Not a “run of the mill” expert…

25 Apr 2019

Mr Aswinkumar (Ash) Vasireddy BSc (Hons) MBBS FRCS, has recently joined our team of experts in his capacity as Consultant Orthopaedic Trauma Surgeon– and he is not a ‘run of the mill’ expert witness by any stretch of the imagination.

His day job is working as a Consultant Orthopaedic Trauma Surgeon based at Kings College Hospital in London – one of London’s four Major Trauma Centres, where he treats, as a matter of course, patients with the most urgent, life threatening injuries. Mr Vasireddy is a full-time fellowship-trained Orthopaedic Trauma Surgeon qualifying at Guy’s, King’s & St. Thomas’ Medical School, completing his orthopaedic training on the prestigious South East Thames Rotation. He specialises in the management of complex open/closed pelvic, acetabular, upper limb and lower limb fractures and amputations.

He is also one of a small group of surgeons, and the only contemporary Orthopaedic Surgeon, in the UK who works as a HEMS (Air Ambulance) Pre- hospital Care Doctor.

HEMS provides an Advanced Trauma Team which consists of a Doctor and Paramedic, to the scene of an incident via the helicopter during the day or fast response cars at night. Mr Vasireddy’s training extends quite uniquely to delivering advanced medical interventions, such as rapid sequence induction of anaesthesia, to injured patients in order to improve their outcome.

An example of a hostile scene with numerous scene safety issues but where timely extrication and clinical management of the patient is imperative

This provides the unique opportunity to treat patients in time-critical, life- threatening situations, often in hostile environments, for example under trains, lorries and in the middle of roads and building sites.

The training to be a part of this elite team on top of the extensive medical training to qualify as a surgeon, is a further intensive six-week training course culminating in a 12-hour assessment during a clinical shift. Some aspects of the course can be very stressful, even more so than the study required to be a surgeon! During training, all shifts are supervised by senior colleagues and all ‘missions’ are debriefed in a “very open and blunt fashion” to better understand the understandable and inevitable limitations and deficiencies the team often find themselves facing.

Many seminal journal articles need to be committed to memory, including the results of the studies as well as their limitations, so that the clinicians understand the evidence that underpins the interventions provided by the service. There are also more than 50 Standard Operating Procedures (SOPs) that need to be learnt. Other associated documents need to be read, e.g. the London Emergency Services Liaison Panel (LESLP) Major Incident Procedure Manual. It is important to note that the Air Ambulance service has been involved in the majority of major incidents we see reported on the news, including the 7/7 bombings and numerous railway crashes. Mr Vasireddy was one of the medics involved in treating the casualties from the Westminster terrorist incident.

Some of the reading material that needs to be committed to memory!

All shifts are 12 hours long and are from 7am to 7pm (day) or 7pm to 7am (night). The general routine (for which there is an SOP!) involves the Doctor and Paramedic preparing and checking equipment prior to taking a handover from the previous team – all with the aid of a checklist. Duplicate equipment is present in both the car and aircraft so that both transport options are available depending on the incident location. Once at an incident, they carry two Thomas packs that contain all the necessary drugs and medical equipment. Once all medical interventions are completed, the patient is then escorted to hospital via land or air.

Clinical governance is a crucial part of the service with twice-weekly Death and Disability meetings in which clinical cases are discussed. There is also a monthly Clinical Governance Day, open to all outside the organisation, in which clinical cases are audited. A fair-blame culture is key in order to highlight areas of improvement. Guest speakers also lecture in their particular areas of interest, which include clinical and non-clinical topics.

Mr Vasireddy’s medico legal practice includes those who have sustained high-energy injuries. With his unique level of training and expertise he’s able to provide a range of comprehensive reports and review all aspects of a patient’s treatment. His consultation rooms are in London and Essex, and he may be available for domiciliary visits in London and the South East.

Mr Vasireddy can be instructed via Medicolegal Partners by calling 020 7118 0650 or contacting us on info@medicolegal-partners.com