A journey to Palau – swimming across one of the deepest trenches in the world, media medical work with the BBC

Watch BBC Big Splash tomorrow, 20th June, at 4.30 BBC2 to see Dr Amy Hughes supporting Blue Peters two world records for swimming in one of the deepest stretches of water on the planet.

As often is the case, many of the media operations requiring a medic often do so at the very last minute. This in no way reflects badly on the programme or producers themselves, it is often just the case that many don’t think about the requirement of medical cover for a shoot until highlighted by either the insurance documents or, with final plans in place, the realisation of quite how remote the shoot is! The benefits of this for the medic is that it adds a whole new dimension to the event, as limited preparation time only adds to the wonderfully enjoyable challenge of working with the media.

In this case, I had a couple of days to prepare for an overseas shoot with the BBC (Blue Peter). The main challenge for this project arose with the planning of medical kit to take. I needed enough for a 10 strong boat crew, an endurance swim and a country with a scarcely resourced hospital. Once on the boat, the minimal casevac time was thought to be around 24 hours from the time taken to sail from the depths of the pacific ocean to an air strip or helicopter pick up point. And so began my 48 hour almost sleepless venture of composing, ordering and searching for various drugs and bits of kit I may need for any possible medical or traumatic eventuality. In planning it can often be easy to focus on the activity at hand and what injuries could result from that, and overlook the more common likely events that may happen amongst the crew – for example someone slipping on a wet deck and banging their head resulting in a extradural or subdural bleed (time critical) or a myocardial infarction (pretty time critical). Everything needs to be considered, including quantities sufficient to treat one or more individuals who may suffer a similar illness at the furthest possible casevac point – for example a severe bout of food poisoning requiring intravenous fluids and antiemetics 23 hours 59 minutes from aeromedical retrieval! Something to be aware of is that ordering drugs, especially opiates and controlled drugs, takes at least 24 hours and that can be delayed due to stock levels. Also, various forms of signed official paperwork are required prior to online pharmacies dispensing opiates which is time consuming (those who are hospital doctors will find this is the best way to source drugs such as morphine and fentanyl. GPs often have access to a controlled drug prescription pad).

Palau, Latitude 70 30’00″ North, longitude 1340 30’00” east; is an island of approximately 459 square kilometers and with a population of 20000, sitting about 500 miles east of the Philippines forming part of the Micronesian state. The island hosts a beautiful outcrop of rock islands as well as probably the most beautiful coves of sand and gardens of coral. It is a truly stunning island, slowly becoming popular with divers although the dive sites are still relatively untouched.

Palau was to be the island from which Blue Peter presenter Andy Akinwolere started his journey of swimming 8km across one of the worlds deepest trenches. For someone with a fear of deep water and having only learnt to swim ten weeks prior, it was an incredible achievement.

Fortunately the only medical emergency that I was required for was the delivery of an intramuscular injection of Stemetil in a futile attempt to cease the vomiting of a sea sickness victim. The rest of the trip was uneventful and an absolute delight to be part of. In a way though, there is always that slight disappointment that my 26kg of medical kit wasn’t put to use……….!

Dr Amy Hughes, Medical Director Expedition and Wilderness Medicine