The Resus Room | Podcast kostenlos online hören

Verfügbare Folgen

5 von 269

Resuscitation Guidelines 2025; Roadside to Resus
Whether you're just stepping into your first cardiac arrest or you've been running them since the days of paddles, this one's for you. The 2025 resuscitation guidelines have landed after further collaboration between ILCOR, the ERC and the Resuscitation Council UK and in this episode we break down exactly what's new, what's stayed the same, and how it all fits into day-to-day practice. Across the board the 2025 updates represent evolution, a steady refinement of evidence rather than wholesale change. Adult ALS remains rooted in early recognition, high-quality compressions and rapid defibrillation, but you'll notice sharper guidance around ventilation, pad positioning, and the sequence of vascular access and drugs. There's a new section on physiology-guided CPR and the emerging science behind arterial-line-driven resuscitation as we covered in the SPEAR epsiode. We also take a look at the special circumstances algorithms from hypothermia to traumatic and obstetric arrest and discuss how an emphasis on reversible causes, data-driven debriefing and system performance might reshape post-event learning. Paediatric and newborn life support see subtle but important refinements too, including pad placement, shock energy escalation, simplification of adrenaline timings and a new Out-of-Hospital Newborn Life Support algorithm aimed squarely at the pre-hospital world. All this and more in the episode! Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
--------
56:30
--------
56:30
November 2025; papers of the month
This month we've got four cracking UK-led studies that really speak to how pre-hospital and emergency medicine continue to evolve, not just in the kit and skills we use, but in how we think about the whole patient journey. We'll start with a paper fromAnaesthesia with Pallavicini et al., exploring pre-hospital central venous access for patients in haemorrhagic shock. Drawing on London's Air Ambulance experience, it shows that large-bore central catheters can be placed safely and effectively, delivering earlier transfusion and improved survival to ED arrival. It's high-stakes medicine in extreme circumstances, and this study gives some of the best real-world data we've seen on it. Next up we look at the impact of a paper that's genuinely changed national practice from Aljanoubi et al. in Resuscitation, looking at what happened after the AIRWAYS-2 trial landed. You'll remember AIRWAYS-2 showed no functional benefit of tracheal intubation over supraglottic airways in OHCA, but did it actually shift behaviour? This registry study of over 70,000 patients shows that it did - and dramatically. The rate of pre-hospital intubation has fallen from around 44 percent in 2014 to 14 percent by 2020, with a clear inflection right after the trial's publication. Real-world proof that evidence can truly change practice. Then, we turn to two linked Delphi consensus studies from Tim Nutbeam and colleagues, published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. The first, optimising the care of the trapped patient, develops expert-endorsed principles for managing physically trapped casualties, marking a real shift from "movement-minimisation" to time-sensitive, patient-centred extrication. The second, prioritising time-critical injuries and interventions, complements that work by defining which injuries and treatments truly can't wait — creating a shared language for multi-agency teams at the roadside. Together, these papers show how thoughtful, collaborative UK research is shaping the next generation of trauma and resuscitation care — evidence, consensus, and practice all pulling in the same direction. These latter two papers are from the team at IMPACT; The Centre for Post-Collision Research, Innovation & Translation. We've been lucky enough to collaborate with the team and deliver an online Extrication course which is now available! A bit about the course; Target audience: Fire and Rescue Service personnel, Police officers, community response scheme members, and clinicians who respond to collisions or who wish to update their awareness of consensus extrication guidance. Aims: To improve awareness and adoption of evidence-based, patient-focused extrication principles among operational responders by providing a concise, accessible, and practical educational resource that bridges consensus guidance and real-world operational practice.Learning outcomes: The course will enable participants to: Describe the evidence base underpinning contemporary extrication practice. Apply a patient-focused approach to decision-making during extrication. Employ endorsed decision support tools, including EXIT decision aids, to case-based scenarios. Recognise and challenge outdated or unsafe norms in extrication practice. To find out more about the course head over to Post-Collision Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob
--------
33:26
--------
33:26
Pre-Alert '25; Roadside to Resus
How, when and why to make the call… The pre-alert is one of the most powerful and sometimes most painful parts of emergency care. It can feel like the Spanish Inquisition, trigger tension between pre-hospital and ED teams, or drop another challenge into an already overflowing department. But done well, a pre-alert isn't an irritation; it's an opportunity to line up critical care for the next patient and genuinely improve outcomes. In this episode, Simon, Rob and James break down The UK NHS Ambulance Services and Emergency Department Pre-Alert Guideline, jointly released in July 2025 by RCEM and the Association of Ambulance Chief Executives. It's the first national attempt to give clear, shared expectations on who to pre-alert, what to say, and how to receive those calls, it's full of practical recommendations for both sides of the phone. We kick things off with a review of the evidence base, including brand-new studies showing just how varied pre-alert practice is across the UK. From inconsistent criteria and mixed training to the problem of "pre-alert fatigue", the data make a strong case for standardisation. We then walk through the new guideline's key principles: pre alerting for pre-specified physiological parameters or specific conditions. We finish off with top tips for making and taking better pre-alerts - selling a story, leading with the headline, and understanding what the other side actually needs. This episode combines frontline pragmatism with real-world research and might just make your next pre-alert smoother, faster, and better received. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
--------
52:31
--------
52:31
October 2025; papers of the month
This month we've got three really interesting papers that shine a light on aspects of cardiac arrest management that many of us will recognise from clinical practice. First up, we look at the feasibility of arterial line placement during ongoing cardiac arrest in the Emergency Department. In our SPEAR episode we talked about the balance between securing invasive monitoring versus the potential distraction from other essential parts of resuscitation. This paper takes a pragmatic look at whether arterial access is achievable in that critical period in the Emergency Department, the success rate and the time required. Next up, we look at a paper that helps to give us a more accurate feel for the rate and predictors of high-risk adverse events for Emergency Department paediatric ketamine sedation. Our final paper looks at ultrasound during cardiac arrest. Specifically, whether the hands-off time during the pulse check are longer with traditional manual checks or with ultrasound. This systematic review and meta-analysis puts some numbers to the best way to minimising hands-off time. So whether you're a regular on the arrest team, sedating children, or supporting resuscitation from the periphery, these papers provide some useful food for thought on where our focus should be in those critical minutes. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob
--------
29:25
--------
29:25
Sickle Cell Disease; Roadside to Resus
a focus on its acute presentations and the care we can deliver to improve outcomes for our patients. Sickle cell disease (SCD) is a lifelong inherited blood disorder that affects over 15,000 people in the UK, and millions worldwide. It's caused by the production of abnormal haemoglobin molecules, which distort red blood cells into a crescent, or "sickle," shape. These rigid cells can block small blood vessels, leading to painful vaso-occlusive crises and organ damage. While the condition has long been most prevalent in parts of Africa, the Middle East, the Mediterranean and India, today it's a global health issue, and one we encounter regularly in UK emergency care. Tragically, failings in care have too often led to avoidable harm. The 2021 parliamentary report "No One's Listening" laid bare some of these cases, highlighting missed opportunities, poor awareness, and systemic issues that cost lives, such as the death of Evan Nathan Smith. So why are we revisiting this now? In 2024, RCEM published new Best Practice Guidelines on managing sickle cell disease in the ED. These provide clear, evidence-based standards for recognition, triage, analgesia, infection control, and safe discharge. In this episode, we take you through the key elements; Pathophysiology – how a genetic mutation drives sickling, vaso-occlusion and inflammation. Clinical presentations – from painful crises and acute chest syndrome, to stroke, anaemia, infection, priapism and pregnancy-related complications. Recognition and triage – why timely pain control within 30 minutes is a must, and how to spot red flags. Investigations and treatment – including the role of reticulocytes, the importance of knowing a patient's baseline haemoglobin, and principles of analgesia, transfusion, oxygen, and supportive care. Discharge and ongoing care – ensuring safe, joined-up planning, and involving haematology and specialist pathways wherever possible. The take-home message? Every sickle cell crisis is a medical emergency. We need to listen to patients, escalate early, involve haematology, and deliver care that meets the standards they deserve. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James
--------
51:21
--------
51:21