3. The Worlds Most Boring Slide: To
get it out of the way
• C Cylinder: 440L
• D Cylinder: 1600L
• E Cylinder 3800L
Vox pop, hear what they are saying on the street
“man, that was so boring”
4. Transfer & Retrieval
• Why Transfer (& when NOT to) and aim
• Modes of Transport with increasing levels
of care
• The Essentials of Patient Preparation: Aim
to do nothing en route with some
exceptions
• Problems
5. Choice of Mode
• Distance (Transit and
Transfer)
• Escort requirements
• Geographical
considerations
• Availability &
resources
7. Preparing
•
•
•
•
•
•
•
Aim to do everything before transport
Aim to do nothing during transport
Prepare for all eventualities
Early advice and communication by site
Early liaison with transport providers
Destination unit
Empty / Check everything (tubes, lines, relatives,
bladders)
• All documentation, investigations
10. Requesting a transfer
1800 625 800
Clinical Coordinator
Operator for basic details
Retrieval doctor for clinical details.
Tasking, fuel, hours, vermin checks, logistics.
Prioritises and determines crew and flight parameters.
Advises on management and preparation for flight.
Liaises with receiving hospital including bed finding.
14. RFDS National Priorities
(WA figures for 2009/2010)
• Priority 1 (n=557)
– Life / limb threatening
– “ One for One!” time of call to doors closed <60 mins
• Priority 2 (n=2987)
– Urgent
– Depart for patient within 4 hrs
• Priority 3 (n=2223)
– “Routine”
– within 48 hrs
– Timeframe can be specified
17. ICU in a phone box
•
•
•
•
•
•
•
•
All operations consistent with
Joint Faculty standards.
Intensive Care Medicine
Ventilators, Monitors with
invasive pressures, ETCO2
Blood Gases, electrolytes
Ultrasound
Transcutaneous pacing/12 lead
ECG
Infusion pumps.
O neg packed cells.
Time critical drugs, eg
antivenoms, digibind
25. If you would have pushed!
• RFDS has ACEM and Anaesthetic accredited
terms
• One term has come up at short notice for next
year
• Email hakan.yaman@rfdswa.com.au if
interested
• (if you objected, join the radiology training
program)
33. Broad Tasking Criteria
• Skill critical
– Skills of RFDS MO/CCP
• Time critical
– Time to tertiary hospital
• Access
– No road, Rottnest, no airstrip, rescue requirement
• Resources
– No fixed wing aircraft or other resources available
• Likely to improve patient outcome
34. Road v Helicopter
Example of patient awaiting retrieval in Narrogin
To Hospital
Waiting transport
Initial Resus
Transport
Road
Helicopter
0
50
100
150
200
39. Major incident
• Defined by the need for extraordinary
resources (location, number, severity, type of
live injuries)
– Natural vs. manmade
– Simple vs. compound (infrastructure intact vs.
damaged)
– Compensated vs. uncompensated (whether
additional resource mobilization sufficient)
40. Major Incident: Response based on
MIMMS
• 1) Preparation: Planning/equipment/training
• 2) Response: All hazards approach ‘CSCATTT’
•
•
•
•
•
Command & Control
Safety: Self, scene, survivors
Communications: METHANE
Assessment
Triage/Treatment/Transport
• 3) Recovery
50. Hospital based response
• Notification
• Preparation
– Equipment: Incl. disaster kits (green airway, blue
breathing, red circulation bags)
– Expand resources
– Area
• Receival: Greatest good for the greatest no?
• Recovery
51. SCGH
• Code Brown
– Areawide medical co-ordinator will contact duty
ED consultant
• Can request disaster response team
• Activation of disaster plan
– Duty ED consultant activates-contacts hospital
health co-ordinator who in turn activates the
emergency response team and emergency control
group (exec group)
– Also Code CBR (prepare PPE, decontaminate)