HEMS Debrief - Retrieval and Pre-Hospital Medicine #4. Damage control resuscitation with London HEMS

G'day and welcome back. We are currently editing new episodes of the podcast, they will be coming out soon - episodes on brain injury associated shock, post-ROSC care and more. In the meantime, here is a re-post of an episode with the pre-hospital ECMO (Pre-Care) team in conversation with senior road paramedics. In this episode, the team discuss the challenges and successes of rolling out this trial in the Greater Sydney basin - but more crucially, also discuss the flow-on effect personalised resuscitation care has on 'standard' ALS care. This episode was very well received the first time around, and so we re-post it now as the technical learning points provided by the team also nicely summaries lots of the learning from subsequent episodes. Chat soon.

Welcome back! We are busy recording new episodes, in the meantime here is a re-post of an episode prior to our move to Spotify/podcasts with Emergency and Pre-Hospital Consultant Dr Ian Ferguson. Ian is the lead author on a published randomised control trial assessing the haemodynamic effects of adding fentanyl to an induction regime of ketamine and rocuronium for rapid sequence intubation in the emergency department. The FAKT study. This multicenter study conducted in New South Wales, Australia, has yielding some thought-provoking results, and may change your in- or out-of-hospital anaesthesia practice in future.

G'day, and welcome back. Pre-hospital clinicians are used to working under pressure. Teams work in often austere environments, with limited resources caring for some of the most severe patient pathologies at their most undifferentiated. Within all this, individuals and teams must perform at their peak. But this is easier said than done. So how, in this most niche of clinical areas, can an individual, a team and an organisation promote, harness and maintain peak performance? Dr Stephen Hearns is an Emergency and Pre-Hospital Physician from Glasgow, Scotland. Stephen has spent most of his career working out-of-hospital, both in the UK and around the world. Throughout, Stephen has reflected on his own journey of peak performance, and has dedicated more recent years to the study and deep dive into what contributes to an individual and team functioning most highly in the pre-hospital space. In this episode, we discuss Stephen's research and published work to inform this topic. Stephen has spent time with other peak-performing groups including but not limited to Armed Forces and sporting teams, and has developed a package of learning to inform daily optimal performance. We talk about communication strategies, cognitive aids, team selection and organisational leadership - all of which, and more, contribute to peak performance. This episode is a must-listen for all pre-hospital clinicians intent on optimising their attainment, that of the team and that of their organisation.

Hello and welcome back. This is part two of our chat with Dr Matt Hooper, continuing our conversation on emergency last aid. In this episode, we discuss the hows and whens involved when informing a family of their loved one's death, as well as the setting in which to do this. Too, we discuss the importance of maintaining space and safety for one's self and the team, and how a system can encourage psychological safety in this regard. As with part one, please ensure this episode is the right one for you - this is a challenging and emotionally-charged topic and whilst very important, please make sure it is the right episode at the right time for you. Chat soon.

G'day, and welcome back. In today's episode, we are delighted and privileged to be joined by South Australia's Dr Matt Hooper. The practice of medicine - including pre-hospital medicine - often focuses on life preservation. But, as acute care clinicians we often also find ourselves caring for patients at the end of their life. Too, we find ourselves caring for their relatives and loved ones, and the wider medical team. It can be really challenging to provide this care in such an acute, unexpected and unstable setting - so how do we do it, how do we stabilise the moment and continue to deliver compassionate care? This is the work of Dr Matt Hooper, who together with colleagues has created the 'emergency last aid' program - designed to teach the foundational skills needed to deliver compassionate end-of-life care in high-pressure environments. Drawing on his experience as a pre-hospital, intensive care and palliative care physician, Matt talks us through his approach to these challenging, rewarding circumstances. Before listening to this episode, please ensure it is the right episode for you: talking about death, dying and grief can be triggering for some, so please ensure that this episode is what you need, at the right time, and that you have support around you.