Health Matters WBOP April 2017

Mock trauma tests team It’s four o’clock in the morning. The Ambulance service has radioed in. Paramedics have a drunken man in his twenties on board. It’s a motor vehicle verses power pole crash. The patient was stable at the scene, but is fast deteriorating. That’s the information a team of junior doctors at Tauranga Hospital were faced with recently, taking part in a mock exercise to test how they’d respond and perform in a real life trauma. Clinical Director of Emergency Medicine, BOPDHB Derek Sage says, “Simulation ‘in-situ’ training is crucial to improving the safety and quality of our patient care. You wouldn’t expect the All Blacks to be the best rugby team in the world without training and practicing their team moves. The same applies to our trauma teams only the stakes are much higher.” Trauma team training takes place in one of the resuscitation bays in the Emergency Department (ED). With the aid of some clever make-up and 2.5 litres of fake blood, the patient, (Dr Tom Brown) is made to look like he has head and chest injuries. ED Senior Medical Officer Dr Paul Blakemore who manages the exercise says “It’s a typical severe trauma. We try to make the scenario as realistic as possible, to make sure we’re putting those involved in a pressured environment just as they would be in real life. Staging the scenario in ED, using a real person and make-up adds to the level of intensity.” It’s the ED Senior Registrar’s responsibility to pull a trauma team together and delegate roles. The call’s made, and within minutes a multidisciplinary team of Resident Medical Officers (RMOs) from surgery, orthopaedics and anaesthetics, together with nursing staff and radiographers are called into ED. Just as would be the case in a real trauma, the patient’s vitals are changing, forcing the trauma team to adapt on the spot. consults with the on call consultant surgeon and the patient is urgently moved to theatre. “The monitor screen showing the patient’s vital signs is actually an I-pad controlled by a nurse educator who’s in the room changing the patient’s vitals throughout the exercise. Dr Sage, who also chairs the BOPDHB Simulation Advisory Group, says the logistics of staging the trauma training in ED can be tricky. “There is a lot of preparation involved, and there’s always a high chance the exercise will be cancelled at the last minute due to a real emergency.” “Systems are tested too. The fake blood is in realistic packaging and has to be hooked up correctly and warmed just as it is done in real life”, says Dr Blakemore. The simulation training is modelled on Crew Resource Management developed by the aviation industry in the late 1970s to reduce pilot error. The scenario is over in 45 minutes when the surgical RMO From the Chair All of us across the Bay of Plenty are well aware of the devastating effect cyclones have had on our region the past few weeks. It has been shocking to watch the news and see the devastation of people’s lives, their homes destroyed and precious possessions lost. I was at the public meeting in Whakatāne after the Edgecumbe flood and to hear what people have lost was heartbreaking. The only positive aspect was that no lives were lost, and the community worked together to ensure everyone got out alive, a great effort by so many willing volunteers and local families. Sally Webb, Chair Bay of Plenty District Health Board The Civil Defence and other agencies together with local communities have rallied to provide emergency assistance however those who have lost so much will need ongoing support, and for some they will have nothing to retrieve when they get back into their houses. So I am asking everyone to think seriously contributing to the ‘Givealittle’ Mayoral Flood Appeal at ebopmayoralfund If you haven’t done so already, I can’t emphasize enough the importance of being prepared with an emergency kit and plan when a disaster strikes without warning. Aside from survival items, it’s also important to take some sort of personal identification such as your driver’s license with you. Copies of bank account numbers, lists of medications and some cash are items that should also be included but easy to forget. For more advice about preparing for a disaster including a step by step guide see www. “We’re fortunate to have senior staff highly experienced in medical and simulation training. It’s recognised worldwide as a core part of professional training in healthcare.” Dr Sage says ED clinicians are developing further simulation ‘in-situ’ scenarios which will involve clinical teams across both Tauranga and Whakatāne hospitals. For information about protecting the health of you and your family and whānau during and after a flood event see Take care of yourselves and your loved ones. Arohanui Sally Webb