Patient safety in helicopter emergency medical services (HEMS): The safety management system

alanah2013's avatarAuckland HEMS

“Insanity: doing the same thing over and over and expecting different results”. Albert Einstein.

You could be right in thinking that “safety crusaders” are the glass half empty type, right? Those that believe “what can go wrong, will go wrong” (Murphys Law).

I’m not a pessimist, but I do believe in being prepared for the potential for error, or for when things do genuinely go wrong.  We need to avoid Einstein’s insanity; repeating that same thing and expecting different results the next time (as the next time might be a catastrophic outcome).  As HEMS clinicians we have a responsibility to get our patients from the pre-hospital to the hospital environment without harm, to the best of our abilities.  A culture of safety and forethought, identifying and mitigating for potential hazards (threat and error management) is a prominent facet of our work.

Both Aviation and medicine involve…

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A Military Aviation model for Patient Safety?

alanah2013's avatarAuckland HEMS

In the September 2013 edition of the British Medical Journal, Robyn Clay-Williams has published a thought provoking article on the modelling of clinical risk management on civil aviation practices, and questions whether a military aviation model may be more prudent when assessing and managing risk in the healthcare environment.  The abstract can be found HERE.

The author questions the appropriateness of translating sometimes rigid civil aviation processes (and a zero tolerance for risk) into healthcare, as some healthcare systems (such as emergency departments and intensive care units) need more flexibility and autonomy in their workings and risk management. She suggests managing risk in high stakes clinical environments such as these would be more conducive to a military aviation model – the parallels being teams with limited resources who deal routinely with unpredictable situations, complex and time critical operations (as would happen frequently in the pre-hospital environment or the ED…

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Prehospital RSI in the UK

Robbie (@AmboFOAM)'s avatarAmboFOAM

I’m currently away in Japan getting some skiing in, so I’m not up to much I terms of posting.

However, whilst waiting for my wife to return from a shopping rampage in Tokyo, I did catch this post over at the brilliant ScanCrit site about HEMS use of RSI in East Anglia.

It adds to the belief that I have long held: prehospital intubation is not bad if it is done well; it’s prehospital intubation done poorly that is bad.

While you are over at ScanCrit, check out the rest of the site, these guys (and gals?) post some excellent stuff.

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PODCAST #23 – Emergency Trauma Mx with Andy Buck @EDexam

Http://about.me/timleeuwenburg's avatarRural Doctors Net

I have just got back from Melbourne, where I attended the new EMERGENCY TRAUMA MANAGEMENT course. I was deadset keen to attend this, as I intuitively feel that organisers Dr Amit Maini  (EDTCC.com) & Dr Andy Buck (EDexam.com.au) are seeking to bring the same level of FOAMed goodness to Emergency medicine as I am via the RURAL MEDICINE MASTERCLASS. Over and above that, the new ETM Course takes attendees to places that aren;t covered on the usual ‘merit badge’ courses. I am a Course Director for EMST-ATLS and have become increasingly frustrated that the College of Surgeons content does not meet the needs of modern trauma teams.

A full report will be forthcoming shortly via Dr Jeram Hyde (@CriticalHabits), but for me highlights included :

  • a credible and experienced Faculty who facilitated short lectures and hands on skill sessions
  • use of high rep, low fidelity…

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Snakebite in Australia: a practical approach to diagnosis and treatment (December MJA article)

Eastern Brown Snake from Wikimedia site

Continue reading “Snakebite in Australia: a practical approach to diagnosis and treatment (December MJA article)”

Another Podcast with AmboFOAM and KangarooBeach

Robbie (@AmboFOAM)'s avatarAmboFOAM

I was fortunate last night to be able to catch up with Tim Leeuwenberg of ruraldoctors.net  when he flew in to Melbourne for the ETMCourse.  Along with a very convivial dinner at Bistro Vue on Little Collins street, we managed to bash out a quick podcast as well.  We discussed a little of life as a paramedic, treatment of Acute Pulmonary Oedema by MICA Paramedics, and of course the obligatory bit on airway management.

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