Greater Sydney Area HEMS

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.

Hello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest. This is episode 3, and today it is all about ventilation during arrest. It is time to put the P back into CPR. Ventilation has been neglected in cardiac arrest management, and this two part episode focuses on how ventilation can not only help achieve a ROSC but the importance of ventilation too in achieving neurologically intact survival We debate 30:2 or continuous ventilation and the merits of LMA vs intubation vs BVM We talk about the complexities of heart lung interactions Where the research is heading in understanding how best to ventilate these patients We are delighted to be joined by an absolute expert in this area, Dr Hans van Schuppen from Holland. Hans is an anesthesiologist and HEMS physician at the Amsterdam University Medical Centre. Hans is a combined researcher, clinician and leader. He is an ERC Advanced Life Support Course Director, co-founder of the ResusNL conference, member of the expert group on national ambulance guidelines on resuscitation and is a member of the jury of the Dutch National Resuscitation Competition. As a member of the Dutch Resuscitation Council, he co-authored the national resuscitation guidelines, and helped to develop and implement a nationwide standard operating procedure for the handover of out-of-hospital cardiac arrest patients. Currently, Hans is the chair of the Medical Committee and board member of the Dutch Resuscitation Council. His research evolved into a formal PhD with the ARREST (AmsteRdam REsuscitation STudies) group and the department of Anesthesiology, resulting in his thesis “Prehospital Advanced Life Support”. He now serves as director of resuscitation science of ARREST and works towards close collaboration between clinical care, education, research and innovation in resuscitation. We could not stop talking to Hans, so please tune back in next week for the second half of our conversation.   We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.    

Hello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest. In the second episode of this series, we talk to Dr Tommaso Scquizatto from Milan, Italy. Tommaso is a Doctor, researcher and innovator in cardiac arrest, resuscitation, and emergency critical care medicine. He works in the Department of Anaesthesia and Intensive Care at IRCCS Ospedale San Raffaele in Milan, Italy, where he leads cardiac arrest research and innovation. His clinical and research efforts focus on improving the entire chain of survival for out-of-hospital cardiac arrest, from prevention to advanced resuscitation, including the use of extracorporeal life support and novel technologies. He serves on the Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR) and the 2025 Guidelines Working Groups for BLS, ALS, and extracorporeal CPR of the European Resuscitation Council (ERC). He is also an editorial board member and social media editor for Resuscitation and Resuscitation Plus. With Tommaso in this episode, we talk about targeted physiology in cardiac arrest included targeted diastolic blood pressure, Tommaso’s research, and how systems and workflows may adapt to incorporate new intra-ACLS interventions such as transoesophageal ECHO. We hope you enjoy the episode, please be sure to hit subscribe and tune back in next week.   We are delighted to be sponsored by Corpuls - delivering high-tech and innovative equipment for emergency and intensive care medicine for over 35 years.      

Hello, and welcome back to the Sydney HEMS debrief, focus on cardiac arrest. This is the first in a series of podcasts dedicated entirely to cardiac arrest, the physiology driving the clinical presentation and how we can more effectively use physiological principles and basic science to underpin clinical care and research.  In this week's episode, we have the privilege of talking with Dr Paul Rees. Who better to talk all things myocardial perfusion and it’s optimisation during cardiac arrest than an interventional cardiologist and pre-hospital physician. Paul explains the physiology of cardiac arrest from an interventional cardiologist perspective as we ask him the hard questions on: Optimal diastolic blood pressure thresholds to improve ROSC The role of adrenaline in improving coronary artery perfusion, the downside to it’s administration and the potential alternatives  The role of selective aortic aortic arch perfusion (SAAP), the current ERICA study and the potential for this procedure to improve cardiac arrest survival  The key elements in building a successful endovascular resuscitation program for those services wishing to embark on ECPR and/or REBOA We hope you enjoy this episode, please contact Sam or Nat if you have any comments or questi