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PHEMCAST

Tim Nutbeam and Clare Bosanko

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A UK Prehospital Emergency Medicine Podcast. This podcast and associated website aims to: - Share knowledge and expertise in the field of prehospital medicine with specific reference to the UK working environment - Make this content relevant to all professional prehospital practitioners
 
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Definitions UK definition (RCEM): It describes the sudden onset of aggressive and violent behaviour and autonomic dysfunction, typically in the setting of acute on chronic drug abuse or serious mental illness. Australian definition (NSW Health): Behaviour that puts the patient or others at immediate risk of serious harm and may include threatening …
 
https://phemcast.files.wordpress.com/2020/05/covid-02-05-2020-18.41.mp3 Case definition Current case definition for COVID-19 can be accessed here. Risk stratification This is the Emergency Medicine Specialty guide we discussed in the podcast, which includes use of the NEWS and 40 step test (edit: since recording the podcast yesterday (!) we’ve been…
 
https://phemcast.files.wordpress.com/2019/09/infant-with-fluid-clarification.mp3 A: Optimal airway position for infants Note how a rolled towel is placed under the baby’s shoulders to allow space for the occiput and avoid flexion of the neck and airway. From: https://www.jems.com/2017/02/28/an-overview-of-ems-pediatric-airway-management/ ‘B’ assess…
 
https://phemcast.files.wordpress.com/2019/03/f-psychosomatic-final-31032019-08.27.mp3 Many thanks to Suzanne O’Sullivan for her time in putting this podcast together. Her excellent books “It’s all in your head” and “Brainstorm” are well worth a read. It is certainly one of the PHEMcast recordings which is going to change my own practice the most. W…
 
https://phemcast.files.wordpress.com/2019/01/stroke_final.mp3 The Danish mnemonic to help remember the elements of a cerebellar neurological examination: There are lots of Youtube videos to demonstrate these signs, here are a few which I thought were particularly helpful: Disdiadochokinesis Ataxia Nystagmus Intention tremor If you would like to rea…
 
https://phemcast.files.wordpress.com/2018/07/mi.mp3 Another invitation to the Trauma Care Conference this year inspired us to combine two of the excellent speakers into this podcast considering major incidents. Thanks to both our speakers for sharing their talks from the conference. Trauma Care offer more than the annual conference; there are month…
 
https://phemcast.files.wordpress.com/2018/01/checklists_final.mp3 We recommend reading Atul Gawande’s book ‘The Checklist Manifesto’. It’s a well written, fascinating story about the introduction of the WHO Safer Surgery checklist and the impact it had. This link will take you straight to Amazon if you want to buy a copy (other internet retailers e…
 
https://phemcast.files.wordpress.com/2018/01/txa-final.mp3 The paper which we discuss in the interview is available open access here How does tranexamic acid work? Taken from: https://pbrainmd.wordpress.com/2015/10/15/1335/ Critical appraisal aids To understand more about hierachy of evidence and how a systematic review fits into this please have a…
 
https://phemcast.files.wordpress.com/2017/12/tp2-final-11_11_2017-00-30.mp3 Where can you undertake decompression of a pneumothorax? Be particularly careful when using the 2nd intercostal space mid-clavicular line that you are sufficiently lateral. For example, here are the locations identified as ‘2nd ICS mid clavicular line’ amongst 25 EM physici…
 
https://phemcast.files.wordpress.com/2017/12/tp-1-fin-11_11_2017-00-08.mp3 Firstly, go and read Simon and Tim Harris’ great 2005 paper on the subject which we reference repeatedly in the podcast. It is available free open access here. A pneumothorax exists when air accumulates in the potential space between the visceral and parietal pleura: From: w…
 
https://phemcast.files.wordpress.com/2017/11/io-fin-10-11-2017-22-41.mp3 The various devices which Tony discusses are: This video shows the rapidity of infusion entering the circulation from a humeral IO. This is the paper mentioned by Tony, which shows the stepwise improvement in mortality amongst combat casualties from military conflict 2003-2012…
 
Guest contributor: Lauren Weekes https://phemcast.files.wordpress.com/2017/09/et-06092017-16-24.mp3 What is ETCO2? % or partial pressure of carbon dioxide measured somewhere near the mouth at the end of a normal exhalation (hence end tidal, end of tidal volume breath) To get a measurement the following systems need to be functioning: Metabolically …
 
https://phemcast.files.wordpress.com/2017/07/surg.mp3 The West Midlands surgical skills course offers cadaveric training for PHEM and EM practitioners on rare life saving procedures. Click here to go straight to their page. Anatomy The Guidelines Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults…
 
https://phemcast.files.wordpress.com/2017/06/vent-final.mp3 Many apologies for the delay in the release of this podcast! A second apology is due for the sound quality – it was recorded at a ‘live’ HEMS base – this has led to lots of background noise I am afraid. We have done our best to edit this out / reduce its effect but I’m afraid we are not ex…
 
https://phemcast.files.wordpress.com/2017/03/broken.mp3 This episode has been compiled over a year – many thanks to our four contributors, who have shared their stories and knowledge. They were interviewed at TraumaCare 2016, TraumaCare 2017 and the BASICS/FPHC Conference 2016. If you ever need to talk about the impact of stresses and work experien…
 
https://phemcast.files.wordpress.com/2017/01/blood-final-27012017-11-55.mp3 There is the potential for significant controversy in this month’s episode – and we would really appreciate the feedback of the prehospital community on this one. We have held the ‘no clear fluids’ mantra close to our hearts for most of our prehospital careers. We ‘know’ th…
 
https://phemcast.files.wordpress.com/2017/01/end-of-year-30122016-16-33.mp3 Paediatric Trauma TARN report: Severe Injury in Children Simulation ATACC:The Anaesthesia Trauma and Critical Care course Thanks to Mark Forrest (@ObiDoc) for sharing these videos: References Spurr J, Gatward J, Joshi N, Carley SD. Top 10 (+1) tips to get started with in si…
 
https://phemcast.files.wordpress.com/2016/12/vent-final.mp3 Ventilation – a dark art. Difficult to be a master, easy to be average (or terrible)! This is “part 1”, which includes some of the basic (and not very basic) concepts behind ventilation. We recorded over 60 minutes of excellent content with George – we will post more below as soon as it is…
 
https://phemcast.files.wordpress.com/2016/09/breaking-bad-final.mp3 YouTube videos: From the police officer’s perspective: https://www.youtube.com/watch?v=toaA_TNwcxg From the mother’s perspective: https://www.youtube.com/watch?v=0KJZXOKStao The paper about watching resuscitation is this one: http://www.nejm.org/doi/full/10.1056/NEJMoa1203366#t=art…
 
https://phemcast.files.wordpress.com/2016/07/final-gentle-patient-handlig.mp3 The paper we mentioned by Jonathan Benger and Jules Blackham can be accessed here: https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-17-44 Stable versus unstable spinal injury The location of an injury and involvement of different structures defines the stabilit…
 
https://phemcast.files.wordpress.com/2016/06/stress-2.mp3 Big thanks to Anand Swaminathan @EMSwami, Chris Nickson @precordialthump, Jesse Spurr @Inject_Orange, Chris Hicks @HumanFact0rz, and Tom Evens @doctomevens Their pre-workshop reading/listening recommendations: http://stemlynsblog.org/englishman-south-africa-robert-lloyd-st-emlyns/ http://emc…
 
https://phemcast.files.wordpress.com/2016/06/maternal-collapse-06062016.mp3 Apologies for the quality of the sound – we recorded in a very echo-ey office! The Royal College of Obstetricians and Gynaecologists (RCOG) green top guideline is accessible here: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_56.pdf We have talked about ramp…
 
The recent resurgence in this method of suicide has put emergency responders at a significant increase of serious injury and death. This podcast discussed the current most frequent methods of attempted and successful inhalational suicide – keep safe. https://phemcast.files.wordpress.com/2016/04/chem-final.mp3 There are a multitude of professional a…
 
https://phemcast.files.wordpress.com/2016/01/chemical-incidents.mp3 We hope you enjoyed this PHEMCast. Please feedback your comments via the blog, twitter or email us on PHEMCAST@gmail.com. The NARU video we mention in the podcast can be accessed here: http://naru.org.uk/videos/ior-nhs/ And the paper we discuss is: Chilcott RP. Managing mass casual…
 
Sorry for the slight delay releasing our “October” podcast – but here it is (note how it is cunningly labelled Episode 2)! This month we are reviewing the evidence for the pelvic binder and discussing scenarios in which it should (and should not) be used. https://phemcast.files.wordpress.com/2015/09/pelvis-final-1.mp3 As always, please get in touch…
 
Here it is – our very first podcast, and guess what – it is on supraglottic airways! https://phemcast.files.wordpress.com/2015/08/version-2-lma.mp3 This first episode reviews the history of the laryngeal mask airway and we discuss the relative benefits and risks of supraglottic airway devices. We’ve interviewed Dr Rob Moss, author of the Faculty of…
 
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