20% off entry to Extreme Medicine ’15 as our way of saying ‘thank you for marching’
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To coincide with World Humanitarian Day, a number of the country’s leading medical and NGO experts are calling for an urgent review of the way that healthcare is delivered to those most in need during and in the aftermath of a crisis.
News Release |Wednesday 19 August 2015
The Extreme Medicine Conference is a vital forum to bring the best minds from around the globe together to share and most importantly disseminate information and learning from disparate healthcare specialties.
They bring expertise from diverse environments to develop best practice that is the foundation of healthcare delivery on the frontline. Speakers at the conference will define the necessary proactive rather than reactive response to emergencies, as exemplified by the Ebola outbreak in 2014. Part of this is recognising and deploying the widest range of skillsets in a crisis, and facilitating joined up working across geopolitical boundaries.
‘Extreme medicine’ refers to the provision of medical care outside of conventional settings, typically in low resource environments that exist as a consequence of sudden onset disasters, conflict zones or being expeditionary locations. The medics who work in these remote settings are in a position to universally share relevant knowledge and experience as well as research and techniques with one another. A key benefit of this is integration with local medics delivering healthcare on the ground. It is these skills which experts suggest need to be recognised and cohesively deployed to relevant humanitarian disasters.
Dr Sean Hudson, Remote Medicine Specialist and Extreme Conference organizer said, “The Extreme Medicine Conference brings together specialists from disaster medicine under one roof so we can see and learn from other clinicians operating in other environments. It is one small step in terms of improved disaster response. Global disasters are going to be inevitably more frequent as a result of climate change and we should be on the front foot. Extreme medicine and global health need to be further recognised to allow for better responses across the world.”
Nick Gent, Deputy Head of Emergency Response at PHE “Extreme medicine practitioners come from a range of specialisms but they work in closely related areas so there’s a huge amount that can be shared between them. We have to look back and think about learning for the future, we have to always think about we can improve responses to issues such as Ebola.”
Ivan Gayton, Technological Innovation Adviser with the Manson Unit at Médecins Sans Frontières UK, said: “In order to provide effective health responses to those most in need, we must bring disciplines from all areas of remote and extreme medicine together to share learnings and knowledge. By doing this we can truly understand the constraints of the environments where the most urgent care is needed and draw on the experiences of those in the field to understand what would deliver the most successful outcome.”
Rob Williams, CEO of War Child, Charity partner to the Extreme Medicine Conference said, “Nobody is more vulnerable in conflict than children and War Child work closely with their parents and local staff to ensure they are getting the treatment they so desperately need. They are in dire need of urgent psychological support to help them come to terms with the traumas they have experienced and witnessed. But we want to respond quicker on a global scale and by humanitarian workers and medics from all fields sharing knowledge, we can all learn from each other and reach the optimum response. This is the ethos of the World Extreme Medicine Conference and why War Child is proud to a partner this year.”
ENDS
For more information and/or to arrange interviews with spokespeople, please contact:
Julia Flint | freuds | [email protected] | 0203 003 6593 or 07773331815
Jessica Hampton | freuds | [email protected] |0203 003 6415 or 07949 717217
Notes to editors:
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Thanks to Kris Vandervoort for applying to the Belgian Accreditation Council & securing 32 credit points. Belgian medics will need a certificate of attendance & a copy of the approval she received.
Email [email protected] so we can collate your details.
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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
We are privileged and humbled by all the support that this years Extreme Medicine Conference is receiving. We are so honoured that the London HEMS Team is joining us to offer a two pre conference Pre-Hospital Care Courses – talk about learning from the best!!
About London’s Air Ambulance (http://londonsairambulance.co.uk/) is the charity that delivers an advanced trauma team to critically injured people in London. The service provides pre-hospital medical care at the scene of the incident and serves the 10 million people who live, work and commute within the M25.
Based at The Royal London Hospital and founded in 1989, the service operates 24/7, with the helicopter running in daylight hours and rapid response cars taking over at night and in adverse weather conditions.
The team, which at all times includes an advanced trauma doctor and paramedic, perform advanced medical interventions, normally only found in the hospital Emergency Department, in time critical, life threatening situations. Missions commonly involve serious road traffic collisions, falls from height, industrial accidents, assaults and injuries on the rail network.
London’s Air Ambulance has an international reputation for clinical excellence and delivers pioneering procedures that have been adopted across the world.
The Institute for Pre-Hospital Care. For twenty-five years, London’s Air Ambulance has been a leader in the development and practice of pre-hospital care. Through its research, innovation and education activities, as well as the professional affiliations and publications of its clinical leadership, it has influenced clinical guidelines, governance standards and the practice of numerous air ambulances, in the U.K. and abroad.
The Institute of Pre-Hospital Care at London’s Air Ambulance (www.IoPHC.co.uk) was founded in 2013 to build on and expand this influence. Its mission is to drive excellence in pre-hospital care standards and practice through research, innovation and education; and by fostering collaboration across medical disciplines and institutions dedicated to improving outcomes for people afflicted by critical injury and illness.
In 2014, The Institute created, and will deliver, the UK’s first undergraduate degree in pre-hospital medicine, in partnership with Queen Mary University of London.
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When: Friday 28th March 16:30-18:00
Where: Lecture Theatre 1 – New Hunt’s House, Guy’s Campus, King’s College London
Contact: [email protected]
(c) Guardian news
Deep in the heart of northern Norway lies the Kjølen mountain range, a series of jagged peaks that line the Swedish border. This bleak Arctic wilderness, more than 100 miles from any major hospital, may seem an unlikely setting for an event that changed medical history but, 14 years ago, the miraculous survival story of Anna Bågenholm for ever redefined our understanding of the boundary between life and death.
Bågenholm, a trainee doctor, was skiing off-piste with two of her colleagues when she lost control during a steep descent, falling on to a layer of ice covering a mountain stream. A hole opened in the ice sheet and she was dragged head-first into the freezing meltwater. Trapped hopelessly beneath eight inches of ice, she was slowly freezing to death.
Normally your core body temperature is 37C but with immersion in ice-cold water, this plummets rapidly. Below 35C, the body enters the state of hypothermia, characterised by shivering and pale skin. Below 30C, most victims will lose consciousness and, when body temperature drops to 25C, cardiac arrest will almost certainly occur.
Although Bågenholm’s friends immediately called for aid, it would take an hour and a half for a mountain rescue helicopter to reach their location. After 40 minutes of desperate struggling, Bågenholm’s body went limp. Shortly afterwards her heart stopped.
Following cardiac arrest, the body enters a state known as “downtime”. This is the twilight zone in which the process of dying begins. Normally within a few minutes of downtime, without immediate medical intervention, death will follow.
By the time Bågenholm was brought to the University Hospital of North Norway in Tromso, her heart had stopped for well over two hours. Her core temperature had plunged to 13.7C. She was in every sense clinically dead.
However, in Norway, there has been an old saying for the past three decades that you’re never dead until you’re warm and dead. Mads Gilbert is the head of emergency medicine at the hospital and, from experience, he knew that there was a slim chance the extreme cold had actually kept her alive.
“Over the last 28 years, there have been 34 victims of accidental hypothermia with cardiac arrest who were rewarmed on cardiopulmonary bypass and 30% survived,” he said. “The key question is, are you cooled before you have the cardiac arrest or are you first having a circulatory arrest and then getting cooled?”
While lowering the body temperature will stop the heart, it also reduces the oxygen demand of the body and, in particular, the brain cells. If the vital organs have been sufficiently cooled before the cardiac arrest occurs, then the inevitable cell death from the lack of circulation will be postponed, buying emergency services an extra time window to try and save the person’s life.
“Hypothermia is so fascinating because it’s a double-edged sword,” Gilbert said. “On the one side it can protect you but, on the other side, it will kill you. But it’s all a question of how controlled the hypothermia is. Anna was probably cooled quite slowly but efficiently so that, when her heart stopped, her brain was already so cold that the oxygen need in the brain cells was down to zero. Good CPR can provide up to 30-40% of the blood circulation to the brain and in these cases that is often sufficient to keep the person alive for sometimes seven hours while we try to restart the heart.”
Crucially the levels of potassium in Bågenholm’s blood were normal, a key indicator of the extent of cell damage in the body and the decision was taken to warm her up. If the potassium is beyond a certain threshold, the person has no chance of survival.
Four and a half hours after Bågenholm first fell through the ice, her heart was successfully restarted. She spent 35 days on a life support machine before being moved to intensive care and then a rehabilitation unit. From there, she began the slow process of training herself back to complete restoration.
Her extraordinary story has led to therapeutic hypothermia being introduced as a protective measure for victims of strokes, liver failure and epileptic seizures. Recent studies have also illustrated its effectiveness in newborn babies who have suffered a lack of oxygen at birth.
It is commonly used around the world in open heart operations where surgeons will cool the body down to as low as 10C, allowing them to cut off the arterial supply to the brain for up to 15 minutes without any notable brain damage.
Jasmin Arrich, of the Medical University of Vienna, researches the use of therapeutic hypothermia during or after resuscitation from cardiac arrest.
“In these cases, the patient’s body is cooled down to mild hypothermia (32-34C) for 12-24 hours,” she said. “We do this because when this patient can be resuscitated and the circulation starts again, various pathophysiologic mechanisms are initiated and substances are formed that continuously keep on damaging the brain cells and other cells of the body. Mild hypothermia exerts its beneficial effects on many of these mechanisms and substances.”
However, there has been some controversy over the introduction of therapeutic hypothermia as a mainstream procedure for certain conditions based on unsubstantial evidence. A group of Swedish scientists have released a new paper questioning the levels of hypothermia that are applied as a protective measure to the unconscious survivors of cardiac arrest.
“We have to be careful because hypothermia is also dangerous to the body,” Gilbert said. “It is upsetting the enzyme system, the cellular membrane balance and the integrity of the cells. And in trauma, we know there is a linear relationship between the degree of hypothermia in the trauma patient and the mortality rate. The clotting mechanisms are greatly influenced by hypothermia in a negative way. Anna was able to survive for so long because she didn’t have a trauma. She didn’t have any bleeding anywhere.”
Fourteen years on, Bågenholm now works as a senior radiology consultant in the very hospital where her life was once in the balance. Nobody before or since has been so cold and lived to tell the tale. These days, she once again partakes in extreme skiing in the mountains of north Norway, a living reminder of the human body’s capacity for endurance.
(c) Guardian news
Of Interest
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One Step Forward was hosted and arranged by RSM. I was fortunate enough to be invited to speak on Expedition Medicine.
The other speakers were inspirational and it was delightful to hear a series of lectures by doctors who dont hold to the production line theory of doctor creation.
I tried to follow this theme and aimed to inspire the junior doctors and medical students to expand their horizons and experience other cultures and hopefully to become a more rounded physician in the process. I even got to lecture to Professor Kumar (Kumar and Clark)!