Pre-Hospital Care Podcast

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. 

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. 

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. 

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. 

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.

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.

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. 

In this episode we explore late pregnancy complications 

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.

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.