London’s Air Ambulance & Extreme Medicine to host two-day Pre-Hospital Care Workshop
For 25 years London’s Air Ambulance has been at the forefront of pre-hospital emergency medicine, gaining a reputation for clinical excellence and pioneering procedures which have been adopted across the world.
Next month, ahead of the World Extreme Medicine Expo, on the 6th and 7th of November, London’s Air Ambulance is hosting a two-day Pre-Hospital Care Workshop as a precursor to the Extreme Medicine Conference 2014 to give delegates and medical practitioners an insight into the work of the charity and to share some of its advanced practices.
The charity has achieved survival figures for traumatic cardiac arrest and pre-hospital thoracotomy, and success rates for adult and paediatric intubation, which are among the highest in the world.
The workshop will give practitioners the opportunity to get involved with medical demonstrations and scenario based exercises while also providing access to the senior consultants and paramedics responsible for London’s Air Ambulance governance, major incident planning, research and innovation.
Speaking about the event, consultant and education lead, Dr Gareth Grier said: “London’s Air Ambulance has treated over 31,000 patients, which we recognise is a huge amount of experience and learning developed over 25 years. By passing on this knowledge we can help to drive excellence in pre-hospital care standards”.
“Many of the techniques we have pioneered have become widespread as a result of being heard and talked about at events such as this one. During the workshop we will be showcasing some of our more recent innovations, REBOA being one of them, discussing the future of pre-hospital care, challenging conventional wisdom and hopefully, inspiring the next generation of trauma specialists”.
Earlier this year London’s Air Ambulance became the first service to perform roadside balloon surgery to control severe internal bleeding on a patient who had fallen from height. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is just one of the practical demonstrations delegates can participate in amid a programme that will look at biological terrorism, crew resource management at complex pre-hospital scenes and the role of a UK pre-hospital doctor in the international response to humanitarian disasters.
Introduction and overview of London’s Air Ambulance and Pre-hospital Care in the UK
The role of a UK pre-hospital doctor in the international response to humanitarian disasters
Crew Resource Management at complex pre-hospital scenes
The medical response to major incidents in London
Pre-hospital advanced airway
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
Pre-hospital blood transfusion in civilian trauma
Damage control anaesthesia – lessons from Afghanistan and London
Opportunities for medical students in pre-hospital care
Paramedic scene leadership during advanced pre-hospital interventions
Defying medical dogma – case studies from the pre-hospital phase
The future in pre-hospital care Nanorobots and suspended animation
Various scenario based training exercises
By day Mark Wilson is a Neurosurgeon at Imperial. He also works with London’s Air Ambulance. His specialist area is acute brain problems especially traumatic brain injury (and in particular it’s hyperacute management), but in his spare time he is the developer of a life-saving mobile phone called GoodSAM that crowd sources off-duty doctors, nurses and paramedics to local life threatening emergencies.
Mark has worked extensively overseas both clinically and as an expedition doctor. Locations include India, Nepal, the Arctic, South Africa, and Australia as a GP and as a researcher with NASA. His research areas include the effects of altitude and microgravity on the cerebral circulation, the former of which he extensively researched during the 2007 Xtreme Everest expedition.
He authored The Medic’s Guide to Work and Electives Around the World in 2000 which is now in it’s 3rd edition.
GoodSAM an App that crowd sources off-duty doctors, nurses and paramedics to local life threatening emergencies – GoodSAM. Please take a look and register!
The genetic secrets of a species of frog that hibernates for months could hold the key to safer space voyages, say scientists.
Researchers from the University of Queensland, headed up by Extreme Medicine speaker Professor Craig Franklin, say that ability of the burrowing frog species Cyclorana alboguttata (pictured) to maintain muscle mass while dormant could help overcome the problem of astronaut’s own muscles deteriorating during long trips in zero gravity.
Although floating weightless in space is something many would-be astronauts dream of, this unique environment takes its toll – leaving muscles drastically under-used and causing a number of health problems from tendonitis to fat accumulation.
With a manned mission to Mars taking anywhere between 39 and 289 days depending on how close the planet is, astronauts would certainly benefit from anything that ensured they were in top physical condition upon arrival on the planet’s surface.
Scientists studying the frog say that that one of its genes known as ‘survivin’ could help. When faced with droughts in their native Australia, the frog survives by burrowing underground and covering itself with a cocoon of shed skin.
This keeps them relatively insulated from harm – but the survivin gene is necessary to protect them from their own bodies. Cells have many different ‘suicide mechanisms’ but one in particular kicks in to remove matter that is apparently damaged – something it judges by long periods of inactivity. Survivin stops this from happening.
“If we can understand the cell signalling pathways that confer resistance to muscle wasting, then these could be useful candidates to study in mammalian muscle atrophy,” said PhD student Beau Reilly in a press release.
“These could help to develop therapies to treat bedridden human patients or even astronauts, who frequently lose muscle tone when exposed to reduced-gravity conditions.”
This sort of research could be even more important for journeys into space further afield than Mars. If scientists can’t develop faster propulsion technology in the future then even travelling to nearby stars could take tens of thousands of years.
“I am fascinated in animals that survive in extreme conditions” said Miss Reilly. “I think humans and modern medicine could learn a great deal from organisms such as burrowing frogs”.
Meet Professor Franklin and a whole galaxy of other thought provoking speakers including NASA doc Micheal Barrett at the next Extreme Medicine Conference in London
Sometimes we are utterly humbled…
‘Hi guys I met another person who has done your Expedition and Wilderness Medicine Course, on the roadside, last night and I would like to pass my thanks on to your team. Last night I was asked to attend a Technician crew as Paramedic backup for a traumatic head injury, When I arrived the crew had done an amazing job already and were being assisted by a calm, knowledgeable Nurse who appeared completely at ease in this unusual environment for her. I have done a number of jobs where Nurses have stopped to help and I think it is safe to say they are often as uncomfortable in my environment as I would be trying to work in theirs.
As the job progressed and the patient became more unwell and required more interventions she was part of the team and worked perfectly alongside myself, my pre-hospital colleagues, HEMS and the police. Once we had her packaged and en route to hospital I asked her about her trauma & pre-hospital training (she usually works on an acute medical admission ward). The answer was of course “I did a course on expedition medicine” I asked a few names of the tutors, Sean, Caroline, Piers et al were names we both knew. So thanks to the Nurse, I will find you and make sure this is recognised. But also thanks to Team Expedition Medicine. Last night, by proxy, you were involved in saving a young life, which I think is pretty damn awesome!” Matthew Jones posted on Expedition and Wilderness Medicine’s timeline “Hi guys I met another person who has done your Expedition and Wilderness Medicine Course, on the roadside, last night and I would like to pass my thanks on to your team. Last night I was asked to attend a Technician crew as Paramedic backup for a traumatic head injury.
When I arrived the crew had done an amazing job already and were being assisted by a calm, knowledgeable Nurse who appeared completely at ease in this unusual environment for her. I have done a number of jobs where Nurses have stopped to help and I think it is safe to say they are often as uncomfortable in my environment as I would be trying to work in theirs. As the job progressed and the patient became more unwell and required more interventions she was part of the team and worked perfectly alongside myself, my pre-hospital colleagues, HEMS and the police. Once we had her packaged and en route to hospital I asked her about her trauma & pre-hospital training (she usually works on an acute medical admission ward). The answer was of course “I did a course on expedition medicine” I asked a few names of the tutors, Sean, Caroline, Piers et al were names we both knew.
So thanks to the Nurse, I will find you and make sure this is recognised. But also thanks to Team Expedition Medicine.
Last night, by proxy, you were involved in saving a young life, which I think is pretty dam awesome!!!!’
We know that education opens doors and as the EWM crew are both interested and a bit nosey, we love to hear what our alumni get up to after attending our courses. Naturally then, we were delighted to hear from Ian P, who told us he and his wife loved the 2013 Wild Medicine course so much, they’re busy packing up in the UK and moving to Namibia…
Not many things you can say that change your life! Attending the Wild Medicine course was one of those events. Amazing set of people and a fantastic opportunity to learn about conservation and desert medicine.
The kind of odd things we learnt…
– Take blood from a cheetah,
– Learn about (and touch – optional) many poisonous snakes,
– Sleep in a desert, walk 14km through a dry river canyon,
– What are the problem animals with Rabies? (A: Kudu),
– How can carnivores live outside conservation areas & not get killed by farmers &
– How to build a vineyard in a desert … what?!..
And the thing that changed our lives? Meet the Bushmen and see their need for healthcare! My wife and I are volunteering at Naankuse to run the Bushmen medical services. The real thing we learned? There are many people out there that can benefit from our skills …
Oh and by the way Namibia is amazing you get to see loads … but you can also get a 4×4 and do a week or so trip before the course.
The ‘David Weil Extreme Medicine Award’ (DWEMA) and is by invitation only however, nominations of worthy candidates are welcome for the 2014 Extreme Medicine Conference which will take place at the Royal Society of Medicine in London 26 – 29 October 2014.
To nominate please contact Mark Hannaford, Managing Director, Expedition & Wilderness Medicine; [email protected]
The Extreme Medicine Conference which this year is taking place at the end of this month at Harvard Medical School funding to two medics to attend under a sponsorship arrangement has been provided.
The sponsorship scheme was set up to enable worthy medical candidates, who otherwise might not be able to afford, to attend the conference. The learning’s would then be applied to medicine provided in extreme, front line, disaster & relief environments and in turn relieve suffering and advance medical care in the situations where typically treatment would be lacking. The award also serves to promote new qualified individuals who show great promise in the area of disaster, humanitarian and remote medicine.
David is a Hong Kong/ London based entrepreneur who is passionate about using his resources to make positive social change and has supported EWM for a number of years and he has offered to cover the following expenses;
- Travel & expenses from your home to the conference and return
- Food & Accommodation whilst at the conference
- Free entry to both the Pre Conference workshop running on the preceding weekend and the Conference itself
- Winners have the right to call yourself joint-winner of the 2013 David Weil Extreme Medicine Award to use the conference logos and branding in an appropriate manner
This years winners are;
Dr. Anushavan Virabyan is the Vice Chairman for Disaster and Emergency Medicine at Yerevan State University in Armenia. He is a practicing Cardiologist and Emergency Physician with more than 35 years’ experience. He completed his medical training in 1979 and has specialized in pre-hospital medicine during his career. Dr. Virabyan is married with two children and is fluent in Armenian, Russian, and English. He currently lives in Yerevan Armenia.
He was announced as the best emergency physician in 2013 by the Ministry of Health of Armenia.
Dr. Virabyan became an Emergency Physician at No. 5 Ambulance sub-station, Yerevan Armenia in 1979 and rapidly rose to become a Cardio-Reanimatologist in 1981, and then Chief of that station in 1991. He remains in that position today. The Yerevan city ambulance service responds to nearly 600 ambulance calls per day in and around that capital city. Ambulance station No. 5 is one of the largest stations in the city.
In 1994 Dr. Virabyan became Director of the Emergency and Disaster Medicine Regional Training Center, a jointly sponsored program between the University of Massachusetts Medical School, Boston University School of Medicine, the American International Health Alliance (AIHA), and the Armenian Ministry of Health. This center served as the first and the model for a system of centers that grew to number 16 throughout the former Soviet Union. Under Dr. Virabyan’s direction the center grew to serve all of Armenia in Emergency Medical Services (EMS), Emergency Medicine, and Disaster Medicine training. As the first and model center for the AIHA network of training centers, Dr. Virabyan’s center received numerous awards and accolades for cutting-edge Emergency and Disaster training. From 1994-2002, the center trained nearly 10,000 students and hosted a number of international conferences and training sessions. Under the leadership of Dr. Virabyan, the Yerevan center became the flagship center of the American International Health Alliance network, and was featured prominently in its advertisements and website.
Dr. Anushavan Virabyan continues to serve Armenia as one of its leaders in the medical field, and a pioneer in the fields of Emergency and Disaster Medicine. He has written over 20 published papers and continues to teach young medical students and residents. He was recently appointed Vice President of the Armenian Ambulance Association and helps to drive policy through that position. Armenian history will show that through Dr. Anushavan Virabyan’s forward thinking and advanced training programs, he pioneered the establishment of the fields of Emergency Medicine and Disaster Medicine, revolutionizing the way Emergency care is provided in that country.
Sam was born in London and lived in Essex, enjoying a life in Music during school and college there. He made the decision to enter medicine late and now studies at the University of Manchester, after completing a foundation year for widening access. He is currently fourth year.
Last year he took a year out and intercalated, gaining a BSc in Tropical Disease Biology from the Liverpool School of Tropical Medicine. Although his research focus was on the laboratory growth of filarial parasites, it was there he found a way to begin accessing the sphere of humanitarian medicine, and could begin to further his interest in the structure of humanitarian response and disaster/tropical medicine. He is currently helping to organise a conference on Health in Humanitarian Settings at the LSTM, and is beginning research with members of the HCRI in Manchester. He hopes to enter the world of humanitarianism after FY1/FY2 years.
Dr Luanne Freer, leader of Expedition & Wilderness Medicines Mountain Medicine CME & FAWM course in Nepal and speaker at the 2013 Extreme Medicine Conference at Harvard Medical School, is featured in Outside Magazine…
THURSDAY, MAY 17, 2012
LUANNE FREER: BEHIND THE SCENES IN EVEREST’S EMERGENCY ROOM
This is shaping up to be one of the deadliest seasons on record, with 10 deaths so far and too many helicopter evacuations to count. Here’s a sneak peak at the doctors on the front lines of the world’s highest clinic.
“We’re happy to see climbers,” says Freer, “but in the end, the thing that makes our hearts warm is seeing the little cooks and the Sherpas.”This year has been especially busy for the ER staff, which also includes Dr. Rachel Anderson, 33, of Manchester, England, and the organization’s first Nepalese doc, Ashish Lohani, 27. Within the first three weeks of the season—when we spoke—the ER had already seen 220 patients and overseen roughly a dozen helicopter rescues, more evacuations than in all of 2011. They’ve also seen some rare maladies, including two cases of deep vein thrombosis, an ischemic foot (no oxygen supply, though not frostbite related), a 33-year-old who had a stroke in the ER, and a trekker who’d suppressed her altitude headaches with narcotics and ended up with cerebral edema by the time she reached Base Camp.
In the 10 years that the clinic has been in operation, the biggest change is probably the new ubiquity of helicopters. Freer explained that climbers have always had rescue insurance, but it used to be that helicopters were incredibly scarce in Nepal. In some years, the only option for rescue was a military-owned, Russian-built Mi-8.
“Now we have these big machines,” says Freer, “and heli companies that are competing for the business.” Freer admits that she does sometimes feel under pressure to authorize helicopter evacuations in questionable cases and that she’s sometimes overridden by a climber’s personal physician back home.
“We have an ethical issue,” she says “You have to be reasonable. There was a guy down in Pheriche who wanted to call a helicopter because he had a sinus infection—you have to put your foot down somewhere.”
What Ails You
Here, Freer and Anderson explain the top five reasons people darken their tent flap
1. Khumbu Cough, aka high altitude cough: It’s a little bit controversial in the medical climbing community. There are some people who feel like it’s sub-clinical high-altitude pulmonary edema. “They’re not hypoxic yet, they’re not leaking yet, but it’s pulmonary pressure that causes it,” says Freer. “I’m not in that camp. I believe it’s the extremely dry air—relative humidity is four-five percent here—combined with the cold and it just cracks the bronchial tree.”
2. Viral Respiratory Infection, aka the common cold: Somebody who has a bacterial infection usually has a fever, though you can still get a fever with viral infections. Coughing up a lot of green stuff is usually a sign of bacterial infections. When you listen to the chest, you can hear it. Our bodies have a harder time fighting off illness at high altitude, and we’ve got a really impatient community here. “They want to be fixed in 24 hours with a tablet,” says Anderson. “They’ll say ‘I’m going up tomorrow, gimme the best thing you’ve got.’ And unfortunately, we have to tell them: You’ve got a cold. What would you do at home if you had a cold? We’re sensitive to it, but it gets frustrating.”
3. Gastritis: “It’s more prevalent among the native population,” says Freer. We’re not talking about infection, this is inflammation of the stomach lining that causes pain—acid reflux. With hypoxia from the altitude, the stomach lining doesn’t get as much oxygen, either. It can be more serious up here. When you’re doing really hard work, your body has to decide where the oxygen goes. “The muscles and brain always win out,” says Anderson, “and the gut loses.”
4. Infectious Gastritis: The stomach bug. A simple matter of not washing your hands, and not properly treating water and food. Antibiotics are effective against these.
5. Altitude Issues: Periodic breathing, insomnia, acute mountain sickness (AMS), high-altitude pulmonary and cerebral edema (HAPE and HACE). “We know from big studies that at the altitude of Lobuche (16,210 feet), 50 percent of people will develop AMS—headache, dizziness, loss of appetite,” says Freer. What’s different up here is that people are self-selected. Most people who are going to get sick get sick at lower elevations and never make it to Base Camp. And climbers tend to be pretty well tested at altitude. It’s a group that’s self-selected for success.
The Wilderness Medicine Society has granted the Extreme Medicine Conference 32.25 credits towards the Fellowship of Wilderness Medicine if all 4 days of the conference are attended
The Academy of Wilderness Medicine is a modular system of adult education that organizes the broad range of information in the discipline of Wilderness Medicine. It delivers them in a professionally packaged, standardized fashion according to modern concepts of medical education using objectives as the basis for learning experiences and outcomes evaluation where appropriate.
The most visible of the Academy’s modular programs, and the one that promises to be the most popular, is the Fellowship program (Fellow of the Academy of Wilderness Medicine TM or FAWM). This initiative offers a means to identify those who have achieved a demanding set of requirements validating their training and experience in Wilderness Medicine for the assurances of patients, clients, and the public at large. Society members enroll in the Academy and, by completing lessons from a pre-established Wilderness Medicine curriculum as well as receiving credit for specefic, indentiable experience; accumulate credit toward becoming a Fellow.
Any current member of the Wilderness Medical Society who successfully completes the requirements will have the distinction of being a registered member of the Academy of Wilderness Medicine and entitled to use the designation Fellow of the Academy of Wilderness Medicine (FAWM) and may reference it on resumes, business cards, and advertisements.
Book your ticket for the International ‘World Extreme Medicine’ Conference & EXPO, Royal Society of Medicine, London
Expedition & Wilderness Medicine invites you to the inaugural International World Extreme Medicine Conference & EXPO, Royal Society of Medicine, London
Taking Medicine To The Extremes | Date: 15-18 April 2012 | Venue: Royal Society of Medicine, Central London
Topics: Expedition & Wilderness | Pre-Hospital | Disaster & Relief
Summary: As a major new international ‘World Extreme Medicine’ conference and EXPO series the inaugural event hosted by the Royal Society of Medicine, central London will be held over 15-18 April 2012.
The conference will deliver 4 days of CME & FAWM-accredited knowledge, insight and innovation in the field of remote medicine and sub-disciplines: expedition and wilderness medicine, pre-hospital medicine, and disaster and relief medicine. Delivering these messages will be speakers who are the global leaders in remote extreme medicine, ideally placed to provide expert knowledge transfer to delegates.
Developed specifically with medical professionals in mind, the International ‘World Extreme Medicine’ conference and EXPO will also be of interest to other medical specialists (nurses and paramedics) and as well as for students all with discounted rates.
Wilderness Medicine Student Societies
Specially discounted rates are available for accredited members of WMS societies and groups of medical students booking as a group. For more details please contact Dr Nick Knight, Expedition & Wilderness Medicines University Liaison, for more details.
Download the full ‘Extreme Medicine’ program here.
We look forward to meeting you next April,
Mark Hannaford, Dr Sean Hudson and the Expedition & Wilderness Medicine Team
‘Taking Medicine to the Extremes’
As we get closer to finalising the details for the World Extreme Medicine Conference & EXPO to be held at the centrally located Royal Society of Medicine in London we are proud to give you first glimpse of the conferences logo.
We wanted something modern and contemporary which illustrated in a straightforward dynamic manner the underlying concept. So we approached Fathom, a dynamic creative team based in Poole, who have a similar come up with what we think is a great logo.
Nigel Parsons from Fathom explains more;
‘The idea was born out of simplicity. To create a striking, powerful and easily recognisable logo device that could adapted to the various locations. The use of the knocked back medical emergency icon gives the logo credibility and heritage. Its a logo that works whether on the side of a jacket or the top of a letterhead and one that we will now build on to create a powerful international brand.’
Registration will be opening soon but will be offered initially to those of you who have pre-registered your interest and at special discount. If you would like to pre register your interest then you can do so here – [email protected].