Intensive Care Without Walls


Intensive Care Without Walls

Why do we need BASICS doctors?
When you’re severely injured or ill, the first hour is critical.  You need intensive care.  In the UK, that hour has often passed before you can get it, unless a BASICS doctor is there.  It’s like having a hospital at your side.

What do BASICS doctors add to standard ambulance care?
They can anaesthetise you if you’re critically injured.  That allows them to make sure you can breathe properly (by putting a tube into your windpipe) so you don’t choke or inhale vomit, two common problems with severe injury.   Anaesthetic medicines don’t just put you to sleep – in the case of severe head injury it allows your brain to shut down and recover, and can stop it expanding and causing more damage.

They can administer high-level pain relief.   Paramedics can administer some pain killing drugs like morphine, but doctors can use more potent drugs where the pain is intense – especially when it’s needed to safely extricate a patient and too much morphine would be dangerous.

They can also operate in extreme circumstances.  BASICS Hampshire doctors have saved lives by doing urgent operations on the windpipe (cricothyroidotomy) or the chest wall (thoracostomy) and even open-heart surgery (thoracotomy).

What else do they do?
They have the authority to send the patient to the best hospital for their injury or illness.  Ambulance staff routinely take a patient to the nearest hospital, because that is where they will have the primary treatment they need.   When a BASICS Hampshire doctor is at the scene, that primary treatment will be done at the scene, and they can use their clinical judgement to send them straight to the best care for the next stage.    For instance:  they would take a critically injured child directly to Southampton General,  the only place in Hampshire with specialist intensive care for children.

Isn’t it a waste of time if there’s nothing wrong when they’re called to a scene?
It does happen.  What looks like a bad road traffic accident, for instance – a multiple pile-up – may actually have no one seriously injured.   At that stage a BASICS Hampshire doctor is very useful: they can clear people at the scene so that the ambulance service doesn’t have to take them for unnecessary check-ups at an overloaded emergency department nearby.   For example: a BASICS Hampshire doctor attended an accident involving a school bus with two dozen pupils on board.   He was able to check and clear the children, which freed several ambulances to respond to other emergencies, saved hospital time – and let everyone get on with their lives.