Ambulance UK Feb 2018

Volume 33 No. 1

February 2018

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GREAT EXPECTATIONS! In this issue Community first responders and responder schemes in the United Kingdom: systematic scoping review Life Connections 2018 Update

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CONTENTS

CONTENTS 4

EDITOR’S COMMENT

6

FEATURES

6 C ommunity first responders and responder schemes in the United Kingdom: systematic scoping review

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EDITOR’S COMMENT

EDITOR’S COMMENT Welcome to the latest edition of Ambulance UK, and our first of 2018. Before writing this, I browsed the editorials from previous years, and it seems the common theme is that the preceding year is always the busiest we have seen, with the Christmas period always more demanding than ever before. As it is, 2017 followed the trend, and the media is again full of horror stories of how ambulances delays and long waits in hospital corridors have impacted on patient care.

AMBULANCE UK - FEBRUARY

“As Dr Smith of SWASFT notes, staff are the most valuable part of our service.

We need to listen to them, and more importantly, let them know we are listening.”

However, we see fewer reports about the impact these challenging times have on ambulance staff, whether they work in Emergency Operations Centres or as clinicians on the road. This impact can take various forms, from the need to reach response targets in an ever more demanding environment, or abuse from aggressive patients or relatives who believe that we have not responded to their needs appropriately.

The East of England Ambulance Service NHS Trust (EEAST) has emphasised some of the unacceptable behaviour aimed at ambulance staff, with the launch of its Don’t Choose to Abuse campaign. The campaign raises awareness of the aggression that ambulance staff receive, and aims to reduce it.

Other ambulance trusts from around the UK have recognised the various stresses placed on staff and put processes in place to support their staff when the pressure is having an effect. There are examples of projects in this edition, such as the ‘Staying Well Service’ of the South Western Ambulance Service NHS Foundation Trust (SWASFT), which has been providing support and welfare for its staff for two years now, or the ‘Wellbeing Hub’ recently introduced by the South East Coast Ambulance Service.

These are great initiatives, and I for one encourage them. That being said, I think we may all miss opportunities to help our colleagues. I was talking to an Emergency Operations Centre Paramedic today who noticed that whilst the pace of change in the out of hospital environment is incredible, the details may not make their way down to the teams at the coalface. He described several initiatives, which for whatever reason had not been relayed to the clinicians on the ground. It is a small point, but an important one.

Clinician’s and EOC staff are being listened to. Their ideas and suggestions are vital for change. But if they don’t know that they have been heard, then this increases the stress in an already stressful environment.

As Dr Smith of SWASFT notes, staff are the most valuable part of our service. We need to listen to them, and more importantly, let them know we are listening.

Matt House, Co-Editor Ambulance UK

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FEATURE

COMMUNITY FIRST RESPONDERS AND RESPONDER SCHEMES IN THE UNITED KINGDOM: SYSTEMATIC SCOPING REVIEW Viet-Hai Phung, Ian Trueman, Fiona Togher, Roderick Orner and A. Niroshan Siriwardena Reproduced with permission from the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Abstract

ambulance staff. There were concerns about the possible emotional impact on CFRs responding to incidents. CFRs felt that better feedback

Background: Community First Responder (CFR) schemes support lay people to respond to medical emergencies, working closely with ambulance services. They operate widely in the UK. There has been no previous review of UK literature on these schemes. This is the first systematic scoping review of UK literature on CFR schemes, which identifies the reasons for becoming a CFR, requirements for training and feedback and confusion between the CFR role and that of ambulance service staff. This study also reveals gaps in the evidence base for CFR schemes.

would enhance their learning. Ongoing training and support were viewed as essential to enable CFRs to progress. They perceived that public recognition of the CFR role was low, patients sometimes confusing them with ambulance staff. Relationships with the ambulance service were sometimes ambivalent due to confusion over roles. There was support for local autonomy of CFR schemes but with greater sharing of best practice.

Discussion: Most studies dated from 2005 and were descriptive rather than analytical. In the UK and Australia CFRs are usually lay volunteers

Methods: We conducted a systematic scoping review of the published

equipped with basic skills for responding to medical emergencies,

literature, in the English language from 2000 onwards using specific

whereas in the US they include other emergency staff as well as lay

search terms in six databases. Narrative synthesis was used to analyse

people.

article content.

Conclusion: Opportunities for future research include exploring Results: Nine articles remained from the initial search of 15,969 articles

experiences and perceptions of patients who have been treated by

after removing duplicates, title and abstract and then full text review.

CFRs and other stakeholders, while also evaluating the effectiveness and costs of CFR schemes.

People were motivated to become CFRs through an altruistic desire to help others. They generally felt rewarded by their work but recognised

Keywords: First responders, Prehospital care, Urgent care, Basic

that the help they provided was limited by their training compared with

ambulance care

Background

events, whilst others may also attend road traffic collisions and trauma incidents. Such diversity of provision also carries varying degrees of

A Community First Responder (CFR) “is a member of the public who receives basic emergency care training and volunteers to help their community by responding to appropriate medical emergencies while an ambulance is en route” [1]. They complement the work of the ambulance service. Their work is particularly valuable in rural communities, where it might take ambulances longer to reach medical emergency situations.

training and support of volunteers which could impact on effectiveness, safety and retention of personnel [1].

Some UK regions, such as the East Midlands, have both independent CFR schemes and schemes run by ambulance services. For example, Lincolnshire Integrated Voluntary Emergency Service (LIVES) is an independent voluntary scheme working collaboratively with but not

AMBULANCE UK - FEBRUARY

managed by the regional ambulance service, whereas the CFR scheme Community First Responder schemes have been providing prehospital

in Nottinghamshire is run by the ambulance service. Both, like many

emergency care since the 1990s, enabling patients to receive early

other CFR schemes, have volunteers trained up to ‘first person on

medical attention while awaiting an ambulance response [2]. The

scene’ level [3].

ambulance service deploys an estimated 2,500 CFR schemes, with over 11,000 volunteers in the United Kingdom [1, 3]. They are usually

The Government has called for greater co-ordination and collaboration

charities, either independent or run through ambulance trusts [4].

between ambulance services, the 111 call service, which provides

Currently, no national standards exist concerning CFR service provision,

advice for urgent but non-emergency cases, urgent care and out-of-

training and support of volunteers or quality of services provided. Local

hours services in The NHS 5 year forward view [5]. Such changes are

schemes have developed independently of each other and reflect

likely to affect CFR schemes within ambulance trusts and CFR schemes

each area’s priorities. Many CFR schemes only respond to cardiac

working with other agencies to ensure a more integrated and needs-led

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FEATURE service [6, 7]. Therefore, it is timely to evaluate the CFR role and service

population’, ‘methods and ‘results’. Scoping reviews by their nature do

provision and explore their potential for future development.

not exclude studies with higher risk of bias, so no risk of bias analysis was undertaken.

Research on the benefits of CFR schemes to both patients and ambulance services for health outcomes and ambulance response times have been published for other countries [8] but there has been no review of published literature on CFR schemes in the UK. This is the first systematic scoping review of UK literature on CFR schemes, which identifies the reasons for becoming a CFR, requirements for training and feedback and confusion between the CFR role and that of ambulance service staff. This study also reveals gaps in the evidence base for CFR schemes.

Results Of these nine publications, one was a systematic review, four were qualitative studies, three used quantitative methods, and another employed a mixed-methods approach (Table 1). We used a narrative approach to summarise the main findings in themes described below.

Motivations and reasons to become a CFR Several studies showed that volunteers cited altruistic reasons for

Methods

becoming CFRs [10, 11]. Becoming a CFR was often seen as a way of giving something back to the community by helping others [4, 10–12].

We aimed to map existing published literature relating to current

The role was also seen as a way of enhancing employability within

UK-based CFR schemes in order to identify gaps for future research

the ambulance care sector [13]. Some CFRs joined because they

to explore. To do so, we conducted a systematic scoping review

were already healthcare professionals who felt that it provided a good

of published research on CFR schemes and CFRs including any

learning experience for them in a different setting [13].

interventions, comparisons and outcomes. The purpose of the study was to understand, map and synthesise the range of published

Experiences of being a CFR

literature, regardless of quality [9].

CFRs felt their role was rewarding, although they expressed a need for praise for the work they did [4] and a concern about the limited opportunities for operational debriefing on their activities [10, 14, 15]

Inclusion criteria

CFRs felt they were limited in what they could do because they lacked

The inclusion criteria for selecting publications were that they had to be

the skills of paramedic staff. [1, 12] In some instances, this manifested

published in English and from the year 2000 onwards in order to reflect

in a concern that they were not doing the right thing [1], while some felt

current UK CFR schemes. All studies had to be UK-based, so non-UK

they could and should be able to do more to help patients [16].

studies were excluded. The final agreed search terms were as follows: Training “emergency responder*” OR “lay responder*” OR “first person on

We found no evidence around the content of the initial training of CFRs,

scene” OR “community first respon*” OR “community respon*” OR

but this identified the need for research on the requirements for ongoing

“first respon*” OR “first-respon*” OR “Community” AND “first” AND

training and support. Previous studies pointed to a mandatory period

“responder”

of experience required of CFRs before they were allowed to progress to higher levels of expertise [16]. CFRs felt that ongoing training was

Data sources

essential to enable them to progress.[12, 15]. However, retraining

The following databases were searched: CINAHL; MEDLINE; PsycINFO;

and keeping up to date in a timely manner was considered difficult

Applied Social Sciences Index and Abstracts (ASSIA); International

[1, 15]. CFRs expressed concerns that despite the ongoing training,

Bibliography of the Social Sciences (IBSS); Published International

this training would become less relevant if they had not been called out

Literature on Traumatic Stress (PILOTS).

to patients [1, 12, 15] Furthermore, CFRs felt that provision of training demonstrated how their organisation valued the contribution they made

Search strategy

to patient outcomes [12]. Conversely, a lack of training led to frustration

Search results were scanned individually for relevance. Selection at

among CFRs about not having the skills required to help patients [1].

this stage included direct relevance to the research question (i.e.

In terms of the types of training that CFRs undertook, scenario-based

background information. Articles deemed relevant from each database

training was considered to be the most effective [15]. Training was

were exported into an individual EndNote library. This resulted in 979

sometimes considered to be too focused on skills, with a greater need

articles, of which 174 duplicates were removed, leaving 805 articles

to emphasise the emotional side of being a CFR [1, 15].

for screening. Screening by title and abstract excluded a further 177 articles. Since we wished to focus on UK-based CFR schemes, of the

Patient outcomes and feedback

remaining 628 articles, 528 were rejected because they referred to

CFRs were not usually given feedback about patients they had

schemes outside the UK. The 100 papers left included 56 studies of

attended. This was something that CFRs wished to see change

CPR methods, mass casualty terror acts, etc., which were removed.

[1, 15]. They felt that evidence of improved patient outcomes could

Two researchers (IT and FT) conducted a full-text review of the

enhance their profile in the local community and offer greater personal

remaining 44 articles, in which a further 35 publications were excluded.

recognition of the work they did [4, 12]. Even without formal feedback

This left nine publications in the scoping review (Fig. ​(Fig.1).1). Data

mechanisms, some CFRs derived satisfaction from contributing

were extracted for each study describing ‘aims and objectives’, ‘sample

positively to patient outcomes [10].

AMBULANCE UK - FEBRUARY

included key search terms in title/abstract) or potential usefulness as

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FEATURE

Fig. 1 Study flowchart

Public understanding of CFRs There was a low level of public recognition of the CFRs’ role. There was perceived public confusion about how their role related to that of the ambulance service. [4] For example, the public were concerned that CFRs may adopt roles traditionally associated with ambulance staff,

Suggestions for improvement CFRs expressed a need for ongoing training and support in order for them to feel valued and appreciated. To do this, it was felt that shared governance, collaboration with statutory providers to fully fund training, and assistance with resources would greatly help [11].

reducing the effectiveness of the ambulance service [12]. Recruitment was often poor in areas where the ambulance service was perceived to be performing well [12]. In order to tackle low levels of recognition, CFR programmes felt they needed to work closely with stakeholders and consumers to improve the way they publicised themselves [4, 11].

Relationship between CFRs and the ambulance service There was a perception of ambivalence in the relationship between

In terms of how CFR schemes develop further, there was strong support for local autonomy together with greater collaboration between schemes [11, 15]. A key strength of CFR schemes was that they reflected local needs and demands. If they are to be rolled out more widely, then new schemes could follow best practice from existing schemes that have been shown to work effectively. This potentially conflicted with the suggestion for nationwide minimum standards for CFRs [2].

CFRs and the ambulance service [12]. This stems partly from some confusion over accountability between the ambulance service and CFR schemes. Some CFRs felt undervalued by ambulance service staff [1].

AMBULANCE UK - FEBRUARY

Emotional impact Much of the literature around CFRs centred on the emotional impact of the role. Despite call handlers giving CFRs an indication of the nature of the incidents that they were responding to, CFRs maintained a flexible approach on reaching the patient [10], because what they found at the scene might have been very different to what had been communicated

Discussion Main findings People became CFRs mainly to help others and put something back into their communities. CFRs also wanted to be appreciated and recognised for their work, perhaps through integrating formal feedback mechanisms into practice. Both are relevant considerations for CFR schemes needing to recruit and retain volunteers.

by call handlers. The role also necessitated an ability to switch off from the often traumatic nature of the incidents they attended to [1, 10] There were particular concerns about the potential for lone working to have a high emotional impact [14]. That said, some CFRs valued having support mechanisms to call upon when needed [1, 14].

CFRs particularly valued scenario-based training which they felt would most effectively improve their range of skills. Maintaining the realism of scenariobased training, as well as encouraging CFRs to improve their skills will enable them to attend to a greater range of incidents, which is what they want.

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FEATURE Table 1 Summary of included studies Aims and objectives

Sample population

Methods

Results

Davies et al.

(2008) [10]

To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.

First responders in a community scheme in Barry, South Wales.

In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).

CFRs were motivated by a sense of duty to their community.

They found it rewarding when they contributed positively to a patient’s outcome. They felt it was important to understand their role and the limitations on it. CFRs described an emotionally detached state of mind, which helped them remain calm in these potentially stressful situations

Dennis et al.

(2013) [14]

To investigate which categories of Emotional Support messages could be used to support a CFR when they are experiencing different kinds of stress in the field.

20 participants from Amazon’s Mechanical Turk service. For this validation experiment (HIT), participants had to be based in the US and have an acceptance rate of 90% (90% of the work they do is accepted by other requesters had to be rated as good quality) and were paid $0.50 (US).

As before, the validation experiment took the form of an online questionnaire administered on Mechanical Turk, with the same participation criteria.

Participants were paid $0.50 and we received 40 responses. Participants were asked to indicate their gender, their age from a range and indicate if they were a health professional.

55% were female (45% male), 22.5% were aged 15-25, 45% 26-40, 27.5% 41-65 and 5% over 65. 5% of participants were healthcare professionals.

Directed Action was the most popular category for Mental Demand (where the CFR needs to think), Temporal Demand (time pressure), Frustration, Distraction and Isolation. Reassurance was the most popular category for the remaining stressors – Physical Demand and Emotional Demand. Praise was also popular for Mental Demand, Physical Demand, Frustration, Distraction and Isolation. Emotional Advice appears to be much less popular, only used by few participants in Frustration, Distraction, Emotional Demand and Isolation.

Emotional Reflection was only used for Frustration and Distraction.

Faddy and Garlick (2005) [16]

This review aimed to determine whether 50% nitrous oxide was safe for use by first responders who are not trained as emergency medical technicians.

From the electronic search of the Medline and EMBASE databases we identified 1,585 citations that matched the search criteria. These were screened for potentially relevant studies.

A total of 158 abstracts were retrieved for more detailed evaluation, of which 33 described studies that were potentially relevant to this systematic review. These studies underwent critical appraisal.

Twelve studies satisfied all subject and methodology criteria and were subsequently included in the review

One reviewer performed all of the literature searches.

The reviewer searched the Medline (1966–Oct 2001) and EMBASE (1985—Oct 2001) databases, using an optimally sensitive search strategy, for relevant studies comparing 50% nitrous oxide with placebo or other analgesic agents in the prehospital setting. Again, no studies in the prehospital setting were found.

Consequently, a broader search was performed to find randomised controlled trials from a wide range of clinical settings. Reference lists cited in original articles were examined for relevant studies not identified by the literature search.

Two studies assessed drowsiness in 135 patients treated with 50% nitrous oxide or placebo [16, 18].

The pooled result of these studies showed that 3% of patients treated with nitrous oxide analgesia and 4% of patients treated with placebo experienced drowsiness, indicating that drowsiness was probably unrelated to nitrous oxide inhalation (RD 21%, 95% CI 27% to 5%, p=0.8).

The incidence of hypotension in patients who were treated with nitrous oxide was lower than in patients treated with intravenous midazolam and pethidine (14%).

Farmer et al.

(2015) [12]

This article explored what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considered perceptions of why more follow-up actions did or did not happen.

22 citizens in three Scottish communities (healthcare practitioners, managers and policymakers) all of whom were involved in, or knew about, the original project.

In-depth interviews to capture stakeholders' views. A semi-structured topic schedule was developed to ensure a similar approach across sites.

All citizen participants of community C described the first responder scheme and its establishment during or just after Remote Service Futures, facilitated by training from the Scottish Ambulance Service. They said new volunteers were now needed. Two participants

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Study

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FEATURE Table 1 Summary of included studies (Continued) Table of included studies (Continued) Study 1 Summary Aims and objectives Sample population Davies et al.

(2008) [10]

Dennis et al.

(2013) [14] Harrison-Paul et al.

(2006) [15] et al.

Harrison-Paul (2006) [15]

Kindness, et al.

(2014) [1] et al.

Kindness, (2014) [1] Faddy and Garlick (2005) [16]

Roberts, et al.

(2014) [4]et al.

Roberts, (2014) [4]

AMBULANCE UK - FEBRUARY

Farmer et al.

(2015) [12]

Results that, following the reported initial scheme establishment CFRs were motivated by athe reported that, following and been sensetraining, of duty there toestablishment theirhad community. initial scheme little follow-up by staff any Theytraining, found it rewarding when and there had of been health-related they contributed little follow-upservice bypositively staffand of to anya that current first responders patient’s outcome.

Theyand felt it was health-related service had not received ongoing important to first understand their that current responders training, leaving them feeling role and limitations on it. CFRs had not the received ongoing unsupported.

Community describedleaving an emotionally training, them feeling members felt Community let down which by detached state of mind, unsupported. state questioned helpedauthorities them calm members feltremain let and down byin these whether volunteering should potentially stressfuland situations state authorities questioned continue volunteering as it might beshould whether To investigate which 20 participants from As before, the validation Directed Action was the most hindering continue asprovision it mightofbea categories of Emotional Amazon’s Mechanical experiment took the form popular category for Mental statutory service. hindering provision of a Support messages could Turk service. For this of an online questionnaire Demand (where the CFR statutory service.

To experiences 53 participants, some Semi-structured, Most believed scenarios be explore used to the support a validation experiment administered on qualitative Mechanical needspeople to think), Temporal of people of whom had been interviews. based within their place of work CFRlay when they arehave (HIT), participants had Turk, with the same Demand (timebelieved pressure), To explore thewho experiences 53 participants, some Semi-structured, qualitative Most people scenarios been usehave given training to were most useful preparing experiencing different to whom be based theuse US participation criteria.

Frustration, Distraction and of lay trained people to who of hadinbeen interviews. based within theirinplace of work automatic external defibrillators for ‘real life’.

Manyinpeople kinds trained of stress the field. and have an and acceptance Participants were paid Isolation.

Reassurance was had been toinuse given training to others use were most useful preparing defibrillators.

The research who delivered theothers not received critical incident rate of 90% (90% oftraining. the $0.50 and we received 40 the ‘real most popular category automatic external defibrillators and for life’.

Many people had questions were: How Locations airports, responses. Participants were debriefing after using an AED. work delivered they included do isthe accepted for the remaining stressors – defibrillators.

The(1)research who training. not received critical incident can training courses help railway private There were a variety by otherstations, requesters had asked to indicate their Physical Demand andofansystems questions were: (1) How Locations included airports, debriefing after using AED. prepare people for dealing companies and first in place to Demand. provide after to be rated as good gender, their age from a Emotional Praise can training courses help railway stations, private There were a varietysupport of systems with realpeople life situations?

(2) responder an incident, manyfor ofsupport which after quality) andschemes. were paid range and indicate if they wasplace also to popular Mental prepare for dealing companies and first in provide Who real is ultimately responsible Geographically, the study were informal. $0.50 (US). schemes. were a health professional.

Demand, Physical with life situations?

(2) responder an incident, many Demand, of which for providing critical incident Geographically, covered Nottinghamshire, 55% were female (45% male), Frustration, Distraction and Who is ultimately responsible the study were informal. debriefing andcritical how should Lincolnshire, Yorkshire, 22.5% were aged 15-25, 45% Isolation. Emotional Advice for providing incident covered Nottinghamshire, this be organised?

What Staffordshire, Yorkshire, Essex and 26-40, 27.5% 41-65 and 5% appears to be much less debriefing and how(3)should Lincolnshire, is thebebest process (3) for What the West Midlands the UK. over 65. 5% of participants popular, only used by few this organised?

Staffordshire, Essex in and providing to those the West Midlands in the UK. were healthcare professionals. participants in Frustration, is the bestfeedback process for who have feedback used an AED? Distraction, Emotional providing to those Demand and Isolation. who have used an AED? To further understand the An online survey using a CFRs were asked to gauge 88 CFRs started the survey Emotional Reflection to was only demands stressorsthe modified scoring the demands andtostressors with 40 continuing To further and understand An onlineNASA-TLX survey using a CFRs were asked gauge 88 CFRs started the survey used for Frustration andthat experienced by CFRs. system was sent to 535 experienced during a 'typical' completion.

Frustration demands and stressors modified NASA-TLX scoring the demands and stressors with 40 continuing to Distraction.

Community First to 535 and their 'most stressful' callout, completion. the CFR could not help that the experienced by CFRs. system was sent experienced during a 'typical' Frustration Responders in Scotland. what would beperformed the biggest patient more was TwoCFR studies assessed This review aimed to From the electronic One their reviewer all Community First and 'most stressful' callout, the could notconsidered help the cause of stress present and to be the biggest drowsiness in was 135 stressor patients determine whether search of theinMedline of thewould literature searches.

Responders Scotland. what beifthe biggest patient more considered the stressful time the -period for both a biggest typical and a most treated with 50% nitrous 50% nitrous oxide was and EMBASE databases The most reviewer searched cause of stress if present and to be the stressor during callouts. stressful callout. oxide or aplacebo [16, safe for use by first we identified 1,585 2001) Medline (1966–Oct the most stressful time -period for both typicalEmotional and 18]. a most demand was the Emotional most present (1985—Oct The pooled result of these responders who are citations that matched and EMBASE during callouts. stressful callout. demand in a typical callout 2001) databases, using an studies showed 3%present of and not trained as the search criteria. These demand was thethat most mental in the mostand optimally sensitive search patientsdemand treated with nitrous emergency medical were screened for demand in a typical callout stressful callout. and Ifinpresent, strategy, for relevant studies oxide analgesia 4%most of technicians. potentially relevant studies. mental demand the loneliness and isolation was comparing 50% nitrous oxide patients callout. treated placebo A total of 158 abstracts stressful Ifwith present, deemed toand be the biggest with placebo or other analgesic loneliness experienced drowsiness, were retrieved for more isolation was cause of to stress for CFRs. Prior agents in the prehospital indicating that was detailed evaluation, of deemed be drowsiness the biggest to arrival at scene was the setting. Again, no studies probably nitrous which 33 described studies cause of unrelated stress for to CFRs. Prior most stressful time. in the prehospital setting oxide inhalation (RDwas 21%,the 95% that were potentially to arrival at scene were found.

CI 27% to 5%, p=0.8). relevant to this systematic most stressful time. about CFRs were enthusiastic To capture the CFR activity Participants included Study 1 (March 2009 – Consequently, a broader The incidencetooftheir hypotension review. These studies contributing community. datacapture at the the same time as purposively selected December 2010) evaluated CFRs were enthusiastic about To CFR activity Participants included Study 1was (March 2009 – search performed in patients who were treated underwent critical appraisal.

Supportive relationships gathering depth, robust representatives from the the introduction of a CFR contributing to their community. data at theinsame time as purposively selected December 2010) evaluated to find randomised controlled with nitrous oxide was lower Twelve studies satisfied all amongst volunteers within qualitative in material.

Included representatives Scottish Government (in scheme in an isolated Supportive relationships gathering depth, robust from the the a CFR trialsintroduction from a difficulties wideofrange than schemes in patients treated with subject methodology their and support were stakeholder interviews the areaand of performance region with amongst volunteers within qualitative material.

Included Scottish Government (in scheme insettings. an isolated of clinical Reference intravenous midazolam and criteria and were from the wider ambulance (e.g. with representatives management for created by geography their schemes and support were stakeholder interviews the area of performance region with lists cited in difficulties original pethidine (14%). subsequently included in service staff were reported. of national and local emergency medicine), where the timearticles to from the wider ambulance (e.g. with representatives management for created by drive geography were examined for relevant the review SAS employees CFRs government, health Scottish Ambulance the nearest hospital a service staff wereand reported. of national and local emergency medicine), where the drive timewith to studies not identified by agreed on the scope of authority, health Service personnel, major A & Ehospital department SAS employees and CFRs government, health Scottish Ambulance the nearest with a the literature search. practiceon of the CFRs’ emergency professionals, and community engagement was more 90 minutes. agreed scope of authority, health Service personnel, major A & than E department response community community members), representatives from Study 2 (October – This article explored 22 citizens inengagement three In-depth interviews to capture All citizenofduties, participants of practice CFRs’ but emergency professionals, and community was more than 902010 minutes. members were confused about and groups with the Scottish Health September 2011) investigated whatfocus happened, over Scottish communities stakeholders' views.

A – community C described the response duties, but community community members), representatives from Study 2 (October 2010 the role. individual Council, local after-hours the contribution ofinvestigated sixschedule CFR the longer term, after (healthcare practitioners, semi-structured first CFRs responder and members were scheme confused about and focus CFRs. groups witha the Scottish Health September 2011)topic During therole. focus groups, service managers and schemes in urban, suburban communityCFRs. participation managers andafter-hours was contribution developed toofensure its establishment during or the CFRs individual Council, local the six CFRa CFRs were concerned that General Practitioners and remote Scottish settings. exercise to design future policymakers) all ofand(GPs). similar approach across sites. just after Service During theRemote focus groups, service managers schemes in urban, suburban community members lacked Data remote collection duringsettings. both rural service delivery whom were involved(GPs).

Futures, facilitated bythat CFRs were concerned General Practitioners and Scottish knowledge about response studies were mixed methods. models, and considered in, or knew about, the training from the the Scottish community members lacked Data collection during both anonymised data process, particularly CFRs only Routinewere perceptions of why more original project.

Ambulance Service.

They knowledge about the response studies mixed methods. providedanonymised

by Scottish Ambulance responding once anCFRs ambulance follow-up actions did or said newparticularly volunteers were data process, only Routine Service about calloutsAmbulance were has dispatched.

CFRs did not happen. nowbeen needed.

Two provided

by Scottish responding once anparticipants ambulance Service about callouts were has been dispatched. CFRs To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.

First responders in a community scheme in Barry, South Wales.

Methods

In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).

10 For further recruitment vacancies visit: www.ambulanceukonline.com

FEATURE Table 1 Summary of included studies (Continued) Table 1 Summary Aims of included studies (Continued) Study and objectives Sample population Davies et al.

(2008) [10]

Dennis et al.

(2013) [14] Harrison-Paul et al.

(2006) [15]

Kindness, et al.

(2014) [1] Faddy and Garlick (2005) [16]

Seligman, et al.

(2015) [13]

Roberts, et al.

(2014) [4]

First responders in a community scheme in Barry, South Wales.

Methods

In depth semi-structured analysed.

These were interviews with by six face-to-face subjects or supplemented were analysed using Interpretive telephone interviews, as well as Phenomenological CFR focus groups. Analysis (IPA).

AMBULANCE UK - FEBRUARY

Timmons and Vernon-Evans Farmer et al.

(2012) [11] (2015) [12]

Results that, following the reported initial scheme establishment CFRs were motivated perceived confusion inby a and there had been sensetraining, of duty about to theirreasons community. communities for little by staff of any They follow-up found itschemes. rewarding when introducing health-related service andto a theyCFR contributed positively All volunteers in all that current first responders patient’s outcome.

They felt it was schemes thought that more had not available received ongoing important to understand their publicly information training, leaving them feeling role and the limitations it. CFRs describing the CFR roleon and unsupported.

Community described emotionally “the pointan that the ambulance members felt would let down by detached state of mind, which is on its way” help state andcalm questioned helpedauthorities themmembers remain in these community whether should potentiallyvolunteering stressful situations understand why CFRs continue as it might be volunteer and this may To investigate which 20 participants from As before, the validation Directed Action was the hindering provision of amost impact upon acceptance. categories of Emotional Amazon’s Mechanical experiment took the form popular category for Mental statutory service.

A commonly raised theme Support messages could Turk service. For this of an online questionnaire Demand (where the CFR among CFRs and ambulance To experiences 53 participants, some Semi-structured, Most believed scenarios be explore used to the support a validation experiment administered on qualitative Mechanical needspeople to think), Temporal personnel was thatplace while of people who of whom had been interviews. based within CFRlaywhen they arehave (HIT), participants had Turk, with the same Demand (timetheir pressure), of work volunteers act been trained to use given traininginto were most must useful in preparing experiencing different to be based theuse US participation criteria.

Frustration, Distraction and professionally according to a automatic external defibrillators others for ‘real life’.

Many people kinds of stress in the field. and have an and acceptance Participants were paid Isolation.

Reassurance was had formal code of conduct and defibrillators. The research who delivered the training. not received critical incident rate of 90% (90% of the $0.50 and we received 40 the most popular category protecting patient information, questions were: (1) How Locations airports, responses. Participants were debriefing after using an AED. work they included do is accepted for the remaining stressors – they do notahave the same can training courses help railway private There were variety by otherstations, requesters had asked to indicate their Physical Demand andof systems emergency professional prepare people for dealing companies first in place to Demand. provide support to be rated and as good gender, their age from a Emotional Praise after qualification that their with real life situations? (2) responder an many of Mental which quality) andschemes. were paid range and indicate if they wasincident, also popular for colleagues have.

Who is ultimately responsible Geographically, the study were informal. $0.50 (US). were a health professional.

Demand, Physical Demand, CFRs felt that the lack of for providing critical incident covered Nottinghamshire, 55% were female (45% male), Frustration, Distraction and feedback about how patients debriefing and how should Lincolnshire, Yorkshire, 22.5% were aged 15-25, 45% Isolation. Emotional Advice fared was difficult to deal this be organised? (3) What Staffordshire, Essex and 26-40, 27.5% 41-65 and 5% appears to be much less with. They were not formally is the best process for the West Midlands in the UK. over 65. 5% of participants popular, only used by few informed about what providing feedback to those were healthcare professionals. participants in Frustration, happened to people after who have used an AED? Distraction, Emotional their first response assistance.

Demand and Isolation.

To further understand the An online survey using a CFRs were asked to gauge 88 CFRs the survey This wasstarted challenging because Emotional Reflection to was only demands and stressors modified NASA-TLX scoring the demands and stressors with 40 continuing they worked in the locality used for Frustration and experienced by CFRs. system was sent to 535 experienced during a 'typical' completion.

Frustration that and may know the patient, Distraction.

Community First and their 'most stressful' callout, their the CFR could help the family ornot friends.

Responders in Scotland. what would beperformed the biggest patient moreassessed was considered Confidentiality prevented them Two studies This review aimed to From the electronic One reviewer all cause stress ifsearches. present and to be asking the biggest stressor from they were drowsiness inand 135 yet patients determine whether search of the Medline of the of literature the stressful time the -period often for both a typical and a most interested treated with 50% and nitrous 50% nitrous oxide was and EMBASE databases The most reviewer searched during stressful callout. concerned aboutEmotional fellow oxide or placebo [16, 18]. safe for use by first we identified 1,585 Medlinecallouts.

(1966–Oct 2001) demand wasresult the most present community members.

The pooled of these responders who are citations that matched and EMBASE (1985—Oct demand in a typical 2001) databases, using an studies showed that callout 3% of and not trained as the search criteria. These The paper discusses Students participating Data on the number In the first 15 months of mental in thenitrous most optimally sensitive search patientsdemand treated with emergency medical were screened for the experience of in the SFR scheme in of students participating operation (June If2013– stressful callout. present, strategy, for relevant studies oxide analgesia and 4% of technicians. potentially relevant studies. launching the student the Thames Valley in the SFR scheme were August 2014), were was loneliness andSFRs isolation comparing 50% nitrous oxide patients treated with placebo A total of 158 abstracts first responder (SFR) region. The size of the obtained from SCAS dispatched 343 to tobe theincidents. biggest with placebo or other analgesic deemed experienced drowsiness, were retrieved for more scheme across three SFR group as of August records. SCAS data were The Most common cause of stress for types CFRs. of Prior agents in the prehospital indicating that drowsiness was detailed evaluation, of counties in the 2014 was 72. also obtained to determine calls that they attended to to arrival at scene wasnitrous the setting. Again, no studies probably unrelated to which 33 described studies Thames Valley. the number and type of were: other; respiratory most in the prehospital setting oxide stressful inhalationtime.

(RD 21%, 95% that were potentially incidents to which SFRs emergencies; non-traumatic were found.

CI 27% to 5%, p=0.8). about relevant to this systematic CFRs and were enthusiastic To capture the CFR activity Participants included Studybeing 1 (March 2009 – were dispatched. falls; gastrointestinal Consequently, a broader The incidencetooftheir hypotension review. These studies contributing community. data at the same time as purposively selected December 2010) evaluated An electronic survey was emergencies. search was performed in patients who were treated underwent critical appraisal.

Supportive relationships gathering in depth, robust representatives from the the introduction of a CFR carried out in April–May to find randomised controlled with nitrous oxide was lower Twelve studies satisfied amongst volunteers within qualitative material. Included Scottish Government (inall scheme in an isolated 2015 of all Foundation trials from a wide range than schemes in patientsand treated with subject methodology their support were stakeholder interviews the areaand of performance region with Doctors whodifficulties had been of clinical settings.

Reference intravenous midazolam and criteria and were from the wider ambulance (e.g. with representatives management for created by geography members of this SFR lists cited indrive original pethidine (14%). subsequently included in service staff were reported. of national and local emergency medicine), where the timearticles to scheme during their time werenearest examined for relevant the review SAS employees and CFRs government, health Scottish Ambulance the hospital with a at medical school. studies not identified by agreed on the scope of authority, health Service personnel, major A & E department the literature To understandand why CFR volunteers from Given that than thesearch. participants The mostofcommon route practice CFRs’ emergency professionals, community engagement was more 90 minutes. people volunteer for, one English region. are volunteers who only– was finding out about CFRs but community community members), representatives from Study 2 (October 2010 This article explored 22 citizens in three In-depth interviews to capture response All citizenduties, participants of and continue to bewith Although, asHealth a qualitative meet infrequentlyinvestigated as a through anwere advertisement members confusedthe about and groups the Scottish September whatfocus happened, over Scottish communities stakeholders'2011) views. A community C described active in CFR groups. study, a statistically group, focus groups were in the local newspaper. the role. individual Council, local after-hours the contribution of six CFR the longerCFRs. term, after a (healthcare practitioners, semi-structured topic schedule first CFRs responder scheme and representative sample the most in efficient and Many participants joined During the focus groups, service managers schemes urban, suburban community participation managers and and was developed to ensure a its establishment during or was not Practitioners needed, the (GPs). cost-effective way of settings. to ‘get involved’ or ‘get CFRs were concerned thatout General and remote Scottish exercise to design future policymakers) all of similar approach across sites. just after Remote Service geographical region was collecting data.during both in the community’, as each community members Data collection rural service delivery whom were involved Futures, facilitated bylacked intended to generate a first responder groupresponse is a knowledge about studies were mixed methods. models, and considered in, or knew about, the training from the the Scottish mixture of CFR groups local charity and relies on anonymised data process, particularly CFRs Routine perceptions of why more original project.

Ambulance Service. Theyonly from urban, suburban and volunteers and provided by Scottish Ambulance responding oncefinancial an ambulance follow-up actions did or said new volunteers were rural communities and support from within CFRs the Service about callouts were has dispatched. did not happen. nowbeen needed.

Two participants being mixed in terms of community.

To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.

11 Do you have anything you would like to add or include in Features? Please contact us and let us know.

FEATURE Table 1 Summary of included studies (Continued) Table of included studies (Continued) Study 1 Summary Aims and objectives Sample population

Results that, following the reported initial scheme CFRs motivated by a A keywere factor inestablishment getting and there sensetraining, ofto duty to theirhad community. people volunteer, butbeen little by to staff of any They follow-up found it rewarding when more importantly stay, health-related service androle they the contributed positively to a was flexibility of the that current firstofresponders patient’s outcome.

They felt it was and the nature the role had not received ongoing important to understand itself.

Participants valuedtheir training, leaving them on feeling role and it. CFRs their rolethe as limitations an assistant unsupported.

Community described an emotionally to the paramedic. members felt let downthe by detached state of with mind, which The experiences state andhad questioned helpedauthorities themservice remain calm in these ambulance not whether volunteering potentially stressful always been good.situations Theshould flexible continue mightcommitment be nature of as theit CFRs’ Dennis et al.

To investigate which 20 participants from As before, the validation Directed Action was the hindering of amost may have provision played a part in this.

(2013) [14] categories of Emotional Amazon’s Mechanical experiment took the form popular category for Mental statutory service.

CFR groups rely on money from Support messages could Turk service. For this of an online questionnaire Demand (where the CFR the local community and they Harrison-Paul et al. To experiences 53 participants, some Semi-structured, Most believed scenarios be explore used to the support a validation experiment administered on qualitative Mechanical needspeople to think), Temporal spend a lot oftheir timeplace raising (2006) [15] of people who of whom had been interviews. based within of funds work CFRlaywhen they arehave (HIT), participants had Turk, with the same Demand (time pressure), at local events. been trained to use given traininginto were most useful in preparing experiencing different to be based theuse US participation criteria.

Frustration, Distraction and Participants highlighted the automatic external defibrillators others for ‘real life’.

Many people kinds of stress in the field. and have an and acceptance Participants were paid Isolation.

Reassurance was had significance ofcritical the community defibrillators. The research who delivered theoftraining. not received incident rate of 90% (90% the $0.50 and we received 40 the most popular category supporting theirusing local group, questions were: (1) How Locations airports, responses. Participants were debriefing after an AED. work they included do is accepted for the remaining stressors – and how locals like toofsee good can training courses help railway stations, private There were a variety by other requesters had asked to indicate their Physical Demand and systems work being done that directly prepare people for dealing companies first in place to Demand. provide support to be rated and as good gender, their age from a Emotional Praise after affects themmany and their with real life situations? (2) responder an of Mental which quality) andschemes. were paid range and indicate if they wasincident, also popular for community.

Who is ultimately responsible Geographically, the study were informal. $0.50 (US). were a health professional.

Demand, Physical Demand, for providing critical incident covered Nottinghamshire, 55% were female (45% male), Frustration, Distraction and debriefing and how should Lincolnshire, Yorkshire, 22.5% were aged 15-25, 45% Isolation. Emotional Advice thisand be availability organised? of (3) support What mechanisms Staffordshire, Essex 27.5%in41-65 and 5% appears toSome be much CFRs valued the flexibility to and and to26-40, help them a highly stressful situation.

CFRless schemes is the best process for the West Midlands in the UK. over 65. 5% of participants popular, only used by few help them cope with theproviding stressful feedback incidents,towhich had attempted to rectify this situation by raising awareness in their those they inevitably have were healthcare professionals. participants in Frustration, used an AED? to attend to from time towho time.have Nevertheless, the scoping review raised communities about how they operated.

Distraction, Emotional Demand and Isolation. awareness ofet some associated to using a Kindness, al. of the To known further risks understand the with Anattending online survey CFRs were asked to gauge 88 CFRs started the survey Emotional Reflection to was only (2014) [1] demands and stressors modified NASA-TLX scoring the demands and stressors with 40 continuing particular incidents. It also identifies the stress factors of other, non CFR- Clarifying the role of the CFR is important as their relationship with the used for Frustration and experienced by CFRs. system was sent to 535 experienced during a 'typical' completion. Frustration that related, pressures a responder may struggle with. ambulance service was sometimes mixed.

Sometimes, ambulance crew Distraction.

Community First and their 'most stressful' callout, the CFR could not help the for the preparatory that studies CFRs prior to their arrival.

Responders in Scotland. were grateful what would beperformed the biggest moredid was considered Two assessed Faddy and Garlick This review aimed to From the electronic One reviewer all work patient cause stressstaff ifsearches. present and to be theother biggest stressor drowsiness in 135 patients (2005) whether of some the Medline In other of instances, the of literature While this is[16] a UK-baseddetermine scoping review, it is importantsearch to draw from ambulance and statutory services the most stressful time the -period for bothwith a typical and a most 50% nitrous 50%schemes nitrous oxide and EMBASE reviewer searched comparisons with how CFR workwas in other countries.

In thedatabases UK, viewedThe CFRs with suspicion because treated of a lack of understanding about during stressful callout. Emotional oxide or placebo [16, 18]. safe for use by first we identified 1,585 Medlinecallouts.

(1966–Oct 2001) CFRs are volunteers equipped with who someare basic skills incitations life support to when and the CFR’s role ends and the ambulance crew’s This demand was the begins. most present EMBASE (1985—Oct The pooled result of these responders that matched demand in a typical callout 2001)that databases, using ancould usefully studies explore showed thatperceptions 3% of and of trained as search is criteria. enable them to respond not to medical emergencies. Theirthe purpose to do Thesesuggests future research the mental demand in thenitrous most optimally sensitive search patients treated with emergency medical were screened for the preparatory work at the scene prior to ambulance service staff arriving. ambulance service staff towards CFRs. stressful callout. and If present, strategy, for relevant studies oxide analgesia 4% of technicians. potentially relevant studies.

In the US, first responders can include Police Officers, Afirefighters and loneliness and isolation was comparing 50% nitrous oxide patients treated with placebo total of 158 abstracts deemed to reflected be the biggest with placebo or other analgesic experienced drowsiness, were18]. retrieved for more This tension other emergency services staff, as well as lay people [17, Australian and confusion around roles is partly in the low cause of stress for CFRs. Prior in theabout prehospital indicating that and drowsiness was detailed volunteer response resembles the UK model in that it relies on evaluation, lay people of publicagents awareness differences between CFRs ambulance to arrival unrelated at scene to wasnitrous the setting. Again, no studies probably which 33 described studies volunteering to help emergency services respond to incidents crews.inTothe address this confusion, there needs to be time. greater clarity most stressful prehospital setting oxide inhalation (RD 21%, 95% over that were[19]. potentially were found.

CI 27% to 5%, p=0.8). relevant to this systematic the roles of ambulance staff and CFRs. CFRs were enthusiastic about Roberts, et al.

To capture the CFR activity Participants included Study 1 (March 2009 – Consequently, a broader The incidencetooftheir hypotension review. These studies Strengths and limitations contributing community.

(2014) [4] data at the same time as purposively selected December 2010) evaluated search was performed in patients who were treated underwent critical appraisal.

Supportive relationships gathering in depth, robust representatives from the the introduction of a CFR The precise search criteria applied to this scoping review produced nine all There to is an opportunity tocontrolled explore the with proportion of ambulance service find randomised nitrous oxide was lower Twelve studies satisfied amongst volunteers within qualitative material. Included Scottish Government (in scheme in an isolated trials from a wide range than in patients treated with subject and methodology UK-based publications. were The low number may be because research into cases that are attended to by CFRs and the contribution that CFRs their schemes and support stakeholder interviews the area of performance region with difficulties of Reference intravenous midazolam andresearch criteria were CFRs is relatively recent,(e.g. withwith most studies being from 2005 and onwards. make created to clinical response time targets or patient outcomes.

Outcomes from the wider ambulance representatives management for bysettings. geography lists cited in original articles pethidine (14%). subsequently included in service staff were reported. of national and local emergency medicine), where the drive time to Because much of the research into CFRs was recent,the thereview included could were focusexamined on overallforcaseload or specific time-sensitive conditions, SAS employees and CFRs government, health Scottish Ambulance the nearest hospitalrelevant with a studies not identified by publications tended to be more descriptive than analytical.

Indeed, the such as cardiac arrest.

The scoping review that these are agreedidentifies on the scope of authority, health Service personnel, major A & E department theofliterature search. existing literature mainlyprofessionals, comes from and the perspective community of ‘experts’.engagementmatters policythan which should be clarified in operational practice. Once practice of CFRs’ emergency was more 90 minutes.

Davies et al.

(2008) [10]

To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.

Methods

First responders status. in a The socio-economic community schemehelp to different locations in Barry,a South Wales. create balanced sample.

In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).

AMBULANCE UK - FEBRUARY

response but base community community members), representatives from (October 2010 –might generate Farmer et al.

This article explored 22 citizens in three In-depth interviews to capture All citizen participants of upon these Study are in 2place, research anduties, evidence members were confusedthe about and groupsover with the Scottish Health September investigated (2015) [12] whatfocus happened, Scottish communities stakeholders'2011) views.

A community C described Implications for policyindividual and research decisions can be formalrole. and informal status of the Council, local after-hourswhich the contribution of made sixschedule CFRabout the the longerCFRs. term, after a (healthcare practitioners, semi-structured topic first CFRs responder scheme and Future research should explore the perspectives of the patients who and their within communities they serve. the focus groups, service managers schemes in urban, suburban community participation managers and and CFR services was developed to role ensure a the During its establishment during or CFRs wereRemote concerned that General Practitioners and remote Scottish settings. exercise to design policymakers) all of (GPs). similar approach across sites. just after Service had received care from CFRs as well as thatfuture of CFRs, commissioners, community members Data collection during both rural service delivery whom were involved Futures, facilitated bylacked policymakers and academics. Perceptions of patients are important because The local nature CFR methods. schemes means that byabout definition, they are knowledge response studies wereofmixed models, and considered in, or knew about, the training from the the Scottish there is limited understanding of patients’ experiences the service as well drivenRoutine by localanonymised contextualdata factors, such as demographics, geography, process, particularly only perceptions of why more of original project.

Ambulance Service.CFRs They provided

by Scottish Ambulance responding once an ambulance follow-up actions did or said be newmore volunteers were to as limited public awareness and understanding of what CFRs do. demand and available skills sets. It might appropriate Service about callouts were has dispatched.

CFRs did not happen. nowbeen needed.

Two participants have minimum standards of training for CFRs. Urban and rural service

Patients were sometimes unable to distinguish between CFRs and ambulance crews. In some instances, patients were less concerned about the respective roles of each but instead were grateful and reassured about the presence of someone with expertise and skills

settings may require different operational policies, training priorities, safety measures and follow-up arrangements for CFRs. Outcome standards could vary between local schemes to reflect such local factors. Local CFR schemes need to be clear about what the priorities

12 For more news visit: www.ambulanceukonline.com

FEATURE are in their area. This should then inform their desired outcomes and

Ethics approval and consent to participate

objectives. Once local schemes are clear about their desired outcomes

Not applicable.

and objectives, then they can have a better idea of what role their volunteers should have and tailor their training programmes accordingly.

Publisher’s Note

Future research can clarify the extent to which aims and objectives are

Springer Nature remains neutral with regard to jurisdictional claims in

locally defined as well as how CFR schemes operate to give a more

published maps and institutional affiliations.

nuanced perspective about the links between local provision and local needs. Once more is known about how schemes operate, there is

Received: 10 February 2017 Accepted: 4 June 2017

greater potential for best practice to be shared, especially between

Published online: 19 June 2017

localities with similar demographics, context and need.

References CFRs felt strongly about the effectiveness of scenario-based training and the desirability of having formal feedback mechanisms, therefore, it would be helpful to involve them in deciding how these might be incorporated into local schemes.

2. Weir P. Community first responders: improving access to defibrillation in cardiac arrest. J Paramed Pract. 2015;7(3):114–6.

3. Mort A, Fitzpatrick D, Schneider A, et al. Pre-hospital technology research: reflecting on a collaborative project between ambulance service and academia. J Paramed Pract. 2015;7(4):184–91.

Conclusions This scoping review has identified and highlighted numerous opportunities for future research. These include: exploring patients’ experiences and other stakeholder views; evaluating the effectiveness; costs; and support needed to ensure quality of CFR schemes. Such evidence may inform the way that CFR schemes develop services in future as well as training mechanisms to ensure that CFRs feel valued and well-supported. Further understanding of the stressors associated with the role should assist in limiting turnover rates. This will help to secure the long-term future of the CFR schemes and the vital services they provide in complementing the statutory emergency care services.

Abbreviations ASSIA: Applied social sciences index and abstracts; CFR: Community first responder; IBSS: International bibliography of the social sciences; LIVES: Lincolnshire integrated voluntary emergency service; PILOTS: Published International literature on traumatic stress; UK: United Kingdom Acknowledgements Our thanks to members of the Community and Health Research Unit who commented on the paper.

Funding This is an unfunded study.

Availability of data and materials No additional data available.

The idea for the study came from IT and ANS. FT and IT undertook the scoping review supported by RO and ANS. VHP led the writing of the scoping review with substantial input from RO, IT and ANS. All authors approved the final version of the manuscript.

Competing interests The authors declare that they have no competing interests.

Consent for publication

4. Roberts A, Nimegeer A, Farmer J, et al. The experience of community first responders in co-producing rural health care: in the liminal gap between citizen and professional. BMC Health Serv Res. 2014;14.

5. NHS. Five Year Forward View. London: NHS; 2014.

6. Service EMA. Joint ambulance conveyance project: East Midlands Ambulance Service 2015.

7. (LIVES) LIVES. Newsletter, Autumn 2015. In: (LIVES) LIVES, ed.

Horncastle: Lincolnshire Integrated Voluntary Emergency Service (LIVES), 2015.

8. Howard S, Boyle M. Australian first responder programme. J Paramed Pract. 2012;4(1):41–6.

9. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.

10. Davies E, Maybury B, Colquhoun M, et al. Public access defibrillation: psychological consequences in responders.

Resuscitation. 2008;77:201–6.

11. Timmons S, Vernon-Evans A. Why do people volunteer for community first responder groups?. Emerg Med J. 2013;30(3):e13.

12. Farmer J, Currie M, Kenny A, et al. An exploration of the longer-term impacts of community participation in rural health services design.

Soc Sci Med. 2015;141:64–71.

13. Seligman W, Ganatra S, England D, et al. Initial experience in setting up a medical student first responder scheme in South Central England. Emerg Med J. 2016;33(2):155–8.

14. Dennis M, Kindness P, Masthoff J, et al. Towards effective emotional support for Community First Responders experiencing stress. 2013 Humaine Association Conference on Affective Computing and Intelligent Interaction, 2013.

15. Harrison-Paul R, Timmons S, Van Schalkwyk W. Training lay-people to use automatic external defibrillators: Are all of their needs being met? Resuscitation. 2006;71:80–8.

16. Faddy S, Garlick S. A systematic review of the safety of analgesia with 50% nitrous oxide: can lay responders use analgesic gases in the prehospital setting? Emerg Med J. 2005;22:901–6.

17. Bobko JP, Kamin R. Changing the paradigm of emergency response: The need for first-care providers. J Bus Contin Emerg Plann. 2015;9(1):18–24.

18. Hansen CM, Kragholm K, Granger CB, et al. The role of bystanders, first responders, and emergency medical service providers in timely defibrillation and related outcomes after out-of-hospital cardiac arrest: Results from a statewide registry. Resuscitation.

2015;96:303–9.

19. O’Meara P, Tourle V, Rae J. Factors influencing the successful integration of ambulance volunteers and first responders into ambulance services. Health Soc Care Community. 2012;20(5):488–96.

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Authors’ contributions

Not applicable.

1. Kindness P, Fitzpatrick D, Mellish C, et al. An insight into the demands and stressors experienced by Community First Responders. J Paramed Pract. 2014;6(7):362–9.

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HARROGATE - MARCH 15

First Responder Conference - presentations include: Why Trauma Patients Die (Professor Sir Keith Porter), Assessing & Assisting the Fallen Patient (Dave Sale), Adapting First Responder Skill Set to Meet Wider Patient Needs (Richard Buckley), The Alternative Role of the CFR (James Crawley), Deteriorating Patient - Could it be Sepsis? (Sian Annakin), Dealing with Distressing Incidents (Joane Mildenhall).

Paramedic Conference - presentations include: Futile Resuscitation (Matt House), Preparing for & Managing the Effects of Stress on Performance (Mike Southworth), Just How Bad are Your Clinical Skills - Can Ultrasound Help? (Bob Jarman), Epilepsy Awareness (Jan Bagshaw). Professor Sir Keith Porter will hopefully also be presenting, topic to be advised.

Resuscitation Conference - presentations include: Developments of the Red Arrest Team (Mark Millins), Post ROSC Care Bundle (Kirsty Lowery Richardson), Systemic Local Anaesthetic Toxicity (Giles Farrington), PreHospital Antibiotics and Red Flag Sepsis’ (John Chippendale), ‘Ultrasound Augmented - Clinical Examination in Major Trauma’ (speaker TBA).

First Responder Conference - presentations include: Why Trauma Patients Die (Professor Sir Keith Porter), What Volunteering May Look Like in the Future (Paul Stevens), The Benefits of Community Public Access Defibrillators (Neil Marsay), The Alternative Role of the CFR’ (James Crawley), Epilepsy Awareness (Jan Bagshaw), CPADs and New Technology (Anne Jolly).

BRISTOL - JUNE 21 Paramedic Conference - presentations include: Paramedics & End of Life Care (Jo Stonehouse), Disaster Response Paramedic - The Nepal Earthquake Experience (Simon Greenfield), Advanced Airway Management (Amy Chan-Dominy), Dealing with Distressing Incidents (Joanne Mildenhall), Paramedic Leaders - Past, Present & Future (Adam Layland).

AMBULANCE UK - FEBRUARY

14

Each venue will also include a First Aid Conference - to view the programmes please visit: www.lifeconnections.uk.com.

The delegate rate for our Paramedic, Resuscitation and First Aid Conferences at each venue has been set at £30 per person (incl VAT) to include lunch, tea/coffee, free parking, etc., however, those attending both the morning Paramedic Conference and afternoon Resuscitation Conference will be offered a combined rate of £42. Thanks to the generosity of WEL Medical, we are able to offer First Responder delegates, attending the First Responder Conference, a rate of just £18 (incl VAT).

For those wishing to take full advantage of each event, @PHCCINFO who are one of the largest providers of trauma and airway training to pre-hospital personnel, are running a Basic to Advanced Trauma Skills Workshop from 09.30-12.30 which incorporates Trauma Patient Assessment, Catastrophic Bleeding, etc. and, a Basic to Advanced Airway Skills Workshop in the afternoon from 14.30-17.30 which includes Direct & Video Laryngoscopy, Emergency Surgical Airways, etc. A third Workshop, presented by Paul Savage OBE, entitled Seven Ways to Die in Cold Water which incorporates submersion, drowning and hypothermia also forms part of our Bristol event taking place from 09.30-12.30 and repeated in the afternoon from 14.30-17.30.

Only 12 places are available on each Workshop, except Harrogate which is now fully booked, at a cost of £48.00 per person (incl VAT), to include lunch, tea/coffee, free parking, etc. For delegates also attending any of the morning or afternoon Conferences, a combined rate of £60 will be offered.

As places are limited on all Conferences and Workshops, early registration is advised to avoid disappointment - to view all programmes and secure your delegate place, please visit: www.lifeconnections.uk.com or call the Organisers Office on: 01322 660434.

Further multi conference / workshop one day events are planned for Aylesbury (September 6th) and Stoke on Trent (October 25th). To view all programmes please visit www.lifeconnections.uk.com.

www.lifeconnections.uk.com

FEATURE

Need new equipment now but your budget is stretched?

Consider a leasing option for AEDs and the award-winning range of Brayden CPR training manikins from WEL Medical WEL Medical recognises that buying new, quality medical devices can mean a large financial outlay all in one go. For small and large organisations in the public and private sector, being able to spread the cost over a set period can offer an optimum solution. The cost of investment can be allocated into manageable monthly payments and eases the strain on existing resources and budgets.

We are pleased to announce that a bespoke equipment leasing option is now available through our arrangement with Shire Leasing Plc, the largest independent funding house in the UK for equipment financing and leasing.

There are many benefits to leasing with a final purchase option. It offers a straightforward, alternative way to finance, when you need new equipment: • Pay as you earn - Leasing your equipment means you can enjoy the profits the equipment provides immediately without having to find the full sum up front.

• Cash flow - Using leasing protects your cash flow and allows you to budget more accurately.

• Tax deductible - Lease rental payments are 100% tax deductible against profits.

• Fixed payments - Lease rental payments are fixed which makes budgeting easier.

• Protect existing lines of credit - Using leasing allows you to protect existing lines of credit such as bank loans and overdrafts.

• No major upfront costs - Leasing removes the need for significant outlay or investment in new equipment. Only the first rental is normally required and is usually taken by Direct Debit.

• Quick response - Upon application, you will receive a quick response along with a detailed plan for consideration.

If you require new life-saving AED units and/or CPR training manikins, then leasing these with final purchase over a set period for an agreed repayment can offer your organisation the means to do so at an affordable monthly payment.

As an example, if you needed to purchase new equipment now to the value of £20,000 the repayments would be as follows: Over 3 years

Payment

Over 5 years

Payment

Monthly

£700.00 + VAT

Monthly

£461.93 + VAT

Weekly

£161.54 + VAT

Weekly

£106.60 + VAT

Daily

£23.08 + VAT

Daily

£15.23 + VAT

Finance lease rental payments can be 100% tax allowable against profits.

AMBULANCE UK - FEBRUARY

If you would like to find out more about a leasing option, please contact WEL Medical in the first instance and speak to Paul Mulvey on 01252 344007 and 07525 846121 or email Paul.Mulvey@welmedical.com

15

Do you have anything you would like to add or include in Features? Please contact us and letwww.welmedical.com us know.

NEWSLINE SWAST

Cardiac arrest survivor, Ian, reunited with Lifesaving SWASFT crew A father-of-two who survived a cardiac arrest has been

while wife, Nicky, stayed at her

Green near Bristol when he

turn from red to green. They

husband’s side.

became unwell at around

pulled him out of the vehicle,

12.30am.

and began to administer CPR and defibrillation.

Ambulance clinicians arrived at the rest area outside MOD

Charlie drove his father to

Firearms officer, Ian Womack,

Abbey Wood in Bristol, after

hospital with the rest of the

said: “We did what we could for

a nearby police firearms team

family, but they were forced to

Ian. In the circumstances, I feel

found the Bath University porter

stop beside a busy junction

we left him in the best possible

slumped on the back seat of

when Ian lost consciousness.

condition for the paramedics. It was great teamwork.

the car.

reunited with the South

Nicky said: “Ian had said he

Western Ambulance Service

Ian and his family met the

didn’t feel well, but we really

“I was so happy to hear Ian was

NHS Foundation Trust

emergency services personnel

had to persuade him to go to

alive and well. It shows how

(SWASFT) paramedics and

on Tuesday 16 January for the

hospital.

beneficial it is to be able to put

the Avon and Somerset Police

first time since the incident in

First Aid training into practice.”

officers who saved his life at a

the early hours of 19 November

“In the car he made a funny

roadside layby.

2017.

noise. He stopped breathing

SWASFT Operations Officer,

and starting dribbling. I couldn’t

Michael Anning; paramedic,

Ian Cains, 54, fell ill at home

“I’d like to personally thank

find a pulse. We didn’t know if

Ashley Campbell, and

late at night and was being

the police and paramedics

he would survive. It was very

emergency care assistant,

driven to hospital when his heart

for saving my life,” he said.

traumatic.”

Frances Morton, arrived to

suddenly stopped beating.

“I have no recollection of

His family pulled together – as

Charlie flagged down a police

was given several defibrillator

grateful for what they did.”

firearms team who were inside

shocks, before being

their vehicle at a junction,

transferred by ambulance to the

waiting for the traffic lights to

Bristol Royal Infirmary.

son Charlie, 19, ran to get help; daughter Ellie, 18, dialed 999;

take over from the police. Ian

what happened, but I am very

Ian was at his home in Longwell

AMBULANCE UK - FEBRUARY

Ian Cains (centre right) with wife Nicky and daughter Ellie. Also pictured (left to right) are SWASFT Operations Officer, Michael Anning; paramedic, Ashley Campbell, and ECA, Frances Morton – as well as members of the Avon and Somerset Police firearms team.

16 For further recruitment vacancies visit: www.ambulanceukonline.com

NEWSLINE Ian was put in a coma for 48 hours, because there was a lack of oxygen to his brain. But he has since made a good recovery.

Michael said: “With a cardiac arrest, it’s all about getting there as soon as possible.

Thankfully the police were in the right place at the right time, and between us we were able to give him prompt treatment.

“This case shows that prompt CPR and defibrillation can mean the difference between surviving or not. We were also joined by Jules, a basics doctor who responded

EMAS

Paramedics administer antibiotics for sepsis A recent pilot to identify patients in Scunthorpe and Grimsby with the deadly infection sepsis has been so successful it will be roll out across Lincolnshire.

The initial six month pilot in conjunction with North Lincolnshire and Goole NHS Hospitals Trust (NLAG) saw

Lincolnshire is the first area

collaborative work with NLAG,

of East Midlands Ambulance

United Lincolnshire Hospitals

Service (EMAS) to go live with this

Trust (ULHT) and Pathlinks

approach and all 270 Lincolnshire

Microbiology.

paramedics are being trained how to recognise patients in or

Sepsis is time critical infection. It

approaching sepsis shock to

leads:

administer the IV antibiotics.

• to shock, Jon Chippendale, Clinical

• multiple organ failure and

Development Lead at EMAS said:

• death if not recognised and

“For a patient in septic shock,

treated early.

early antibiotic treatment is their best chance of survival. We are

With septic shock, the sooner

confident that our ambulance

antibiotics can begin working

clinicians can recognise patients

on the infection, the greater the

in or approaching septic shock

chances of the patient surviving.

and swiftly and safely administer

When a person is in septic shock,

antibiotics at the earliest

their chance of survival decreases

promptly to the incident, he

20 paramedics across North

performed advanced interventions

and North East Lincolnshire

opportunity. By encouraging

by 7.6 per cent for every hour an

at the roadside. I was delighted to

trained to administering an

our paramedics to think sepsis

IV antibiotic is not given.

hear Ian had survived.”

antibiotic injection to their

and providing them with training

patients who were assessed

and interventions we have been

Spotting the signs and symptoms

Ian and his family attended

as having possible sepsis. 90

able to improve the outcome of

of sepsis and receiving early

Almondsbury police operations

patients received the treatment

patients.”

intervention can save lives. More

department on January 16 to

at the scene of the emergency

express their thanks to the

administered an average 70

The life-saving treatment

NHS Choices website. (https://

police and paramedics.

minutes sooner.

is possible due to the

www.nhs.uk/conditions/sepsis/)

information can be found on the

AMBULANCE UK - FEBRUARY

17 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

NEWSLINE

AMBULANCE UK - FEBRUARY

18 For further recruitment vacancies visit: www.ambulanceukonline.com

NEWSLINE WAS

‘Performing CPR on your own daughter was indescribable’ – Grieving mother urges others to learn to spot signs of deadly sepsis A grieving mother who lost her teenage daughter to sepsis is urging people to learn to recognise the signs of the deadly infection.

Chloe Christopher, 17, of Cwmaman, died on New Year’s Eve in 2014 after developing the life-threatening illness.

It was thought the Aberdare Community School student was suffering a chest infection at the time. In a new film produced by the Welsh Ambulance Service, Chloe’s mother Michelle has spoken movingly about her death.

She recalls: “It was Christmas week and Chloe seemed to have what we thought was a cold or maybe the start of a chest infection.

“She was a little lethargic with some aches and pains, but it seemed nothing to worry about.

“She spent one evening with one of her closest friends

services immediately and even

whether a patient is suffering

Emergency Operations Centre

though we didn’t know what

from sepsis.

(EOC) for six years, successfully

was happening, we knew it was serious.

assisted with the arrival of a NEWS looks at seven factors,

baby in Luton on 3rd December.

including blood pressure, “Chloe suffered a cardiac arrest

pulse rate, respiratory rate,

in front of us, and having to try

oxygen saturation, level of

and perform CPR on your own

consciousness, temperature

daughter was indescribable.

and whether the patient is receiving supplemental oxygen.

“The emergency staff were amazing, and tried their utmost

Under its new Clinical Response

to save Chloe but to no avail.”

Model, made permanent in

She gave instructions over the phone and the baby was born nine minutes after the 999 call was made and before the arrival of a rapid response vehicle and ambulance crew.

February 2017, the Welsh

The stork badge will be

Sepsis occurs when the body’s

Ambulance Service is measured

awarded to call handlers who

response to an infection injures

against the number of

have assisted with the birth

its own tissues and organs, and

suspected sepsis patients who

of a baby and who have been

it can lead to shock, multiple

have had a documented NEWS

compliant in delivering pre-

organ failure and death,

score.

arrival advice.

Between July and September

It is one of three new pin

2017, this was 102 out of 104

badges designed by the Trust

especially if not recognised early.

Michelle said: “The first time we

(98.1 per cent) patients across

heard of sepsis was at Chloe’s

Wales.

inquest five months later.

Andy Swinburn, the Trust’s “We heard that Chloe had signs

Assistant Director of

of a urine infection which turned

Paramedicine, said: “Sepsis

to sepsis, led to multi-organ

is a serious condition that

failure and then cardiac arrest.

can initially look like flu, gastroenteritis or a chest

“Since Chloe’s passing, it’s

infection.”

excellence of EOC staff.

Nicola Turner, senior EOC manager for EEAST, said: “Our emergency call handlers do a fantastic job and it is a really rewarding role, particularly when it comes to assisting with the birth of a baby.

been my passion to raise awareness and to help educate

to recognise the vital work and

EEAST

New awards launched for control room staff

“These sorts of calls are not a

year; it’s bigger than breast,

A new awards scheme has

comfort and advice to assist

bowel and prostate cancer put

been launched at East of

with the birth.

together.

England Ambulance Service

the public on the signs of sepsis.

“It is estimated that sepsis kills around 44,000 people a

regular occurrence. However, there is no better sound than hearing a baby crying down the phone after providing words of

NHS Trust (EEAST) to further

“We are really pleased to

looking forward to New Year’s

“If caught early, sepsis can be

recognise the achievements

treatable, so the key message

of its control room staff.

recognise the excellent work of

Eve celebrations, as they were going to a fancy dress party.

is education, knowledge and

laughing and joking and

Emergency call handlers at the

‘could this be sepsis?’

EEAST perform a crucial role and handle more than 3,000

Chloe rapidly deteriorated. It

stork award badges.”

The other new pin badges are the platinum award, which will

was so sudden; one minute

“By doing this, it helps keep our

laughing and joking, the next

beautiful Chloe’s memory alive,

she said she felt unwell and a

hoping that maybe we can save

The Trust has awarded its very

bit scared.

a family going through what we

first stork award pin badge to

“She then collapsed in front of

have.”

a call handler for assisting with

badges, which will be awarded

the delivery of a baby.

to call handlers, dispatchers

us. Hearing the words ‘Mam,

calls a day.

be awarded to staff who have achieved 300 high compliance audits, and the discharged alive

and team leaders who have

I’m frightened, I don’t feel very

The Welsh Ambulance Service

well’ will stay with me forever.

uses the National Early Warning

Kerry Summers, who has

played their part in a cardiac

“I phoned for the emergency

Score (NEWS) tool to identify

worked at the Bedford

arrest patient’s chain of survival.

AMBULANCE UK - FEBRUARY

“They were both together as

awareness and to just ask

our call handlers with our first

19 For all your equipment needs visit: www.ambulanceservicesuppliers.com

NEWSLINE

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AMBULANCE UK - FEBRUARY

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20 For more news visit: www.ambulanceukonline.com

NEWSLINE

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AMBULANCE UK - FEBRUARY

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Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

21

NEWSLINE EMAS

Paramedic Matt dares to win Channel 4 SAS show A paramedic student has put his training to good use by signing up to appear in a physically demanding TV programme, airing on Channel 4.

Matt Cornell, who completed his course at the University of Northampton last year and is set to graduate in February with a merit in paramedic science, is one of the stars of the third series of SAS: Who Dares Wins.

Matt is one of the contestants

issues, doesn’t necessarily make

Anyone accessing the SWS can

who will be pushed to their limits

you a weak person. I hope my

be assured that their situation will

in the extreme terrain of the Atlas

appearance in the programme

be dealt with sensitively and in the

Mountains in Southern Morocco.

inspires others on their road to

strictest confidence. Accessible

recovery.”

via phone or email, the service

Matt, who originally comes

has been designed to meet

from Woking but now lives in

Matt’s tutor Andy Macintosh,

the challenges associated with

Northampton, is currently working

Senior Lecturer in paramedic

delivering a range of emergency

for the East Midlands Ambulance

science, added: “Matt was a great

and urgent care services on a

Service. Commenting on why he

student and the embodiment

24-hour basis across an area

agreed to take part in such an

of everything we train our

spanning a fifth of England.

intense programme, he said: “The

paramedics to be: hard-working,

programme was tough-going as

tenacious and able to deal with

Callers may be signposted

we drove our bodies to the edge

difficult situations. It’s no wonder

to occupational health,

through a number of mental/

he was selected to take part

physiotherapy or specialist

physical challenges but in some

in such a gruelling, physically

counselling services. The Trust is

aspects, the paramedic course at

demanding programme like this,

also receiving invaluable support

University of Northampton helped

so best of luck to him for the

from organisations like PTSD UK,

me prepare, especially in relation

weeks ahead!”

Mind, Red Poppy, the Samaritans

to communication and handling stressful situations.

In the programme, which started on Sunday 7 January, 25 civilian

“I wanted to challenge the stigma

recruits are put through their

around mental health as, when I

paces with tasks that derive from

was growing up, I suffered with

actual situations and training

crippling anxiety so I wanted

scenarios the SAS Special Forces

to prove that just because you

Selection have undergone.

have or have had mental health

and a number of safeguarding SWAST

boards.

Ambulance staff staying well service

As well as acting as a support

South Western Ambulance

initiative, which combines the

Service NHS Foundation Trust

skills of safeguarding, HR and

(SWASFT) marked its two year

clinical professionals, is also

anniversary in December for the

designed to be a proactive service

‘Staying Well Service’ for staff.

encouraging people to ‘stay well’.

service for those already in need of support, the purpose of this

Here at the ambulance service, our staff are regularly exposed

Dr Andy Smith, SWASFT

to traumatic incidents by the

Executive Medical Director, said;

very nature of the emergency

“We take the health and wellbeing

life-saving work they do.

of our workforce extremely seriously. Our staff are our

The Staying Well Service

greatest and most valuable part of

has proved a huge success,

our service. We could not deliver

providing support and welfare

our services without them and we

for the 5,000 staff employed by the ambulance service.

invest a great deal in making sure our staff are safe and supported.”

Many staff visit the Staying Well Service for social emotional or work-related issues. Around one third of the referrals received have been for physiotherapy.

WAS

Off duty paramedic saves choking passenger mid-flight

AMBULANCE UK - FEBRUARY

The Staying Well Service (SWS)

PRO M VE A 2 B

W I T H

D I G N I T Y

is provided in addition to the

Paramedics are poised to deal

various support mechanisms

with any emergency – but

already available to staff (like

35,000 feet over the Atlantic

debriefings following challenging

Ocean is the last place you

incidents for example). They can

might expect to have to spring

access this facility for problems

into action.

and issues stemming from their personal life as well as situations

That’s what happened to Jason

occurring at work which are

Williams from the Welsh Ambulance

adversely affecting them.

Service, who was on a plane

22 For more news visit: www.ambulanceukonline.com

NEWSLINE to Cuba with his family when a

“Jason thoroughly deserves our

fellow passenger began to choke.

grateful thanks and those of the

The Community First Responder

patient and airline. The team now

Officer made himself known to the

look forward to hearing about his

cabin crew, and his quick-thinking

next holiday adventures.”

Four things in one pack, one less thing to think about

actions meant the woman regained consciousness just minutes before the pilot was to divert to make an emergency landing.

YAS

Paramedic’s random act of kindness

Jason, of Ewloe, Flintshire, recalls: “We were a couple of hours into the flight when one of the flight attendants went past our row with a first aid kit, and that’s when I

A paramedic from Yorkshire Ambulance Service NHS Trust has gone beyond the call of duty to help one of her patients.

noticed a commotion a couple of rows down.

“I went and introduced myself, explained that I was a paramedic and then took my seat again. A few moments later, I was asked to help.

“Straight away I identified that the woman was not breathing, and with the help of her husband and the cabin crew, lay her down in the aisle where I managed to clear her airway.

“I gave her some oxygen and monitored her vitals using the kit we had available. Eventually, she regained consciousness.”

Jason, who is based in St Asaph, Denbighshire, was Clinical Operations Manager at the Wales Air Ambulance for four years before he took up post as First Responder Officer, and said the patient and her husband were grateful for his intervention.

He said: “Thankfully the patient made a full recovery and continued her journey to her holiday, albeit what had just unfolded. I’m just glad I could be of help.”

Jon Sweet, the Trust’s Area Operations Manager in North Wales, and Jason’s manager, added: “This is another great example of a member of the WAST team quite literally going above and beyond in delivering excellent patient care.

All of his clothes had been cut off whilst he received hospital treatment.

After establishing that he did not need any further treatment, Leilah decided to go to a local charity shop and buy the man some warm clothes - with money out of her own pocket.

Leilah said: “The man we helped was freezing cold. He desperately needed some warm clothing, and as he was homeless with no money, Tom and I felt it would be nice to buy him something warm.

“We went into the British Heart Foundation charity shop and found a T-shirt, warm jumper and coat, which we thought would be suitable for him, and we were happy to buy them for him.

www.i-gel.com

“When we took the clothes back to him, he was so happy and even did a little dance. He was shocked that someone did that for him and said he didn’t know what to say.

“Whilst we were with him, a lady brought him a hot chocolate and another man brought him a sandwich. For whatever reason, this man was living on the streets and had no money for food or clothes and he needed help.

Quality, innovation and choice

AMBULANCE UK - FEBRUARY

she was very embarrassed about

Leilah Nolan and her crewmate, Tom Thackray-Collier, were called to a homeless man who was seen wandering around in a gown after discharging himself from hospital in Leeds.

23 AMBULANCE_UK_09_17_igel_o2_half_page.indd 1 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

20/09/2017 11:21

NEWSLINE “As a paramedic, we aren’t always

the specialist operations centre,

the incidents happening so close

frontline and in our control rooms

needed to help people medically,

where major incidents, such as

together, it has been hard to

– responded to the incidents last

however, it is nice when we can

the attacks in London Bridge and

recover in between, but through

year and we’re grateful to the

help people in other ways.

Westminster, are coordinated from.

it all, you see the true spirit of the

Archbishop for recognising their

ambulance service and the way

hard work.”

“I hope it encourages others to do

He said: “This vital operations

we support and look after one

random acts of kindness. I know if it

centre has sadly been in use too

another.”

had been any of my other colleagues

many times during the atrocities

who attended to this man that

of this year. During these events,

Jo Burchell worked in the

they would have done the same

we have seen the true heroism of

specialist operations centre during

for him. We are all very caring and

the ambulance crews, police, fire

the London Bridge attack as a

compassionate towards our patients

service and security forces who

radio operator. She said: “I was

and treat people with the dignity and

have worked in extremely difficult

liaising with crews on scene and

respect that they deserve.”

situations to keep us safe and

relaying messages back to the

save lives.”

control room. It was stressful and extremely busy as the situation

LAS

Archbishop praises ambulance staff after ‘year of atrocities’

The Archbishop met frontline staff

was constantly changing. I’ve

who attended the terror attacks

worked on major incidents before,

and the fire at Grenfell Tower

but nothing on that scale.”

and spoke to members of the Service’s Christian Fellowship

The Archbishop was greeted

The Archbishop of Canterbury

about how their faith helps them

at the ambulance service

Justin Welby visited ambulance

in their job.

headquarters in Waterloo by Chairman Heather Lawrence

clinicians on 13 December to hear their experiences following

Paramedic Reverend Simon

OBE and Chief Executive Garrett

the 2017 terrorist attacks.

Woodmore attended the

Emmerson.

attacks at London Bridge and He visited the control room where

Westminster and the fire at

Garrett said: “I’m proud of the

999 calls are answered, as well as

Grenfell Tower. He said: “With

way our staff – both on the

AMBULANCE UK - FEBRUARY

24 For further recruitment vacancies visit: www.ambulanceukonline.com

“This vital operations centre has sadly been in use too many times during the atrocities of this year. During these events, we have seen the true heroism of the ambulance crews, police, fire service and security forces who have worked in extremely difficult situations to keep us safe and save lives.”

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NEWSLINE EEAST

SWAST

Medics’ cash-saving pilot set for national roll-out

According to NHS Supply

electrodes every year.

Cancer patients in the SW benefit from new Project:

An award-winning project

The partnership is looking to

A ground-breaking new

take a similar approach with

project will benefit cancer

the procurement of wound care

patients across the South

the East is set to be rolled out

products, IV devices, linen, and

West so they can be treated in

across the whole of the NHS,

splints.

their own homes by highly-

die. Before this project, a 999

skilled paramedics from South

call would be far more likely to

Western Ambulance NHS

result in the patient being taken

Foundation Trust (SWASFT).

to hospital. This is changing for

between the ambulance service and two hospitals in

Chain data, the health service buys more than 270 million

potentially saving millions of pounds.

Sandy Brown, Director of Nursing and Clinical Quality

The scheme, which won an

at EEAST, said following its

“improving value through

success, the project was being

innovation” award from the

extended nationally by the NHS

Health Care Supply Association

Clinical Evaluation Team. “This

(HCSA), was launched between

is the first project of its kind and

the East of England Ambulance

as with many other successful

Service NHS Trust (EEAST),

initiatives it is simple in concept.

Cambridge University Hospitals

This is the first time an ambulance service and Macmillan Cancer Support have worked together to train

says, “Increasing numbers of cancer patients mean ambulance staff will inevitably attend more people with cancer.

Patients prefer to be treated at home where possible and for many people at end of life that is also the place they want to

the better, giving ambulance service staff and patients more options.”

and support paramedics

“Ambulance service staff

and clinicians to deliver care

naturally want to save lives and

for cancer patients. Where

this is what they are trained to

The project includes identifying

possible, cancer patients

products that can be used

do,” adds Joanne Stonehouse,

(CUH) NHS Foundation Trust,

and those with palliative care

across both the ambulance

needs or who are close to the

Macmillan project lead for

Princess Alexandra Hospital, and East of England NHS

and acute sectors with the

end of their life will be able to

Procurement Hub to reduce

purpose to reduce waste and

stay at home rather than being

waste by standardising the use

usage within all signed up

transported to busy emergency

of medical products.

organisations.”

departments.

A pilot began in July,

Ian Hooper, director of

Chief Executive of South

the tools, training and support

which resulted in the

procurement and supply chain

Western Ambulance Service

to deliver the right care in the

ambulance service using

at CUH, said: “The outcome of

NHS Foundation Trust

right place at the right time and

dual use electrodes for

this pilot is a big achievement

electrocadiograms that do not

for all those involved and should

need to be changed when a

provide the foundation for us

patient arrives at an Emergency

to progress standardisation of

Department and can be used

other categories between our

on a patient for up to 72 hours.

organisations, whilst offering

The move could potentially

a case study upon which the

save the NHS £1.2m if adopted

initiative can be rolled out

“We estimate that in a typical

nationwide.

nationally.”

shift, each ambulance clinician

SWASFT. “It’s just as important for our staff to recognise when keeping a patient at home is the best option for them and their family. We are giving them

(SWASFT), Ken Wenman, said; “It’s a ground-breaking project that delivers better care for patients where they want to be

avoid unnecessary emergency admissions.”

treated and reduces hospital

Macmillan’s initial funding

admissions to emergency

was £1m for the project over

departments”

4 years. This has provided a dedicated team to deliver

will attend a patient who has cancer, palliative care needs or who is close to the end of their

cancer care training for staff, including administering additional medications where appropriate. It has also

AMBULANCE UK - FEBRUARY

life. This project enables us to

equipped paramedics with

deliver more appropriate care

new skills to have sensitive

and in many cases, this means

conversations with patients and

treating them at home. This

families when patients are in

approach enables us to deliver

the last few days or hours of

care more in line with patients’ wishes. We do of course still take patients to hospital where that is in their best interests.”

life or experiencing a significant health crisis. The project also involves linking more closely with hospices, GPs and other

Elizabeth Wright, Macmillan’s

services to provide continuity

strategic partnership manager,

of care.

26 For more news visit: www.ambulanceukonline.com

www.emergencyuk.com | Hall 5 | NEC | Birmingham | 19-20 September 2018 | www.emergencyuk.com | Hall 5 | NEC | Birmingham | 19-20 September

Photographs © ESS

The Emergency Services Show bravery

A unique event for everyone who works in the emergency services.

Over 400 exhibitors, free CPD-accredited seminars and live product and rescue demonstrations. Hall 5, NEC, Birmingham. Wed 19 – Thu 20 September 2018.

Free entry at www.emergencyuk.com.

The Emergency Services Show 2018 – it’s all about you Event sponsors

Event supported by

Event partners

NEWSLINE LAS

Police award brave ambulance man

Constable and Metropolitan Police

Blackweir-based Clinical Team

He said: “The public absolutely

Commissioner.

Leader Steve Bennett runs the

love the bikes and because we

unit and said it provides vital

can stop and engage with them

Chief Executive Garrett

reassurance and medical treatment

when we’re not attending a call,

Emmerson, who attended the

for members of the public.

they think it’s superb.”

The medic who took charge of

ceremony with Andy, said: “We’ve

the ambulance response at the

been tested this year like never

He said: “The Cycle Response

The CRU has provided medical

London Bridge terror attack as

before, but Andy and all of his

Unit gives people in the city centre

assistance at a number of major

gun shots were fired, has been

colleagues who responded to

confidence that if anything happens

sporting events in the capital,

commended for his bravery.

these terrible incidents, pulled

then we’re close by to assist them.

including the Champions League final in June, the Six Nations and

together to provide a truly Incident Response Officer Andy

professional response.”

Beasley received an award at a special ceremony held by the capital’s three police forces on 4 December.

Andy, 49, said: “As I arrived on scene at Borough Market, police and members of the public were bringing patients towards me

“Our average time from call to

WAS

Welsh Ambulance Service Cycle Response Unit helps more than 600 patients in a year

with a variety of injuries. It was

minutes, so we’re giving patients

The team has also covered

the best care they can get within

several occasions in neighbouring

the shortest time possible.”

areas, such as Porthcawl’s Elvis Festival and the Red Arrows

The team includes paramedics, and community first responders,

There are now plans to increase

who attend calls on bikes, which

the number of members of the

are specially fitted with a siren and

unit by training more staff and

blue flashing lights.

volunteers during 2018.

NWAS

A two-wheeled team of Welsh

was gunfire so took cover behind

Ambulance Service clinicians

my car. Once it stopped I came

and volunteers has helped more

They carry a range of medical

out and carried on working with

than 600 patients in a year.

equipment, including defibrillators,

my team to get treatment to the

and can give life-saving treatment The Trust’s Cycle Response Unit

while an ambulance is on the way.

(CRU) attended 623 calls on the “It did make me feel extremely

streets of Cardiff during 2017,

They can also treat patients with

nervous, but the training kicks

which was its first full year of

less serious illnesses and injuries

in and you just focus on the job

operation.

at the scene, preventing an

you’re doing.”

display in Barry during August.

emergency medical technicians

then that I heard what I thought

patients as quickly as possible.

the Autumn Rugby Internationals.

response is between three to four

Ambulance technician performs with singing superstars Michael Ball & Alfie Boe

unnecessary journey to hospital The CRU uses pedal power to

and freeing up ambulance

A Liverpool ambulance technician

Andy, who has worked for

reach patients quickly in busy

crews to respond to other calls.

with a secret talent took centre

the Service for 27 years, also

parts of the city centre, such

Steve said the unit has become

stage during ITV’s ‘A Night for

attended the terror attack in

as pedestrianised areas and

an important part of the Cardiff

Emergency Services’ singing

Westminster.

shopping centres, on key dates.

community during the year.

alongside superstars Michael Ball and Alfie Boe.

He added: “I’m proud to accept

AMBULANCE UK - FEBRUARY

this award, but it’s for everyone

The North West Ambulance

who played a part that day – from

Service crew member, who went

the ambulance crews, to the

viral on Facebook earlier in the

control staff who took the calls,

year after being filmed singing

the police and the members of

classical music outside an

the public. Without the help of

ambulance, was surprised by

Londoners, we would not have

Diversity dancer, Ashley Banjo

been able to save as many lives

during his ambulance shift and

as we did.”

was asked to take part in the special variety show celebrating our emergency services.

Andy was one of 200 people recognised for their actions during the terror attacks at

Lewis Quinn, 38, from Liverpool

London Bridge, Westminster

fell in love with classical music

and Finsbury Park this year.

at the age of 16, he has sung in

They were presented by City of London Police Commissioner, the British Transport Police Chief

Picture shows members of the Welsh Ambulance Service’s Cycle Response Unit.

28 For further recruitment vacancies visit: www.ambulanceukonline.com

opera performances in the past but never on this scale. Lewis said: “It was such a fantastic

NEWSLINE Both Carl and Stan have been

which sends electrical pulses

trained in lifesaving skills in

to regulate any abnormal heart

their role as Community First

rhythms which can cause a

Responders (CFRs) with the

cardiac arrest.

ambulance service.

Tony said: “I don’t think I’d be Deputy Security Supervisor Carl,

here today if it wasn’t for all their

who has volunteered with the Trust

efforts to be honest with you.

for 12 years, said: “I was actually

Lewis (central) with crew mate, Jamie Johnston and Ashley Banjo on the day of the big surprise

on my way to deliver a CPR and

“When I came round in hospital

defibrillator session training on

the doctor said I was lucky to be

site, when a call came over the

alive after what happened, and

radio for medical assistance and

he called me the miracle man.

someone said that Tony had fallen

“I’m feeling great now though

down.

and I’ve had no problems since, so I’m extremely grateful to

“I immediately noticed he wasn’t

everyone who helped me.”

breathing so we got a defibrillator experience, everyone treated me

Tony Hurley, a cleaning supervisor

lovely and I was even chauffeured

at St David’s shopping centre in

around in a Mercedes! It was a

Cardiff, was in work one morning

totally different world to me.

when he suddenly collapsed.

“Ball and Boe were really funny and kind and the orchestra I sang with were all members of the emergency services too which made it even more special. All my family, friends and colleagues are very excited to watch the programme but I think I’ll have to watch it later on catch up!”

Lewis’ Sector Manager, who also happens to be his brother, Gene

Carl Thomas, Stan Mann and Kristian Taylor from the centre’s security team quickly rushed to his aid to deliver CPR, as well as using a defibrillator to administer shocks to his heart.

on him and started CPR.

Paramedic Rhian, who has been with the ambulance service for

“After two rounds of CPR his heart

23 years, said: “When we got

started beating again and the

to the call the first responders

paramedic and ambulance crew

at the shopping centre were

continued his treatment.”

doing CPR. We continued and managed to get a pulse back

Tony was taken to the University

and Tony started breathing

Hospital of Wales, where he

again.

remained in a serious condition, and spent time in intensive care.

The Welsh Ambulance Service is currently preparing to launch

After this expert care from the

its annual Defibuary campaign,

Critical Care team at the hospital,

aimed at raising awareness

they were supported by Welsh

the 66-year-old defied the odds to

of where to find your nearest

Ambulance Service paramedic

make a successful recovery.

defibrillator. Tony’s story shows

In less than three minutes,

Jason Griffiths in a rapid response

how vital they can be in a life-

vehicle and ambulance clinicians

Tony had stents fitted to improve

threatening emergency, and

Steve Clee and Rhian Conaghan.

the blood flow to his heart and

he’s backed the Trust’s call for

and I can’t wait to see him on the

Together they were able to get

has also had an implantable

people to familiarise themselves

big stage. All of his colleagues

Tony’s heart beating again.

defibrillator placed in his chest,

with their closest location.

Quinn said: “We’re all so proud of Lewis, he has a fantastic voice

are really excited too and I’m sure they’ll all be tuned in or recording the show if they’re on shift!”

WAS

A shopping centre worker nicknamed the ‘miracle man’ after surviving a cardiac arrest has thanked his colleagues and the ambulance team who saved

AMBULANCE UK - FEBRUARY

Shopping centre worker dubbed ‘miracle man’ after surviving cardiac arrest thanks his lifesavers

his life.

29 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

NEWSLINE Many of those were control

EMAS

room staff who said they had

Ambulance charity launch moving video about helping the helpers

lost sleep and that this type of abuse could impact their own health.

Gary Morgan, Deputy Director for Emergency Operations

Everyday ambulance staff help

Centres (EOC) at EEAST,

patients, often during the worst

said: “Our emergency call

moments of their lives. They are

handlers help save lives every

celebrated for their compassion

day and are a vital part of the

and dedication but it’s important

ambulance service. They give

to remember that sometimes

cardiopulmonary resuscitation

they too need help and support.

(CPR) instructions when a patient is not breathing and in

The Ambulance Staff Charity (TASC) provides fantastic support

provide invaluable support for

to all present and past ambulance

ambulance staff in their moment

staff and their families. To support

of need so we were more than

their latest campaign, a team of

happy to support their charity

East Midlands Ambulance Service

film.

staff volunteered their time to participate in a promotional video.

“Staff from our Hazardous Area Response Team (HART),

The video features staff involved

frontline ambulance crews and

in realistic scenarios as they

control staff took part in the

respond to patients and answer

filming and really enjoyed giving

999 calls in the control room.

their time to support such a

The scenes demonstrate just

worthwhile charity.”

how challenging the role of an ambulance worker can be.

cardiac arrest, they help assist EEAST

with the birth of babies and

Television presenter backs Don’t Choose to Abuse campaign

are a reassuring voice when a

A television presenter,

best for patients.”

vulnerable patient is having a crisis. It is unacceptable they experience abuse from callers when they are trying to their

known for his zero tolerance approach, has backed a hard-

Shelley Moore, who has

hitting new campaign.

worked as a call handler for two years, said: “I know that as

Television presenter backs Don’t

call handlers we are not face

Choose to Abuse campaign

to face with aggression and abuse like the frontline crews,

Sue Noyes, TASC Chair and former CEO of East Midlands

A television presenter, known

but it can have a physical effect

for his zero tolerance approach,

on you. It’s horrible, and as an

has backed a hard-hitting new

emergency service we should

campaign.

not have to tolerate it. We must

Richard Henderson, Chief

Ambulance Trust added: “I

Executive at East Midlands

would like to give a warm

Ambulance Service said:

thanks to all EMAS colleagues

“As part of our dedication

for their kind help in making this

The East of England Ambulance

to supporting staff we work

excellent film. Your support is

Service NHS Trust (EEAST)

Jeremy Kyle added, “Ambulance

closely with TASC. They

very much appreciated.”

launched its Don’t Choose to

staff should be able to do their

Abuse campaign highlighting

job in a safe environment. It

the unacceptable aggression

is a very important thing. The

that ambulance staff receive.

service is incredible. Please,

not tolerate it.”

Don’t Choose to Abuse.”

Jeremy kyle, who was filming for his new series of the Kyle Files, recorded a video message supporting the campaign.

SECAMB

AMBULANCE UK - FEBRUARY

SECAmb introduces new Wellbeing Hub

He said: “Ambulance staff

Paramedics from the Hazardous Area Response Team filming a scene near the Theatre Royal in Nottingham

join the service to do their

The South East Coast

best for patients with life-

Ambulance Service NHS

threatening conditions and it is

Foundation Trust, (SECAmb),

totally unacceptable they face

has introduced a new Wellbeing

aggression and violence.”

Hub for all staff and volunteers.

More than 75 per cent of staff from

The hub, part of the Trust

EEAST said they received verbal

wellbeing strategy which was

abuse regularly or on every shift.

launched last year, brings together

30 For more news visit: www.ambulanceukonline.com

NEWSLINE to organise the 90-minute performance based around a series of short emotive films and live speakers from the emergency services, the NHS and bereaved families and victims. The show ran for two weeks in November with two performances per day that featured real-life stories of personal experiences and the consequences of road traffic collisions involving young people.

Thousands of college students from across Greater Manchester were a range of previously separate

“During the consultation for the

invited to watch the performance

services under one umbrella

strategy, staff explained that they

which aims to positively influence

meaning an array of support is

wanted to access all wellbeing

the attitudes and behaviours of

available via just one email or

services quickly and easily. I’m

learner and novice drivers and also

phone call.

really proud that we now have our

their passengers.

new Wellbeing Hub. Duncan Mayoh, Advanced

The strategy is designed to ensure staff and volunteers have the support they need and, in turn, are best placed to meet the needs of the Trust’s patients.

The hub includes access to

“Staff wellbeing is an integral

Paramedic with NWAS said: “As

part of our strategy and I see this

ambulance clinicians, we see first-

launch as a real step forward in

hand the horrific and devastating

demonstrating our commitment to

impact of serious road traffic

hopefully will make them think

make things better for all staff and

collisions. Anything that we can

carefully when they get in the car

volunteers.”

do to help prevent death or life

not only as a driver but also as a

changing injuries and to reduce

responsible passenger too.”

mental and emotional wellbeing support, physical health including physiotherapy referrals and Trauma Risk Management – a system which provides access to speak and meet with colleagues who have undergone specialist training in the management of people who have experienced traumatic incidents.

The confidential service can also provide access to support for other matters including relationships, finances, drugs and alcohol, sleep, nutrition and fitness and access to the dedicated team of Trust chaplains.

of workshops, specialist training and events to meet the needs of all its staff and volunteers.

NWAS

the pain and anguish caused by

Award win for Safe Drive Stay Alive initative

such tragedies, even if it’s just for

The Health Business Awards

one person, is definitely worth it.

recognise and celebrate the

An emotional and powerful initiative that aims to reduce the number of young driverrelated deaths has won at the Health Business Awards in

significant contributions made “It is fantastic how it has

each year by organisations and

grown and it still amazes me

individuals that work in and

to witness the reaction of the

alongside the NHS.

young audience as they watch the performances as you can

To find out more about Safe Drive

clearly see what they have seen

Stay Alive visit

has had an impact on them and

www.safedrivegm.co.uk.

London.

Safe Drive Stay Alive (SDSA) Greater Manchester was launched in 2014 and is a partnership between North West Ambulance Service (NWAS), Salford Royal NHS Foundation Trust, Greater Manchester Fire and Rescue (GMFRS), Greater Manchester Police (GMP) and bereaved family members in an attempt to reduce the number of

SECAmb Chief Executive Daren

young driver-related deaths on

Mochrie said: “One of the first

North West roads.

things I did when I joined the Trust in April last year was to sign off

Every year, all involved in the

the Trust’s new wellbeing strategy.

partnership come together

(L to R): Duncan Mayoh (Advanced Paramedic, NWAS), Carolyn Southern (Advanced Nurse Practitioner in Emergency Medicine, Salford Royal), Nick Corlett (Familiy Liaison Co-ordinator, GMP).

AMBULANCE UK - FEBRUARY

It will also co-ordinate a wide range

“It is fantastic how it has grown and it still amazes me to witness the reaction of the young audience as they watch the performances as you can clearly see what they have seen has had an impact on them and hopefully will make them think carefully when they get in the car not only as a driver but also as a responsible passenger too.”

31 For all your equipment needs visit: www.ambulanceservicesuppliers.com

IN PERSON SCAS News

SCAS Honours Outstanding Staff

They never give up and this constant reflection

everything that she does; she is passionate and

and analysis makes them a strong team and a

driven to deliver a service of quality and high

great example of team working.”

standards and she does this with a smile.”

Non-Emergency Patient Transport Service

Paramedic Team Leader, Caroline

The annual staff and volunteer awards,

Team Leader, Lenore Mulford, based at the

Edwards, based at the Trust’s Wexham

known as the Ambies, were held by

Trust’s Southern House in Otterbourne,

Resource Centre, won the Governors’

South Central Ambulance Service NHS

won the Commercial Services Contact

Ambassador Award.

Foundation Trust (SCAS) at Heythrop Park

Centre Person of the Year Award.

Caroline was nominated for the award by

Crowne Plaza, on Friday 24 November.

Lenore received a number of nominations

a colleague in Thames Valley Police, who

The Ambies showcase those members

from colleagues, with one writing: “She is

wrote as part of the nomination: “I cannot

of staff and volunteers who epitomise the

understanding, kind and always willing to help

recommend Caroline highly enough for this

Trust’s values of teamwork, innovation,

no matter what service area it concerns.”

award. Thanks to her dedication, enthusiasm and professionalism, she has made a

professionalism and care.

NHS 111 Clinical Service Manager, Nicola

significant and important difference to the

This prestigious black tie event is made

Harper, based at the Trust’s Clinical

way that our two emergency services interact

possible thanks to the generous contribution of

Coordination Centre in Otterbourne, won

and work with each other, resulting in the best

a number of sponsors, including main sponsor

the 111 Person of the Year Award.

possible outcome for our patients.”

Hexagon Safety & Infrastructure, along with

Nicola also received a number of nomination

O&H Vehicle Conversions, Terrafix, Ortivus and

from colleagues, one of whom wrote: “She

Senior Emergency Call Taker, Michelle

Zoll.

continually puts the needs of the service, her

Barford, based at the Trust’s Bicester

colleagues and her team before her own,

Headquarters, won the Clinical

It was an evening to remember for the winners

Nicola has compassion for her patients and her

Coordination Centre 999 Person of the

below:

staff. This is demonstrated in her calls and her

Year Award – sponsored by Hexagon

endeavour to meet both patient and staff needs.”

Safety & Infrastructure.

NHS 111 South Team Leaders and Shift

Michelle received a number of nominations

Managers, won the Team of the Year –

Recruitment Advisor, Laura Farrow, based

from colleagues, with one writing: “Her

Operations Award – sponsored by Ortivus.

at the Trust’s Bicester Headquarters, won

commitment and enthusiasm for this job, the

The person who nominated the team wrote:

the Support Person of the Year Award.

Trust and the patients are outstanding and she

“The team is immensely proud of working for

Her nominator wrote: “Laura’s attitude and

is an asset, a credit and an exceptional friend

SCAS and everyone is dedicated to their roles.

dedication to SCAS shines throughout

and manager.”

AMBULANCE UK - FEBRUARY

Joint Winners – Partners and Stakeholders’ Award for Innovation L-to-R: Kirsten Willis, Clinical Operations Manager, West Berkshire (representing Spencer Winch & the RBH OT Team), Chris Tarrant OBE, Lisa Brown and Vikki Stockley (Demand Practitioners), Nick Chorley and Julie Crombie (from award sponsors Hexagon Safety & Infrastructure), SCAS Chief Executive, Will Hancock

32 For further recruitment vacancies visit: www.ambulanceukonline.com

IN PERSON Senior Operations Manager, Simon Bosher, based at the Trust’s Bicester Headquarters, won the Commercial Services Operations Person of the Year Award.

Simon also received a number of nomination from colleagues, one of whom wrote: “Simon has completely transformed the nonemergency patient transport service. He is always ready to listen to issues or questions and has a positive attitude that is infectious.”

HEMS Paramedics Neil Plant and Andrew Colledge, along with Dr Oliver Hawksley, based at RAF Benson on the Thames Valley Air Ambulance, won the 999 Person of the Year Award.

Neil, Andrew and Oliver were nominated for their utmost professionalism and teamwork in response to a serious road collision that had left one van driver trapped and critically injured. They carried out a complex, clinical procedure on the patient in the mangled cab – having to surgically amputate one of his legs.

Their nominator concluding: “Performing this exceptional level of care in such a physically challenged situation, under such pressure, was a truly amazing example of brilliant patient care.

Without these three inspirational individuals, the patient would not be here today.”

Education Manager, Paul Grant, based at the Boars Hill Education Centre, Oxfordshire, and Paul Haly, Hazardous Area Response Team (HART) Team Leader, based at Winchester & Eastleigh Resource Centre, were Joint Winners of the Educator of the Year Award.

Paul Grant was nominated for “his willingness to go the extra mile for students, even for those on courses he is not assigned to. He is always willing to work with students who are struggling to develop their knowledge and/or skills in an attempt to overcome barriers and issues to improve competence and confidence.”

The Patient Experience Team, based at the Trust’s Southern House in Otterbourne, won the Team of the Year – Support Award.

The team’s nomination included: “The team is continually improving and changing the way they do things for the better. Despite an ever-increasing workload, they have remained a dedicated and flexible workforce with a strong work ethic who

Scheme Co-ordinator and Community First Responder for New Milton, Penny Smith, won the Volunteer of the Year Award.

In the nomination submitted for Penny, her nominator wrote: “Before April 2016 there were no community first responders in New Milton.

In a little over a year there is now a strong team of nine CFRs in the town, the group has a high local profile and that is largely down to Penny’s efforts, her passion, commitment and dedication to her local community.”

Reading-based paramedic, Spencer Winch and the Royal Berkshire Hospital Occupational Therapy (RBH OT) Team, along with the Demand Practitioner Team (who operate across SCAS) were joint winners of the Partners and Stakeholders’ Award for Innovation, sponsored by Hexagon Safety & Infrastructure.

Spencer and the RBH OT Team were nominated for: “Developing a falls and frailty response programme to provide a rapid response service to those patients at risk of falls or the frail elderly and provide a collaborative approach to their care.

Patients who had fallen were supported and preventative measures undertaken to ensure they could remain safe and cared for appropriately in their own homes.”

The Demand Practitioners were nominated for: “showing great innovation not only for SCAS but country-wide. The patient plans they develop are used within the clinical coordination centres to better understand a patient’s needs and provide them with a higher level of support. This process reduces the number of inappropriate dispatches and vastly improves patient care.”

Specialist Paramedic, Gary Toohey, based at the Chipping Norton First Aid Unit, won the People’s Pride Award – sponsored by O&H Vehicle Conversions.

Gary received 11 nominations, mostly from members of the public, who have seen firsthand what a fabulous job he and his team do at the Chipping Norton First Aid Unit. One nominee wrote: “Gary cared for my five-yearold daughter after she received a nasty burn in an accident at home. He could have referred her back to our GP or the hospital for her daily dressing changes, but as he’d worked hard to build up rapport with her (he was incredible at calming her down and helping her to be brave), he welcomed her back every day with a big smile. Gary is calm, bright, bubbly, warm,

friendly and professional and I know a number of people in the community who all have similar stories about this wonderful man.”

All the winners received their awards from award-winning broadcaster, Chris Tarrant OBE, who said at the event: “When I or members of my family have had to call on the ambulance service, the response has always been fantastic. You are all wonderful people and I thank you for what you do. It was my absolute pleasure to be at the Ambies 2017 and we all had an amazing night.”

Chief Executive, Will Hancock, said: “The Ambies was a fitting celebration of our most successful year to date and I am very proud of what we have all achieved together.

We had a record number of entries from our staff, partners and members of the public so it was a tremendous achievement to be shortlisted let alone be announced as a winner on the night. On the eve of the NHS’ 70th birthday, our winners and nominees have shown that we have the people with the determination, pride and ability to meet any challenge and keep the NHS the envy of the world.”

News

Board of Kent, Surrey & Sussex Air Ambulance Trust welcomes three new members Kent, Surrey & Sussex Air Ambulance Trust has appointed three new trustees to its Board as the charity enters an ambitious new phase of development.

Caitlin Blewett, Michael Docherty and Barney Burgess were welcomed to the Board by Helen Bowcock, Chair of Trustees and Adrian Bell, Chief Executive of Kent, Surrey and Sussex Air Ambulance Trust.

Helen Bowcock, Chair of Trustees, said: “I am delighted that Caitlin, Michael and Barney have agreed to join our Board. In seeking to diversify our skill set we have succeeded in finding three people who bring considerable breadth and depth of experience in areas that are of great strategic importance to us.”

Caitlin Blewett is the Head of Digital at Deloitte LLP, and brings a wealth of experience in marketing, advertising, digital and technology.

AMBULANCE UK - FEBRUARY

Paul Haly’s nominee wrote: “He is a natural educator who has developed and delivered a variety of different educational packages which are massively in demand not only from SCAS staff but from partner agencies. These packages enhance staff safety, increase staff knowledge and improve patient care.”

never fail to console, comfort and provide support and guidance to all those who contact them.”

33 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com

IN PERSON In her current role she leads on the firm’s digital strategy to drive increased impact and effectiveness of the firm’s marketing.

Caitlin has also worked on the agency side, developing brands, cultivating innovation and creating award-winning marketing programmes for leading corporations around the world.

Michael Docherty is Director of Digital and Supporter Experience at Cancer Research UK. Among many significant achievements he has been responsible for leading digital transformation at the UK’s largest charity and building its fundraising and event platform. He has 20 years’ experience gained in the internet, media, telecommunications and charity sectors including driving the use of media sponsorships for Telstra.

Barney Burgess served consumer businesses for McKinsey & Co before joining Tesco plc where he ran their grocery home shopping business and was a commercial director. His achievements included introducing the grocery ‘Click and Collect’ service to the UK. He is now a partner in Hattington Investment Partners, a private equity partnership. Significantly, in 2015, he was airlifted

by KSSAA and brings enormous passion and commitment to the charity which saved his life.

Adrian Bell, Chief Executive, said: “I greatly look forward to working with Caitlin, Michael and Barney at a time when, as a charity, we are introducing new services and are embarking upon a growth strategy.”

SECAMB News

Trust appoints new independent Non-Executive Director South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is pleased to announce the appointment of a new independent Non-Executive Director.

Tricia McGregor, from Epsom, Surrey, will initially serve a three-year term from 1 January 2018 and fills a vacant clinical specialism post.

AMBULANCE UK - FEBRUARY

Tricia is a speech and language therapist and a visiting professor in the School of Health Sciences at the University of Surrey.

She is also an experienced board-level leader with some 30 years’ experience in the healthcare, social enterprise and employee-owned sectors.

Tricia also serves as a Non-Executive Director for the Kent, Surrey and Sussex Academic Health Science Network (AHSN) and was awarded an MBE in 2011 for services to social enterprise, while serving

as Managing Director for CSH Surrey (formerly Central Surrey Health).

SECAmb’s Nominations Committee recommended that the Trust’s Council of Governors make the appointment following a decision by an interview panel consisting of three governors.

A focus group also met with each candidate and candidates were asked to lead a discussion relevant to their NED specialism.

SECAmb Chairman Richard Foster said: “I am delighted that Tricia is joining the board and I am sure her background and expertise will ensure she makes a strong contribution as we continue to move forward. On behalf of everyone at SECAmb I welcome her and look forward to working closely with her very soon.”

Tricia said: “I’m really pleased to join SECAmb. I’m looking forward to working with patients, staff, volunteers and the Board so that SECAmb can continue to improve and deliver the very best care.”

WAS News

Welsh Ambulance Service stalwart ‘truly honoured’ by Queen’s Ambulance Service Medal award A Welsh Ambulance Service stalwart says he is ‘truly honoured’ after being awarded the Queen’s Ambulance Service Medal.

wife Julie, mother Kath and son Gino, said he accepted the award on behalf of his family, friends and colleagues.

He said: “Of all people it is my family that deserve this for their unconditional love, support and patience over the past 32 years.

“It was a further honour to represent the distinguished ranks of past and present colleagues, all of whom have made important contributions throughout their careers.

“It was also a true privilege to represent CFRs from across Wales, who do such an incredible job and are true unsung heroes.

“I also have to mention my PONT charity friends, who I cannot thank enough for inspiring me to do what I can to help empower our friends in Uganda.”

Tony began teaching lifesaving skills in the 1980s when he supported Dr Richard Lewis with the Save a Life campaign, and has delivered training in basic life support and effective use of a defibrillator to more than 20,000 volunteers.

In 2003, his contribution to pre-hospital care was recognised by the British Heart Foundation, when he became the first paramedic in the United Kingdom to be funded by the charity to carry out his role.

He was also involved in the successful launch of a Welsh Government funded Public Access Defibrillator initiative.

Community First Responder (CFR) Officer Tony Rossetti was presented with the medal

by Prince Charles during a ceremony held at Buckingham Palace.

It comes after he was recognised in Her Majesty’s Birthday Honours List in June for distinguished and meritorious service.

Tony, who lives in Bridgend and works in Cardiff, has been part of the ambulance service for 32 years.

He has dedicated himself to growing the number of CFR volunteers, who give up their spare time to provide first hand emergency care to communities in Wales.

He is also a leading contributor to the PONT charity, which helps the poorest communities in Uganda, and has devised and delivered lifesaving training for health workers in the Mbale district.

Tony, who attended the ceremony with his

34 For more news visit: www.ambulanceukonline.com

Welsh Ambulance Service Community First Responder Officer Tony Rossetti pictured with his Queen’s Ambulance Service Medal outside Buckingham Palace

IN PERSON When Kuldip is not responding to 999 calls,

News

EMAS News

Mark Treherne awarded Queens Medal

Royal recognition for East Midlands Ambulance Service clinician

he works with his local community raising

East Midlands Ambulance Service (EMAS)

explained: “As a British Sikh, doing what I

technician, Kuldip Singh Bhamrah has been

consider to be the best the job in the world,

named in the New Year’s Honours List to

I am passionate about raising awareness of

receive the prestigious Queen’s Ambulance

the many different roles in the ambulance

Service Medal for Distinguished Service.

service within the Black and Asian Minority

Mark Treherne, Special Operations Response Team Leader for the Scottish Ambulance Service East Division, has been awarded the Queen’s Ambulance Service Medal.

Mark has been with the Scottish Ambulance Service for 26 years. He began his career at Edinburgh South Station with the Patient Transport Service as an Ambulance Care Assistant, he then trained firstly as an ambulance Technician and then Paramedic, before moving into special operations work and leadership roles.

awareness about the ambulance service, teaching emergency first aid skills, fundraising through using his singing talents and highlighting careers within the service. Kuldip

Ethnic (BAME) communities. I especially want The medal, presented at Buckingham Palace

to encourage young people within the BAME

in London, recognises ambulance personnel

communities to consider, what I believe to be

who have shown exceptional devotion to duty,

an incredibly rewarding profession”.

outstanding ability, merit and conduct in their role.

Commenting on his achievement Mark Gregory, EMAS General Manager for

Based in Newbridge Edinburgh, Mark is responsible for leading and coordinating our special operations teams to respond to challenging incidents for the Service.

Kuldip is one of only a very small select group

Leicestershire and Rutland, said: “Kuldip is an

of ambulance colleagues from the ten English

asset to our service. I am proud to have him as

ambulance services to receive the award this

part of my team. His dedication to EMAS, as

year. When told about the news, he said: “I was so overwhelmed and proud when I first heard that I was going to be a recipient of this

He has held a key role in planning, training and

award. It was completely unexpected. It still

testing our preparedness to respond to major

hasn’t quite sunk in”.

incidents; and providing greater support and security for patients and our staff. In doing

Kuldip has been serving the people of

so he works very closely with a range of

Leicestershire and Rutland for 36 years.

other organisations and services promoting

He began his ambulance career as a

effective team working in extremely hazardous

member of the non-urgent Patient Transport

situations.

Service in 1981 based at the then Welford Road Ambulance Station. In 1982 Kuldip

Following the announcement, Mark said:

well as his passion for community engagement work is a source of inspiration.”

Kuldip has also received recognition when he was awarded the EMAS Chief Executive’s Commendation for his actions whilst on holiday in London. He was first on the scene at a cardiac arrest in a public place and even after colleagues from London Ambulance Service arrived on scene, Kuldip remained and provided assistance.

successfully trained and qualified as a technician and has responded to thousands

“It is a great honour to receive the Queen’s

of 999 calls, receiving many commendations

Ambulance Medal. I care passionately about

from the public for his professional and

working for the Service and it brings me

compassionate conduct.

a great sense of pride to receive such an accolade.

Kuldip is a much loved and respected member of the EMAS team, known for his humour, generosity and listening ear. He said: “My

greatly supported in my role by an incredibly

colleagues at EMAS, both past and present,

hard working and dedicated team who

have become my second family. It’s all down

continue to strive to further improve specialist

to their love and support that I am where I am

care in east Scotland and beyond!”

today”.

Pauline Howie, Scottish Ambulance Service

As an ambulance technician Kuldip works

Chief Executive said:

alongside an emergency care assistant or paramedic to respond to 999 calls. He is

“I am delighted that Mark’s commitment and

required to make clinical decisions and is the

dedication in providing specialist care to our

lead clinician if crewed up with an emergency

patients has been recognised in this year’s

care assistant, providing patients with potentially

honours. Mark leads by example and has

life-saving care at the scene and getting patients

played a significant role in the development

to hospital if further treatment is required.

and innovation of specialist services that have benefited, not only our patients, but

Working shifts and in all weathers; Kuldip deals

also our staff.”

with a range of different people and situations.

AMBULANCE UK - FEBRUARY

However, I could not achieve this alone, I am

35 For all your equipment needs visit: www.ambulanceservicesuppliers.com

COMPANY NEWS Built to face your challenges: Dräger’s latest emergency ventilator PREPARED TO TAKE ON ANY CHALLENGE: When it really matters, you should be able to concentrate only on one thing – your patient. This is why we have developed a portable emergency ventilator, which is designed to allow you to do just that: the Dräger Oxylog® VE300.

Robust, ergonomical and simple to operate. The VE300 is one device with many added values. However, there is one item we saved on: weight. Weighing a mere 3.6 kg the emergency ventilator is easy to hold. The result: we have made it 30% easier for you to handle compared to the previous model!

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than just a new emergency ventilator. It combines all sorts of features that make it ideally suitable for first responses, as well as emergency ventilation of the patient during transport and in the hospital. At your disposal are volume-controlled ventilation, noninvasive ventilation (NIV with CPAP) as well as spontaneous breathing and pressure support. Switching AMBULANCE UK - FEBRUARY

to the CPR-mode requires only a single keystroke. And all presets automatically comply with the international ventilation standards according to ERC und AHA.* This

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und American Heart Association.

software solution and base end system.

Terrafix Limited are awarded the Department of Health Mobilisation Application contract December 2017 saw The Department of Health and Social Care (DHSC) award Terrafix Limited with the contract to design, develop, supply and support a National Ambulance Mobilisation Software Application Contract as part of the DHSC replacement Ambulance Radio Programme (ARP) for the English Ambulance Service with the option to include Scottish Ambulance Service and Welsh Ambulance Service NHS Trust. The contract value is £8.5 million over 5 years with the possibility of 2 years extension.

App, will “enable mission critical communications between

Terrafix, said:

responding resources and control rooms”. Designed and developed

“Winning the contract to supply

by Terrafix the Mobilisation App,

The Department of Health and

will operate on either a windows

Social with our new Mobilisation

or android platform and ensure

App is great achievement; we are

that responding resources,

pleased to be chosen and we will

Paramedics, Community

be utilising our knowledge of the

Responders, even Nurses and

ambulance mobile environment

GP’s can communicate with

we have amassed over the past

control rooms. It also provides a

25 years, to ensure that we will

powerful resourcing tool which

enable all the Ambulance Trusts

will allow a controlled sharing of

to communicate quickly, efficiently

emergency assets across different

and effectively with the control

trusts when necessary, such as in

rooms and dispatchers in a timely

major incidents or planned events.

Terrafix was chosen by competitive tender as the company which best

emailing med-marketing.uk@

meets The Department of Health

draeger.com or visit www.draeger.

and Social care’s requirements for

com/oxylog for more information.

the delivery of a bespoke, resilient

The Terrafix solution, Mobilisation

Chris Green, Managing Director of

makes your job easier.

Contact us today for a quote by

and accurate manner.”

36 For further recruitment vacancies visit: www.ambulanceukonline.com

COMPANY NEWS the accolade, he said; ‘It was a

the country and included a project

worth of ambulance call out costs

privilege to attend the BHTA Awards

trail with North Manchester CCG &

being avoided over the trail period.

and a great honour to be walking

20 of their care homes. Each care

away with the Most Effective

home was given a Mangar ELK

Another trail in South Wales had

Marketing Campaign Award.’

and asked to use the cushion to

also seen ambulance call-outs to

lift uninjured residents instead of

a Bridgend Care Home reduced

calling an ambulance.

by 55% in just 2 months.

raise awareness on the amount

Care home staff were able to safely

Andrew Macphail, Strategic Key

of uninjured fallen residents in

and quickly lift an uninjured fallen

Accounts Director, concluded,

care homes being left on the

resident in a dignified manner after

‘We’ve been working with

floor for hours whilst waiting for

assessing them with the West

ambulance services for the past

an ambulance to come and pick

Midlands Ambulance Service

15 years and have a strong

them up.

guide known as ‘ISTUMBLE’.

working relationship with them.

Clare Birt, Marketing Director

Daniel Kelly, Manager at Chestnut

has an ELK Lifting Cushion on

Mangar Health entered their

from Mangar Health who also

House Care Home explained

board and the ISTUMBLE guide

recently launched new generation

attended the awards evening

his thoughts on the ELK Lifting

has been an integral part of the

Mangar ELK Emergency Lifting

commented; ‘It was a special

Cushion; ‘This equipment is an

#UpLiftingCare campaign’.

Cushion and Airflo 24 Compressor

moment to receive recognition for

absolute godsend. We’ve used it

supported by the #UpLiftingCare

our #UpLiftingCare Campaign

20 times at least, preventing 999

If you’d like more information

marketing campaign designed to

and was a pleasure to work

on every occasion. Residents

regarding the #UpLiftingCare

highlight the need to lift uninjured

closely alongside CCGs, Care

are happier, families are much

Campaign, please visit

fallen residents quickly and safely.

Homes and Ambulance Services

happier, and the staff find it easy

www.mangarhealth.com/uk/

throughout it.’

and safe to use’.

upliftingcare or if you’d like to

Big Award Win for Mangar Health at the British Healthcare Trades Awards Mangar Health scooped the Most Effective Marketing Campaign Award at the British Healthcare Trades Awards which took place at the Park Plaza London Riverbank Hotel.

Mangar Health’s #UpliftingCare Campaign was launched to

In fact, every NHS ambulance

request a free demonstration of

Simon Claridge, Chief Executive Officer from Mangar Health was

The Campaign was supported by

The trail demonstrated a great

the Mangar ELK Emergency Lifting

at the awards evening to collect

CCGs and Health Boards across

success with more than £88,000

Cushion please call 0800 280 0485.

AMBULANCE UK - FEBRUARY

Pictured, left to right: Simon Claridge, Chief Executive Officer, Clare Birt, Marketing Director and Andrew Macphail, Strategic Key Accounts Director from Mangar Health

37 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com

AUK_August_AUK_August_2013 11/10/2013 10:53 Page 254

THE CLASSIFIED SITE For For further further information make information or or to to make aa reservation reservation please please contact contact

Terry Terry or or Brenda Rachel Tel: Tel: 01322 01322 660434 660434 Fax: Fax: 01322 666539 email:

info@mediapublishing info@mediapublishing company.com or by post to: Media Media House, 48 High Street 48 Swanley Swanley KentBR8 BR88BQ BQ Kent

Life Connections 2014 Exmed Study Day

Theme: Difficult Airway Course EMS™ – An introduction Thursday 15TH May 2014 Kettering Conference Centre, Kettering NN15 6PB

AMBULANCE UK - FEBRUARY

38

TIME: A.M

PRESENTATION

TIME: P.M

08.30 - 09.00

Registration

12.00 - 12.30

09.00 - 09.15

Introduction & History of the Course

09.15 - 09.45

The Airway Algorithms

12.30 - 13.30

09-45 - 10.30

Prediction of the Difficult Airway

13.30 - 14.00

10.30 - 11.15

BVM and Laryngoscopy

11.15 - 11.30

Tea/Coffee, Exhibition

11.30 - 12.00

Skills Stations (4 rotations/30 min. each)

PRESENTATION Skill Stations Rotation 2 Lunch, Exhibition Skill Stations Rotation 3

14.00 - 14.30

Skill Stations Rotation 4

Group 1

BVM, ETI

14.30 - 14.45

Group 2

EGD’s & Rescue Airways

14.45 - 15.00

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Needle & Surgical Airway

15.00 - 17.00

Group 4

Video Laryngoscopy

17.00

Airway Self Scope Video Tea/Coffee, Exhibition Practical Moulages Wrap up

Topics and Speakers correct at the time of press but may be subject to change

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Delegate Rate: £72.00 (inc VAT) includes: delegate bag, refreshments and the opportunity to visit over 60 trade stands.

Only 7 places remain available!!

To register call 01322 660434 or visit:

www.lifeconnections.uk.com For further recruitment vacancies visit: www.ambulanceukonline.com

PARAMEDICS - SOUTH WEST £22,128 TO £35,577 (PLUS ENHANCEMENTS)* Join us and you’ll find an Ambulance Service that understands the better we look after you, the better equipped you’ll be to look after our patients.

We are passionate about providing care closer to home and equip all of our staff with the training, support and skills they need to deliver a higher level of care, enabling more of our patients to be treated without conveyance to hospital. And we want a better future for you too. Our career framework supports our paramedics to develop specialist or managerial careers, with the progression of many of our current staff testament to our commitment to internal progression and career development Whether you crave a coastal location, the best of the British countryside or the historic cities of Cheltenham, Bath and Bristol (to name but a few), you really will find a better lifestyle outside of work here in the beautiful South West.

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Does he need a trauma centre or the local hospital?

Twenty-year-old male in a motor vehicle accident. Airbag has deployed. Car has significant front-end damage.

Is he bleeding internally? Will he need a trauma centre?

These are some of the questions you need to answer on a suspected trauma call, as haemorrhage is the leading cause of death after injury.1 The new trauma parameters on the ZOLL X SeriesÂŽ help you accurately and quickly assess your patients so you can feel more confident in your treatment decisions.

Insight for informed decisions. www.zoll.com/uk/trauma-care Acosta JA, et al. Journal of the American College of Surgeons. 1998;186(5):528-533.

1

Š2016 ZOLL Medical Corporation, Chelmsford, MA, USA. X Series and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.

MCN IP 1601 0092-05