Laura Nicol / Surgical Registrar, Inverness
If you are looking to gain some exposure and confidence in Pre-hospital medicine or are thinking of getting involved in event and rural medicine, this may be the course for you.
The Pre-Hospital Emergency Care Course (PHECC) is certified by the Faculty of Prehospital Care of Royal College of Surgeons of Edinburgh and run by the British Association for Immediate Care (BASICS).
It is a three-day facilitated and assessed course covering a broad range of emergency care in the pre-hospital setting including medical, obstetric and paediatrics as well as trauma emergencies and basic incident management. This tots up to around 22 hours of teaching and so makes for a pretty busy weekend.
It is open to doctors, nurses and paramedics who work or have an interest in working in the pre-hospital field.
Candidates must sit and be successful at two practical exams (cardiac and trauma) and an MCQ paper, which are usually incorporated into the last day.
There is a manual provided several weeks before the start of the course. Surprisingly user friendly, (and with lots of pictures) it contains pretty much everything you need to know to pass the MCQ component at the end as well as supporting the lectures all the way through.
Candidates and faculty members come from a variety of backgrounds, which adds a variety of perspectives and experiences into the mix. This allows skill sharing and varied peer support and definitely induces some camaraderie.
My course was full with 21 students from various medical and allied professions. Most rural GP practices will expect their GPs and indeed GPST3 trainees to be BASICS trained and so the bulk of students are GPs or GPs with an extended role such as Emergency Care Practitioners. Other students tend to be Emergency Medicine trainees, paramedics, and the occasional surgeon…
Subsidized funding is available for a number of places by NES (NHS Education for Scotland), which means that the student is only responsible for the admin fees of the course (around £200-300). This is not the case in the rest of the UK and the course fee is currently £800.00 for BASICS Members and £865.00 for Non-Members. Additional fees may be applicable depending on whether the course is residential or not.
The BASICS Scotland courses take place at a number of rural locations around Scotland. I went to Nairn, a town about 16m east of inverness famous for golf courses, beaches, beautiful scenery and occasional sightings of Tilda Swinton who resides nearby.
Broadly speaking the course can be split into two sections:
Trauma / Trauma covers assessment of the scene, extraction of the patient from a vehicle, C-spine immobilization and resuscitation following ATLS principles. Crash helmet removal, splints and principles of triage. It’s a thorough run down in everything you need to know to approach and deal with an RTA as the first person on the scene. This is a great component of the course, especially for those who like to get hands on with Trauma scenarios. The casualties are realistic and the logistical difficulties surrounding extrication and casevac are covered well.
Medical & Cardiac Emergencies / This covers everything from advanced life support to the assessment and management of the critically unwell person outside the hospital setting. A really broad yet thorough coverage with discussion of logistical aspects of care keeps this interesting.
All topics are delivered as enthusiastic lectures and then practiced to perfection in small group skill stations, moulages and demonstrations. This gives candidates the opportunity to lead the team, be the patient and practice different roles within trauma teams. A typical day starts at 08:30 with the first half hour in mentor groups which gives students a chance to talk with their supervisors, practice any airway skills they feel less confident about and have a coffee. There is generally plenty of opportunity to have a quiet word with your mentor and brush up on unfamiliar skills and techniques away from the group environment if needs be.
The rest of the day is split up into lectures and small group sessions. With two breaks for some coffee and cake or biscuits provided by the hotel and an amazing cooked lunch, you definitely don’t go hungry!
The assessment consists of an MCQ paper followed by two moulage stations, one on trauma and one on cardiac emergencies. There is an oppourtunity to immediately resit either or both stations if you have a bit of trouble or nerves get the better of you, however given the enthusiastic and friendly faculty involved, it’s easy to relax and get immersed in your scenario.
As with all manuals, they only work if you read them! The course is quite intense, a lot is packed into the three days, so doing as much reading as you can beforehand will really help.
Warm clothing – I’d recommend Merino wool and waterproofs – essential as much of the course is outside and you will spend time standing around observing and even taking on the role of the patient which can get quite chilly in the Highlands. Billy Connolly aptly summed this up when he said: “there are only two seasons in Scotland: June and Winter.”
The course offers excellent value for money and delivers first class teaching by like-minded individuals. Group numbers are small and mixed specialty which lends a valuable inter-professional educational aspect to the course. For anyone who lives in a rural area and has an interest in becoming a first responder, for those taking on a role as a medic in a remote location or for those who simply prefer a weekend of event medicine as opposed to a weekend hospital locum job, this is the course for you.
If nothing else, PHECC will make you a lot more confident if you were to come across a road traffic accident as the first person on scene.
BASICS offer other courses including Emergency Medical Care and a specialist Pre-Hospital Paediatric life support course amongst others. Details are here for those in Scotland and here for those in England and Wales. Information regarding particular BASICS schemes and relevant contacts can be found here. Finally, for those interested in the trauma aspect of pre-hospital care, a Prehospital Trauma Life Support (PHTLS) course is definitely worth a look too.