Prehospital Traumatic Cardiac Arrest (TCA) is a rare and particularly stressful presentation to paramedics and emergency clinicians.
We should be comfortable with the different algorithm rescusers should use in resuscitation and understand the reasonings for modifications in these low output states in trauma.
So, why dont we do chest compressions in a traumatic cardiac arrest? Should TCA's be given adrenaline and what does HOTT Stand for? We've got the answers to all this and more.

Pulmonary Embolism is a common emergency presentation to paramedics and emergency medicine clinicians.
We discuss why PEs cause right ventricular strain, the types of PE from massive, to submassive and subsegmental, how to work up and diagnose pulmonary embolism, how do D-Dimers work? and what are the high risk pulmonary embolism criteria.

All diving represents a hazard, as humans we're not designed to live under water. The deeper divers go and the longer they dive for, the greater the potential risks. Although the bends or decompression sickness, arterial gas embolisims and other diving related emergencies arent the most common presentation to emergency care clinicians. We thought it would be good to revise this medical presenation.
In partnership with our colleagues at HM Coastguard we've developed this CPD podcast. We talk to a Deepwater technical dive instructor from purpleturtle diving, and a dive doctor from DDRC healthcare.

With thanks to Toni from www.purpleturtlediving.com/
and Felix from www.ddrc.org/

Patient safety should be the key aim at the heart of any healthcare system, including the NHS. Yet we know that every single day, patients come to avoidable harm as a result of errors and mistakes. Human Factors and CRM have become increasingly common schools of thought after the tragic Elaine Bromley case and the great work coming from the clinical human factors group.
This month we look at the Human Factors at play in a pre-hospital RTC case study and consider how ambulance clinicians and first responders might be affected by these. We discuss Startle and Suprise, Amigdyla highjack, Bandwidth, Leadership and heirarchies within teams, communication skills and graduated language.

Heroin overdose or other opiate poisoning is an emergency that most paramedics and ambulance staff will be familiar with. However, there are some elements that can cause uncertainty for responders. What comes first CPR or naloxone? What are the signs of opiate toxicity? How much naloxone antidote do you give to someone to reverse opiate induced respiratory arrest?

**This podcast features discussion of suicide and hanging**

Hanging is one of the most common methods of suicide in the western world. Ambualnce crew are likely to come across these cases in the course of their work and so it is important that we understand the pathophysiology and managment of them.

This month we discuss how hanging causes cardiac arrest, clarrify commonly used terms, discuss the managment as well as emotional support for family and staff involved in these cases.
Make sure you debrief the incident, take care of your own emotional and mental health after incidents such as these. The ambulance staff crisis phone line is 0300 373 0898. Look after your health and that of your colleagues.