Student paramedic conference helps advance cardiac care

The Advanced Cardiac Care Conference took place at the impressive Pilkington Building, an ex-Royal Navy barracks at the Universities at Medway campus on 13 September 2014. Organised by the Canterbury Christ Church Student Paramedic Society (CCCSPS), an organisation run solely by student paramedics in their second and third years of study, this all day conference welcomed over 90 attendees and eight prestigious guest speakers who are experts in the field of acute cardiac care.

Co-founders Silas Budd and Phil Barber and treasurer Sam Pearson opened with an introduction and breakdown of the day's events. They began by thanking the attendees for coming before speaking briefly of the planning and organisation of the conference. Silas then welcomed Dr Richard Lyon, clinical lecturer in emergency medicine and pre-hospital care, and clinical lead for Kent, Surrey, Sussex Air Ambulance Trust.

Lyon's keynote talk was entitled ‘Elite Resuscitation’, and began by addressing key issues surrounding the management of pre-hospital cardiac arrest, particularly the importance of Q-CPR (quality CPR). Using a case study as an example, Lyon demonstrated the benefit to patients of dispatching specialist clinicians to help streamline resuscitation attempts. The talk had a distinct theme of evidence-based practice, with Lyon highlighting current research and the possibility of incorporating innovative new techniques such as therapeutic hypothermia and extracorporeal membrane oxygenation (ECMO) in the pre-hospital environment.

After a short break, Ken Hopkins then gave a talk entitled: ‘AEDs, what's under the hood?’ Boasting a career of more than 20 years working with electronic and medical equipment, Hopkins displayed an extensive knowledge of defibrillation of the arrested heart, which he demonstrated with an array of equipment. Questions arising from this talk sparked an interesting discussion of the feasibility of hands-on defibrillation and the application of a ‘stepwise approach’ to defibrillation, to which the consensus, demonstrated by a sponsor representatives T-shirt, was: ‘Stay calm and charge to 360 Joules!’

Taking a short break from discussion of physiological matters of the heart to concentrate on proverbial ones, Dr Nick Wilson, an anaesthetic trainee at the Royal London Hospital then spoke about the CCCSPS Charity of the Year, Friends of Nepal Ambulance Service. Using striking pictures from his medical elective in Kathmandu as a backdrop, Wilson spoke of the selfless work exhibited by the Nepal Ambulance Service (NAS), and of the hurdles that had to be overcome in its foundation. In discussing the necessity of monetary and educational contributions, Wilson went on to explain the opportunities for qualified health professionals in traveling to Nepal to train, research, and further develop the NAS.

Following lunch, the afternoon's talks began with a shift from looking at acute cardiac care secondary to medical aetiologies, to that of a traumatic origin. Mr Tom König, British Army doctor and trauma and vascular surgeon at the Royal London Hospital, opened with an engaging talk on the emergency resuscitative thoracotomy. Presenting some very interesting research figures, König highlighted the poor survival rates of patients receiving closed chest compressions versus the relative success of a thoracotomy approach. Despite being directly after lunch, an array of graphic slides sparked intellectual discussion surrounding the treatment of cardiac tamponade caused by stab wounds, with the key message being minimal on-scene times and rapid diagnosis, and surgical intervention by a suitably trained physician.

For the next talk, consultant paramedic and Chair of the College of Paramedics, Professor Andy Newton, looked at current affairs within pre-hospital care. During his talk, Newton highlighted the challenges ambulance services currently face in managing the increased demands of recent years. He went on to discuss the establishment of specialist practice within pre-hospital care, such as the paramedic practitioner and critical care paramedic advanced roles, and their current and future application to this unique environment.

Following an afternoon break, the board welcomed Erica Ley, a critical care paramedic currently working with Essex and Hertfordshire Air Ambulance Trust, for the penultimate talk of the conference. This talk, ‘Why do trauma patients die?’ started with an overview of recent research into trauma deaths and highlighted that the majority of these were preventable. Giving first hand experiences of cases she had attended, Ley clearly demonstrated that all too often clinicians are arriving on scene and pronouncing life extinct due to traumatic injuries, where reversible causes have not been fully addressed, often due to misconceptions of futility. Ley's talk also highlighted the recognition and treatment of reversible causes of traumatic cardiac arrest, easily memorable by the ‘HOT’ mnemonic (hypovolaemia, oxygenation, tension pneumothorax).

The last presentation of the day was preceded by a video, captured by chance during a documentary about the Yorkshire Air Ambulance. This video documented the treatment of an emergency medical dispatcher having suffered a sudden cardiac arrest at the air ambulance base. The footage served as a stark reminder of the purpose of the conference: to improve attendees understanding and management of the pre-hospital, acute cardiac patient. The emergency medical dispatcher videoed was Chris Solomons who, having survived his cardiac arrest, was welcomed to the stage by tumultuous applause from the audience. Over an emotionally provocative 15 minutes, he described his experience that day, and how he may not have survived had only a few details been different. He expressed his continuing gratitude to all members of the air ambulance and of the hospital team that helped save his life. Additionally, he spoke graciously of the cameraman, who paused in filming to assist with chest compressions and help the team as they delivered life-saving treatment.

Overall the conference brought to light an array of topics pertaining to modern, evidence-based treatment for acute cardiac care in the pre-hospital and emergency medical environment. Delegate feedback was extremely positive and everyone left with new ideas and information to apply to their individual fields of practice.

Finally, on behalf of the CCCSPS, we would like to thank our speakers, sponsors, and everyone behind the scenes, without whom this event could not have gone ahead. For further information about the Advanced Cardiac Care Conference, the CCCSPS, and our future events, please contact us using the information provided.