2020/21 Scholarship Report - Adam Spicer

In 2019/20 I had the opportunity to spend 18 months working in Africa with Arusha Medivac (sic), Tanzania's only dedicated air ambulance service.  Operating a single Piper Navajo aircraft well suited to bush airstrips, the company provides primary retrieval services across Tanzania and secondary retrievals to tertiary facilities in Nairobi and Dar Es Salaam.   I chose this course to improve my knowledge base so that I am better equipped to mentor my Tanzanian colleagues in aeromedical and pre-hospital medicine.

The course was facilitated by Dr. Stefan Mazur and Ms Anita Robertson, both experienced clinicians in the aeromedical field.  It was delivered online over 15 weeks and consists of seven modules including the history of aviation medicine, aviation physiology, aeromedical retrieval systems, risk and expenditure, technical requirements, co-ordination and clinical governance. Assessment for the course was two written papers and a two-hour closed-book exam.

Modules 1 and 2 examined the main drivers for the introduction of aeromedical retrieval services and the growth of these services in Australia and overseas.  Particular attention was given to the history and development of the Royal Flying Doctor Service and their model of operations.

Module 3 focused on aviation physiology with particular emphasis on gas laws and respiratory physiology.  Areas covered included the aetiology and treatment of hypoxia and barotrauma, the effects of altitude on diving conditions and of flight dynamics on a patient's condition. Oxygen requirements and delivery calculations were also discussed.  The university's online forum gave many opportunities for robust discussion regarding clinical considerations and treatment priorities through a range of case studies. 

Running over 3 consecutive weeks, Module 4 compared different models of aeromedical care, including adult, paediatric and neonatal transports, pre-hospital, interhospital and long-haul international retrievals.  The use of military assets was examined, including their capability, tasking arrangements and the differences between civilian aeromedical services. This unit also considered factors that influence patient outcomes, contrasting the benefits versus the cost associated with aeromedical transports and outlining the decision-making process used to mitigate risks in retrieval operations.

Module 5 looked at the Technical Requirements associated with Retrieval Medicine, including aircraft characteristics, flight safety and medical equipment for the aeromedical environment. I was particularly interested in advances in mechanical ventilator technology having used a rudimentary ParaPac 200D in Africa. This module also debated the ideal skills mix for flight crews.

Module 6 investigated the clinical co-ordination of retrieval flights and the key factors that influence prioritisation and tasking of aeromedical retrieval assets. The use of information technology in this context was also examined.  

Finally, Module 7 reviewed the clinical governance requirements for an aeromedical service including medico-legal issues, international standards and accreditation, systems-based approaches to quality management, training and research and special issues associated with international aeromedical retrievals. 

While an experienced road paramedic, the course addressed many of the gaps in my knowledge of aviation physiology and retrieval operations. The information I learned through this course has allowed me to continue to support Arusha Medivac from Australia during the current international border closures, by assisting the organisation with the development of their operating procedures and clinical practice guidelines, building professional networks and continuing to source donations of medical equipment.  

I would like to thank the Aeromedical Society of Australasia for providing the Professional Development Scholarship and would encourage future applicants to take advantage of this generous opportunity. 

Adam Spicer

Photos: James Cook University campus |  Operations in Africa, Retrieval from Selous National Park.