Pre-Hospital Care Podcast

In pre-hospital care, we spend a great deal of time preparing for the moments that matter most: cardiac arrest, major trauma, difficult airways, and emotionally challenging conversations. We train, rehearse, and work hard to achieve technical excellence. But what happens after the event may be just as important as what happens during it.
Debriefing is a familiar concept in healthcare. We often think of it as a chance to review what happened, identify what went well, and consider what we could do differently next time. But for some of the world’s highest-performing teams, debriefing is much more than a learning exercise. It is a fundamental part of how they operate.
Few organisations demonstrate this better than the Blue Angels. Their debriefing culture is immediate, structured, honest, and uncompromising. Every action can be examined, every assumption challenged, and every team member is expected to contribute. The goal is not to assign blame but to understand performance, learn quickly, and get better.
So, what can healthcare learn from a team where the margin for error is measured in milliseconds? To explore that question, David and I are joined by John Hiltz, who brings firsthand experience of the Blue Angels’ debriefing culture, leadership, and approach to developing high-performing teams. John offers a unique perspective on what exceptional teams do differently, and how the principles of aviation debriefing could help pre-hospital teams build greater trust, accountability, learning, and performance.
In this episode, we explore whether debriefing is simply a tool for learning from what has already happened or one of the most powerful mechanisms we have for building better teams.

NEAS Specialist Capabilities Conference 2026
The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.
Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.
The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.
Other speakers include Lee Thompson, who will discuss regional critical care, alongside specialists from EPRR and HART. Dräger supports the conference and focuses on collaboration, innovation, excellence, resilience and the communities we serve.
The closing date to register your interest is 11 October 2026.
👉 Register your interest for NEAS Specialist Capabilities Conference 2026
Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, Newcastle, Gateshead

Every critically ill newborn represents one of the most demanding moments in healthcare. Within seconds of birth, teams may need to assess, communicate, prioritise, and intervene in an environment where the margin for error is extraordinarily small. Technical expertise is fundamental, but safe and effective resuscitation depends on much more than clinical knowledge alone. Communication, leadership, teamwork, situational awareness, and other human factors can profoundly influence how teams perform under the highest pressure.
My guest today is James Yates, Critical Care Paramedic, educator and instructor on the Advanced Resuscitation of the Newborn Infant (ARNI) programme from the Resuscitation Council UK. ARNI is a specialist two-day programme that combines advanced clinical skills with communication, human factors, structured simulation and debriefing for clinicians caring for critically ill and sick newborns.
James brings extensive experience in teaching clinicians how to perform effectively under pressure, not simply by developing technical competence, but by strengthening the non-technical skills that underpin high-performing teams.
In this episode, we explore what high-performing teams do differently, why communication can break down during complex emergencies, and how structured simulation and expert debriefing can transform both individual clinicians and the wider systems in which they work.
We discuss psychological safety, cognitive overload, shared mental models, leadership, communication, and the challenges of facilitating meaningful debriefs with experienced clinicians. Most importantly, we consider what neonatal resuscitation can teach us about team performance more broadly, and why these lessons extend far beyond the delivery room into pre-hospital medicine, HEMS, emergency care and critical care.
If you are interested in how teams develop, adapt, and perform under pressure, this episode offers lessons well beyond neonatal resuscitation.

NEAS Specialist Capabilities Conference 2026
The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.
Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.
The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.
Other speakers include Lee Thompson, discussing regional critical care, alongside specialists from EPRR and HART. The conference is supported by Dräger and focuses on collaboration, innovation, excellence, resilience and the communities we serve.
The closing date to register your interest is 11 October 2026.
👉 Register your interest for NEAS Specialist Capabilities Conference 2026
Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, Newcastle, Gateshead

Major haemorrhage remains one of the most time-critical emergencies in pre-hospital care. When a patient is bleeding to death, stopping the haemorrhage is the immediate priority, but what happens next is equally important. What are we actually replacing?
In this special compilation of The Pre-Hospital Care Podcast, we explore the evolving science and practice of blood-based resuscitation in major trauma. In Part One, Professor Ross Davenport explores the science of bleeding and coagulation in trauma, examining trauma-induced coagulopathy, fibrinogen, haemostasis, and why conventional fluid-based resuscitation may fail to address the underlying physiological problem.
In Part Two, we move from physiology to practice in Blood Administration in Haemorrhagic Shock within EMS Systems. We examine the evidence for pre-hospital blood administration, lessons from military and civilian systems, the RePHILL trial, and the practical challenges of introducing blood products into emergency medical services.
Together, these conversations explore a fundamental shift in trauma resuscitation: moving beyond simply replacing volume, towards replacing the components the patient has actually lost. Because when someone is bleeding to death, the question isn't simply “How much fluid do they need?” It is “What does this patient need us to put back?”

NEAS Specialist Capabilities Conference 2026
The North East Ambulance Service Specialist Capabilities Conference 2026 takes place on 3 November 2026 at The Glasshouse International Centre for Music, NewcastleGateshead.
Under the theme “Collaborate, Innovate, Excel,” the conference brings together professionals working across specialist emergency care, with sessions covering Emergency Preparedness, Resilience and Response (EPRR), critical care and HART.
The keynote speaker is Adam Desmond, the 7/7 Kings Cross paramedic, who will deliver a no-holds-barred talk on human factors and bandwidth saturation during major incidents.
Other speakers include Lee Thompson, discussing regional critical care, alongside specialists from EPRR and HART. The conference is supported by Dräger and focuses on collaboration, innovation, excellence, resilience and the communities we serve.
The closing date to register your interest is 11 October 2026.
👉 Register your interest for NEAS Specialist Capabilities Conference 2026
Date: 3 November 2026
Venue: The Glasshouse International Centre for Music, NewcastleGateshead

This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.
PAX – built to perform, made to last.
Learn more at ⁠⁠https://www.pax-bags.com/en/⁠

Every resuscitation is different. Different patients, different teams, different environments, and often very different outcomes. But one thing remains constant: every clinical encounter has the potential to teach us something. The challenge, particularly in pre-hospital and acute care, is creating the time, space, and culture needed to turn those experiences into meaningful learning and sustained improvement.
Debriefing is often viewed as something that happens after the event, a chance to review what happened, identify what went well, and consider what could have been done differently. But effective debriefing is far more than a post-event checklist or a quality improvement exercise. Done well, it can strengthen psychological safety, build trust, improve communication, and help teams develop the shared mental models and expertise needed to perform under pressure.
In this episode, David and I are joined by Dr Bridgid Joseph, whose work across resuscitation practice, in-situ simulation, and interprofessional education has given her a unique insight into how teams learn in high-stakes clinical environments. She brings a practical perspective on what makes debriefing effective, and what prevents teams from getting the most from it. Together, we explore whether debriefing is simply a way of learning from what has already happened, or something much more powerful: a mechanism for developing better teams, improving performance, and ultimately delivering better care to patients.
This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.
PAX – built to perform, made to last.
Learn more at ⁠⁠https://www.pax-bags.com/en/⁠

Artificial intelligence is advancing rapidly in healthcare, but what could it mean for pre-hospital care? In this compilation episode, we bring together two conversations exploring how AI could support clinicians, improve decision-making, and transform the way emergency care is delivered.
We begin with Zane Perkins, exploring AI-TRiPS, an AI Risk Prediction and Decision Support System for trauma care. We discuss how AI and Bayesian networks could support clinical reasoning, identify risk and reduce cognitive burden in high-pressure environments such as major trauma and air ambulance care.
But with that potential comes important questions around trust, cognitive bias, human factors and clinical responsibility. What happens when clinicians disagree with an algorithm? And could we become too reliant on technology?
We then broaden the discussion with Nico Preston, exploring the wider applications of AI across pre-hospital care, from dispatch and demand prediction to diagnostics, risk stratification and clinical decision support.
Across both conversations, one theme becomes clear: the future of AI in emergency care is unlikely to be about replacing clinicians. Instead, the opportunity may be to create human–AI systems that combine computational power with clinical experience, judgement and contextual awareness. But getting that balance right will be critical. Can AI make us better clinicians, and how do we ensure we use it safely?

This episode is sponsored by PAX: The gold standard in emergency response bags.
When you’re working under pressure, your kit needs to be dependable, tough, and intuitive. That’s exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They’ve partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.
PAX doesn’t chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.
PAX – built to perform, made to last.
Learn more at ⁠⁠https://www.pax-bags.com/en/⁠