, prescribing, Abx, · Anecdotal thoughts on evolution of both the profession and the paramedic practice curriculum. The undergraduate Paramedic Science course at St Georges University London can be found here: https://www.sgul.ac.uk/study/courses/paramedic-science Please enjoy this conversation with two fantastic guests.
October 25, 2021
The 'Psychoses and Neuroses' with Anna Basquil
In this episode we will examine the various pathologies related to psychosis and neurosis in mental health that clinicians can see within practice. We also examine some of the key aspects of these pathologies so that clinicians can construct both meaningful and targeted treatment to this extremely difficult cohort of patients. To do this am am joined by Anna Basquil, a special mental health practitioner who joined the ambulance service in January 2020, seconded by her mental health trust to provide and help embed the 'dual assessment model' on patients. She works on the 'Mental Health Joint Response Unit' together with a Paramedic. Prior to this Anna was working in an 'early intervention service' with patients experiencing their first episode of psychosis. Anna worked in patients early years of diagnosis to help them both integrate and cope with their symptoms to help normalise and stabilise their lives. In the interview we discuss: Some of the fundamental differences between psychoses and neuroses. The demographics of each pathology Deep dive into Psychoses – definition, types, signs and symptoms. Examine schizophrenia as the most common type of psychosis. Brief look at prodromal phase, acute phase and recovery phase of psychotic episodes. Deep dive into Neuroses – definition, types, signs and symptoms. Examine depression and anxiety as the most common types of neuroses. Brief look at triggers for neuroses. Managing episodes of neurosis Managing psychotic episodes More information on the 'Mental Health Joint Response Unit' can be found here: https://aace.org.uk/initiatives/mental-health-joint-response-car/ I hope you enjoy this episode with an engaging and informative guest.
October 16, 2021
‘Reflections from a newly qualified Critical Care Paramedic’ with Adam Clegg
In this session we will examine some of the prevailing educational learning from a colleague who has just qualified as a critical care paramedic in London. We will unpack some of the revelations, nuances, and comparisons that critical care has brought from their perspective from other roles. In the episode we dig into Adam’s background and why the Advanced Paramedic Practitioner in critical care career pathway was appealing to him. We also examine what has it brought Adam from a wider perspective and the nuances in care compared to standard paramedic practice. We then unpack Adam's personal revelations that were previously unknown and what he took from the mentoring aphase of his critical care training. We finish off by looking a few seminal cases and how that both inspired him and helped him learn along the way. I hope you enjoy this episode with both an honest and insightful guest.
October 05, 2021
Transient Loss of Consciousness (TLOC) with Nick Gall
In this session we will examine the varied pathology of Transient Loss of Consciousness (TLOC), the definition, the causes, the sequalae, and the management. I wanted to also examine some of the key aspects of TLOC that are red flags and should be examined further within clinical practice. To do this I have Consultant Cardiologist and Honorary Senior Lecturer, Dr Nicholas Gall with me. In the episode we look at an established definition of TLOC, Nick's efforts to start a blackout pathway, the fundamental problem of TLOC in unpacking why undifferentiated TLOC can be a clinical minefield. We then examine the aetiology of TLOC and the diagnostic tools with which to differentiate the pathology (USS and ECG nuances). We then look at red flags warning signs and subtle information cues with TLOC, treatment of TLOC patients (broad take home messages) and clinical examples from practice. I hope you enjoy this episode with a fascinating and insightful guest.
September 29, 2021
Public Health with Professor Kelechi Nnoaham
In this session I speak with Professor Kelechi Nnoaham. We examine the prevailing themes of public health within the contemporary pandemic. We examine some of the key aspects of public health necessary to overcome one of the most challenging public health issues since the inception of the NHS. We dissect some of the fundamental principles of public health, the info-demic war of information, the contemporary evidence-based research, decentralised leadership and more. Professor Kelechi is the Executive Director of Public Health and lead for Research & Development, Innovation and Value-Based Health for Cwm Taf Morgannwg University Health Board, Wales. Kelechi has held Honorary Professorships in Public Health and Epidemiology at Plymouth University (since 2015) and Cardiff University (since 2021) medical schools and previously worked as the Director of Public Health for Plymouth and Bristol City Councils. He has subsequently worked throughout leadership roles in public health and healthcare leadership across the UK. Kelechi has an MPH in Global Health Science (with Distinction) at Oxford University and followed that up with a PhD in Public Health & Epidemiology at Oxford University in 2011. In the conversation we examine: The current public health climate – acute versus chronic needs, secondary infection rates. Collaboration – joined up working versus independent initiative The information war – The ‘info-demic’ ‘Press release’ medicine – effectiveness and impact. The principles of public health - The big 5 - population health management, prevention, population health research, knowledge mobilisation and collaborative working with communities. The 4, 4, 54 principles within a public health context Empirical research in the current climate; disaggregation of data (lack of sub-group analysis), action with absence of published data, equity of authorship, retraction of papers, robustness of evidence, retraction of studies, increase in corrections in 2020, decrease in RCTs & Meta analysis, decrease in ethics and consent. Decentralised ownership of health (internal locus of control). Professor Kelechi can be contacted through the following platforms; • Twitter - @CwmTaf_DPH, @KelechiNnoaham • LinkedIn - linkedin.com/in/kelechi-nnoaham-1649937 Please enjoy this interview with an insightful and fascinating guest.
September 13, 2021
Failure: The Impartial Executioner of Leaders, Followers, and Their Organisations with David Stehlik
In this episode I speak with Dr David Stehlik on leadership, followership and organisations. Dr Stehlik is the programme director for the Keith Bussey School of Business and entrepreneurial leadership at the University of St Francis in Fort Wayne in the US. He is also the the founder of a strategy and business education consultancy ‘Fourscene’ related to the field of strategic foresight. He is a strategist, an educator and team developer, he has also published a book called ‘Integrated delivery - innovating leadership for outstanding healthcare outcomes’ that was released at the beginning of 2021. In this episode we speak about what constitutes ‘great leaders’, and then dissecting the antithesis of this in the anatomy of failing leaders. We also examine: Self-awareness and tools to help get there (SWOT analysis, Johari’s window) Great followers and failing followers The consequences model & Role-playing model & conflict resolution The AI model Great organisations & failing organisations You can contact David at https://www.foursceneventures.com/about.html You can also read the article that the interview is based on here: https://www.regent.edu/acad/global/publications/jpc/vol5iss1/3-stehlik.pdf I hope you enjoy this episode with a fantastic guest.
August 03, 2021
Infant Resuscitation with Mark Faulkner
In this session we will examine a recent publication by Clinical Practice Development Manager of the Advanced Paramedic Practitioner for critical care scheme in London Ambulance Service, Mark Faulkner, which is featured in the Scandinavian Journal of Trauma, resuscitation and emergency medicine. The case study involved the resuscitation of a VF cardiac arrest in a 3-month-old infant. The link to the case report can be found in the show notes and in this episode, we will be speaking with Mark (one of the authors) to both explore the case and some of the essential learning points that surround cases like this. We explore the following themes: The current statistical climate of cardiac arrest and infant cardiac arrest Prodromal symptoms of sick infants The utility of sense checks with a clinician in the control room Use of standard and extended diagnostics to recognise ROSC such as USS Deviation from protocol (post shock pause) for good reason Differentiating recurrent from refractory VF from the download Underlying causes of structural and electrical abnormalities and cardiac myopathies The utility of a HOT debrief in these cases as an intrinsic benefit. The article from the interview can be found here: https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00871-9 References to articles that Mark mentions throughout the interview can be found here: https://pubmed.ncbi.nlm.nih.gov/19913971/ https://www.sciencedirect.com/science/article/pii/S1521689620301087 https://www.magonlinelibrary.com/doi/full/10.12968/jpar.2021.13.6.232 I hope you find this episode insightful and useful.
July 17, 2021
Ultrasound with Gaynor Prince - WEMcast re-post
In this session, we interview Gaynor Prince. Gaynor is an emergency physician based in New Zealand and has developed a subspecialty interest in ultrasound in ED. We take a look at point of care ultrasound, its utility and its limitations. We will be especially focussing on the EFAST and how it has been adaptive and progressive in point of care treatment in the past 5 years. We also take a look at ultrasound probes and the positive and negative interaction with tissue. Gaynor unpacks some of the fundamental advantages and disadvantages of POCUS and how it has been adapted, been made portable and democratised amongst clinicians in recent years. We unpack the principles of EFAST, what we are looking for, when to look and where. We examine the difference image representations of fluid, blood, ascites, urine, intestinal contents, lungs, air. Gaynor them looks at the anatomical variations and how to optimise the view, interplay with clinical questioning, repetition of scans and preferential windows to see the anatomy. We go sequentially through the EFAST and look at tips and tricks from Gaynor's practice and how these can be related to everyone's ultrasound practice and decision making. We finally look at a prime example of when USS has been really useful to Gaynor's practice in one of the remotest and most extreme environments - Antarctica. She recalls a story of when ultrasound greatly assisted her decision making, illustrating some of the unique examples of this modality in remote and austere locations. You can see more from Gaynor here: https://www.wem.academy/videos/extreme-medicine-research/ultrasoundinextremeenvironments/ This episode has been kingly re-shared from WEMcast. World Extreme Medicine provide courses, resources, training and conferences and can be found at: https://worldextrememedicine.com Please enjoy the episode.
June 30, 2021
Maternity episode 4 with Stacey Robinson and Sarah Brown
Caroline Philips is back for the fourth instalment of the maternity mini series. Caroline is joined by Stacey Robinson the LAS practice lead midwife and Sarah Brown the LAS practice lead paramedic. In this episode they focus the on management of various pathologies, including bleeding, cord prolapse, shoulder dystocia, and all types of other maternal emergencies and treatment modalities seen within the pre-hospital environment. They dig into the technical and non-technical elements of care for the above pathologies and some of the different manoeuvres that optimise the mother and baby’s health in difficult deliveries. In this final episode we hear from these two specialists as they draw upon their experience, knowledge and oversight to relay some of the most essential aspects of care in maternal emergencies. Our thanks goes to London Ambulance Service for allowing these professional perspectives to be shared and for being a forerunner in recruiting midwives and specialist paramedics with a maternal pre-hospital care focus to support the wider frontline staff. We hope you enjoy this episode with two fantastic clinicians.
June 23, 2021
Maternity episode 3
In this episode we explore late pregnancy complications
June 14, 2021
Maternity Part 2 - Challenges and emergencies of early pregnancy with Stacey Robinson
In this episode Caroline Philips speaks with Stacey Robinson, prehospital midwife about challenges and emergencies of early pregnancy. They discuss bleeding, termination of pregnancy, and miscarriage. Stacey addresses why bleeding occurs and how to assess for it in the first trimester; inclusive of the subjective terms of 'light' and 'heavy' bleeding. They also discuss the potential risks and the atypical presentations that can occur within the first trimester. Stacey discusses some of the nuisances of care that can be provided to this cohort of patients, together with the hidden signs of bleeding. Stacey also discusses the psychosocial aspects of care around bereavement and loss which can occur around this pathology. Stacey reinforces the importance of psychological reassurance and care which are vitally important to this patient group. Relevant links that are useful for this episode can be found here: https://www.miscarriageassociation.org.uk/wp-content/uploads/2019/08/Ambulance-Crews-first-responders-Good-Practice-Gude.pdf https://www.miscarriageassociation.org.uk/information/for-health-professionals/e-learning/ https://nbcpathway.org.uk/professionals We hope you find this interview valuable with an insightful and engaging guest. To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team. https://www.medics.academy/courses/medics-academy-fellowship-programme-application You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases: · skill training and learning, · skill development · skill application The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment. As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
June 03, 2021
Maternity Part 1 with Stacey Robinson
In this episode Caroline Philips interviews Stacey Robinson; pre-hospital midwife, on a variety of maternity and newborn topics that pre-hospital providers might face on scene. Having embedded herself within an ambulance service, Stacey gives a unique and insightful perspective on common myths, unique presentations, and healthy fundamental baselines of maternal and newborn care. This is a four part series, in this episode Stacey unpacks her role, the 'normal labour' scenario and deviation in physiology to be expected in pregnancy. They look at why physiology changes and some of the important details around history and examination. They also examine some of the non-pharmacological methods of optimising birth (skin to skin, micturition, non-technical skills, drying). Here are some useful links for this mini series: https://cprguidelines.eu/assets/guidelines/RESUS-8907-NLS.pdf https://nbcpathway.org.uk/professionals https://www.miscarriageassociation.org.uk/information/for-health-professionals/e-learning/ https://www.miscarriageassociation.org.uk/wp-content/uploads/2019/08/Ambulance-Crews-first-responders-Good-Practice-Gude.pdf https://www.tommys.org/baby-loss-support Please enjoy this episode with a truly insightful guest and experienced midwife. To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team. https://www.medics.academy/courses/medics-academy-fellowship-programme-application You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases: · skill training and learning, · skill development · skill application The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment. As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
May 26, 2021
7/7 with Ken Murphy - Major incident mini series
This session will be the first of a mini-series examining the first-hand accounts of clinicians at some of the most well-known major incidents in the past 20 years. We will start the series by looking at the London bombings from both my perspective and a paramedic Team Leader now Critical Care Paramedic Ken Murphy. We will examine from our anecdotal experience how the scene unfolded and how it became apparent that 3 other bombs had detonated in quick succession. We will walk through some of the thoughts, recollections and structural components and just how it felt to be part of the largest coordinated terrorist attack that the UK has ever seen. In the episode we examine: Our day up until that point The initial call to Kings Cross for a reported power surge The confirmation down in Aldgate East Arrival on scene and what met us The triage and extrication CSCATTT and closer look at the 3 Ts Transfer of patients to the Royal London Hospital Kings Cross – the casualty clearing station and transfer of patients I hope you enjoy this first hand account that examines the difficulties and realities of major incidents. To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team. https://www.medics.academy/courses/medics-academy-fellowship-programme-application You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases: · skill training and learning, · skill development · skill application The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment. As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
May 18, 2021
Expedition Medicine with Natalie Taylor and Jamie Patterson
In this episode I speak with GP Natalie Taylor and Paramedic Jamie Patterson on Expedition Medicine. We examine the skills, schemes, teams and courses that are helpful to prepare you for this dynamic environment. We will dive into our guests experiences to see what has worked for them and how they have navigated previous expedition trips. A special thanks goes out to World Extreme Medicine as we all met through this platform and have indeed all worked for WEM throughout our careers. We take a look at: The diversity of experience of both guests Main themes of expedition medicine – % of non-medical issues, Human Factors, self-care, self admin, primary care Group / team dynamics and how psychological health also plays a part Trauma on expedition Education and experience needed to go on the trips Rate limiting steps on all expeditions and things to be minded of as a clinician The casevac - nuances and tips Some of Nat and Jamie’s most amazing highlights from expedition I hope you enjoy the episode. You can find more from World Extreme Medicine, courses and everything expedition here: https://worldextrememedicine.com To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team. https://www.medics.academy/courses/medics-academy-fellowship-programme-application You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases: · skill training and learning, · skill development · skill application The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment. As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
May 12, 2021
Critical Care Communication
In this episode I examine critical care communication and why this is so important within clinical practice. I look at definitions & statistics, the communication problem, the anatomy of communication, the patient, team and individual, leadership communication, empathetic communication, conflict management communication and finally crisis communication. I examine the approach to individual communication that can optimise both sent and received communication, the main facets of non-verbal, verbal and tonality that is needed to confer vital information. I also look at a number of theories that have deconstructed the problem of communication, these are; communication theory, Millers Magic number 7, The communication triangle, signal detection theory, and finally meta-cognition. I break down some of the central concepts of the main aspects of critical care communication that are used on a day-to-day basis, that of, leadership, empathy, conflict and crisis. I hope you enjoy this topic. We are going to start mixing up the content on the podcast and feature more educational content, lecture sets as well as more traditional interviews and conversations with experts within their field of practice. To apply for the Medics Academy Fellowship please apply here quoting 'PHC' for Pre-Hospital Care to let the team know you'd want to work with the podcast team. https://www.medics.academy/courses/medics-academy-fellowship-programme-application You will acquire the digital skills to both create and harness cumulative attention to knowledge domains and speakers through the podcast platform and co-aligned spaces. As a Fellow you also gain access to Medics.Academy workshops, courses, resources, discounts and masters level accreditation. We are continuously developing the programme to make it a robust and exciting experience for those that are successful in joining. The Fellowship Programme is for a duration of 18 months and comprises three phases: · skill training and learning, · skill development · skill application The phases progress the fellow from a stage of independent working to small group and eventually large group production of a project. In each phase you will be mentored and guided by a specific individual within the company who has experience in producing aspects of the project. On average a fellow will spend 3-6 hours a week in producing the task and the timeframe for tasks will become more independently governed by the fellow as they progress into the next phases. This programme is ideal for individuals with other commitments as it provides a flexible working environment. As a Fellow you can enrol in the post graduate certification programme (PG Cert) in Clinical Practice, Management and Education. This programme is run by Medics.Academy and accredited by the University of Central Lancashire (UCLan) Medical School. The work you do as a Fellow will count towards the overall requirements of the PG Cert. For the joint Medics.Academy Fellowship Programme with postgraduate certificate we require the programme to be completed in 18 months with a potential for a six-month extension to complete programme assessments and elements.
April 25, 2021
New Horizons - Paramedic Practice in the 21st Century - College of Paramedics podcast collaboration
In this session we examine some of the ways in which we have seen paramedics diversify through a multitude of roles within the healthcare economy. We chat with Gary Strong; Paramedic and CPD lead from the College of Paramedics and Caroline Phillips; my co-host, Paramedic and Palliative care Paramedic. The session is intended to unpack, examine our roles and journey through pre-hospital care and finally give insight into some of the positive and challenging aspects of diversification we have seen within paramedic practice in the contemporary climate. In the episode we discuss: The variety of roles that are open to Paramedics & ways in which Paramedicine is changing. We examine Gary’s path through Paramedicine, how he has got to where he is now and what got him there (education, roles and reflections). Caroline’s path through Paramedicine, from education, roles and reflections on current and past job titles within paramedic practice. My own (Eoin’s) path through Paramedicine, how I have got to where I am now and what got me there (education, roles, reflections) Final thoughts on pathways, education and the future of diversity and the role of a paramedic itself. As we see the diversity of roles within our expansive field of practice we reflect on where the profession has come from and how quickly it has adapted to new eco-systems of healthcare. We also reflect on some of the fundamental traits of paramedics around adaptability and flexibility as the DNA of what makes a paramedic so integrated and embedded within various domains of practice. I hope you enjoy this wider ranging conversation on the evolution of the 'paramedic'.
April 01, 2021
COPD with Sarah Aldington
In this episode Caroline Philips interviews Sarah Aldington; a Consultant Emergency Physician in Sydney, she is also a pre-hospital & retrieval specialist with Sydney HEMS. Sarah formerly worked in respiratory medicine in the UK before studying her PhD in New Zealand focusing on the prevalence of cannabis smoking induced COPD and lung cancer. Whilst in Wellington Sarah established a choir for COPD patients called 'Sing Your Lungs Out (SYLO)'. In this interview Sarah gives a fantastic insight into advanced lung disease and a patient focused approach to this life limiting illness. Sarah recounts this amazing initiative that took on a life of its own and instilled a community of like minded sufferers. Sarah and Caroline share insightful perspectives on what truly matters to patients and how this initiative changed Sarah's perspectives on her approach to medicine. Please enjoy this episode with a fantastic guest. More on the choir they speak about can be found here: https://pubmed.ncbi.nlm.nih.gov/27650768/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294022/ https://pcnnz.co.nz/wp-content/uploads/2016/05/Health-Happiness-Community-Gayle-Williams.pdf https://givealittle.co.nz/org/sylo#:~:text=The%20Sing%20Your%20Lungs%20Out,living%20with%20chronic%20lung%20disease.&text=Neighbourhoods%20Fun%20Awareness-,The%20Sing%20Your%20Lungs%20Out%20(SYLO)%20Choir%20is%20a%20community,of%20life%20and%20lung%20function.
March 24, 2021
Advanced Paramedic Practitioners in Urgent Care (APPUC) with Nikki and Andrew
In this session Caroline Philips interviews two of the advanced paramedics in urgent care. The conversation includes; their role on a day to day basis, this structure of the scheme and how there time is spent. They also examine how previous pre-hospital roles (such as clinical advise, team leader/manager roles) have helped with the senior clinical role as an APPUC. Nikki and Andrew also catalogue the variety of patients that they see and the in-depth patient focussed history taking and nuanced risk/benefit analysis undertaken. They also discuss some of the skills that the scheme supports such as wound care assessment and closure methods, point of care tests, additional medications and utilisation of alternative referral pathways. Nikki and Andrew also denote the adjunctive education and skills that have been fostered within the APPUC scheme. As the prevailing percentage of demand within pre-hospital care are medical pathologies, this scheme has had bilateral benefit of supporting frontline paramedics and managing patients in the community and avoiding the transfer through to the emergency department where possible. They also denote the change in communication skills that Nikki and Andrew have both witnessed within their practice. Please enjoy this fantastic episode with two insightful practitioners.
March 17, 2021
Frailty with Claire Norman
Claire is a registered Nurse and Paramedic working as a frailty coordinator at Brook Green Medical Centre, London (HAFP Primary Care Network) with Dr Anna Wilson (Lead GP) and Dr Emily Eve as part of a frailty team. She also sits on the College of Paramedics Committee for primary and urgent care specialist interest group. Claire works as a part community matron as well as a registered paramedic and receives referrals to both support and link the patient into appropriate care pathways. In this episode Claire and Caroline discuss the definition of frailty, contributing factors and the sequelae of neurological disorders contributing to frailty. Clare also discusses baselines of health and the phenotype model and the cumulative deficit model. Caroline also talks about the fall decision tool and frailty syndrome. Please enjoy this episode with an insightful guest. For more on frailty please see the links below: https://www.bgs.org.uk/ British Geriatric Society https://podcasts.apple.com/gb/podcast/the-mdtea-podcast/id1073719746 MDTea Podcast https://www.rcem.ac.uk/ Royal College of Emergency Medicine
March 10, 2021
Resilience with Tony Underwood
Tony Underwood is a former English Rugby Union professional who played as a winger for both country and at club level. He made his England debut in October 1992 against Canada, and went on to win a total of 27 English performances/caps. Having trained as an airline pilot, went on to fly for Easy jet, Virgin Atlantic and Emirates. In this conversation we talk about resilience, high performing teams, relationship with failure and success, continual improvement & feedback mechanisms, transitioning & adaptation to change, meta-programs, co-aligned lessons with aviation and medicine and finally human factor mitigation. I hope you enjoy this interview with an insightful and interesting guest. To find out more about Tony please head to: wordplaygroup.com Twitter: @underwood_tony
March 04, 2021
The bleeding patient with Ben Watts
In this conversation with Ben Watts we look at the sequential approach to arresting bleeding. We also examine the second/third generation haemostatic compounds (celox, quik-clot), pharmacological agents such as TXA, FFP, FDP, blood, cryoprecipitate. We also examine the utility of tourniquets (origins, usage and types), neck zones and wounds, Blunt injury and junctional wounds, Hypotensive management and Pain management modalities and preferential agents. Ben is a specialist retrieval practitioner/CCP working in Scotland and previously as a CCP in the Thames Valley and before this in South West of England. He also has an extensive history of expedition work in various international locations, I first met Ben whilst working for World Extreme Medicine as a fellow paramedic and he has been a contributor to both WEMcast and to the College of Paramedics podcast. I hope you enjoy this wider ranging conversation as much as we did.
February 27, 2021
Addiction with Mark Dempster
Mark Dempster is an addiction specialist working with patients with drug addiction, gambling addiction, sex addiction, alcohol addiction, internet addiction, and more. He is a counsellor dedicated to helping people regain control and turn their lives around. In the conversation we look at some of the statistics around the health burden & impact on the individual and extended families, how people become addicted (habit Vs addiction), the 5 stages of addiction, common cognitive pitfalls and finally breaking the cycle. We also explore some of therapies that are evidence based and are commonly practised such as CBT, DBT, ACT, and PET. In 2013, the Centre for Social Justice determined that the level of addiction in the UK made it the “addiction capital of Europe.” This includes the use of legal substances, mainly alcohol, and the use of Class A drugs, that include heroin, cocaine, meth, and hallucinogens. £36 billion is spent by the nation every year on treatment relating to drug and alcohol abuse. At the time of filing their report, titled No Quick Fix, the UK had the highest rate of addiction to opioids and the highest lifetime-use of amphetamines, cocaine, and ecstasy across Europe. Many view addiction as something that only affects the users themselves but, in reality, casualties from substance abuse are taxing on entire communities, the NHS and society as a whole. It has a direct affect on healthcare workers and on the frontline of the emergency services on a daily basis. Please enjoy this interview with Mark, his clinic and work can be found here: http://markdempstercounselling.com/
February 20, 2021
Critical Care Teams (CCT) with Johannes von Vopelius-Feldt
In this interview I interview Johannes von Vopelius-Feldt, Johannes is an emergency physician currently working in South West England. He has written and undertaken extensive research into the utility and demographics of critical care teams. He has also empirically examined the impact of critical care within certain patient presentations to examine the benefit that these teams can bring. In the conversation we examine; the overall proven benefit of critical care versus standard care within pre-hospital care. We also examine skill mix versus intervention, intervention versus outcome, the wider utility to critical care outside of cardiac arrest and some of the prospective studies which may benefit transparency into the usefulness of CCTs. We also examine the shift in mindsets and underlying concepts that are now well known and accepted around human factors and mitigation strategies compared to 10 years ago. Johannes' research can be found below - please enjoy this conversation with an insightful and engaging guest as he brings an inquisitive and research based perspective to the domain of critical care. J von Vopelius-Feldt, JR Benger - European Journal of Emergency Medicine 20 (6), 382-386 45, 2013 Who does what in prehospital critical care? An analysis of competencies of paramedics, critical care paramedics and prehospital physicians J von Vopelius-Feldt, J Benger - Emergency Medicine Journal 31 (12), 1009-1013 40, 2014 Critical care paramedics: where is the evidence? A systematic review J von Vopelius-Feldt, J Wood, J Benger Emergency Medicine Journal 31 (12), 1016-1024, 18 2014 Systematic review of the effectiveness of prehospital critical care following out-of-hospital cardiac arrest J von Vopelius-Feldt, J Brandling, J Benger - Resuscitation 114, 40-46 17 2017 The impact of a pre-hospital critical care team on survival from out-of-hospital cardiac arrest J von Vopelius-Feldt, A Coulter, J Benger Resuscitation 96, 290-295 15 2015 Critical care paramedics in England: a national survey of ambulance services J von Vopelius-Feldt, J Benger - European Journal of Emergency Medicine 21 (4), 301-304 13 2014 Prehospital critical care for out-of-hospital cardiac arrest: An observational study examining survival and a stakeholder-focused cost analysis J von Vopelius-Feldt, J Powell, R Morris, J Benger - BMC emergency medicine 16 (1), 1-7 11 2016 Should physicians attend out-of-hospital cardiac arrests? J von Vopelius-Feldt, JR Benger - Resuscitation 108, A6-A7 4 2016 Response to: influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation
February 15, 2021
Pandemic in focus Pt 4 with ACP Lucy Grimwade
In this session we interview Lucy Grimwade who works as an Advanced Clinical Practitioner (ACP) and Matron in an Emergency Department in Manchester. Lucy gives a fantastic perceptive on the current climate within the emergency department throughout the first and second spike of Covid-19. She gives an honest and insightful first hand recollection of her clinical and personal experiences around the effects in patients physical and mental health. She also provides an insightful commentary on the mental health of the shared ED community and habits that have served her well during the lockdown period. Please enjoy this interview providing a unique cross-section of life on the frontline of the NHS during the greatest health crisis it has ever faced.
February 11, 2021
‘The Commando Way’ with Bram Connolly
In this episode I talk with Bram Connolly. Bram is former special forces operative with the Australian Special Forces with 20 years of experience on the frontline. Bram was was awarded the Distinguished Service Medal for leadership in the Australia Day awards 2012. Bram is the Managing Director and founder of Hindsight Leadership and Resilience. He is the author of "The Fighting Season" and "Off Reservation" and the leadership book "The Commando Way" published in 2020. In the conversation we talk about: Resilience, leadership, values and optimisation. We explore various facets of the book 'The Commando Way' and dig into some of the 20 years experience that taught Bram the lessons he depicts in the book. I hope you enjoy this interview with an inspirational leader. Bram also has a podcast: https://podcast.warrioru.com.au/podcasts/ Hi book 'The Commando Way' can be found here: https://www.amazon.co.uk/s?k=the+commando+way&adgrpid=55975240794&gclid=Cj0KCQiA0-6ABhDMARIsAFVdQv-06UsRi2ZQL-Obrchizx8P0WYzCaepcjXf-70TtIPFVkJAksF7S0IaAtPbEALw_wcB&hvadid=259062984695&hvdev=c&hvlocint=9046009&hvlocphy=21468&hvnetw=g&hvqmt=e&hvrand=11852429682160879921&hvtargid=kwd-302016437038&hydadcr=24402_1816050&tag=googhydr-21&ref=pd_sl_39q7xnnmde_e
February 04, 2021
Pandemic in focus Pt 3: Reflections from GP Lloyd Evans
In this episode we speak with Lloyd Evans a GP in Wales around his experiences of the second wave of the pandemic. We explore some of the fundamental issues that have led to a rise in demand and stress both within the general population and the frontline NHS staff. We explore some of the second and third order effects of the covid pandemic, together with the unintended positive aspects that it has incurred. I hope you enjoy this episode with an insightful and honest practitioner as it gives a rounded cross-section of accounts from the frontline of the largest health crisis that has befallen the NHS since its inception in 1948.
February 01, 2021
Pandemic in focus Pt 2: Reflections from APP Alec Wilding
In this mini-series I talk to Alec Wilding who is an Advanced Paramedic Practitioner (APP) on the frontline of the healthcare system within the UK. Alec gives me an honest and transparent perspective of life tackling the second wave of the covid pandemic and his thoughts on how it is impacting the mental and physical health of both the population and the staff. Alec gives an honest and insightful recollection into the incremental effects of the pandemic and is the second of four accounts from the frontline - I hope you get as much out of it as I have.
January 25, 2021
Pandemic in Focus with EMD Lucy Gough
In this mini-series I talk to a cross section of individuals at the frontline of the healthcare system within the UK. In this episode I speak with friend and colleague Lucy Gough. Lucy is an Emergency Medical Dispatcher (EMD) within London. She gives me an honest and transparent perspective of life in the Emergency Control Room and her thoughts on the contemporary demand profile within the pandemic in London. Lucy is both honest and insightful into the unique challenges that she and colleagues face on a day-to-day basis and the overall challenge that the ambulance service faces in response to the largest health demand since the creation and inception of the NHS. This is the first of four accounts from the frontline - I hope you get as much out of it as I have.
January 22, 2021
Best of Restore 2020
This has been a unique and challenging year for everyone. It has been a real privilege to have over a 100 conversations on various podcasts and platforms (PHCP, Restore and WEM). I have included this recording of the best of Restore as mental health has taken a central spotlight in this pandemic and has been an inescapable facet to manage for all of us as things have become difficult in work and personal lives. My hope for 2021 is that a continued narrative both encourages you and gives everyone listening to these podcasts a sense of hope in a time that has required every clinician to engage with difficult times. I hope to help encourage every healthcare professional in this time of demand and great need, these conversations are designed to hopefully give back to you - I sincerely hope they serve this function at this time. My thanks also goes out to everyone that has contributed to the PHCP in 2020, platforms like this will always benefit from a plenary of perspectives rather than just individual ones. Eoin
January 04, 2021
Pre-hospital mental health with Anna Basquil and Dan Fisher
In this episode we explore the initiative of pre-hospital co-responding mental health nurses working alongside paramedics within London, UK. We look at the prevalence of mental health within the capital and how Anna and Dan have seen the initiative add benefit to pre-hospital assessment, management and the resultant access to healthcare. We look at some of the current prevailing mental health statistics (MIND 2020), such as: 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. We also look at anecdotal commonalities in acute MH presentations within the community and the interplay between the Mental Health Act and the Mental Capacity Act in assessment and treatment of mental health patients. Lastly, we look at case studies to understand the dual assessment model that Anna and Dan use to assess patients within the pre-hospital environment. I hope you enjoy the episode.
December 09, 2020
Life Under Fire with Jason Fox
In this episode I chat to Jason Fox about his new book ‘Life Under Fire’ for those of you that aren’t familiar with Jason, he is 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 in 2001, serving with the Special Boat Service till 2012. 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. The book is split into two parts, the first part the battle mind looks at his journey to a resilient life and mental approach. The second part - Strength and Guile looks at the lessons learned from his 20 years as an operator and royal marines commando and inferred learning to the reader. Concepts we explore include: The concept of graded exposure to training. The sense of community and brotherhood from war. Jason's struggles with PTSD and the emotional combat indicators that signify it. The ‘cigar moment’ and how it calms the central nervous system down. Awareness of your own vulnerabilities and how it can help protect you. The preferential mode of de-escalation over aggression (grey man, passive use of the weapon). High performing teams ability to self regulate rather than externally regulate. Reframing negative events and what it can teach us about resilience. The power of debrief also known as Sensitive Site Exploitation/SSE. The concept that there is a flattened hierarchy and everyone can contribute a game changing piece of information. Not resting in the aftermath of success and using failure as a teacher. I hope you enjoy the episode. You can find 'Life under fire' by Penguin books here: https://www.penguin.co.uk/books/111/1119268/life-under-fire/9781787633193.html
November 16, 2020
EOLC 4: Grief and bereavement with Julia Samuel MBE
In this episode Julia Samuel and Caroline Phillips discuss grief and the process of bereavement. We discuss important skills for breaking bad news, bereavement by exposure and ways in which we can support our own resilience as healthcare professionals. Julia Samuel is a psychotherapist who has spent the last thirty years working with bereaved families. She has worked both in private practice and in the NHS at St Mary’s Hospital Paddington where she pioneered the role of maternity and paediatric psychotherapist. In 1994 she worked to launch and establish Child Bereavement UK as its Founder Patron, where she played a central role until September 2019. Julia was awarded an MBE in the 2015 New Year’s Honours list for services to bereaved children. She is the author of two books: Grief Works and This Too Shall Pass. We hope you enjoy the episode. Further reading: - Child Bereavement UK https://www.childbereavementuk.org/?gclid=Cj0KCQjw2or8BRCNARIsAC_ppyYXJ4jJ5kW2226C30UnEuOOBqUA8vUbrBPiCuZFHmJ4sh1L8HHhydIaAjssEALw_wcB - Information about Julia Samuel’s books, ‘Grief Works’ and ‘This too shall pass’ can be found here, as well as her ‘Pillars of Strength’ tips - https://juliasamuel.co.uk - Cruse Bereavement UK has practical resources and information for personal and professional use - https://www.cruse.org.uk
November 13, 2020
EOLC 3: Advanced Neurological Disease with Diane Laverty
This episode explores advanced neurological conditions with Palliative Nurse Consultant Diane Laverty. Diane has over 30 years experience in palliative care and spent time in her doctorate exploring informal carers needs when looking after those with progressive neurological conditions. Motor Neurone, Parkinson’s and Multiple Sclerosis conditions are discussed, common symptoms and potential exacerbations are covered and the wider social implication on family and carers are discussed. Further reading: - Motor Neurone Disease Association https://www.mndassociation.org - Parkinson’s Foundation https://www.parkinson.org - Multiple Sclerosis Society https://www.mssociety.org.uk/about-ms/what-is-ms - Oxford Handbook of Palliative Medicine (2019) We hope you enjoy the episode.
November 06, 2020
PHCP - house keeping episode
I just wanted to do a house keeping episode to let you know what to expect in this season. We are half way through the mini series on End of Life Care and had 'recognising the dying phase' with Dr Emma Hall and 'oncological emergencies' with Merel a cancer clincial nurse specialist. We have two more instalments of EOLC and these are around advanced neurological disease with Diane Laverty and Grief and bereavement with Julia Samuel MBE. Caroline Philips has done a fantastic job at cataloging some of these essential conversations and really helping us appreciate some of the deeper facets of end of life care. We will have some skill based episodes with myself and Nick Brown. These are looking at the skills undertaken by clinicians and everything that the text books don’t tell you around experiential learning and reflections of performing these on a daily/weekly basis - we will look at IO, splintage, intubation, IV access and other skills. We will look at pain management with a pain specialist and some of the types and methods of acute and chronic pain management that we might face in the pre-hospital environment. We will do a deep dive into one of the prolific drugs in society and that we interact with on a daily basis - that of alcohol. We will look at chronic alcoholism and how it changes physiology. We will also look at acute intoxication and why these patients can be so difficult to look after. We will start with a mini case review series as well - dissecting some challenging cases and what we can learn from these cases. We will also look at urgent care with a GP and urgent care advanced paramedic in more detail and some of the subtitles that we can learn to pick up as clinicians. Finally we will look at some of the diverse range of pre-hospital career options that are available for clinicians (paramedics, doctors and nurses) in the current climate. We hope you enjoy the season.
November 01, 2020
EOLC part 2: Oncological Emergencies with Merel and Caroline Philips
In end of life care we are mindful of respecting patient’s wishes, including those relating to conveyance to acute care settings. However there are some presentations, specifically in relation to cancer, which we need to be aware of and rapidly refer onto either acute or specialist colleagues. In this episode we explore these reversible oncological emergencies based on cases seen in Merel’s clinical experience as a Cancer Clinical Nurse Specialist in a specialist cancer centre in The Netherlands. We review Neutropenic Sepsis, Superior Vena Cava Obstruction, Metastatic Spinal Cord Compression and Hypercalcaemia. Further reading: - AACE JRCALC Clinical Guidelines (2019) – End of Life Care - NICE Guidelines - Metastatic spinal cord compression in adults: risk assessment, diagnosis and management - NICE Guidelines - Neutropenic sepsis: prevention and management in people with cancer - Oxford Handbook of Palliative Medicine (2019) We hope you enjoy the episode.
October 30, 2020
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
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.
October 08, 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.firstname.lastname@example.org • Clubdrugclinic.email@example.com • www.clubdrugclinic.com • @ClubDrugClinic @OwenBowdenJones www.neptune-clinical-guidance.co.uk
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.
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.
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.
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.
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
August 06, 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.
July 08, 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.
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
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.
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
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.
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.
June 09, 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
June 01, 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
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.
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.
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
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
May 04, 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
May 03, 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.
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.
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.
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.
April 06, 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.
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.
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.
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.
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.
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.
July 01, 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.
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.
June 03, 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.”
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.
May 06, 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.
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?
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.
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.
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.
January 02, 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?
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.
December 05, 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.
November 20, 2018
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.
November 02, 2018