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.
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.
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.
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