Regional Trauma Case Study – Applying MARCHE when it matters (S2 Ep7)

Every second counts during a cardiac arrest, and the actions taken before an ambulance arrives can make a critical difference. In this Shocktober episode of Clinical Practice Radio (CPR), the team is joined by St John WA Community Response Manager Caitlyn Pavey-Smith and Resuscitation Improvement Specialist Jason Belcher to explore the importance of early intervention and the role our community plays in strengthening the chain of survival. Together, they discuss St John WA's First Responder app and State Defibrillator Network, and how these initiatives help connect people experiencing cardiac arrest with trained community responders and accessible defibrillators in those crucial first few minutes. Through real-life examples, they highlight the importance of early CPR, defibrillation and the collective effort involved in responding to cardiac arrest. The conversation also explores how everyone can play a part, from learning CPR and completing first aid training to registering a defibrillator or becoming a community first responder. A great discussion about how the chain of survival helps save lives.

It's Shocktober! In this episode, the team is joined by St John WA Resuscitation Improvement Specialist Jason Belcher to take a deep dive into the science of defibrillation and the small changes that can help make the first shock the best shock. The conversation focuses on the three Ps – placement, prep and perfusion – exploring why correct pad placement matters, how preparing the patient can improve pad contact, and why minimising interruptions to chest compressions is so important when delivering a shock. The team also discusses the differences between public AEDs and the defibrillators used by paramedics, high-performance CPR and some of the emerging approaches to defibrillation, including vector change and double sequential defibrillation. They unpack what current research tells us, where the evidence is still developing and why getting the fundamentals right remains key. A practical discussion on the science behind defibrillation and how clinicians can optimise everything within their control to give patients the best possible chance during cardiac arrest.

In this episode, Megan Currie and Nick Overington are joined by St John WA First Nations Lead and Paramedic Jeremy Maitland-Smith to explore trauma-informed and culturally informed care when working with First Nations patients and communities. The conversation explores the key principles of trauma-informed practice - safety, trust, choice, collaboration and empowerment - and how these can be brought back to two simple concepts: respect and trust. Jeremy shares practical considerations for culturally informed care, highlighting that clinicians don't need to know everything about every culture. Instead, keeping an open mind, asking respectful questions and taking the time to listen can help clinicians better understand the individual, their family and the cultural considerations that may influence their care. An insightful discussion on starting the conversation, allowing space for silence and working with patients to make decisions about their care – principles that can support better interactions with every patient, every time.

In this episode of Clinical Practice Radio, Megan and Nick are joined by hyperbaric physician Dr Ian Gawthrope and critical care paramedic intern Andrew “Wishy” Wishart to discuss decompression illness, including decompression sickness and arterial gas embolism. The team explores how diving-related bubbles affect the body, common symptoms, the importance of taking a detailed dive history, and conditions that can mimic DCI, such as immersion pulmonary oedema and inner-ear barotrauma. For pre-hospital clinicians, key management priorities include early hyperbaric consultation, keeping patients supine, administering high-flow oxygen, assessing neurological status, giving fluids and analgesia, preventing hypothermia, and arranging timely transport.

Pre-hospital emergency anaesthesia is about far more than intubation. In this episode, the team is joined by St John WA Critical Care Paramedic Cornell Greyling to explore the preparation, teamwork and clinical decision-making that underpin one of the most complex interventions in pre-hospital care. Together, they discuss when pre-hospital emergency anaesthesia is indicated, how understanding patient physiology helps clinicians prepare for induction, and why optimising oxygenation, ventilation and haemodynamics before intubation is critical to patient safety. The conversation also unpacks the structured approach used by Critical Care teams, highlighting the importance of communication, human factors and shared situational awareness throughout the procedure. Whether you're interested in airway management, critical care or improving team performance in high-pressure environments, this episode provides practical insights into safely navigating one of paramedicine's most challenging clinical procedures.