GPs should consider risks of hospital admission for pneumonia patients, says NICE
18 July 2019
Profile – Dr Tim Baker
Roles – GP with a special interest in sports and emergency medicine at University of Nottingham Health Service; regional professional lead for St John Ambulance; emergency doctor for British Association for Immediate Care with East Midlands Immediate Care Scheme
Hours worked – Eight NHS GP clinical sessions; medical director, out-of-hours emergency responder and events cover
On the banks of Nottingham’s River Trent, elite international teams are competing to secure a place at the Tokyo 2020 Olympic Games, which will see the debut of triathlon mixed relay. Mixed relay involves tag teams of two women and two men each completing a mini-triathlon.
The Nottingham event has attracted some 800 entries, 15,000 spectators and international broadcast media. There’s been plenty of preparation beforehand, such as meeting all agencies involved, from safety stewards to organisers.
My role is to ensure our medical plan is in place, that access and egress routes around the medical facility are established, and last-minute changes are safe. I stick to the mantra ‘prior planning prevents poor performance’, so I run through possible scenarios with colleagues, in line with the major incident plan.
When the primary medical cover team arrives onsite, the plan becomes operational. We grab breakfast, then brief the team of first-aiders, cycle responders, nurses and ambulance crew, all of whom are fellow St John Ambulance volunteers.
I double-check the equipment, then confirm emergency plans with the track officials and water-safety team. This includes running a timed scenario, concerning water-extraction of a critically ill athlete into the medical tent, resuscitation and rapid emergency ambulance transfer to hospital.
The start gun fires, and the non-elite competitors set off. Sadly, torrential rain means it’s not safe to swim in the Trent, so the event becomes a run-bike-run race. This doesn’t dampen supporters’ spirits, though, and loud applause accompanies the athletes as they sprint to the first transition, where they swap their trainers for cycle shoes to jump into the saddle for an 18km bike ride, on flat roads with some vicious turns.
The competitors race past us with each lap, until they complete the stage, dismount and start a 4.5km run.
At no point in the day can we take our eyes off the ball. We’re there to pick up the pieces if there’s a cycle pile-up or, when the weather permits, an incident in the water. This might be looking after an injured, cold or overheated athlete, a spectator who collapses in the stand or a child who has a fall.
The medical response depends on the nature of the incident. It could be from the cycle responders out on the course, first-aiders at a static post, or the ambulance crews, for instance.
In a slightly quieter moment, I’m able to take in my surroundings and compare this setting with my standard GP routine. Days like this allow me to practise medicine in a challenging environment that’s outwardly very different to the consultation room, but actually entails a number of similarities.
I feel fortunate to volunteer with St John Ambulance. My time and effort is rewarded by the ability to give something back – teach, lead a committed group of people and of course assist those who need medical attention.
The elite races don’t start until later in the afternoon, but they’re a key part of the day, for the teams fighting tooth and nail to win points towards their Olympic place – and for us medics!
The last race wraps up and as the crowd thins out, the team wastes no time in dismantling the media equipment, stands and cabins. However, while we’re tidying up, we do keep an emergency bed open.
Race control gives us the ok to stand down, and we exchange thanks and debriefs. Events like today’s couldn’t happen without charities like St John Ambulance, whose highly trained volunteers work hard to keep everyone safe.