I was lucky enough to get to Ireland a bit before #smaccDUB for the #EMSG16 in Killarney, which is one of the most beautiful places I’ve been. I got there from Dublin by driving, which was an adventure in itself. Surprisingly, switching seats and sides of the road was not a huge challenge and I got used to it pretty quickly.
The EMS Gathering has been held in Killarney three times since its start in 2013. It is special in that it brings together EMS from throughout the country in a way that is meant to inspire progress in their system. I think this year was unique because providers from all over the globe attended, most before going to SMACC. I only knew about the gathering because the SMACC organizers were kind enough to mention it in their registration process. Despite not knowing about it before, the EMSG became one of the most valuable experiences of my Ireland trip.
To start, Killarney is beautiful. One of the most scenic spots in Ireland, or so I hear. The downtown area is full of activity and it is a fun place to be. It turned out to be a perfect spot for the gathering. One of the best parts about the EMSG was getting to meet EMS providers from around the world. Many were from Ireland but probably half of the people I met were not.
On Wednesday night the gathering staff hosted an EMS symposium at The Malton, which was a spectacular venue for the conference. They served a great meal and there were a few talks given that night. Paul Gallen and others spoke about the EMS system in Ireland. It was interesting to hear the similarities and differences. It seems that Irish EMS is working to become more professionalized and gain more respect in the medical industry. This seems to be a theme worldwide.
Dr. Mark Forrest gave an entertaining promo on Penthrox, an inhaled analgesic designed for prehospital use. It sounds like it could have great value once it become more widely recognized.
The two most striking talks were from Gerry McCoy and John McManus. They each had unique talks about trauma in their settings. Mr. McCoy spoke about trauma in Belfast before the trauma system became what it is today. They were seeing a massive influx in firearm injuries which helped form the trauma programs that exist now. Prof. McManus gave a talk about the trauma experience he has gained working in Iraq in the military setting. Both were accompanied by incredible stories and great images.
The conference officially ran on Thursday and Friday. The days were divided into didactic sessions in the morning and and hands-on/breakout sessions in the afternoon. The morning session on Thursday was a spectrum from birth to end of life care. The first talk was from Dr. Mairead O’Riordan who made assisting with delivery sound easy. In reality, most babies will do well with little intervention. Mom will put herself in whichever position is most suitable to deliver the baby so always let her move as she needs to.
Professor Tony Ryan spoke about the Helping Babies Breath program which was launched in Africa. He put on a short skit which demonstrated the typical process of a baby being delivered in an impoverished setting. He then showed the differences in the care that can be provided after implementation of the program. In most of the third world access to medical care is nonexistent. However, many of the medical providers in small villages are there to help mothers deliver. Despite the effort many babies die because of lack of basic neonatal care that can be provided by almost anyone. The program is designed to train the providers in basic ventilation and airway techniques that can help a baby survive through its first few minutes of life. This is often all that is needed to improve outcomes in this population.
The next talk was from David Hennelly who is the clinical development manager for the Ireland National Ambulance Service. He spoke about the One Life Project which is working to improve cardiac arrest outcomes in Ireland. They have made great strides in improving access to rapid care throughout the country and they have seen increasing survival rates as a result.
The final morning talk was about end of life care from Prof. Will Molloy. The topic is one that is poorly known throughout EMS, emergency medicine, and critical care. There is often little thought given to what is truly the right thing for a patient at the end of their life. The focus should often be comfort and allowing the patient to die in a way that they want to, rather than being artificially supported for long periods of time.
The afternoon activities were similar both days and unfortunately you can’t do all of them! The feedback from all the sessions was very positive. Most of them involved leaving the venue and participating in some sort of outdoor activity. There were a wide variety of activities including bicycling, motorcycle riding, and a boat tour all of which had a different medically related topics incorporated. One of the most popular sessions was the farm injuries course. This was held on a real farm and there were multiple immersive, high-fidelity simulations of farm injuries that are commonly encountered. There were also indoor activities which included ultrasound, EKG interpretation, and simulation.
Both of my afternoons were spent helping as an instructor for EMS Pocus in the point-of-care ultrasound programs. I have a strong interest in ultrasound and our group is working to get the technology into the prehospital setting. Our sessions provided education on some of the most common and useful exams to perform in an critically ill patient. These included: basic cardiac ultrasound, lung ultrasound, and the RUSH exam. For more information click here.
On Thursday night another social event was held. It was set in the picturesque Irish countryside. Dinner and drinks were served and a Helicopter EMS and Search and Rescue panel was the featured event. There were providers from some of the world’s leading helicopter programs including Sydney HEMS, London HEMS, Travis County STAR Flight, and many more. There was much discussion about some of the unique challenges that face prehospital providers. As always, there was some debate about how to ideally staff a medical helicopter. In the end, it comes down to the mission profile to determine the right crew configuration.
The talks on Friday were primarily all about trauma care. We heard from experts about
their individual trauma programs and ones they had worked in. Adrian Murphy spoke about his experience at London HEMS and Mike Abernethy gave an informative talk on farm injuries which carried into his SMACC talk.
Ashley Liebig sat on the couch, kicked her shoes off, and gave a talk on human factors. She spoke about how stress influences us as providers and how patients are affected. She used swift water rescue as an example, describing how she has to balance the patient’s life with her own stress while rescuing a distressed swimmer. As always, she gave an impactful and meaningful talk.
Friday night was the Grande Finale final event sponsored by the EMSG organizers. It was held at the scenic Muckross Farms. We were fed like royalty and got to experience some Irish entertainment. There were kids Hurling and Mike Abernethy and others became expert hurlers. There were also falconers there with a variety of rare bird species that were fascinating to see in person. Overall, an incredible night of fun and socialization.
The EMS Gathering was an amazing precursor to SMACC. My Ireland experience would not have been the same without it. It demonstrated that Ireland is a leader in EMS worldwide and has a progressive outlooks for their EMS system. I would encourage anyone to attend this event if it is held again and to visit Killarney as it is a truly beautiful place.