Clinical Conversations

Episoder

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  Clinical Updates: August 2026 02.09.2026 30min

  Your monthly clinical update from Ambulance Victoria covering: Clinical Practice Update:2026 CPG changes Respiratory illness Avian influenza Calcium gluconate precipitation Dual sequential and vector change defibrillation Patient safety update: Shortened RSI checklist Cutting the bougie for cricothyroidotomyGuideline monitoring: Evaluation of sedation for acute behavioural disturbance Paper of the month: STEMI care in Victoria Temporal imp...
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  Clinical Updates: July 2026 06.08.2026 24min

  Your monthly clinical update from Ambulance Victoria covering: Paediatric anaphylaxis and asthma – a message from Safer Care VictoriaPre-hospital blood productsPatient safety update: CSO Matt Shepard on paediatric airway managementGuideline monitoring: Head injury guidelinePaper(s) of the month: Torniquet use for severe bleeding | Pre-hospital vital signsEquipment updateProfessional development opportunitiesSmall steps to transform your practiceResources Paediatric Anaphylaxis: Acute Pa...
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  AI in paramedicine 27.07.2026 1t 24min

  Can a machine diagnose, triage, document a case, or show empathy? AI is everywhere and the pace of change makes it difficult to know when to stop and take stock. In this episode, we explain how AI works for clinicians, what the evidence shows, what the risks and benefits are in healthcare, and what it means for our clinical practice. Disclaimer: While we did our best to ensure the content was accurate, we don’t script everything and sometimes we do make mistakes. If you hea...
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  Clinical Update: June 2026 19.06.2026 19min

  Your monthly clinical update covering: · Clinical Practice Update: Forthcoming CPG changes including AF referral pathways, low‑risk chest pain risk scoring, and paediatric gastro guideline Ebola bulletin and CHO advisory Cardiac Arrest Team Performance Report: insights and practical takeaways for improving CPR quality PANDA trial update · Patient safety update: Non-transport decisions, assessment, trusting our equipment · Paper of the month: Naloxone and Clinical Outcomes in Susp...
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  Clinical Updates: May 2026 11.05.2026 37min

  Your monthly clinical update covering: · CPG updates: New measles CPG + updated CPP for ACOs & CERTs · Hand hygiene refresher: Back to basics in challenging environments · Cardiac arrest outcomes: Conversation with Ziad Nehme on recent improvements · Survey plug: Clinical & Operational Service Delivery Plan · Patient safety: Case review – consulting via the Clinician when engaging external agencies (e.g. PIPER) · Tourni...
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  Clinical Updates: March 2026 27.03.2026 18min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). This month's episode covers: Planned updates to CPGs in 2026Posterior StrokePatient Care RecordsEvaluation data of droperidol and dexamethasone as antiemeticsPaper of the Month: IV vs IO in cardiac arrestEquipment updateProfessional development opportunitiesSmall steps to transform your practicePaper of the Month Vascular access by paramedics during cardio...
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  Paramedics DO diagnose: diagnostic safety with A/Professor Carmel Crock 01.03.2026 1t 3min

  In this episode of Clinical Conversations, we're joined by Associate Professor Carmel Crock (Director of the Emergency Department at the Royal Victorian Eye and Ear Hospital and Chair of the Quality & Patient Safety Committee at the Australasian College of Emergency Medicine) to unpack what diagnosis is, how diagnostic error happens, and how we can make diagnosis safer. We explore common pitfalls like premature closure and diagnostic momentum, and practical ways to improve diagnostic safe...
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  Clinical Updates: February 2025 15.02.2026 31min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Cardiac Arrest Update with AV Resuscitation Coordinator Steve MusgravePatient Safety Update: Stroke Assessment and Elderly FallsAlpine and Wilderness Response AlagaesiaToxicology EvaluationAlcohol Withdrawal GuidelineEquipment Update: Syringe DriversPaper of the Month Prehospital transesophageal echocardiography versus conventional advanced life support in...
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  Non-Invasive Ventilation (CPAP and BiPAP) 01.02.2026 45min

  In this episode of Clinical Conversations, James Oswald and Ambulance Victoria Medical Director Dr David Anderson unpack non-invasive ventilation (NIV) for prehospital care. They explain the key physiology (oxygenation vs ventilation), the practical difference between CPAP and BiPAP, and how this guides use in COPD, acute pulmonary oedema, COVID, asthma, and undifferentiated dyspnoea. The discussion also covers patient coaching, mask fit troubleshooting, essential monitoring, and how to recog...
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  Clinical Updates: December 2025 23.12.2025 38min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine). Hear from Louise Reynolds (Victoria’s Chief Paramedic Officer) on the women’s pain inquiry findings—and what it means for paramedic practice.Spotlight the VVED back pain pathway: for many patients, opioids + ED isn’t the answer—community physio support can be surprisingly effective.Adam Ho (AV Senior Pharmacist) answers the most common medication questions...
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  Clinical Conversations: Medical Director Live Q&A 22.12.2025 48min

  In our first ever live episode of Clinical Conversations, James Oswald (CPG specialist and paramedic) is joined by Ambulance Victoria Medical Director Dr David Anderson for an end-of-year Q&A on the latest CPG updates. We work through staff questions on the “why” behind key changes—including respiratory care and oxygen targets, NIV expansion and mask issues, airway and RSI updates (including crash induction and consultation for single-responder MICA), and several medication updates such a...
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  Clinical Updates: November 2025 02.12.2025 22min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 02:10 – CPG Update Released • Highlights major 2025 CPG changes, app issues, and expected three-month transition period (IFS ceases immediately). • Emphasis on professional judgment, understanding over memorisation, and upcoming live Q&A. • Request for staff feedback on new learning methods. 05:42 – Women’s Pain Inquiry Findings • Large V...
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  Clinical Updates: October 2025 02.11.2025 29min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): 01:40 – 2025 Clinical Update Coming Soon 02:20 – IFS Retirement & Paediatric RSI Feedback 07:05 – STEMI Performance Update 08:50 – Free Birth: Paramedic Implications 11:50 – PANDA Trial Update 13:50 – Patient Safety: Cognitive bias & discounting concerning symptoms 19:20 – Missing PCRs in Severe Adverse Events 21:50 – Guideline Monitoring: Minor ...
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  Clinical Updates: Paediatic intubation special 06.10.2025 39min

  James Oswald is joined by an expert panel to discuss the background, evidence and rationale behind the retirement of intubation facilitated by sedation: Richard Armour – MICA paramedic, PhD candidate, CPG specialist.Dr Claire Wilkin – PEM, AV Medical Advisor - PaediatricsA/Prof David Anderson – AV Medical Director Get in touch ⁠[email protected]⁠ David: ⁠@expensivecare⁠ | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations
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  Clinical Updates: September 2025 19.09.2025 26min

  Your monthly clinical update from James Oswald (Clinical Practice Guideline Specialist) and A/Prof Ben Meadley (Director of Paramedicine): Clinical Update Warm IV fluid (13:38): Stop warming IV fluids in overhead compartments or with hot water bottles. Risks scalding/superheating. Store in equipment towers only.Paediatric distraction (03:26): kits available now. Evidence-based, non-digital active tools work best. Order via iProc. Document use in VACIS.Paediatric NIV (9:20): pathways with RCH/...
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  Cardiogenic shock 15.09.2025 48min

  This month James and David look at cardiogenic shock: recognition and classification, oxygen targets, fluid resuscitation, vasopressors, inotropes, and the possibility of shock centres in the future. They're joined by Professor Dion Stub, an interventional cardiologist, prolific researcher, professor at Monash University, member of the Australian Resuscitation Council, and medical advisor to Ambulance Victoria. Further resources Avoid trial: https://www.ahajournals.org/doi/10.1161/circulati...
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  Clinical Updates: August 2025 08.08.2025 29min

  Your monthly clinical update covering: Mandatory VVED Consults for Infants <28 Days – trends, rationale for policy, clarifications, and case example demonstrating impact. Stroke updates - performing ACT-FAST on all MASS positive patients, changes to VACIS and a plug for IV access. Complex Paediatric Respiratory Patients – Managing patients on home non-invasive ventilation, maintaining continuity of care, and upcoming resources. Trauma Updates – Blood component therapy expansion and complia...
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  Q&A: Sedation, trauma, why we need to change and the future of paramedicine. 25.07.2025 53min

  In this special Q&A episode of Clinical Conversations, James Oswald and Dr. David Anderson respond to the most common — and most complex — questions we've received on sedation, CPG implementation, and the evolving role of paramedics. We also reflect on why clinical guidelines are becoming more detailed, how to balance complexity with emergency care, and what the future holds for paramedics. Get in touch ⁠[email protected]⁠ Socials David: ⁠@expensivecar...
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  Clinical Updates: July 2025 09.07.2025 27min

  Your monthly update on clinical issues including: Clinical Practice Care and Control Powers (02:38 – 07:10) Overview of section 232 and 241 powers. Documentation: VACIS + RiskMan entries are essential. More info: See Mental Health Crisis Reform on OneAV. Verification of Death (07:10 – 08:48) Verifying death is voluntary for paramedics. Review WinOps 025 for current processes. AV is working with VicPol to improve processes. Encourage local discussion with TM/CSO about your approach. &...
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  Paediatric acute behavioural disturbance 30.06.2025 56min

  In this episode of Clinical Conversations, we explore the complexities of managing acute behavioural disturbance (ABD) in children and adolescents—a small but increasingly common and high-risk cohort. Host James Oswald and AV Medical Director Dr. David Anderson are joined by paediatric emergency physician Dr. Claire Wilkin, who brings deep expertise in paediatric critical care. Together, they discuss the causes of ABD in younger patients, differences from adult presentations, principles of de...