Pre-Hospital Care Podcast

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

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. 

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

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.

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.

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.

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 

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.

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

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