Pre-Hospital Care Podcast

Today on the Pre-Hospital Care Podcast, we’re tackling a topic that challenges one of the most deeply embedded concepts across Pre-hospital care. For decades, we’ve taught clinicians to think in binary terms: STEMI or not STEMI. Spot the ST elevation, activate the pathway, and move the patient toward reperfusion. It’s a model that has transformed care and saved countless lives. But what if that fr...

Some of the most important diagnoses in pre-hospital care are the ones we least expect, conditions that challenge our assumptions, present outside familiar clinical patterns, and can be missed when we rely too heavily on traditional assessment tools. In this episode, we revisit two important conversations from the Pre-Hospital Care Podcast that highlight the consequences of diagnostic overshadowin...

Today, we’re exploring a critical challenge in stroke care: identifying patients with large vessel occlusion (LVO) and getting them to the right hospital as quickly as possible. Mechanical thrombectomy can transform outcomes, but access depends on rapid identification and appropriate prehospital triage. Current clinical assessment and stroke severity scales have limitations, making it difficult to...

A good clinical handover sounds simple. But when the environment is noisy, time is limited, cognitive load is high, and the stakes are significant, communicating the right information and ensuring it is understood becomes much harder. In this compilation episode, we explore the relationship between trauma handover, human factors, simulation and performance under pressure, bringing together two con...

A fall from standing height can have devastating consequences in an older adult. In this episode, Professor Ian Roberts joins the Pre-Hospital Care Podcast to discuss CRASH-4 , a major randomised trial investigating whether giving intramuscular tranexamic acid (TXA) within three hours of injury can reduce intracranial bleeding, disability and death following symptomatic mild traumatic brain injury...

In this special Pre-Hospital Care Podcast tactical medicine compilation, we explore the clinical, operational and human challenges of providing care in high-risk and austere environments. Steve Woods examines the management of ballistic trauma, including whole blood administration, pleural drainage and recognising injury patterns, before discussing an equally important topic: clinician self-care a...

Few presentations generate more uncertainty, anxiety, and clinical challenge than the febrile child. Every day, paramedics, emergency clinicians and critical care teams are faced with one of the most difficult questions in medicine: is this simply a self-limiting viral illness, or the early stages of a life-threatening condition? The challenge lies not in recognising the obviously sick child, but...

In this episode, Deb Swann and Roger Alcock take us behind the scenes of humanitarian medicine, sharing their experiences of working in two very different global health emergencies: the 2023 Türkiye–Syria earthquake response and the 2014–2016 West African Ebola outbreak . On 6 February 2023 , a series of devastating earthquakes struck southern Türkiye and northern Syria. More than 59,000 people we...

In pre-hospital care, we spend a great deal of time preparing for the moments that matter most: cardiac arrest, major trauma, difficult airways, and emotionally challenging conversations. We train, rehearse, and work hard to achieve technical excellence. But what happens after the event may be just as important as what happens during it. Debriefing is a familiar concept in healthcare. We often thi...

Every critically ill newborn represents one of the most demanding moments in healthcare. Within seconds of birth, teams may need to assess, communicate, prioritise, and intervene in an environment where the margin for error is extraordinarily small. Technical expertise is fundamental, but safe and effective resuscitation depends on much more than clinical knowledge alone. Communication, leadership...

Major haemorrhage remains one of the most time-critical emergencies in pre-hospital care. When a patient is bleeding to death, stopping the haemorrhage is the immediate priority, but what happens next is equally important. What are we actually replacing? In this special compilation of The Pre-Hospital Care Podcast , we explore the evolving science and practice of blood-based resuscitation in major...

Every resuscitation is different. Different patients, different teams, different environments, and often very different outcomes. But one thing remains constant: every clinical encounter has the potential to teach us something. The challenge, particularly in pre-hospital and acute care, is creating the time, space, and culture needed to turn those experiences into meaningful learning and sustained...

Artificial intelligence is advancing rapidly in healthcare, but what could it mean for pre-hospital care? In this compilation episode, we bring together two conversations exploring how AI could support clinicians, improve decision-making, and transform the way emergency care is delivered. We begin with Zane Perkins, exploring AI-TRiPS, an AI Risk Prediction and Decision Support System for trauma c...

The most dangerous part of an intubation is often not the moment the laryngoscope goes in; it’s the ten minutes before it ever leaves the tray. In this episode of the Pre-Hospital Care Podcast, we focus on The Last 10 Minutes Before Intubation: the critical phase where outcomes are often decided long before airway instrumentation begins. Joining us is Cosmo Scurr, Consultant Anaesthetist, bringing...

High-fidelity simulation has become far more than an opportunity to practise clinical procedures in a controlled environment. For pre-hospital clinicians working in complex, unpredictable and high-stakes environments, simulation can provide something that conventional classroom teaching cannot: the opportunity to rehearse performance when the environment itself becomes part of the problem. In this...

Resuscitation is often seen as individual performance, but cardiac arrest care is ultimately a system outcome, shaped by training, communication, leadership, feedback, and the systems supporting the team. In this three-part debriefing series, I’m joined by David Hiltz as co-host, and in this first episode, Ann Doll from the Resuscitation Academy, to explore how high-performing systems turn resusci...

Decision-making is one of the defining skills of pre-hospital practice. Every shift requires clinicians to interpret incomplete information, navigate uncertainty, balance competing risks, and make consequential decisions, often under intense time pressure. But does faster decision-making necessarily lead to better decisions? In this compilation episode of the Pre-Hospital Care Podcast, we explore...

In this episode, I’m joined by Neil Jeffers to explore Crew Resource Management (CRM) and why it remains one of the most important safety tools in aviation, healthcare, and pre-hospital care. We begin by tracing the origins of CRM, examining how a series of aviation accidents shifted the focus from technical proficiency alone to the human factors that influence decision-making, communication, lead...

Today, we’re joined by Diane Dollar, a pilot whose career sits at the intersection of frontline HEMS operations, training, and the future of the aviation workforce. Diane is a professional helicopter pilot and check airman for a major air medical operator, with a background that spans tours, VIP charter, organ transport, and helicopter air ambulance missions. Alongside this, she continues to fly e...

Fatigue is one of the most significant yet under-recognised threats to safety in pre-hospital care. Every day, ambulance clinicians make complex clinical decisions, drive emergency vehicles, and care for critically ill patients while working long shifts, overnight hours, and often with inadequate recovery. Despite decades of evidence demonstrating the impact of fatigue on cognitive performance, de...

Cardiac arrest remains one of the most scrutinised and resource-intensive presentations in prehospital care. We invest heavily in improving what happens in the moment, compression quality, airway strategies, defibrillation timing, and team coordination. Yet one of the most powerful determinants of system performance often sits outside the resuscitation itself: what we do with the data afterwards....

In this episode of the Pre-Hospital Care Podcast, we're joined by Dr Jo Mildenhall to explore a critical and often under-discussed issue in pre-hospital medicine: burnout. Frontline ambulance staff experience some of the highest rates of sickness absence in the NHS, with stress, anxiety, and depression frequently cited as the cause. While much attention has traditionally focused on the impact of m...

On the Pre-Hospital Care Podcast, we spend a lot of time discussing clinical decision-making, operational challenges, and the science that underpins emergency medicine. But now and again, it's important to step back and remember why we do what we do. Behind every dispatch is a person. Behind every set of observations is a family. And behind every successful mission is a story that often contin...

The illicit drug market is evolving faster than ever before. Novel psychoactive substances (NPS), synthetic opioids and increasingly potent club drugs are creating new challenges for pre-hospital clinicians, emergency departments and critical care teams. Patients are presenting with unfamiliar toxidromes, unpredictable physiology, and rapidly deteriorating clinical conditions that demand evidence-...

Pain is one of the most immediate and universal experiences of trauma, yet in emergency and pre-hospital care, it remains surprisingly under-treated. Despite decades of awareness, oligoanalgesia, the inadequate treatment of acute pain, continues to affect patients in the very moments when compassionate, effective care matters most. Too often, the focus in emergency systems has been on processes: w...