trauma 2004 - roadside to critical care

Anaesthetic Trauma and Critical Care First International Trauma Conference
22-24th November 2004 Crowne Plaza Hotel, Liverpool, UK

Our first Trauma Conference held in November 2004 was a huge success, attracting International speakers and delegates from all services involved in trauma care. The programme followed our philosophy of patient care from roadside to critical care and was educational, inspiring and entertaining.

Miss Sharon Blanckley
Conference Director Orthopaedic
SPR ATACC MRT

 

Session 1 – UK Pre-Hospital trauma care providers

An interesting start to the conference with summaries from some of the main pre-hospital medical care providers in the UK. Dr Mark Forrest, Consultant Anaesthetist, Medical Director ATACC, Dr Dave Lockey, Consultant Anaesthetist, HEMS and Dr Rod MacKenzie, Medical Director MAGPAS, contributed their views. Clearly much work is going on to provide good quality medical care in the pre-hospital environment, but problems exist with standardising the service, training and funding.

Session 2 – ‘Roadside to Critical Care’

A Trauma Scenario This was a truly novel session presenting a fictional trauma case from time of accident through to the Intensive Care Unit. The ATACC Medical Rescue Teams multidisciplinary approach to care was highlighted.

Sub-Officer Nick Holmes, Cheshire Fire Service – EXTRICATION

Mr Rob Griffiths, SODP – PRE-HOSPITAL CARE

Dr Tom Hurst, SpR Anaesthestics – PRE-HOSPITAL

Mr John Black, Consultant Emergency Medicine – A+E

Miss Sharon Blanckley, SpR Orthopaedics – IN-HOSPITAL TRAUMA TEAM/THEATRE

Dr Tony Nicholson, Consultant Radiologist – INTERVENTIONAL RADIOLOGY

Dr Dave Southern, Consultant Anaesthetist – CRITICAL CARE

This scenario highlighted issues, some controversial (!!), with regard to management of an entrapped driver following MVC.

On scene care included:

• Scene Safety
• Massive haemorrhage control prior to airway management
• Initial airway management by ODP (LMA)
• Rapid extrication with speed board
• Circulation preservation techniques
• Pre-hospital RSI (anaesthetist)

Session 3 – Pre-hospital Care Controversies

Issues raised and discussed included LMA vs RSI, Dr Graham Jones, Consultant Anaesthetist, ATACC Medical Rescue Team, Emergency Thoracotomy, Mr John Black, Consultant Anaesthetist and Tension Pneumothorax, Dr Tim Harris, Consultant ED/PHC and Dr Simon Leigh-Smith, SpR A+E.

Session 4 – Terrorism and Trauma A very interesting and thought provoking session, ‘Bullets, Blast and Ballisitics’, Mr Alex Stronge, Military Medic, ‘Surgical management of Gunshot wounds’, Mr Eddie Chaloner, Consultant Vascular Surgeon and ‘Genetics of Survivors’, Dr Hugh Montgomery, Consultant Anaesthetist.

Session 5 – Breakout Topics

1 – Trauma Surgery – Chaired by Mr Mike McNicholas, Consultant Orthopaedic Surgeon, this session included a lecture by Mr Eddie Chaloner, Consultant Vascular Surgeon, on trauma in the developing world. The bulk of the session concentrated on the dilemma faced on occasions with regard to limb salvage/amputation following severe trauma. Thanks to Mr Durai Nayagam, Consultant Orthopaedic Surgeon / Limb Reconstruction Service Liverpool and Mr Steve Cannon, Consultant Orthopaedic Surgeon, for their contributions and expertise.

2 – Trauma Radiolgy – Dr Tony Nicholson

3 – Human Patient Simulator Demonstration – an opportunity to observe the simulator in action and to take part in moulage scenarios as taught on our trauma courses.

Session 6 – Extreme Medicine

A truly refreshing end to a full day!! Experiences shared from some truly extreme environments, ‘Technical Diving Medicine’, Dr Tristan Cope, Consultant Anaesthetist (when asked..why??, answer…’cos we can…..!!!!), ‘RTA in the Middle of Nowhere’, Dr Bob Mark, Consultant A+E (eye-opening experiences from the Namibian Vintage Rally) and ‘Extremes of Trauma’, Mr Dave Connell, Military Medic (hostile and dangerous environments, title speaks for itself). Dr Kevin Fong, Extreme Medicine Group, NASA gave an entertaining and enlightening talk on his involvement with the Mission to Mars.

Session 7 – Shock and Fluids

The concept of Circulation Preservation was discussed by Dr Mark Forrest, Consultant Anaesthetist, ATACC Medical Director and convincing lectures on the use of Hypertonic fluids and Factor VIIa by Professor Walter Mauritz, Professor Anaesthesia and Critical Care, Austria and Professor Yoram Kluger, Chairman Dept. Surgery, Rambam Medical Centre, Israel, respectively

Session 8 – Breakout Topics

1 - Case Presentation
2 – Fire / EMS – Chaired by Sub-Officer Nick Holmes, Cheshire Fire Service, this session covered extrication issues and a lecture from Mr Phil Keating, Engineer Thelwall Viaduct, on the Medical Team at the viaduct.
3 – Human Patient Simulator Demonstration

Session 9 – Trauma Education Trauma education techniques are ever evolving and an insight into the use of Human Patient Simulators was given by Dr Graham Jones, Consultant Anaesthetist, and on-line teaching with trauma.org by Mr Scott Millington, Editor Image Bank, Trauma.org.

Session 10 – The Future The conference raised many issues and areas which are clearly likely to be at the forefront of trauma care in the future. Sub-Officer Nick Holmes introduced the issue of new car design and the problems thus facing rescuers of entrapped victims. Dr Andrew Healey, Radiology Fellow, continued the theme of the importance of early interventional radiology, but resources are sadly lacking in this field in the UK at present. Dr Jason van der Velde, SHO A+E, ATACC Medical Rescue Team, introduced our new medical response unit, ‘Rescue 1’, which is a first in the UK as it brings together members of the fire service, police and medical profession in one vehicle. Operational duties are set to start in early 2005 and will centre on the M6 corridor and will attend all major motor vehicle collisions and entrapments.

Conference Dinner
The formal conference dinner was held at the superb Sefton Park Palm House and was catered for by Chapman Holmes Ltd. A memorable and enjoyable evening was had by all.

AV Thanks to John Mills Co. Ltd for their audio-visual assistance.
Sponsors Thanks also to the companies which exhibited : SP services, Mediwrap, BPL, Intavent, Ferno, Dynamed, Cardiac Science, Intersurgical, Fresenius, Novonordisk, Zoll and Hutchinson Technology.
A final thanks to everyone who worked so hard and contributed to the success of the conference

Miss Sharon Blanckley Conference Director
Dr Mark Forrest Medical Director