Video interview from Queensland – the north-eastern territory of Australia

By May 4, 2020 May 18th, 2020 2 Comments

Interview with Per Bredmose, RACQ Lifeflight Rescue Critical Care Doctor with LifeFlight in Queensland, Australia, on preparing and training for the corona virus crisis

Interview with Per Bredmose from AirDoc on Vimeo.

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– What is the status, situation and experience in Australia regarding the Covid challenges? Stephen «AirDoc» Sollid, Medical Director in Norwegian Air Ambulance Foundation (NAAF), asks Per Bredmose.

Per Bredmose has been in Queensland as a HEMS Critical Care Doctor for a three months now, it is his second time here. They do primary and secondary missions on a broad variety of platforms; helicopters and planes.

Queensland and Cairns as the city furthest north. Illustration: Google Map

LifeFlight is covering a population of around 5 million inhabitants, who lives both urban and rural, from the inland to the Great Barrier Reef.

LifeFlight is based in Cairns, and has up to 2,5 to 3 hours of flying time. They cover a lot of small hospitals that are not that used to trauma- and critical care patients.

Most patients in Sydney and Melbourne

– What is the situation in Australia?

– It is a big country and it is huge discrepancies between the situation in the larger cities like Sydney and Melbourne, that are overwhelmed, have a lot of patients and has large pressure on the health structure and especially the ICU’s and ventilator beds.

It is a good deal better in Brisbane, the capital of Queensland and up in far north Queensland, where Bredmose works.  

– We haven’t seen that many patients. We are up in 34-35 confirmed cases, and haven’t had the same pressure on the ICU’s or the ventilator beds.

Still the same there is a complete lock down to protect the citizens. The state borders are closed. There are restrictions on non-essential travels.

– Basically, we have to stay at home.

Preparation – simulation and task training

– So how have you prepared? Any special training or changing of the concepts?

– RACQ LifeFlight as an organization has prepared, and we have prepared locally on our HEMS base.

Per Bredmose describes that they have rewritten the standard operating procedures (SOP’s) and then changed the SOP’s again when new knowledge has arrived.

– I think we are quite well prepared, and we got more time to be prepared than most places in Europe.

Can you talk a little bit about simulations?

– There have been various simulations both to develop and to do quality control of the SOP’s. Locally we have been running full scale longitudinal simulations from call out to scrambling, what to bring and not to bring, going to hospital, doing intubation, and bringing the patient back. We have tried out the whole flow of the corona patient.

They have also done task training like taking on and off PPE, and taking patients in and out of the aircraft.

– We have done that frequently when the SOP’s have changed or anyone has transported a suspected or confirmed patients, and used the experiences.

Shared experiences

LifeFlight has a solid structure where all the cases are audited and followed closely. How was the transport? Were there any issues? Experiences are shared within the organization.

Has simulation brought some learning? Anything you have seen that needed to be changed?

– There has been lots of smaller things. You need tape to bridge the gap between your gloves and your PPE. That the gowns don’t work so well on helicopter flights, suits are better. Use of double gloves. We haven’t discovered any rocket science that anyone else haven’t discovered.

– Any real time experience transporting patients? Has the simulation brought positive effects?

– Yes, definitely. The focus and training on using correct PPE. And we have discovered the challenges the PPE rises. The temperature is 30-35 degrees Celsius and it is demanding to work in PPE for many hours.

It is important to drink properly before missions, and as soon the mission is finished it is good if someone helps cleaning up.

– Dehydration of the staff is an issue.

Transportation – mainly by road

– How do you transport a Covid patient? You use EpiShuttle or something else?

– If we have a confirmed or suspect Covid 19-patient, the preferred way is we deliver the team by aircraft and go back by road. Due to big distances, that will not be reasonable or feasible all the time, but so far we haven’t done transfers by air as far as I am aware, but we certainly have had some road transports.  

The transports have all gone well.

Writing a transport guideline to be shared

Now they are finalizing the writing of a Covid 19 transport guideline or suggesting a platform, written together with colleges in Adelaide and Europe.

Finally, Per Bredmose acknowledges the effort this webpage does to share experiences.

– I appreciate the initiative to make a platform that shares the experiences among pre-hospital services worldwide for the transport of these patients, which is very much along the same lines as the initiative to write an article together with colleagues from various Australian and European HEMS. I think this is something that will do, can do and should bring pre-hospital services regardless of platform and crew conversations closer together, and learning from each other. And maybe something good comes out of this as an icebreaker, more cooperation, more shared SOP’s than ever. So, I highly appreciate this initiative!

– We hope this will continue to exist beyond the Covid pandemic, Stephen Sollid replies.  

 Thank you so much for your time and thanks to your service that allowed us to talk to you!