Published by Sydney HEMS Team
The Pre-Hospital & Retrieval Medicine Team of NSW Ambulance
Listen on Apple PodcastsG'day, and welcome back. Pre-hospital clinicians are used to working under pressure. Teams work in often austere environments, with limited resources caring for some of the most severe patient pathologies at their most undifferentiated. Within all this, individuals and teams must perform at their peak. But this is easier said than done. So how, in this most niche of clinical areas, can an individual, a team and an organisation promote, harness and maintain peak performance? Dr Stephen Hearns is an Emergency and Pre-Hospital Physician from Glasgow, Scotland. Stephen has spent most of his career working out-of-hospital, both in the UK and around the world. Throughout, Stephen has reflected on his own journey of peak performance, and has dedicated more recent years to the study and deep dive into what contributes to an individual and team functioning most highly in the pre-hospital space. In this episode, we discuss Stephen's research and published work to inform this topic. Stephen has spent time with other peak-performing groups including but not limited to Armed Forces and sporting teams, and has developed a package of learning to inform daily optimal performance. We talk about communication strategies, cognitive aids, team selection and organisational leadership - all of which, and more, contribute to peak performance. This episode is a must-listen for all pre-hospital clinicians intent on optimising their attainment, that of the team and that of their organisation. Learn more here: https://corecognition.co.uk/ Chat soon!
Hello and welcome back. This is part two of our chat with Dr Matt Hooper, continuing our conversation on emergency last aid. In this episode, we discuss the hows and whens involved when informing a family of their loved one's death, as well as the setting in which to do this. Too, we discuss the importance of maintaining space and safety for one's self and the team, and how a system can encourage psychological safety in this regard. As with part one, please ensure this episode is the right one for you - this is a challenging and emotionally-charged topic and whilst very important, please make sure it is the right episode at the right time for you. Chat soon.
G'day, and welcome back. In today's episode, we are delighted and privileged to be joined by South Australia's Dr Matt Hooper. The practice of medicine - including pre-hospital medicine - often focuses on life preservation. But, as acute care clinicians we often also find ourselves caring for patients at the end of their life. Too, we find ourselves caring for their relatives and loved ones, and the wider medical team. It can be really challenging to provide this care in such an acute, unexpected and unstable setting - so how do we do it, how do we stabilise the moment and continue to deliver compassionate care? This is the work of Dr Matt Hooper, who together with colleagues has created the 'emergency last aid' program - designed to teach the foundational skills needed to deliver compassionate end-of-life care in high-pressure environments. Drawing on his experience as a pre-hospital, intensive care and palliative care physician, Matt talks us through his approach to these challenging, rewarding circumstances. Before listening to this episode, please ensure it is the right episode for you: talking about death, dying and grief can be triggering for some, so please ensure that this episode is what you need, at the right time, and that you have support around you. Part two coming soon, chat then.
G'day and welcome back. Damage control resuscitation - what is it, why should a pre-hospital provider do it, what does it look like in real life, and what are the results. These are but some of the questions asked in this episode of Dr Dan Nevin and Mr Zane Perkins, Consultants with London's Air Ambulance. In conversation with Sydney's Dr Ian Ferguson, we explore this approach to the care of the bleeding trauma patient, focusing on the key tenants of this method and some of the mandated actions required when a patient is declared a damage control resuscitation case. To be clear - these are patients requiring a modified approach to even a 'code crimson/red' patient - these are the absolute most sick of all pre-hospital bleeding trauma patients. Too, as ever we discuss the effect on the wider system of this novel approach as well as the potential associated modifications to conventional trauma care. Thanks for listening, chat soon.
G'day and welcome back to the podcast. ECMO....in trauma? Today, we are talking about a more general emergency medicine / intensive care medicine topic, that of advanced trauma care. It is fair to raise an eyebrow at 'advanced trauma care' and 'ECMO' in the same sentence - these patients are anatomically disrupted, prone to bleeding and suffering huge multi-system injuries. So placing them onto a heparinised ECMO circuit seems counterintuitive. But, Chris Bishop and the team from London offer a different perspective. Chris is a Senior Clinical Research Fellow at the Centre for Trauma Sciences at Queen Mary University of London, UK. His PhD research focuses on the potential utility of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) to treat cardiac dysfunction associated with major trauma haemorrhage. Indeed, as we have discussed elsewhere in the podcast, these patients often have refractory cardiogenic shock secondary to an unfavourable metabolic storm following massive acute trauma - and it is partly this which ECMO may help bridge. Too, we discuss with Chris the benefit of ECMO as part of a neuro-protection package of care in patients with severe lung injury who are challenging to ventilate. This is real cutting edge medicine, and we are delighted to share with you our chat with Chris. Speak to you soon.
G'day and welcome back into part two of our conversation with Prof Sheldon Cheskes from Toronto, Canada. Here we continue our discussion about refractory cardiac dysrhythmias with the Sheldon, the principal investigator of 'The dose VF' study. In this part two, we talk to Sheldon about chemical strategies to overcome these dysrhythmias, as well as ask Sheldon about this best case ever - its a cracker! Thanks for listening, chat soon. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the HEMS debrief podcast. We are back with part one of a two part episode with Professor Sheldon Cheskes from Toronto, Canada. Sheldon is a Professor of Emergency Medicine by trade, a clinical scientist and a medical director for ambulance services within the Canadian province of Ontario. Perhaps, though, Sheldon is best known for his work as the principal investigator in the 'Dose VF' study, during which Sheldon and the team demonstrate the effectiveness of double sequential external defibrillation (DSED; rapid sequential shocks from two defibrillators) and vector-change (VC) in patients suffering from shock refractory ventricular fibrillation. This ground-breaking out-of-hospital trial has been the subject of great interest amongst pre-hospital and in-hospital clinicians alike, and demonstrates very promising data supporting these two defibrillation strategies. We are delighted, then, to talk to the man himself on the podcast today. Sheldon shares with us data from the study, and talks with us about the underlying physiology and pathology of this patient cohort, as well as how a health care system needs to best accommodate this potential salvageable group of cardiac arrest sufferers. A link to the New England Journal of Medicine paper is below, and as ever we hope you enjoy listening to this and part of of Sheldon's episode. Chat soon! https://www.nejm.org/doi/full/10.1056/NEJMoa2207304 We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back. Today, we continue our conversation on pre-hospital thoracotomies. To do this, we have teamed up with Professor Ewoud Ter Avest, an Emergency Physician with the London HEMS service. Ewoud is an author on the London's recently published review paper discussing the Service's experience with pre-hospital thoracotomies over the past 20 years. In conversation with our own Dr Ian Ferguson and Chris Ennis, who are authors on a similar paper out of Sydney, we will consider the shared themes, learnings and evolutions of this acute procedure between the two services. In so doing, we continue to discuss optimal timing of a pre-hospital thoracotomy, what constitutes signs of life, and which patient groups are most likely to most benefit from the procedure. This is a fascinating episode and as ever, we hope you enjoy it. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back. In this part two of our chat with Prof Laurie Morrison from Toronto, we continue our conversation around the latest ILCOR guidelines. We discuss, amongst other things, strategies to manage recurrent / refractory dysrhythmias, as well as the use of mechanical CPR devices and the administration of adrenaline. Too, we quiz Laurie on how guidelines and written and interpreted, and the choice of the language used. As ever, we hope you enjoy this episode - be sure to tune back in soon for more general retrieval topics, as well as more focused discussion around cardiac arrest. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back to the HEMS debrief - continuing our chats on cardiac arrest. We are thrilled to be again joined by Prof Laurie Morrison from Toronto, Canada. Laurie is an Emergency Physician and has dedicated her career to the research and improvement of out-of-hospital cardiac arrest care. To this end, Laurie is a member of ILCOR where she has previously been named a 'Giant in Resuscitation'. Today, join Laurie in conversation with Nat for part one of a two part episode discussing the latest 2025 ILCOR guidelines. These guidelines are packed - with concern given to CPR modes, effective defibrillation and the use of adrenaline to name but some. Who better to discuss this than Laurie herself - who with Nat spells out the guidelines to best help us all improve our cardiac arrest care. Be sure to tune in soon for part two of this episode, as well as for more chat on pre-hospital thoracotomies. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Debrief, another episode here of the cardiac arrest deep dive. Today is a cracker - we have our very own Dr Cliff Reid in conversation with Nat, discussing PEA. Now, anyone who knows Cliff will know he is passionate about many things, one of which is PEA - specifically the nomenclature around PEA and the differences between PEA patients, and thus how we treat them; not all PEAs are the same, and therefore the treatment considerations need to be equally as nuanced. In this episode, Nat and Cliff break down different PEA cohorts, and use their own experiences to colour-in the fascinating discussion of this often over-looked subset of cardiac arrest patients. A huge thank you to all those who listen to the podcast in NSW, Australia and beyond - we are so grateful for your continued encouragement and support. Let's continue to get excited about cardiac arrest, as we listen to Nat and Cliff discuss all things PEA. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day, and welcome back to the Sydney HEMS Debrief podcast. Today, we re-introduce some more general pre-hospital retrieval medicine matters, and what could be more retrieval medicine than a pre-hospital thoracotomy. Joining the pod today, we have Dr Ian Ferguson and CCP Chris Ennis who together discuss their recently published research paper on this HALO procedure. This case series reviews all cases of pre-hospital resuscitative thoracotomy undertaken from 1st Jan 2013 until 31st December 2024, within the NSW physician-CCP pre-hospital system. In concert with recently published data from the London team, Ian, Chris and Sam, discuss the nuances of this procedure - the why, the when and the unexpected survivors observed within the Sydney study cohort. Too, we discuss the use of ultrasound in this patient cohort and the importance of the 'everything else' beyond the procedure itself. A reference of the full text is below, and as ever please do share with your peers and network. Chat soon. Ennis C, Tant J, Burns B, Oliver H, Ostrowski K, Oliver M, Kruit N, Ferguson I. Pre-Hospital Resuscitative Thoracotomy Performed in New South Wales, Australia: A Case-Series. Emerg Med Australas. 2025 Dec;37(6):e70186. doi: 10.1111/1742-6723.70186. PMID: 41362072.
G'day, and thanks for tuning in to another episode of the HEMS Debrief podcast - this is our focused series on cardiac arrest. Today we are joined by Canadian Physician-Researcher Dr Brian Grunau. Brian is an Assistant Professor at the University of British Columbia Department of Emergency Medicine and works clinically as an Emergency Physician at St. Paul’s Hospital in Vancouver, Canada. His research investigates methods to improve outcomes from out-of-hospital cardiac arrest, and in so doing he has received over $15 million in research funding and published over 190 peer-reviewed articles. Brian is a member of the International Liaison Committee on Resuscitation (ILCOR) Advanced Life Support Task Force, which creates resuscitation treatment recommendations. In today's episode, we specifically quiz Brian on the time dependent yields of conventional resuscitation vs eCPR initiation, as well as how a system can best promote cardiac arrest research at every step of the chain of survival. Thanks as ever for listening! As we move deeper into 2026, the podcast will re-introduce episodes on more general Retrieval / Aeromedical topics, addressing both the technical and non-technical of this fascinating and challenging speciality. Do hit subscribe to stay up to date! And as ever, thank you for listening. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the HEMS debrief podcast. It is 2026, and we are kicking off with an episode of the cardiac arrest mini-series dedicated to paediatric cardiac arrest. Sadly Nat could not join, so instead Sam alone is in conversation with Dr Janice Tijssen. Janice is a paediatric critical care physician from London, Ontario. Having trained in London (Ontario) and Toronto, Janice is now a member of the Paediatric Life Support Taskforce for the International Liaison Committee on Resuscitation (ILCOR) and is the medical director for her hospital's Paediatric Advanced Life Support (PALS) education program. Too, Janice leads her hospital's Paediatric Critical Care Outreach Team (PCCOT). In this episode, we reflect on the changes in the recent ILCOR guidelines around paediatric cardiac arrest, as well as deep dive into some of the physiology of the arrested paediatric patient, asking both how can we prevent arrest, and how can we optimise the arrested physiology to best achieve sustained ROSC. We sure hope you enjoy this episode, there is a lot in here for any paediatric critical care provider. As we move deeper into 2026, the podcast will re-introduce episodes on more general Retrieval / Aeromedical topics, addressing both the technical and non-technical of this fascinating and challenging speciality. Do hit subscribe to stay up to date! And as ever, thank you for listening. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'Day and welcome back to the HEMS debrief, cardiac arrest mini-series. This is part two of our conversation with the pre-hospital ECMO team from Paris, France. Following part one, in this part two we continue to chat with Alice and Lionel about their extended research in the out-of-hospital cardiac arrest space, including but not limited to rapid cooling and ventilation strategies. Too, we discuss the cultural reluctance of systems to further adopt pre-hospital ECMO, as well as share some tips for those systems considering embarking on ECMO provision. As 2025 draws to a close, thank you sincerely for listening throughout 2025, and we cannot wait to talk again in 2026. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Sydney HEMS Debrief podcast - this is our focused mini-series on Cardiac Arrest. Today's episode is a big one. We have the absolute privilege of speaking to the Dr Alice Hutin and Prof Lionel Lamhaut from the pre-hospital ECMO team in Paris, France. The team, part of the Service d’Aide Medical d’Urgence (aka SAMU) in Paris, have been performing pre-hospital ECMO for OOHCA since 2011. For the past 10 years, the team have been available 24/7, working in concert with the pre-hospital ICU team dispatched to cardiac arrests in the greater Paris region. Truly ground-breaking, Alice and Lionel join us to reflect on over a decade of pre-hospital ECPR care, system implementation and challenges. Too, and perhaps most significantly, Alice and Lionel reflect on the extent to which the pre-hospital ECPR service has influenced every step of the chain of survival in the Paris system - promoting high quality basic and advanced life support at multiple levels within the pre-hospital response. Too, Sam does not shy away from asking some tough questions around just who should be performing ECPR - high specialised, limited access services or should this therapy be adopted and delivered more widely. This is part one of a two part episode, and is an absolute cracker. Be sure to tune in to part two very soon! We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
G'day and welcome back to the Sydney HEMS debrief, with our focus still firmly on cardiac arrest. In this episode 14, Nat is joined by Dr Helen Oliver in conversation with Dr Caroline Leech from the UK. Caroline is an emergency and pre-hospital physician who's academic interest focuses on maternal cardiac arrest. Specifically, Caroline's work concerns resuscitative hysterotomy; the when, the how, and the what to do after performing this HALO procedure. Additionally, Nat, Helen and Caroline discuss the physiology of maternal cardiac arrest and how we can best optimise our holistic resuscitation care as well as some of the ethical considerations surrounding this very challenging and confronting circumstance. We hope you enjoy this challenging episode, and of course share widely with your network. Chat soon. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
Welcome back, this is part two of Nat's chat with Dr PO Berve from Norway. Continuing the conversation, Nat and PO discuss physiological markers of ALS effectiveness as well as broach how to most judiciously use adrenaline during cardiac arrest. Too, PO dives into how to use the end tidal capnogram as a marker of CPR effectiveness - and it is not how you may think! Of course, this would not be a Sydney HEMS debrief episode without talking about eCPR and ventilation during CPR - the later being a favourite topic of Nat's for sure. As ever, thanks for listening and chat again soon. We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.
As we move our the podcast onto both Spotify and Apple Podcasts, we are re-posting this episode originally published in March 2024. In this episode, Nat and Alex join Sam to discuss the Sydney PRECARE pre-hospital ECMO trial as it is just getting under way. Focusing on workflows and team integration, Nat and Alex share their experiences, challenges and successes in these early days for the trial. We hope that the content here may help frame that of other episodes in this cardiac arrest series, as well as flavour future episodes as we reflect on PRECARE several years later.
Hello, and welcome back to the Sydney HEMS debrief podcast. This is our focused series on cardiac arrest. Today we have part one of two in conversation with Dr PO Berve from Norway. PO is an Anaesthetist and Pre-Hospital physician from Oslo where he works on the physician response car of the region. PO's research has been absolutely fundamental to the modern understanding of CPR physiology and the haemodynamics of the arrested patient, and his work is rightly lauded as critical in the practice of physiology-guided resuscitation. Have you ever wondered what happens during one chest compression? In this episode, Nat deep-dives with PO into the physiology of the arrested patient – specifically what happens, or what should happen, during one perfect chest compression. It’s a fascinating conversation not to be missed by anyone with an interest in performing high quality resuscitation tailored to a specific patient. Part two coming soon! We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.