Clinical Conversations

Your monthly clinical update covering: · Clinical Practice Update: Forthcoming CPG changes including AF referral pathways, low‑risk chest pain risk scoring, and paediatric gastro guideline  Ebola bulletin and CHO advisory Cardiac Arrest Team Performance Report: insights and practical takeaways for improving CPR quality PANDA trial update · Patient safety update: Non-transport decisions, assessment...

Your monthly clinical update covering: ·  CPG updates: New measles CPG + updated CPP for ACOs & CERTs  ·  Hand hygiene refresher: Back to basics in challenging environments  ·  Cardiac arrest outcomes: Conversation with Ziad Nehme on recent improvements  ·  Survey plug: Clinical & Operational Service Delivery Plan  ·  Patient safety: Case review – consulting via the Clinician when engaging...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). This month's episode covers: Planned updates to CPGs in 2026 Posterior Stroke Patient Care Records Evaluation data of droperidol and dexamethasone as antiemetics Paper of the Month: IV vs IO in cardiac arrest Equipment update Professional development oppor...

In this episode of Clinical Conversations , we're joined by Associate Professor Carmel Crock (Director of the Emergency Department at the Royal Victorian Eye and Ear Hospital and Chair of the Quality & Patient Safety Committee at the Australasian College of Emergency Medicine) to unpack what diagnosis is, how diagnostic error happens, and how we can make diagnosis safer. We explore common...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Cardiac Arrest Update with AV Resuscitation Coordinator Steve Musgrave Patient Safety Update: Stroke Assessment and Elderly Falls Alpine and Wilderness Response Alagaesia Toxicology Evaluation Alcohol Withdrawal Guideline Equipment Update: Syringe Drivers Paper...

In this episode of Clinical Conversations , James Oswald and Ambulance Victoria Medical Director Dr David Anderson unpack non-invasive ventilation (NIV) for prehospital care. They explain the key physiology ( oxygenation vs ventilation ), the practical difference between CPAP and BiPAP , and how this guides use in COPD, acute pulmonary oedema, COVID, asthma , and undifferentiated dyspnoea . The di...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Hear from Louise Reynolds (Victoria’s Chief Paramedic Officer) on the women’s pain inquiry findings—and what it means for paramedic practice. Spotlight the VVED back pain pathway: for many patients, opioids + ED isn’t the answer—community physio support can be...

In our first ever live episode of Clinical Conversations , James Oswald (CPG specialist and paramedic) is joined by Ambulance Victoria Medical Director Dr David Anderson for an end-of-year Q&A on the latest CPG updates. We work through staff questions on the “why” behind key changes—including respiratory care and oxygen targets, NIV expansion and mask issues, airway and RSI updates (including...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 02:10 – CPG Update Released • Highlights major 2025 CPG changes, app issues, and expected three-month transition period (IFS ceases immediately).  • Emphasis on professional judgment, understanding over memorisation, and upcoming live Q&A.  • Request for st...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 01:40 – 2025 Clinical Update Coming Soon 02:20 – IFS Retirement & Paediatric RSI Feedback 07:05 – STEMI Performance Update 08:50 – Free Birth: Paramedic Implications 11:50 – PANDA Trial Update 13:50 – Patient Safety: Cognitive bias & discounting concern...

James Oswald is joined by an expert panel to discuss the background, evidence and rationale behind the retirement of intubation facilitated by sedation: Richard Armour – MICA paramedic, PhD candidate, CPG specialist. Dr Claire Wilkin – PEM, AV Medical Advisor - Paediatrics A/Prof David Anderson – AV Medical Director   Get in touch ⁠clinicalguidelines@ambulance.vic.gov.au⁠ David: ⁠@expensivecare⁠ |...

Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): Clinical Update Warm IV fluid (13:38): Stop warming IV fluids in overhead compartments or with hot water bottles. Risks scalding/superheating. Store in equipment towers only. Paediatric distraction (03:26): kits available now. Evidence-based, non-digital active...

This month James and David look at cardiogenic shock: recognition and classification, oxygen targets, fluid resuscitation, vasopressors, inotropes, and the possibility of shock centres in the future. They're joined by Professor Dion Stub, an interventional cardiologist, prolific researcher, professor at Monash University, member of the Australian Resuscitation Council, and medical advisor to...

Your monthly clinical update covering: Mandatory VVED Consults for Infants <28 Days – trends, rationale for policy, clarifications, and case example demonstrating impact. Stroke updates - performing ACT-FAST on all MASS positive patients, changes to VACIS and a plug for IV access. Complex Paediatric Respiratory Patients – Managing patients on home non-invasive ventilation, maintaining continuit...

In this special Q&A episode of Clinical Conversations , James Oswald and Dr. David Anderson respond to the most common — and most complex — questions we've received on sedation, CPG implementation, and the evolving role of paramedics. We also reflect on why clinical guidelines are becoming more detailed, how to balance complexity with emergency care, and what the future holds for paramedi...

Your monthly update on clinical issues including: Clinical Practice Care and Control Powers (02:38 – 07:10) Overview of section 232 and 241 powers. Documentation: VACIS + RiskMan entries are essential. More info: See Mental Health Crisis Reform on OneAV.   Verification of Death (07:10 – 08:48) Verifying death is voluntary for paramedics. Review WinOps 025 for current processes. AV is working with...

In this episode of Clinical Conversations , we explore the complexities of managing acute behavioural disturbance (ABD) in children and adolescents—a small but increasingly common and high-risk cohort. Host James Oswald and AV Medical Director Dr. David Anderson are joined by paediatric emergency physician Dr. Claire Wilkin, who brings deep expertise in paediatric critical care. Together, they dis...

Your monthly clinical update covering: Clinical Practice 03:10 – Respiratory CPG Update: Pulmonary edema, COVID, ILI, paediatric asthma changes coming soon. 04:00 – First Responder Analgesia: Supply challenges beingaddressed; updates coming.  05:10 – Button Batteries: New blue dye marker—importantvisual sign but not universally present. 06:00 – Mushroom Season Warning: Watch for toxidromes; VPIC s...

James Oswald and Dr David Anderson explore how consultation has evolved from a perceived weakness to a hallmark of clinical maturity. They discuss the growing role of virtual emergency care, particularly the Victorian Virtual Emergency Department (VVED), in supporting paramedics with decision-making—especially when assessing young infants. Joined by pediatric emergency specialist Dr Harith Al-Rawi...

Your monthly clinical update covering: VVED Consultations for small infants New requirement: VVEDconsultation for non-transport of infants ≤28 days Strong recommendation for 29days–3 months Driven by patient safety reviewand expert consensus Not about removing autonomy —it’s about adding clinical support RSI Checklist Update Addition of a pop-off valve checkfollowing a critical safety event Preven...

In Part 2 of their sedation safety conversation, hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) cover preparation for sedation and how to recognize and respond to deterioration. They break the problem into three evidence‑backed pillars: Prevent deterioration (have a listen to Part 1) Prepare for side‑effects – if yo...

Your monthly clinical update covering: Cardiac arrest outcomes An update on the sedation safety guideline Lessons learned from the patient safety team: appropriate use of the CT-6 traction splint and having a high index of suspicion for spinal and head injuries in older adults followingstanding height falls BVM blow off valve reminder Paper of the month: Prehospital antibiotics in sepsis Miller bl...

In this episode of Clinical Conversations , hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) dive into one of the most ethically and clinically complex areas of pre-hospital care—the questions of safety for during sedation for acute behavioural disturbance (ABD). They explore the ethical and legal considerations surro...

James and Ben cover the latest clinical news from across Ambulance Victoria, including: Intranasal Fentanyl Update – Using IV preparation for intranasal use. Other guidelines updates: Extrication monitoring, shoulder reduction, wilderness pain relief. Blood Administration – New pre-hospital blood transfusion training coming. Rocuronium Storage – Heat-related potency issues; rotate every 30 days. C...

In this episode of Clinical Conversations , James Oswald (Paramedic and Clinical Practice Guidelines Specialist) and Dr. David Anderson (Ambulance Victoria Medical Director) tackle one of the most challenging aspects of paramedicine—delivering bad news. Joined by guest Liz Perry (MICA Paramedic), they explore the difficulties paramedics face when communicating death and critical updates to familie...