The second in a series of two, Joel continues his chat on the role of the Advanced Practitioner in Critical Care (APCC) and what they can bring to help you at different scenes and conditions. 

Top tips 

1)   Maintain dialogue with the incoming APCC and make any stand down decisions a discussion 

2)  APCC are not just there for incidents you would consider a red team for, instead think of  them as supporting you with any incidents that perhaps push your own boundaries and you  need some help and support 

3)  When you meet the team, please engage, ask questions, have a look and kit and have a chat,  they are there to support you in any way they can.

Joel Symonds is an Advanced Practitioner in Pre-hospital Critical Care from Edinburgh.  On leaving school he worked as a nanny, a pyrotechnician, a children’s actor and a civil servant.  He joined the Ambulance Service in 2005 and was promptly told by a burned-out colleague – “The problem with joining the ambulance service is once you’ve become a paramedic there’s nowhere else to go”.  Choosing to ignore this nihilism, Joel has spent his career exploring the opportunities available to staff with pre-hospital management skills.  Since then, he has worked in international motor racing, desert search and rescue, hostile environment industrial health care, governance consultancy, education and research. He is regularly asked where he’ll be in five years’ time: he has no idea, but can’t wait to find out.

Joel has a special interest in human factors, interactions and experience within emergency care, believing that everything we do ultimately hinges on the patients, care providers and bystanders involved.  Joel lives in Edinburgh with his family, plays geeky board games and emerged from the 2020 pandemic as a runner and baker.  He’ll probably have found something different next week.

Mary chats us through aspects of the autistic conditions, shining a light on the challenges but also some providing top tips on how to help manage patients from this group in an emergency situation including approach and communication strategies.

• Keep calm and use a confident demeanour

Sign national guidance 145

The Scottish strategy for autism

brain and hand app

Part 5, adults with incapacity act

Mental welfare commission

Mary is a Nursing Officer for the Mental Welfare Commission Scotland. She has many years of experience in both learning disability and mental health nursing. One of her specific areas of interest is working with autistic people. Mary has been involved in Supporting families of autistic children, working with both the child and parents, she has worked jointly with a Speech and Language therapist in the provision of Social Skills training for young autistic adults.

The first in a series of two podcasts, Joel talks us through the roles, responsibilities, skills and capabilities of the APCC team, where they can be found and why and when we should use them.  

Top tips 

1)   Maintain dialogue with the incoming APCC and make any stand down decisions a discussion 

2)  APCC are not just there for incidents you would consider a red team for, instead think of  them as supporting you with any incidents that perhaps push your own boundaries and you  need some help and support 

3)  When you meet the team, please engage, ask questions, have a look and kit and have a chat,  they are there to support you in any way they can.  

Joel Symonds is an Advanced Practitioner in Pre-hospital Critical Care from Edinburgh.  On leaving school he worked as a nanny, a pyrotechnician, a children’s actor and a civil servant.  He joined the Ambulance Service in 2005 and was promptly told by a burned-out colleague – “The problem with joining the ambulance service is once you’ve become a paramedic there’s nowhere else to go”.  Choosing to ignore this nihilism, Joel has spent his career exploring the opportunities available to staff with pre-hospital management skills.  Since then, he has worked in international motor racing, desert search and rescue, hostile environment industrial health care, governance consultancy, education and research. He is regularly asked where he’ll be in five years’ time: he has no idea, but can’t wait to find out.

Joel has a special interest in human factors, interactions and experience within emergency care, believing that everything we do ultimately hinges on the patients, care providers and bystanders involved.  Joel lives in Edinburgh with his family, plays geeky board games and emerged from the 2020 pandemic as a runner and baker.  He’ll probably have found something different next week.

David “Heavy” Whalley with his plethora of civilian and military search and rescue experience chats us through the effects events such as the Lockerbie disaster has had on him.  He discusses the culture and attitude change to the effects these incidents have on the responder, what to look for and how to create healthy coping systems and networks.

• Look after your team and know and look out for the signs that things are not going so well

Personal Website – www.heavywhalley.com

David’s love of the mountains was inspired by his parents, a member of the RAF Mountain Rescue (MR) for 37 years in the roles of Team Leader of RAF Leuchars, RAF Kinloss and Deputy Team leader at RAF Valley in North Wales. He spent his last four years working in the ARCC Aeronautical Rescue Co-ordination Centre at RAF Kinloss. 

With over 1000 mountain and 80 aircraft incidents, David was also the Senior team leader at the Lockerbie disaster. 

As a member of the Scottish Mountain Rescue Executive Team for over 20 years, he fulfilled roles as the Chairman, Accident Statistician and Torridon Mountain Rescue Team member.

He was awarded the BEM, MBE and the Distinguished Service Award for Service to Mountain Rescue

Heavy is retired now and is in the process of writing a book and lecturing on Mountain Rescue and Mountain Safety in the UK and overseas.

As a police officer Ben was seriously injured when involved in a series RTC at work, where the car he was travelling in crashed into a tree and caught on fire.  Ben relates the incident, how he felt and what it feels like to be a patient but most importantly some hints and tips for responders and what they can do to help patients in the emergency setting. 

Biography: 

Ben is an Officer on the Bed, Cambs & Herts Roads Policing Unit who enjoys fishing and motorbikes. Ben has been a Police Officer for 6 years and has been on the Roads Policing Unit for 3 years. 

Top 3 hints 

1) Smile for the patient as this makes the patient feel better 

2) Be yourself, being human Is a great quality 

3) Be honest with your patients 

Twitter: 

@pcbenOnTheMend 

Audra, based in Brisbane, Australia and is a specialist in nutrition and wellbeing and her focus is on shift work, how it affects you and how you can look after yourself better while working shifts.

• Prioritise your sleep, this is critically important.

www.healthyshiftworker.com

Audra Starkey is a clinically trained nutritionist accredited trainer, shift work veteran and author of the best-selling book –Too Tired To Cook. After more than twenty years in the aviation industry, Audra decided to switch careers and complete a bachelor of health science degree, majoring in nutritional medicine, to gain a better understanding of the impact a disrupted sleep-wake cycle and poor dietary habits have on our health. With a particular interest in preventative health, Audrawent on to found The Healthy Shift Worker, a company that provides shift-work-specific wellness services for individuals, along with corporate wellness programs via her signature Healthy Shift Worker Workplace Wellness Seminars and online training programs.

Mark chats us through pain assessment treatment in the age ranges and how we can                       best manage the whole situation when a child is in pain 

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 support clinician for BASICS Scotland. His interests include the management of critically unwell children anywhere.  

 Top Tips: 

1) Treat pain management in the child as a team approach wherever possible, engage with their care givers for information and  

2) Approach the pain in the psychological, emotional and physical management  

3) Use your JRCALC as a guide and don’t be afraid to give opiods in a measured  approach 

Resources: 

Wong baker scale 

https://wongbakerfaces.org/ 

FLACC pain scale 

https://media.gosh.nhs.uk/documents/Revised_FLACC_Paperwork.doc.pdf 

In this podcast Iain Craighead gives the benefit of his experience as a BASICS Scotland Responder.

He stresses the importance of getting to know your Sandpiper bag and equipment inside out, as well the benefits of building a strong relationship with your local ambulance colleagues.

Iain also urges patience with gaining experience as a Responder and becoming a really valuable local emergency resource.

1  Know your kit inside out

2 Get to know your local ambulance colleagues and work closely with them

3 Stick with it!  Be patient and take time to gain the experience!

Dr Iain Craighead is a GP based in Dingwall and has been a BASICS Scotland Responder for the last 6 years. He qualified as a GP in 1996 and  worked in West Oxfordshire before spending 5 years working with International Nepal Fellowship based at Green Pastures Leprosy and Rehabilitation Hospital in Pokhara. On returning to the UK he lived and worked in Kirkwall where he attended a PHEC course and together with Dr Kirsty Cole and the local ambulance manager Lyndon Sinclair, set up a BASICS Scotland Responder scheme covering the Orkney mainland. In 2016 he moved south and joined Dingwall Medical Group and the Highland PICT team just at the point when it introduced a paramedic crewed response car. He remains an active BASICS Scotland Responder whilst at home on the Black Isle.

Dr Craighead has been a GP trainer for 10 years and is 1st team doctor for Ross County Football Club.

Pam and Duncan from SAS SORT team talk us through information on how to handle CBRNE  events and what the roles and responsibilities of the SORT and other teams play in these  events, and what we can do if first on scene. 

Top Tips

1) Use the steps 1,2,3 approach, uphill, uphill, scene safety, by looking after yourself you are  looking after the patients 

2) Consider the remove, remove, remove approach 

3) Tie in with the NARU tools as this keeps you up to date on chemicals and changes to them  and this will help with e.g. toxic triage 

Resources: 

Toxbase 

https://www.toxbase.org/ 

WIRELESS Information System for Emergency Responders 

https://webwiser.nlm.nih.gov/getHomeData;jsessionid=33A01B8B55E62338F7234504E1BE9BF4 

Remove, remove, remove 

https://naru.org.uk/remove-remove-remove-refreshed-ior-messaging-is-released-by-naru/ 

National Ambulance Resilience Unit (NARU) 

https://naru.org.uk 

Joel Symonds talks us through humour in the prehospital care arena, when it is appropriate to use and when humour is not appropriate but perhaps most poignantly why it is important and its use in emotionally protecting responders and its role in mental resilience.

• Reflect on and acknowledge that the humour that we use is a really powerful tool and it keeps us together as a tribe, keeps us safe and is a really strong protective factor and we should be careful about being so embarrassed about it that we don’t allow it to come to the fore.

• Think about where and who the audience is when using this type of humour and make sure it is in a safe environment where the audience and environment are appropriate where it can’t be interpreted as being cruel or derogatory or offensive and with people who know you well enough that they know your intentions.

• If a colleague cracks a joke about a job that sounds pretty extreme or if they say something that you absolutely would not want to hear in the wrong arena, rather than thinking how unprofessional this is, or trying to distance yourself from it, instead find a quiet moment just to catch up with them and check that they are ok and use it as a channel to open conversations.

Joel Symonds is an Advanced Practitioner in Pre-hospital Critical Care from Edinburgh.  On leaving school he worked as a nanny, a pyrotechnician, a children’s actor and a civil servant.  He joined the Ambulance Service in 2005 and was promptly told by a burned-out colleague – “The problem with joining the ambulance service is once you’ve become a paramedic there’s nowhere else to go”.  Choosing to ignore this nihilism, Joel has spent his career exploring the opportunities available to staff with pre-hospital management skills.  Since then, he has worked in international motor racing, desert search and rescue, hostile environment industrial health care, governance consultancy, education and research. He is regularly asked where he’ll be in five years’ time: he has no idea, but can’t wait to find out.

Joel has a special interest in human factors, interactions and experience within emergency care, believing that everything we do ultimately hinges on the patients, care providers and bystanders involved.  Joel lives in Edinburgh with his family, plays geeky board games and emerged from the 2020 pandemic as a runner and baker.  He’ll probably have found something different next week.