Chief Inspector Phillip Brooks of NSW Police Crash Investigation Unit (CIU) opened the day with insights into the state’s road mortality. With 185 000km of public roads and over 7 million people, Ch Insp Brooks believes that mobile phones will present the newest obstacle to road safety. Illicit drug use has been a target of the NSW police with rural areas showing high rates of drivers testing positive to substances like methamphetamines in particular. Ch Insp Brooks suggested that medical personnel may aid the CIU with information such as: survivability, nature of injuries and aerial photographs.

Two workshops were conducted thereafter. The first was a triage and tasking exercise by Dr. Clare Richmond, who works in the state retrieval office. The fictional tasking day commenced at 7am and quickly demonstrated the many constraints and logistics in tasking the assets of the state – a feature often overlooked when performing our retrieval missions. Dr. Jill Lee covered the next workshop on difficult ventilation, using the Oxylog 3000 plus. The benefits of volume control vs pressure control, waveform use, ramping and non-invasive ventilation strategies were discussed.

A quick trip to Virtual Reality sim suite placing doctors in the position of aircrewmen/paramedics/pilots, rapidly highlighted how complex and important radio communication and winching strategies were.

The day ended with case study of Sydney HEMS’ most recent clamshell thoracotomy. Interesting points which were discussed included:

• mitigating bystander trauma
• intubation vs LMA in this traumatic cardiac arrest
• delegation of duties such as aortic compression
• team leadership in the operating theatre, where there may not be a clear team leader, such as in the emergency department