ANZCA Bulletin June 2011 - Australian and New Zealand College of ...

Heading Sample
Below from left: Dr Geoff Healy, in front of
the Base of Operations, upon bump out of
the area; Departing Richmond RAAF base on
the C-17.
“ It was akin to a warzone,
with barely perceptible
concrete structures
surrounded by wooden
and minor structural
litter spread across
vast areas.”
in the case of the Japanese deployment,
radiation.
Fortunately, the USAR team comprises
not only trained personnel, but a team
of safety officers to assess and mitigate
risks, and a hazardous materials
(HAZMAT) team to identify and manage
potential exposure, decontamination,
and guide appropriate treatment.
We were alerted early in the deployment
to the nuclear reactor issues at
Fukushima, and rapidly developed
detection, monitoring and risk
mitigation plans. This also involved
regular liaison with the Australian
regulatory bodies (ANSTO) associated
with radiation and nuclear sciences,
and access to medical literature
regarding radiation medicine, from
the Director of the Medical Retrieval
Service, Dr Ron Manning.
The ability to be able to communicate
effectively and learn radiation
medicine relatively in-depth displays
not only the power of modern day
communications, but also highlights
the massive behind-the-scenes efforts
that occur back in Australia during an
overseas humanitarian deployment.
This included daily or second daily
briefings back to Australia, and regular
updates to our family members to
reassure them we were okay. Nothing
in the world worries loved ones more
than the media talking about nuclear
catastrophes on every major station and
bulletin when they are at home and we
are in the “catastrophe”! Fortunately
these concerns were able to be managed
by regular and reassuring updates, and
from being able to communicate directly
with our loved ones.
The next challenge we encountered was
the local environment. The information
available pre-departure mentioned local
conditions from 4 to 15 degrees celsius
in Japan. We were not quite expecting
several nights of below -17 degrees
celsius temperatures and heavy snow!
The anaesthetist in the field
The anaesthetist, as part of a multidisciplinary
team, makes an ideal
pre-hospital clinician. We are used
to dealing with a variety of different
individuals, each with different
priorities, akin to managing a busy
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victim identification members, and
specialist search dogs and dog handlers
bring their services, in addition
to specialist hazardous materials
(HAZMAT) personnel from the NSW Fire
Brigades.
The medical personnel consist of a team
of eight special casualty access team
(SCAT) intensive care paramedics, and
two specialist pre-hospital care doctors.
An additional specialised intensive
care paramedic medical team leader
coordinates activities and liaises with
the incident management team.
The disaster cache consists of more
than 20 tonnes of heavy and light
rescue equipment, sustainability gear
(tents, food, water, amenities) and a
large, well-equipped medical cache.
Our medical abilities include the UN
mandated capability to manage up to
10 critically ill patients, and up to 20
minor injured patients, in addition to
the critical and primary medical care of
our own USAR team. We can manage up
to two ventilated patients, and provide
critical care services and retrieval
through to appropriate local resources
or coordinate repatriation if needed.
The role of the USAR doctor
The primary role of the USAR doctor is
the health and safety of the USAR team.
The secondary role is the management
of injured patients encountered in the
USAR environment. The additional
role, if needed, is the reconnaissance,
assessment and mobilisation of further
medical resources (for example, the
medical and surgical deployment team,
AUSMAT) for humanitarian purposes.
Interestingly, the role of the USAR
doctor also includes the health and
welfare of the search dogs!
The USAR doctors in NSW are collective
trained pre-hospital clinicians from
either emergency, intensive care or
anaesthesia backgrounds, and work
within the Medical Retrieval Service
of the NSW Ambulance Service.
ANZCA Bulletin June 2011
39