Marys Medicine

Anzcp.org.au

ANZCP
CONFERENCE
2015

14th & 15th August
Aerial UTS Function Centre
Ultimo, Sydney

Welcome to
ANZCP Conference 2015
The College welcomes you to Sydney and to the ANZCP Conference 2015. It has been four years since the
College held a major conference in Sydney, and while the past couple of years have seen the College's
activities grow into other states, it is certainly pleasing to deliver this conference in our membership
heartland.
ANZCP Conference 2015 brings together leaders of the Australian and New Zealand paramedicine field, expert clinical physicians, paramedic educators and academics to provide a paramedic focused and highly relevant conference. The College's focus has always been on high quality professional development opportunities for paramedics and all those working in the emergency field, and we hope the ANZCP Conference 2015 lives up to that goal for you. For all those interstate and regional members who have made the journey to join us today; thank you for your commitment to education and being part of this event. We would also like to make a special mention of all those new members who have joined the College as part of your Conference ticket – welcome to the College and we look forward to supporting you throughout your career in paramedicine. In our minds, a conference is not about what your hear but about what you take away; so while we expect our presenters to deliver great presentations, with new and interesting information (or some old information that is worth considering again in our practice), it is important that we engage with those presentations fully and be greedy in gaining as much as we can from the experience – be open and ready to receive! Best wishes for a successful and rewarding conference experience, Your organising committee: Conference Schedule: Day 1 – Friday 14th August Welcome
Marty Nichols, ANZCP Chair
Opening Keynote
Back to the Future
Ray Creen - Chief Executive NSW Ambulance
Future Proof Your Organisation
David Foot - Chief Officer ACTAS
What is the role for tranexamic acid in pre-hospital care?
Dr Tony Smith - St John NZ
Thinking about how you think: enhancing paramedic decision making through
metacognition
Dr Paul Simpson
Antarctic Medicine – medicine in the extremes
Dr Jeff Ayton - Australian Antarctic Division
Droperidol - An oldie but a goodie
Matthew Caffey, CQ University
Resus in the National Park
Cameron Edgar
Children - are they really that different
Dr Tony Smith - St. John NZ
The AVOID Trial
Mick Stephenson - AV
AV Cardiac Arrest Registry
Associate Professor Karen Smith
CPR Challenge
Janelle White
Welcome Drinks
UTS Function Centre Bar & Balcony Conference Schedule: Day 2 – Saturday 15th August Welcome
Clare Beech, ANZCP Director
Early Intervention profoundly affects long term outcome in patients with acute
burns
Dr John Harvey
Transportation of Obstetric Emergencies and High Risk Pregnancies
Alex Peck - Flight Nurse, NSWA
Prehospital care for Major Trauma - who, how, why?
Ben Meadley - MICA Paramedic
More than One – Multiple Casualty Management
Dr Sanj Fernando
Extreme Measures
Dr Cliff Reid
Trauma Panel Discussion
Ben, Sanj, Cliff - Chaired by Marty Nichols
Why you should care about paramedic registration
Associate Professor Michael Eburn
The nasty side of Party Drugs
Tony Hucker ASM - QAS
Australia's response to the Ebola epidemic in West Africa: establishing an Ebola
Treatment Centre (ETC) in Sierra Leone
Paul McRae - ICP, NSWA
"The future ain't what it used to be" – a short history of the interesting bits of
resuscitation
Clinical Associate Professor Paul Middleton
Day 1 - Friday 14th August
Ray Creen ASM
Chief Executive – NSW Ambulance
In March 2013 Ray Creen took on the role of Chief Executive NSW Ambulance having been
CEO of SA Ambulance Service since July 2008. Since commencing with NSW Ambulance,
Ray has commenced taking the organisation on a journey of transformational change.
Beginning with the appointment of a new executive structure and team, Ray developed
‘Today is the Day we make Tomorrow Different' – a bold and exciting direction for NSW
Ambulance that sets an agenda of modernised service delivery, cultural change and values-based leadership. In addition to his role with NSW Ambulance, Ray currently holds the positon of Chair for the Council of Ambulance Authorities (CAA). In his former appointment leading SA Ambulance Service, it rose to one of the top performing ambulance services in Australia and has become renowned for its innovative approach to delivering high-quality, patient focused out-of-hospital care. Ray's leadership saw SA Ambulance Service move away from the traditional model of always transporting patients to hospital to a more tailored ambulance service which provides patients with the most appropriate treatment option for their needs. In 2008 Ray developed a new service delivery model for SA Ambulance Service – ‘Defining the road ahead' – which set the reform agenda for the organisation. Since 2008 SA Ambulance Service has introduced a wide range of new patient service initiatives including motorcycle response unit paramedics, bicycle response unit paramedics, extended care paramedics (ECPs) and single paramedic response and intervention (SPRINT) paramedics. In 2012 Ray also took on the management and governance of three additional agencies of SA Health – SA Pathology, SA Pharmacy and SA Imaging under the banner of Statewide Clinical Support Services. Overall Ray was accountable for 6068 direct staff, 354 facilities and an operating budget of $644 million. During his time as Deputy CEO and Director, Statewide Operations for SA Ambulance Service, Ray held responsibility for all of South Australia's ambulance operations including communications, emergency response, pre-hospital clinical care, emergency and major events and patient transfer services. Ray has provided advice and consultancy to the Wellington Free Ambulance Service, New Zealand and ambulance services in parts of Asia and the Pacific including Tonga and Malaysia. Ray currently holds positions on a number of advisory, governance and medical committees including: · Chair, Council of Ambulance Authorities · Former Board Member, Southern Adelaide Fleurieu and Kangaroo Island Medicare Local · Chair, CAA National Clinical Committee · Chair, CAA National Paramedic Education Committee · State Controller (for major disasters) and member of State Controller Reference Group. Before moving to Australia to take up his role with SA Ambulance Service, Ray held a number of senior leadership positions in ambulance services within the National Health Service (NHS), United Kingdom. Ray was instrumental in the improvement of response, clinical and leadership performances of many ambulance services around the UK. On top of his National Health Service (NHS) Trust roles with ambulance services in the UK, Ray also worked as an affiliate in the NHS Modernisation Agencies, Improvement Program for Ambulance Services. In these roles, he supported a number of Ambulance Trusts to improve their performance, and he was a member of a working group that developed national ‘best practice' guidelines for Ambulance Control rooms and operations management. A career paramedic, working in rapid response, dispatch, training and education roles, frontline management, driving instructor, CBRN commander and helicopter search and rescue roles Ray has over 30 years of operational experience. Back to the Future
The future of out of hospital car e is one characterised by profound advancements in technology driving models of service delivery, clinical care and community engagement. However as we embark on this revolutionising journey we must not forget the cornerstones of paramedic practice; compassion and care. Ray's presentation will explore the future as something requiring the blending of traditional ambulance care, focused less on clinical interventions and more on caring for people, with the ever evolving technological tools designed to enable better care. Starting as early as the 1880s and rapidly progressing to 2020, Ray will extract the learnings of paramedic practice that we must never forget and that we must strive to include in all our plans for the future.
David Foot ASM
Chief Officer – ACT Ambulance Service

David commenced his career with ambulance in 1986 joining the NSW Ambulance Service
as a recruit. In 1989, David was accepted into Intensive Care Paramedic Course 25
completing his training at North Shore Hospital.
David left NSW in 1992 to take up a front line position with the ACT Ambulance Service. In
1994, David was promoted to Superintendent. In the following ten years, David worked
across a number of operational and administrative areas of the service with some of the
more memorable times including leadership and front line roles during the 1998 Sydney to
Hobart Yacht rescues and 2003 Canberra Bushfires.
David's commitment to advancing ambulance services has been recognised at a number of
levels with citations including the Ambulance Service Medal, National Medal, ACT Bushfire
Medal and Meritorious Service Medal.
Future Proof Your Organisation

Australian ambulance services consistently achieve patient satisfaction scores exceeding
97%. Wouldn't it be great if we could achieve exactly the same levels of satisfaction across
all levels of our organisation?
This presentation examines a recent exercise in which the ACT Ambulance Service
embarked upon an exercise to undertake a review of organisational culture & highlights
the importance of paying as much attention to our people as we do to our technical
capability.

Dr Tony Smith
Medical Director, St John New Zealand

Tony Smith is the Medical Director for St John in New Zealand. He is also an Intensive Care
Medicine Specialist at Auckland City Hospital.
Tony chairs the working group that develops the Clinical Procedures and Guidelines for the
ambulance sector in New Zealand and he oversees all of the clinical aspects of St John
activities in New Zealand, noting that the ambulance service is just one aspect of this. He is
a member of the New Zealand Resuscitation Council and the Australian and New Zealand
Committee on Resuscitation. He has an active involvement in pre-hospital research, with a focus on a collaborative approach to contributing to multicenter trials. He is a member of the HEMS team in Auckland and has a very active ‘hands on role' in pre-hospital care. What is the role for tranexa
mic acid in pre-hospital care?
There is increasing evidence that the development of acute coagulopathy following trauma increases blood loss and increases mortality rates. The cause of the coagulopathy is complex and is contributed to by genetics, tissue damage, inflammation, shock, hypothermia, acidosis, hyperchloremia, dilution and clot breakdown from fibrinolysis. The contribution of fibrinolysis to the development of acute traumatic coagulopathy has revitalised interest in the role of anti-fibrinolytics such as tranexamic acid (TXA) in patients with traumatic injuries. In a very large multicentre, randomised, placebo controlled trial (the CRASH 2 trial) TXA reduced the mortality rate from 16% to 14.5% in a group of patients that were deemed to be ‘at risk of bleeding' following trauma. The results of this trial resulted in many calling for TXA to be administered to all such patients, however many clinicians were concerned that the results from the CRASH 2 trial could not be automatically translated into our healthcare environment. The concerns included:  The majority of patients were from countries with poorly developed healthcare systems and did not have access to treatments such as massive transfusion protocols.  The majority of patients did not die from bleeding.  There was an unexplained increase in mortality if TXA was administered more than three hours after the trauma.  The mortality rate of similarly injured patients in Australasia is less than 5%, so the number needed to treat will be substantially different. In a retrospective, observational study in a military setting (the MATTERs trial) TXA was associated with a reduction in mortality rate from 23.9% to 17.4%. These patients were treated in what we would consider to be a modern healthcare setting and had access to massive transfusion protocols. However, again clinicians had concerns that the results from the MATTERs trial could not be automatically translated into our healthcare environment. The concerns included:  The trial was not prospective and was not randomised.  The nature of deaths following trauma in a military setting are fundamentally different from the nature of deaths following trauma in a civilian setting.  There appeared to be a much higher rate of clinically significant complications following thromboembolism in the group of patients that received TXA. This is of particular concern if the mortality rate from the underlying injuries is low. A number of clinicians decided that further evidence was required and this has resulted in the planned Pre-hospital Anti-fibrinolytics for Traumatic Coagulopathy and Hemorrhage (PATCH) trial. This is a large, multicentre, randomised trial of TXA vs placebo in patients with traumatic injuries and a high risk of death. Sites throughout Australia and New Zealand plan to take part. Recruitment has already commenced in Victoria and commences in New Zealand shortly. This is an exciting and important trial and we are encouraging as many sites as possible to take part.
Dr Paul Simpson
Director of Academic Program, University of Western Sydney

Dr Paul Simpson is the Director of Academic Program for Paramedicine at University of
Western Sydney, and a currently certified intensive care paramedic.
Thinking about how you think: enhancing paramedic decision making through
metacognition

As the role of contemporary paramedics continues to expand and diversify, high-level
decision-making capacity becomes increasingly important. Paramedics are confronted with an array of clinical and non- c linical decisions throughout the course of a single incident. Regardless of the perceived acuity of a patient, the complexity of decision- making is increasing as patient s th emselves become more complex due to increasing age, comorbidities and polypharmacy, and as the paramedic scope of practice grows. Uncommonly described in the context of paramedicine, metacognition is the process of ‘thinking about you think' – it is about understanding of the decision making process and the internal and external factors that impact on that process. It is about understanding the bias that these factors can create, and how to cognitively adjust when providing patient care. This presentation will discuss the concept of metacognition in the context of paramedical decision-making, its application to clinical decision-making, and strategies to integrate it into individual paramedic practice.
Dr Jeff Ayton
Chief Medical Officer – Australian Antarctic Division
Adjunct Associate Professor – James Cook University

Dr Ayton has a passion for rural and remote medicine and has inspired Australian doctors,
and students to pursue a career in rural and remote medicine. Following medical
graduation, Dr Ayton has sought out experience in rural and remote medicine that few
doctors would have the opportunity to experience.
In 1992, he wintered at Australia's extremely remote Casey Station, in Antarctica, as the
station doctor. He has subsequently gained varied experience in other rural and remote
medical practices as a procedural general practitioner, GP obstetrician and GP anaesthetist
including Lorne, Victoria, Norfolk Island, South Pacific, and Papua New Guinea. He has also
been the Deputy Medical Director for International SOS (Australasia).
Dr Ayton's appointment with the Australian Antarctic Division (AAD) as Chief Medical
Officer in 2002 saw him gain responsibility for the AAD's medical support and human
biology and medicine research.
He is current Australian delegate to Scientific Committee of Antarctic Research Life
Sciences Scientific Group and Chief Officer of the SCAR COMNAP Joint Expert Group of
Human Biology and Medicine.
Dr Ayton has also played a significant role in policy development and professional
leadership in rural and remote medicine. He is a Past President of the Australian College of
Rural and Remote Medicine (ACRRM) having served as ACRRM President from 2009-2011.
He is also a board director of General Practice Training Tasmania (GPTT) and Chair of
ACRRM's National Telehealth Advisory Committee promoting telehealth across rural and
remote Australia.
Antarctic Medicine – Medicine in the Extremes


Matthew Caffey
Senior Lecturer, Central Queensland University

Matthew Caffey is a physician assistant (PA-C), critical care paramedic (CCEMTP),
Academic Paramedic with New South Wales Ambulance, and Senior Lecturer for Central
Queensland University's Graduate Diploma of Paramedic Science (Critical Care)
program. He holds a Bachelor of Science in Emergency Health Services from the University
of Maryland, Baltimore County and a Masters of Medical Science from Saint Francis
University. Additionally, he is also the author of the text "Paramedic and Emergency
Pharmacology Guidelines" and the App "Emergency Pharmacology Guidelines" used
throughout Australia and New Zealand. Droperidol: An Oldie but a G
o odie
Droperidol is an older dopamine - 2 receptor antagonist from the same class as haloperidol that was a traditional typical antipsychotic used regularly for four decades. Concerns over the side effects of this medication with QT prolongation led to a significant decrease in its use for the last 15 years. However, new studies have demonstrated that the side effects are highly dose dependent and this is a relatively safe medication when used in appropriately. This presentation reviews droperidol discussing its reapplication for agitation/sedation while taking a deeper look at other indications, benefits, risks, comparison with other behavioural medications, and classic pearls with its use.
Cameron Edgar
SCAT Paramedic, NSW Ambulance

Currently a ‘Special Casualty Access Team' Helicopter Paramedic, Superintendent Cameron
Edgar is the Zone Manager for helicopter operations across Southern NSW. His role sees
him managing the day-to-day operations of ambulance rescue helicopters and their
medical teams responding to bush, canyon, cliff, cave and aquatic search and rescue
missions. Cameron has been a paramedic for over 20 years and has a personal interest in
the ability of ‘people' & ‘organisational' skills to facilitate team goals and is a strong
advocate for systems that focus on 'human factors' to achieve good governance and
safety.
Resus in the National Park

Over the last 40 years of helicopter operations in NSW, the delivery of care has evolved to
meet the needs of patients – many of them recreational adventure seekers, often found in
remote and difficult to reach locations. This presentation will take you through the
important differences between care in conventional versus unconventional locations and
the need to tailor the response for patient and clinician safety.

Dr Tony Smith
Medical Director, St John New Zealand

Children: Are they really that different?

It is often said that children are not little adults and that sick children require a totally
different skill set than sick adults. While there is some truth to these, I think these
differences are often over-emphasised, resulting in some people being very scared of sick
children and this may result in delivery of poor treatment. I want to help change this by
de-emphasising the differences and discussing a simplified approach to the assessment
and treatment of children in the ambulance setting. If you know what to do to a sick or injured adult in a particular circumstance (for example septic shock, traumatic brain injury or cardiac arrest), then you also know what to do to a sick or injured child in the same circumstances. There are some differences you need to remember, but the key principles are the same. In New Zealand we have taken a simplified approach to the assessment of small children using what is often termed the paediatric assessment triangle. This involves an assessment of: activity, breathing (particularly respiratory rate and work of breathing) and circulation (particularly heart rate and peripheral perfusion). This assessment is quick, easy and allows children to be identified (at this particular moment) as either: not very sick, very sick or dying. In addition, the abnormal aspects of the assessment help determine the primary problem, for example a brain problem, a breathing problem or a circulation problem. The assessment of children and the recognition of deterioration may be further enhanced by the use of a physiological sc oring system such as an early warning score. There is a lot of interest in the role such scores may have in the ambulance setting, noting that so far very few ambulance services have introduced them into clinical practice. In New Zealand we have taken a simplified approach to drug dosing. All children are rounded off to the nearest weight of: 5, 10, 20, 30, 40 or 50 Kg. All children 50 Kg and above receive an adult dose. All other children receive the fraction of an adult does that is appropriate for their weight, for example a 30 Kg child gets 60% of the adult dose and a 40 Kg child gets 80% of the adult dose. Although the dose administered may differ slightly from what is in the dosing guidelines, the difference is not clinically significant and our approach has substantially simplified dosing and reduced dosing errors. There is one recurring area of difference that I cannot ignore and this is the additional emotional distress of dealing with a situation where a child dies. I am not an expert in the area of dealing with emotional distress, but I have found myself in a large number of very distressing situations so far in my career. I eventually realised that tragedies are happening all the time and just because I happened to be involved doesn't make this particular tragedy any more tragic than one that I wasn't involved in. It has helped me and it may help others.
Mick Stephenson
General Manager Regional Services – Ambulance Victoria

Mick Stephenson has been a paramedic with Ambulance Victoria since 1996 and Intensive
care paramedic since 1999. He is a former intensive care nurse. He is interested in
algorithmic patient care, cardiac arrest improvements, systematic patient assessment and
problem solving, and the validation of paramedic work through research. He is a co-author
and/or steering committee member on a number of trials including hypothermia in cardiac
arrest and brain injury, oxygen in STEMI and cardiac arrest, and the relevance of BP to
survival after cardiac arrest. Mick has held positions such as MICA Team Manager, MICA
Group Manager, Regional Manager and is currently the General Manager of Emergency
Operations with Ambulance Victoria. Mick was awarded the Ambulance Service Medal in
the 2015 Australia Day Awards for his work at AV in improving patient outcomes and
clinical leadership.
The AVOID Trial

Oxygen therapy is commonly administered to patients with ST-segment elevation
myocardial infarction (STEMI) despite previous studies suggesting a possible increase in
myocardial injury.
The AVOID investigators conducted a pragmatic, multicenter, prospective, randomised
controlled trial comparing oxygen (8 L/min) with no supplemental oxygen in patients with
STEMI diagnosed on paramedic 12-lead electrocardiogram in Melbourne Victoria.
Between October 2011 and January 2014, 638 patients were randomised, of which 441
had confirmed STEMI under coronary angiogram. The primary endpoint was myocardial
infarct size as assessed by cardiac enzymes, troponin (cTnI) and creatine kinase (CK).
Myocardial infarct size at 6 months was measured using cardiac MRI.
In a world-first, the AVOID trial showed that routine oxygen therapy was associated with
an increase in myocardial injury after STEMI. The results of the trial have been presented
internationally, and it jars with more than a century of clinical practice. The results suggest
that the routine use of oxygen therapy in patients with STEMI but without hypoxia can no
longer be recommended.
Associate Professor Karen S
Manager Research and Evaluation – Ambulance Victoria A/Prof Karen Smith establishe e Research and Evaluation Department at Ambulance Victoria (AV) in 2006. The AV research portfolio currently contains over 50 active projects involving collaborations with key universities, hospitals and government departments. Karen has a PhD in epidemiology from Monash University and was the recipient of a National Health and Medical Research (NHMRC) PhD scholarship and NHMRC Post-Doctoral Fellowship. Karen has retained an Honorary Senior Lecture position at the Department of Epidemiology and Preventive Medicine at Monash University. Karen co-founded and chairs the Victorian Cardiac Arrest Registry (VACAR) which contains information dating back to 1999, for all patients in Victoria, who suffer cardiac arrest and receive ambulance attendance. This registry is regarded internationally as a key quality assurance activity and has resulted in over 47 publications in peer reviewed journals. She
also co-founded the Victorian State Trauma Registry (VSTR) at Monash University and
remains on the Steering Committee. In 2012 she was awarded the Ambulance Victoria
Inaugural CEO Award for Leadership Excellence.
A/Prof Smith is a Chief Investigator (CI) on the NHMRC funded Australian Resuscitation
Outcomes Consortium Centre for Research Excellence, established in 2012. The "AUS-
ROC" aims to promote and conduct multicentre clinical research in the area of cardiac
arrest, modelled on (and in collaboration with) the highly successful North American
Resuscitation Outcomes Consortium (ROC). She has also been a Chief Investigator on large
randomised, controlled clinical trials (RCT) in cardiac arrest patients including interventions
such as pre-hospital post-ROSC therapeutic hypothermia and therapeutic hypothermia
during CPR. A/Prof is also a CI on the recently conducted multicentre, prospective, RCT to
investigate supplemental oxygen therapy in alert patients with chest pain who had a
diagnosis of STEMI on paramedic 12-lead electrocardiogram (the AVOID trial), recently
published in Circulation. Also in the pre-hospital setting, A/Prof Smith was a CI on a study
of paramedic rapid sequence intubation in patients with severe traumatic head injury.
Over the past five years, Karen has been involved in winning competitive grants totalling
over $8 million, including four NHMRC grants.
Victorian Ambulance Cardiac Arrest Registry

Prognosis following out-of-hospital cardiac arrest (OHCA) is largely determined by the
quality and timeliness of prehospital interventions. In fact, survival from OHCA is almost
entirely dependent on the attainment of return of spontaneous circulation in the field by
paramedics. The American Heart Association recommends that the monitoring of
treatment of OHCA by Ambulance Services be the sentinel measure of quality of
prehospital care in the community. However, of the 28 clinical registries operating in
Australia in 2009, only the Victorian Ambulance Cardiac Arrest Registry (VACAR) was
recognised as an EMS surveillance initiative.
To date, VACAR has captured over 77,000 OHCA events attended by paramedics in
Victoria. The VACAR collects over 150 standardised data elements containing patient
demographic, treatment, and operational data, including the Utstein-style descriptors and
definitions. The information is used to benchmark OHCA outcomes in Victoria, and
measure the impact of improvements to the system of care for OHCA patients. The
purpose of this presentation is to present the findings of ten years of OHCA surveillance in
Victoria, including trends in bystander cardiopulmonary resuscitation, event survival and
survival to hospital discharge.
Day 2 - Saturday 15th August
Associate Professor John Harvey
Head of Burns Unit, The Children's Hospital at Westmead

Associate Professor John Harvey is Head of Burns Unit at The Children's Hospital at
Westmead. John is Chair of ACI NSW SBIS Burns Practice Review Committee, and past
President of the Australia and New Zealand Burn Association.
John's current interests include application of laser therapy in the management of burns
scars; and burn prevention through primary school education.
Early Intervention profoundly affects long-term outcome in patients with
acute burns

Appropriate and judicious initial intervention in acute burns has a major impact on eventual outcome.
Alex Peck
Flight Nurse, NSW Ambulance

Alex Peck is a Registered Nurse and Registered Midwife, with over 10 years of nursing
experience in a tertiary ICU, specialising in Cardiothoracic ICU. Alex is a CNS in CTICU and
has a postgraduate certificate in Critical Care Nursing – ICU as well as a Diploma of
Midwifery. For the last 5 years, Alex has been working as a Flight Nurse / CNS for The
Ambulance Service of NSW, fixed-wing operations based at Sydney International Airport.
Alex is the Flight Nurse Representative for the ASNSW Clinical Advisory Committee.
Transportation of Obstetric Emergencies and High Risk Pregnancies

This presentation will discuss the most common Obstetric emergencies and High Risk
Pregnancy presentations, and reasons behind transportation decisions.

Ben Meadley
MICA Flight Paramedic, Ambulance Victoria

Ben Meadley has nearly 18 years experience as a paramedic, having completed his initial
training in Victoria and New South Wales. Ben currently works as an Intensive Care
(MICA) Flight Paramedic in regional Victoria, and as a Lecturer and Unit Coordinator in
the postgraduate prehospital programs at Monash University. Actively involved in
prehospital research, Ben has published a number of papers in recent times, with areas
of focus including clinical aspects of winching in HEMS, epidemiology of HEMS patients,
and prehospital anaesthesia in paediatric patients.
Prehospital care for Major Trauma - who, how, why?
Prehospital trauma care is often an emotive and controversial topic. What interventions are proven? What benefits patients the most? Who should provide trauma care? Is advanced trauma care a waste of time? Ben's presentation will look at where paramedics fit in the big picture of basic and advanced prehospital trauma care. Drawing on his own prehospital experience, as well as recent research within his own ambulance service, this presentation aims to provide paramedics an insight to how we can all provide the best care for major trauma patients in the unique and often austere prehospital environment. Dr Sanj Fernando
Senior Emergency Staff Specialist, Director EMET

Sanj Fernando is a short, bald, black man who grew up on a coconut plantation in Sri
Lanka He immigrated to Australia with his family and met his wife at a beer drinking
competition at the University of Tasmania. He completed his medical degree and
specialised in Emergency medicine, training predominantly at St. Vincent's hospital in
Sydney. He is currently a senior Emergency Specialist working in South West Sydney. He
has a n interest in pre-hospital medicine and has been a specialist with NSW Ambulance
HEMS since 2006. He also has an interest in medical education and currently holds an
education portfolio funded by the College for Emergency Medicine. Like many
Emergency physicians he has a short attention span and hence many additional interests
which guarantee that his hair will not grow back any time soon.
More Than One: Multiple Casualty Management

More than one, but less than a major disaster. This is the challenging in-between space
between full-blown disaster management and managing multiple patients with multiple
injuries. We will look at some mini- disaster scenarios and discuss the approach to the
scene, the patients, the hospital and other agencies. We will explore the basic tenants of
major disaster management and how that applies to the smaller 'disaster'. The need for
additional resources, what form those resources should take, performing rapid triage and
identification of patients for early evacuation as well as what interventions to perform
now and what to leave for others will be discussed. Thus providing a framework of
principles to guide you through the multiple patient mini- disasters.

Dr Cliff Reid
Director of Training for Greater Sydney HEMS

Cliff Reid is Director of Emergency Medicine training at NSW Ambulance and a Senior
Staff Specialist in Prehospital & Retrieval Medicine with Greater Sydney Area HEMS. He
has worked for aeromedical and ground-based EMS systems in the UK and Hong Kong.
Cliff is Clinical Associate Professor in Emergency Medicine at Sydney University Medical
School.

Extreme Measures

A number of life, limb and sight saving procedures in trauma are so time critical,
consideration must be given to performing them in the prehospital setting.
This presents challenges in terms of clinical staff training and equipment.
Such procedures include surgical airway, lateral canthotomy, thoracostomy,
thoracotomy, escharotomy, amputation, and resuscitative hysterotomy.
These procedures share the following characteristics: they lose their value if delayed,
they are technically simple to perform, and they may be too rarely encountered to be
taught by an instructor in the typical clinical setting. Novel training strategies are
therefore required to ensure clinician competence and team readiness. The presentation
focuses on the practical aspects of the procedures, modern training strategies, and the
legal, ethical, and practical considerations of performing them in the prehospital setting.
Associate Professor Michael Eburn
ANU College of Law
Michael Eburn is a Barrister an d Associate Professor at the ANU College of Law. He has served as a volunteer with St John Ambulance (NSW) and as both a full time and honorary ambulance officer with NSW Ambulance. He also worked as a legal officer with NSW Health prior to joining the University sector. He is the author of Emergency Law (4th ed 2013, Federation Press) as well as numerous papers on the law and the emergency services. Dr Eburn is the current Chief Investigator on a research project funded by the Bushfire and Natural Hazards CRC on Policy, Institutions and Governance of Natural Hazards. He is an affiliate with the Disaster and Development Network at Northumbria University (UK)
and the Joint Centre for Disaster Research, Massey University (NZ). Michael is a member
of the editorial board for the Australian Journal of Emergency Management and a
member of the Advisory Board for the Australian Emergency Management Institute.
Why you should care about Paramedic Registration

There is ongoing pressure for paramedics to join the ranks of registered health
professionals under the Australian Health Practitioner Regulation Agency. If this happens
paramedics will be registered in the same way as doctors, nurses and 12 other health
professions. This presentation will look at why paramedics should take an interest in the
registration debate and how registration would facilitate paramedic practice and
standing.

Tony Hucker ASM AdvDip HlthSci Grad Dip-Admin MHlthSci-Ed
A/Director Clinical Quality and Patient Safety, QAS
Critical Care Paramedic; A/Director Clinical Quality and Patient Safety, Queensland
Ambulance Service; Adjunct Associate Professor, University of the Sunshine Coast.
Tony is a Critical Care Paramedic who has accrued 36 years ambulance experience
wandering around Victoria, Tasmania and QLD. A Masters Degree in Health Science
Education supports Tony's passion for clinical teaching and innovation. He was awarded
the Ambulance Service Medal in 2001 for his leadership in the development of
Queensland's Intensive Care Paramedic Program and Queensland Police Service Special
Emergency Response Team medical support program.
Tony is a Senior Medical Educator on the Royal Australian College of General
Practitioners Clinical Emergency Management Program. Tony has written and delivered
an advanced medic program for tactical officers with the Australian Federal Police. Along
with many years of clinical experience in rural, urban and flight settings he maintains a
special interest in clinical simulation and tactical EMS. And, of late has become the
reluctant QAS spokesperson on party drugs
The Nasty Side of Party Drugs

Tony's presentation will focus on the challenges of managing severely agitated patients
under the influence of amphetamine type stimulants (ATS) in the pre hospital setting.
Paul McRae
Intensive Care Paramedic, NSW Ambulance I am an Intensive Care Parame c and have worked for NSW Ambulance since 1981. My position title is Inspector (Duty Operation Manager), Hunter New England Sector based in Tamworth. I am also a member of NSW Ambulance Special Operation Team, as a Rescue Paramedic/Instructor and Swift Water Technician. I have worked in the aeromedical environment for 15 years as a Helicopter Paramedic. I also maintain accreditation as a Registered Nurse working in the perioperative environment. I completed the first internationally registered randomised clinical trial for NSW Ambulance that involved paramedics, unsupervised performing a fascia iliaca compartment block for femoral fractures (regional anaesthetic block). The study was the
first of its type and was part of my BMedSci (honours) degree. The findings were
presented at the ECP Seminar 2010 and ACAP Conference 2011.
In addition to my deployment to Sierra Leone, I have deployed on four occasions to East
Timor and Solomon Islands as a helicopter paramedic and nurse supporting peace-
keeping operations.
Australia's response to the Ebola epidemic in West Africa: establishing an
Ebola Treatment Centre (ETC) in Sierra Leone

The Ebola virus causes an acute, serious illness that is often fatal if untreated. An
unprecedented outbreak of Ebola Viral Disease (EVD) has been ongoing in West Africa
since January 2014 and only officially declared in March 2014. The most affected
countries were Guinea, Liberia and Sierra Leone with a total of over 27,000 reported
cases of Ebola with more than 11,000 reported deaths. A total of 869 health care workers
are known to have been infected with EVD during this outbreak and 507 have died.
In early November 2014, the Australian government announced that it would join and
support the international response to the current Ebola outbreak in West Africa. The
Australian government, through the Department of Foreign Affairs and Trade, engaged
an Australian global medical service provider to operate a 100 bed Ebola Treatment
Centre in Sierra Leone (Freetown). An agreement forged between the Australian and
British governments laid the foundation for an ETC to be built. The ETC was built
following a request from the United Nations through the establishment of the United
Nations Mission for Ebola Emergency Response for the international community to adopt
a regional and collaborative approach to stop the Ebola outbreak.
I was one of five nurses, three doctors and an environmental officer who established the
Australian led ETC in Sierra Leone. My presentation will outline in general terms our
preparations, both in Australia and in country, training with Medicine' San Frontiers
(MSF), training national staff, opening the ETC and treating Ebola.
Clinical Associate Professor
Paul Middleton
RGN MBBS DipIMCRCS(Ed) MD MMed(Clin Epi) FRCS(Eng) FANZCP FRCEM FACEM Clinical Associate Professor , University of Sydney Clinical Associate Professor Paul Middleton is a specialist in prehospital and emergency medicine, and has worked as part of prehospital trauma and helicopter critical care retrieval teams in both the UK and Australia. Paul is Chair of the NSW branch of the Australian Resuscitation Council and was the convenor of the first Resus At The Park conference in May 2014. He is also the Chair and one of the founders of Take Heart Australia, a new charitable public health advocacy and educational organisation designed to include all Australians in a mission to increase
survival from sudden cardiac arrest. Take Heart Australia is working with ambulance
services, voluntary bodies and the ARC to develop innovations such as a cardiac arrest for
NSW, a national AED registry, the Heartsafe Communities plan and the promotion of the
GoodSAM app. He is the Principal Investigator of the Distributed Research in Emergency
and Acute Medicine (DREAM) Collaboration, working with partners in emergency
departments across NSW and beyond to perform epidemiological studies of all patients
seen in ED.
Paul has taught hundreds of doctors and nurses how to treat serious illness and injury in
adults and children, and is Director of the Australian Institute for Clinical Education,
which develops blended-learning clinical educational courses for doctors, nurses and
paramedics. He was the lead author of What To Do When Your Child Gets Sick (2010)
published by Allen and Unwin, and is the principal of SavingLittleLives, a company
founded to teach parents and other carers how to recognise sick and injured children.
Paul is Clinical Associate Professor in the Discipline of Emergency Medicine at the
University of Sydney's Central Clinical School; Conjoint Associate Professor in the School
of Biomedical Engineering and Conjoint Senior Lecturer in the School of Public Health and
Community Medicine, both at the University of New South Wales. He is a Fellow of the
Royal College of Emergency Medicine, the Australasian College for Emergency Medicine,
the Royal College of Surgeons of England and the Australian and New Zealand College of
Paramedicine, and has published extensive clinical research on non-invasive assessment
of illness, pre-hospital research and clinical trials, patient safety, epidemiology, health
economics and critical patient transport.
He has been an author for the International Liaison Committee on Resuscitation (ILCOR)
cardiac arrest guidelines, is a member of the research committee of the International
Federation of Emergency Medicine, and represents Australia on the Asian EMS Council.
Paul's former roles include several years as Medical Director of the Ambulance Service of
NSW, founding Director of the Ambulance Research Institute and Chief Medical Officer to
St John Ambulance, Australia.
"The future ain't what it used to be" – a short history of the interesting bits of
resuscitation

Resuscitation seems to be straightforward today, even though people keep trying to
make it complicated with research and evidence. All the shiny machines, expensive drugs
and complicated interventions are only the tip of the iceberg, however, with a long and
fascinating history of interesting, obscure and occasionally painful therapies lurking
under the surface.
In this talk you will hear about the history underpinning our resuscitation practice,
describing not only the remarkable innovation and impressive vision of many of our
eminent past colleagues, but also some of the lesser-known byways that we may be
happy we didn't continue travelling down.
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Laerdal Medical

Laerdal Medical is a leading provider of training,
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Our vision is that no one should die or be disabled unnecessarily during birth or from sudden illness or trauma. Laerdal's portfolio of medical simulation products, CPR training manikins and emergency therapeutic products are used by enterprises around the world. For more information, visit ANZCP Conference 2015 Sponsors
Ferno Austalia

When lives are on the line, there is a company just as dedicated to
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Careflight

CareFlight is proud to sponsor the 2015 ANZCP Conference. As a charitable organisation whose mission is to save lives, speed recovery and serve the community through the provision of the highest quality pre-hospital critical care, CareFlight seeks to ensure that all pre-hospital care providers are afforded the opportunity to advance their professional knowledge so that they too may "save a life". From volunteer first-aiders and emergency services personnel through to on-road paramedics and budding aeromedical staff, CareFlight Education can offer a course delivered by industry leaders to suit your needs. Drop by our display and enquire as to how attending one of CareFlight's specialty courses can better prepare you for the next step in your career. For more information, visi
Zoll Medical Corporation

ZOLL Medical Corporation, an Asahi Kasei Group company,
develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, fluid resuscitation, and therapeutic temperature management, ZOLL provides a comprehensive set of technologies that help clinicians, EMS, and lay rescuers treat victims needing resuscitation and critical care. For more information, visi

Source: https://www.anzcp.org.au/wp-content/uploads/2015/08/Program-Notes-Final-v2.pdf