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Elective Competition Winner 2017

By Kerry Bramley

Elective Competition Winner 2017

Meet Kerry Bramley, a medical student and one of the winners of our Wesleyan Elective Competition 2017.  She's sharing with us her elective experience in Malawi and the UK.
 
Here's Kerry fourth update on the next leg of her elective adventures.

My Elective with the Essex and Herts Air Ambulance - Part 2

As mentioned in Part 1 of my blog on my elective with the Essex and Hertfordshire Air Ambulance, I found the clinical shifts the most useful, as it enabled me to develop a good understanding of Pre-Hospital care and the management of acutely unwell patients.

Kerry-Royal-LondonMy fourth flying shift was a busy one! We attended an elderly patient who had gone into cardiac arrest but received immediate bystander CPR, and return of spontaneous circulation (ROSC) was achieved.

The HEMS doctor performed a rapid sequence induction (RSI), but the patient had a difficult airway and visualisation was challenging due to it being sunny, meaning it took 3 attempts to intubate. We took the patient directly for PCI and she had stents inserted.

Later that day, we were called to a teenager who had been stabbed multiple times, including a chest wound adjacent to the sternum, and a deep wound to the palmar aspect of the hand. He remained stable, but was flown to the Royal London Hospital (RLH) as a major trauma.

The RLH helipad (see pictures) was 17 stories high and had fantastic views over London.

Thankfully, the CT scan revealed that the knife wound to the chest had missed the patient's heart and lungs, but the patient was likely to need surgery to their hand.Kerry-helipad-from-flight

During my final flying shift, we were called to a major road traffic collision between two cars, resulting in multiple casualties. This was an eye opening experience, as I had never seen anything like it before. Both of the cars were badly smashed up and sadly, one of the patients suffered a traumatic cardiac arrest and died.

When we arrived, there were a number of ambulances, police and fire vehicles on scene, and another air ambulance crew en-route. The anaesthetist and paramedic walked the scene to triage the casualties and determine who needed their help the most urgently.

One of the passengers had a reduced GCS and a head injury, with a palpable skull fracture. The doctor suspected an underlying haemorrhage, so they focused their efforts on this patient and performed an RSI before flying them to the nearest major trauma centre.

My sixth shift was on the rapid response vehicle. We were on-call from 6pm-2am. We had one call out, to another stabbing to the chest. Again, the patient was stable with good vital signs, but had reduced air entry to the lung base, so a pneumothorax was suspected.

During my final week, the EHAAT annual aeromedical conference took place. This was a free conference and the focus was on mental health.

There were some really interesting speakers including a patient who had required the help of the air ambulance who spoke about her journey to recovery, and how it affected her mental health.

Another was a clinician, who spoke about the major incidents they had attended, and how she had struggled to cope afterwards.

Both of my elective placements provided great experiences, and I hope you have enjoyed reading about them!

Watch out for some more updates about her elective adventures from Kerry!

Are you going on an elective?  Head off on your travels safe in the knowledge that we've got you covered for problems such as cancellations for exam re-sit cancellations, HIV needle-stick injuries or unforeseen medical expenses with elective insurance from Wesleyan.

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