Clinical Conversations

Paramedics DO diagnose: diagnostic safety with A/Professor Carmel Crock

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 safety. Get in touch⁠clinicalguidelines@ambulance.vic.gov.au⁠ SocialsDavid: ⁠@expensivecare⁠ | @expensivecare.bsky.social | LinkedInJames: https://linktr.ee/ClinicalConversationsProducer: Liam Hennebry 

Clinical Updates: February 2025

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 MonthPrehospital transesophageal echocardiography versus conventional advanced life support in out-of-hospital cardiac arrest (PHTEE–OHCA) – a randomized controlled pilot study: https://link.springer.com/article/10.1186/s13054-025-05805-wProfessional Development OpportunitiesFast-Tracked Higher Education Pathway for AV Clinical Instructors:  https://ambulancevic.sharepoint.com/sites/OneAV-news-and-updates/SitePages/Exciting-Opportunity-Fast-Tracked-Higher-Education-Pathway-for-AV-Clinical-Instructors.aspx?web=1 ACP Primary Care Conference Canberra: 21-22 May ACPIC Melbourne : 8-11 SeptemberEMS Asia Singapore 7-13 November Grad Cert MH: https://victoriauniversity.online/ppc/graduate-certificate-mental-health https://www.latrobe.edu.au/courses/graduate-certificate-in-mental-health#/overview?location=ON&studentType=dom&year=2026 https://online.scu.edu.au/online-courses/graduate-certificate-mental-health https://handbook.monash.edu/2024/courses/m4039 AICG: Clinical Governance, Effective Leadership, Clinical Education, Clinical Feedback.  https://www.aicg.edu.au/education/online-courses/ Get in touchclinicalguidelines@ambulance.vic.gov.auX / Twitter James: ⁠⁠⁠@JamesOz1⁠⁠ Ben: ⁠@ben_meadley⁠LinkedinJamesBenProducer: Liam Hennebry 

Non-Invasive Ventilation (CPAP and BiPAP)

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 recognise early success vs failure—including when to escalate and call for help.Get in touch⁠clinicalguidelines@ambulance.vic.gov.au⁠ SocialsDavid: ⁠@expensivecare⁠ | @expensivecare.bsky.social | LinkedInJames: https://linktr.ee/ClinicalConversationsProducer: Liam Hennebry 

Clinical Updates: December 2025

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.Paper of the Month: a must-read on post-intubation hypotension.Ben runs through key professional development opportunities for 2025 and what’s coming in 2026.Equipment update.And we wrap with small steps to transform your practiceFurther resourcesVVED Back pain pathway presentation (AV employees only): https://engage.cloud.microsoft/main/threads/eyJfdHlwZSI6IlRocmVhZCIsImlkIjoiMzU5OTQ5NzU4NzMzNTE2OCJ9?trk_copy_link=V1AI Professional Development CoursesFree micro-skill course in AI: https://www.australianindustrygroup.com.au/education-training/centre-for-education-and-training/blog/free-introduction-to-artificial-intelligence-microskill-courseDigital health 101: https://digitalhealthworkforce.org.au/education-and-resources/Australian Institute of Digital Health AI essentials: https://cpd.digitalhealth.org.au/course/ai-essentials AI PodcastsNEJM AI Grand rounds (AI Podcast): https://store.nejm.org/signup/ai/podcastsBeyond the prompt (AI podcast): https://www.beyondtheprompt.ai/Paper of the monthPrehospital Postintubation Hypotension and Survival in Severe Traumatic Brain Injury: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2841682Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults: https://www.nejm.org/doi/abs/10.1056/NEJMoa2511420Get in touchclinicalguidelines@ambulance.vic.gov.auX / Twitter James: ⁠⁠⁠@JamesOz1⁠⁠ Ben: ⁠@ben_meadley⁠LinkedinJamesBenProducer: Liam Hennebry 

Clinical Conversations: Medical Director Live Q&A

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 as magnesium compatibility, levetiracetam after midazolam, IV GTN in APO, and opioid choice and multimodal analgesia. They also cover practical operational issues like VVED wait times and what to do when access delays are affecting crews.Get in touch⁠clinicalguidelines@ambulance.vic.gov.au⁠ SocialsDavid: ⁠@expensivecare⁠ | @expensivecare.bsky.social | LinkedInJames: https://linktr.ee/ClinicalConversations