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This is a pretty special episode! If you’re involved in cardiac arrest management or care of critically unwell patients then there’s some ground breaking practice we’ll be discussing with the two founders of the SPEAR course;

Jon Barratt;

  • Lt Col, British Army
  • Emergency Medicine and PHEM Consultant, University Hospitals of the North Midlands
  • Clinical Lead – Research and Clinical Innovation, Yorkshire Air Ambulance
  • MERIT Consultant, West Midlands Ambulance Service
  • Senior Lecturer, Academic Department of Military Emergency Medicine

Paul Rees;

  • Surgeon Commander Royal Navy
  • Consultant, East Anglian Air Ambulance & Barts Heart Centre
  • Lead for Resuscitation Barts Health NHS Trust
  • Reader in Cardiology & Resuscitation, University of St Andrews & QMUL London
  • Defence Lead for Endovascular Resuscitation
  • SPEAR co-founder

Ultimately in the episode we navigate through to the delivery of endovascular resuscitation both pre and in-hospital, building on the fundamentals of care and logistics which enable its delivery. We’ll be covering;

  • Blood pressure monitoring both invasive and non-invasive, the evidence and the cohort of patients we should be targeting with invasive blood pressure monitoring
  • Delivering complex medical interventions in unpredictable circumstances and environments
  • Balancing the benefits of interventions with time required and workflow
  • REBOA for medical arrests, the theory and the ERICA trial
  • Improving recognition of ROSC
  • The SPEAR course
  • How to prepare services and departments for upcoming advances in resuscitation

There is something for everyone in here and a huge thanks to Jon and Paul for their time. Make sure to check out the links to the papers discussed in the episode below.

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

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References

SPEAR – EMTACCS Course

Implementation of advanced vascular access, physiological monitoring and goal-directed resuscitation during OHCA in a helicopter emergency medical service. Shadman. J Vasc Access. 2025

Implementation of a point-of-care ultrasound archiving system and governance framework in a UK physician-paramedic staffed helicopter emergency medical service. Aziz. SJTREM. 2024

Prehospital invasive arterial blood pressure monitoring in critically ill patients attended by a UK helicopter emergency medical service– a retrospective observational review of practice. Butterfield. SJTREM. 2024

A protocol for the ERICA-ARREST feasibility study of Emergency Resuscitative Endovascular Balloon occlusion of the Aorta in Out-of-Hospital CardiacArrest. Shadman. Resuscitation Plus. 2024

The association between intra-arrest arterial blood pressure and return of spontaneous circulation in out-of-hospital cardiac arrest. Resuscitation. Aziz. 2024

Short and long-term complications of prehospital arterial catheterisation performed by a Helicopter Emergency Medical Service in the United Kingdom. Sin. Crit Care. 2025

Selective aortic arch perfusion: a first-in-human observational cadaveric study. Simpson. SJTREM. 2023

Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Yannopoulos. Lancet. 2020

Feasibility of Pre-Hospital Resuscitative Endovascular Balloon Occlusion of the Aorta in Non-Traumatic Out-of-Hospital Cardiac Arrest. Brede. J Am Heart Association. 2019