Explorez tous les épisodes du podcast The St.Emlyn’s Podcast
| Titre | Date | Durée | |
|---|---|---|---|
| Ep 300 - Decisions under pressure from Tactical Trauma | 17 oct. 2026 | 00:16:11 | |
Making decisions with incomplete information is part of everyday emergency and trauma care. But when the stakes are particularly high, how do you know when you have enough information to act? Waiting too long may cost lives. Acting too soon may put patients, colleagues or yourself at unnecessary risk. For our 300th St Emlyn’s podcast, Iain Beardsell revisits conversations he and Liz Crowe recorded at Tactical Trauma in Sweden. Drawing on interviews with Claire Park, Sean Brayford-Harris, Alice Hutin and Chris Bishop, he explores how clinicians and first responders make difficult decisions under pressure, from major incidents and mass casualty triage to prehospital eCPR and ECMO in trauma. In this podcast:
About the contributors Claire Park is a consultant in prehospital emergency medicine with extensive experience of high-threat incident response. Sean Brayford-Harris is a London Ambulance Service paramedic who helped develop Ten Second Triage. Alice Hutin is an emergency physician working with the prehospital eCPR service in Paris. Chris Bishop is a clinical perfusionist and research fellow investigating VA-ECMO for cardiogenic shock following major trauma. Links and resources You can explore the original conversations and their accompanying St Emlyn’s articles:
More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. Subscribe to the St Emlyn’s Podcast wherever you get your podcasts. Tactical Trauma is an international conference held in Sundsvall, Sweden, bringing together doctors, paramedics, police officers, military medics and rescue services to share experiences of delivering care in challenging and sometimes hostile environments. The programme covers prehospital trauma care, resuscitation, major incidents, tactical medicine and human performance, with a particular emphasis on learning from real-world experience. The next conference takes place on 2–4 November 2026, and these conversations were recorded at the last Tactical Trauma meeting. | |||
| Ep 299 - Which patients with chest pain need a troponin? | 03 oct. 2026 | 00:19:31 | |
Chest pain that sounds like indigestion, feels mild or seems “atypical” can still be myocardial infarction. The difficult question is not whether troponin is useful, but which patients actually need testing — and how much weight we should give symptoms, cardiovascular risk factors and clinical judgement. Professor Rick Body looks at the evidence behind those decisions, drawing on his own research and other studies of patients with suspected acute coronary syndromes. He explores which clinical features genuinely change the probability of myocardial infarction, which are less useful than we might think, and how to balance the risks of missing MI against unnecessary investigation. In this podcast:
The numerical probabilities discussed come from populations already selected for investigation of suspected myocardial infarction, so they should not simply be transferred to every patient presenting with chest pain. About Rick Body Rick Body is Professor of Emergency Medicine at the University of Manchester and an Honorary Consultant in Emergency Medicine at Manchester University NHS Foundation Trust. His research has focused extensively on diagnostics in acute coronary syndromes, including cardiac troponin and strategies for the early rule-out of myocardial infarction. Timestamps 00:00 – Which patients with chest pain need a troponin? 02:00 – What individual symptoms do to pre-test probability 05:00 – Vomiting and observed sweating 08:00 – The problem with “typical” and “atypical” symptoms 10:00 – Do traditional cardiovascular risk factors help? 13:00 – How reliable is clinical judgement or gestalt? 16:00 – Avoiding both under-investigation and over-investigation 17:00 – Rick’s practical approach to deciding when to test Links and resources The value of symptoms and signs in the emergent diagnosis of acute coronary syndromes ‘Chest pain typicality’ in suspected acute coronary syndromes and the impact of clinical experience More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. | |||
| Ep 298 - Traumatic Cardiac Arrest: Rethinking Resuscitative Thoracotomy with Laura Kocierz at Trauma 2030 | 26 sept. 2026 | 00:14:18 | |
Traumatic cardiac arrest demands rapid treatment, but one of the hardest decisions is whether a resuscitative thoracotomy is likely to help. Can the location of a penetrating injury and the rhythm on the monitor give us better information than an uncertain history of when the patient arrested? Recorded at Trauma 2030 at the Royal College of Surgeons of England, Iain Beardsell speaks with Laura Kocierz about a data-driven approach developed from London’s Air Ambulance experience. They discuss distinguishing cardiac tamponade from exsanguination, using ECG rhythm as a surrogate for arrest duration, and why thoracotomy should target the underlying pathology rather than simply the diagnosis of traumatic cardiac arrest. In this podcast:
About Laura Kocierz Laura Kocierz is a consultant in intensive care medicine and anaesthesia in Worcester and a consultant with London’s Air Ambulance. Her work includes research examining how clinical information available at the scene can support decision-making in traumatic cardiac arrest. Timestamps 00:00 – Defining traumatic cardiac arrest 02:00 – Injury location, tamponade and exsanguination 05:00 – When should resuscitative thoracotomy be considered? 07:00 – Using the ECG as a surrogate for arrest duration 11:00 – Combining likely pathology with presenting rhythm 13:00 – Moving beyond a simple 15-minute rule 14:00 – Why thoracotomy is not the treatment for exsanguination Links and resources Read the London’s Air Ambulance study of 601 prehospital resuscitative thoracotomies Find out more about Trauma 2030 More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. Subscribe to the St Emlyn’s Podcast wherever you get your podcasts. Trauma 2030 TRAUMA 2030 united experts and innovators to shape the future of trauma care. Over two days, it explored breakthroughs in science, systems, and frontline practice, fostering collaboration across disciplines. The symposium aimed to inspire research, inform policy, and build a bold roadmap for trauma care worldwide. | |||
| Ep 297 - The 5th Universal Definition of MI - what emergency clinicians need to know | 18 sept. 2026 | 00:17:10 | |
The Fifth Universal Definition of Myocardial Infarction changes some familiar language around MI and puts new emphasis on how we interpret troponin, myocardial injury and imaging. For emergency clinicians, these changes affect both how we describe what is happening and how confidently we can make the diagnosis. Iain Beardsell introduces Rick Body, Professor of Emergency Medicine at the University of Manchester, who works through what has changed and what it means in practice. In this podcast:
About Rick Body Rick Body is Professor of Emergency Medicine at the University of Manchester and an honorary consultant at Manchester Foundation Trust. He is also Editor-in-Chief of the Emergency Medicine Journal and chairs the NICE Interventional Procedures Advisory Committee. Timestamps 00:00 – Introduction and why the new definition matters 02:00 – Primary, secondary and procedure-related MI 04:00 – Sex-specific troponin thresholds 05:00 – Imaging and confirmation of myocardial infarction 06:00 – Acute myocardial injury and its causes 09:00 – Chronic myocardial injury in the ED 11:00 – Absolute versus relative troponin deltas 15:00 – OMI, STEMI and NSTEMI terminology Links and resources Read the accompanying St Emlyn’s article Read the Fifth Universal Definition of Myocardial Infarction View the IFCC high-sensitivity cardiac troponin assay reference tables More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. | |||
| Ep 296 - Trauma, Systems Thinking and High-Risk PE (April 2026 Round Up) | 12 sept. 2026 | 00:25:34 | |
Small decisions in the resus room can save minutes; badly designed systems can waste thousands of hours. In the April 2026 St Emlyn’s round-up, Iain Beardsell and Simon Carley move between both ends of that spectrum, from external haemorrhage control and chest drains before CT to ED crowding, clinician productivity and the reflex to solve safety problems with more mandatory training. There is also new evidence on smoking cessation in the emergency department and HI-PEITHO, a randomised trial of catheter-directed thrombolysis for higher-risk pulmonary embolism. In this podcast:
Links and resources Read TTL Tip 8: External Haemorrhage Control Read TTL Tip 9: Chest Drain Before CT? Think, Decide, Communicate Read Explaining Emergency Department Crowding Using a Cognitive Bridge Read How Many Patients Should We See Per Hour? Read Fit to Quit? The Trial Evidence for Smoking Cessation Interventions in ED Read the Emergency Medicine Journal systematic review of ED smoking cessation interventions Read the St Emlyn’s review of HI-PEITHO Read the original HI-PEITHO trial in the New England Journal of Medicine Read TTL Tip 10: Put the Trauma Patient Straight onto the Portable Monitor More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. | |||
| Ep 295 - PE, Whole Blood, HEMS and Smarter CPR (March 2026 Round Up) | 13 août 2026 | 00:30:35 | |
In this month’s St Emlyn’s podcast, Iain Beardsell and Simon Carley work through some of the most interesting recent posts and papers from the blog. The conversation ranges from the latest pulmonary embolism guidance to the persistent problem of emergency department crowding, and from pre-hospital whole blood to the uneven availability of enhanced critical care across the UK. They also look at whether TOE might help us deliver more effective CPR, why arterial pressure may be a more useful resuscitation target than simply watching compressions, and a remarkable report from Gaza that challenges some long-held assumptions about pericardiocentesis in traumatic tamponade. As ever, the focus is less on simply repeating what the papers say and more on what they mean in practice. Some of the evidence is reassuring, some of it is uncomfortable, and several of the studies raise as many questions as they answer. It is a discussion about uncertainty, physiology, systems and the importance of being willing to change your mind when the evidence does not fit what feels intuitively right. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. | |||
| Ep 294 - Experts Are Made, Not Born: Sara Crager on Mental Models and Rapid Sequence | 11 juil. 2026 | 00:33:56 | |
What separates an expert from someone who simply knows a lot? Sara Crager argues that expertise is less about accumulating facts or hours of experience and more about developing better mental models: structured ways of organising knowledge and approaching difficult problems. Iain Beardsell speaks with Sara about deliberate practice, how experts can make their thinking visible to learners, and Rapid Sequence, the clinical simulation game she developed with Ryan Ernst to let clinicians practise complex decision-making, cognitive load and critical care physiology without putting real patients at risk. In this podcast:
About Sara Crager Sara Crager is an emergency physician, intensivist and medical educator with a particular interest in making complex critical care physiology understandable and clinically useful. She created ICUedu and co-developed Rapid Sequence with emergency physician and educator Ryan Ernst. Links and resources Explore Rapid Sequence and play a sample case More from St Emlyn’s St Emlyn’s provides free, evidence-based education for the emergency and acute care community. Explore our blogs, podcasts and other resources. If you have an idea you would like to share, would like to write with us, or want to get involved with St Emlyn’s, we’d love to hear from you. Learning from podcasts? If podcasts form part of your CPD, MedPod Learn helps you turn listening into documented learning. You can use it across all your podcasts — not just St Emlyn’s — to record your listening, make notes, answer questions, reflect on what you have learned and create a record of your CPD. | |||
| Ep 293 - Making Feedback Sticky, TTL Tips and more (February 2026 round up) | 27 juin 2026 | 00:17:11 | |
In this episode of the St Emlyn’s Podcast, Iain Beardsell and Simon Carley catch up on the February blog posts, recorded in the rather unseasonal context of a UK heatwave. They begin with congratulations to Simon on his reappointment as Dean of the Royal College of Emergency Medicine, before reflecting on recent conferences including IFEM in Hamburg and Don’t Forget The Bubbles in Glasgow. The clinical focus this month is trauma team leadership, with practical tips on interpreting trauma CT reports, maintaining momentum after the scan, performing safer log rolls, and making feedback more useful for learners and colleagues. Key learning points
Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. | |||
| Ep 292 - Leadership, Culture and Psychological Safety in Pre-Hospital Care with Anna Dobbie at Trauma 2030 | 17 juin 2026 | 00:21:06 | |
In this episode of the St Emlyn’s Podcast, Iain Beardsell speaks with Anna Dobbie, consultant in emergency medicine and pre-hospital care, and Clinical Lead for London HEMS. Recorded at Trauma 2030 at the Royal College of Surgeons in London, the conversation explores what it means to lead exceptional teams in one of the most high-pressure areas of emergency medicine. Anna reflects on six years as Clinical Lead for London HEMS, sharing lessons on leadership, culture, psychological safety, difficult conversations, managing strong personalities, and supporting clinicians to do their best work. The discussion also touches on the unique nature of pre-hospital care, where teams move rapidly between downtime and high-intensity clinical decision-making, and where trust, openness and mutual respect are essential. Anna describes the importance of making sure all voices are heard, not just the loudest, and explains why leaders need to be consistent, approachable and willing to have honest conversations when things do not go as well as they should. Anna also reflects on learning leadership on the job, the value of formal leadership training, the challenge of maintaining boundaries when you care deeply about a service, and the relationship between London’s Air Ambulance and its supporting charity. Finally, Iain and Anna look ahead to the future of trauma care and pre-hospital medicine, including research, ECMO, marginal gains, quality improvement, and the continuing ambition to reduce preventable deaths from trauma. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. Trauma 2030 TRAUMA 2030 united experts and innovators to shape the future of trauma care. Over two days, it explored breakthroughs in science, systems, and frontline practice, fostering collaboration across disciplines. The symposium aimed to inspire research, inform policy, and build a bold roadmap for trauma care worldwide. | |||
| Ep 291 - January 2026 Round-Up: RSI Trial, Trauma Leadership, and the Reality of Corridor Care | 17 avr. 2026 | 00:34:22 | |
In this episode, Iain and Simon catch up on the papers, posts, and conversations that have been sitting with us since the start of the year. Some are familiar. Some are uncomfortable. All of them feel relevant on shift. We start with the RSI trial — ketamine versus etomidate. A study that generated a lot of noise, and perhaps more certainty than it deserved. We move through trauma team leadership. Not as a checklist, but as a set of decisions made under pressure — when to call a Code Red, how to structure a handover, and what it means to lead a team that hasn’t worked together before. There’s a discussion about trauma units. Not the big centres. The places where most patients go. Fewer resources. Different pressures. The same expectations. We talk about spinal cord injury and blood pressure targets. Numbers are useful. But they’re still just numbers. And then corridor care. Not a new problem. But one we may have started to accept in ways that should make us uneasy. We discuss: • What the RSI trial actually showed — and what it didn’t • Why secondary outcomes should make you pause, not pivot practice • How and when to activate a massive haemorrhage protocol • Why early senior decision-making matters more than perfect diagnosis • What good trauma handover looks like — and why it often doesn’t happen • How trauma teams function differently in trauma units • The limits of blood pressure targets in spinal cord injury • Why corridor care is not just operational — but ethical This is not a guideline episode. It’s a conversation about practice. About judgement. About the small decisions that shape outcomes long before the data catches up. If you’re listening after a shift, you’ll recognise most of it. If podcasts are part of how you learn, you can log your listening, reflect, and build CPD through MedPod Learn. It works across podcasts, not just this one. As always, thanks for listening. these ideas are tested in practice. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing.
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| Ep 290 - Shock with Rich Carden at Trauma 2030 | 11 avr. 2026 | 00:18:29 | |
Shock is one of the most used words in emergency medicine. It’s also one of the most misunderstood. In this episode, recorded at Trauma 2030 at the Royal College of Surgeons, I sit down with one of St Emlyn's own, Rich Carden — former emergency physician, now intensive care trainee and PhD graduate in trauma sciences — to explore what shock actually means beyond the blood pressure reading. We discuss: • Why shock is fundamentally about oxygen delivery and utilisation at a cellular level • The difference between pressure and perfusion • The concept of the “dose” of shock — magnitude and duration • Why haemorrhage may only be the first phase • How trauma patients transition between haemorrhagic, inflammatory, vasoplegic and septic states • The glycocalyx — and why losing it matters • The risks of early vasopressors in an empty system • Why doing the basics exceptionally well remains our best intervention This is not a protocol episode. It’s a physiology conversation. A systems conversation. A reminder that restoring a number is not the same as restoring oxygen to mitochondria. If you’re interested in pre-hospital and trauma systems thinking, do take a look at Tactical Trauma — spaces where these ideas are tested in practice. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. Trauma 2030 TRAUMA 2030 united experts and innovators to shape the future of trauma care. Over two days, it explored breakthroughs in science, systems, and frontline practice, fostering collaboration across disciplines. The symposium aimed to inspire research, inform policy, and build a bold roadmap for trauma care worldwide. As always, thanks for listening. | |||
| Ep 289 - Refractory VF, Double Sequential Defibrillation, and the Future of Cardiac Arrest | 20 mars 2026 | 00:28:52 | |
What do we really know about treating refractory ventricular fibrillation? And why are we still waiting to use strategies that might actually work? In this episode, we talk to Sheldon Cheskes about the evolving science of cardiac arrest, with a focus on refractory and recurrent ventricular fibrillation. We explore the evidence behind double sequential external defibrillation (DSED), how it compares to standard defibrillation, and what the DOSE VF trial has changed in practice. This is not just about adding another shock. It’s about understanding why defibrillation fails, how vector and energy delivery matter, and when a different approach might improve outcomes. We also discuss:
This is a conversation grounded in real-world resuscitation. It challenges current practice without overselling the evidence. Key Learning Points
Why This Matters Cardiac arrest survival remains low. Small improvements in early resuscitation can have large system-wide effects. Understanding when standard care is failing — and what to do next — is where expertise matters. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. If you are already listening, you may as well make it count. | |||
| Ep 288 - Training Reform, Trauma Leadership, AI on the Shop Floor and more (November/December 2025) | 03 mars 2026 | 00:29:27 | |
You’re about to hear a conversation that ranges widely — from training reform and trauma leadership to ondansetron, paracetamol protocols, and artificial intelligence. But it isn’t really about any single topic - It’s about where emergency medicine is heading. And whether we are ready for it. This is our November and December 2025 round-up, and revisits the blog posts from the end of last year. A pause. A reset. A chance to look again at ideas that still matter on shift. We explore
What this means for trainers, medical schools, and the future of clinical judgement This episode closes Season 12 of the St Emlyn’s podcast. Season 13 is coming — including London 2030 content and more from recent conferences. Upcoming events Tactical Trauma returns 2–4 November in Sundsvall, Sweden. It remains one of the most focused and practical trauma meetings in Europe — small faculty, serious discussion, no fluff. If you are interested in pre-hospital and in-hospital trauma care, it is worth your time. IncrEMentuM is approaching fast, with limited places remaining. If you’ve heard us talk about it before, you’ll know why people come back. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. If you are already listening, you may as well make it count. More conversations from recent meetings — including Trauma 2030 — will follow in upcoming episodes. Thanks for listening | |||
| Ep 287 - Damage Control Pre-hospital Care with Harriet Tucker at Trauma 2030 | 24 févr. 2026 | 00:29:02 | |
You’re about to hear a conversation about doing less. But it isn’t really about doing less. It’s about time. Recorded at Trauma 2030 at the Royal College of Surgeons, this episode explores a shift in mindset in pre-hospital trauma care — away from maximal intervention on scene and towards rapid recognition of the patient who cannot be fixed pre-hospital. I’m joined by Harriet Tucker — consultant at London’s Air Ambulance, HEMS Governance Lead at Air Ambulance Kent Surrey Sussex, and Trauma Team Leader at St George’s Major Trauma Centre — to talk about damage control pre-hospital care. We discuss:
This approach focuses on a small but critically unwell group of patients — often penetrating trauma with rapidly exsanguinating haemorrhage — where the only definitive treatment is surgical control of bleeding. The key intervention is speed. Harriet also discusses the governance work behind this change, the importance of reviewing every case, and how to bring ambulance services and in-hospital teams along with the shift in thinking. This episode is part of a series recorded at Trauma 2030. More conversations from the meeting will follow in upcoming episodes. Upcoming events Harriet will be speaking at Tactical Trauma, 2–4 November, Sundsvall, Sweden. IncrEMentuM is now only eight weeks away, with limited tickets remaining. Learning from podcasts? If podcasts form part of your CPD, you can log your listening time across all podcasts on MedPod Learn — not just St Emlyn’s — and generate structured reflection. The app is free to download, includes a one-month free trial, and offers globally adjusted pricing. Trauma 2030 TRAUMA 2030 united experts and innovators to shape the future of trauma care. Over two days, it explored breakthroughs in science, systems, and frontline practice, fostering collaboration across disciplines. The symposium aimed to inspire research, inform policy, and build a bold roadmap for trauma care worldwide.
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| Ep 286 - Building HEMS in Northern Ireland: Systems, People, and the Legacy of John Hinds with Nigel Ruddell at BASICs 2025 | 14 févr. 2026 | 00:17:29 | |
In this episode of the St Emlyn’s Podcast, we’re joined by Nigel Ruddell, Medical Director of the Northern Ireland Ambulance Service, recorded live at the BASICS Conference. This is a conversation about Helicopter Emergency Medical Services (HEMS) — but not in the way you might expect. It’s not really about aircraft. It’s about people. Nigel talks us through the long, often uncomfortable journey to building Air Ambulance Northern Ireland. From early fundraising attempts in the 2000s, through the influence and legacy of Dr John Hinds, to the eventual partnership between charity and the statutory ambulance service that made a doctor–paramedic HEMS model possible. We explore: • Why the helicopter isn’t the intervention — the team is • The charity–NHS partnership model in Northern Ireland • Geography, rurality, and the realities of serving 1.9 million people • Dispatch challenges and the use of video triage (including the GoodSAM platform) • Cross-border working with the National Ambulance Service of Ireland • The cultural work required to convince colleagues that HEMS is not a “Cinderella service” • Humility, leadership, and the people who quietly build systems We also reflect on John Hinds's legacy and how his passion catalysed change, including the significance of the Delta 7 callsign. This is a thoughtful conversation about system design, pre-hospital care, and what it actually takes to introduce enhanced critical care capability into a region that has never had it before. If you enjoy thinking about pre-hospital medicine, trauma systems, and the future of emergency care, you may also want to look at: the IncrEMentuM Conference and Tactical Trauma And if you want to go deeper into the evidence behind the conversations we have on this podcast, explore MedPod Learn — now hosting nearly 5,000 medical podcast episodes with linked multiple-choice questions to support structured learning. As always, thanks for listening. | |||
| Ep 285 - Resuscitative Hysterotomy with Caroline Leech at BASICs 2025 | 27 janv. 2026 | 00:21:40 | |
In this episode of the St Emlyn’s Podcast, Iain Beardsell and Simon Carley talk with Caroline Leech at the BASICs Conference about resuscitative hysterotomy following maternal cardiac arrest. This is a calm, evidence-led discussion of a rare, high-stakes intervention that most clinicians will encounter once, if at all — and still need to get right. What we cover
Key takeaways
This episode is not about heroics. It is about realism, evidence, and being prepared for one of the most confronting moments in emergency care. About MedPod LearnMedPod Learn is a medical podcast player designed to help turn listening into structured learning, with tools to support reflection, CPD, and appraisal. Available on the App Store and Google Play. IncrEMentum 2026 - April 22 - 24IncrEMentuM was born to revolutionise how we approach emergency medicine. It’s not a traditional conference — it’s an immersive experience that pushes professionals to act, think, and make decisions in real time. Our mission is to bring together healthcare providers, experts, and emergency personnel from around the world to share experiences, train in realistic scenarios, and test their skills under extreme pressure. In 2026, we return with an even more intense and lifelike edition — all with one clear goal: to prepare you for what cannot be predicted. Tactical Trauma - April 22 - 24This is an international conference covering various aspects of working in high-stakes environments, primarily related to pre-hospital trauma and critical care, with a tactical twist. Our program is rich and diverse, featuring state-of-the-art lectures from world-class speakers. We aim to bring together all organisations working with pre-hospital trauma in tactical/hostile environments, including physicians, HEMS, EMS, police anti-terror units, military, fire and rescue services and more.
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| Ep 284 - Trauma, Cardiac Arrest, and the Myth of the Silver Bullet (October 2025) | 13 janv. 2026 | 00:24:41 | |
In this (rather delayed!) October round-up, Iain Beardsell and Simon Carley catch up on recent St Emlyn’s blog posts and papers that continue to shape emergency and resuscitation practice. The discussion moves across trauma, analgesia, cardiac arrest physiology, emergency department systems, and antimicrobial stewardship—less about novelty, more about what actually holds up on shift. Trauma and haemorrhage The episode opens with a discussion of the FIRST-2 trial, examining fibrinogen concentrate and prothrombin complex concentrate versus fresh frozen plasma in severe traumatic haemorrhage. Despite promising physiological theory, the trial shows no meaningful reduction in blood product use compared with standard care, reinforcing the ongoing role of FFP in early trauma resuscitation. Upper limb injuries and regional anaesthesia The team explore the SUPERB trial comparing supraclavicular brachial plexus blocks with Bier’s blocks for upper limb reductions. Both techniques provide excellent analgesia. The conversation reflects on changing practice, procedural sedation pressures, ultrasound access, and how physical space—not evidence—often dictates what we do. Cardiac arrest: signals worth paying attention to Three recent cardiac arrest papers are reviewed, focusing on physiological markers rather than new devices:
These are not definitive answers, but they point towards cardiac arrest management that is more physiological and less ritualistic. Emergency department systems: repair, not reinvention A reflective discussion on “designer repair” challenges the idea that emergency departments need constant transformation. Instead, the focus shifts to recognising and supporting the clinicians quietly holding fragile systems together every day—and why fixing small, broken things often matters more than grand redesigns. Sepsis and antibiotics The episode closes with a critical look at broad-spectrum antibiotic use in suspected sepsis. Observational data suggest significant overtreatment and real harm, reinforcing the need to pause, think, and choose the right antibiotic—not just the fastest one. This episode is a reminder that good emergency medicine is rarely about silver bullets. It’s about judgement, physiology, and paying attention to what actually works in the real world. About MedPod Learn MedPod Learn is a medical podcast player designed to help turn listening into structured learning, with tools to support reflection, CPD, and appraisal. Available on the App Store and Google Play. | |||
| Ep 283 - Best Bits of 2025 — Bonus: Clinical Pearls | 02 janv. 2026 | 00:14:24 | |
This bonus episode is a quick-fire collection of clinical pearls drawn from across the St Emlyn’s podcast in 2025. Short, practical, and deliberately focused, these are the moments that make you stop and think: “That’s useful — I want that in my head.” There’s minimal commentary and no deep dives. Each clip stands on its own as a clear takeaway, designed to be listened to in one go or dipped back into when needed. In this episode
This episode is designed to be saved, revisited, and shared — the kind of learning that pays off later. Featured episodes Clips in this episode are taken from the following full St Emlyn’s episodes:
All full episodes are available in the podcast feed. About MedPod Learn MedPod Learn is a medical podcast player designed to help turn listening into structured learning, with tools to support reflection, CPD, and appraisal. Available on the App Store and Google Play. | |||
| Ep 282 - Best Bits of 2025 — The Things You’ll Be Glad You Remember | 30 déc. 2025 | 00:13:54 | |
Some of the hardest moments in emergency medicine aren’t hard because they’re complicated. They’re hard because they’re rare — and when they arrive, you’re relying on things you last thought about a long time ago. This final episode in the Best Bits of 2025 series is the “file it away” collection: rare, high-stakes situations where preparation is largely cognitive, decisions are time-critical, and there may be no second chance. The clips in this episode are drawn from full St Emlyn’s episodes released during 2025 and focus on recognition, decision-making, and human factors in uncommon but consequential scenarios. In this episode, we explore
This episode is designed to be listened to slowly, and returned to when needed — the kind of learning that pays off long after you first hear it. Featured episodes Clips in this episode are taken from the following full St Emlyn’s episodes:
All full episodes are available in the podcast feed. About MedPod Learn MedPod Learn is a medical podcast player designed to help turn listening into structured learning, with tools to support reflection, CPD, and appraisal. Available on the App Store and Google Play. | |||
| Ep 281 - Best Bits of 2025: Getting Better the Sustainable Way | 27 déc. 2025 | 00:11:53 | |
January often brings pressure to improve — to fix gaps, sharpen skills, and somehow be better than the year before. Done badly, that drive can become another source of burnout. This third episode in the Best Bits of 2025 series focuses on how improvement actually works in emergency and acute care — and how to do it in a way that is realistic, sustainable, and kind to the people doing the work. The clips in this episode are drawn from full St Emlyn’s episodes released during 2025 and reflect some of the most practical conversations about learning, feedback, and professional development from the year. In this episode, we explore
This episode is designed for listening on the way to work, on the way home, or during a quieter moment when you’re thinking about how to improve practice without adding more weight. Featured episodes Clips in this episode are taken from the following full episodes:
All full episodes are available in the podcast feed. About MedPod Learn MedPod Learn is a medical podcast player designed to help turn listening into structured learning, with optional tools to support reflection, CPD, and appraisal. Available on the App Store and Google Play. | |||
| Ep 280 - Best Bits of 2025: Staying Human Under Pressure | 23 déc. 2025 | 00:14:57 | |
Winter pressure doesn’t just affect patient flow. It affects people. This second episode in the Best Bits of 2025 series focuses on the human side of emergency medicine: culture, moral injury, compassion, and the small but meaningful behaviours that help clinicians stay grounded when work is relentless. The clips in this episode are drawn from full St Emlyn’s podcast episodes released during 2025 and reflect some of the most thoughtful conversations of the year. In this episode, we explore:
This episode is designed for listening on shift, on the way home, or during a quieter moment over Christmas and New Year. Featured episodes Clips in this episode are taken from the following full St Emlyn’s episodes:
All full episodes are available in the podcast feed. About MedPod Learn MedPod Learn is a medical podcast player designed to help turn listening into structured learning, with optional reflection and tools to support CPD and appraisal. Available on the App Store and Google Play. | |||
| Ep 279 - Best Bits of 2025: Decisions When It’s Busy | 21 déc. 2025 | 00:12:07 | |
Emergency medicine strips decision-making back to its essentials when departments are full and time is short. This first episode in the Best Bits of 2025 series brings together some of the most practically useful moments from the St Emlyn’s podcast this year — focusing on how clinicians make good decisions under pressure, when conditions are far from ideal. Each clip comes from a full episode released in 2025. In this episode, we explore:
This episode is designed to be useful on shift, in the car, or during a quiet moment before the next job. Featured episodes Clips in this episode are taken from the following full St Emlyn’s episodes:
All full episodes are available in the podcast feed. About MedPod Learn MedPod Learn is a clinician-built medical podcast player designed to turn listening into structured learning, with optional MCQs, reflection prompts, and saved activity for appraisal and CPD. You can find it on the App Store and Google Play. | |||
| Ep 278 - Trauma 2030 Highlights: Damage Control Resuscitation, Resuscitative Thoractomy and more. | 16 déc. 2025 | 00:13:19 | |
Join Iain Beardsell and Hutch as they review key insights from the Trauma 2030 conference hosted by the Institute of Pre-Hospital Care, part of London's Air Ambulance. The discussion highlights the emphasis on speed in damage control resuscitation, the ongoing debate on 'scoop and run' versus 'stay and play' approaches, and the nuanced use of resuscitative thoracotomy. The episode delves into advanced therapies like ECMO, their expanding role in trauma care, and the importance of relentless self-evaluation in medical practice. Discover how London's focused approach can provide broader lessons for trauma care and the potential for innovative treatments to become more widespread. Look out for more podcasts from Trauma 2030 over the coming weeks, where we will talk about team leadership in pre-hospital teams, more on damage-control pre-hospital care, nuancing the management of traumatic cardiac arrest, the increasing use of ECMO, and the shocked trauma patient. The Institute of Pre-Hospital Care The Institute of Pre-Hospital Care is part of London’s Air Ambulance Charity, focused on advancing pre-hospital care. They train clinicians, use case studies to guide our priorities, develop new clinical interventions and conduct research. They are also proud to educate and inspire the next generation of pre-hospital care experts through our two degree programmes, co-convened with Queen Mary University London (QMUL). Through the training and education of The Institute of Pre-Hospital Care, they ensure their unique team of doctors and paramedics are there for London, today, tomorrow, always. Listen on MedPod Learn MedPod Learn is a new app that turns medical podcasts into structured learning. Alongside the audio, you get concise learning points, exam-style MCQs, and short reflection prompts — with listening time and activity logged automatically for CPD and appraisal. If you already learn through podcasts, this is a way to make that learning count. | |||
| Ep 277 - Cognitive HALOs and Advanced Simulation Training with Halden Hutchinson-Bazely at BASICs 2025 | 06 déc. 2025 | 00:25:59 | |
Recorded at the BASICS Conference 2025, Iain talks with Haldon “Hutch” Hutchinson-Basley about the idea of a “cognitive HALO” — those rare moments where your mental bandwidth hits maximum power. Hutch describes a traumatic cardiac arrest he encountered alone, with no warning and no crewmate to share the load. He explains how he recognised cognitive overload and used simple strategies — “lighting a flare”, “norming the abnormal”, and dropping tasks he couldn’t safely achieve — to regain decision-making space. The discussion links this experience to his work on the ATACC course and the emerging SPEAR programme, exploring how realistic, human-centred simulation prepares clinicians to function when the stakes and stress are highest. MedPod Learn turns trusted FOAMed podcasts into structured CPD, adding concise learning notes, single-best-answer questions, and role-specific reflection prompts to thousands of episodes. Everything you do — listening time, MCQs, reflections — is saved automatically and downloadable in one click for appraisal. The app is free to download, with a one-month trial of the full learning tools. Just search MedPod Learn on the App Store or Google Play. | |||
| Ep 276 - Ejection Seats and the Injured Pilot – Aviation Medicine with Phil Lucas at BASICs 2025 | 22 nov. 2025 | 00:23:54 | |
In this St Emlyn’s podcast, Ian Beardsell and Simon Carley speak with RAF GP Phil Lucas from the Royal Air Force Centre of Aerospace Medicine at the BASICS conference in Leicestershire. They explore what really happens when a pilot pulls the ejection handle, and what this means for pre-hospital and Emergency Department teams who may be the first to see an ejectee. Phil explains: • Why the aviation environment is so hostile to humans and how aerospace medicine supports aircrew • How modern ejection seats work – from canopy jettison and rocket firing to parachute deployment and landing • The decision making required to eject in a matter of seconds, and how pilots are trained to be “mentally ready” • Typical injury patterns after ejection, how technology has reduced spinal compression injuries, and where the remaining risks lie • Practical considerations for ED and pre-hospital teams when a pilot presents after ejection, including spinal precautions and safe removal of flight equipment • The psychological impact of surviving a crash or ejection, how support needs can change over months, and what helps people return to flying • Aviation medicine as a career path, including the role of the RAF Centre of Aerospace Medicine, the diploma in aviation medicine, and how this can sit alongside general practice or emergency care This conversation draws strong parallels between aviation and emergency medicine: human factors, training under pressure, using simulation and mental rehearsal, and the importance of honest, individualised psychological support after critical incidents. | |||
| Ep 275 - Targeted Resuscitation, Arterial Lines, Hydrofluoric Acid Burns Treatment and more (August/September 2025) | 11 nov. 2025 | 00:36:03 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Simon Carley review blog posts from August and September. They reflect on their experience at the BASICs Conference, highlighting discussions on resuscitation science and new resuscitation council guidelines. Topics covered include the physiological-targeted resuscitation, arterial line placements during cardiac arrest, the PECan abdominal trauma rule in pediatric emergency care, intra-arrest stellate ganglion blocks, hydrofluoric acid burns treatment, and pediatric status epilepticus. They also delve into the evidence trial on moving patients with refractory out-of-hospital cardiac arrest to hospitals for specialised care, and review discussions on moral injury among emergency responders. Additionally, they mention the upcoming Geckos Global Health and Emergency Care Research Summit and explore the potential future of emergency medicine by 2038. 00:00 Introduction and Conference Highlights 02:55 Arterial Line Placement During Cardiac Arrest 05:27 Pediatric Abdominal Trauma Rule 10:25 Intra-Arrest Stellate Ganglion Blocks 14:35 Moral Injury in Emergency Responders 23:22 Hydrofluoric Acid Burns Treatment 25:38 Ketamine for Pediatric Status Epilepticus 28:57 Refractory Out-of-Hospital Cardiac Arrest 33:59 Global Health and Emergency Care Research 35:09 Conclusion and Future Episodes | |||
| Ep 274 - What medical conferences offer in 2025 (and how they’ve changed) | 18 oct. 2025 | 00:42:30 | |
Episode summary
Guests
Key themes
Practical takeaways for clinicians
Practical takeaways for organisers
Risks and tensions
How conferences translate to patient care
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| Ep 273 - Surg Cap Ed Barnard on the Abdominal Aortic & Junctional Tourniquet (AAJT) for Exsanguinating, Non-Compressible Haemorrhage at BASICs 2025 | 09 oct. 2025 | 00:26:23 | |
Recorded at the BASICS Pre-Hospital Care Conference at Sketchley Grange, this episode explores one of the most experimental tools in civilian trauma care — the abdominal aortic and junctional tourniquet. Dr Ed Barnard joins us to discuss why this device was developed, how it works, and where it might — just might — save lives when all other options have failed. The conversation traces the problem of non-compressible haemorrhage, the leading cause of potentially survivable trauma death. Conventional limb tourniquets, pelvic binders and packing can’t reach these deep bleeding sites. The AAJT offers a radical alternative: external aortic compression to buy a few crucial minutes until surgical control or REBOA is possible. Ed explains the mechanism — an inflatable, ratcheted belt that can occlude the aorta or major junctional vessels — and the evidence so far. Laboratory and volunteer data show that it can stop flow, but pain and tissue ischaemia make it difficult to tolerate for long. Clinical experience remains limited to small case series, mostly in military or research settings, and no human trials yet demonstrate a survival benefit. The discussion is candid about risk and realism. The AAJT is a last-resort device, to be used only within strict governance, with clear time limits and immediate plans for definitive haemorrhage control. It’s not something you reach for on a normal shift — it’s something you might need once in a career, and only if every other option has failed. Ed shares insights from ongoing research, including its potential role as a bridge to REBOA, and the governance frameworks that should surround any trial use. The episode ends with a look to the future: how civilian and military collaboration might refine indications, training, and data collection for this rare but potentially life-saving intervention. Surgeon Captain Ed Barnard Surgeon Captain Ed Barnard is a Consultant in Emergency Medicine at Addenbrooke’s Hospital, Cambridge, and a Professor of Emergency Medicine with the Defence Medical Services. He also serves with East Anglian Air Ambulance as a HEMS doctor (having had many years as a BASICS responder). His academic work focuses on prehospital and military trauma care, with a portfolio spanning clinical trials, blood product innovation, and trauma system development. Ed’s academic work focuses on improving survival from catastrophic bleeding, particularly non-compressible and junctional haemorrhage. He has published and presented widely on trauma resuscitation, traumatic cardiac arrest, and the evolving role of devices such as the abdominal aortic and junctional tourniquet (AAJT) and REBOA. He is a co-author of the 2025 BMJ Military Health systematic review examining the utility of the AAJT-S in military practice. He is also an experienced educator, contributing to trauma training for BASICS, HEMS, and Defence Medical Services, and continues to combine clinical work with research aimed at translating lessons from military to civilian trauma care. About BASICS: The British Association for Immediate Care (BASICS) is a UK charity uniting clinicians dedicated to pre-hospital emergency medicine. Founded in 1977, it supports regional immediate-care schemes, delivers national training, and hosts the annual BASICS Pre-Hospital Care Conference, bringing together experts in trauma, retrieval, and critical care — like this conversation with Dr Ed Barnard. | |||
| Ep 272 - Toxicology, Hyperthermia and the Future of Emergency Care (June and July 2025) | 23 août 2025 | 00:32:08 | |
In this episode of the St Emlyn's Podcast, Iain and Simon discuss the latest updates in emergency medicine during the hot UK summer. They discuss the latest research and content from the St Emlyns blog, touching on topics like serotonin syndrome, the impact of the new urgent and emergency care plan in the UK, and the use of salbutamol as an analgesic for renal colic. They also highlight the growing issue of nitazenes, a new class of synthetic opioids, and their implications for emergency medicine. Lastly, they emphasise the importance of staying updated on toxicology to effectively manage high-acuity, low-occurrence events such as drug-induced hyperthermia. 00:00 Introduction 01:35 Upcoming Conferences 03:41 Med Pod Learn 05:09 Serotonin Syndrome Deep Dive 10:22 Urgent and Emergency Care Plan 18:04 Salbutamol for Renal Colic 22:07 Hypothermia in Toxicology Emergencies 27:04 Nitazines: A Growing Problem | |||
| Ep 271 - Behavioural Disturbance, Trauma scores, Compassion, Thoracotomies and more | 11 juil. 2025 | 00:35:54 | |
Iain and Simon return after a brief hiatus to discuss key blog posts from April and May on the St Emlyn's Podcast. They highlight notable conferences including IncrEMentum 2025 in Spain, The Big Sick in Zermatt, and the BASICs Conference. Discussions cover content from recent emergency medicine research, the importance of compassion and patient-centred care, and operational strategies to avoid emergency department overcrowding. Insights are also shared from fieldwork in South Africa on emergency thoracotomies and their impressive survival rates. | |||
| Ep 270 - Insights on Cannabis Edibles, Pre-Hospital Thoracotomy, and more | 04 juin 2025 | 00:31:25 | |
In the March 2025 episode of the St. Emlyn's podcast, Iain Beardsell and Simon Carley discuss a variety of topics covered in their latest blog posts and podcasts. Key discussions include the implications of cannabis edibles in emergency departments, expert viewpoints on pre-hospital resuscitative thoracotomy for traumatic cardiac arrest, and the use of ketamine for opioid-dependent patients. Highlights from recent conferences such as The Big Sick, IncrEMentuM 2025, and the Royal College of Emergency Medicine (RCEM) conference in Birmingham are shared. The episode also delves into department culture, addressing resilience, risk management, and other critical topics in emergency medicine. The podcast concludes with a recommendation of Matt Morgan’s book "A Second Act: What Nearly Dying Teaches About Really Living." 00:00 Introduction and March 2025 Roundup 01:45 Cannabis Edibles in the Emergency Department 05:25 Pre-Hospital Resuscitative Thoracotomy 12:38 Ketamine for Opioid Users in Acute Pain 15:17 Conference Highlights and Reflections 27:13 Matt Morgan's Inspirational Talk 30:50 Conclusion and Farewell | |||
| Ep 269 - Monthly Round Up Janury 2025 - Prehospital Papers Galore!.... | 14 mai 2025 | 00:23:55 | |
In this episode of the St Emlyn's Podcast, Iain Beardsell and Simon Carley revisit January's blog posts and podcasts, covering several seminal studies relevant to emergency and pre-hospital care. Topics include the Sub 30 Feasibility Study on pre-hospital ECMO, comparisons of pre-hospital versus in-hospital emergency anaesthesia, variations in maintenance of pre-hospital anaesthesia in trauma patients, and the effectiveness of physician-led pre-hospital teams. They also discuss the economic implications of advanced pre-hospital interventions and highlight reviews from the London Trauma Conference. 00:00 Introduction and January Recap 01:58 Pre-Hospital ECPR Study: The Sub 30 Study 07:09 Emergency Anaesthesia: Pre-Hospital vs. Emergency Department 13:55 Maintenance of Pre-Hospital Anaesthesia: Variations in Practice 16:57 Physician-Led Pre-Hospital Teams: Do They Improve Outcomes? 22:12 Additional Insights and Upcoming Content | |||
| Ep 268 - Top Papers of 2024 from The Big Sick Conference | 23 avr. 2025 | 00:22:46 | |
In this special edition of the St Emlyn’s podcast, Iain Beardsell and Simon Carley review the top medical papers of 2024, originating from Simon’s talk at The Big Sick conference in Zermatt. The discussion includes a comparison of non-invasive versus arterial pressure monitoring, the association of intra-arrest arterial blood pressure with ROSC, the efficacy of serratus anterior plane blocks for rib fracture management, and the evaluation of a micro axial flow pump in cardiogenic shock. They also delve into double sequential external defibrillation in refractory out-of-hospital cardiac arrest and provide a rapid-fire review of additional critical papers discussed at the conference. Notable mentions include the HEMOTION trial, PRE OXI trial, BLING III, and PARAMEDIC-3, among others. A must-listen for those passionate about evidence-based medicine in emergency and pre-hospital care. You can read more about all the trials, including links to all the papers here (part 1) and here (part 2) 00:00 Introduction and Conference Highlights 01:51 Non-Invasive vs. Arterial Pressure Monitoring 03:28 Intra-Arrest Blood Pressure and ROSC 05:34 Serratus Anterior Plane Blocks for Rib Fractures 08:38 Micro Axial Flow Pump in Cardiogenic Shock 10:49 Double Sequential Defibrillation in Cardiac Arrest 13:17 HEMOTION Trial 15:01 PRE OXI and BLING III Trials 17:08 Fluid Management in Septic Shock 18:37 Expedited Transfer vs. On-Scene Resuscitation 20:39 Intraosseous vs. Intravenous Access 21:48 Conclusion and Final Thoughts | |||
| Ep 267 - Social Media and Artifical Intelligence in Medicine with Peter Brindley at LTC | 16 avr. 2025 | 00:18:19 | |
Join hosts Iain Beardsell and Natalie May at the London Trauma Conference as they welcome Peter Brindley back to the St Emlyn’s podcast. In this engaging episode, they delve into the nuances of social media, digital footprints, and the burgeoning influence of artificial intelligence in medicine. Brindley discusses the importance of maintaining an authentic digital presence and addresses the impact of misinformation and disinformation in the digital age. They explore the challenges and opportunities presented by AI in clinical decision-making and share insights on navigating this evolving landscape as healthcare professionals. Tune in for a thought-provoking conversation on staying relevant and responsible in a digitally-driven world. 00:00 Introduction and Welcome 01:40 Understanding Digital Footprint 03:53 Navigating Information and Misinformation 05:41 The Role of AI in Information Search 08:45 AI in Clinical Decision Making 15:28 The Kardashian Index and Social Media Influence 17:39 Conclusion and Final Thoughts | |||
| Ep 266 - Monthly Round Up February 2025 - Skills Fade, Resuscitation Targets and more | 09 avr. 2025 | 00:26:22 | |
In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley reflect on their experiences at recent conferences, including the IncrEMentuM 2025 and The Big Sick. They discuss the exceptional quality and innovative formats of presentations at IncrEMentuM, emphasizing the enthusiasm and positive atmosphere. The discussion also covers key emergency medicine topics from February's blog posts, including the maintenance of clinical skills, the importance of diastolic blood pressure in resuscitation, and a systematic review on resuscitative hysterotomy. Additionally, they explore new guidance on the diagnosis of death, particularly in intensive care settings. Special thanks to Galen Pharmaceuticals and PM Cardio for their support. 00:00 Introduction and Recent Conferences 00:42 Highlights from IncrEMentuM 2025 04:47 Emergency Medicine Blog Posts Overview 05:10 Maintaining Competency in Rare Procedures 11:23 Diastolic Blood Pressure in Resuscitation 15:37 Resuscitative Hysterotomy Insights 20:43 Understanding Death Criteria 24:48 Conclusion and Acknowledgements | |||
| Ep 265 - Excellence in Debriefing with Richard Lyon at LTC | 26 mars 2025 | 00:21:05 | |
In this episode of the St Emlyn's Podcast, Iain Beardsell and Natalie May speak with Richard Lyon, an emergency doctor and deputy medical director of the air ambulance service at Kent, Surrey, and Sussex. Recorded at the London Trauma Conference 2024 in Kensington, Richard shares experiences and lessons from his talk on five critical cases that shaped him as a clinician and human being. Discussion topics include the importance of case debriefing, the impact of video recording in clinical practice, overcoming the challenges of self-reflection, and the evolving culture of pre-hospital emergency medicine. Richard emphasizes the significance of supportive and structured debriefing processes and offers insights on integrating video reviews into emergency practices for improved education and reflection. 00:00 Introduction and Guest Welcome 00:37 Richard Lyon's Background and Talk Overview 01:00 The Importance of Case Learning and Debriefing 02:12 Challenges and Strategies in Case Learning 04:24 The Power of Video Recording in Clinical Practice 07:30 Implementing Video Recording: Practical Steps 08:24 Addressing Concerns and Building Trust 12:56 Senior Clinicians and Vulnerability 17:33 Supporting Pre-Hospital Clinicians 20:35 Conclusion and Final Thoughts The Guest - Richard Lyon Professor Lyon is an active UK NHS Consultant in Emergency Medicine and Pre-hospital Care in Edinburgh and Deputy Medical Director for Air Ambulance, Kent Surrey & Sussex. A globally recognised leader in pre-hospital and emergency medical care, Prof Lyon works for multiple world class organisations, helping to develop current and future state-of-the art medical devices, systems and concepts aiming to save lives across the globe. A respected clinical leader and senior medical advisor to both governments and global corporations, with a track record of delivering high quality output and success across clinical, academic, research and innovation. Prof Lyon was made a Member of the Most Excellent Order of the British Empire (MBE) by HM The Queen in the 2017 Honours, for Services to Emergency Healthcare, after he established a programme of work on out-of-hospital cardiac arrest for Scotland. Prof Lyon holds a personal Chair of Pre-hospital Emergency Care at the University of Surrey and has an established research portfolio in pre-hospital resuscitation and trauma care, with an extensive publication record. Prof Lyon is a current member of the Faculty of Pre-hospital Care and author of several international guidelines. Prof Lyon is a Physician with the UK International Search & Rescue Team. | |||
| Ep 264 - High Performance Teams with Dan Dworkis at Tactical Trauma 24 | 12 mars 2025 | 00:16:55 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe welcome Dan Dworkis, an ER doctor from Los Angeles and host of the Emergency Mind podcast. Dan shares his expertise on optimizing team and individual performance in high-stress medical environments. The discussion delves into the concept of excellence beyond merely avoiding negative outcomes, using a rosebush metaphor to illustrate the need for proactive growth. They explore how teams can benchmark and improve performance, the importance of creating a culture of continuous improvement, and strategies to maintain positivity and energy even in challenging conditions. Dan also highlights the Mission Critical Team Institute and its role in supporting teams in life-or-death situations. This episode is essential listening for medical professionals committed to pushing the boundaries of excellence in their practice. 00:00 Introduction and Guest Welcome 01:06 Defining Excellence in Medicine 02:29 Measuring and Achieving Team Performance 06:13 Small Changes for Big Impact 10:03 Maintaining Positivity and Energy 15:30 Mission Critical Team Institute 16:33 Conclusion and Farewell The Guest - Dan Dworkis Dan Dworkis, MD, PhD, FACEP is the Chief Medical Officer at the Mission Critical Team Institute, the founder of The Emergency Mind Project, a board-certified emergency medicine physician, and an assistant professor at the Keck School of Medicine at USC. His work focuses on the optimal development of mission critical teams in and out of emergency departments. He completed the Harvard Affiliated Emergency Medicine Residency at Massachusetts General Hospital / Brigham Health, and also earned an MD and PhD in molecular medicine from Boston University School of Medicine. Dr. Dworkis is the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure.
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| Ep 263 - Hyperbaric Medicine with Jeff Kerrie at LTC | 05 mars 2025 | 00:13:19 | |
In this episode of the St. Emlyn's podcast, hosts Iain Beardsell and Natalie May discuss hyperbaric medicine at the London Trauma Conference with Dr. Jeff Kerrie, an internal medicine physician from Canada. Dr. Kerrie provides insights into dive and hyperbaric medicine, covering the basics of hyperbaric therapy, its applications, and key practices for emergency departments when treating patients with decompression illness. The conversation also touches on misconceptions and unregulated uses of hyperbaric chambers, emphasizing the importance of consulting certified medical professionals. 00:00 Introduction to the Podcast and Guests 00:58 Understanding Hyperbaric Medicine 0 1:33 Dive Medicine and Decompression Illness 04:15 Emergency Response and Treatment Protocols 07:26 Hyperbaric Chamber Mechanics 10:05 Beyond Dive Medicine: Other Uses of Hyperbaric Therapy 11:43 Challenges and Misuses of Hyperbaric Therapy 12:38 Conclusion and Final Thoughts The Guest For the last three years, Jeff Kerrie has served as the Island Health Medical Director of Quality, Safety, and Ethics. Dr. Kerrie has a master’s degree in clinical bioethics from Clarkson University/Icahn School of Medicine at Mt. Sinai in New York. Over the last six years, Dr. Kerrie helped build the Island Health ethics program, where he has provided ethics consultations and teaching to staff, patients, and families. Dr. Kerrie underwent medical training at the University of Manitoba before completing residency in Internal Medicine at UBC. He practices as a general internist in Victoria, and is an Assistant Clinical Professor with the University of British Columbia and the University of Victoria. Other medical work has included medicine in atypical environments (including dive/hyperbaric medicine, ski patrol, and high altitude environments), obesity medicine, and international health. Dr. Kerrie is also a graduate of the Physician Quality Improvement program at Island Health. In his spare time Dr. Kerrie enjoys aviation, skiing, and SCUBA diving. | |||
| Ep 262 - GoodSam Update with Mark Wilson at LTC 2024 | 26 févr. 2025 | 00:17:04 | |
In this episode, Iain Beardsell and Natalie May speak with neurosurgeon Mark Wilson at the London Trauma Conference. Mark provides an in-depth look at the evolution of the GoodSAM app over the past decade. Initially designed to alert off-duty trained individuals to assist in emergencies, particularly for cardiac arrests and impact brain apnoea, the app has grown to include applications in police services, public health during COVID-19, and community volunteer efforts. It employs advanced technology, such as real-time video guidance and AI, to offer immediate assistance and improve outcomes in medical emergencies and other crises. Mark's insights shed light on how this innovative platform is saving lives and transforming emergency and public response systems worldwide. 00:00 Introduction and Reunion 00:47 The GoodSAM App: A Decade of Evolution 01:52 GoodSAM's Impact on Cardiac Arrests 02:09 Expanding GoodSAM: Police and Community Involvement 02:35 How GoodSAM Works 05:54 GoodSAM's Role During COVID-19 13:42 The Future of GoodSAM: AI and Community Support 15:04 How to Get Involved with GoodSAM 16:26 Conclusion and Final Thoughts The Guest 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 am 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. His specialist areas are acute brain injury (mostly traumatic brain injury) and its very early management. He is co-director of the Imperial Neurotrauma Centre and am co-founder of GoodSAM, a revolutionary platform that alerts doctors, nurses, paramedic and those trained in basic life support to emergencies around them. Mark have 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). He also wrote The Medics Guide to Work and Electives Around the World. His research is mainly into the brain in trauma and in hypoxia (using it as an injury model) in humans. | |||
| Ep 261 - Moral Injury with Caroline Leech at Tactical Trauma 24 | 19 févr. 2025 | 00:15:41 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe welcome back Caroline Leech, a emergency medicine consultant with extensive pre-hospital care experience. Caroline discusses the concept of moral injury, delving into its distinction from moral distress. She introduces three mechanisms of moral injury: acts of commission, acts of omission, and betrayal. Caroline provides insightful examples from emergency medicine to illustrate these concepts, emphasizing the importance of identifying and addressing moral injury to support healthcare professionals. The discussion highlights the emotional and cognitive distress faced by emergency responders and the necessity for professional psychological support when moral distress accumulates into moral injury. 00:00 Introduction and Welcome 00:23 Introducing Caroline Leech 01:10 Defining Moral Injury and Distress 03:42 Acts of Commission 07:12 Acts of Omission 12:30 Betrayal in Healthcare 15:00 Conclusion and Final Thoughts The Guest - Caroline Leech Caroline Leech is Deputy Clinical Lead of The Air Ambulance Service and has 25 years of prehospital clinical experience. She is a Consultant in Emergency Medicine at University Hospital Coventry, the West Midlands Trauma Network Director, and the Trauma Lead for the Institute for Applied & Translational Technologies in Surgery (IATTS). Caroline is currently undertaking a NIHR funded Clinical Research Scholarship with Warwick University. Her research interests include maternal out-of-hospital cardiac arrest, calcium in traumatic haemorrhage, and frailty in major trauma. She is committed to improving equality and diversity in PHEM, and promoting strategies for supporting the wellbeing and psychosocial care of prehospital responders. | |||
| Ep 260 - Monthly Round Up December 2024 - Chest trauma, IO access, AI and more | 12 févr. 2025 | 00:20:36 | |
In this season-ending episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley come together in Zermatt, Switzerland, to discuss recent studies and updates. They highlight a randomized control trial on early exercise in blunt chest wall trauma, revealing its limited impact on recovery outcomes. Additionally, they explore the long-term safety of intraosseous access based on new evidence from Denmark. The episode also provides insights into updated imaging guidelines for paediatric trauma and broad considerations on the growing role of AI in healthcare, especially in emergency settings. There are closing remarks on recent blog posts about toxic alcohol poisoning and the Difficult Airway Society meeting, while looking forward to upcoming conferences in Spain and Vienna. 00:00 Welcome to St Emlyn's Podcast 00:31 Exploring the Big Sick Conference in Zermatt 01:25 Evidence-Based Medicine: Early Exercise in Blunt Chest Wall Trauma 04:30 Intraosseous Access: Long-Term Complications 06:37 Imaging Decisions in Pediatric Trauma 09:17 The Promise and Perils of Artificial Intelligence in Healthcare 13:10 Toxic Alcohol Poisoning: A Critical Review 16:17 Conference Highlights and Future Events 19:19 Season 11 Finale and Looking Ahead to Season 12 | |||
| Ep 259 - Skills Fade with Nathalie Pattyn at Tactical Trauma 24 | 05 févr. 2025 | 00:16:22 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe talk with Nathalie Pattyn at TacTrauma24 in Sweden about the phenomenon of skills fade amongst emergency physicians. Nathalie discusses her extensive background in medicine, psychology, and neuroscience, and shares insights from her research on how skills can deteriorate during low workload deployments, such as her 15-month clinical stint in Antarctica. They delve into the lack of systemic measures to address returning to practice after long absences, how cognitive and psychomotor skills are affected by skill fade, and the contrast between teaching technical skills and ensuring they become automatic and stress-resilient. The conversation highlights the need for evidence-based guidelines to ensure healthcare professionals maintain their proficiency, which ultimately benefits patient care and the healthcare system. 00:00 Introduction and Guest Introduction 00:13 Natalie's Background and Expertise 00:38 Skills Fade in Emergency Medicine 01:01 Personal Experience with Skills Fade 02:14 Regulations and Policies on Skills Maintenance 04:19 Imposter Syndrome vs. De-skilling 06:42 Aviation vs. Medical Field: Skills Certification 08:27 Aging and Cognitive Decline in Medical Skills 09:57 Teaching vs. Training in Medical Education 12:42 Future Directions and Systemic Solutions 14:31 Conclusion and Contact Information The Guest Nathalie Pattyn, MD, MPsy, PhD, received a degree in medicine from the Université Libre de Bruxelles (magna cum laude, 2001), a Master in Clinical Psychology from the Vrije Universiteit Brussel (cum laude, 2004), a PhD in Psychological Sciences from the Vrije Universiteit Brussel (2007) and a PhD in Social and Military Sciences from the Royal Military Academy (2007). She also holds a postgraduate degree in Aerospace Medicine; a postgraduate degree in Emergency Medicine; a postgraduate degree in General Practice ; a postgraduate degree in Disaster Medicine ;and a Master in Global and Remote Healthcare. She completed her Junior Officer Course with the Belgian Defense College in 2005, and her Staff Officer Course in 2008. She has a mixed clinical, research and operational background, having been deployed as a medical officer in various Middle Eastern and African countries, and having completed missions in Antarctica for a total duration of more than two years. Her longest deployment was 15 months to the Halley VI Research Station in Antarctica, where she worked as the station physician while setting up a new biomedical research laboratory for the European Space Agency. She is currently still working as an emergency physician and a flight surgeon. Her research interests include the psychophysiological measures of performance in elite populations; and Human Factors approach to isolated and confined environments, ranging from space to submarines. In 2010, she founded a research unit within the Royal Military Academy, dedicated to the multidisciplinary study of human performance in operational environments. This led her to be the project manager for designing a tailored Human Performance Program for the tier one unit of the SOF community in Belgium. She is currently an Associate Professor in Physiopathology at the Vrije Universiteit Brussel and in Human Performance at the Royal Military Academy. You can read Nathalie's excellent book "Handbook of Mental Performace" for free here. | |||
| Ep 258 - Compassionate Resuscitation with Matt Hooper at LTC | 29 janv. 2025 | 00:24:57 | |
Welcome to our first episode recorded at the London Trauma Conference 2024. In this episode, hosts Iain Beardsell and Natalie May are joined by Matt Hooper from Adelaide to discuss his unique career path, from emergency medicine to pre-hospital and retrieval medicine, intensive care, and more recently, palliative and end-of-life care. The conversation centres around the principles of end-of-life care, particularly in acute and traumatic scenarios, and how these can be integrated with life-saving efforts. Key points include the challenges of shifting focus from survival to quality of death, the importance of recognizing and supporting witnesses and caregivers, and the concept of 'compassionate resuscitation.' Practical tools such as the 'pause' are also explored, aiming to humanize highly charged medical environments and potentially prevent burnout and PTSD among healthcare providers. 00:00 Introduction and Guest Welcome 01:00 Key Messages on Death and Palliative Care 02:12 Challenges in End-of-Life Care 03:20 Improving Quality of Death and Relationships 04:32 Emotional Impact on Care Providers 06:41 Navigating End-of-Life Conversations 12:17 Practical Applications in Intensive Care 16:41 The Pause: A Tool for Reflection 21:58 Conclusion and Final Thoughts The Guest - Matt Hooper Matt is an accomplished intensive care specialist with a diverse background in emergency medicine, prehospital & retrieval medicine, and palliative care. Notable for his leadership in developing critical care service models, he founded South Australia’s MedSTAR Emergency Medical Retrieval Service. He has also co-authored a highly regarded case-based text book and held key teaching and examining roles nationally and internationally in prehospital and retrieval medicine. With a strong focus on high-performance teams working within high acuity, high consequence environments, Matt's expertise has also extended to human factors in healthcare, cardiothoracic intensive care, ECMO, and clinical ultrasound. More recently however, he has pivoted towards palliative and end of life care, pursuing a Master's degree at Cardiff University and consulting at Mary Potter Hospice in Adelaide. He is passionate about exploring new and innovative ways to prevent potentially avoidable suffering and enhance end of life outcomes for patients in acute care clinical environments. | |||
| Ep 257 - Ten Second Triage with Sean Brayford Harris at Tactical Trauma 24 | 22 janv. 2025 | 00:19:47 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe speak with Sean Brayford Harris, a paramedic and interoperability development officer with the London Ambulance Service, about the development of the 10 second triage tool—a new, streamlined method for triaging casualties in high-stress environments like major incidents. They discuss its creation and implementation, including collaboration with the Metropolitan Police and other emergency services. Key points include the shortcomings of the previous 'sieve and sort' system, the challenges of developing a simplified tool, and the benefits of this new approach for non-medical first responders. The episode emphasizes the importance of cross-team collaboration in emergency scenarios and the potential impact of the tool on reducing distress and improving outcomes for both responders and patients. 00:00 Introduction 00:37 Background on Major Incident Triage 01:01 Challenges with Existing Triage Systems 01:15 Designing the 10 Second Triage Tool 05:16 Implementing the Triage Tool 06:50 How the 10 Second Triage Tool Works 13:48 Real-World Applications and Benefits 18:54 Conclusion and Final Thoughts | |||
| Ep 256 - Monthly Update November 2024 - Learning Culture, Chest Drains, Arterial Lines and more | 15 janv. 2025 | 00:31:54 | |
During Winter's Challenges, Iain Beardsell and Simon Carley reviewed the November 2024 blog posts for St Emlyn's podcast, marking the start of 2025. They discuss the busy state of emergency departments, critical incidents, and the importance of maintaining a learning culture. They highlight the upcoming Big Sick Conference in Zermatt and the IncrEMentuM in Spain, noting their potential benefits for networking and education. Simon emphasizes creating a psychologically safe environment and fostering curiosity, growth, and knowledge-sharing among emergency department staff. They also review a range of medical studies, including those on small bore vs. large bore chest tubes for haemothorax, intra-arrest arterial blood pressure monitoring, and the new GLP-1 receptor antagonists for obesity treatment. Lastly, they address the importance of handling bad behavior in the team and maintaining kindness and professionalism, even during high-stress periods. 00:00 Introduction and New Year Greetings 00:35 Current State of Emergency Departments 01:17 Upcoming Conferences: The Big Sick and IncrEMentuM 03:43 Building a Learning Culture in Emergency Medicine 12:24 Pre-Hospital ECPR and ECMO 13:58 Small Bore vs Large Bore Chest Tubes 17:37 Intra-Arrest Arterial Blood Pressure Monitoring 24:01 New Drugs and Toxicology 24:47 Care in the Hot Zone 27:12 Addressing Bad Behaviour in Emergency Departments 30:42 Conclusion and Future Plans for St Emlyn's | |||
| Ep 255 - Likelihood Ratios: Critical Appraisal Nugget 12 | 08 janv. 2025 | 00:11:30 | |
In this episode of the St. Emlyn's podcast, Rick Body and Greg Yates delve into the concept of likelihood ratios, an advanced yet practical tool for diagnosing patients in the emergency department. Building on the previous episode about predictive values, they explain how likelihood ratios help compare the probability of test results between diseased and non-diseased patients. They provide examples, like evaluating chest pain and using the Smith Calculator for Anterior ST Elevation, to show how likelihood ratios can change clinical decision-making. Rick and Greg also discuss Bayesian reasoning and how pretest and post-test probabilities are used in practice. 00:00 Introduction to the Podcast 00:34 Understanding Likelihood Ratios 02:05 Practical Example: Chest Pain Case 03:53 Calculating Likelihood Ratios 07:17 Applying Bayesian Reasoning 09:50 Recap and Conclusion | |||
| Ep 254 - Monthly Round Up October 2024 - Toxicology, Cardiac Arrest and more | 18 déc. 2024 | 00:27:03 | |
In this episode of the St Emlyn's podcast, Iain Beardsell and Simon Carley provide a comprehensive update for October 2024. They discuss key blog posts covering diverse medical topics, including highlights from the Royal College of Emergency Medicine's academic science conference focusing on toxicology, high-potency opioids, novel benzodiazepines, and the use of flumazenil. They also explore the Green ED project and the impact of climate change on healthcare. Additionally, they delve into recent research on ventricular fibrillation pad positions, the use of tranexamic acid (TXA) in trauma care, and the importance of maintaining a positive outlook amidst winter challenges by seeking small wins and engaging in enjoyable aspects of emergency medicine. The episode offers valuable insights and updates for emergency medicine professionals. 00:00 Welcome and Introduction 01:27 Highlights from the Royal College of Emergency Medicine Conference 01:50 Toxicology Insights: High Potency Opioids and Benzodiazepines 05:11 Climate Change and Healthcare: The Green ED Project 08:23 Medical Conferences: A Phoenix from the Ashes 10:38 Ventricular Fibrillation and Pad Position: New Insights 17:22 Tranexamic Acid (TXA) in Trauma Care 24:01 Maintaining Positivity in Challenging Times | |||
| Ep 253 - Highlights from the London Trauma Conference 2024 | 11 déc. 2024 | 00:19:46 | |
In this episode of the St Emlyn's podcast, Iain Beardsell and Natalie May reflect on their experiences at the London Trauma Conference, a four-day event covering various aspects of trauma and pre-hospital care. They discuss key takeaways from sessions on cardiac arrest, including talks on perioperative cardiac arrest and the prognostication of cardiac arrest patients. The episode also delves into wellness in the medical field, featuring insights from senior emergency physician Rod McKenzie and pre-hospital expert Matt Hooper on practical psychosocial care. Additionally, the podcast highlights advancements in trauma care, defibrillation strategies, and the importance of correct pad placement and basic practices. The episode underscores the holistic approach to patient care and the significance of personal well-being for medical professionals. 00:00 Welcome to the St Emlyn's Podcast 00:52 Highlights from the London Trauma Conference 01:13 Cardiac Arrest Symposium Insights 03:53 Prognostication After Cardiac Arrest 06:44 Defibrillation Strategies and Basics 08:29 Wellness and Mental Health in Emergency Medicine 11:10 Palliative Care in Pre-Hospital Settings 12:32 Trauma Conference Highlights and Innovations 16:48 Poster Presentations and Stand-Up Science 17:58 Key Takeaways and Reflections 18:43 Closing Remarks | |||
| Ep 252 - ECMO in Trauma with Chris Bishop at Tactical Trauma 24 | 04 déc. 2024 | 00:13:51 | |
In this episode of the St Emlyn's podcast, hosts Iain Beardsell and Liz Crowe are joined by Chris Bishop, a clinical research fellow at the Centre for Trauma Sciences at Queen Mary University of London. Chris discusses his PhD research on veno-arterial ECMO support for cardiogenic shock following major trauma haemorrhage and explains the principles and applications of ECMO, particularly in trauma patients. The conversation covers the current practices, challenges, and future directions in the use of ECMO for trauma care, including multidisciplinary decision-making, patient selection criteria, and pioneering techniques like selective aortic arch perfusion and emergency preservation and resuscitation. 00:00 Introduction 01:12 Understanding ECMO and Its Applications 02:20 ECMO in Trauma Patients 04:17 Challenges and Resistance in ECMO Adoption 05:36 Current Research and Practices 11:31 Future Directions in Trauma Resuscitation 13:28 Conclusion | |||
| Ep 251 - Bad Behaviours in Teams with Liz Crowe at Tactical Trauma 24 | 27 nov. 2024 | 00:18:14 | |
This episode, recorded live at Tactical Trauma 24 explores the concept of bad behaviour within high-performing medical teams. Liz Crowe, who will be well known to regular listeners, discusses what constitutes bad behaviour, its impacts on team dynamics and patient safety, and the importance of self-awareness among medical professionals. Key findings from recent research highlight that even subtle actions like eye-rolling can negatively affect patient safety as much as overt harassment. The speaker emphasises the importance of psychological safety, trust, competence, authenticity, consistency, and empathy in maintaining a healthy team environment. Practical advice includes assessing one's own behaviour and seeking honest feedback from colleagues and loved ones. Comprehensive show notes are available here 00:00 Introduction: Addressing Bad Behaviour 01:18 Defining Bad Behaviour 01:49 Impacts of Bad Behaviour 03:15 Psychological Safety and Team Dynamics 04:24 Personal Experiences and Observations 05:46 Types of Bad Behaviour 07:19 Research Findings on Workplace Behaviour 09:10 Self-Awareness and Behavioural Impact 14:21 The Karpman Drama Triangle 17:29 Conclusion and Final Thoughts | |||