Prospectus Pre-hospital / Retrieval Registrar Sydney NSW Australia

Transcription

1 Prospectus Pre-hospital / Retrieval Registrar Sydney NSW Australia CareFlight is an Australian not-for-profit aeromedical organisation. Our mission is to save lives, speed recovery and serve the community. CareFlight is dedicated to excellence in the management of the sick and injured, during transport. We use helicopters, fixed wing aircraft and road ambulances to bring a hospital level of care to our patients. Our doctors and nurses care for over 5,000 patients per annum. CareFlight has a high clinical profile and a significant international research reputation. Accredited with ACEM, ANZCA and CICM, CareFlight is a sought-after career path for registrars. CareFlight provides medical services at many different levels. In NSW, these services include: Helicopter Emergency Rapid Response Trauma Service Provision of doctors to Ambulance Service of NSW (ASNSW) CareFlight is also contracted to provide aeromedical services across the Top End of Australia. Working out of bases in Darwin, Gove and Katherine, CareFlight operates four dedicated Beechcraft King Air B200 fixed wing aircraft and a BK-117 helicopter. The aircraft are used to conduct pre-hospital and interfacility transfers. The helicopter also participates in search and rescue operations. The Medical Retrieval Service The Medical Retrieval Service (MRS) is the medical arm of CareFlight. The MRS comprises senior medical specialists in Anaesthesia, Intensive Care and Emergency Medicine. All specialists work parttime in retrieval and must be clinically active in their chosen specialty. CareFlight also employs registrars who are suitably qualified and experienced to perform retrieval. The registrars are employed on a full-time basis. Training recognition CareFlight is recognised for training by: Australasian College of Emergency Medicine recognised for six months advanced training for fourth and final year registrars Australian and New Zealand College of Anaesthetists recognised for six months training for third, fourth and final year registrars Joint Faculty of Intensive Care recognised for three months training with consideration of six months upon request Retrieval training hones the resuscitation skills of registrars rather than introducing them to the concepts. Basic science knowledge to the level of the relevant primary exam is therefore assumed, and teaching concentrates on the clinical application of this knowledge in the field of retrieval medicine. All doctors should be EMST or ATLS trained. Page 1 of 6

2 CareFlight Sydney NSW Australia CareFlight provides doctors to Ambulance Service of NSW to undertake retrievals from bases in Bankstown and Orange. These doctors conduct primary (pre-hospital) and secondary (inter-facility) retrieval missions using helicopters, fixed wing aircraft and road vehicles. The retrieval doctors must be familiar with all modes of transport and how they impact upon the care of their patients. CareFlight s Helicopter Emergency Rapid Response Trauma Service, based at Westmead, follows on from CareFlight s Head Injury Retrieval Trial (HIRT). From 2005 to 2011, HIRT was the centrepiece of CareFlight s research program. This randomised, controlled trial compared two models of care for patients with potentially serious head injuries: standard care by ASNSW paramedics and care by a helicopter rapid response physician/paramedic team. The trial has resulted in delivery of medical teams with response times that are unprecedented in pre-hospital medicine in Australia. The tasking for HIRT was protocol based and included non-randomised responses to all severe paediatric trauma in the Greater Sydney Area. The service remains the only rapid launch pre-hospital paediatric trauma service in NSW. Education plays a vital part in CareFlight s goal of promoting excellence in pre-hospital and retrieval medicine. This is evident in the registrar induction training, the ongoing education program with its strong emphasis on practical scenarios and simulation, and CareFlight s Pre-Hospital Trauma Course which is open to external applicants. Breakdown of missions by type - January to December 2011 (NSW) 1172 cases, of which: 406 trauma (35%) 63 sepsis (5%) 145 respiratory (12%) 50 other (4%) 141 neurological (12%) 1 musculoskeletal (<1%) 71 metabolic (6%) 7 haematological (<1%) 4 gynaecological (<1%) 17 genitourinary (1%) 81 gastrointestinal (7%) 184 cardiovascular (16%) 2 obstetric (<1%) And further broken down as: 306 (26%) pre-hospital 866 inter-hospital 101 FW (9%) 517 helicopter (44%) 7 MPV (<1%) 544 road (46%) 19 winches by doctors Age under 1, 1 (<1%) Age 1-3, 14 (1%) Age 4-10, 14 (1%) Intubated 603 (51%) Inotropes 286 (24%) Page 2 of 6

3 Clinical Supervision and Specialty Support Registrars receive extensive clinical and operational supervision from the retrieval specialists. CareFlight / ASNSW Medical Services Agreement CareFlight has a contract to provide medical retrieval specialists and registrars to ASNSW for helicopter, fixed wing and road retrieval missions. CareFlight doctors work at both the Bankstown and Orange ASNSW Greater Sydney HEMS aeromedical retrieval service bases. Bankstown Base (ASNSW) CareFlight provides 50% of the doctors to the Greater Sydney Area, and ASNSW provides the other 50%. The service at Bankstown base is a frontline emergency service for all of NSW. The same number of doctors are rostered for day shifts and night shifts, 24/7. Registrars work between three and five shifts per week, including weekends. Rosters comprise a mix of day, evening and night shifts. Day duty shifts are on base, and day oncall shifts are with staff required to be not more than one hour from base while on call. Evening duty shifts are Night duty shifts are on base, and night on-call shifts are The 24 hour operational support shift is designed to cover sick relief and to support the night shift doctors to cover fatigue. This shift runs from Orange Base (ASNSW) CareFlight provides 100% of the doctors to the Orange base, with the base being managed overall by ASNSW. The Orange base currently has one shift a day duty shift from Registrars on the Sydney roster are rotated to the Orange base for several days at a time, every few weeks. Registrars rotating to the Orange base undertake medical retrievals in accordance with the policies and procedures of ASNSW. Registrars fly to Orange on commercial airlines or may be reimbursed for costs incurred driving to and from Orange. CareFlight provides serviced townhouse accommodation of a high standard and registrars are encouraged to take family whenever possible. A car is provided for personal use. CareFlight Helicopter Emergency Rapid Response Trauma Service This service operates from CareFlight s Westmead operations base, seven days a week, from Page 3 of 6

4 The service is tasked by ASNSW to severe pre-hospital trauma missions. It is also the first response for all severe paediatric trauma. CareFlight retrieval specialists staff the rapid response helicopter. These specialists are among the most experienced retrieval specialists in the world. Registrars make up the primary care giving team where possible. Roster The service operates 12/7. CareFlight International Air Ambulance (CFIAA) CareFlight International Air Ambulance provides a medical evacuation service throughout the Asia Pacific region. This provides support for Australian Government and Defence missions and for travellers. Services are also provided within Australia, most frequently on the Darwin to Adelaide route. We currently staff jets based in Sydney and Darwin. Longer haul missions (to Europe, UK, USA and Asia) are conducted on regular passenger aircraft. CFIAA provides both high and low acuity medical retrievals/repatriations. Missions per year CFIAA undertook 269 cases in Diagnosis groups: 51 Cardiovascular (19%) 20 Gastrointestinal (7%) 4 Genitourinary (<1%) 4 Haematological (<1%) 4 Metabolic (<1%) 5 Musculoskeletal (<1%) 79 Neurological (29%) 13 Other (5%) 38 Respiratory (14%) 2 Sepsis (<1%) 49 Trauma (18%) Registrar Training Program Registrars complete a five week orientation comprising: Tutorials Practical demonstrations and hands-on training Ground school and flights with helicopters Road ambulance and fixed wing training Buddy shifts Following successful completion of orientation, registrars are accredited to perform solo missions. Each mission is discussed with a senior specialist/deputy medical director from both ASNSW and CareFlight. Page 4 of 6

5 Where appropriate, a senior specialist will accompany the registrar on missions in a supporting and supervisory role buddy shifts. Training is conducted by CareFlight s highly experienced education faculty staff, with input from both local and interstate experts. We understand that working in this environment is daunting, and we tailor our training to overcome this issue. General Orientation Program The general orientation program incorporates: Helicopter Underwater Escape Training (HUET) Ground school, winch training static and airborne, airborne flights, buddy retrievals Pre-hospital and inter-hospital transfers helicopter, fixed wing aircraft and road ambulance Pre-Hospital Trauma Course (PHTC) CareFlight International Air Ambulance training Ongoing Training Fortnightly protected paid teaching time covers more advanced elements of retrieval medicine. has a significant practical +/- simulation component. Quality Assurance Missions are debriefed with a retrieval specialist. Complex missions may be debriefed more formally. Multidisciplinary retrieval meetings are a great opportunity to explore issues of tasking and operational difficulties. CareFlight has robust computer based incident reporting and management systems so clinical, operational and aviation issues may be followed up and resolved. Employment Criteria for Sydney Primary examination in anaesthesia, emergency medicine or ICU Australian Registrars o Latter part of 3 rd Year Advanced Trainee in Anaesthetics o 4 th Year Advanced Trainee in Emergency Medicine or ICU. UK Registrars o ST5 Anaesthetics o ST6 Emergency Medicine or ITU Extensive experience in the management of critically ill patients, including trauma Completion of EMST or equivalent Ability to work at heights and in water Ability to safely adapt clinical practice Superior verbal and written communication skills Page 5 of 6

6 Physical fitness Current passport Local medical registration Desirable: o completion of APLS/ATLS or MIMMS o research interest o good computer and administrative skills Remuneration Salary and conditions are commensurate with Public Hospital Medical Officers Award. Page 6 of 6