uhcwspires logo 225



We offer excellent ‘hands on’ Pre Hospital Emergency Medicine Emergency Surgical Skills Courses at our state of the art facility, the world class West Midlands Surgical Training Centre.

Course Introduction

Pre Hospital Emergency Medicine Emergency Surgical Skills Course

This one-day course provides candidates with the knowledge and practical experience (using human cadavers) to perform emergency surgical procedures in the pre-hospital setting. The course covers the emergency surgical skills of surgical cricothyroidotomy; emergency thoracotomy; upper and lower limb amputation; and intra-osseous vascular access.

The course has been awarded 6 CPD points by the Royal College of Surgeons of Edinburgh.

In the pre-hospital environment there are some urgent life-saving interventions which cannot wait for arrival at hospital. It is extremely difficult to train for these scenarios as they are rarely encountered in supervised clinical practice or in non-emergency situations (for example, chest drain insertions can be practiced by insertion for spontaneous pneumothorax, or RSI in theatre).

This course provides the knowledge and surgical skills to perform life-saving procedures in the pre-hospital setting.  Often the most challenging aspect of a case is the initial decision to perform the procedure, ensuring it is for the correct indications, and being confident that there are no viable alternatives left. These elements will all be discussed in the course.

The course is instructed by PHEM doctors with comprehensive experience of performing these procedures with the basic equipment, surgical skills and minimal assistance that you are likely to find in your clinical practice. The emergency amputation experience will be provided by Professor Sir Keith Porter, and will include 3D video demonstrations of amputation with fire service equipment.

Candidate eligibility

Due to the nature of the course content, this course is only suitable for:

  • Senior, experienced PHEM doctors who currently work as a Consultant-level practitioner in a governed pre-hospital organization
  • PHEM trainees undertaking approved sub-specialty training programmes.

There are a limited number of places for Critical Care Paramedics / HEMS paramedics / Pre-hospital Nurses who work with physicians in their operational duties. These candidates will have the opportunity to observe the full course and assist the medical teams as if in a real life situation. Paramedics will have the opportunity to practice surgical airway, thoracostomy, and EZ-IO as autonomous procedures.

For each procedure the relevant anatomy will be presented by a Professor of Anatomy using human surface anatomy, plastinate models, and cadaveric specimens.

The theory including the indications, complications, post-procedural care and tips for trouble-shooting will be covered in lecture format.

There will then be a demonstration in real time followed by practical experience using whole human cadaveric specimens, under instructor supervision. Finally real cases will be discussed to put the theory and practical difficulties into context.

The clinical scenario for each of the procedures is as follows:

  • Surgical airway: can’t intubate, can’t ventilate after RSI
  • Emergency Thoracotomy: traumatic cardiac arrest five minutes ago following penetrating chest wound
  • Emergency Amputation: Patient trapped by limb, peri-arrest, all efforts to release patient have failed. Fire & Rescue Service are on scene with cutting equipment.
  • Humeral EZ-IO access: shocked polytrauma patient, unable to obtain IV access for emergency resuscitation.

PLEASE NOTE Attendance at this course does not give you the authority to undertake any of the surgical skills on this course in your pre-hospital work. These procedures should only be undertaken within the scope of your practice, & after sign off by your organisation, working within a system of robust clinical governance.

Help and Guidance

The PHEM Emergency Surgical Skills Course is only appropriate for the following candidates:

  • Senior, experienced PHEM doctors who currently work as a Consultant-level practitioner in a governed pre-hospital organization
  • PHEM trainees undertaking approved sub-specialty training programmes.
  • Critical Care Paramedics or Advanced Paramedics working in a HEMS setting

If you do not meet this criteria but believe that the course would be appropriate for you to attend, please  enquire via our CONTACT US page. We may ask you to provide evidence from your pre-hospital line manager that the course is will be suitable for your CPD.

What happens if book onto course and I am told that I am unsuitable?

It is your responsibility to ensure you fall within the relevant course. If your experience is below the required level we reserve the right to withdraw you from the course without compensation.

Certificates are issued approximately 2 weeks (often sooner) after your course via PDF.

This allows you time to complete the online evaluation; which closes after 1 week of your course.

Certificates of attendance will not be issued after this time.

Certificates are not provided to course observers or to delegates who have not completed the course.

Have you changed email? Has the centre got your correct contact details?

If you did not complete online feedback within 1 week of the course (and thus did not trigger the certificate process) you will not receive a certificate.

Unfortunately if more than 1 week has elapsed and you have not submitted feedback, duplicates will not be available.

If within this time frame please request a duplicate via our contact us page.

After any course you should complete feedback, your evaluation as a participant is an essential course requirement, enabling us to maintain the quality of courses we offer and help to improve future sessions

All feedback is conducted anonymously; names are only used to validate the responses.

You should complete online feedback as soon as possible after your course and within 1 week of the end of the course when the online feedback will close.

See upcoming PHEM ESS events

Find out more by registering today

Using our secure online booking system


On behalf of the West Midlands Surgical Training Centre and our Faculty, we wish to extend our thanks for your commitment to making our educational event so successful.

Your generous contribution to our training events, be it financial or with equipment contribution has helped ensure our vision for world class training has become a reality.

As we continue to grow as a Centre, please know that partnerships with our sponsors is vital to our success.


Meet The Faculty

All our clinical instructors are highly skilled at performing Emergency Surgical Skills from extensive experience in Emergency Medicine and/or Pre-hospital Emergency Medicine.



Download a programme for the next course and find out about what happens on the day including registration, timings, talks and the all important hands-on procedures.


Course Details

Cost: £550.00 for Doctors & £200.00 for Nurses/Paramedics
Duration: One Day Course
Course Lead: Dr Caroline Leech
Location: West Midlands Surgical Training Centre

PHEM ESS Gallery

Viewer discretion is advised

Meet The Faculty

Dr Caroline Leech

Caroline is a Consultant in Emergency Medicine at UHCW in Coventry. She founded this course in 2009 after identifying that it was very difficult for her colleagues to train for procedures rarely encountered in clinical practice. Her emergency surgical skills experience comes from working in many emergency departments as well pre-hospital work with the Warwickshire & Northamptonshire Air Ambulance and London HEMS. Caroline is currently the West Midlands Training Programme Director for Pre Hospital Emergency Medicine and the Regional Examinations Advisor for the Diploma of Immediate Care examination.

Dr Anil Hormis

Anil is a Consultant in Anaesthesia, Critical Care Medicine & Pre-hospital Emergency Medicine at the Rotherham NHS Foundation Trust and is the Training Programme Director for Pre-hospital Emergency Medicine (PHEM) in the Yorkshire & Humber Postgraduate Deanery.

He has worked in Pre-hospital Emergency Medicine for over 12 years working with a number of pre-hospital providers including the Yorkshire Air Ambulance and London HEMS.

Professor Sir Keith Porter

Professor Sir Keith Porter is a Consultant Trauma Surgeon and the Clinical Director for Trauma at University Hospital Birmingham. He is Professor of Clinical Traumatology at the University of Birmingham. Since 2000 he has been the civilian clinical lead for the care of injured soldiers returning to the UK from both Iraq and Afghanistan and has been a member of the Defence Scientific Advisory Committee and the Surgeon General Research Strategy Group. Keith has played an integral part of the development of Pre Hospital Emergency Medicine in the UK in his roles as the past Chairman of Faculty of Pre-hospital Care; past Chairman of the Intercollegiate Board for training in Pre-hospital Emergency Medicine; past President of BASICS and the founder of the West Midlands CARE team. He is an active immediate care practitioner for MARS and the CARE team.

DR Louise Woolrich-Burt

Louise has been a Consultant in Emergency Medicine at UHCW in Coventry since 2005. Her previous experience includes 18 years as a doctor in the British Army, UK EM rep to NATO, and a specialist registrar post with London HEMS in 2003/4. Her specialist interests are trauma, and simulation for medical education.

Professor Peter Abrahams

Professor Abrahams joined Warwick as the Medical School’s first Professor of Clinical Anatomy. His impressive career has taken him from the jungles of Borneo to his most recent position as Fellow of Girton College, Cambridge.

During his career, he has published more than 50 peer-reviewed research papers and 15 new student text books. Peter is married to an academic GP and he has three grown-up daughters. In his spare time he can be found climbing volcanoes in the jungles of St Vincent or diving in the Caribbean.

Dr Imogen Virgo

Imogen is a Consultant in Emergency Medicine at UHCW in Coventry. Her emergency surgical skills experience comes from a pre-hospital emergency medicine post with the Essex & Herts Air Ambulance.

Dr Neil Thomson

Neil has been involved in pre-hospital medicine for all his working life starting in Zimbabwe working for the City of Harare Emergency Services. In the UK he has worked with the Warwickshire & Northamptonshire Air Ambulance and has recently completed a full-time registrar post with London HEMS. He responds to BASICS cases in the South Central and East Midlands Ambulance Services and works at Milton Keynes emergency department. In his spare time Neil is Assistant Medical Director for the London Ambulance Service.

Mr Richard Steyn

Richard is a Consultant Thoracic Surgeon at Heart of England NHS Foundation Trust in Birmingham. He is the current Chairman of the British Association for Immediate Care (BASICS) and is a pre-hospital doctor working with the Mercia Accident Rescue Scheme (BASICS MARS) and the West Midlands CARE Team.

Dr Tim Nutbeam

Tim is a Consultant in Emergency Medicine in Plymouth. He has an interest in PHEM, early critical care interventions and disaster mass-casualty medicine. He is the co-editor of the medical textbooks ABC of Pre-Hospital Emergency Medicine and ABC of Sepsis. His emergency surgical skills experience comes from a year in South Africa working in EM and ICU.

Mr Brian Burnett

Brian Burnett has over 15 years experience in the fields of Pathology and forensic examination and has been instrumental in developing the West Midlands Surgical Training Centre, training over 4000 Surgeons, Doctors and Nurses since it’s opening in the summer of 2009.

Brian has co-founded several national and international training courses for healthcare professionals and has established training packages for professional organisations including the Police, Forensic Science Service and the Association of Anatomical Pathology Technologists. Brian has been recognised with awards for innovation and research with colleagues from Warwick medical School in the field of 3-D anatomy education.