Military Anaesthesia

The Academic Department of Military Anaesthesia and Critical Care (ADMACC) marked five years as a department in 2013 and has gone from strength to strength with the continuing support of the RCoA, AAGBI and NIAA. A key milestone was the move from honorary to formal appointments of lecturers and senior lecturers facilitated by the RCoA and NIAA - for which I am very grateful.

Departmental members continue to deploy in support of UK forces around the world and actively publish and pursue research interests. The rest of this summary is given over to introducing departmental members.

Col Peter F Mahoney OBE TD MSc MBA FRCA FIMC FFICM L/RAMC
Defence Professor Anaesthesia and Critical Care
Visiting Professor, Centre for Blast Injury Studies, Department of Bioengineering, Imperial College London.

Defence and Security Accelerator (DASA) themed competition: regenerative medicine at the front line

This themed competition seeks to make a real difference in saving lives and reducing disability following serious injury. It is open to proposals that harness developments in regenerative medicine to offer practical approaches suitable for use early after injury.

Up to £500,000 is available for phase 1 of this competition. At least another £500,000 will be made available for phase 2 of the competition. Only those projects funded through phase 1 will qualify for entry into the phase 2 competition. More information is available here.



Professor

Col Tom Woolley

Colonel Tom Woolley
Col Tom Woolley MD FRCA L/RAMC is the Defence Professor of the Academic Department of Military Anaesthesia and Critical Care Medicine (ADMACC) based at the Royal Centre for Defence Medicine (RCDM), Birmingham. He is the clinical lead for the military's blood "Far Forward Programme" aimed at ensuring blood based resuscitation is available to military trauma patients on the battlefield. He is also the academic lead for military Chemical, Biological, Radiological and Nuclear (CBRN) medicine. He is a Consultant Anaesthetist at Derriford Hospital, Plymouth with an interest in hepato-biliary and colorectal anaesthesia. Research interests include trauma resuscitation and the management of trauma induced coagulopathy.


Emeritus Professor

Col Peter Mahoney

Colonel Pete Mahoney
Col Pete Mahoney CBE OStJ TD PhD MBA FRCA L/RAMC was appointed as the foundation ADMACC Defence Professor of Anaesthesia & Critical Care in 2008. He established the academic department and encouraged individuals to undertake research and higher degrees. He deployed actively to ensure that research was closely linked with the needs of the operational military and was awarded the OBE, a QCVS and the US Military Bronze Star. He was promoted to CBE in 2015, became Emeritus Professor in 2016 and undertook ballistic research at Cranfield University. He moved across to Reserve Service in 2020. Current academic appointments and projects include Honorary and Visiting Chairs at Cardiff University (research into novel analgesics), Imperial College London (Centre for Blast Injury Studies), King's College London (Military Medical Ethics) and a project with Dr Paul Wood and Dr Emrys Kirkman at Defence Science and Technology Laboratory (DSTL) concerning blast injury and nerve damage. He also works in the independent film industry as an Executive Producer and fight coordinator having gained instructor qualifications in Filipino Martial Arts.



Senior Lecturers

Heidi Doughty

Dr Heidi Doughty
Dr Heidi Doughty OBE OStJ TD Dr Philos MBA FRCP FRCPath is a consultant in Transfusion Medicine with an interest in military medicine and transfusion emergency preparedness. She served as an Army Reservist for 30 years during which time she actively deployed, commanded a field hospital and served as Defence Consultant Advisor (DCA) Transfusion. Following retirement in 2013, she served as Chair of the NATO blood panel, Colonel Commandant, and civilian adviser. Initiatives have included introduction of an enhanced massive transfusion capability, operational apheresis, lyophilised plasma, and transfusion governance. She completed her doctoral studies in military transfusion in Bergen, Norway and continues to support pre-hospital developments. Current appointments include Senior Research Fellow SRMRC and President of the British Blood Transfusion Society. She was awarded the OBE in 2013 and elected Honorary Fellow of St John's College Cambridge in 2020.


Surg Cdr Elspeth Hulse

Surgeon Commander Elspeth Hulse
Surg Cdr Elspeth Hulse PhD FRCA DipMed Tox RN is a Consultant Anaesthetist at a major trauma centre in Newcastle-upon-Tyne specialising in major colorectal and maxillofacial surgery.

She gained her PhD in toxicology (2016) at the University of Edinburgh investigating the type and severity of lung injury created through aspiration of both gastric contents and organophosphorus (OP) pesticide, often seen in self-poisoning patients in rural Asia. This work may be transferable to other OP compound poisoning such as nerve agents. The PhD involved running a large-animal ICU facility, human pilot study work in Sri Lanka and conducting animal ex-vivo lung perfusion (EVLP) modelling. She also used some of the visual lung assessment techniques learned in the PhD and applied it to human blast lung injury measurement.

As well as continuing to write OP poisoning literature, she is now focusing on building future Defence medical research capability through improved clinical digital data collection for the next conflict. This work involves encouraging anaesthetic trainees to engage with data science and machine learning and exploring innovative ways to exploit emerging medical technology and military clinical data for the benefit of the battlefield casualty of the future.

Surg Cdr Hulse also set-up the Tri-Services Trainee Audit and Research (Tri-STAR) group in 2017 and continues to mentor the committee made up of senior military anaesthetic trainees (see below).


Surg Cdr Sam Hutchings

Surgeon Commander Sam Hutchings
Surg Cdr Sam Hutchings PhD OBE RN is a Consultant Intensivist working at King's College Hospital, London and is an Honorary Senior Lecturer at the Department of Inflammation Biology, School of Immunology and Microbial Sciences at King's College London. His areas of academic interest are the relationship between tissue perfusion and organ dysfunction in critically ill patients with a focus on translational clinical research. Other areas of interest include the use of point of care monitoring and imaging and the creation of predictive models for critically ill patients. Current studies are investigating the role of perfusion in the development of sepsis induced acute kidney injury and the efficacy of optic nerve ultrasound in the management of severe traumatic brain injury. Sam is also working with ICNARC to develop predictive models for outcomes in critically ill patients following traumatic injury.


Surg Cdr Adrian Mellor

Surgeon Commander Adrian Mellor
Surg Cdr Adrian Mellor MB ChB Dip IMC Dip MM MD FRGS FRCA RN is a Consultant Cardiothoracic Anaesthetist working at James Cook University Hospital, Middlesbrough. Appointed Senior Lecturer within ADMACC in 2012 Adrian's research interests are in extreme environments researching adaptation to hypoxia and exercise and how this impacts effectiveness on deployments. This work resulted in an MD from Newcastle University awarded in 2016.

Adrian is a visiting Professor at Carnegie Research Institute, Leeds Beckett University where work has included the investigation of moderate hypoxia on motor and cognitive skills involved in medical decision making.

Current research projects include improving outcomes after major surgery (enhanced recovery pathways and perioperative treatment of anaemia), the role of biomarkers in intensive care and the use of wearable technology to reduce injury and improve performance in extreme environments.


Giles Nordmann Nov 13

Colonel Giles Nordmann
Col Giles Nordmann MD FRCA L/RAMC is a Consultant Anaesthetist working in Plymouth with special interests in paediatric, trauma and hepato-biliary anaesthesia. In addition to his Senior Lecturer post he is also the Army lead Consultant in Anaesthesia and advises Army Headquarters on military anaesthesia, resuscitation and critical care transfers. He is also a Deputy Editor for BMJ Military Health.

Having deployed throughout the world on eight occasions in the last decade, he is keen to ensure his research and other work is focused on the requirements of the troops and clinicians on the ground. He is equally passionate about ensuring a continued cohort of junior military anaesthetists develop an academic interest.

Academically, he has been involved in military research since the department's inception, working predominantly with the team at DSTL, Porton Down on pre-hospital resuscitation, the coagulation changes in ballistic trauma and damage control resuscitation - some of which formed part of his MD at Durham University. Translational research in the deployed environment in conjunction with Oxford and London Universities has led to more recent work on similar subjects with a particular interest in blast.



Lecturers

Lt Col Andy Johnston

Lieutenant Colonel Andy Johnston
Lt Col Andy Johnston is a Consultant in Respiratory and Intensive Care Medicine at RCDM based at Queen Elizabeth Hospital, Birmingham. He is studying critical care outcomes of military polytrauma patients and has interests in blast and ballistic trauma as well as CBRN medicine.


Lt Col Damo Keene

Lieutenant Colonel Damian Keene
Lt Col Damian Keene is a Consultant in Anaesthesia and Pre-Hospital Emergency Medicine based at the Queen Elizabeth Hospital, Birmingham. He has a research interest in pre-hospital care, particularly the phase of damage control resuscitation and physiological triage. He is currently researching ways to improve triage using machine learning.


Surg Cdr Tim Scott

Surgeon Commander Tim Scott
Surg Cdr Tim Scott PhD MRCP FRCA EDIC FFICM RN is a Consultant Anaesthetist, Intensive Care and Pre-Hospital physician working the Royal Stoke University Hospital and is a Senior Lecturer at Keele University. Interests are predominantly acute lung injury. Currently involved in a UKRI funded project to model Covid-19 pneumonitis as well as several other Covid-19 related projects, and an MoD funded project to model and select therapeutic options for phosgene induced lung injury in collaboration with DSTL, Porton Down. He is supervising a project with Staffordshire University to mitigate against pressure ulcers in the deployed environment. Over the horizon, he is in the early stages of a multi-centre trial of inhaled Xenon for the management of traumatic brain injury.



PhD Students

Lt Col Alex Kumar

Lieutenant Colonel Alex Kumar
Lt Col Alex Kumar FRCA is a Consultant in Anaesthesia at King's College Hospital and in Pain Medicine at Chelsea and Westminster Hospital and Defence Medical Rehabilitation Centre (DMRC-Stanford Hall). He specialises in anaesthesia for HPB and trauma surgery and also in acute and chronic pain management. His research interest lies in pain after major trauma and he is undertaking a PhD with the pain research group at Imperial College, London. Chronic Neuropathic Pain after Combat Trauma (CONTACT) aims to define pain within the Armed Services Trauma Rehabilitation Outcomes Study (ADVANCE). Subsequently it will deeply phenotype those with nerve injury and neuropathic pain in an attempt to identify patient clusters. This research is directly translatable to civilian trauma and a parallel project is planned with a cohort of major trauma patients from the London Trauma Network.

Tri-STAR

The Tri-Services Trainee Audit and Research (Tri-STAR) group is a trainee research network (TRN) with a specialist interest in Defence anaesthesia. Tri-STAR is part of the Research and Audit Federation of Trainees (RAFT), a national organisation which represents all the regional and national TRNs. Tri-STAR has a national footprint with trainee members based across eight deaneries. Previous projects conducted by Tri-STAR have included evaluating the use of regional anaesthesia in trauma within the NHS and evaluating burnout amongst Defence anaesthesia trainees.

Ongoing projects include:
Pre-Hospital Temperature Management in Trauma (PHMInT) - a retrospective study evaluating temperature management in trauma.

Point of Care Regional Anaesthesia (POCRA) - a remote teaching programme to upskill regional anaesthesia within the cadre.

Chair

Major Allan Pang

Major Allan Pang
ST5 Anaesthesia Trainee - Northern Deanery


Secretary

Squadron Leader Alice Jamie Humphreys

Squadron Leader Alice Jamie Humphreys
ST5 Anaesthesia Trainee and Academic Clinical Fellow - South West Deanery


Assistant Secretary

Squadron Leader Rory McDonald

Squadron Leader Rory McDonald
ST4 Anaesthesia Trainee and Academic Clinical Fellow - Oxford Deanery