Clinical Governance Day 25th March 2015

There are two exciting workshops planned for the day, covering management of obstetric emergencies and revising our basic neonatal resuscitation.

Prior to the CGD it would be well worth having a quick read of the following documents:

Pre-eclampsia

Obstetric Emergencies

Neonatal Resuscitation

See here for directions

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Clinical Governance Day 11th March 2015

It would be really helpful if everyone can prepare for the session by having a read through Life in the Fast Lane’s description of pacing, and watch this short video on pacing with the Lifepak15

See here for directions

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STaR-studded Simulation

Simulation, Training and Research (STaR) shifts have recommenced at Bankstown this week with registrars putting each other through their paces with daily simulation.

Scenario – Road team attending a 70 year old male who has fallen 4-5m from his roof landing on his right side. He has sustained an obvious head injury with reduced consciousness and brisk scalp bleeding.

Scene – Male patient in right lateral position at base of wall. First-responder team arrived 5 mins earlier and applied a collar, placed an IV and have given IV ondansetron for “vomiting on several occasions”. They are struggling to control bleeding from a scalp laceration. Wife has just told paramedics he “only takes warfarin for AF”.

STAR SIM 01 02-03-15

Patient – Obtunded with partial airway obstruction and a briskly bleeding right scalp laceration. Extensive right chest wall contusions with subcutaneous emphysema and reduced air entry. RR 28, SaO2 93%, P 105 (AF), BP 148/90, GCS 6. Pupils equal 4mm.

Learning points from debrief:

  • Obtain observations as early as possible. This only helps to prioritise care and interventions.
  • Optimise the environment to optimise your resuscitation. Move the patient to a safe location to make your care easier.
  • Adopt neuroprotective measures post-RSI for all patients with traumatic brain injury. Don’t forget to reassess the pupils.
  • Control brisk scalp bleeders if possible. Employ others to apply direct pressure & don’t forget that we carry staples !!
  • If possible notify the receiving ED for potential need for early warfarin reversal (PCCs & FFP).

STAR SIM 02 02-03-15

Thanks to Dan (Doc), Laurie (Para), Alex (SRC), Jimmy (trusty assistant #1), Keith (trusty assistant #2) & Chris (STaR).

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Clinical Governance Day 25th February 2015

 Sandra Ware will be talking through the recently published Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) Trial. It’s worth having a read through the article (unfortunately not open-access) before the Clinical Governance Day

See here for directions

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Simple surgical airway technique

Model and pig cricothyroidotomy practice at Sydney HEMS Induction 2015 demonstrating the approach: DECISION, INCISION, FINGER, BOUGIE, TUBE, CUFF, ETCO2 by Cliff Reid and Karel Habig

 

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PEEP For Lung Recruitment

As we continue to increase the number of ways to use our procedure lab day for training, Dr Geoff Healy demonstrates the effect of incremental PEEP on lung recruitment in a pig carcass at Sydney HEMS Induction Training

 

 

See here for how we apply lung recruitment strategies in difficult-to-oxygenate patients.

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Advanced Airway – Flexible Optic Intubation

Dr Geoff Healy explains the use of the Ambu a-Scope 2 for flexible-optic intubation at HEMS Team Induction Training in Sydney.

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