Pre-Hospital Emergency Medicine

by Amy Royston, NSACC Treasurer 2017-18

We joined with NEMSOC (Newcastle Emergency Medicine Society) to create an event featuring a talk by Dr Chris Johnson, an Anaesthetics Registrar and Great North Air Ambulance medic, a mass casualty simulation, and clinical skills stations that would be used by pre-hospital medics on call outs.

The evening started with a presentation and several case discussions from Dr Johnson. He covered the ABCDE approach to assessing a casualty, explained the role of GNAA consultants when having to travel to emergencies, and showed us some pretty gruesome pictures that he’s had to attend to! Everyone found talk inspiring, highlighting all the benefits and excitement to be gained from a career in pre-hospital medicine.

Following the talk, the group was split in two; based on levels of previous experience in Emergency Medicine and Anaesthetics. For the more experienced, they started with the mass casualty situation before moving through to the clinical skills lab for stations on C-spine immobilisation, combat application tourniquets, pelvic binder application and IO needle insertion.

The mass casualty event was run by the NEMSOC committee, and featured 4 patients with varying degrees of “injury” following an explosion. We were split into smaller teams for each patient, with one overall leader who was to oversee the medial treatment and decided the priority for them to be removed to hospital. One patient was severely bleeding and required the use of tourniquets, another needed the c-spine collar and release of a tension pneumothorax, one was defibrillated and intubated, and the other had a head injury. It was fantastically organised, and all members were involved in using the skills they had just been taught by NSACC.

The skills stations were run by trainees and consultants in both Emergency Medicine and Anaesthetics. All members had the chance to practice applying a cervical collar, and identify the small mistakes that are frequently made with doing so. There was the chance to practice running to our casualty and quickly applying a Combat Application Tourniquet that all emergency crews, police and the army carry. It was enlightening to learn how many lives this simple piece of equipment has saved; both here and in Afghanistan. The pelvic binders came in a range of different styles and were complicated to apply, but are a regularly used and vital piece of equipment in a queried pelvic fracture. Finally, we had to opportunity to use the intra-osseous needles and drill to give fluids when vascular access cannot be achieved. These are all skills we do not practice within our degree curriculum, but are achievable and can dramatically change a patient’s outcome. It gave great insight into what would be required from both career paths.

 

We had excellent feedback from all of those that attended, and they wished for more joint events in the future.