Picture the scene: you have just had a full day at work in general practice, you finally get home, sit down to eat your evening meal and your pager goes off.
This is a pager you volunteer to carry so the local ambulance service can call you out to accidents. You answer the call and make your way to the accident.
What is BASICS?
The British Association for Immediate Care (BASICS) is a registered charity that was formed in 1977. It acts as the national co-ordinating body for both schemes and individuals providing immediate care throughout the UK.
BASICS doctors assist ambulance services, and provide medical services at sporting events, concerts and on expeditions.
How I got started
My interest in immediate care started at university when I had an A&E placement. There was a rapid response vehicle attached to the department and a consultant who was keen to attend prehospital incidents.
I was fortunate enough to gain some experience there, which really whetted my appetite. I continued with my medical training and enjoyed dealing with trauma cases.
When I started my GP VTS, as luck would have it, the senior partner at the surgery I was attached to was a BASICS doctor. After several conversations I became involved in the local scheme. After a two-day introduction course - standard at that time - I was issued with my kit and a pager, and started responding.
BASICS doctors have a variety of qualifications. I did the prehospital emergency care course about two years ago.
This is a three-day course run by BASICS and covers emergency care in the prehospital setting. Subjects covered include trauma, medical, paediatric and obstetric emergencies and incident management.
The course is a great mix of a small number of lectures with a lot of practical sessions and interactive small-group work. There are written and practical exams on the final day and successful participants are awarded the prehospital emergency care certificate by the Royal College of Surgeons of Edinburgh. The course is the best I have done.
This qualification is fast becoming the minimum standard expected by local BASICS schemes to enable a doctor to work for them.
Other qualifications in pre-hospital care are available and it is best to check with BASICS or the faculty of prehospital emergency care at the Royal College of Surgeons of Edinburgh.
Remember to inform your medical protection provider that you are intending to carry out immediate care work.
Being called out
The call-out process varies from scheme to scheme. I carry a pager, which is activated by the Yorkshire Ambulance Control; this triggers anyone carrying a pager within a specified distance of the incident.
The BASICS responder sets the radius in which they are willing to respond and the times at which the pager can be activated. Doctors can also be called to their mobile phones from the control room, which tends to happen during the night (thankfully not very frequently) or if a local paramedic has requested a BASICS doctor to attend.
The incidents I get called to are mainly road traffic accidents, often when the driver or passengers are trapped. The other types of call outs are to major trauma, such as falls, industrial accidents, and cyclists and pedestrians being knocked down. Occasionally, we are called to provide analgesia to patients when that provided by the paramedics has not helped. I have been called to some category A calls such as collapses and chest pains.
The main role is to assist the emergency services in providing care to critically ill patients and to supplement their skills, helping assess, diagnose and treat patients while working as a team.
BASICS doctors carry a larger and more varied range of drugs providing analgesia, sedation and medication to manage emergencies in the prehospital setting. We can perform surgical airways and thoracostomy among various other procedures.
I keep a log of all the calls I have been to. I also keep separate notes of what I did, clinical details and whether I travelled with the patient to hospital. Recently, the local scheme has set up a secure online log for us to enter the call details.
This has formalised the recording of notes and will help monitor activity. It is currently the only one of its kind.
Like most BASICS responders, I drive under green lights. Some BASICS responders undertake a driving course and can then apply to the chief commissioner of the local constabulary to drive under blue lights with a siren.
Green lights act to alert the road user of your presence. They do not entitle the driver to break speed limits, run red lights or break other rules of the road.
It is important to inform your motor insurance company that you are using your car to respond to accidents and will be driving under green lights.
The most important thing you need is a very understanding and supportive family, which I certainly have, as often the pager goes off early in the morning, late at night or just as you are sitting down for a meal.
Understanding work colleagues also help as, again, you may be called out from surgeries.
- Dr Young is a GP partner in Hull
- This topic falls under section 7 of the RCGP curriculum, Care of Acutely Ill People', www.healthcarerepublic.com/curriculum
1. Make contact with BASICS or your local scheme via www.basics.org.uk to get more information.
2. Do the three-day PHEC course or other similar courses.
3. Inform your medical defence organisation.
4. Work as a team with the emergency services.
5. Remember to keep good notes.
6. Inform your motor insurance provider you are responding for local immediate care organisation and driving under green lights.