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 www.givealittle.co.nz/cause/
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. getthru.govt.nz
“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
www.ttophs.govt.nz/flooding
Take care of yourselves and your loved ones.
Arohanui Sally Webb