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


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


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.
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.

Tranexamic acid podcast and resources

In this post Andrew Petrosoniak discussed the use of tranexamic acid in the prehospital trauma setting, and  Auckland HEMS is currently developing a prehospital protocol its use in our service.

About a year ago, Scott Weingart from interviewed Dr Tim Coats, one of the lead authors of the CRASH 2 trial. The interview, which covers a lot of practical territory, became a podcast on in early 2012.

The podcast is here.

Dr Weingart’s ‘show notes’, which include a link to a draft protocol by Minh Le Cong for tranexamic acid in the prehospital setting, are here.