Pre-Hospital Care Podcast

In this episode, we explore how REBOA can become an integrated tool for deliberate physiologic support in profound shock. REBOA is a word that immediately commands attention in pre-hospital care. For many teams, it represents the edge of capability, a high-stakes intervention reserved for catastrophic haemorrhage and profound shock.  Many clinicians still think of it primarily as a haemorrhage-con...

Today’s episode, Trauma Fundamentals: Chest, Pelvis & Spine , brings together a curated compilation of three core areas of major trauma that every pre-hospital clinician must be confident in managing. In this episode, we revisit thoracic trauma with Dr Geoff Healy, exploring the life-threatening pathologies that demand early recognition and decisive intervention. We then move into pelvic traum...

In this episode, we examine the evolving model of Community Emergency Medicine (CEM) ,  a quietly transformative approach that is reshaping how urgent and emergency care is delivered. With increasing pressure on emergency departments and prolonged ambulance handover delays, CEM offers a different paradigm: delivering high-quality emergency care directly to patients in their homes, communities, and...

This three-part series from the Pre-Hospital Care Podcast explores the evolving and critical role of ambulance clinicians in palliative and end-of-life care, from first principles through to the final hours of life. In Part 1, we introduce key concepts of palliative and end-of-life care alongside a dedicated specialist team. We examine the differences between generalist and specialist palliative c...

For many clinicians, the traditional pathways of healthcare offer purpose and stability, but they can also feel restrictive, misaligned with evolving identities, or incompatible with a life that values adventure, education, and time outside conventional systems. Changing direction within or adjacent to healthcare is rarely a single leap; more often, it is a series of deliberate steps shaped by cur...

In this blog audio, we interview Kelly Wright. In the piece, we examine the multifaceted and increasingly precarious role of National Park rangers, portraying them as both frontline first responders and long-term stewards of fragile ecosystems. The narrative positions rangers at the intersection of public safety and environmental protection, highlighting how their responsibilities extend far beyon...

In this episode of the Pre-Hospital Care Podcast , we explore the evolving management of Neck of Femur (NOF) fractures, one of the most common and operationally challenging presentations in pre-hospital care. With an ageing population driving a rising incidence, these injuries represent a significant clinical and systems burden, requiring both rapid assessment and increasingly sophisticated early...

In this piece, Kelly Wright explores how choosing a nursing specialty is less about prestige or opportunity and more about aligning personal characteristics with the realities of the clinical environment. She argues that long-term satisfaction and sustainability in nursing depend on an honest assessment of one’s personality, lifestyle priorities, and stress tolerance, rather than external expectat...

Today on the Pre-Hospital Care Podcast, we are joined by Paige Mason, MA, a researcher, paramedic, and educator whose work reframes how we think about wellbeing on the front line. In this episode, we unpack her work and what it means for individual paramedics, teams, and services striving to build resilient, healthy, and sustainable careers in pre-hospital care. Paige is a Primary Care Paramedic w...

In The Physical Toll of High Adventure Healthcare, Kelly Wright examines the often-unacknowledged physical and psychological cost of working at the sharp edge of medicine. Drawing on experience from flight nursing and hospital-based practice, she describes how cumulative occupational stressors steadily erode clinician health, threatening both well-being and career longevity. Kelly outlines how hea...

Out-of-hospital cardiac arrest remains one of the most emotionally complex and ethically challenging events in pre-hospital care. Families can transition from normality to devastating loss within minutes, while clinicians must make rapid, high-stakes decisions that often leave a lasting emotional impact. Traditionally, EMS practice has centred on the moment of “termination of resuscitation”, a cli...

In this episode, Laura Hall reflects on a six-month journey as a volunteer with a Search and Rescue (SAR) team operating in a remote region of Colorado, offering listeners a grounded insight into the realities of wilderness emergency response. The discussion outlines the breadth of skills required to function effectively in SAR, from technical rope rescue and casualty care to drone operations, nav...

Professor David K. Menon joins us for an in-depth exploration of Traumatic Brain Injury (TBI). As the Founding Director of the Neurosciences Critical Care Unit at Addenbrooke’s Hospital, Professor Menon has been instrumental in shaping modern understanding of TBI physiology, monitoring, and management. In this episode, we break down intracranial pressure physiology in a way that translates directl...

In this episode, Laura Hall addresses the often-overlooked impact of secondary trauma on emergency responders and healthcare professionals, emphasising the need for meaningful mental health support and long-term resilience. Drawing on personal experience, the discussion challenges the effectiveness of traditional debriefing models, highlighting how well-intentioned but poorly designed institutiona...

In this episode, Alec Wilding is joined by Nikki Hewitt, a clinician who has been among the first Paramedics in the United Kingdom to deliver pre-hospital ECMO as part of London’s Air Ambulance (LAA), Endovascular Cardiac Arrest Team, known as ECAT. This represents one of the most significant steps forward in resuscitation science within the pre-hospital environment, and Nikki has been at the cent...

In this episode, Alec Wilding is joined by Nikki Hewitt, a clinician who has been among the first Paramedics in the United Kingdom to deliver pre-hospital ECMO as part of London’s Air Ambulance (LAA), Endovascular Cardiac Arrest Team, known as ECAT. This represents one of the most significant steps forward in resuscitation science within the pre-hospital environment, and Nikki has been at the cent...

In the final episode of our three-part series marking the anniversary of the 7/7 London bombings, we hear from paramedic Sam Sinclair, who was deployed to Tavistock Square following the fourth and final explosion. This episode brings the series to a close by focusing on the realities of frontline decision-making at a major incident scene and the lasting impact such experiences have. Sam recounts a...

In this episode of the Pre-Hospital Care Podcast, we’re joined by Dr Ron Daniels BEM, one of the most influential voices in the global fight against sepsis. Ron is an NHS Consultant in Intensive Care in Birmingham, the Executive Director of the UK Sepsis Trust, and a key member of the Executive Board of the Global Sepsis Alliance. His work has played a central role in shaping national and internat...

In Part 2 of our special three-part series marking 20 years since the 7/7 London bombings, paramedic Adam Desmond shares a deeply personal and unflinchingly honest account of responding to the attacks at King’s Cross. This episode centres on the realities of working at the epicentre of a complex, evolving major incident and the lasting impact such events have on those who respond. In conversation,...

Today, we’re diving into an increasingly urgent and complex area of frontline medicine: novel psychoactive substances and synthetic drugs. Over the past decade, the drug landscape has shifted dramatically. Potent synthetics, unpredictable chemical variants, and rapidly evolving supply chains are creating new clinical challenges for ambulance crews, HEMS teams, and frontline responders. These subst...

In this opening episode of a special three-part podcast series marking 20 years since the 7/7 London bombings, we begin with a personal testimony from me on the World Extreme Medicine podcast. This episode is hosted on the Pre-Hospital Care Podcast, with kind permission from the World Extreme Medicine Podcast, hosted by Will Duffin. Part 1 focuses on the immediate response: arriving into uncertain...

Today, we’re exploring a fascinating and complex topic: the differences and disparities in trauma management systems across NATO nations during the Afghanistan conflict. Coalition operations in Afghanistan brought together militaries with very different medical doctrines, training, and resources. While all aimed to deliver life-saving care in challenging environments, the way pre-hospital trauma w...

In this episode, Laura Hall explores Acute Mountain Sickness (AMS) and the underlying physiology that drives altitude illness. As atmospheric pressure falls with increasing elevation, the body struggles to absorb adequate oxygen, triggering symptoms that often begin as headache, nausea, fatigue, and a “hangover-like” malaise. While these early features are common and often benign, Laura highlights...

In this episode of the Pre-Hospital Care Podcast, we delve into the psychology and practice of performing under pressure, examining how we can prepare clinicians not only to survive stress but also to thrive within it. Joining me once again is Andy Bell, Deputy Director of Paramedicine at St John WA, a leading voice in clinical education, leadership, and performance optimisation. Together, we expl...

In this episode, we explore “The Circle of Life,” a deeply reflective personal narrative by Dr Sarah Spelsberg. The reflection from Sarah captures a powerful sequence of events during a remote medical assignment that starkly illustrates the emotional and clinical breadth of rural and austere medicine. Sarah begins with the peaceful death of a terminally ill patient, setting a quiet and contemplati...