Education Day – Wednesday 31st January 2024

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Coffee & Cases Snippets – November 2023 Newsletter

Coming to you a little later than the release date, here are the top coffee and cases learning snippets from November 2023.

  1. In cases of major haemorrhage or difficult IV access – consider inserting a trauma line.
  2. If you feel that a job is running too slowly, declare this to the team and ensure both members are matching their speeds. Slow is smooth, smooth is fast.
  3. Promethazine 12.5mg IV – effective for motion sickness and light sedation for long transport times to hospital.
  4. QuikClot is for compressible haemorrhage. It requires pressure for at least 3 minutes in order to be effective. Consider it as an extension of your finger into the hole.
  5. If a patient is haemodynamically unstable or has a labile BP, double pump your inotropes. The medical team should be prepared to maintain oversight of this at BOTH ends of the transfer.
  6. Two NPAs and an OPA with jaw thrust (“tripod” or “supported tripod” with jaw thrust) should be used if there is difficulty maintaining an open airway.
  7. Apply a pelvic binder, when indicated, ASAP. There can be a tendency to lay the binder across the stretcher and apply it after moving the patient there – this may however involve multiple moves with the pelvis not stabilised. Try to get the binder onto the spine board (which is used for extrication) or slide it directly under the patient prior to rolling/extrication.

Keen for more Coffee & Cases Snippets goodness?

Why not test yourself and learn at the same time with this C&C snippets quiz! You might learn something too 🙂

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Clinical Governance Day – Wed 17 Jan 2024

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HEMS Debrief #11 – Dr Ruby Hsu

Welcome to episode 11 – likely our last episode of the year!

The feedback has been fantastic – thank you to all who have taken the time to let me know your thoughts, and for helping to shape the episodes into what they are.

In this end of year episode, we are joined by Sydney HEMS Staff Specialist Dr Ruby Hsu. Ruby and I sat down for a chat with no real agenda, but knowing that she had a fantastically varied and colourful pre-hospital career across several countries, I thought it valuable to hear Ruby’s thoughts on – amongst other things – safe systems, career building, and luck.

I hope you enjoy it, and speak to you in the New Year.

Sam

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Education Day – Wednesday 3rd January 2024

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Clinical Governance Day – Wed 20 Dec 2023

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HEMS Debrief #10 – Dr Brian Burns (part two)

Join for the second part of Dr Brian Burns’ episode, as we continue to discuss mimics of shock in our trauma population.

See some show notes below for more resources.

Thanks for listening!

Show notes:

Reference on pulmonary embolism: https://emcrit.org/pulmcrit/eight-pearls-for-the-crashing-patient-with-massive-pe/

Reference on pulmonary contusion: https://pubmed.ncbi.nlm.nih.gov/30906578/

Reference on pulmonary contusion lung ultrasound: https://coreultrasound.com/pulmonary-contusions/

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HEMS Debrief #9 – Dr Brian Burns (part one)

In the ninth episode of the Sydney HEMS Debrief series, we have the first half of a two-part episode!

Join us as Sydney HEMS Senior Staff Specialist Dr Brian Burns discusses the recognition, aetiology and treatment of different types of shock in our pre-hospital trauma patients. Whilst pre-hospital clinicians may have a natural bias towards hypovolaemic shock secondary to blood loss, Dr Burns discusses the many mimics of hypovolaemic shock, and how it is crucial we remain mindful of other causative acute and subacute pathologies.

See some show notes below for more resources.

Thanks for listening!

Show notes:

Reference on impact brain apnoea: https://pubmed.ncbi.nlm.nih.gov/27211834/

Reference on spinal cord injury: https://www.nature.com/articles/nrdp201718

Reference on blunt cardiac injury: https://www.aast.org/resources-detail/blunt-cardiac-injury

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Clinical Governance Day – Wed 22 Nov 2023

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HEMS Debrief #8 – Dr Nat Kruit

Welcome back to the Sydney HEMS debrief! In this episode 8, we are joined by the extraordinary Dr Nat Kruit. Dr Kruit is a Sydney HEMS Consultant, Cardiac Anaesthetist, and ECMO Specialist. Given the increasing global chatter around ECMO, and to give it its full name, extracorporeal membrane oxygenation is going to be the focus of this episode. Join us as Dr Kruit takes us through the physiology, patient selection, and retrieval considerations of this fascinating – and very specialised – area of medicine.

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