Fellowships Spotlight

Dr. Flora Bird -  Traumatic Brain Injury 

Dr. Flora Bird is a Consultant in Emergency Medicine at the Royal London Hospital. She works clinically in Emergency and Pre-Hospital Medicine, and as a Research Fellow for The Institute of Pre-Hospital Care at London's Air Ambulance pursuing her interest in the hyperacute physiology of Traumatic Brain Injury (TBI). 

Dr. Bird has experience in expedition medicine, pre-hospital care in the UK (London's Air Ambulance, Essex and Herts Air Ambulance) and abroad (AMREF, East Africa), and has completed an MPhil in applied physiology investigating children's responses to immersion and swimming in cold water. She currently holds roles as an Emeritus Physician for Essex and Herts Air Ambulance, Honorary Senior Lecturer for Queen Mary University of London and is lead for the Trauma Sciences Module of the iBSc in Pre-Hospital Medicine. 

Traumatic Brain Injury remains a significant cause of morbidity and mortality and is the most common cause of death or disability in those under 40 years old in the UK. It is increasingly being recognised as a medical, public health and socio-economic problem worldwide. 

Despite advances in injury-related mortality over the last 30 years, the same improvements have not been seen in outcomes from TBI. Whilst animal studies describing the effects of head injury have been documented since the late 1800's, literature related to the earliest phase of severe head injury in humans is limited and remains poorly understood. It has been suggested that the critical phase of TBI occurs within the pre-hospital phase, involving changes in cerebral and systemic physiology that will impact on morbidity and mortality.

In recent times, medical teams from London's Air Ambulance have redefined the hyperacute phase of head injury. They attend on average five critically injured patients every 24 hours, a large proportion of which result from head injury and affect patients of all ages. Given the frequency, acuity, and time-frame within which they attend these patients, it offers a unique opportunity to study this cohort, with the aim of better understanding the early physiology of head injury in the hyperacute pre-hospital phase. For example, we have acknowledged the impact of head injury on the breathing system, so that our attention is drawn to the very urgent correction of breathing abnormalities. This can involve using artificial ventilation to prevent irreversible brain damage. 

Only through better understanding may it be possible to identify opportunities for management strategies and novel therapeutic interventions that may improve outcome. Therefore, we are delighted to have Dr. Bird as The Institute of Pre-Hospital Care at London's Air Ambulance's Head Injury Fellow to progress this crucial area of research.