HEMS April Education Day Summary

Cold & Hypothermia

Shital Patel presented a challenging case which outlined the importance of early detection of hypothermia pre-hospital trauma missions. She reviewed the topic of hypothermia in detail and to list a few of her many valuable pearls:

  • Reduce drug doses in hypothermic patients
  • Use only a single adrenaline and a single defibrillation in hypothermic patients in arrest. If no response, wait until core temperature is over 32C before repeat doses and shocks
  • Take great care when moving hypothermic patients as their myocardium is unstable and they can easily go into ventricular fibrillation.

 

Transport of Infectious Patients & PPE

Clare Richards gave an excellent presentation on the difficulties of transporting infectious patients. This is a good reminder to make sure you get your flu shot this year and know what size P2 mask you wear (small, regular, large). If in doubt about whether it is safe to transport an infectious patient, don’t hesitate to contact the DRC or ACC for advice. Road crews carry a card that lists the type of precautions for each infectious illness.

 

Literature Review

Kiran Somani gave an excellent review the following 2 articles:

Wafaisade A, Lefering R, Bouillon B, Böhmer AB, Gäßler M, et al. Prehospital administration of tranexamic acid in trauma patients. Critical Care. 2016 May 12;20(1):S3.

Lansom JD, Curtis K, Goldsmith H, Tzannes A. The Effect of Prehospital Intubation on Treatment Times in Patients With Suspected Traumatic Brain Injury. Air Med J. 2016 Sep;35(5):295–300.

 

Practical Environmental Temperature Control Workshop

Paul Kernick gave an interactive session on protecting both the medical team and patients from cold and wet temperatures. He covered the safety concerns when using a warming blanket, the importance of layering, and ways to stay warm using items in your pack if you have to spend the night in the bush.

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Simulation

Our immersive simulation for the day covered the initial assessment and stabilization of an unstable patient requiring a P1 interhospital transfer. This simulation highlighted the many priorities of care and considered how we might assign tasks during a time critical inter hospital retrieval. Themes covered included patient assessment, verbal prioritization of tasks (do this early and thoroughly), how to move an already sited ETT, double pumping inotropes, and the scenario rehearsed interacting with our hospital colleagues.

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Non-Technical Skills Bingo

The day ended with a presentation by Laurence Boss, a guest from St George hospital, with a fun learning exercise about non-technical skills.

 

The next HEMS Training Day will be on Wednesday 3rd of May 2017

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Vascular & Osseous Access in Resuscitation

Cliff Reid and Geoff Healy discuss challenges in prehospital intraosseous and intravenous access, covering how to avoid pitfalls and what their own individual practice preferences are in the prehospital and in-hospital settings (22 mins).

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Clinical Governance Day – Wednesday 22nd March

The next GSA-HEMS Clinical Governance Day is on Wednesday 22nd March at the new NSW Ambulance / Toll base.  This month we’re lucky to welcome Luke Regan who will be talking about the challenges of prehospital care in the Scottish highlands and the Highland PICT project.  Check out the website https://highlandpict.wordpress.com for more information.  In addition we have a review of a challenging vertical access and winch job by Marty Pearce as well as our regular mortality & mortality, learning from excellence, airway audit and review of winch operations.  All this and a BBQ lunch!

March 2017 CGD

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HEMS Education Day Summary 2017/1

The inaugural HEMS Education Day was held in the ACE Training Centre. Here is an overview of points covered.

Mission Oversight

Cameron Edgar outlined the mission oversight process, its history, and the ways in which it has reduced risks of helicopter operations. The policy is HELI.OPS.34 – Mission Oversight.

Handover

Jimmy Bliss provided an interactive session on clinical handover, as our first topic from the Diploma in Retrieval and Transfer Medicine syllabus

Winch Stretcher Packaging and Airway Workshop

Marty Nichols ran a workshop outlining use of the patient protection bag and the NEANN Immobilisation & Extrication Jacket (NIEJ), in order to manoeuvre a patient into the winch stretcher using just two rescuers. This created an opportunity to explore optimal intubating positions in remote environments for patients in the winch stretcher. Solutions included (a) placing the stretcher on a rock platform

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‘Rock’ platform allowing kneeling-height ergonomics

(b) using the NIEJ to elevate the head to the level of the stretcher side

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The NIEJ has been used to support the patient in a head elevated position on the edge of the basket stretcher. Note optimal ear-to-sternal-notch alignment.

 

This use of the NIEJ has the added advantage of moving the patient further up to allow neck extension if a surgical airway is required

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This exploratory workshop enabled the team to review options, none of which are official policy or operating procedure.

Simulation

The immersive sim designed and run by Rob Scott covered a trauma patient requiring multiple life saving interventions. Themes covered included handover, positioning of bags and equipment, task delegation, and prioritisation of resuscitative interventions.

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Literature Update

The day closed with excellent summaries by Kevin Ostrowski and Claire Seiffert of recent literature and guidelines we should be familiar with:

Weaver AE, Hunter-Dunn C, Lyon RM, Lockey D, Krogh CL. The effectiveness of a “Code Red” transfusion request policy initiated by pre-hospital physicians. Injury. 2016 Jan;47(1):3–6.

Frontera JA, Lewin JJ III, Rabinstein AA, Aisiku IP, Alexandrov AW, Cook AM, et al. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage. Critical Care Medicine. 2016 Dec;44(12):2251–7.

Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Critical Care Medicine. 2017 Jan;:1.

 

The next HEMS Training Day will be on Wednesday 5th April 2017

 

 

 

 

Posted in Airway, General PH&RM, simulation, Tips, training

First Education Day – Wednesday 8th March

march-8th-education-day-flyerThe NSW Aeromedical Retrieval Service would like to welcome you to our first Education Day for 2017 this Wednesday 8th March. This will be a regular event every 4 weeks and we would love to see a wide and varied attendance to maximise everyone’s learning experience.

This week we will be kicking off with Cam Edgar giving us some excellent perspective on Complex Mission Oversight and Planning. Jimmy Bliss will be providing some insight into studying for the Diploma of Retrieval and Transfer Medicine and covering off on how to approach Clinical Handover. We then have some great simulation and workshops to get involved in before rounding out the day with a look at some of the latest literature in Prehospital and Critical Care medicine. All this and a BBQ lunch!!!

See you there!

The Education Team

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CGD 22nd February 2017

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Next CGD at the new ACE training facility is on Wednesday 22nd February starting at 9am. We’ll be reviewing our cases, airway management and winch missions from January.  In addition we have a discussion of roping missions by Sam Immens and Jason Minns from Toll will be presenting an aviation safety case study.  There will also be a BBQ lunch.

All NSW Ambulance and Toll employees are welcome to attend.

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Seeing Is Believing

Our Sydney HEMS specialist Clare Richmond is one of the brilliant women in this video who inspire the next generation of authors, marine biologists, and HEMS physicians. The video was made for Sydney Opera House’s flagship All About Women festival.

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