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.

 

 

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.

Continue reading

Test pilots wanted! Auckland HEMS app goes live

We are delighted to announce the release of the Auckland HEMS mobile app!

————————-

ALERT! January 2015: Since the publication of this post the app has been updated, including the launch of the Auckland HEMS simulation-based prehospital care curriculum podcasts. You can read  about the latest additions by clicking HERE

————————-

This app is a work in progress, and will be a living, dynamic project.

photo 2

Auckland HEMS home screen

We are very keen to have feedback regarding app development and improvement from the prehospital, aeromedical, and emergency medicine communities.

At the heart of the app are the emergency situation checklists that have been developed by Dr Robert Gooch (Canadian Emergency Medicine trainee and recent Auckland HEMS Fellow) and Dr Chris Denny (Auckland HEMS Medical Director).

Auckland HEMS also gratefully acknowledges the efforts of the pilots, paramedics, and crewmen who took place in the simulation-based usability-testing of the checklists, the work of Atul Gawande, and the international HEMS fellowship for allowing Dr Gooch to complete this patient safety initiative.

emergency checklist menu

The app also contains other clinical and non-clinical resources.

How can we make it better? We would like to hear your thoughts.

Please use the feedback button in the app, or post comments below.

The app was developed using a platform called ibuildapp‘. This is a web-based subscription service that has the following features:

  • straightforward user interface to construct and test the app – if you can create a powerpoint presentation, you can build an app!
  • NO coding required
  • apps created are functional on both iOS and Android
  • immediate updating – alterations to the master version will appear on user’s versions the next time they open the app
  • low startup costs compared to having an app professionally coded

The monthly subscription cost to Auckland HEMS increases as more users download the app. As a result we have had to introduce a small charge for iOS users to offset our ongoing costs. Due to some inflexibility regarding price alterations on Google Play (and a failure to read the fine print!), the app will remain free for Android users – it’s your lucky day…

No individual will make a personal profit from this project; any income above our development and subscription costs will go towards further app development and other Auckland HEMS educational and training activities.

uncle-sam-we-want-you

Our vision is to use a large team of ‘test pilots’ to make the app as effective as possible for clinical and operational use prior to creating a professionally coded ‘Auckland HEMS 2.0′.

ARE YOU UP FOR THE CHALLENGE?

A test pilot who WAS up for the challenge: Chuck Yeager and the Bell X1

A test pilot who WAS up for the challenge: Chuck Yeager and the Bell X1

Some improvement suggestions will be possible within the technical features of ‘ibuildapp’, but many will not, and these will be added to the future development list for version 2.0.

TO DOWNLOAD THE APP:

Click HERE for iOS users

Click HERE for Android users

Thank you for being a part of the Auckland HEMS team!