PODCAST #19 – Dr James Doube on Austere Medicine & FOAMed

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

It’s been a pleasure having former KI Doc, Dr James Doube back on Kangaroo Island for a short locum stint, but also a chance to catch up and talk about various schemes.

Jamie is a rare breed – a former career as paramedic and wildlife conservationist, he’s also a GP-surgeon, recent JCCA-graduate GP-anaesthetist and has carved out a niche career in truly remote & austere medicine with the Australian Antarctic Division & other organisations.

Dr Doube is also a wonderful experimental test subject.

He is WAY to modest to mention his award of the 2012 Australian Antarctica Medal for his services as both expedition medical officer but also conservationist – read more about his exploits here. He’s been involved in eradicating rabbits from Macquarie Island & with TEAM RAT on South Georgia.

In this brief podcast we discuss his work with AAD and particularly the potential for FOAMed…

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Advanced Wilderness Life Support

Scott Orman's avatarAuckland HEMS

Recently I had the pleasure of attending a superb AWLS course in Queenstown. The course was run by a group of intrepid clinicians who decided several years ago to import AWLS from the United States. You can read about the group (and more importantly, book a place on the course!) here:

wildmed

Wilderness medicine is in may ways the ultimate in prehospital care – it involves providing care to patients in an frequently austere environment with often very limited personnel, equipment, and communications. For emergency department doctors like myself, it also separates us from the security of readily accessible diagnostic investigations.

At its core wilderness medicine represents the same pathologies as emergency medicine, although environmental issues are obviously more common than in our urban ED and regional HEMS (check out this article about some recent lightning strike patients treated in Waikato ED!). The challenges encountered by treating clinicians however are…

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See Auckland by air for FREE!*

Scott Orman's avatarAuckland HEMS

*Conditions apply: You ARE required to have a medical qualification that was not purchased over the internet, and you WILL occasionally have to share your flight with a patient or patients with varying pathologies. Oh, and you will occasionally have to make an appearance at the hospital too (which fortunately has a top-notch helipad)

Auckland ED Specialist

Auckland ED Fellow

auckland

 

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Crisis Resource Management – from Academic Life in Emergency Medicine

Scott Orman's avatarAuckland HEMS

Sim

From ALiEM:

CRM and SBT… just another set of acronyms in the world of medical education?  Don’t we already have enough??

Not quite!  Rather, Crisis Resource Management (CRM) is a complementary approach to Simulation Based Training (SBT). It can enhance current ongoing medical simulations or provide foundation for a vigorous curriculum when launching new simulation programs.

WHAT IS IT?

Crisis Resource Management is the ability to translate medical knowledge to real world actions, in the setting of an emergency.

Rather than a separate entity from medical simulation, CRM principles can be looked at as a way to focus and shape medical simulation curriculum and especially the objectives of each case to focus upon development of critical skill-sets that contribute to optimal team function and success during crisis.”

Read the rest HERE

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RAPID: Ticagrelor e Copidogrel a confronto nel paziente con STEMI.

Dont let language barrier stop the FOAMED..use Google Chrome translator to convert Italian to English in one click!

medest118's avatarMEDEST

Comparison of Prasugrel and Ticagrelor Loading Doses in ST-Segment Elevation Myocardial Infarction Patients

RAPID (Rapid Activity of Platelet Inhibitor Drugs) Primary PCI Study

Guido Parodi, MD, PHD, Renato Valenti, MD, Benedetta Bellandi, MD, Angela Migliorini, MD, Rossella Marcucci, MD, Vincenzo Comito, MD, Nazario Carrabba, MD, Alberto Santini, MD, Gian Franco Gensini, MD, Rosanna Abbate, MD, David Antoniucci, MD Florence, Italy

OBJECTIVES: This study sought to compare the action of prasugrel and ticagrelor in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). BACKGROUND: It has been documented that prasugrel and ticagrelor are able to provide effective platelet inhibition 2 h after a loading dose (LD). However, the pharmacodynamic measurements after prasugrel and ticagrelor LD have been provided by assessing only healthy volunteers or subjects with stable coronary artery disease. METHODS: Fifty patients with STEMI undergoing PPCI with bivalirudin monotherapy were randomized to receive 60 mg…

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Prehospital blood product use

Scott Orman's avatarAuckland HEMS

Auckland HEMS is currently exploring the use of blood products in our prehospital environment.

Two interesting papers regarding prehospital blood product use were recently published by the Queensland Ambulance Service. The Queensland Ambulance Service maintains a 24/7 doctor/paramedic trauma response team that is dispatched to significant trauma cases in the greater Brisbane area.

Despite the fact that the prehospital service in these studies is road-based, the patient cohort (predominantly blunt trauma), prehospital staffing (often initially ambulance crew followed by doctor/paramedic team), and prehospital times are highly applicable to our service.

The feasibility of civilian prehospital trauma teams carrying and administering packed red blood cells

This paper examined the feasibility, limitations, and costs involved in providing prehospital trauma teams with blood products (2 units of O-negative red cells)

  • Of 500 units of RBCs provided to the service over 18 months, 26% were transfused
  • 97.8% of non-transfused units were returned to the…

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Greater Sydney Area HEMS podcasts

Scott Orman's avatarAuckland HEMS

cropped-hems5

Our colleagues from Sydney have created an excellent group of podcasts about pre-hospital and retrieval medicine:

NEUROPROTECTION – covers retrieval of patients with neurological and neurosurgical emergencies; also view their helicopter operating procedure HERE

INTERHOSPITAL PATIENT ASSESSMENT – overview of the assessment of a critically ill patient requiring transfer from one facility to another

THE TRAPPED PATIENT – overview of the approach to a patient trapped in a vehicle

INTRODUCTION TO SYDNEY HEMS

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Human factors in aviation errors – The Dirty Dozen

Scott Orman's avatarAuckland HEMS

DirtyDozen_Silent_giants

Following a spate of aviation accidents in the 1980’s and 1990’s, Transport Canada and the aviation industry came up with the aviation ‘Dirty Dozen’ – human factors in aviation maintenance that commonly lead to errors.

Consider these in the context of your prehospital or emergency service:

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dirty-dozen-human-factors

(thanks to Tim Leeuwenburg at KIdocs.org for this one!)

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