PODCAST · health
Clinical Conversations
by The Ambulance Victoria Office of the Medical Director
The podcast for paramedics and anyone involved in out-of-hospital care that is critical, urgent, or unplanned. Hosted by James Oswald (Paramedic and clinical guideline developer) and A/Prof David Anderson (Medical Director).Keyword: Paramedic, paramedicine, Emergency Medical Service, EMS, Emergency Medical Technician, EMT, prehospital, pre-hospital critical care, retrieval medicine, ambulance, Helicopter Emergency Medical Service, HEMS, air ambulance, emergency, first responder, first aid.
Episodes
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Spinal Injury: Clinical Clearance (Part 1)
When is a clinical examination reliable enough to clear the spine? In this first episode of our spinal series, James and David unpack clinical spinal clearance - stable and unstable injuries, challenge common assumptions about neurological deterioration, compare NEXUS with the Canadian C-Spine...
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Clinical Updates: August 2026
Your monthly clinical update from Ambulance Victoria covering: Clinical Practice Update: 2026 CPG changes Respiratory illness Avian influenza Calcium gluconate precipitation Dual sequential and vector change defibrillation Patient safety update: Shortened RSI checklist Cutting the bougie for...
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Clinical Updates: July 2026
Your monthly clinical update from Ambulance Victoria covering: Paediatric anaphylaxis and asthma – a message from Safer Care Victoria Pre-hospital blood products Patient safety update: CSO Matt Shepard on paediatric airway management Guideline monitoring: Head injury guideline Paper(s) of the...
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AI in paramedicine
Can a machine diagnose, triage, document a case, or show empathy? AI is everywhere and the pace of change makes it difficult to know when to stop and take stock. In this episode, we explain how AI works for clinicians, what the evidence shows, what the risks and benefits are in healthcare, and…
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Clinical Update: June 2026
Your monthly clinical update covering: · Clinical Practice Update: Forthcoming CPG changes including AF referral pathways, low‑risk chest pain risk scoring, and paediatric gastro guideline Ebola bulletin and CHO advisory Cardiac Arrest Team Performance Report: insights and practical takeaways for...
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Clinical Updates: May 2026
Your monthly clinical update covering: · CPG updates: New measles CPG + updated CPP for ACOs & CERTs · Hand hygiene refresher: Back to basics in challenging environments · Cardiac arrest outcomes: Conversation with Ziad Nehme on recent improvements · Survey plug: Clinical & Operational Service...
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Clinical Updates: March 2026
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). This month's episode covers: Planned updates to CPGs in 2026 Posterior Stroke Patient Care Records Evaluation data of droperidol and dexamethasone as...
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Paramedics DO diagnose: diagnostic safety with A/Professor Carmel Crock
In this episode of Clinical Conversations, we're joined by Associate Professor Carmel Crock (Director of the Emergency Department at the Royal Victorian Eye and Ear Hospital and Chair of the Quality & Patient Safety Committee at the Australasian College of Emergency Medicine) to unpack what...
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Clinical Updates: February 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Cardiac Arrest Update with AV Resuscitation Coordinator Steve Musgrave Patient Safety Update: Stroke Assessment and Elderly Falls Alpine and Wilderness…
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Non-Invasive Ventilation (CPAP and BiPAP)
In this episode of Clinical Conversations, James Oswald and Ambulance Victoria Medical Director Dr David Anderson unpack non-invasive ventilation (NIV) for prehospital care. They explain the key physiology (oxygenation vs ventilation), the practical difference between CPAP and BiPAP, and how this...
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Clinical Updates: December 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Hear from Louise Reynolds (Victoria’s Chief Paramedic Officer) on the women’s pain inquiry findings—and what it means for paramedic practice. Spotlight the…
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Clinical Conversations: Medical Director Live Q&A
In our first ever live episode of Clinical Conversations, James Oswald (CPG specialist and paramedic) is joined by Ambulance Victoria Medical Director Dr David Anderson for an end-of-year Q&A on the latest CPG updates. We work through staff questions on the “why” behind key changes—including...
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Clinical Updates: November 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 02:10 – CPG Update Released • Highlights major 2025 CPG changes, app issues, and expected three-month transition period (IFS ceases immediately). • Emphasis…
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Clinical Updates: October 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 01:40 – 2025 Clinical Update Coming Soon 02:20 – IFS Retirement & Paediatric RSI Feedback 07:05 – STEMI Performance Update 08:50 – Free Birth: Paramedic...
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Clinical Updates: Paediatic intubation special
James Oswald is joined by an expert panel to discuss the background, evidence and rationale behind the retirement of intubation facilitated by sedation: Richard Armour – MICA paramedic, PhD candidate, CPG specialist. Dr Claire Wilkin – PEM, AV Medical Advisor - Paediatrics A/Prof David Anderson –...
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Clinical Updates: September 2025
Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): Clinical Update Warm IV fluid (13:38): Stop warming IV fluids in overhead compartments or with hot water bottles. Risks scalding/superheating. Store in...
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Cardiogenic shock
This month James and David look at cardiogenic shock: recognition and classification, oxygen targets, fluid resuscitation, vasopressors, inotropes, and the possibility of shock centres in the future. They're joined by Professor Dion Stub, an interventional cardiologist, prolific researcher,...
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Clinical Updates: August 2025
Your monthly clinical update covering: Mandatory VVED Consults for Infants <28 Days – trends, rationale for policy, clarifications, and case example demonstrating impact. Stroke updates - performing ACT-FAST on all MASS positive patients, changes to VACIS and a plug for IV access. Complex...
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Q&A: Sedation, trauma, why we need to change and the future of paramedicine.
In this special Q&A episode of Clinical Conversations, James Oswald and Dr. David Anderson respond to the most common — and most complex — questions we've received on sedation, CPG implementation, and the evolving role of paramedics. We also reflect on why clinical guidelines are becoming more...
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Clinical Updates: July 2025
Your monthly update on clinical issues including: Clinical Practice Care and Control Powers (02:38 – 07:10) Overview of section 232 and 241 powers. Documentation: VACIS + RiskMan entries are essential. More info: See Mental Health Crisis Reform on OneAV. Verification of Death (07:10 – 08:48)...
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Paediatric acute behavioural disturbance
In this episode of Clinical Conversations, we explore the complexities of managing acute behavioural disturbance (ABD) in children and adolescents—a small but increasingly common and high-risk cohort. Host James Oswald and AV Medical Director Dr. David Anderson are joined by paediatric emergency...
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Clinical Update
Your monthly clinical update covering:Clinical Practice 03:10 – Respiratory CPG Update: Pulmonary edema, COVID, ILI, paediatric asthma changes coming soon. 04:00 – First Responder Analgesia: Supply challenges beingaddressed; updates coming. 05:10 – Button Batteries: New blue dye...
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Paediatric assessment, consultation and virtual emergency care
James Oswald and Dr David Anderson explore how consultation has evolved from a perceived weakness to a hallmark of clinical maturity. They discuss the growing role of virtual emergency care, particularly the Victorian Virtual Emergency Department (VVED), in supporting paramedics with...
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Clinical Updates: April 2025
Your monthly clinical update covering: VVED Consultations for small infants New requirement: VVEDconsultation for non-transport of infants ≤28 days Strong recommendation for 29days–3 months Driven by patient safety reviewand expert consensus Not about removing autonomy —it’s about adding clinical...
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Sedation safety for acute behavioural disturbance (Part 2)
In Part 2 of their sedation safety conversation, hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) cover preparation for sedation and how to recognize and respond to deterioration. They break the problem into three...
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Clinical Updates: March 2025
Your monthly clinical update covering: Cardiac arrest outcomes An update on the sedation safety guideline Lessons learned from the patient safety team: appropriate use of the CT-6 traction splint and having a high index of suspicion for spinal and head injuries in older adults followingstanding...
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Sedation safety for acute behavioural disturbance
In this episode of Clinical Conversations, hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) dive into one of the most ethically and clinically complex areas of pre-hospital care—the questions of safety for during...
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Clinical Updates: February 2025
James and Ben cover the latest clinical news from across Ambulance Victoria, including: Intranasal Fentanyl Update – Using IV preparation for intranasal use. Other guidelines updates: Extrication monitoring, shoulder reduction, wilderness pain relief. Blood Administration – New pre-hospital blood...
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"He's going to die" - Breaking bad news
In this episode of Clinical Conversations, James Oswald (Paramedic and Clinical Practice Guidelines Specialist) and Dr. David Anderson (Ambulance Victoria Medical Director) tackle one of the most challenging aspects of paramedicine—delivering bad news. Joined by guest Liz Perry (MICA Paramedic),...
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Clinical Updates: January 2025
James Oswald and Director of Paramedicine Dr Ben Meadley discuss the important clinical messages for January 2025: patient safety during sedation and the importance of planning for resuscitation; the exploration of low acuity pathways; and they review a significant research paper on physician-led...
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Pain (Part 3) - Systems issues and special circumstances
Pain is one of the most common reasons people seek help from paramedics and other healthcare professionals. Do we take it seriously? Could we be doing better? James sits down with paramedicine luminary and pain researcher A/Prof Bill Lord for a three-part series on pain. In Episode 3, we look at...
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Clinical Updates: December 2024
A monthly summary of clinical information from the Ambulance Victoria Office of the Medical Director. Overview 1. Clinical Practice Updates •CPG App Update Details: oSecondary triage review oChanges to pediatric analgesia guidelines oStacked shock CWI updates oMinor error corrections •Pediatric...
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Pain (Part 2) - Management
Pain is one of the most common reasons people seek help from paramedics and other healthcare professionals. Do we take it seriously? Could we be doing better? James sits down with paramedicine luminary and pain researcher A/Prof Bill Lord for a three-part series on pain. In Episode 2, we look at...
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Clinical Updates: November 2024
A monthly summary of clinical information from the Ambulance Victoria Office of the Medical Director. Quick summary (0:30) Patient Safety (1:30) Discussing the lessons from specific adverse events is challenging due to patient privacy/consent, crew psychological safety, and investigation…
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Pain (Part 1) - Assessment, bias and disparities in care
Pain is one of the most common reasons people seek help from paramedics and other healthcare professionals. Do we take it seriously? Could we be doing better? James sits down with paramedicine luminary and pain researcher A/Prof Bill Lord for a three-part series on pain. In Episode 1, we look at...
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Clinical Updates: October 2024
This is the first in a new series of monthly clinical updates for Ambulance Victoria clinical staff. Director of Paramedicine A/Prof Ben Meadley and Clinical Guideline Specialist James Oswald summarise the need-to-know clinical information, all in one spot. This month: New CPG updates, trends in...
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The Future of Paramedicine
In this episode, James speaks with critical care paramedic, academic, and newly appointed Director of Paramedicine, Associate Professor Ben Meadley. We discuss strategic clinical leadership and the future of the profession. X / Twitter David: @expensivecare James: @JamesOz1 Ben:...
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Sepsis (Part 2) - Management
Part 2 of David's discussion with Associate Professor Andrew Udy on Sepsis Management. Get in touch [email protected] X / Twitter David: @expensivecare James: @JamesOz1 Resources mentioned [PHANTASI trial] Alam N, Oskam E, Stassen PM, Exter Pv, van de Ven PM, Haak HR…
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Sepsis (Part 1) - Assessment and diagnosis
Sepsis is arguably the most common time critical emergency we face as paramedics. This is the first of a two part series on sepsis with Professor Andrew Udy. Andrew is Head of Research at The Alfred ICU, and Deputy Director, Australian and New Zealand Intensive Care Research Centre. He was…
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Penetrating trauma
In Australia, penetrating truncal trauma is rare and the care of these patients involves a quite different mindset than we're used to. This is a cohort where our stay-and-play approach can do harm. James and David discuss the evidence relating to penetrating trauma and practical recommendations…
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National clinical practice guidelines - are they the future?
Clinical practice varies between the different state ambulance services in Australia. Yet we all claim to be evidence-based. So why is this, how big of a problem is it and what should we do about it? Are national guidelines the answer? James speaks with paramedic and PhD candidate Matt...
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Tranexamic acid
For over a decade after a large study showed a mortality benefit, this drug remained controversial. David and James look at the TXA saga.
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We're back: Why a podcast?
Clinical conversations is back. But where have we been, what have we been doing and what do we have planned for the future?
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OMI vs STEMI
We’re all familiar with the concept of STEMI. But the definition is built around a single ECG sign – not the underlying problem itself. Is that the best way to do it? Should we be thinking about this in a totally different way? Is Occlusive Myocardial Infarction (OMI) the new STEMI? Notes OMI...
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Capnography
Capnography plays a crucial role in the treatment of a range of life-threatening conditions. Its central role following intubation is undeniable and it's also an important part of our approach to cardiac arrest and sedated patients of all kinds. Yet it is not always as straightforward as it might...
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Shock
Shock is the quintessential critical illness. Bread and butter for everyone involved in prehospital and critical care. But do we really understand it? Could we be doing better for these patients? James is joined by Assoc. Prof. David Anderson, intensivist and Ambulance Victoria Medical Director,...
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Acute Behavioural Disturbance
People experiencing acute behavioral disturbance are some of the most vulnerable patients we treat. It’s a deeply distressing situation for the patient and extremely confronting for clinicians and carers. In this episode, we speak with psychiatrist Dr Alison Taylor about important changes we're...
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Family violence
Family violence is a deeply confronting and serious problem that occurs across all ages, genders, and socioeconomic groups. It has a profound impact on the health and well-being millions of people across the globe. How can we identify family violence? How should we respond to a disclosure of…
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Withholding or ceasing resuscitation
The decision to withhold or cease resuscitation is one of the most impactful and also one of the more confronting decisions that paramedics make in the field. AV Medical Director Associate Professor David Anderson discuss Dr Natalie Anderson, PhD discuss the decision making process and how to...
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Pain Relief and Intranasal Ketamine
Ambulance Victoria recently introduced intranasal ketamine for the treatment of moderate and severe pain. It has proven to be effective but we have identified opportunities to do better. Clinical Practice Development Specialist James Oswald and Medical Director David Anderson discuss the new...
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ABOUT THIS SHOW
The podcast for paramedics and anyone involved in out-of-hospital care that is critical, urgent, or unplanned. Hosted by James Oswald (Paramedic and clinical guideline developer) and A/Prof David Anderson (Medical Director).Keyword: Paramedic, paramedicine, Emergency Medical Service, EMS, Emergency Medical Technician, EMT, prehospital, pre-hospital critical care, retrieval medicine, ambulance, Helicopter Emergency Medical Service, HEMS, air ambulance, emergency, first responder, first aid.
HOSTED BY
The Ambulance Victoria Office of the Medical Director
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Frequently Asked Questions
How many episodes does Clinical Conversations have?
Clinical Conversations currently has 50 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is Clinical Conversations about?
The podcast for paramedics and anyone involved in out-of-hospital care that is critical, urgent, or unplanned. Hosted by James Oswald (Paramedic and clinical guideline developer) and A/Prof David Anderson (Medical Director).Keyword: Paramedic, paramedicine, Emergency Medical Service, EMS, Emergency...
How often does Clinical Conversations release new episodes?
Clinical Conversations has 50 episodes. Check the episode list to see recent publication dates and frequency.
Where can I listen to Clinical Conversations?
You can listen to Clinical Conversations on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts Clinical Conversations?
Clinical Conversations is created and hosted by The Ambulance Victoria Office of the Medical Director.
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