BASICS Scotland Podcast

Pete talks us through the definition of damage control resuscitation and the application of this concept to critically injured patients in the pre-hospital setting. The discussion ranges from the practicalities of delivery to novel therapies sitting on the horizon. 

Top 3 tips: 

1. Remember that the classic ABC algorithm has morphed into CABC and that C stands for the control of catastrophic haemorrhage. This has to be immediate and concurrent with managing the airway, breathing and circulation.

Biography: 

Pete qualified in medicine in 1987 and has served in the UK Defence Medical Services ever since, apart from a nine-year sabbatical in New Zealand during which time he trained in helped to produce three children, trained in Emergency Medicine and explored the Southern Alps. He is a Consultant in Emergency Medicine and Retrieval Medicine, working between the Queen Elizabeth University Hospital in Glasgow and the Emergency Medical Retrieval Service (a component of the Scottish Specialist Transfer And Retrieval Service - ScotSTAR) when not deployed on Regimental duties. A climber and skier since his teenage years, these sports have taken him on adventures throughout the world and continue to foster his passion for Wilderness Medicine. 

Stuart chats us through the Scottish Trauma network, what a major trauma centre is and the major trauma triage tool, helping us get the right patient to the right place at the right time. 

BIOGRAPHY

Stuart is a Paramedic with the Scottish Ambulance Service (SAS) based in Paisley and is currently the Project Lead Major Trauma Triage Tools (MTTT). Stuart started his SAS career as a Community First Responder with Neilston and Uplawmoor First Responders who were awarded the Queen’s Award for Voluntary Service in 2018. Stuart has been involved since the group was established and is still hugely involved with their work.

Stuart was appointed as Project Lead Major Trauma Triage Tools (MTTT) at the start of the year to roll out the MTTTs. “The Scottish Ambulance Service is a fundamental part of the STN and this is a really exciting time for us as the MTTTs will allow paramedics and technicians to triage patients to definitive care wherever possible”.

3 TOP TIPS

• Utilise the MTTT where applicable. Apply the MTTT to all significantly injured patients or those involved in high mechanism incidents.

Fiona talks us through our responsibilities to the child in the community, what red flags to look for and what we can do about our concerns. 

Bio 

I am a Registered Mental Health Nurse.  I specialised in adult addiction and the impact this has on children and young people.  I have worked across both statutory and non-statutory agencies including Youth Justice and was the lead nurse for child protection across Glasgow city addiction services and then the Lead Officer for Glasgow Child Protection committee. My focus of keeping children safe from harm began over 20 years ago when I took on the role of working with children and families affected by substance misuse.  I am currently a consultant in Child Protection with a children’s charity in Scotland and recently became a short-break foster carer and Independent Foster Panel Member. 

Top 3 tips 

1. Do not be worried about getting it wrong, better to get it working than do nothing at all. 

1. Seek advice, do not feel you are one your own. 

1. Remember that children and young people need adults to keep them safe from harm and abuse.  It is everyone job.   

Resources/links 

Getting it right for every child (GIRFEC) https://www.gov.scot/policies/girfec/ 

Aebhric focuses on some aspects and some hints and tips for delivering prolonged field care in remote areas 

Biography

Aebhric is a former US Army Green Beret, a Psychologist and a board-certified Critical Care Paramedic. He is the dean for the College of Remote and Offshore Medicine Foundation which offers medical education programmes for the remote, austere and offshore industries. Aebhric taught on the NATO Special Operations Combat Medic course in Pfullendorf, Germany and taught Battlefield Advanced Trauma Life Support (BATLS) for the MoD. He has earned the Diploma Tropical Nursing from LSHTM and is currently writing a clinical doctorate from the University of Stirling. 

Top tips 

1. Be. Here. Now. This is a survival technique from the bookDeep Survival. It forces you to be in the moment and not be blinded by the stress of the situation. 

Over the next few weeks we will run a series of podcasts on Major incidents.  Throughout the series Dr JP Loughrey talks through how the services prepare, what resources are available, some of the lessons learned from major incidents and communication and triage.

Top tips  

• Communicate effectively, using a recognized framework for consistency (METHANE) 

Resources and links 

Twitter handle @Jploughrey 

Stephen pinker The better angels of our nature 

https://stevenpinker.com/publications/better-angels-our-nature

EMRS app 

https://www.emrsscotland.org/news/2015/5/14/emrs-app

Prometheus app 

https://www.prometheusmedical.co.uk/news/prometheus-methane-app-now-free

OS locate app 

https://shop.ordnancesurvey.co.uk/os-locate-faq/ 

JESSIP app 

https://www.jesip.org.uk/jesip-app 

National Ambulance Resilience Unit - Triage sieve 

http://naru.org.uk/wp-content/uploads/2014/02/NARU-TRIAGE-SIEVE-JU5A304D.pdf 

NHS England - Clinical Guidelines for Major Incidents 

https://www.england.nhs.uk/publication/clinical-guidelines-for-major-incidents-and-mass-casualty-events

Biography

JP is a Consultant in EM in the QEUH Glasgow, and Retrieval Medicine with EMRS in the West of Scotland, with a particular interest in major incidents, As the ScotSTAR lead for Major Incident planning he has been involved in several large-scale incidents and training exercises. He keeps himself exceedingly busy, between his working life and his energetic young family! 

Over the next few weeks we will run a series of podcasts on Major incidents.  Throughout the series Dr JP Loughrey talks through how the services prepare, what resources are available, some of the lessons learned from major incidents and communication and triage.

Top tips  

• Communicate effectively, using a recognized framework for consistency (METHANE) 

Resources and links 

Twitter handle @Jploughrey 

Stephen pinker The better angels of our nature 

https://stevenpinker.com/publications/better-angels-our-nature

EMRS app 

https://www.emrsscotland.org/news/2015/5/14/emrs-app

Prometheus app 

https://www.prometheusmedical.co.uk/news/prometheus-methane-app-now-free

OS locate app 

https://shop.ordnancesurvey.co.uk/os-locate-faq/ 

JESSIP app 

https://www.jesip.org.uk/jesip-app 

National Ambulance Resilience Unit - Triage sieve 

http://naru.org.uk/wp-content/uploads/2014/02/NARU-TRIAGE-SIEVE-JU5A304D.pdf 

NHS England - Clinical Guidelines for Major Incidents 

https://www.england.nhs.uk/publication/clinical-guidelines-for-major-incidents-and-mass-casualty-events

Biography

JP is a Consultant in EM in the QEUH Glasgow, and Retrieval Medicine with EMRS in the West of Scotland, with a particular interest in major incidents, As the ScotSTAR lead for Major Incident planning he has been involved in several large-scale incidents and training exercises. He keeps himself exceedingly busy, between his working life and his energetic young family! 

• If a Firefighter offers to do a removal from the car to create space and uses jargon that you don’t understand, ask for a time scale for the job, there are many terms such as B-post removal, roof flap, or dashboard roll we might not be sure of, but everyone knows 3-4 minutes.

Fire Scotland Website

David works in a remote and very beautiful area in the North of Scotland and wears a number of hats in his community.  He has been a member of the Scottish Fire and Rescue Service team for 22 years and has also worked for The Scottish Ambulance Service for 10 years, 5 of these as a paramedic.  As well as being a married father of 2 David also volunteers as a BASICS responder in his spare time.

Murdo explains the reason effective Search Management is vital when looking for missing people. Discussing the rational and some of the techniques behind the decisions that are made supported by in-depth research. Additionally, the role that BASICS and other medical responders may find themselves playing. 

• People are often nearer their place last seen than the lay-person would think they are - put yourself in the casualties shoes

Paul Watson, project lead for end of life care at the Scottish Ambulance Service talks about how the service is striving to bring better palliative care to patients across Scotland with some discussion around the areas of non-technical skills, “just in case” boxes, and the other tools that can be used to support these patients.

• Remember to check the patients emergency care summary, key information summary.  This holds a wealth of useful information.

https://www.spict.org.uk/

https://www.ec4h.org.uk/

https://www.palliativecareguidelines.scot.nhs.uk/

https://www.resus.org.uk/respect/

Paul is a Paramedic working for the Scottish Ambulance Service and is based in Glasgow.

In July 2019 Paul was appointed to Project Lead for a joint partnership project between the Scottish Ambulance Service and Macmillan.

The aim of this project was to pilot the requirements to improve our ability to deliver better End of Life Care for the patients attended to as part of normal practice.

The project workload has included development of education packages, clinical guidelines and joint working with various Health Boards and palliative care interest groups.

Paul looks forward to further developing the project nationally with a particular interest on how technology can be used to support both patients and clinicians.

Mark talks us through the process of managing ROSC in the paediatric patient. 

Bio: 

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

Top Tips: 

1) Do the basics well and use the ABCDE approach you would in the adult approach and  just tweak the equipment and maneuvers to suit 

2) IO access may be very valuable in children where IV access can be more tricky to gain and think about the needle sizes 

3) Phone a friend for top-down cover and discuss the pathway and help available 

Resources: 

EasyIO Intraosseous vascular access system 

https://www.teleflex.com/usa/en/clinical-resources/ez-io/index