A student in NOSM’s new Master of Medical Studies program works to improve pain management for Northern trauma patients transported by air

Unfortunately, it’s a recurring story in the North. Serious accidents happen causing trauma, and the air ambulance is called to transport patients to hospital. For Dr. Sabrina Slade, most critical is the extreme pain many patients must endure during lengthier air transport—an experience she hopes to improve.

Dr. Slade is a second-year orthopedic surgery resident at the Northern Ontario School of Medicine (NOSM) and a graduate of the MD Class of 2019 at Queen’s University. She currently works part-time in the emergency department at Thunder Bay Regional Health Sciences Centre. She’s one year into the Master of Medical Studies (MMS) program at NOSM, working on her thesis titled “Alleviating pain for trauma patients transported by air in the North.” Dr. Slade recalls her firsthand experiences with emergency trauma patients transported by Ornge, Ontario’s provider of air ambulance and critical care transport services.

“I’ve been fortunate to ride along with Ornge while patients are being transported,” says Dr. Slade. “It’s a challenging environment in which to manage pain while being jostled around. The study is focused on patients who are being transported from remote areas after suffering a multi-system trauma. It’s not uncommon to have a patient arrive from a trauma after a four-and-a-half-hour flight and their pain is not well controlled. Our goal is to build upon the breadth of knowledge and skills of Ornge paramedics to improve pain management for our patients.”

She says improving pain management in the air is possible. Her challenge is to determine if it is feasible. The study is two-fold—the first portion assesses whether paramedics could independently administer a specific pain block medication which is frequently used in emergency departments for those who have suffered hip or femur fractures. The block lasts up to six hours, but is currently available to patients only if administered in consultation with a physician.

“We must first assess if it’s feasible for Ornge paramedics to administer the block using what we call a ‘blind technique’ when they first arrive on the scene; meaning without the consultation of a physician and without ultrasound,” says Dr. Slade. “There are good techniques to do this effectively.”

The second portion of her study is a chart review assessment of the experiences of previous trauma patients during air transport. Specifically, Dr. Slade is studying traumas that include multiple injuries to determine if the current standard of pain management during air transport is sufficient. Part of that work involves detailed chart re-evaluations of the medications that trauma patients received during their air transport time.

Dr. Slade considered programs at various universities across Canada before choosing NOSM’s Master of Medical Studies program. For her, it’s the program of choice because it was created to address pressing Northern health-care challenges. “The program really resonated with me because it highlights issues in communities and it is best suited to researching transport medicine and critical care.”

Working under the supervision of emergency physicians and NOSM faculty members Drs. David Savage, Rob Ohle, Sean Moore, Russell McDonald, the study will also cross-reference air transport pain management techniques in the US, Australia and New Zealand where air transport medics have a progressive scope of practice.

Dr. David Savage, research supervisor, NOSM Assistant Professor, and Emergency Physician at the Thunder Bay Regional Health Sciences Centre, says Dr. Slade has chosen a really important research topic for our northern and rural population. “Ornge plays a really important role in caring for sick and injured patients in the North. If we can improve a patient’s pain management, we hope that both their experience during transport and their medical outcome is improved.”

Dr. Slade’s personal goal is to have the research completed by spring with a paper in progress by June 2021. “I’m hoping more learners and supervisors see the program as an opportunity to both address critical health issues and expand our academic health network. There are excellent researchers in the North who are able to broaden our scope of practice and research.”

Visit the NOSM website to learn more about the Master of Medical Studies program, including a flexible program schedule which allows for full- and part-time options for learners to complete between two to six years. Applications for the 2021-2022 academic year are currently open until February 26, 2021.