Pre-Hospital Care Podcast

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/⁠

The most dangerous part of an intubation is often not the moment the laryngoscope goes in; it’s the ten minutes before it ever leaves the tray.
In this episode of the Pre-Hospital Care Podcast, we focus on The Last 10 Minutes Before Intubation: the critical phase where outcomes are often decided long before airway instrumentation begins. Joining us is Cosmo Scurr, Consultant Anaesthetist, bringing extensive experience in managing critically ill patients and high-risk airway emergencies. Cosmo brings an anaesthetist’s perspective to the physiology, preparation, decision-making and team behaviours that underpin safe airway management.
This is not a discussion about laryngoscopy technique. Instead, we explore the preparation, physiology and human factors that shape success or failure before the first attempt is made.
We’ll examine how experienced clinicians approach pre-oxygenation in sick, hypoxic patients, and why seemingly small decisions can dramatically influence peri-intubation oxygen reserve. We’ll explore the physiology of induction and the pitfalls of hypotension, including why cardiovascular collapse during airway management is often predictable rather than sudden.
The conversation also examines role allocation in high-acuity environments, failed-airway planning and cognitive load management when the room is under pressure. What does good preparation actually look like? How should teams approach equipment preparation, briefing, task allocation and contingency planning? And how can we create shared mental models before the situation becomes time-critical?
Ultimately, this episode is about recognising that airway management begins before the airway is touched. The quality of those final ten minutes may determine what happens in the ten minutes that follow.
Through a case-based lens, we’ll ask: what do experienced HEMS and critical care clinicians do differently in those final minutes? What habits, checks, and assumptions separate smooth intubations from catastrophic ones?

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/⁠

High-fidelity simulation has become far more than an opportunity to practise clinical procedures in a controlled environment. For pre-hospital clinicians working in complex, unpredictable and high-stakes environments, simulation can provide something that conventional classroom teaching cannot: the opportunity to rehearse performance when the environment itself becomes part of the problem.
In this compilation episode of the Pre-Hospital Care Podcast, we bring together two conversations that explore how high-fidelity simulation can be designed, delivered and debriefed to create meaningful improvements in clinical and team performance.
We begin with Dr Neel Bhanderi, Head of Education and Training at MedSTAR Retrieval HEMS in Adelaide and Consultant in Emergency Medicine at the Royal Adelaide Hospital. Recorded in 2023, our conversation explores the concept of creating an "analogue of reality" and using simulation to introduce progressively more complex stressors into training. We discuss skills acquisition under stress, communication, handover, environmental noise, task loading, debriefing and the relationship between simulation and operational case review.
We then move to a more recent conversation with Ben King, Founder and CEO of Best Practice Medicine. Ben explores the role of high-fidelity simulation in preparing clinicians for the complexity and uncertainty of real-world pre-hospital care. We look at experiential learning, team coordination, human performance under stress, targeted debriefing and the use of video-assisted debriefing to translate simulation into measurable performance improvement.
Across both conversations, a common theme emerges: the value of simulation is not determined simply by how realistic the mannequin, environment or equipment looks. It is determined by how deliberately the simulation reproduces the cognitive, behavioural, environmental and interpersonal demands of clinical practice, and what happens during the debrief afterwards.
We explore:
What actually makes simulation "high fidelity"?
How can training progressively introduce stress without overwhelming learners?
The difference between technical skills and performance in complex environments
Communication and handover under pressure
Environmental stressors, distraction and task loading
Simulation as a tool for developing team performance
How video can enhance debriefing and reflective learning
Psychological safety during debriefing
Using real-world case review to identify simulation and training needs
Moving from simulation as an educational event to simulation as a performance-improvement system
How we can better prepare clinicians for the reality of pre-hospital care
The central question is simple:
If we expect clinicians to perform under pressure, should we not train performance under pressure?
High Fidelity Simulation with Neel Bhanderi
Originally released 15 May 2023
Listen to the original episode on Apple Podcasts
High Fidelity Simulation in Pre-hospital Care: Training for Reality, Debriefing for Impact with Ben King
Originally released 27 April 2026
Listen to the original episode on Apple Podcasts
The Pre-Hospital Care Podcast brings together leading clinicians, researchers, educators and practitioners to explore the science, practice and human factors behind modern pre-hospital care.
If you enjoy the episode, please subscribe, leave a review and share it with a colleague involved in clinical education, simulation or pre-hospital care.