Coda Change

The future of pre hospital care; Treatments and technologies on the horizon.

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Chile's has unique characteristics which pose several challenges for rescue and retrieval medicine.

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Over the past 30 years point-of-care ultrasound has been influencing patient outcomes in critical care environments by finessing patient assessment and optimising management. The newer generation ultrasounds are smaller and more portable, and as a result are joining physicians in the prehospital arena. Are they making a difference though? In the high-stakes environment of mass casualty events, ultrasound may provide the upper hand to clinicians by enhancing diagnostic accuracy, optimising resource utilisation and guiding crucial procedures towards those who need it most.

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Mulinda discusses standardising pre-hospital care in Africa and some of the major issues experienced such as access to prehospital care services.

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When the Chief of Defence Staff (CDS) of the Canadian Armed Forces decided to create a brand new forward aeromedical evacuation capability, he wanted it completed from the ground-up in a little over one year time.

In this talk, Lieutenant Colonel Leilani Doyle recounts how this was accomplished from the early concept, through development and finally to the deployment of the CMERT (Canadian Medical Emergency Response Team) on the UN mission Operation MINUSMA in Mali in 2018.

Lessons from the talk focus on three areas: commitment, cooperation and patience. The true test of commitment is seeing an idea actualised. Lieutenant Colonel Doyle and her colleagues had written a memo arguing that the Canadian Armed Forces needed a MERT-type capability. The CDS agreed with them, so despite the daunting nature of the task and tight timelines, they needed to bring the idea to fruition.

This project required immense cooperation. When tackling it, the team found experts from various disciplines were generous with their time and knowledge. Rather than reinventing the wheel, they sought assistance from colleagues, allies and established aeromedical services with training, equipment, SOPs, etc. With their help, they never felt that they were going at it alone.

Finally, patience when evaluating the results of these efforts is crucial. Once in theatre, they were eager to see if what they had developed was up to the task. If necessary, they were prepared to adjust plans based on the realities on the ground. They learned that conflicts have changed as casualty volumes are not the same now as what occurred in Afghanistan. This is obviously a good thing, but it also means that it will take longer to garner lessons learned and see where improvements will eventually need to be made.

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Training and psychological preparedness is essential for prehospital and disaster clinicians, in order to effectively care for victims in austere environments.

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Resuscitating a critically injured child is one of the most stressful jobs in pre-hospital medicine. We are all human, many of us parents and the unbelievable emotional cost of a child who has life threatening injuries can take its toll. A year of serious paediatric trauma gave me an interesting perspective on paediatric trauma resuscitation and a new take on the word "resilience."

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Explore "change" from the early days of PHaRM to the current day.

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The future of pre hospital care; Treatments and technologies on the horizon.

For more head to: codachange.org/podcasts

Dr Sinead Campbell-Gray will be presenting the story of the Northern Ireland HEMS Service, from the Political and Public campaign to get it started right through to the team-work and hard work involved in making this project a reality. She will outline how the Service has been founded on excellence in Trauma Care and Resuscitation Medicine, how the Clinical Service Model works, some lessons learned along the way, and what the future holds for the Northern Ireland HEMS as it continues to develop and become more established on the Global HEMS stage.

For more head to: codachange.org/podcasts