Pre-Hospital Care Podcast

In pre-hospital care, few environments demand more precise and timely judgment than within a HEMS system. Decisions are made rapidly, often with incomplete information, within dynamic and unforgiving conditions. It is an operational space where clinical urgency intersects with aviation risk, and where each intervention requires a careful balance between decisive action and the principle of doing no harm.
Today’s guest, Adele Dobler, works at this exact interface. With thousands of flight hours spanning urban HEMS, remote medical evacuation, and high-risk environments, from central London to the deserts and high-altitude regions of Kenya, she brings exceptional depth of experience in high-stakes decision-making. Her operational background includes flying aircraft such as the H135 and H145, frequently at night, under night vision goggles (NVG), and within complex, evolving mission profiles across diverse global settings.
In this episode, we examine the realities of decision-making in HEMS, including cognitive load, inherent biases, operational trade-offs, and the critical inflection points that shape outcomes. The discussion focuses on dynamic judgment, risk management, and professional accountability in an environment where decisions must be made in real time, with minimal scope for error. 
This episode is sponsored by PAX: The gold standard in emergency response bags.
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What you do in the first few minutes after a burn injury can influence not only survival, but pain, healing, scarring, and long-term quality of life.
In this special compilation episode, we've brought together both parts of our conversation with burns specialist Krissie Stiles into one comprehensive masterclass. Whether you're revisiting these episodes or listening for the first time, this is an evidence-based guide to the assessment and management of burns in the pre-hospital environment.
Across the episode, we discuss:
The pathophysiology of burn injury and why it matters clinically
Evidence-based burns first aid, including optimal cooling strategies
Assessing burn depth and total body surface area (TBSA)
Airway assessment and recognising inhalation injury
Analgesia and pre-hospital pain management
Fluid resuscitation—who needs it and when
Dressings, packaging and transport considerations
Referral criteria and working with specialist burns services
Common myths and pitfalls in burns management
The lifelong physical and psychological impact of burn injuries
Krissie combines decades of clinical expertise with practical advice that can be applied immediately by paramedics, emergency physicians, nurses, and all clinicians involved in pre-hospital emergency care.
Listen to the original episodes:
Part 1 – Pre-Hospital Burns with Krissie Stiles
https://podcasts.apple.com/us/podcast/part-1-pre-hospital-burns-with-krissie-stiles/id1441215901?i=1000672971414
Part 2 – Pre-Hospital Burns with Krissie Stiles
https://podcasts.apple.com/us/podcast/part-2-pre-hospital-burns-with-krissie-stiles/id1441215901?i=1000673376119
Whether burns are a rare part of your clinical practice or something you encounter regularly, this episode is packed with practical pearls that will improve your confidence and your care.
If you enjoy this episode, please consider subscribing, leaving a review, and sharing it with colleagues; it really helps us continue producing free educational content for the pre-hospital community.

Communication under pressure is one of the most critical and most fragile skills in pre-hospital care. When it fails, the consequences can be immediate and profound. In this episode, we explore why communication breaks down in high-stress environments, what that costs us clinically, and, crucially, what we can do to improve it.
Joining me is Dr Stephen Hearns, one of the most influential figures in emergency and retrieval medicine. A consultant in emergency and aeromedical retrieval medicine, he is the founding force behind Scotland’s Emergency Medical Retrieval Service (EMRS), a government-funded critical care organisation delivering advanced pre-hospital care across some of the UK’s most remote and challenging environments. With over 30 years of experience spanning HEMS, mountain rescue, expedition medicine, and medico-legal practice, Stephen is a globally recognised authority on human performance under pressure. He is an Honorary Senior Lecturer at the University of Glasgow, has published extensively on human factors in acute care, and has played a key role in developing postgraduate education in retrieval and transfer medicine.
Further reading relevant to this episode from Stephen can be found here:⁠ https://corecognition.co.uk/performance-infographics/8-tools-to-improve-communication-under-pressure
Learn more about Core Cognition:⁠https://corecognition.co.uk/⁠

Point-of-care ultrasound (POCUS) has become one of the most exciting developments in modern pre-hospital care. From enhancing clinical assessment and supporting critical interventions to influencing transport and treatment decisions, ultrasound is increasingly finding its place in the hands of pre-hospital clinicians.
In this special compilation episode of the Pre-Hospital Care Podcast, we bring together three previous episodes that explore the role of ultrasound from different perspectives. Together, they provide a comprehensive overview of the opportunities, limitations, and governance considerations surrounding pre-hospital ultrasound practice.
In this episode, we discuss:
The evolving role of ultrasound in pre-hospital decision-making
How POCUS can augment clinical assessment in critically ill and injured patients
The use of ultrasound in trauma care and time-critical interventions
Current evidence supporting pre-hospital ultrasound
Training, competency and governance requirements
Challenges of implementation and avoiding over-reliance on imaging
The future of ultrasound in pre-hospital and critical care practice

Featured Episodes
Sound Decisions: The Evolving Role of Pre-Hospital Ultrasound
https://podcasts.apple.com/gb/podcast/sound-decisions-the-evolving-role-of-pre/id1441215901?i=1000723373532
Point-of-Care Ultrasound in Critical Care with Dan Nevin
https://podcasts.apple.com/ca/podcast/point-of-care-ultrasound-in-critical-care-with-dan-nevin/id1441215901?i=1000625086379
Pre-Hospital Ultrasound in Trauma: Practice & Governance
https://podcasts.apple.com/gb/podcast/pre-hospital-ultrasound-in-trauma-practice-governance/id1441215901?i=1000724321110

Resources
For more episodes and educational resources, visit the Pre-Hospital Care Podcast and follow us on social media for updates on future episodes and series.
If you enjoyed this compilation, please consider subscribing, leaving a review, and sharing the episode with colleagues who have an interest in pre-hospital critical care.

Paediatric mental health presentations are becoming an increasingly common part of pre-hospital and emergency care. Yet, many paramedics report feeling under-prepared when it comes to recognising and responding to psychological distress in children and adolescents. Unlike physical illness or injury, mental health concerns often present subtly, evolve dynamically, and sit within complex family, social, and developmental contexts.
Today’s guest, Kristina Maximous, is a dual-registered Paramedic with extensive clinical and academic experience in both Australia and the United Kingdom. She currently serves as a Lecturer in Paramedicine and Academic Resourcing Lead and is completing a PhD focused on paediatric mental health screening and assessment within paramedic-led emergency care. Her research has explored how paramedics make decisions about children and adolescents in psychological distress, and the limitations of current screening tools in dynamic, time-pressured environments. Kristina’s work aims to inform more developmentally appropriate, biopsychosocial approaches that support safer, more equitable care for young people. 
In this episode, we explore the distinction between screening and assessment, unpack the challenges paramedics face on the frontline, and discuss what a more holistic, biopsychosocial model might look like in practice. You can find Kristina's scoping review here: https://science-health.csu.edu.au/schools/nursing-paramedicine-health/research/projects/reframing-paediatric-mental-health-screening-and-assessment