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For our second AF of the year we had two speakers:
1) Vaneesa Keeley, a 3rd PCP Student, who spoke about a case she attended last year. The talk consisted of a description of a case where there was a difficult extrication due to the nature of the environment that the crew on scene were in. There was also a discussion on prehospital resuscitation and the guidelines that are in place for these events. 2) Dr Sameer Mal, who is a London Air Ambulance HEMS doctor, spoke about his work in Australia and the major difference in prehospital medicine there and in the UK. With a major difference on distance from rural locations to major trauma centres. In addition, Dr Mal spoke about the various terrains that they would need to work in, in Australia - with this the extensive training that they would need to go through continously.
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 Our first PCP Academic Forum of the 2018/2019 of the Year, which was organised by 3rd year Sruthi Vydyula. The forum explored the risk of knife crime and violence in London.
1) Started off with a talk by 3rd PCP Student, Ellen Richards, who discussed a case she had attended in the last year. With her discussing this case is Dr Gareth Grier, a HEMS doctor, and bought his perspective on this case. 2) Followed by a talk by Dr Duncan Bew, clinical director for Trauma and Acute Surgery at King's and is involved with the charity Growing Against Violence. 3) A panel was then set up that included Sean Harris (PCP Lead Paramedic), Dr Duncan Bew, Shareef Mahdi (Volunteer with StreetDoctors) and Dr Gareth Grier. This involved a discussion between the panel based on a question that was asked about by the audience (image shown on right).  We are sad to announce that Tuesday 25th April saw our last Academic Forum of the Academic Year. The final forum was based around the theme of Nerve Agents.
The evening opened with Graham Chalk, Lead Paramedic & Clinical Liaison Officer in the LAA. Graham acts as the main point of contact between London's Air Ambulance and London Ambulance Service. in 2015 Graham became Paramedic Education & Development Lead. He also acts as lead faculty member for the Pre-hospital Care Course and a member of Board of Directors at Association of Air Ambulance. Graham discussed the challenges the paramedics who work tirelessly at the HEMS dispatches desks face. Sharing real 999 calls received by the HEMS desk, Graham taught the audience the difficulties in interrogating members of the public in order to decipher those patients who are in most need of the HEMS unit. This was a very eye opening talk, and gave the audience a completely different perspective of pre-hospital medicine. After the break we were joined by Dr Gareth Grier - Con-convenor of the Prehospital Medicine iBSc. A familiar face to the PCP and academic forums; Dr Grier is a Consultant in Emergency Medicine and Pre-hospital care, working with the LAA. Dr Grier delivered an interactive lecture on chemical nerve agents, with a particular focus on Sarin. Recruiting members of the audience to act as members of the public, members of parliament and police and HEMS doctors and paramedics - the scenario re-enacted a sequence of events to re-enact a chemical attack in London. The presentation taught us the toxidrome of nerve agents, and how people may present if exposed to Sarin, as seen recently in the Syria attacks. It re-instated Graham's talk earlier on how a paramedic working in the control room might react. The session focused on how we felt the emergency services would respond in such a scenario - reflecting on escalating a major incident and the issue of decontamination. It was discussed how such an event might be managed in the capital - with the take home message of being able to recognise characteristics of such nerve agents on people.  March's Forum saw aspects of prehospital medicine from an alternative perspective....
The evening began with Louise Elstow; a consultant in Emergency Management for a range of clients in public and private sectors; both in the UK and internationally. Clients across a wide range of bases. including: healthcare, nuclear and transport industries. Louise has an MSc in risk, crisis and disaster management; and is currently undertaking a PhD in nuclear recovery and contamination issues. She was a member of the team who delivered and facilitated the LiveEx in Exercise Unified Response - in her role of coordinator. The talk delivered at the forum described the exercise unified response training exercise that was executed last year. The training programme involved over 100 organisations - including all members of the emergency team, including those from abroad. Louise explained in detail the set up of the mass casualty, which was based on two underground trains colliding, with multiple casualties. The complexity of scene management and multi-organisation response was highlighted, especially with the incorporation of aid received from the EU. It was interesting to see the learning points that were raised, and how each branch of the emergency services is developing their protocols and plans with regards to a major incident, in response to this exercise. See the video for how this exercise was executed. After a short break, and information regarding the new PCP application process, we were joined by BSc PCP student Matthew Dawson. Matt delivered his dissertation talk on gang and youth violence in relation to an event he attended whilst on a PCP shift. The case presented was a young man who had been stabbed, which resulted in a thoracotomy and transport to hospital. The talk focused however on our perceptions of young people who become victims to crimes such as this, with emphasis on the fact that "Serious youth violence does not always equal gang crime". The talk concluded with some key learning points regarding how violence in these subgroups of young people can be reduced and prevented, through organisations such as St Giles Trust and Street Doctors by breaking the cycle of offending. For more information on these organisations please visit: http://www.stgilestrust.org.uk/ http://streetdoctors.org/  2017 welcomed us into a PCP forum like no other! With the Perrin Lecture Theatre packed full; the evening began with Dr Ben Singer, consultant in critical care, ECMO and anaesthetics, as well as HEMS emeritus for KSS discussing prehospital ECMO. Dr Singer spoke about the role of ECMO (Extra-corporeal membrane oxygenation) in a prehospital cardiac arrest scenario. It was emphasised the importance of being able to administer ECMO within a 30 minute window in order for better outcomes - with evidence showing an increase in survival post discharge from a prehospital cardiac arrest from <10% to 30%. Dr Singer provided an insightful account of his own experiences of ECMO and what the future held in this exciting area of prehospital care. The second half of the forum provided a bit of a twist compared to the normal AF setup. Based on a case attended by PCP student Ella Smith, a real time re-enactment was performed of the case: starting with the 999 call through to the handover in A&E. We were privileged to have HEMS, LAS and Police Medics participating in the live demonstration, giving the audience a real time account of what happens at a call out, in this scenario of a motorcyclist involved in an RTC. The interactive session gave audience members the opportunity to think through what they would do if they were in the shoes of either the doctor and paramedic on scene. The forum was wrapped up with a discussion based on the case from the live demonstration, allowing both the participants and the audience to reflect on the difficulties the case presented. 2017 is off to a great start and we look forward to seeing you all on February 28th!
This months forums focus was on haemorrhage and the use of blood products in the prehospital environment,
Our second academic forum of the year kick started with 2nd year PCP student Catharine White presenting a case discussion of a hemorrhage patient observed whilst on shift. This moving account was accompanied by on key learning points when managing such a patient. This was followed by Lead Clinician for the Prehospital Care Programme, Consultant in Emergency Medicine & Prehospital Care at The Royal London Hospital, and Lead Clinician for London's Air Ambulance Dr Ann Weaver. In keeping with the theme of haemorrhage; Dr Weaver talked about the challenges of administering prehospital blood products and the research that is being done to optimise this.  Our first Academic Forum of the year had a great response with the Perrin LT being packed out with medical students and LAS members.
Tonight's theme was on Medical vs. Traumatic Cardiac Arrest. The evening kicked off with a case presentation by 2nd year PCP student Jack Dryburgh-Jones discussing a medical cardiac arrest attended on an FRU shift. Jack talked through his own experience of a medical out of hospital cardiac arrest. Multiple aspects of the case were discussed including scene management and conducting a primary survey; highlighting the difficulties in the assessment of a non-responsive patient in the prehospital setting. LAS guidelines on management of a cardiac arrest were discussed, including the eight reversible causes. In keeping with the case scenario further teaching was provided on hypovolaemia within cardiac arrest. Jack’s talk concluded with a discussion; emphasising the importance of reflecting on difficult cases. This was followed by a talk from HEMS Anaesthetist Dr Miller; who has experience not only working for LAA but also Sydney HEMS and Surrey Sussex Air Ambulance Trust. Dr Miller spoke about traumatic cardiac arrest and the challenges within the pre-hospital environment. This was reinforced by discussion on the difficulties of gathering and comparing data on traumatic cardiac arrest. We hope this forum sets a precedent for the upcoming year and we look forward to seeing you on the 29th of November.  We've had our final public Academic Forum of 2015, and by all accounts it was a fantastic night! Tonight's theme was on Haemorrhage and Shock, and we kicked off with a talk from St George's Hospital Paediatric Emergency Consultant and Kent & Surrey Air Ambulance Consultant Dr Kevin Enright.
Dr Enright talked about the history of doctors in the prehospital field and the recent advances in carrying blood/blood products via the air ambulance out to prehospital scenes. He then talked through a number of cases and mechanisms of injury, from splenic rupture to aortic dissection, and bleeding head injuries to tension pneumothoracies forgotten in the panic of treating bleeding. Overall Dr Enright's talk will ensure there's now 200+ prehospital clinicians well armed for recognising and treating haemorrhage. For the second half our audience broke into year groups, with first years going through the ABCDE approach, second years learning practically how to deal with haemorrhage, third/fourth/fifth years learning about burns management and fluid replacement, and paramedics/paramedic students going trough when and when not to use to fluids in the prehospital environment. We have to give special thanks to Dr Anne Weaver, Dr John McKenna, and Lead Paramedic Sarah Mortimer from London's Air Ambulance; PC Andrew Barrett a police medic; and a huge number of LAS Paramedics for giving up their time to teach students all about haemorrhage and shock. Finally we can't finish without mentioning our very Dr Gareth Grier, who won the Association of Air Ambulances Doctor of the Year award last week! A huge congratulations and well done to an inspirational leader and teacher. We hope to see you all back in January for the next academic forum on London Trauma. We've taught Airway, Breathing, and Circulation in 2015... 2016 will be bringing high profile cases and complex trauma to the PCP Academic Forums!  Another month, another Academic Forum! This month's focused on airway management and respiratory emergencies, and we're fairly certain nobody's going to neglect the airway after tonight.
We began with PCP and Prehospital Medicine iBSc student Mark Murphy discussing a hanging case. Mark brought in academic papers as well as his own experiences to talk through the steps in managing a compromised airway, airway adjuncts, and even the principles of rapid sequence induction. Next up Lead Paramedic Craig Cassidy spoke about a case of severe asthma which saw a patient go from being essentially well to exceptionally unwell in a matter of minutes. Craig discussed the management of asthma, but also imparted fantastic advice about dealing with frightening situations. Finally Dr Gareth Grier taught about rapid sequence induction (RSI; prehospital general anaesthesia) in terms of the procedure as well as which cases it would be indicated in. We then finished the night using television medical dramas to demonstrate how forgetting the airway can be devastating. We were also lucky enough to be joined by students from Aarhus University's Anaestheisology and Traumatology Society from Denmark! The PCP is going international! Overall a wonderful evening and we hope to see you in November for Haemorrhage and Shock.  We had an amazing first night back with the Cardiac Arrest Academic Forum, thank you so much to everyone that made it possible and everyone that joined us for the evening.
The night started off with a welcome address by Lead Student Siobhan Williams, who told everyone what the PCP is all about and what to expect in the year to come. Next up was PCP student Prasanth Sritharan who presented a cardiac arrest case he attended; as well as teaching all about reversible causes of arrests, ABGs, ECGs, primary survey, and physiology of blood pressure! An exceptional presentation that even had people on their feet acting out heart rhythms! Following that was Conrad Witek, an almnus from the inaugral year of the Barts and The London Prehospital Medicine intercalated BSc. Conrad told us all about the role of echocardiography during cardiac arrest, as well as re-affirming the importance of good quality CPR. Everyone will have taken something away from what was called a conference-worthy talk by a doctor in the audience. Finally Dr Jenny Townsend spoke about thoractomy and what extra skills the London's Air Ambulance can bring to cardiac arrest. Jenny inspired everyone by telling her story, from being an excited prehospital-interested student (just like those in the audience) to now being a London Air Ambulance doctor. She also covered scene safety and crowd management, important skills in the prehospital environment. To end the night Dr Gareth Grier found some volunteers to enact a stabbing scenario complete with LAS responders, LAA arrival, and ultimately a thoracotomy (though thankfully no volunteers actually received a thoracotomy!). Overall a fantastic evening filled with fantastic teaching, interactive scenarios and hopefully inspiration for future generations of doctors and paramedics. We hope to see you on October 27th for the next Academic Forum! |
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