🚑 Specialist Paramedic Critical Care | 🧠 Clinical Educator | 🎤 Speaker | 📚 Founder & Director @VHA_Education | 🩺 Advancing Clinical Practice
United Kingdom
Joined September 2015
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No observation in isolation.
A reassuring number can hide a deteriorating patient.
SpO₂, ETCO₂, respiratory rate, ECG, BP... each is one piece of the greater clinical picture.
Treat the patient, interpret the trend, understand the physiology 🚑🫁📈
Never lose sight of the human behind the patient.
Whether it’s a first breath, a final breath, a routine intervention or a fight for life - every interaction matters.
Clinical excellence is essential. But so is kindness, compassion and simply being human.
Treat the person 💚
Phil Poskitt retweeted
Avoiding unrecognised oesophageal intubation
The @RCoA & @dasairway have agreed to drop ‘no trace wrong place’
The message now is that we need to exclude oesophageal intubation by identifying SUSTAINED EXHALED CO2
This requires 4 elements
-CO2 rises & falls with respiration
-sustained (non-fading, >7 cycles)
-amplitude >1 KPa
-clinically appropriate
It replaces ‘no trace wrong place’ which is insufficient & therefore inadequate
See these two updated webpages
Sustained exhaled CO2
rcoa.ac.uk/safety-standards-…
Prevention of future deaths
rcoa.ac.uk/safety-standards-…
@AAGBI @AndyHiggsGAA @NicholasChrimes
Phil Poskitt retweeted
🚑 Calling all prehospital clinicians!
Take part in the PRECEPT-OHCA study exploring confidence, practice, and barriers in identifying reversible causes of OHCA.
⏱️ 5–7 min survey
📱 Scan QR or use the link: redcap.link/gmq3h1w4
Your experience can help shape future cardiac arrest care.
Phil Poskitt retweeted
Clinical excellence is built through deliberate reflection.
Team resilience is built through psychological safety.
Neither, happen by accident.
#Leadership #CriticalCare #Paramedic #PreHospitalCare #HumanFactors #ClinicalLeadership
linkedin.com/posts/vertexhea…
Phil Poskitt retweeted
Great performance rarely comes from working harder - it comes from creating bandwidth.
- Bandwidth to think before acting.
- Bandwidth to anticipate rather than react.
- Bandwidth to communicate clearly under pressure.
Flow isn’t accidental. It’s engineered.
#HumanFactors
Phil Poskitt retweeted
Because the strongest teams aren't built by exceptional individuals.
They're built by leaders who make everyone around them better.
#CriticalCare #Leadership #HumanFactors #PreHospitalCare #CriticalCareParamedic #FOAMed #ClinicalLeadership #Teamwork #HealthcareLeadership
Phil Poskitt retweeted
The purpose of this study was to evaluate the efficacy of ketamine on quality of life measures following severe injury. The results of this study suggest acute ketamine administration has an impact on long-term mental health of injured patients, specifically anxiety and PTSD.
journals.lww.com/jtrauma/abs…
Phil Poskitt retweeted
Finishing off the third of our annual Clinical Response to Major Incidents annual refresher for our critical care paramedics today. This year it’s a tabletop exercise focusing on creating clinically appropriate casualty flow and making ‘the least bad decision’ when overwhelmed
Phil Poskitt retweeted
Pre-hospital acute behavioural disturbance, a guest post by Jack Lyon. What does the evidence say about Ketamine and other sedatives.
#FOAMedhttps://www.stemlynsblog.org/pre-hospital-abd/
Phil Poskitt retweeted
Excellent first lecture in the Difficult Airway Course by @jarrodmosier
The difference between complicated and complex; a watch is complicated but airways are complex!
Human factors are underestimated: the three foot world view can predominate leading to people trying to “plan a harder”
Two cardinal rules:
1. Do not wander into failure
2. Intubate with a team, not an audience
Phil Poskitt retweeted
In the RSI trial involving critically ill patients undergoing intubation in EDs or ICUs, the use of ketamine for the induction of anesthesia did not lead to significantly lower in-hospital mortality than etomidate. Full trial results and Research Summary: nejm.org/doi/full/10.1056/NE…
ALT The New England Journal of Medicine Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults A Research Summary based on Casey JD et al. | 10.1056/NEJMoa2511420 | Published on December 9, 2025 Visual representations of the patients in the trial and the treatments they were assigned. Read the full Research Summary at NEJM.org.
Phil Poskitt retweeted
Great day of learning with @YorkshireAirAmb & colleagues, focusing on individualised, physiological targeted resuscitation, aimed at optimising survival & ROSC in the most challenging cases.
Thanks to @EMDocJB & @HaldenHB & the rest of the faculty.
OHCA management beyond #ALS
Phil Poskitt retweeted
Making the most of q…t time on 06:00-18:00 critical care RRV shift - @TheResusRoom podcast on “Excellence in Defibrillation”, supported by latest paper by Dr Sheldon Cheskes et al, “Defib Current & Pad Efficacy”.
Is it time for A-P position from the start?
#OHCA #prehospital
Great to have been there!
Great to host Yorkshire Air Ambulance at Ortus House last week for a SPEAR course with Dr Jon Barratt.
Specialist endovascular resuscitation that delivers real‑time data to support critical on‑scene decisions during cardiac arrest.
@YorkshireAirAmb
#SPEAR #Resuscitation
