Preparation for patient retrieval – podcast and checklist

The first RFDS aircraft

The first RFDS aircraft

While Auckland HEMS does not currently perform many inter-hospital transfers, we anticipate that we will be doing more of this work in the future.

Our colleagues in Australia do a lot of these missions, and have produced some great FOAM resources.

This audio clip (right click to save) is a podcast from Minh Le Cong at prehospitalmed.com, in which he, along with Cliff Reid and Brian Burns from Greater Sydney Area HEMS discuss pearls and tips in preparing the critical patient for retrieval and transport.

Minh’s page for the podcast is here, and includes a very useful post by Tim Leeuwenburg from ruraldoctors.net in the comments section.

Tim’s checklist for patient transport is located here.

Helicopter cabin design for emergency medical services and interhospital transfer

AW169

AW169

ARHT is purchasing an AgustaWestland AW169, due for delivery in 2015. This provides an opportunity to to create a purpose-built interior that will best serve the helicopters mission profiles, and a considerable amount of planning is going into this.

This paper, published in Air Medical Journal 2012, details how specific cabin elements were designed and constructed for a German EC145 (the successor to the BK117 that the ARHT currently operates). Key to the design was a sliding module containing essential medical and monitoring equipment – the module can slide a considerable distance out the rear doors of the helicopter to aid the process of loading/unloading ventilated patients with lots of monitoring equipment in situ.

Full-text pdf of this article is available here (secure area limited to ADHB staff only – ADHB maintains an online subscription to this journal through the Philson Library at the University of Auckland School of Medicine)

Summer in New Zealand

The New Zealand summer runs from December to February inclusive. At midnight on the 30th of November, the following rules come into effect:

1) the entire population must spend as much of the summer at the beach as possible

2) Living in New Zealand for more than three days qualifies you to operate a powerboat or yacht

3) alcohol hones your water safety skills and judgement

4) wearing life jackets, using fins with your bodyboard, swimming between the flags, and using dive decompression tables are all signs of weakness

Here is someone from Christchurch who clearly believes rules 1,2,3, and part of 4:

With these rules in mind, here are some slide sets regarding pathology that we may have to deal with over the summer:

Key issues for Auckland HEMS:

1) The hyperbaric chamber is at the Devonport Naval Base. They have minimal medical equipment and DO NOT have the capability to receive critically ill patients directly from the prehospital setting (I have discussed this with them before!). Critically ill patients will require transport to hospital with a subsequent trip to the decompression chamber.

2) our helicopter is not pressurised – transportation of patients with DCS or AGE should occur below 1000 feet of altitude

The contact number for the decompression physician (24 hours) is 0800 4 DES 111

Patients with submersion injuries may have been treated by Surf Lifesaving New Zealand. A link showing the tiers of Surf Lifesaving prehospital medical care is here. They may have access to AEDs, oxygen, monitoring, and cervical collars, but do not generally have access to advanced airway management.