Join Iain Beardsell and Liz Crowe in an engaging discussion with Alice Hutton, an emergency physician from Paris, at Tactical Trauma 24 in Sundsvall, Sweden.

The episode delves into the implementation and logistics of pre-hospital eCPR (Extracorporeal Cardiopulmonary Resuscitation) by SAMU in Paris. Alice shares insights from her PhD research on refractory cardiac arrest and discusses the use of therapeutic hypothermia, including experimental approaches like total liquid ventilation.

Key topics include team composition, decision-making for patient eligibility, real-time management strategies, bypassing traditional emergency rooms for specialized facilities, and the challenges of scene management, family communication, and post-event debriefing.

This conversation offers a comprehensive look at the latest innovations that could transform pre-hospital emergency medical services.

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00:00 Introduction and Guest Introduction

01:29 eCPR in Paris: Current Practices

02:35 Dispatch and Response Protocols

03:32 On-Scene Procedures and Challenges

04:23 Decision Making and Scene Management

05:53 Training and Handling Difficult Situations

06:59 Challenges of eCPR Decision-Making

08:07 Importance of Team Debriefing

08:52 Post-Resuscitation Procedures

10:12 Operational Logistics and Success Rates

11:20 Innovative Research in Therapeutic Hypothermia

13:13 Future of Pre-Hospital Cooling Techniques

13:46 Conclusion and Final Thoughts

In this episode of the St. Emlyn's podcast, hosts Iain Beardsell and Simon Carley share their insights from recent conferences, including Gateshead's RCEM scientific conference, Tactical Trauma 24 in Sweden, and the Premier Conference.

They explore 'Goldilocks moments' for executing life-saving procedures in critical care, emphasizing optimal timing for interventions like thoracotomies. The episode also discusses innovative training methods like shadowboxing to enhance decision-making in high-stress medical scenarios. In addition, they review a significant trial on smoking cessation in emergency departments, highlighting its potential role in broader public health initiatives, including sexual health and HIV screening.

Discussions also cover various pain management strategies, such as the use of intranasal vs. intravenous Ketorolac for renal colic. The hosts critique the traditional peer review process in medical research and advocate for open peer review to support equitable and accessible scientific publishing.

00:00 Introduction and Catching Up

02:07 The Goldilocks Moment in Critical Care

05:25 Training and Decision-Making in Emergency Procedures

07:23 Smoking Cessation in Emergency Departments

10:07 Challenges in Implementing Preventive Health Strategies

10:38 Successful Public Health Projects in Emergency Medicine

11:19 Exploring Alternative Interventions in Emergency Departments

11:52 Highlights from the Premier Conference

12:54 Intranasal Ketorolac for Pain Management

15:46 The Future of Peer Review in Medical Research

20:09 Concluding Thoughts and Upcoming Content

In this episode, recorded at Tactical Trauma 2024, Andrew Petrosoniak discusses real-world experiences in trauma care, and the innovative use of simulation to resolve systematic issues in blood delivery and overall trauma resuscitation protocols.

Key takeaways include the concept of intelligent failure, reducing cognitive overload for medical staff, and the creation of efficient medical environments. Moreover, the episode delves into the significant improvements achieved through simulation, such as a 50% reduction in blood delivery times, and the integration of performance data to enhance CPR and clinical space design. Emphasizing the importance of using data to drive improvements, the conversation explores the implementation of roles like a CPR coach and the scalable application of these practices across individual, team, and systemic levels.

Listeners are encouraged to view failures constructively and leverage simulations and data for better patient outcomes and team performance.

00:00 Introduction to Simulation in Emergency Medicine

01:05 A Real-Life Trauma Case

02:18 Identifying Systemic Issues

02:46 Implementing and Testing Solutions

05:45 The Concept of Intelligent Failure

09:41 Scaling and Impact of Simulation

10:22 The Power of Simulation in Experimentation

10:56 Data Integration in Healthcare and Sports

11:29 Evaluating CPR Quality Through Simulation

12:14 Using Data to Improve Clinical Performance

13:47 Designing Clinical Spaces with Simulation Data

15:28 Scaling Impact with Simulation

18:02 Efficient Team Communication in Trauma Bays

19:04 Broadcasting and Recording Simulations for Education

19:39 Conclusion and Future Directions

Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael’s Hospital and an Assistant Professor in the Department of Medicine at the University of Toronto. He has completed a Master of Science in medical education where he focused on the use of in situ simulation (practice in the actual workplace) in procedural skill acquisition.

Andrew’s field of research includes in situ simulation and simulation-based technical skill acquisition. His work focuses on usability testing and the identification of personnel- and systems-based safety threats within acute care medicine. He is the principal investigator of the TRUST study (Trauma Resuscitation Using in Situ simulation for Team Training) that includes a partnership with human factors experts to evaluate systems and processes during high-stakes trauma simulations.