The Third Rule of PHARM

KNOW YOUR LOCATION

HAVE A LINE OF RETREAT

Whether its a trip down the corridor to the CT or MRI scanner or a flight into a remote location hundreds of miles from anywhere, the astute retrieval practitioner should be familiar with the geography, know the routes of escape/retreat and have backup plans

You need to know how long its going to take to drive a ventilated patient back to the air strip to load onto your fixed wing aircraft? Why? because you might run out of portable oxygen if you seriously underestimated the time!

That trip to the CT scanner..do you know how far it is, what obstacles might present themselves like dodgey lifts? Are you prepared to handle critical events en route and in the remote location like the CT scanner? What lines of communication and backup do you have established prior to leaving your ED or ICU? What is the physical layout of the CT room? Can you intubate normally there or do you have limited space so less staff able to assist?

NEVER ENTER A ROOM OR GO TO A REMOTE LOCATION WITHOUT KNOWING IF YOU CAN LEAVE IT IN A HURRY!

SO, study maps of your region, landing points in remote areas. Even better go and visit these areas in your spare time, talk to the people living there and ask about how past emergencies were handled. Same in your hospital. Walk the routes of passage to your CT or MRI from your ED and ICU. At start of shift, walk the routes again to see if anything has changed. Maybe some building work has started and has changed the route you would normally take.

And THEN DO FIRST AND SECOND RULE OF PHARM !

NOW HERE IS A GOOD EXAMPLE OF ALL THREE RULES OF PHARM. WATCH AND LEARN!

See how knowledge of London Traffic and roads is vital for a rapid road response..its not just using GPS device!

See how leadership and command skills provides effective CRM when the retrieval team arrives to the ambulance crew. Everyone in the ambulance has a role and knows it.

See how there is rapid but thorough checking of the intubation gear, drugs and procedure talk through.

The THIRD RULE OF PHARM

KNOW YOUR LOCATION

Minh