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2019 Elective Report Alexandra Jowett

Elective WAST 2019 Report: 10 Lessons in Pre-Hospital Care

I was absolutely delighted to win the Faculty of Pre-Hospital Care elective. The elective, run in conjunction with the Welsh Ambulance Service, offered opportunities across the UK to give an insight into the sub-speciality of Pre-Hospital Emergency Medicine. Having had very little previous experience in this area of medicine, I couldn’t quite believe it when they told me I had won. During this report I’ve highlighted 10 of the most important lessons that I’ve learned in the last 6 weeks.




My elective commenced within the Welsh Ambulance Headquarters listening in to 999 calls, with allocator services, triage nurses and on the Welsh Flying Medics desk where clinical specialists listen to calls across Wales to allocate helicopter resources to the 0.125% of calls that need their services.

Lesson 1: The Grief Reaction

Ambulance Head Quarters 999 call. 90-year-old male found deceased.

Patient: ‘Hello. Sorry I don’t mean to bother you but I think my husband has died…I think it happened around 3am this morning but I didn’t want to take up your time at that time of day…No, no there’s no point commencing CPR love, he’s gone.’

Me (to call handler): ‘Is this a common reaction?’

Call Handler: ‘More common than you’d think.’


Having spent time in headquarters, I proceeded on to Worcestershire. I took part in a 3-day trauma course which applied my skills from emergency medicine to the pre-hospital setting. This was an invaluable experience as it gave me the confidence to apply what I studied in medical school in the real world. We learnt the basis of the {C}ABCDE approach as well as applying the approach in trauma scenarios such as road traffic accidents, stabbings and traumatic cardiac arrest. These were skills that I not only learned but applied over the course of the elective. It also gave me a chance to appreciate the diversity within pre-hospital care. I was on the course with Fire Service, Paramedics, Military Medics, Armed Police & Doctors, who all bought different skills and experience to the table.

Lesson 2: The Importance of Self Confidence

Trauma Moulage: Stabbing Debrief

Trainer: ‘So you thought it was best for your team to proceed with the examination… in the dark?’

Me: ‘No, I knew we needed to move the casualty before we could assess them.’

Trainer: ‘So why didn’t you say anything?’

Me: ‘I was scared I was wrong.’


To read Alexandra's full report click here

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