February 2014 - Waypoint Interview
Multi-role medical expert
From air rescue helicopters to Learjets, Dr David Sinclair, medical supervisor for European Air Ambulance (EAA), has gained hands-on experience providing care in the air to patients around the world. Waypoint spoke to him about the progression of his air medical career, as well as why continuing to work in a hospital setting is of vital importance
- Where were you born, where did you grow up, and where do you live now?
I was born in Madrid, Spain as the second son of my German mother and Australian father. At the age of two I moved to Germany, unfortunately too early to have acquired considerable language skills in Spanish. I grew up in Sindelfingen (famous for its Mercedes factory), and moved on after finishing secondary school and compulsory community service. My family and I have now settled in the state of Saarland, with its attractive proximity to the French Moselle region and Luxembourg.
- Where did you do your medical training?
I attended medical school at the historic University of Tübingen, founded in the 15th century.During my second year of medical school, I qualified for a scholarship, which brought me to Dartmouth Medical School in the US, where I spent eight months. The surgical term of my final year in medical school, I spent at the University of San Diego in California, US.
I started my specialisation in anaesthesiologyat the Winterberg hospital in Saarbrücken; a Level I Trauma Centre, which offered an excellent 5 year residency program. After 4 years I moved to the St. Elisabeth hospital in Saarlouis, where I finished my final year of residency and completed a fellowship in critical care medicine and emergency response medicine.
- What does your current role at EAA involve? How does it fit in with the rest of the team?
I started my career at Luxembourg Air Rescue (LAR) as a flight physician in 2002, even before LAR and DRF Luftrettung founded European Air Ambulance (EAA) in 2006.
Both DRF Luftrettung and LAR have a similar set-up regarding the medical department. These are headed by an experienced person with a background in medical management, and for specific medical questions they are assisted by several medical supervisors. I am one of the supervisors for the Luxembourg entity, with Didier Dandrifosse as head of the medical department.
Thus my role is a combination of flight physician for fixed wing & rotor wing missions and medical supervisor to assess critical patients, validate medical procedures and represent the company at conferences, publications and lectures.
- Do you work in hospitals as well as in the air ambulance? If so, what is your role and how do you think it complements your job as medical supervisor for EAA?
Yes! I have never stopped working as an anaesthetist in a hospital setting. I have divided my labour time into 50-per-cent hospital work and 50-per-cent air ambulance/rescue medicine. In the hospital, I am a consultant in an association of eight anaesthetists.
Our customers, and even more our patients, deserve the highest-quality of care from the medical team in every circumstance. These key skills are best sustained when performed on a daily basis. This, however, can only be achieved in a hospital setting. Therefore, all of our physicians remain active in a clinical setting.
- What made you want to work in air medicine? And what was your first role in the air medical industry?
My first contact with the air medical industry was during my residency in Saarbrücken. A rescue helicopter is based on the hospital’s premises, which is staffed by the department of anaesthesiology. This enabled me to fly my first rescue missions during my residency.
However, the cornerstone of my involvement in air medicine was laid many years before – my mother used to work for a commercial airline, and therefore travel became a significant part of my life from my early childhood onwards.
In 1995, while I was a student at Dartmouth Medical School, my father suffered a severe stroke on a business trip in Chicago. He could only return back home with the help of a medical escort. Living through such a tragedy has influenced my decisions at some crossroads in my life.
- In your opinion, what are the most critical on board medical tools that you make use of?
The most critical tools remain the basic items you use on every mission, such as a monitor to survey the patients’ vital signs or a respirator. But the poorer the standard of the discharging hospital is, the more valuable sophisticated surveillance machines become. A good example for this purpose is an arterial blood gas monitor or the Pronto7 by Masimo, for non-invasive and quick spot checking of total haemoglobin, pulse rate, and perfusion index. Surveillance means nothing without the possibility of treatment, therefore a wide range of pharmacotherapy is equally essential.
I also consider the experience and professionalism of our flight nurses and pilots to be of the utmost importance during our missions.
- Can you tell us about the most challenging repatriation mission that you have performed? Why was it so difficult?
My experience has taught me that very often, the transition phase poses a risk for problems. A good example is a patient who measured approximately 195 cm (6 ft 4 in) and had suffered a C6 fracture, which left him as a quadriplegic. We had a hard time transporting him in an African ground ambulance from the hospital to the airport without further compressing his spine, as he was too tall for the ambulance. Another time, I arrived in the UK with a ventilated patient with every piece of monitoring, plus three syringe pumps, attached. The customer had sent a Ford Galaxy car as an ambulance, which did not have the capacity to transport all of us to the hospital, and in addition on this occasion, oxygen was running low.
- You have also worked for humanitarian relief organisations in the past – where did these missions take you?
My brother Marc, a paediatric orthopaedic surgeon, is also initiator of “The Little Wings Foundation”, an independent non-profit organisation dedicated to providing medical assistance to children in the Middle East and North Africa. Over the past five years, I have had the opportunity to join him four times in Palestine, and in January 2010, one week after the devastating earthquake, we had a team in Petionville, Haiti. My next humanitarian mission will take me to Tbilisi, Georgia in March 2014.
- What do you enjoy most about your work?
When people travel for recreation, they hardly ever think about injury or illness. However, when the unexpected happens, far from home, friends and family, they find themselves in a most despairing condition. Being able to help in such a situation fills me with great satisfaction.
Furthermore, I love to interact with people of different origins and improvise, if the situation demands it. Working in the global repatriation sector allows me to do all of these in combination with each other!
- If you could do any other job in the world, what would you like to do?
If you have the best job in the world, why pick another one?! No, seriously … for me, I have found the perfect working model. After a tiring week of repatriation I look forward to my operation theatre and vice versa. I can honestly say that I wake up every morning with anticipation for what the day will bring.
- What are you most proud of, personally and professionally?
Personally, my three delightful daughters fill me every day with pride, as, of course, does my wonderful wife, the anchor of our family. I can confirm that, behind every successful man, stands a strong woman. Without her compensating for my days of absence, I would not be able to do this job.
Professionally, I find my satisfaction rather in the help of individual fates than a specific achievement. Regardless of whether it relates to repatriation, a humanitarian mission, a serious car accident or anaesthesia for surgery. The honest gratitude of my patients is my contentment and keeps me going.