About Scott Orman

Emergency Medicine Specialist, Auckland Hospital; Auckland HEMS Doctor

Safe transport of a patient undergoing CPR

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

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

Checklists – Part 1

By Damjan Gaco, MD, ARHT HEMS Fellow

History

The origin story of checklists goes as follows: A pilot in the 1930’s stepped off a newly built bomber and said something along the lines of “that is too much plane for one person to handle”. In an ever more complicated world, those words echo true today – especially in the field of medicine. For example, the act of intubation carries many steps – all important: pre-treatment, induction, intubation, back-up plans, confirmation of tube placement, post-tube sedation, and post-intubation care. A post written two years ago by then Auckland HEMS Fellow Dr. Robert Gooch outlines this ever-complicated environment, and the ultimate goal of reducing burden on clinicians.

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