Johnny chats us through the urgent care section of the ambulance service 

Top 3 tips 

• With Urgent Care Patients, take your time. Ask yourself "What does my patient need, where best can that be achieved, and in what timescale is it required".  

Biography 

 Jonathon Will started his paramedic journey with London Ambulance Service before becoming the Lead Emergency Care Paramedic for Croydon University Hospital. After the loss of his wife aged just 39 (attributed to poor care in an overrun maternity unit and a strong driver for his passion to make NHS systems better), Jonathon returned home to Scotland and worked first as a Paramedic, then Specialist Paramedic, and Trainee Advanced Paramedic, before moving into the Clinical Directorate. Moving on, Jonathon is about to become an NHS National Improvement Adviser for the Scottish Government as part of the Redesign of Urgent Care program. He is also Tayside Mountain Rescue medical Officer, works with several events and expedition companies and is involved with teaching and assessing for SMR, WEMSI, MRT,  UE, Wild Fitness and more. Jonathon is Co-Founder of the 'Healthiest Town' project and is also a Kick Boxing instructor and a single dad - as he puts it... a busy little human! 

Bernd and Hermann talk us through their research into performing CPR with restricted patient access. 

Three top tips

1 - In an asphyxiated patient start ventilation as soon as possible     

2 - In a situation of restricted patient access, don't think about standard CPR, start ventilation asap, even if in a really awkward or alternative position.

3 - Even minimal training makes a difference so regular training and practice of CPR is crucial and should be included in other training, such as avalanche training courses.

Biographies:

Hermann Brugger MD, born in Bruneck / Bolzano / Italy, December 30th, 1951; married to the painter Elfriede Gangl, 1978; children: Franz, Johanna. MD at the University Vienna, Austria, 1978; Medical assistant at the Hospital Sisters of Charity, Linz, Austria, 1979-1983. General Practitioner at the National Health Service, Bruneck, Italy, from 1983 to 2017.

Emergency physician for the Emergency Medical System and mountain rescue physician of the Mountain Rescue Organization of South Tyrol from 1983 to 2017. Eduard Wallnöfer Prize Tyrolean Industry, 1992; Georg Grabner Prize University Vienna, 1995; Research Award of the Wilderness Medical Society USA, 2012; Paul Auerbach Award Wilderness Medical Society USA, 2016. Member of the Board of the Italian Society of Mountain Medicine, 1999-2005; Member of the Board of the Medical Commission of the Union Internationale des Associations d’Alpinisme UIAA MEDCOM, 2001-2009; President of the International Commission for Mountain Emergency Medicine ICAR MEDCOM, 2001-2009; Member of the Board of the International Society of Mountain Medicine ISMM, from 1999; President of the International Society of Mountain Medicine ISMM, from 2016; Member of the International Commission for Mountain Emergency Medicine ICAR MEDCOM, from 1991; Associate Editor of High Altitude Medicine and Biology, from 2001; Guest lecturer University Padova, from 1999; Associate Professor and lecturer at the Innsbruck Medical University, from 2006; Founder and head of the EURAC Institute of Mountain Emergency Medicine at the European Academy Bolzano, Italy, from 2009. President of the International Society of Mountain Medicine ISMM, from 2016.

Around 60 book chapters, 280 publications (current cumulative IF [2020-10-27]: 869) in emergency medicine. 

Responders of all types are focused on saving life but what happens if the scene becomes a crime scene?  What is a crime scene and how do we manage this?  Peter takes us through the roles, responsibilities of the police and responders at the scene and what might happen post the event.

Key points from this podcast:

• Understand that the Police aim is to save life

After working in the leisure industry for 12 years in a variety of locations including London, the West coast of Scotland and Saudi Arabia I joined Northumbria Police in 1997 starting in Newcastle upon Tyne then moving to the Scottish Borders.  In 2008, fed up with spending so much time driving to the highlands to spend time in the mountains, I moved house to Perthshire joining Tayside Police, which has since morphed into Police Scotland.

As well as being a Sergeant , I am also involved in training officers in multi-agency response to Chemical, Biological, Radiological and Nuclear (CBRN) incidents.  I have also been involved in planning the policing of a number of large events including T in the Park and the Ryder Cup.

I am currently working as Police Scotland Search and Rescue Coordinator, the strategic link between the mountain rescue teams in Scotland and Police Scotland, the coordinating authority for all land based search and rescue in the country.  I am also a member of the Police Scotland (Tayside) Mountain Rescue Team, deploying to incidents involving lost, missing or injured members of the public in the hills and other difficult to access areas.

When not a work I can often be found walking my two collie dogs in the hills or paddling on one of Scotland’s many lochs and rivers in an open canoe.

Pam and Duncan talk us through the roles, responsibilities and capabilities of the SORTs  across Scotland.  They detail what and when the SORT team can be of help and what their  roles are in the scape of multiagency responses. 

Top tips: 

1) Gather information and details from the scene, the more information is passed back the  more help can be targeted to the situation. 

2) Work with other agencies and use their skills and resources 

3) Don’t be afraid to ask for advice and help. 

Resources: 

JESIP Principles 

https://www.jesip.org.uk/five-principles 

John chats us through the skills, roles and responsibilities of the Scottish Fire and Rescue Service, what can they do on scene, how they can help with the patients, and how this all fits into the multi-agency working to bring the best care to the patient. 

Top tips 

1) Visit your local Scottish fire and rescue station and get to know and train with the crews 

2) Remember the hierarchy of safety, your safety is paramount.  Wear correct PPE and follow any briefs given/discussed 

3) Don’t be afraid to ask for help at a job, the crews are trained and willing to help where they can. 

Bio:

I have two children, Lewis and Eilidh, and am married to a very understanding wife Alison. I joined Grampian Fire Brigade (later to become Grampian Fire and Rescue Service and eventually Scottish Fire and Rescue service) in January 2003 and was posted to Altens Fire Station. Over the years I have also served at Central Fire Station and North Anderson Drive, all in Aberdeen city. For the past 10 years I have been an Instructor for the service and now run a small team looking after Aberdeen city stations training.

My whole-time job is extremely varied involving many disciplines including Breathing apparatus, Fire Behaviour, road traffic collision, recruitment selection and training for new recruits, Incident command, trauma care, Urban search and rescue, safe working at heights and their assessment, as well as the training and accreditation of new Instructors.  

I moved to the village of Gourdon on the north east coast in 2008 and joined the nearest retained duty Fire Station of Inverbervie. I now run this station as Watch Commander and I'm on call to respond to a variety of incidents whenever I'm not performing my whole-time role.  

For the past 11 years I have been a member of the United Kingdom International Search and Rescue team, on call 6 months of the year for international disasters deployed by the Foreign Commonwealth Development Office and accredited by the International Search and Rescue Advisory Group which is part of the United Nations. The team specialises in heavy to light urban search and rescue and has been deployed many times all over the world. I was deployed to Nepal after the 2015 earthquake. 

I have been involved in the humanitarian aid charity Operation Florian since 2007, delivering Search and Rescue training in Macedonia and Nepal, raising money for projects, and collecting unused fire service kit and sending it to countries that do not have access to fire and rescue equipment.

I have keen interest in trauma care and its advancements, I love learning new techniques and working closely with paramedics, nurses, and doctors to improve my own knowledge on the subject and allow me to pass this on to my colleagues in SFRS and my work overseas. 

Damon, Chair of Scottish Mountain Rescue, chats us through the roles, responsibilities and skillsets of the volunteer rescue teams that the organisation represents.  As part of our multi-agency series, which gives us some insight into the organisations that we may meet as responders in the field.

• Notify the teams early, don’t delay in asking for the response the teams would much rather be tasked early and stood down when not needed than have a late response.

Scottish Mountain Rescue

Damon grew up to the north of Manchester and, having trained as a mathematician, eventually managed to avoid the repeated Friday night drives up the M6 by moving to Scotland permanently. Since moving to Scotland Damon and his wife have been running a holiday cottage business and an energy conservation consultancy. Damon has been involved in Mountain Rescue in Scotland since he moved here and was Team leader in Oban for 12 years before becoming chair of SMR 4 years ago.

Stuart chats us through the roles, responsibilities and skill set of the voluntary emergency service the Royal National Lifeboat Institution (RNLI), including not only their role of saving lives at sea but also their involvement with patient transfer, education and other lesser known about duties.

• Have a look at the RNLI check cards and see how they work and how useful they are in a handover and management of the patient.

RNLI Website: www.rnli.org

Respect the Water Campaign: https://rnli.org/safety/respect-the-water 

RNLI Check Cards

Stuart is a doctor with experience in Anaesthetics and Emergency Medicine. He has worked on Search & Rescue Aircraft in both Alaska and New Zealand. He is a full-time Winchman Doctor and Crew Resource Management (CRM) Trainer with Rescue Bond 1 Search & Rescue Helicopter based in Aberdeen.

He has been involved with the RNLI for over 16 years in various roles as All-Weather & Inshore Lifeboat Crew, All-Weather Lifeboat Mechanic and member of the RNLI National and International Flood Rescue Teams. He has been based predominantly in Aberdeen and North Kessock.

Dr Paddy Morgan talks us through what happens when your body meets cold water, what to do, not only as a casualty but also if you are called as a responder to deal with a suspected drowning event. 

• Oxygen, Oxygen, Oxygen, Oxygen!! 

World sea temperatures 

https://www.youtube.com/watch?v=jncVb2onYC4

Management of the Drowning Patient

RNLI cold water shock

Paddy is a Consultant Anaesthetist and Trauma Team Leader based in Bristol (UK), and Consultant with Emergency Medical Retrieval and Transfer Service (EMRTS) Cymru, and Great Western Air Ambulance.

Prior to his medical studies, Paddy worked summer seasons as a surf lifeguard and went onto to instruct and mentor at a national level, retaining an active role in flood/swift water rescue. He is the honorary medical advisor to Surf Lifesaving GB, member of the UK governments Search and Rescue (UKSAR) Advisory Medical Group, previously sat on the Royal National Lifeboat Institute’s Medical & Survival Committee, is a member of the International Life Saving Federation’s (ILS) medical advisory committee, an Invited Honorary Member of the International Drowning Research Alliance (IDRA), and is Medical Director for HM Coastguard.

As a postgraduate student and independent medical officer for the Extreme Environment Laboratory at the University of Portsmouth, his areas of research interest include drowning, the cardio-respiratory responses to immersion and submersion in cold-water, hypothermia and the response of the human body in extreme environments. He has lectured internationally and has several publications related to these subjects.

A slight departure from our usual format. This weeks podcast is an excerpt for 2022's virtual conference. The first of twelve experts on the theme of

"THE BASICS OF CHALLENGING SCENES AND SITUATIONS"

If you are interested in hearing further fantastic content from our panels sign up here: https://basics-scotland.org.uk/basics-scotland-virtual-conference-2022/

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James takes a look at Major Incidents, the definition, roles of the first doctor on scene and some case discussions following his involvement as a medical incident officer at two recent major incidents. 

Aims of the podcast 

1) To define a major incident 

2) To consider the expectations for the first doctor on scene 

3) To discuss some cases involving major incidents 

Biography

James is a consultant in emergency medicine based in Crosshouse Hospital, Kilmarnock.  Since 2010 he has also had a sessional commitment as a consultant in pre-hospital and retrieval medicine with the Emergency Medical Retrieval Service (EMRS), the adult component of ScotStar, the National Retrieval Service. 

Prior to starting with EMRS James also worked as a consultant in Emergency Medicine for a 3-year period in Adelaide, South Australia, working both in the Emergency Department of the Royal Adelaide Hospital and with the South Australian Retrieval Service. 

Following his return from Australia James successfully completed a Masters degree in Aviation Medicine incorporating a Postgraduate Diploma in Aeromedical Retrieval and Transport Medicine at the University of Otago, New Zealand. 

Top 3 points:

1. Seek feedback

About Caitlin:

Caitlin Wilson (Twitter: @999_Caitlin) is a paramedic for North West Ambulance Service NHS Trust and is currently undertaking a PhD on prehospital feedback at the University of Leeds funded by the NIHR Yorkshire and Humber Patient Safety Translational Research Centre. Her final PhD study is an online diary study exploring predictors and effects of prehospital feedback for patient-facing ambulance staff in the UK. The study is open to recruitment until end of August 2022 and more details can be found at http://bit.ly/prefeed-diary

Relevant publications:

Wilson, C., Howell, AM., Janes, G and Benn, J. (2022) The role of feedback in emergency ambulance services: a qualitative interview study. BMC Health Services Research, 296 (2022).https://doi.org/10.1186/s12913-022-07676-1

Wilson, C., Janes, G., Lawton, R. and Benn, J. (2021) The types and effects of feedback received by emergency ambulance staff: a systematic mixed studies review with narrative synthesis. British Paramedic Journal, Vol. 5 No. 4, pp. 68-69. https://doi.org/10.29045/14784726.2021.3.5.4.68

Wilson, C., Janes, G., Lawton, R. and Benn, J. (2021) The types and effects of feedback received by emergency ambulance staff: protocol for a systematic mixed studies review with narrative synthesis. International Journal of Emergency Services, Vol. 10 No. 2, pp. 247-265. https://doi.org/10.1108/IJES-09-2020-0057

Wilson C, Janes G, Lawton R and Benn, J. (2021) PP24 Prehospital feedback in the United Kingdom: protocol for a review of current practice using a realist approach. Emergency Medicine Journal 2021;38:A10-A11.

Caitlin Wilson 

University of Leeds / North West Ambulance Service NHS Trust

Email: [email protected]

Twitter: @999_Caitlin

Recent Publications

Wilson, C., Howell, AM., Janes, G. et al. The role of feedback in emergency ambulance services: a qualitative interview study. BMC Health Serv Res 22, 296 (2022). https://doi.org/10.1186/s12913-022-07676-1