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Like most rural generalists, Dr Bruce Dixon has been called to all matter of medical incidents over his 35 year career, including his share of obstetric emergencies.
“I’ve been practicing for a long time, and have done over 600 caesareans in that time. Most deliveries go smoothly, but you occasionally get confronted with a really critical, life-threatening emergency where you need a lot of medical input,” says Dr Dixon.
Dr Dixon believes the key to feeling confident and capable to manage these emergencies is a practical learning approach. As a result, he has become a regular attendee of Mater Education’s Maternity Emergency Management programs.
“Mater is renowned for its obstetric care, and their Maternity Emergency Management program allows you to safely practice these rare, but critical situations, where there are often two lives at risk,” said Dr Dixon.
Mater Education’s Maternity Emergency Management program is highly interactive workshop series, which provides immersive simulation-based training to interprofessional teams manage a range of maternity emergencies—such as eclampsia, haemorrhage, shoulder dystocia, breech birth, and other birth suite emergencies.
“Over the course of one training day, you’re exposed to a variety of emergency scenarios, which would typically take years to see in a rural environment.
“You walk into a very realistic birth suite scenario knowing there is going to be an emergency, but not knowing exactly what to expect. You have to observe and assess the situation immediately and work out how best to respond to the patient and coordinate the team to manage the emergency effectively.
“It’s a very safe environment to practice these high stress scenarios. You have the opportunity to reflect and debrief with the team about the role each member played, what they did well and how they could have done things differently.
“There are people with all different specialisations and skill level taking part in the program: midwives, obstetricians, junior doctors, nurses and GPs are all in there together learning with, and from, each other. There’s no judgement, and the facilitators turn every potential mistake into a valuable learning opportunity.
“It’s about the reinforcement and triggering the memories, by putting the skill into practice. Each time I attend the program, I feel more and more confident in my ability to manage the situation safely in the real world.”
Dr Dixon has spent the majority of his career working rurally across Queensland and WA, from Derby and Fitzroy Crossing in the Kimberley, to Longreach and Goondiwindi.
“In towns such as these, some women opt to travel to a tertiary hospital to mitigate the risk, but not everyone can afford the time or expense. We need well trained doctors on the ground in regional areas, who can confidently deal with these kinds of obstetric emergencies,” he says.
“It can go from being a quiet, relaxed environment, to a high-stress medical or obstetric crisis in an instant. It’s about having the confidence and the skill in those rare situations.
“It is different being in a rural birth suite and only doing a small number of deliveries – hypothetically you might do 150 deliveries in a year, and of these, perhaps 35 caesareans and one or two actual emergencies.
“That’s why this training is so important and why I continually return to Mater to refresh my skills in this space.
“Being in that birth suite environment and facing that actual emergency; having to do things with your hands and issue instructions—it’s a totally different learning experience. It’s like learning to ride a bike by reading a book about it, rather than getting on the bike. The only way to learn is to feel it.
“Thankfully, in my 35 years I haven’t had a bad outcome; I’ll do everything I can to avoid any in future also.”
Dr Dixon believes it’s important for rural GPs to take part in this program to ensure rural communities can be confident in the medical services and health care they rely on.
“I would encourage more GPs to undertake the program. There are generalists all over Australia who need this immersive training to be better prepared to respond in real world obstetric emergencies,” said Dr Dixon.
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