Clinical Conversations

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...

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...

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...

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...

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...

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 ⁠clinicalguidelines@ambulance.vic.gov.au⁠ David: ⁠@expensivecare⁠ | @expensivecare.bsky.social | LinkedIn James: https://linktr.ee/ClinicalConversations

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...

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 ⁠clinicalguidelines@ambulance.vic.gov.au⁠ Socials David: ⁠@expensivecar...

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...

James Oswald and Dr David Anderson explore how consultation has evolved from a perceived weakness to a hallmark of clinical maturity. They discuss the growing role of virtual emergency care, particularly the Victorian Virtual Emergency Department (VVED), in supporting paramedics with decision-making—especially when assessing young infants. Joined by pediatric emergency specialist Dr Harith Al-Rawi, the episode dives into the challenges of remote pediatric assessment, the value of collaboratio...

In Part 2 of their sedation safety conversation, hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) cover preparation for sedation and how to recognize and respond to deterioration. They break the problem into three evidence‑backed pillars: Prevent deterioration (have a listen to Part 1)Prepare for side‑effects – if you plan to sedate, you must plan to resuscitate Recognise & Respond when things go wrong Furth...

In this episode of Clinical Conversations, hosts James Oswald (paramedic and clinical guidelines specialist) and Dr. David Anderson (Medical Director of Ambulance Victoria) dive into one of the most ethically and clinically complex areas of pre-hospital care—the questions of safety for during sedation for acute behavioural disturbance (ABD). They explore the ethical and legal considerations surrounding the use of sedation, the significant clinical risks, and real-world cases that highlight th...