Author Archives: Scott Orman

About Scott Orman

Emergency Medicine Specialist, Auckland Hospital; Auckland HEMS Doctor

Auckland HEMS Prehospital and Retrieval Medicine Practitioners Wanted

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By Dr Chris Denny
Medical Director, Auckland HEMS
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The Auckland Helicopter Emergency Medical Service (HEMS) was established in 2011. An initial two-year (week-day only) pilot to assess the value of a doctor-paramedic critical care team was guided by the CEOs of the ADHB and the ARHT, with clinical support from Drs Robin Mitchell, Tim Parke & John McDougall (a strong Scottish connection).
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After two years, the DHB Clinical Practice Committee reviewed this pilot project, lending their support and approval for the HEMS doctor-paramedic model to expand to every day of the week. Our HEMS doctors currently represent Anaesthesia, Emergency Medicine and Intensive Care Medicine. Senior Medical Officers are drawn from across the region, including Waitemata, Auckland, Counties Manukau & the Bay of Plenty.
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Recognising the development of Prehospital and Retrieval Medicine in Australasia, Auckland HEMS became the first service in New Zealand to be accredited by the Australasian College for Emergency Medicine for training in Prehospital and Retrieval Medicine. Our service was re-accredited for five years in 2018.
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We are now a regional service. As the Northern Rescue Helicopter Trust, we are now building our capability into a NASO Service Category One team: This will provide a 24/7/365 continuous doctor-paramedic service to our region.
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Please consider joining our team.
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We need your help!

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By Dr Chris Denny
Auckland HEMS Medical Director
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Colleagues,
1. We are in the midst of prototyping our new clinical packs. And we need your help. Soon we will be flying in our AW169.
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It is five years since we last redesigned our packs – details are here.
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3. The concepts of ergonomic design remain current:
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a) Functional coherence
b) Facilitation of communication
c) Facilitation of task accomplishment
d) Adaptable space
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 4. We welcome your feedback. 
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 Here are two videos of our prototype packs (with our Clinical Leads for Ergonomics and Equipment explaining their design philosophy):
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And here are a few photos of the individual modules:
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IMG_0948
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IMG_0958
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The Airway and Ultrasound modules use foam inserts. This is a new concept for us.
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Your input would be greatly appreciated.
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Feel free to join us on Twitter: @aucklandhems
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Safe transport of a patient undergoing CPR

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Dr Chris Denny, Auckland HEMS Medical Director

 

Much of critical care medicine is a race. A relay race.

teamwork

 

Enhancing the chain of survival for cardiac disease requires a series of interdependent tasks:

ED ECMO 36 – Crushing the nihilism of cardiac arrest

 

In the Auckland region, we are fortunate to work with an excellent ‘team of teams’. Our team includes:

A regional alliance

Clinically focused tasking

A prehospital and retrieval medical team – Auckland HEMS and ARHT 

A resuscitation hub

Interventional Cardiology

Extra-corporeal membrane oxygenation (ECMO)

 

The 2015 ILCOR Guidelines state:

Mechanical Chest Compression Devices 2015 (Updated) – The evidence does not demonstrate a benefit with the use of mechanical piston devices for chest compressions versus manual chest compressions in patients with cardiac arrest. Manual chest compressions remain the standard of care for the treatment of cardiac arrest. However, such a device may be a reasonable alternative to conventional CPR in specific settings where the delivery of high-quality manual compressions may be challenging or dangerous for the provider (eg, limited rescuers available, prolonged CPR, CPR during hypothermic cardiac arrest, CPR in a moving ambulance, CPR in the angiography suite, CPR during preparation for ECPR).

This short video is a credit to our Auckland City Hospital Emergency Department Nurses. And to our Auckland HEMS Fellows. I would especially like to thank Dr Sean Fair (The University of Calgary). This video was shot in one take, then edited, all on Sean’s smartphone! Since my technical prowess peaked in the days of making a ‘mixed tape’, I am grateful for the next generation of wizardry.

 

With thanks to the nursing team at AED. And to Dr Chase Krook (Auckland HEMS Fellow) for serving as our Lead Actor.

We value your feedback. How do other services interact with their Emergency Departments and Interventional Cardiology teams? In our service, we are working with Cardiology to develop our pathways to definitive care.

 

 

MEDUMAT Standard 2 Ventilator

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By Dr Brendan Wood – Auckland HEMS Fellow, and Stefan Gabor – Intensive Care Paramedic, Clinical Educator

The ARHT has recently purchased the Weinmann Medumat Standard 2 Ventilator. The introduction of a modern transport ventilator will provide the service with additional ventilation and monitoring modalities to improve the care we can offer to our patients. In addition, our new ventilators will allow us to offer non-invasive ventilation which will be a new modality for many of our team. With additional capabilities comes increased complexity both operationally and clinically. The educational team will be commencing a simulation based curriculum shortly to train duty crew in the use of our new ventilators and in that context we would like to provide resources to maximize your learning. Please note that mechanical ventilation is a vast subject and education around this topic will be ongoing.

Click here to access the education package