BASICS Scotland Podcast

Mark chats us through seizures in the paediatric patient from febrile convulsions to status epilepticus 

Top Tips: 

1. Follow your ABCDE

Biography:

Mark is a Paediatric Intensivist at Royal Hospital for Children in Glasgow, a consultant in Paediatric Critical Care Transport at ScotSTAR and a responder and Co -Director for pre-Hospital care for BASICS Scotland.  His interests include the management of critically unwell children anywhere.  

Mark chats us through commonly occurring respiratory disorders such as wheezing, asthma, breath stacking, pneumonia and COVID in the paediatric patient 

Top Tips: 

1. Take your time and ask questions to try and work out where in the respiratory tract the problem is.  A good history will aid this

Resources: 

Resuscitation council UK Paediatric basic life support guidelines   

Paediatric basic life support Guidelines | Resuscitation Council UK 

Biography:

Mark is a Paediatric Intensivist at Royal Hospital for Children in Glasgow, a consultant in Paediatric Critical Care Transport at ScotSTAR and a responder and Co-Director for pre-Hospital care for BASICS Scotland. His interests include the management of critically unwell children anywhere.   

Mark chats us through the commonly occurring respiratory disorders of choking, epiglottitis, croup and bronchiolitis. 

Top Tips: 

1. Take your time and ask questions to try and work out where in the respiratory tract the problem is.  A good history will aid this

Resources: 

Resuscitation council UK Paediatric basic life support guidelines   

Paediatric basic life support Guidelines | Resuscitation Council UK 

Biography:

Mark is a Paediatric Intensivist at Royal Hospital for Children in Glasgow, a consultant in Paediatric Critical Care Transport at ScotSTAR and a responder and Co-Director for pre-Hospital care for BASICS Scotland. His interests include the management of critically unwell children anywhere.   

Introduction:

Mark chats us through anaphylaxis in children and how we can treat them 

3 Top Tips: 

• When you are assessing a child, think could this be anaphylaxis in your differential

Resources: 

Resuscitation council Guidance for healthcare proifessionals : anaphylaxis 

Emergency treatment of anaphylactic reactions: Guidelines for healthcare providers | Resuscitation Council UK 

Biography:

Mark is a Paediatric Intensivist at Royal Hospital for Children in Glasgow, a consultant in Paediatric Critical Care Transport at ScotSTAR and a responder and Co -Director for pre-Hospital care for BASICS Scotland.  His interests include the management of critically unwell children anywhere.  

Caitlin Chats us through hyperventilation syndrome, classically referred to as “panic attack” and how we can spot it and treat the syndrome  

Top 3 tips: 

• Keep an open mind – Hyperventilation Syndrome (HVS) is a diagnosis of exclusion! 

• Use your diagnostic tools & clinical judgement - Don’t guess what findings might be! 

• Be cautious when diagnosing HVS in older patients or when you’re uncertain in HVS being the sole diagnosis + safety net the patient when considering non-conveyance! 

Biography: 

Caitlin Wilson is a paramedic for North West Ambulance Service NHS Trust and conducted a research study on Hyperventilation Syndrome (HVS) as part of her MSc Clinical Research Methods in 2015/16. Caitlin went on to publish findings from her research and was involved in updating the JRCALC guidelines for HVS. Currently, Caitlin is undertaking a PhD in prehospital feedback at the University of Leeds funded by the NIHR Yorkshire and Humber Patient Safety Translational Research Centre. 

Links and resources: 

Wilson, C., Harley, C., & Steels, S. (2020). How accurate is the prehospital diagnosis of hyperventilation syndrome?. Journal of Paramedic Practice, 12(11). doi:10.12968/jpar.2020.12.11.445 

Wilson, C. (2018). Hyperventilation syndrome: diagnosis and reassurance. Journal of Paramedic Practice, 10(9), 370-375. doi:10.12968/jpar.2018.10.9.370 

Wilson, C., Harley, C., & Steels, S. (2018). Systematic review and meta-analysis of pre-hospital diagnostic accuracy studies. Emergency Medicine Journal, 35(12), 757-764. doi:10.1136/emermed-2018-207588 

Top 3 tips 

• Put your own oxygen mask on first. Take the time to look after yourself first - you can’t help anyone else if you’re running on empty. Even if it’s just 5 mins for a cuppa and a chance to unwind, take that time. 

• Don’t be afraid to talk about mental health. If you’re concerned about someone else, ask them if they’re okay, but make sure to ask them twice because most people’s first response will be something like “I’m fine, just tired”.  

• Always be kind. None of us know what anyone else is coping with, either at work or in their personal life. We could all benefit from people being kinder to each other. It could be the little bit of light in someone’s day that helps them keep going.   

Resources 

https://www.lifelines.scot/ 

https://www.ruok.org.au/ 

https://www.samh.org.uk/ 

https://www.mind.org.uk/news-campaigns/campaigns/blue-light-programme/ 

https://royalfoundation.com/mental-health/ 

https://drdavidhamilton.com/the-5-side-effects-of-kindness/ 

Books  

The Mental Health And Wellbeing Of Healthcare Practitioners - Esther Murray and Jo Brown (includes a chapter on our campaign) 

Biography

I've worked in the SAS for over 22 years, initially in ACC before moving to operational duties and I've been based in West Lothian ever since. My mental health has been negatively affected by some harrowing incidents I have responded to and I became frustrated by the lack of support sometimes being offered afterwards, so Ruth Anderson and I developed a campaign for informal peer support. It was called “R U OK?”, based on the Australian mental health charity, and I hope it helped promote conversations about mental health and well-being within the SAS. 

Our own Dave Strachan become the interviewee and discusses suspension trauma

Top 3 tips 

1 Suspension trauma happens quickly so be aware!

2 We, the rescuers, are potentially the cause of some of this so in an MRT or technical rescue think about patient position and getting patients to move their limbs where possible

3 Look at the data! Understanding of this condition is changing rapidly as more research is carried out.

Resources and links 

https://www.wemjournal.org/action/showPdf?pii=S1080-6032%2820%2930070-3 

https://www.wemjournal.org/action/showPdf?pii=S1080-6032%2819%2930164-4 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346344/pdf/cureus-0012-00000008514.pdf 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602116/pdf/ham.2018.0089.pdf 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658225/pdf/237.pdf 

Biography:

Dave started working in pre hospital care in 2006 as an event medic and member of Tayside Mountain Rescue. When he finally graduated from Dundee in 2014 he had spent just enough of the intervening years not having fun in the hills to actually qualify as a Doctor. Currently a Captain in Royal Army Medical Corps, he now holds diplomas in Leadership, the Management of Conflict and Catastrophe and Immediate Medical Care. He has climbed and led expeditions on 5 continents and spent most of the past few years deployed on operational tours and military exercises around the world.

At home in Pitlochry, Dave can be found responding for BASICS, playing ‘hide and seek’ with the rescue team or running (slowly) around the hills looking for things to climb.

April talks us through falls in the community, how we can treat and refer these patients ensuring the right care at the time in the right place 

Top 3 tips: 

1. Always establish a patient's baseline and compare this to their presenting complaint for realistic assessment 

1. Consider potential detrimental impacts to patients with an unnecessary ED admission 

1. Engage with local falls pathways and use Prof to Prof links. 

Biography: 

April has 31 years of clinical background in NHS Scotland. April is a a trained Occupational Therapist and has worked in a variety of areas.  Starting off in mental health then in-patients, stroke and care of the elderly and laterally her career has been in the evolution of discharge teams to community care and then with Health and Social care partnership Greater Glasgow and Clyde. 

Her interest in frontline services started with a specialist role in trauma orthpaedics , addressing supported discharge and admission avoidance.  This work developed into A&E patient assessment, intermediate care and projects with the Scottish Ambulance Service. 

April is presently with The Scottish Ambulance Service on a 2 year secondment and believes that she is the first Occupational Therapist within the service.  It is her hope to establish a sustainable model to support patients and crews to utilise and embrace all components of health and social care that can provide best outcomes to patients who present to the ambulance teams with falls and frailty.  

April is passionate about patients having the right care at the right place with informed choice, and embracing new and innovative options and models of practice. 

Winston chats to us about burns and the treatment of these in the prehospital environment 

Top 3 tips: 

1. Take a SAFE approach 

1. Stop the burning process 

1. Cool the burn but not the patient 

Biography: 

Dr de Mello undertook his medical training at Guy’s Hospital and Southampton. He served in the RAMC as a Regular and Reservist from 1976 to 2013 ending his military career as Colonel TA BATLS from 2007-2013. His NHS employment as an Anaesthetist and Pain Medicine Physician was at Mid Yorkshire and Manchester University Hospital. His clinical interests include pelvic pain, burns, pre-hospital care and trauma. He is a Founding Member of the Pre-Hospital Care Faculty at the Royal College of Surgeons Edinburgh and the College of Remote & Offshore Medicine at Malta. He retired in 2020 and is Trustee at the Vulval Pain Society UK and Chair of the Pre-hospital SIG at the British Burns Association. 

Links and resources:

Clinical Pearls: 

• Take a SAFE approach: Shout for help, Approach with care, Free from danger and Evaluate the ABCs 

• Stop the burning process 

• Clingfilm also provides analgesia 

• Electrical burns may need 24hour ECG monitoring in vulnerable patients 

Lucy talks us through the obstetric emergencies of shoulder dystocia and cord prolapse, and how to treat these in the pre-hospital environment.                       

Top 3 tips:

1.  Be aware of the signs and symptoms of shoulder dystocia and cord prolapse

2. Call for help as soon as possible and make sure the receiving maternity unit is pre-alerted to the emergency you are bringing in

3. The debrief is very important for these emergencies, considering the parents, the responders and the hospital staff in this emergency

Lucy is currently the Educational Lead for the Scottish Multiprofessional Maternity Development Programme (SMMDP)

Lucy qualified as a midwife in 1984 and has worked in a variety of clinical posts throughout the UK and joined SMMDP in June 2017.

SMMDP are part of NHS Education for Scotland and are Scotland’s leading provider of maternity and neonatal clinical skills training. SMMDP provide affordable, post-registration courses to any professional group who request training.

Lucy is married to Andrew and they have a daughter Samantha who is studying at Glasgow University. Lucy also has a greyhound called Indy, who keeps her fit and active whatever the weather.