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 our patient safety data, and new cardiac monitors.   Times stamps: 2:00 New CPG updates 4:40 Snakebite 6:30 Acute coronary syndrome and activating the cath lab 7:35 Patient safety...

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: ⁠@ben_meadley⁠

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 for your practice. Further resources Over view of major traumatic injury in Australia–Implications for trauma system design The evil of good is better: Making the case for basic life support...

For over a decade after a large study showed a mortality benefit, this drug remained controversial. David and James look at the TXA saga.

Clinical conversations is back. But where have we been, what have we been doing and what do we have planned for the future?

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 Manifesto Amal Mattu on YouTube Subtle STEMI iOS app The Ancient Scholar

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 seem. In this episode, David and James speak with Matt Humar (intensive care paramedic, acting patient safety review lead at Ambulance Victoria, and secretary of the safe airway society) about...

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, for a... shocking discussion. 

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 making to improve care for these patients.

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 family violence? How can we help victim survivors? Ambulance Victoria Safe Guarding Care Lead Amber Smith joins James and David to discuss this important issue. MARAM Family violence practice guide

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 David Anderson discuss Dr Natalie Anderson, PhD discuss the decision making process and how to better approach these difficult cases.   

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 Clinical Practice Guideline and some of the lessons we've learned along the way.