Author Archives: Scott Orman

About Scott Orman

Emergency Medicine Specialist, Auckland Hospital; Auckland HEMS Doctor

Auckland HEMS Air Ambulance Fellows wanted!

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Fellow – Adult Emergency Department–076540
Update April 2015: Applications for this round of Fellowship positions are now closed. If you wish to make an informal enquiry about working with Auckland HEMS please use the ‘contact’ section of this website. Thank you for your interest in Auckland HEMS!

Helicopter Emergency Medicine Service (HEMS)

Fellow position – 6 month fixed term (ACEM accredited special skill term in Air Ambulance)

June 2015 – December 2015

Auckland City Hospital is the largest public Hospital in New Zealand and one of the best trauma centres in the country .The Emergency department is a modern purpose built, world class facility that opened in 2003. We have an enthusiastic team of clinicians who have expertise in resuscitation, ultrasound, simulation, toxicology and retrieval medicine. The closely knit team consists of  FACEM’s, Medical officers and Resident Medical Officers. The department sees about 60,000 adult patients annually with a high patient acuity.

The department in conjunction with the Auckland Rescue Helicopter trust run the Helicopter Emergency Medical service (HEMS) which has been successful in providing fully integrated care for trauma patients. The department is also active in research and is currently involved in a number of key national and international projects.

The Adult Emergency Department is accredited by the Australasian College for Emergency Medicine (ACEM) for Advanced Training. We run a highly successful fellowship training program and are accredited for special skills training for Air Ambulance retrieval work which is both ICU inter-hospital transfer and primary response by Helicopter.  The Department is affiliated with the University of Auckland, Schools of Medicine and Health Science and is actively involved in clinical and university based teaching. The department runs several courses including the ACME course, ACLS, Ultrasound and difficult airway courses.

Eligible Applicants

This Fellow position is an ACEM special skills post in Air Ambulance and will involve working on the Helicopter Emergency Medical Service (HEMS) and in the National Air Ambulance ICU retrieval service.

Suitably qualified candidates can discuss the position with the AED Clinical Director, Dr Anil Nair at aniln@adhb.govt.nz  or Dr Chris Denny Medical Director of the HEMS service at CDenny@adhb.govt.nz.

For more information please contact Ansonette Willemse, Recruitment Consultant, at Ansonett@adhb.govt.nz quoting job title and reference number 076540.

Apply now at www.careers.adhb.govt.nz. Please attach a Cover Letter and your latest CV as only applications submitted online via the ADHB website will be accepted. Any emailed applications will not be acknowledged or considered.

Applications close: 3 March 2015.

For the biggest health sector job board in New Zealand visitwww.kiwihealthjobs.com

Auckland HEMS dealing with unsuccessful job applicants

Auckland HEMS deals with an unsuccessful job applicant

Auckland HEMS app updates

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Firstly, thank you to all of you for your interest in and support of the Auckland HEMS app! In addition to the Auckland HEMS team, we have over 250 app test pilots from other services and locations, and have received valuable feedback about functionality and content.

Prehospital transfusion SOP

Prehospital transfusion SOP

The app has undergone a series of updates in recent days, as you may have noticed from the push notification spam appearing on your phones (apologies, this is an automatic feature that I have not yet figured out how to turn off!) The iBuildapp platform offers automatic updating on users’ phones, so you should (in theory) have the most up-to-date version already; if however the app is crashing I suggest deleting and re-installing it. Android users may encounter an ‘error 961’ when reinstalling the app, if so follow these instructions, or perhaps just buy an iPhone…

The most important additions to the app are the SOP and checklist for prehospital blood transfusion. As of today, Auckland HEMS will be carrying a unit of Whole Blood on prehospital missions.

 

interactive checklists

interactive checklists

Other additions include:

* Interactive checklists – Auckland HEMS checklists now include tick boxes that can be filled in as the checklist is completed. There is not yet a functional feature to export the data (this is a work in painful progress!) but in the meantime a completed checklist can be preserved on a smartphone by taking several screenshots.

* Expanded ‘resources’ section – a project has begun to turn the resources section into a prehospital and aeromedical reference library, with links to podcasts, video, and other useful clinical material. What do you think should be in the ‘resources’ section? Please use the feedback button in the app to let me know about your favourite resources so they can be included.

* Map feature with live tracking

Thank you again for your interest in the Auckland HEMS app, and please keep the feedback coming!

 

resources

resources

map feature

map feature

map feature

Auckland HEMS prehospital blood transfusion – coming soon to a helicopter near you

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Bloody hell.

Pretty much summarizes the severe traumas that define the essence of our trade.

And sometimes, the answer to critical bleeding is to give blood.

We are grateful to our colleagues at Sydney HEMS, who advise: “blood is provided to transfuse patients with life-threatening bleeding after meticulous attention to hemorrhage control.”

Auckland HEMS is poised to begin providing prehospital blood as part of our bundle of critical clinical interventions. We are fortunate to collaborate with the New Zealand Blood Service and with our local District Health Board to provide this service. http://www.nzblood.co.nz

Herein, please find our training video. We welcome your feedback.

Our draft Blood SOP is undergoing usability testing with our clinical teams. Once finalized, we will share this for FOAM.

This is an unsystematic review of the current literature. A few themes are emerging:

1. There is now evidence of survival benefit in the military and in the civilian literature.
2. Beyond packed red blood cells, services are also exploring the use of plasma, and of whole blood.
3. Pouring in blood is frivolous without meticulous hemorrhage control.
4. If we are to forge strong links in the chain of trauma survival, these critically ill patients must move quickly to definitive care. We are working with our local trauma centres to move seamlessly from out of hospital into ED, Resus, Operating Theatres and Critical Care. Please share your experiences with us.
—
Dr Chris Denny, Auckland HEMS Medical Director
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(Auckland HEMS team members click HERE for access to the draft SOP)
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References:

Pretrauma Center Red Blood Cell Transfusion Is Associated With Reduced Mortality and Coagulopathy in Severely Injured Patients With Blunt Trauma

Prehospital blood transfusion in the en route management of severe combat trauma: a matched cohort study

Initial UK experience of prehospital blood transfusion in combat casualties

The effects of prehospital plasma on patients with injury: a prehospital plasma resuscitation

The feasibility of civilian prehospital trauma teams carrying and administering packed red blood cells

Prehospital Transfusion of Plasma and Red Blood Cells in Trauma Patients

Emergency whole-blood use in the field: a simplified protocol for collection and transfusion

Blood Far Forward–a whole blood research and training program for austere environments

Australian Patient Blood Management Guidelines

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…and for simulation purposes, here is a blunt force trauma scenario:

An unidentified surfer discovers the hazards of being caught inside at a notoriously shallow reefbreak during the biggest swell in two years..