The videos on this page form part of the Australian College of Rural and Remote Medicine (ACRRM)’s Pre-Hospital Emergency Care (PHEC) course pre-learning.
Sandpiper Australia is grateful to ACRRM for sharing these resources with the Sandpiper Australia community.
Overview of ACRRM's PHEC course
The ACRRM’s Pre-Hospital Emergency Care (PHEC) course is a course intended to help rural generalists translate their existing skills to the pre-hospital setting. Scenario based training reinforces key components of clinical decision making, sequencing of interventions and core skills.
The Sandpiper Bag Overview
Whilst the ACRRM PHEC course is one route to training, the cornerstone of providing good prehospital care is equipment.
The Sandpiper Trust Bag is used commonly across the UK and has been adapted for use in Australia. Dr Claire Arundell provides an overview of the bag and its components.
General Prehospital Principles
The CALM approach
Dr Edi Albert outlines the CALM approach for Sandpiper clinicians
Scene Assessment
Attending a pre-hospital incident poses numerous challenges, not least your own personal safety, working with other emergency services and considering the appropriate timing and extent of clinical interventions. Dr Edi Albert discusses an approach to scene assessment
The Pre-hospital Environment
The pre-hospital environment poses many challenges. Unlike an air-conditioned resus room, the prehospital scene may be hot or cold, wet or dry, cramped or exposed.
“Control the environment, don’t let it control you”
Here Dr Edi Albert provides an overview of environment and the importance for patient and rescuers.
Pre-Hospital Analgesia
Dr Edi Albert describes some methods of pre-hospital analgesia.
Pre-Hospital Haemorrhage Control
DDIT (direct pressure, direct pressure, indirect pressure, tourniquet) is the suggested approach to catastrophic haemorrhage. Splinting is also part of haemorrhage control.
Understanding the indication and use of various devices recommended to be carried in the Sandpiper Australia bag, including the arterial tourniquet, modular bandage, IO device, pelvic and femoral splints, is essential in a pre-hospital setting.
Arterial tourniquet
Dr Tim Leeuwenburg demonstrates use of an arterial tourniquet for major exsanguinating injury.
Modular bandage
It’s recommended that the Sandpiper Bag contains a modular bandage (typically either the OLAES or Israeli/Emergency Bandage). Dr John Hall explains use of a modular bandage.
Intraosseous access
There are several sites for IO access; the commonly taught tibial IO may not be appropriate in cases of long bone or pelvic fracture. The humeral IO allows faster flow rates, rapid access to central circulation – but the landmarks can be harder to recall. Dr Tim Leeuwenburg provides an overview.
Splinting
Splinting of deformed bones (particularly femur and pelvis) is an essential component of haemorrhage control. The maxims ‘splint to skin’ and ‘splint to anatomical alignment’ summarise the basic principles. There are a variety of splint devices on the market; here we explain a few.
Femoral Traction Splints
Dr John Hall demonstrates the Slishman splint.
Femoral Traction Splints
Dr Tim Leeuwenburg demonstrates the CT-7 splint.
SAM Pelvic Binder
Dr John Hall demonstrates the SAM pelvic sling, commonly taught on many trauma and emergency courses.
The SAM splint is available in XS, S, M, L and XL sizes – which means having to carry five pelvic binders! Great for an ambulance, but sadly not so great for a Sandpiper Bag.
Prometheus Pelvic Binder
The Prometheus Pelvic Binder is preferred for the Sandpiper Bag due to its compact size, light weight and being a ‘one size fits all’ piece of equipment. Dr Tim Leeuwenburg demonstrates it in this video.