Case study: An application of intubation training A senior medical officer who works at rural hospitals, and who regularly trains aboard the mobile surgical bus, recounted an occasion where those skills were used in an emergency. The situation A patient presented to the senior medical officer at the emergency department of [a hospital] on a Sunday evening. The patient was not feeling well, having recently had laser treatment on the vocal cords. I could hear that the patient had developed noisy breathing. The situation quickly deteriorated to the point where the patient could not breathe because of a swelling in the vocal cords following surgery and was lapsing into unconsciousness. The medical intervention It was apparent that the patient required an immediate intubation insertion of an – endotracheal tube to open the airway and enable ventilation. This invasive procedure typically requires anaesthesia. Before intubation, I had to take steps to sedate the patient using propofol and then administer medications to paralyse the patient so as to reduce any risk of vomiting. I then inserted the endotracheal tube to enable ventilation. The outcome By the time the patient was transferred to [a base hospital], the oxygen levels in the were normal and the patient was being ventilated. The patient remained in the intensive care unit for a couple of days before making a complete recovery. An ambulance came to the patient (as the rescue helicopter was unable to fly that evening due to weather conditions), but this took over hour and a half and the patient wouldn’t have survived without that procedure. The impact of the training The senior medical officer valued the opportunity to regularly assist aboard the mobile surgical bus as one way to help maintain these skills. My experiences on the bus meant I had more familiarity to competently and safely deal with the anaesthetic drugs involved and to take steps to stabilise the patient. For example, the drugs reduce blood pressure and so you think ahead to compensate to avoid cardiac arrest. It’s about having the skill to correctly place the tube in the airway. It’s not straightforward and you have to avoid the oesophagus. I teach Advanced Cardiac Life Support, but practicing on mannequins is not the same, as you can’t duplicate the anatomical nuances. This refresher experience is crucial, as you don’t deal with these situations frequently enough in smaller centres, but they do occur. So I value being able to access the bus.
Case study: An application of intubation training A senior medical officer who works at rural hospitals, and who regularly trains aboard the mobile surgical bus, recounted an occasion where those skills were used in an emergency. The situation A patient presented to the senior medical officer at the emergency department of [a hospital] on a Sunday evening. The patient was not feeling well, having recently had laser treatment on the vocal cords. I could hear that the patient had developed noisy breathing. The situation quickly deteriorated to the point where the patient could not breathe because of a swelling in the vocal cords following surgery and was lapsing into unconsciousness. The medical intervention It was apparent that the patient required an immediate intubation – insertion of an endotracheal tube to open the airway and enable ventilation. This invasive procedure typically requires anaesthesia. Before intubation, I had to take steps to sedate the patient using propofol and then administer medications to paralyse the patient so as to reduce any risk of vomiting. I then inserted the endotracheal tube to enable ventilation. The outcome By the time the patient was transferred to [a base hospital], the oxygen levels in the were normal and the patient was being ventilated. The patient remained in the intensive care unit for a couple of days before making a complete recovery. An ambulance came to the patient (as the rescue helicopter was unable to fly that evening due to weather conditions), but this took over hour and a half and the patient wouldn’t have survived without that procedure. The impact of the training The senior medical officer valued the opportunity to regularly assist aboard the mobile surgical bus as one way to help maintain these skills. My experiences on the bus meant I had more familiarity to competently and safely deal with the anaesthetic drugs involved and to take steps to stabilise the patient. For example, the drugs reduce blood pressure and so you think ahead to compensate to avoid cardiac arrest. It’s about having the skill to correctly place the tube in the airway. It’s not straightforward and you have to avoid the oesophagus. I teach Advanced Cardiac Life Support, but practicing on mannequins is not the same, as you can’t duplicate the anatomical nuances. This refresher experience is crucial, as you don’t deal with these situations frequently enough in smaller centres, but they do occur. So I value being able to access the bus.
mss-review-report.docx