Rich completed the Medicine in Remote Areas Course (MIRA) in December. It’s a step away from day to day clinical dentistry but it focuses on the skills needed to save a life. As dentists this requirement can occur in the event of a medical emergency in surgery or in practice. Performance Smiles run the DiRA® (Dentistry in Remote Areas) course and the cross over of skills from surgery to the remote environment, whether that be in the Jungle, desert, arctic or mountainous setting become important. The MIRA course compliments Pre-Hospital Care skills and presents additional knowledge to enable casualties in a remote environment to be dealt with. The course focuses on stabilisation of the injured through to the knowledge and skills required for prolonged field care.
The MIRA course is certified by the Faculty of Pre-Hospital Care, Royal College of Surgeons in Edinburgh, and is designed for medics working in the oil/gas industry, media industry, expedition and exploration personnel and medical support for disaster relief including humanitarian organisations, mountain rescue, and search and rescue personnel. The course Rich attended had 5 delegates – a cave explorer, a TV producer (who apparently discovered Bear Grylls!), a mountain rescue paramedic and an ex French foreign legion soldier….oh and a Dentist!
Iqarus provide the course and aim to provide the essential underpinning, knowledge and skills to manage a casualty using the primary survey. This has an emphasis of understanding the “why” as well as the “how” casualties occur in the remote environment. When circumstances occur outside of the norm, MIRA trained personnel can adapt their training for the benefit of their injured colleagues.
The course structure is primarily based on providing the student with the fundamental skills required to manage a casualty in a remote/challenging environment. During the 5 days we covered the following topics:
– Management of injuries from road traffic collisions, ballistics and violent assaults
– Oxygen therapy
– Intermediate and advanced airway management including surgical airways
– Life threatening chest injuries and management including needle decompression
– Circulatory system and Haemorrhage control
– Shock and fluid replacement (I.V & I.O)
– Head injuries
– Medical emergencies
– Fractures, dislocations and burns
– Environmental illnesses
– Remote area and prolonged patient care
An intensive 5 days of lectures from 0800-1730hrs the brain exercise and learning of pneumonics was cleverly interrupted with hands on practicals in the immersive suites specifically built to replicate arctic, mountain , desert and urban environments. A final ex with gunfire, flashbangs, burst water mains and falling debris in buildings created a challenging environment to treat casualties with gunshot wounds and amputations. A steep and humbling learning curve but only a toe in the water of what a real world scenario would be like. My full respect to our emergency services.
This course is underpinned with the Medicine in Remote Areas certificate, endorsed by the Faculty of Pre-Hospital Care, Royal College of Surgeons, Edinburgh.
The course is valid for three years and I would recommend it to anyone with prior medical learning or those who are designated as medical cover when visiting remote environments.
Performance Smiles® 
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