Dr Cathal O’Donnell: Medical Director National Ambulance Service
A medical graduate of University College Cork, he completed his Emergency Medicine training in a number of Irish hospitals in Cork and Dublin, and subsequently completed a Clinical Fellowship in Emergency Medical Services at the University of Toronto in 2005. This involved working with both Toronto EMS and the Ontario Air Ambulance Base Hospital Programme.
On completion of this, he returned to Ireland to take up a post as Consultant in Emergency Medicine at the then Mid-Western Regional Hospital Limerick.
Cathal became NAS Medical Director in 2011, initially on secondment from his hospital post – he moved permanenently to NAS in 2013.
Also in 2013, Cathal was appointed Adjunct Senior Clinical Lecturer at the Graduate Entry Medical School, University of Limerick.
A day in the life of Dr Cathal O’Donnell
I arrive in my office in Limerick, put on the kettle, reply to some emails and prepare for a teleconference later that morning. While en route to work I logged on with our National Emergency Operations Centre (NEOC) in Tallaght via the digital radio set in my Rapid Response Vehicle to advise I am available for emergency calls if required. Every one in the National Ambulance Service (NAS) driving a NAS vehicle must make themselves available to respond to an emergency call if required.
Teleconference with senior managers in a hospital group and senior colleagues in NAS. The hospital group are considering moving a clinical service in one hospital to another hospital within their group, and wish to discuss how this might impact on NAS, and how NAS might support this move. A number of options are discussed and analysed; we agree a common approach.
Coffee-time — ambulance services, no more than emergency departments rely totally on coffee to function!
Called by NEOC – there is a cardiac arrest in a suburb of Limerick City – am I available to respond? Yes I am, and off I go. On arriving at scene, I found an emergency ambulance with a paramedic crew already in attendance. They were driving quite close to the address when the 999 call was received, and our computerised dispatch system alerted the emergency dispatcher in Tallaght they were nearest – response time to call 3 minutes 15 seconds. While they were responding, the 999 calltaker in Tallaght instructed the 999 caller over the phone how to do CPR, which meant CPR commenced immediately.
The crew informed me that they had delivered one shock from their defibrillator – the patient was still in cardiac arrest. They inserted a supraglottic airway (a tube into the patients throat), continued CPR while supporting breathing. I inserted an IV line and administered some medications – we delivered another shock and the patient’s heart restarts. We quickly moved our patient towards the hospital – a successful outcome.
Back in the office I grab a quick sandwich (plus more coffee) while catching up with some scientific journals, and email an interesting one on prehospital trauma management to some colleagues.
Called by the aeromedical desk in NEOC – a hospital on the West coast has requested an emergency helicopter patient transfer to a specialist Dublin hospital, but the request did not quite fit our criteria for allocating a helicopter – the dispatcher would like some advice. We discussed the call for a few minutes – the patient was very unwell and needed a specialist procedure – I advised that the transfer should be done by air. An Irish Air Corps AW139 helicopter is tasked to the call – the patient will be in Dublin in less than an hour (road transfer time closer to three hours).
I head for Tallaght – our new National Headquarters is in Tallaght, and I have a meeting at 1500 on hospital bypass procedures for stroke patients. We have a number of clinical bypass procedures that mean patients with particular conditions such as heart attack, stroke, major trauma etc are transported to the hospital best suited for them, not necessarily the nearest.
En route, the radio chirps – an ambulance crew in Roscrea have a patient with a dislocated hip in severe pain, and have requested an Advanced Paramedic (AP) to administer morphine for pain relief. The nearest AP is 15 minutes away, I am less than 5 – can I respond? Absolutely! When I arrive, the patient, home from hospital post hip replacement only 6 weeks ago, was in considerable pain – I administered IV morphine, and she immediately became more comfortable. The crew transported her to hospital and I continue on my merry way.
A little late (but with a good excuse!) I arrived in Tallaght for the meeting. We reviewed our stroke hospital bypass activity for the last quarter – the data is very reassuring, I made a note of some minor issues to clarify with hospital based colleagues on one or two of the calls.
Head back to Limerick – return some phone calls on the way, and then listen to a podcast on sport downloaded the night before. I do a lot of work-related driving, podcasts are a great way to keep up with the Cork hurlers and my beloved Arsenal FC! Hopefully no more 999 calls on the way home……….(oh yes, and make sure to stop for a coffee half way).