By Doctor Ruth Parsell, Deputy Medical Director – Rapid Response Service and Retrieval Specialist

As an aeromedical organisation that prides itself on delivering a ‘patient first service’, we are constantly on the lookout for outstanding medical and aviation professionals to crew our aircraft that fly across Australia.

A critical part of our aeromedical crews are registrars who share our passion for delivering healthcare to those who need it most.

CareFlight holds a teaching accreditation with the Critical Care Medical Colleges of Anaesthesia (ANZCA), Emergency Medicine (ACEM) and Intensive Care (CICM). Retrieval specialists like myself are passionate about teaching registrars the skills to care for the critically ill and injured in a pre-hospital and aeromedical retrieval environment.

The doctors who join our registrar training program are all in the final stages of completing their specialist training in emergency medicine, anesthesia or intensive care. They undergo regular, hands-on training that includes tutorials, Helicopter Underwater Escape Training (HUET), envenomation talks at the Australian Reptile Park and ongoing training in austere environments with manikins and actors.

On top of this, CareFlight’s registrars accompany our aeromedical crews as an additional doctor, or when they have accumulated enough experience, the sole doctor on a clinical team. For the registrars on the CareFlight Rapid Response Helicopter (CRRH), they are the fifth member of a tightly knit team comprising of a pilot, aircrew officer, specialist doctor and NSW Ambulance critical care paramedic.

Having worked in the pre-hospital environment for more than twenty years and completed my Emergency training as a registrar with CareFlight, I now oversee CRRH’s registrar training program, including one of the major assessments. Every registrar who flies on the CRRH undergoes an intensive and high-fidelity scenario assessment day where they are evaluated in two different missions.

The scenarios are high-pressure assessments designed to prepare our registrars for the worst possible mission they will face when flying on the helicopter. Registrars begin the day at CareFlight’s Westmead hangar and wait for the ‘bat-call’ to summon them and the aircrew to their individual missions.

The first ‘mission’ is somewhat of an intense ‘warm-up’ for our registrars where they respond to a trauma in a remote area surrounded by nothing but trees, bushes and a dirt trail at best. As soon as the helicopter touches down, they alight with the onboard paramedic and navigate their way to the scene of the ‘incident’ where a medical manikin has experienced some form of trauma.

Through the joint effort of clinicians who volunteer to be bystanders, ‘relatives’ of the manikins and paramedics who are already on the scene, a hyper-realistic scenario is created for the doctors to deliver the best possible level of care they can. It is an intensely busy scene where the registrars are trying to manage the deteriorating condition of the manikin under the critical eye of their assessors.

Once that scenario is completed, the registrars have a few hours respite before they are tasked again to a chaotic mission. This time, the pressure is ramped up as they fly to a more chaotic mission that involves personnel from NSW Fire and Rescue, NSW Police, NSW Ambulance and other emergency services agencies who are responding to a serious car accident. It is an immense logistical undertaking that allows various first responders to come together in a training exercise and learn how to work best with each other.

Once the registrars arrive at the scene, they are overwhelmed by the intensity of activity: firefighters are working to release the manikin from a crushed car using the jaws of life, police are onsite to contain the scene and teams of paramedics are working hard to save the manikin’s life. Amidst the crowds of people, the registrars are working with the various agencies to treat and stabilise the manikin while it is trapped and extricated from the vehicle.

As you can imagine, only the registrars who are the best in their field are able to pass CareFlight’s rigorous assessments. By putting them through realistic and high-fidelity scenarios, we are ensuring that the doctors who are flying to their rescue are equipped with the necessary skills to save a life after a trauma.

Once the registrars complete their terms with CareFlight, they are then accredited with core training by the Critical Care Medical Colleges mentioned earlier.

The next time you see the CareFlight Rapid Response Helicopter, I hope you can appreciate the calibre of medical expertise that is flying to the rescue.