The Clot Module

From Dr Chris Denny, Auckland HEMS Medical Director:

Dear colleagues,
1. We need your help.
We are testing a new clinical module: The ‘Clot Module.’
Why do we want another module? To borrow an ergonomic phrase – to task cluster.
2. Please read this article (password-protected for Auckland HEMS team members only) from the 2014 Annals of Surgery; the abstract is here
3. Our early experience with prehospital blood transfusions suggest that while the mechanics of administering blood are straightforward, the cognitive stress associated with trying to perform this task, plus obtain vascular access, plus keep the patient alive, in the dark, in the rain, makes it a challenge in real life. Our vision is to cluster:
  • Two units of whole blood stored in our Credo Blood Cooler

with:

  • Pumps sets
  • TXA
  • Belmont Buddy Lite Fluid Warmer
  • checklists, wristbands and paperwork

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Early testing in Clinical Simulation Lab (AW169 mock-up)

Early testing in Clinical Simulation Lab (AW169 mock-up)

4. In the spirit of the ‘flipped classroom’, please review these three videos before or at the start of your next HEMS shift. We will then progress through a series of drills to enable our clinicians to improve their knowledge and skills in the arena of advanced circulation. Please see yourselves in the role of test pilots. It is through usability testing that lessons will be learned.
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5. There are many people to thank for getting us this far:
Dr. Paul Blakemore (Auckland HEMS Fellow)
Dr. Richard Charlewood (New Zealand Blood Service)
Jonathan Davies (UK Medical Student on Resuscitation elective with Auckland HEMS)
Stefan Gabor (ARHT Clinician Educator)
Rob Gemmell (ARHT Paramedic Lead for Equipment & Ergonomics)
Dr. Alana Harper (Auckland HEMS Lead for Safety & Quality)
Dr. James Le Fevre (Auckland HEMS Lead for Strategy & Innovation)
Dr. Cameron Rosie (Auckland HEMS Lead for Operations; Equipment and Ergonomics)
Plus our colleagues at Sydney HEMS, MedSTAR and the Scottish EMRS for sharing their wisdom.
Please share your questions and suggestions with us.

Auckland HEMS app updates

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

Usability testing of new Auckland HEMS packs

By Dr Chris Denny, Auckland HEMS Medical Director

IMG_8142

New packs for Auckland HEMS

In the early days of Auckland HEMS, we loosely ‘bolted on’ our equipment to the existing paramedic gear. As time passed and we forged a strong collaborative relationship with our paramedic colleagues, the performance gap in our gear required a solution. One year ago we held an ‘Ergonomic Equipment Exercise’, led by Dr. Samantha Bendall (on sabbatical from Sydney, NSW). From this evening of pack testing we learned to focus on integration. Several design concepts guided our work:

a) Functional coherence
b) Facilitation of communication
c) Facilitation of task accomplishment
d) Adaptable space
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We are now testing our prototype packs.
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This testing will move through three phases:
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Phase I: ‘Kicking the tyres”
Phase II: Simulation-based usability testing (carrying the packs, winching the packs, airway tasks, vascular access tasks, splinting tasks,…)
Phase III: Live operational testing
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Here is a valuable website: www.usability.gov
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ARHT paramedic Rob Gemmell winches with one of the packs

ARHT paramedic Rob Gemmell winches with one of the packs

We are very keen to learn from the HEMS community. What are other services using? What works? What is the future of PHARM medical equipment going to look like?

Please share your thoughts using the ‘comments’ section below, or the  ‘contact’ button on the home page of this site.