The Cutting Edge

Thanks to Kenu Dilega Parker for photography

I’ve just had the incredible good fortune to spend a few days between GP15 and PAIC2015 as a speaker and facilitator at RescueExperienceOz events in Victoria and Tasmania.

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The one day Rescue Experience workshops are provided free of charge around the world by Holmatro – the makers of rescue tools.  I don’t know anything about hydraulics or cutting equipment, but has previously browsed the rather excellent ‘Vehicle Extrication Techniques’ book from extrication guru Ian Dunbar (@dunbarian).  You can get the book as either hardcover or as an interactive app (both OSX and Android versions available). It’s useful for clinicians to have an idea of vehicle extrication at the roadside!

“Excellence – Innovation – Education”

So it was a pleasure to meet the legendary Ian Dunbar (aka “Dumpy”). A former firefighter with Cheshire Fire Brigade in the UK, Ian now has the enviable title of ‘rescue consultant’ with Holmatro and gets to travel the world – not selling tools, but advising on technical aspects of road crash rescue.  He also plays a mean guitar and has a keen interest in all aspects of road crash rescue – not least trauma management.
Also helping were SA-born firefighter Joff van Ek and SES guru Kris Parker – they a part of the team at Extrication Matters and both struck me as incredibly knowledgable and engaging folk – a sort of FOAMed for SES/fire services!


“Road crash rescue – safer, quicker, easier”

I was struck by the similar ethos between these vehicle extrication expert and my trauma gurus – both governed by the maxim of bringing cutting edge techniques to the roadside in whatever form.

I was particularly interested in Ian’s involvement with ATACC – the “anaesthesia trauma and critical care” course is one which I’ve long championed (see blog post here).

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Unlike ATLS-EMST, the ATACC course offers immersive simulation from prehospital to tertiary centre.. It is also a multidisciplinary course, with doctors, paramedics and fire/rescue participants.

“Extrication practice should not happen in isolation – it requires multi-agency training and inter-agency understanding”

Ian told me how he attended ATACC as a rescue operative over a decade ago – and became passionate about learning clinical skills as well as road crash rescue – a sensible decision, given that fire/rescue services are often first on scene and may have to deal with a critically ill patient with minimal training. Of course, even if paramedic & retrieval services are on scene, it is essential for all agencies to understand each other’s operational priorities and capabilities. As well as being an instructor on ATACC, Ian (and fellow ATACC Faculty) have championed the institution of BTACC  a one day course designed to give first responders the necessary skills to deal with such patients, in addition to their usual role as vehicle rescue operators.

Teaching vehicle rescue workers the MARCH approach
Clinical & Extrication priorities need a shared plan

Details of BTACC, RTACC and ATACC are available by clocking the respective links.  Sadly there is nothing like this available in Australasia of which I am aware, although the Sydney-HEMS induction course comes pretty close by all accounts.

Needless to say I think this is definitely something that could (and indeed should) be brought ‘down under’ – an ATACC course in Oz would certainly fill a niche – but perhaps more useful would be a suite of courses including BTACC…

The rescue operators whom we taught were mostly drawn from ranks of the State Emergency Service (SES) as well as Country and Metro Fire services – and all seemed to enjoy the mix of practical hands on demos and inspirational lectures we delivered.

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Of course it’s not just courses that make a robust system – my paper with John Hall on establishing a national Australia-wide rural responder network was published this week in Emergency Medicine Australasia and has attracted some positive feedback – but wouldn’t it be awesome to tap into the available workforce of other emergency agencies to help deliver support when it’s needed?

Perhaps the BEST bang for buck will be to support the freely available GoodSAMapp.  This is not specific for trauma – in fact, it’s better for delivery of crowdsourced basic life support (airway opening and CPR) by trained personnel such as SES, fire, surf life saving as well as off duty clinicians.

I would be so proud if attendees at ResExOz15 and colleagues in SES, fire and surf lifesaving would download both the GoodSAM ‘responder’ and ‘alerter’ apps  and register as a GoodSAM responder

Once done, encourage friends and family to download the ‘alerter’ app.


Thanks to Kenu Dilega Parker for photographs – see more of her excellent work here


1 thought on “The Cutting Edge”

  1. Nice report on the Holamtro Rescue Experience. I was there on Sunday and enjoyed your presentation and practical activity very much.

    Thanks again ….
    Just a minor point – the colour photos in your article were taken by myself. Kenu Dilega Parker took the B&W ones.

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