BASICS Scotland Podcast

Richard Lyon - Management of Traumatic Cardiac Arrest

In this podcast Professor Lyon discusses Traumatic Cardiac Arrest; he looks at the rationale of the different management needed to medical cardiac arrest and talks through the practical application of the HOT algorithm, which he developed with colleagues to provide an effective tool for the management of Traumatic Cardiac Arrest.

 

Key points from this podcast:

• Do not assume the patient is in Traumatic Cardiac arrest (TCA)! When you hear that this is a TCA call, think this is highly likely to be a critically ill person that is going to need my intervention and go into that case positively thinking that you are going to create a survivor.
• Know the HOTT algorithm, know it well, know it inside out, practice it and stick to addressing the HOTT reversible causes quickly, simultaneously, as rapidly and effectively as you can.
• Consider the possibility that the cardiac arrest is of a medical origin with 10% of all TCA cases having a medical cause and don’t forget to check that they are not in VF and might just need a shock to achieve Return Of Spontaneous Circulation

Resources related to this podcast:

Traumatic Cardiac Arrest Algorithm

Elsevier – Development of a simple algorithm to guide the effective management of traumatic cardiac arrest

About Richard

Professor Lyon is a Consultant in Emergency Medicine at The Royal Infirmary of Edinburgh, HEMS Consultant and Director of Research for Kent, Surrey & Sussex Air Ambulance and an Honorary Senior Clinical Lecturer at the University of Edinburgh.

Prof Lyon has an established research portfolio in pre-hospital resuscitation, trauma care and emergency medicine with an extensive publication record.

He has won numerous international awards including the top research award from the European Resuscitation Council. Prof Lyon was a lead doctor for the London 2012 Olympic Stadium and takes leading role in Event Medicine.

He is an active member of the UK International Search & Rescue Team and has previous experience in the British Armed Forces. Prof Lyon is a current member of the Resuscitation Council (UK) Executive Committee and author of several international pre-hospital guidelines.

Stephen Hearns - Peak Performance Under Pressure

Dr Stephen Hearns chats to us about the critical importance of how we perform when the pressure is on; he draws on his huge experience in Pre-Hospital medicine to show that staying at the peak of performance at a job is a trait that can be learnt and improves outcomes for the team and patient. He shares practical hints and tips on preparation, communications, controlling your stress and regaining your composure when the frazzle hits.

Key points from this podcast:

3 key points to improve performance under pressure-

• Drilling through turning predictable tasks into automatic actions and freeing up cognitive ’space’ for decision making
• Using cognitive aids (checklists, guidelines)
• Using ‘rally points’ to share and update your mental model

Resources related to this podcast:

For more information on Stephen and his publications, visit https://corecognition.co.uk/

About Stephen

Stephen is a consultant in emergency and aeromedical retrieval medicine. He works with Scotland’s Emergency Medical Retrieval Service (EMRS). This aeromedical retrieval service delivers pre-hospital critical care for major trauma patients, rural hospital secondary retrievals and major incident responses. Inspired by experience gained working on London’s air ambulance and in Queensland Australia, Stephen led the establishment of this team from a small voluntary service in 2004 to what is now a fully government funded aeromedical retrieval organisation with an international reputation. Stephen has published a number of papers and book chapters relating to emergency medicine and pre-hospital care.

Lucy Powls - Maternal Hypertension and Pre-eclampsia

Introduction: 

Lucy talks us through the risk factors, signs and symptoms of maternal hypertension, the long term management and prehospital emergency treatments including that of eclamptic seizures.

  

Top 3 tips: 

 

1)   Pre-eclampsia is quite common and blood pressure and urinalyses should be checked at every available opportunity

2) Severe hypertension requires urgent management so if systolic greater than 160mmHg

3) Management of eclampsia involves basic ABC support and Magnesium Sulphate is the drug of choice for seizure activity

  

Links and Resources

 

Maternity NEWS charts

https://ihub.scot/improvement-programmes/scottish-patient-safety-programme-spsp/maternity-and-children-quality-improvement-collaborative-mcqic/maternity-care/national-mews/

 

NICE guidelines for hypertension in pregnancy

https://www.nice.org.uk/guidance/ng133

 

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