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In this episode of Medic in the Middle, I’m joined by Jack Shacklady (SP, ACP in Emergency Medicine and trainee CCP with Lincs & Notts Air Ambulance). Together we dive into three trauma papers discussion Intubation, oxygenation, and thoracotomy decision making. We break down the evidence, discuss what it actually means on the road and in critical care, and highlight the take-home points for prehospital and emergency clinicians. Expect discussion around trauma systems, outcomes, and evolving evidence in major trauma care — including how where a patient goes and what interventions they receive can influence survival and recovery. https://pubmed.ncbi.nlm.nih.gov/39657224/ https://pubmed.ncbi.nlm.nih.gov/41233917/ https://pubmed.ncbi.nlm.nih.gov/37657143/

Human Factors & CRM In this episode of Medic in the Middle, I’m joined by Specialist Paramedic, university lecturer, and PhD doctoral candidate Jamie Hahn to explore the role of human factors and Crew Resource Management (CRM) in pre-hospital care. We break down what human factors are, why they matter, and how they influence the decisions paramedics make. We discuss the origins of CRM in aviation, and why its principles are just as relevant on the road as they are in the cockpit. We also explore how communication, situational awareness, cognitive overload, hierarchy, fatigue, and decision-making pressures shape patient care in the unpredictable pre-hospital environment. Jamie shares his academic and frontline perspective, bridging the gap between theory and practice, and highlighting how understanding human factors can make clinicians safer, more effective, and more resilient. This episode is essential listening for paramedics, student paramedics, and any healthcare professional working in high-pressure environments who wants to better understand why mistakes happen and how we can reduce them. In this episode, we cover:• What human factors are and why they matter in pre-hospital care• The aviation origins of Crew Resource Management (CRM)• How CRM principles apply directly to paramedic practice• Decision-making under pressure and cognitive load• Communication, hierarchy, and team dynamics on scene• How human factors awareness can improve patient safety Whether you’re on the road, in training, or just interested in the science behind decision-making in emergency care, this episode offers practical insights grounded in real-world experience and current research. 🎙 Medic in the Middle - real conversations from the frontline of pre-hospital care.

In this episode, we sit down with Dr. Omar Khan - an Anaesthetist with Midlands Air Ambulance Charity (MAAC) to explore the realities of sedation in pre-hospital and critical care settings. We take a look at what safe and effective sedation looks like outside the hospital environment, and how Enhanced care teams approach it in the PHEM setting. 🔍 Topics covered include: What sedation actually is in the context of pre-hospital careThe four principles of sedation and how they guide safe practiceCommon indications for sedation in trauma and medical emergenciesContraindications, cautions, and red flags to watch forA breakdown of sedative agents: what’s used, why, and whenMonitoring standards during sedation – what’s essential and what’s idealThe role of human factors, team communication, and decision-makingBalancing risk vs. benefit in dynamic and often unpredictable environmentsReal-world insight into how sedation fits within critical care team operations Whether you're working on the road, in the air, or building your knowledge as a junior clinician, this episode offers practical, experience-based insights from a leading pre-hospital provider https://www.annemergmed.com/article/S0196-0644(25)00076-9/fulltext https://www.midlandsairambulance.com/ Twitter - @MedicMiddle

In this episode, I sit down with the Education Team from Midlands Air Ambulance Charity (MAAC) to talk all things training and professional development. We explore the wide range ofcourses offered not only to clinicians but also to members of the public.Whether you're an aspiring paramedic, a seasoned healthcare professional, orsomeone looking to gain life-saving skills, MAAC has something for you. We dive into: ·       RCUK-accredited courses (E-ALS) ·       European Trauma Course (ETC) ·       PHEM-focused training tailored for pre-hospital clinicians ·      Courses delivered by MAAC’s own critical careclinicians,combining real-world experience with evidence-based practice These high-quality, accessiblecourses are designed to support continuous professional development and raisethe standard of emergency care across the region. 🔗 Find out more or book a course at: ⁠https://www.midlandsairambulance.com⁠ Twitter- ⁠@MAA_Charity⁠ @Medicmiddle

Welcome back to Medic In The Middle! In this episode we are joined by EM consultant and PHEM legend Dr.Caroline Leech In this episode we tackle; - Definitions of Shock - Types of Shock - The Hateful Eight in trauma - Why patient's may present atypically - Management of Shock - Questions from twitter - Practical takeaways https://www.binasss.sa.cr/ene23/25.pdf https://pubmed.ncbi.nlm.nih.gov/1473289/ https://www.resuscitationjournal.com/article/S0300-9572(24)00854-2/abstract https://pmc.ncbi.nlm.nih.gov/articles/PMC1342509/pdf/jaccidem00006-0007.pdf https://litfl.com/thinking-beyond-bleeding/

Welcome back! In this episode we cover Rapid sequence induction, Consultant anaesthetist Nageena (The air ambulance service Helimed 53+54) joins us on this episode to discuss RSI In this episode we cover -definition -indications for the procedure -equipment and resources required for RSI -pre procedure and post procedure checks -RSI drugs Twitter @Medicmiddle

Welcome back to the show! In this episode we chat to Consultant Anaesthetist Doctor James Nayyar (The Air Ambulance Service) whom is the creator of the FOAMed platform Kid Confident - https://www.kidconfident.org/ We take you on a whistle stop tour of Paediatric trauma, discussing key concepts when managing and treating these patients. Twitter - @MedicMiddle @KidConfident23

In this episode we are joined by Consultant anaesthetist Lauren Weekes (Devon air ambulance, BASICS Devon, University Hospitals Plymouth) Topics covered in this episode: -epidemiology -pathophysiology -assessment + management in pre-hospital setting -Primary + Secondary Brain injury -pre-hospital critical care interventions Twitter @Medicmiddle @WeekesLauren

Hello! Welcome back to the show. In this Episode, James Yates (GWAAC, Resus Room, soNAR) Joins us to discuss Neonatal Management and transition of the newborn at birth. Topics covered include: - What is soNAR? - Neonate definition - Pre term birth - Neonate assessment and management - Fetal + newborn circulation - Stabilisation at birth (DCC, Thermal Care) - Assessing and managing a newborn - Neonatal Life Support/ Post Transitional care Twitter @medicmiddle

Welcome back to Medic in The Middle, in this episode we speak to YAS HART Critical Care Paramedic Jonathan Bush to talk about Drownings In this Episode expect to hear about - Drowning definition + Epidemiology - Drowning Physiology - The 'Metabolic Ice box' - Scene safety and scene management - When is resuscitation futile ? - ALS considerations during cardiac arrest

Welcome back to Medic In the Middle!  In this episode we are joined by West Midlands Care Team  The West Midlands Central Accident, Resuscitation & Emergency team is a charitable organisation who respond to serious medical incidents within the West Midlands, UK providing enhanced clinical care to critically ill patient's. For more information on WM CARE head to https://wmcareteam.com/wmct/ Featuring: Dr Emir Battaloglu Dr Steph Cowan CCP Pete Bowles In this episode we discuss Road traffic collisions, extrication, pelvic injuries, and management of pelvic injuries. Twitter Handle @medicmiddle

Welcome back to Medic in the Middle. In this episode we were lucky enough to catch up via a long distance call with Firefighter/EMT Jordyn Goddard, based in Virginia - USA. In this episode we discuss the Day to day life of an American Firefighter/EMT and how EMS systems are structured in the USA. We also discuss the similarities and differences to USA vs UK EMS systems plus much more! Many thanks again to Jordyn for featuring on the show! Twitter @medicmiddle

Hello!  Welcome back to Medic in The Middle. On this episode we are joined by Midlands Air Ambulance Critical care paramedic Ryan Ferris.  We discuss Brain impact apnoea and discuss if isolated head injury can be the cause of cardiovascular collapse in trauma patients.  Covered in this episode:  - Overview  - Pathophysiology + differences to TBI - Prevalence of Brain Impact Apnoea - Assessment and Mangement Strategies - Cardiovascular collapse associated with Brain impact apnoea

In this Episode we discuss LVAD (Left ventricular assist Devices) with LVAD Specialist Nurse and Heart+Lung transplant Co-ordinator Philippa Doherty. Topics covered in this episode; - LVAD definition - LVAD epidemiology - Assessing an LVAD patient  - Complications in LVAD patients  - The unconscious + acutely unwell LVAD patient  - Rhythm Management/Cardio-version/Defibrillation  - Cardiac arrest considerations + management Twitter: @MedicMiddle

Welcome back to Medic in The Middle!  As winter dawns and it is starting to get a bit chilly, We thought it would be rather fitting to delve into the topic of Hypothermia! Joined by Rob Fenwick ACP EM (The Resus Room) we together tackle this subject and recap on some key points when managing Hypothermic patients. Covered on this show; - Definition of Hypothermia and Incidence - Primary + Secondary Hypothermia - Mechanisms of heat loss + Homeostasis - Pathophysiology associated with Hypothermia  - Considerations to Treatment - Considerations of Extreme Hypothermia and Cardiac arrest.