RickInOz

I’ve been doing yet more work for Mediflight and the jobs will prompt the subject matter of this posting. Yesterday and today I have been out to what we call a “Primary”. These are tasked by SAAS directly in response to feedback from the ambulance crew who attend vehicle accidents and trauma cases. This means we will actually go to the scene, often requiring us to work in remote and potentially hostile environments.

The first we know of these missions is the call from SAAS Comms notifying us that the helicopter will be coming to the helipad and giving us 10 minutes notice to get upstairs. This isn’t actually that long as we have to get our packs ready, obtain blood units for transfusion and get up to meet the chopper. We often have very little detail to work with to start with and start the outward journey ignorant of what awaits. Occasionally whilst we are in the air we are updated by the paramedics on the ground, but there is still a strong anticipation on landing.

Our key objective is to assess, package and transport the patient as quickly as possible. We have little resources and means to perform complex interventions at the scene and only 4 units of blood. Therefore if the patient is badly injured then getting them to definitive treatment (i.e.: hospital) is paramount. We tend to follow a “A-B-C” approach by taking measures to make sure the patient is getting oxygen to their brain. This can be achieved by ventilatory assistance if they are unconcious or unable to breathe properly and resuscitation with fluids and blood if they are bleeding. Sometimes we are delayed if the patient is still trapped in their vehicle or inaccessible due to terrain. Fortuantely the Fire Service and State Emergency Service also attend these calls and help with getting the patient to us, or us to the patient.

We also have to be mindful of spinal injuries so the patient always has a hard collar applied and is transported on a Vacmat. This is a padded mattress that is filled with polystyrene beads. We use a suction pump to create a vacuum within the mattress and when fully deflated it becomes inflexible and will hold the shape we apply. This means we can package a patient very securely so they can’t move and worsen injuries whilst in transit.

Then we hightail it back to the RAH and aim to deliver the patient to the Emergency Department in reasonable shape. Then our job is done but we tend to follow their progress through hospital to ensure that we identified their injuries and delivered appropriate treatment in a timely fashion.

A couple of pictures to finish. Firstly the overturned car containing the two patients I brought back from Two Wells yesterday, demonstrating the dangerous combination of high speed and inexperience:

And now a picture of the SES winching a patient up a cliff-side at Wattle Point after a fall resulting in a badly fractured leg: