Volume 33 No. 5
October 2018
DEDICATED TO THE AMBULANCE SERVICE AND ITS SUPPLIERS
BRAYDEN JUNIOR
✔ Easy to convert Brayden Adult to Brayden Junior ✔ Cost Effective practical and convenient ✔ Anatomically correct ✔ AHA and ERC compliant Supplied by
In this issue 4 Ways Trauma Pros Can Improve Care For Burn Patients Identifying Pre-Hospital Factors in a Regional Trauma Network Life Connections 2019 5 Regional Events to Choose From
CONTACT US TO FIND OUT MORE Tel: 01252 344007 | www.brayden.co.uk/junior Email: braydenjunior@welmedical.com
Powerful Powerful solutions solutions for forEMS EMScare care
A surgeon A surgeon must must always always rely rely on on hishis or her or her own own clinical clinical judgement judgement when when deciding deciding which which treatments treatments andand procedures procedures to use to use with with patients. patients. ForFor verifying verifying availability availability of Stryker of Stryker products products in your in your area area please please contact contact your your Stryker Stryker representative. representative. Copyright Copyright © 2017 © 2017 Stryker. Stryker. TheThe products products shown shown above above areare CECE marked. marked. Stryker Stryker Corporation Corporation or its or its divisions divisions or other or other corporate corporate affiliated affiliated entities entities own, own, useuse or have or have applied applied forfor thethe following following trademarks trademarks or Service or Service marks: marks: Stryker, Stryker, Power-PRO Power-PRO XT,XT, XPS, XPS, Power-LOAD. Power-LOAD. ©2017 ©2017 Physio-Control, Physio-Control, Inc.Inc. AllAll names names areare trademarks trademarks or registered or registered trademarks trademarks of their of their respective respective Specifications Specifications areare subject subject to change to change without without notice. notice. NotNot all all products products areare available available worldwide. worldwide. Check Check thethe manufacturers’ manufacturers’ Declarations Declarations of Compliance of Compliance forfor a list a list of products of products andand accessories accessories authorised authorised forfor useuse within within thethe EU.EU.
CONTENTS
CONTENTS 177
EDITOR’S COMMENT
178
FEATURES
178 4 Ways Trauma Pros Can Improve Care For Burn Patients
Ambulance UK This issue edited by: Sam English c/o Media Publishing Company 48 High Street SWANLEY BR8 8BQ ADVERTISING: Terry Gardner, Brenda Pickering
182 Identifying Pre-Hospital Factors in a Regional Trauma Network
CIRCULATION: Media Publishing Company
192
NEWSLINE
Media House, 48 High Street
207
IN PERSON
Tel: 01322 660434 Fax: 01322 666539
210
THE CLASSIFIED SITE
SWANLEY, Kent, BR8 8BQ E: info@mediapublishingcompany.com www.ambulanceukonline.com PUBLISHED BI-MONTHLY: February, April, June, August, October, December
COVER STORY Smart development of Brayden manikins for adult and paediatric CPR training The benefits for CPR training offered by Brayden manikins since their launch were quickly recognised by professionals. The innovative use of lights that give real time feedback of CPR performance and function have proved an invaluable training tool and demand for a paediatric version is now being met with the development of a Brayden Junior conversion kit. Brayden adult manikins can now be quickly and easily converted for paediatric training through three simple procedures. Users can convert the Brayden adult by changing the face and torso skins and chest spring, with the latter providing chest compression and ventilation that accurately reflects a 10-12 year old child. There is no need for any other device (phone/tablet) so training is convenient, quick and easy to set up for training and assessment purpose; plus, the intuitive feedback lights on Brayden Junior will work in the same way as on the Brayden adult.
The Brayden Junior package will be available before the end of this year. For further information contact braydenjunior@welmedical.com
Media Publishing Company Media House 48 High Street SWANLEY, Kent, BR8 8BQ PUBLISHERS STATEMENT: The views and opinions expressed in this issue are not necessarily those of the Publisher, the Editors or Media Publishing Company. Next Issue December 2018 Subscription Information – October 2018 Ambulance UK is available through a personal, company or institutional subscription in both the UK and overseas. UK: Individuals - £24.00 (inc postage) Companies - £60.00 (inc postage) Rest of the World: £50.00 (inc. surface postage) £75.00 (airmail) We are also able to process your subscriptions via most major credit cards. Please ask for details. Cheques should be made payable to MEDIA PUBLISHING. Designed in the UK by Hansell Design
AMBULANCE UK - OCTOBER
The advantages are clear for users to see in terms of ease of conversion and cost effectiveness. As important, the conversion upgrade package means that users only require one manikin for both adult and paediatric CPR training purposes.
COPYRIGHT:
175 Do you have anything you would like to add or include? Please contact us and let us know.
BUY ONE GET ONE HALF PRICE* SPECIAL OFFER ON NEW DRÄGER OXYLOG® VE300
Built to face your challenges. Our new Oxylog® VE300 transport ventilator has been designed especially for the emergency services. Highlights include: • • • • •
Integrated O2 Cylinder Nine Hour Battery Life Intuitive ‘Flip’ Screen Display CPR Mode Bluetooth Enabled Data Export Option
Hurry, this offer is only available for orders placed before the 31st October 2018! To take advantage of this special offer, please email med-marketing.uk@draeger.com and quote AUVE30018.
www.draeger.com/oxylog O 31S FFER T O EN CT DS OB ER
*T&Cs apply. Offer only valid for Dräger Oxylog® VE300 orders placed before 31st October 2018. Offer is only valid for purchases made in the UK & Ireland. Cannot be combined with any other offer or promotion. Not valid on previous purchases. Whilst stocks last.
EDITOR’S COMMENT
EDITOR’S COMMENT Welcome to this issue of AUK For those of you keeping up to date, the Carter review released today makes for some interesting but concerning reading. Whilst it recognises the key role of Paramedics in admission avoidance, it also spells out some of the barriers, including a need to invest in fleet, more highly skilled staff and a serious review of working practices. I am a humble person, not wise in the mysterious art of finance but even I am trying to understand where this investment will come from and how it might weigh against the savings that everyone is being asked to make. To me, it assumes that there will be overall savings from non-conveyance and a more uniform, efficient, UK wide operating model, but maybe that just moves the problem sideways, since review and refer needs something, or someone, to review and refer to…that might cost more than is saved.
“If we’re totally honest, there’s a lot to be said about educating the public”
It’s not that I don’t believe it. It’s good news that the ambulance sector is at last receiving the consideration it deserves and is rightly placed as a key component of a modern healthcare system. I suppose, in a way, I am a passionate supporter of much of what is being said. It is sensible and set against growing demand probably what most of the NHS, especially the A&E departments, want to hear. I hope that it comes to fruition, it’s just a niggling suspicion that it might not be quite as shiny as we might be led to believe. That said, the world is changing albeit slowly, I’m currently looking at the role of clinicians much earlier in the patient journey and the numbers look promising in terms of reduced risk and more appropriate disposition. Just my own thoughts, but I wonder how long it will be before HE institutions include modules on telephone triage for aspiring Paramedics or services start to recruit millennials on portfolio contracts which include such wizardry. Then again, if we’re totally honest, there’s a lot to be said about educating the public, Carter says “the ambulance service is not a taxi service”, true, you have to pay for a taxi...! But even if you start with the youngsters it might take two or more decades before people start to realise it really is becoming a ‘don’t abuse it you’ll lose it’ service. Maybe some more investment here might help just as much as more ambulances or perhaps we just need to occasionally say ‘no’... Anyway, it will be interesting to see the commentary over the next few days. It will make a change from ... what is it they say on TV? “Winter is coming...!”
Sam English, Co-Editor Ambulance UK
AMBULANCE UK - OCTOBER
177 For all your equipment needs visit: www.ambulanceservicesuppliers.com
FEATURE
4 WAYS TRAUMA PROS CAN IMPROVE CARE FOR BURN PATIENTS BY DAVID W. VOIGT MD, CHRISTI CHAVES MA RN FACHE AND ESTHER RATHJEN MSN RN APRN-CCNS ON AUGUST 18, 2017 About 486,000 people receive medical treatment for burn injuries in
2. Do not delay intubation for burn patients
the United States every year. For the most seriously burned patients,
In our experience, providers are sometimes reluctant to intubate a
this involves transfer to one of the nation’s 66 verified burn centers.
burn patient. Verified trauma centers are usually very good about this
But the vast majority of burn patients are treated in trauma centers
aspect of care, but many ED staff in smaller communities do not feel
and emergency departments without a specialised burn unit.
comfortable with intubation. As a result, they will often wait for the transport team to intubate the burn victim.
As burn specialists, we see the most serious end of the thermal injury spectrum every day. Our hospital, CHI Health St. Elizabeth in Lincoln,
Clearly, however, delaying intubation can have disastrous effects. At St.
Neb., became one of the first verified burn units in the U.S. in 1973.
Elizabeth, we would rather take an endotracheal tube out of a burn patient
Today, we treat more than 150 seriously burned patients every year.
who didn’t need it than to have the patient arrest two blocks from our hospital.
Recently, we were asked what trauma centers, non-trauma EDs and
Our recommendation: If there is any doubt, intubate the patient. The
prehospital providers can do to improve their care for burn patients. The short
airway is only going to get worse as the resuscitation continues and the
answer, in our view, is greater collaboration with your regional burn center.
tissues swell, so early intubation is a critical component of care.
Verified burn centers offer expertise that can improve outcomes for burn patients - even if those patients never set foot in a specialised burn unit.
Again, for all of the clinical management issues surrounding burn care, the best overall solution is to make sure trauma providers take the ABLS Course.
Strong collaboration requires information sharing. Based on best practices and available resources, following are four ways that trauma
3. Use burn center referrals to guide early care
providers can leverage burn center expertise to improve care for burn
The ABA has established criteria for referral to a verified burn center.
victims in every setting.
These criteria include:
1. Avoid “fluid creep”
• Partial thickness burns greater than 10% of total body surface area
In many regions, one of the biggest opportunities to improve burn care
• Burns that involve the face, hands, feet, genitalia, perineum or major joints
is to more carefully manage fluid resuscitation for burn victims. Too
• Third-degree burns in any age group
often fluids are run “wide open” in burn patients. This can lead to the phenomenon referred to as “fluid creep”.[1] The result is increased lung
However, there is some confusion about burn center referral. It
water, which leads to increased ventilatory time and all its associated
is important to understand that referral to a burn center does not
consequences. Fluid creep has also been linked to abdominal
necessarily mean transfer to a burn center.
compartment syndrome. There are times when a patient meets the ABA criteria for referral, but How can trauma providers avoid fluid creep? First, make sure you are
there is nothing that the burn center would do differently, at least initially. In
following current guidelines from the American Burn Association (ABA)
these cases, referral entails coordination with burn center staff. The burn
for calculating fluid needs. The best way to learn these guidelines is to
specialist can provide advice on different aspects of burn treatment, plus
take the ABA’s Advanced Burn Life Support (ABLS) course. This course
guidance on whether to transfer and when transfer is recommended.
educates trauma and emergency department staff on the most current practices for resuscitating and treating burn victims.
For example, a child touches the hot glass of a fireplace and develops
AMBULANCE UK - OCTOBER
a blister on the palm of their hand. Most of these burns will heal well Second, make sure you understand how to estimate burn size.
without the need for transfer. However, these cases should be referred
Research has shown that inexperienced practitioners often overestimate
for burn specialist consultation. At St. Elizabeth, we often perform these
the size of a burn.[2] Since burn size is a key factor in fluid resuscitation
referrals using telehealth tools that allow us to view the injury. Where
formulas, burn overestimation will result in patients receiving too much
telehealth is not available, a phone consult might often suffice.
fluid, even if the current resuscitation guidelines are used. 4. Understand the resources available at your regional burn center Fluid resuscitation guidelines are constantly evolving, so we also
Here’s a common scenario: A patient presents at a trauma center with
encourage trauma centers and non-trauma EDs to maintain ongoing
mechanical injury and concomitant thermal injury. Surgeons on staff
communication with their regional burn center to stay up to date on the
are able to graft the burns, so the decision is made that the injury is not
latest recommendations.
“bad enough” for referral to a verified burn center.
178 For more news visit: www.ambulanceukonline.com
In some cases, this decision is appropriate. However, we would
Video laryngoscopy FEATURE wherever and whenever you intubate
encourage trauma center leaders to consider the full range of care needs of the burned patient - and the full range of resources available at verified burn centers. First, treating burn patients is not just about grafting. Burns are best treated by a team approach that can only be delivered at a verified burn center. In addition, burn centers offer treatments that are not available in most trauma centers, and certainly not in smaller critical access hospitals. These include xenografts and allografts that can accelerate the healing process, decrease pain, potentially eliminate twice-a-day dressing changes, and prepare infected burns for final grafting. Second, verified burn centers also offer follow-up care that can make a big difference in the patient’s ultimate outcome. Resources include specialised splinting, education on scar control, compression garments and now the burn laser. Follow-up care at a burn center is provided by physical, occupational and recreational therapists who are experienced with the special challenges presented by the burn patient. Finally, burn centers take care of more than just burns. Studies have shown that toxic epidermal necrolysis, a potentially life-threatening skin disorder, is best treated at a burn center.[3] Burn center specialists have also become the experts in treatment of frostbite using intra-arterial thrombolyis. For frostbite patients transferred to a burn center within 24 hours of their injury, we can save many of the limbs that in the past would have been lost to amputation.[4] Seamless care Clearly, a patient with both mechanical trauma and burn injury should never bypass a verified trauma center to get to a burn center. However, early coordination and consultation with burn center specialists can enable seamless care across the entire continuum and better overall outcomes. David W. Voigt, MD is co-medical director, Christi Chaves, MA, RN, FACHE is nursing director, and Esther A. Rathjen, MSN, RN, APRNCCNS is clinical nurse specialist at the Burn Center at CHI Health St. Elizabeth in Lincoln, Nebraska. References 1. Saffle JI. The phenomenon of “fluid creep� in acute burn resuscitation. J Burn Care Res. 2007 May-June; 28(3): 382-95.
3. Palmieri TL, Greenhalgh DG, Saffle JR, et al. A multicenter review of toxic epidermal necrolysis treated in U.S. burn centers at the end of the twentieth century. J Burn Care Rehabil. 2002 March-April; 23(2): 87-96. 4. Gonzaga T, Jenabzadeh K, Anderson CP, et al. Use of intra-arterial thrombolytic therapy for acute treatment of frostbite in 62 patients with review of thrombolytic therapy in frostbite. J Burn Care Res. 2016 July-August; 37(4): e323-34.
www.intersurgical.co.uk/info/iview
AMBULANCE UK - OCTOBER
2. Hammond JS, Ward CG. Transfers from emergency room to burn center: errors in burn size estimate. J Trauma. 1987 October; 27(10): 1161-5.
Quality, innovation and choice
179
NEWSLINE
The new corpuls cpr has redefined the standard for the next gerneation of chest compression devices used by the emergency services and hospitals. PROTECT YOUR AMBULANCE CREW
USER FRIENDLY
The corpuls cpr has the capability of being able to
The corpuls cpr comes with clearly visible colour
supply fully automated chest compressions, ensuring less
display and easy to access control panel buttons.
strain on rescue workers, particularly when performed in
The compression depth and/or rate, can be manually
a moving vehicle. The corpuls cpr is able to check its
adjusted when required.
position of the compression pad after each ventilation break or 100 compressions (in continuous mode) to compensate for any impact cpr has on the patient’s thorax.
TS S O C G N I N ESSION PADS N U R W O L MPR ABLE
REUS
CO
AMBULANCE UK - OCTOBER
The compression pads come in two sizes and can be disinfected with all common agents, keeping running costs to a minimum. This ensures that the corpuls cpr can be deployed on every CPR job without financial impact.
180 For more news visit: www.ambulanceukonline.com
NEWSLINE
The Tireless Arm that saves lives BLE A L I A V A ES I D U T S E NEW CAS
sales@theortusgroup.com www.theortusgroup.com T: +44 0845 4594705 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
AMBULANCE UK - OCTOBER
corpuls cpr compliant to current ERC/AHA guidelines.
181
FEATURE
IDENTIFYING PRE-HOSPITAL FACTORS ASSOCIATED WITH OUTCOME FOR MAJOR TRAUMA PATIENTS IN A REGIONAL TRAUMA NETWORK: AN EXPLORATORY STUDY Lee Thompson1*, Michael Hill2, Caroline Davies1, Gary Shaw1 and Matthew D Kiernan2 Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017 25:83 https://doi.org/10.1186/s13049-017-0419-4 © The Author(s). 2017, Published online 2017 Aug 23 Reproduced with permission from the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Abstract Background Major trauma is often life threatening and the leading cause of death in the United Kingdom (UK) for adults aged less than 45 years old. This study aimed to identify pre-hospital factors associated with patient outcomes for major trauma within one Regional Trauma Network. Method Secondary analysis of pre-hospital audit data and patient outcome data from the Trauma Audit Research Network (TARN) was undertaken. The primary outcome used in analysis was ‘Status at Discharge’ (alive/ deceased). Independent variables considered included ‘Casualty Characteristics’ such as mechanism of injury (MOI), age, and physiological measurements, as well as ‘Response Characteristics’ such as response timings and skill mix. Binary Logistic Regression analysis using the ‘forward stepwise’ method was undertaken for physiological measures taken at the scene. Results The study analysed 1033 major trauma records (mean age of 38.5 years, SD 21.5, 95% CI 37–40). Adults comprised 82.6% of the sample (n = 853), whilst 12.9% of the sample were children (n = 133). Men comprised 68.5% of the sample (n = 708) in comparison to 28.8% women (n = 298). Glasgow Coma Score (GCS) (p < 0.000), Respiration Rate (p < 0.001) and Age (p < 0.000), were all significant when associated with the outcome ‘Status at Discharge’ (alive/deceased).
Isolated bivariate associations provided tentative support for response characteristics such as existing dispatching practices and the value of rapid crew arrival. However, these measurements appear to be of limited utility in predictive modelling of outcomes. Discussion The complexity of physiological indices potentially complicate their predictive utility e.g. whilst a Systolic Blood Pressure (SBP) of < 90 mmHg serves as a trigger for bypass to a Major Trauma Centre, the utility of this observation is nullified in cases of Traumatic Brain Injury. Analysis suggested that as people age, outcomes from major trauma significantly worsened. This finding is consistent with existing research highlighting the relationship between trauma in elderly patients and poorer outcomes. Conclusion Findings lend further validity to GCS, Respiration Rate and Age as predictive triggers for transport to a Major Trauma Centre. Analysis of interactions between response times, skill mix and triage demand further exploration but tentatively support the ‘Golden Hour’ concept and suggest a potential ‘load and go and play on the way’ approach. Keywords: Pre-hospital, Trauma, Outcome, Age, Timings, Response
Background AMBULANCE UK - OCTOBER
Major trauma is often life-threatening and is the leading cause of death
Research Network (TARN) [4]. TARN is a national organisation that
in the UK for adults under 45 years [1].
collects and processes data on moderately and severely injured patients in England and Wales. TARN data allows networks, major
In April 2012, after reports identifying the need for specialist trauma
trauma centres, trauma units, ambulance services and individual
care, Regional Trauma Networks (RTN) were introduced across the
clinicians to benchmark their trauma service with other providers
UK which enabled ambulance services to bypass local emergency
across the country. The combination of TARN with the RTN pre-
departments and transport severely injured patients direct to definitive
hospital database enabled the creation of a meaningful dataset and
care at specialist Major Trauma Centres [2, 3].
allowed for a more comprehensive exploration of factors relating to pre-hospital trauma care. A key consideration in this analysis was
Following the introduction of the local RTN a regional pre-hospital
understanding the epidemiology of a trauma system whilst taking
trauma registry was created. This data was combined with outcome
into account the unique geographical features and demography
data from the national trauma registry maintained by the Trauma Audit
of the region. Understanding the local regional major trauma
182 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE epidemiology through this preliminary and exploratory study, with
HEMS doctors within the region are also trained to manage
the intention of providing a baseline from which to evaluate future
cardiothoracic trauma up to and including resuscitative thoracotomy,
performance, would potentially identify trends and ultimately improve
peri-mortem C-section, rapid sequence induction (RSI) and the
patient outcomes.
administration of blood products (although blood products were not on the aircraft at the time of this study).
The aim of this study was to explore the pre-hospital casualty and response factors associated with major trauma outcomes in a RTN.
Hazardous Access Response Team (HART) Paramedics are also available within the region to access patients at height, in water or in remote or difficult locations. At the time of the study there were 58
Methods
ambulance stations throughout the region with over 500 Paramedics who work alongside emergency care assistants and technicians.
The study analysed combined data from TARN and RTN pre-hospital database for the North East (England) Ambulance Service producing a comprehensive dataset of regional major trauma patients. The entry criteria for patient inclusion within the RTN pre-hospital database can be seen in Fig. 1. Ethical approval for the study was granted via Northumbria University Research Ethics Review Panel. Reporting of the study followed the STROBE guidelines [5]. Study period and population The sample comprised of data collected between 1st of April 2012 and 30th September 2012 with each patient record within the dataset containing 69 variables. The study identified two groups of variables:
Data analysis Descriptive statistics were used to characterise the study sample in terms of casualty and response characteristics. Categorical and ordinal variables were expressed as proportions and continuous variables expressed as means with standard deviations. The primary outcome measure used in causal analysis was ‘Status at Discharge’ (alive/deceased). Independent variables were loosely grouped into two sets;
and
‘Casualty Characteristics’ obtained from patient care records, which included physiological measurements, age, MOI etc.; and ‘Response Characteristics’ obtained from Computer Aided Dispatch (CAD) records, which included response and transport times, crew skill mix and triage
(i) casualty characteristics e.g. age and physiological indices,
(ii) response characteristics e.g. skill mix and transport time.
practices.
Whilst there were multiple recordings of physiological indices
Within the sample there was a small number (n = 36, 3.5%) of
purposes were the observations used by the attending crew in their
for most patients within the study, the set employed for analysis
casualties who were not classified as major trauma at initial triage, but were retrospectively included into the sample because they were later identified as meeting major trauma criteria. All ‘under-triaged’ patients managed at the Major Trauma Centres or Trauma Units were subsequently entered into the database. The regional ambulance service covers an area of 8365 km2 serving over 2.71 million people in a mixed geography of rural and urban areas and receives over 1.5 million emergency and urgent calls per annum. The RTN, at the time of the study, had 9 Trauma Units and 2 Major Trauma Centres. There are 2 Helicopter Emergency Medical Service (HEMS) bases within the region which are charity-funded and each aircraft is staffed by Doctors qualified in Pre-Hospital Emergency Medicine (20 part-time doctors and 4 in training) and Paramedics (11 full-time equivalents). These aircraft do not fly at night, or when weather restricts visibility, but crews are able to respond to calls via a rapid
pre-alert or alternatively, those observations that prompted the use of the major trauma triage tool shown in Fig. 2. Preliminary bivariate analysis was undertaken in order to explore relationships between these factors and outcome ‘Status at Discharge’ (alive/deceased). To adjust for collinearity and potential amplification bias a binary logistic regression analysis was undertaken with the outcome ‘Status at Discharge’ (alive/deceased) as the dependant variable. Only independent variables that were individually associated with the outcome ‘Status at Discharge’ (alive/deceased), at a p ≤ 0.05 level were entered into the binary logistic regression model. All candidate predictor variables were entered into the model using a forward stepwise method, and each variable’s contribution to the overall fit was estimated using likelihood ratio tests. Analyses were undertaken using the Software Package for the Social Sciences (SPSS; Version 22, IBM Inc.; Armonk, NY, USA).
response vehicle during these times. At the time of this study HEMS a rapid response vehicle.
Results
Paramedics within the RTN are trained and educated to carry out
The study sample consisted of 1033 patient records that met the
multiple interventions for trauma patients. These interventions include
pre-hospital major trauma triage protocol criteria, as shown in Fig. 2.
advanced airway management (endo-tracheal tube intubation and
Table 1 highlights descriptive analysis of demographic characteristics
supraglottic airways), needle decompression of pneumothoraces and
of the sample group and key emergency response characteristics.
intravenous and intraosseous access. The application of haemorrhage control devices (tourniquets, haemostatic gauze) as well as Tranexamic
Bivariate analysis revealed that a number of variables were
Acid and immobilisation/splinting devices are also available to pre-
significantly associated with outcome ‘Status at Discharge’ (alive/
hospital paramedics.
deceased) shown in Tables 2 and 3.
AMBULANCE UK - OCTOBER
teams were available to respond on a Friday and Saturday night utilising
183 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
Fig. 1 Criteria for patient entry into pre-hospital database
Binary logistic regression analysis In order to address problems of collinearity and the potential for
Step 2 Nagelkerke’s R2 (59.8%) the model included ‘GCS’ score and
amplification bias, binary logistic regression was undertaken for 571
‘Age’ and indicated a stronger relationship between prediction and
casualties using outcome ‘Status at Discharge’ (alive/deceased) as
grouping.
the dependant variable. Analysis proceeded on the basis of ‘listwise’ exclusion, and this resulted in a total of 462 cases being excluded from
Step 3 the final model included ‘GCS’, ‘respiratory rate’, and
the analysis sample (N = 1033). Variables were entered into the model
casualty’s ‘age’ and indicated that these factors are significant
AMBULANCE UK - OCTOBER
on the basis of the ‘forward stepwise’ method. All candidate variables
predictors of outcome ‘Status at Discharge’ (alive/deceased) (χ2 =
considered for inclusion in the binary logistic regression model were
155.902, p < 0.000). The other four candidate predictors, ‘transport
individually associated with the outcome ‘Status at Discharge’ (alive/
time’, ‘triage’, ‘skill mix’ and ‘systolic BP’, were not significant.
deceased) at the p ≤ 0.050 significance level. ‘GCS’, ‘age’ and ‘respiratory rate’ were all significant at the 5% level A test of the full model against a constant only model was statistically
(‘GCS’ – p < 0.000; ‘age’ - p < 0.000; ‘respiratory rate’ - p < 0.001).
significant, indicating that the predictors as a set reliably distinguished between alive or deceased (χ2 = 103.862, p ≤ 0.000). Collectively, all
The odds ratio (OR) were as follows: ‘GCS’ was 1.587 (95% CI:
seven candidate predictors “explained” 94% of the variability in ‘Status
1.374–1.833); ‘Age’ was 0.923 (95% CI: 0.894–0.952); ‘respiratory
at Discharge’ (alive/deceased).
rate’ was 1.165 (95% CI: 1.067–1.272). The model correctly predicted 99.3% of the variability of an ‘Alive’ outcome, and 67.6%
Step 1 Nagelkerke’s R2 (45.8%) the model included ‘GCS’ score only
of ‘Deceased’ outcome at discharge, giving an overall percentage
and indicated a moderate relationship between prediction and grouping.
correct prediction rate of 97.4%.
184 For more news visit: www.ambulanceukonline.com
FEATURE
Fig. 2 Major trauma triage protocol
Discussion The findings of this study suggest that physiological measures taken
calls) within 8 min regardless of rural or urban location [14]. The rise
at the scene are of greater predictive utility than are emergency
of evidence-based medicine has brought with it the unintentional
services response characteristics. Specifically, GCS, respiration rate,
consequence of ‘therapeutic nihilism’ [15], in which failure to establish
and age formed significant elements of the predictive model. Further
supporting evidence for an intervention is (incorrectly) interpreted as
analysis suggested that as people age, outcomes from major trauma
a warrant for therapeutic inertia. The pressures to ‘do nothing’ are
significantly worsened. This finding is consistent with existing research
further exacerbated during times of fiscal austerity, where being unable
highlighting the relationship between trauma in elderly patients and poorer outcomes [6–8]. Almost all previous studies with regard to physiology and trauma were exclusive to the in-hospital setting [9–12]. The evaluation of prehospital physiological variables as predictors of trauma outcome has, hitherto, been neglected. However, it should be noted that the inherent complexity of physiological indices (and their significance) potentially complicate their predictive utility e.g. whilst a Systolic Blood Pressure Centre, the utility of this observation is nullified in cases of Traumatic Brain Injury (TBI). Recent research [13] has identified that each 10 mmHg reduction in SBP is associated with an 18% increase in mortality
erosion of service standards such as crew response times. In terms of the current study, it would appear that (abnormal) physiological measurements, possibly as a reflection of the severity of trauma and nature of the physiological insult, underpin the most accurate predictive model of mortality outcomes. Existing research considering the impact of timings and skill mix is markedly limited to consideration of on-scene times and predominately focused on the impact of physician led teams in prolonging ‘on-scene’ times [16–19]. These studies have typically added fuel to the ‘stay and play’ or ‘load and go’ debate and highlight the ‘golden hour’ of
when SBP falls below 120 mmHg. These findings should make us
immediate care [20, 21]. However, the typical lack of standardisation in
reconsider the hypotensive threshold for the isolated TBI patient group.
how ‘on-scene’ times are defined and recorded raises valid questions concerning the potential generalisability of these findings beyond the
Emergency services response characteristics most often form the basis
context in which individual studies were undertaken. In the context of the
for Key Performance Indicators (KPI’s) for ambulance service delivery
current study, HEMS teams took longer to arrive on scene, compared
and evaluation: For example, the UK Department of Health requires
to land based resources, had extended ‘on-scene’ times and longer
ambulance services within England to respond to Red (life threatening
overall mean time from emergency call to arrival at receiving facility.
AMBULANCE UK - OCTOBER
(SBP) of <90 mmHg serves as a trigger for bypass to a Major Trauma
to unequivocally establish an evidence base can underpin the further
185 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
Table 1 Demographics, crew attendance, timings and triage Age in years
Years [SD] (95% CI)
Mean
38.5 [21.5] (37–40)
Missing
86
Adult/Child <17
n (%)
Adult
853 (82.6)
Child <17
133 (12.9)
Missing
43 (4.2)
Sex
n (%)
Male
708 (68.5)
Female
298 (28.8)
Missing
23 (2.2)
Pre-hospital Traumatic Cardiac Arrest (TCA) – Active Resuscitation
n (%) 30
Died on scene
7 (23)
Transported to hospital
23 (77)
Alive at discharge
3 (10)
Died in hospital
18 (60)
Missing
2 (7)
In hospital deaths from pre-hospital major trauma (Not pre-hospital TCA)
n (%) 43 (4)
Attended by
n (%)
HEMS
168 (16.3)
Land Crews
844 (81.7)
Missing
17 (1.6)
Crew arrival times
Minutes [SD] (95% CI)
Mean
12 [13.5] (11–13)
HEMS
14 [11.5] (12–16)
Land Crews
11.5 [13.5] (10.5–13)
On scene times
Minutes [SD] (95% CI)
Mean
36 [19.5] (35–37.5)
HEMS
51.5 [21.5] (48–55.5)
Land Crews
33.5 [18] (32.5–35)
Transport time
Minutes [SD] (95% CI)
Mean
17 [11.5] (16–17.5)
HEMS
13 [9.5] (11–14.5)
Land Crews
17.5 [12] (16.5–18.5)
Time to definitive care (999 call to arrival at receiving facility) Mean
Minutes [SD] (95% CI) 65 [27] (63–66.5)
AMBULANCE UK - OCTOBER
HEMS
78 [23] (73.5–81.5)
Land Crews
62.5 [27] (60.5–64.5)
Triage
n (%)
Correct triage
744 (72.0)
Under triage
36 (3.5)
Over triage
248 (24)
Missing
5 (0.5)
186 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE Table 2 Relationship of Independent variables associated with outcome ‘Status at discharge’ (Alive/Deceased), obtained using bi-variate analysis Independent Variable
Test Statistic
p
df.
Mean Difference
95% CI(Lower)
95% CI(Upper)
GCS 2 Relationship of Independent t = −10.222 44.15 p ≤outcome 0.000 7.28 points (Alive/Deceased), 5.845 8.715 Table variables associated with ‘Status at scale discharge’ obtained using bi-variate analysis Respiratory Rate t = −5.241 43.55 p ≤ 0.000 8 per min. 5 12 Independent Variable Systolic BP at Scene GCS Age Respiratory Rate Transport Time Systolic BP at Scene Skill Mix Age Triage Transport Time
Test t =Statistic −3.027 t = −10.222 t = −5.464 t = −5.241 t = −2.085 t = −3.027 u = 18,239 t = −5.464 u = 19,959 t = −2.085
df.37.52 44.15 738 43.55 685 37.52 738 685
p p ≤ 0.004 p ≤ 0.000 p ≤ 0.000 p ≤ 0.000 p ≤ 0.037 p ≤ 0.004 p ≤ 0.036 p ≤ 0.000 p < 0.000 p ≤ 0.037
Mean 11.4 Difference mmHg 7.28 scale points 17.8 years 8 per min. −3.78 min 11.4 mmHg 17.8 years −3.78 min
95% CI(Lower) 11.46 5.845 11.47 5 −7.14 11.46 11.47 −7.14
95% 57.7CI(Upper) 8.715 24.24 12 - 0.21 57.7 24.24 - 0.21
Skill Mix
u = 18,239
-
p ≤ 0.036
-
-
-
Triage u = 19,959 p < 0.000 As previously noted, HEMS teams have a wider scope of practice and involved, the potential for collinearity and amplification bias by means of
are able to initiate additional interventions such as RSI. More widely,
multiple comparisons using the same variables would risk Type I errors.
the huge variation in scope of practice between professions in different regions and countries [22] makes direct comparisons difficult. Although
As is the case with all uses of secondary data, analysis is constrained
pre-hospital timings were extended for HEMS teams, compared to land
by the fact that data are collected for purposes other than the
based teams, this study did not examine whether the presence of HEMS
researcher’s intentions [24]. Furthermore, the large number of personnel
improved timings for ongoing management such as time to theatre or
involved in data collection inevitably potentiates the risk of poor inter-
time to Computerised Tomography (CT) scan [23].
rater reliability [25]. Whilst mortality data serves as an absolute binary outcome measure, morbidity data is less tangible [26]. Further research
Significantly, within this study it was noted that those major trauma
is required in order to understand the utility of the predictor variables
casualties who were correctly triaged were more likely to have poorer
considered in this paper in predicting morbidity outcomes, especially in
outcomes. This finding may suggest that crews are using existing
the case of life-changing morbidity.
triage practices in order to correctly classify trauma severity. Whilst some patients are incorrectly over triaged and transported to a Major Trauma Centre and some major trauma patients inappropriately under triaged and transported to local hospital emergency departments, these eventualities did not appear to be statistically associated with significantly adverse outcomes. The tendency to over-refer casualties to Major Trauma Centres is perhaps an artefact of the precautionary principal in action.
Conclusions This study identifies that local pre-hospital major trauma predominantly affects the male population with the mean age of 38.5 years. Further research is required in order to more fully understand the predictive utility of age in determining major trauma outcomes and possibly to allow the generation of age-specific triage criteria.
Limitations
Contrary to current English ambulance performance targets, this study identified that there is greater predictive utility in relation to
The study was conducted during the spring and summer months and
outcome from physiological measures taken at the scene than
does not account for seasonal variations which may have affected
emergency services response times which, paradoxically, comprise key
mechanism of injury, available flying time (daylight in northern UK is
performance indicators for service delivery.
18 h in the summer and 6 h in winter) and driving conditions due to adverse weather during the winter months (snow and ice). There is a
Rather than interpreting this finding as a warrant for the therapeutic
strong likelihood of ecological and confounding relationships within the
nihilist instruction to abandon targets, we conclude that further analysis
current data set. Whilst bivariate analysis such as is reported above can
is required in order to establish the value of response characteristics in
reveal interesting associations, the large number of degrees of freedom
relation to morbidity outcomes and the alleviation of suffering.
Significant Variables the regression predictive model Table 3 Results from binarywithin logistic analysis of Wald ‘Status P Odds Ratio (alive/ predictorVariable variables for outcome at Discharge’ deceased) Step 3 GCS 39.662 p ≤ 0.000 1.587 (95% CI: 1.374–1.833) Significant Variables25.097 within the model Age p ≤predictive 0.000 0.923 (95% CI: 0.894–0.952) Variable Wald P Odds Respiratory Rate 11.553 p ≤ 0.001 1.165Ratio (95% CI: 1.067–1.272) Step 3 GCS
39.662 p ≤ 0.000 1.587 (95% CI: 1.374–1.833)
Age
25.097 p ≤ 0.000 0.923 (95% CI: 0.894–0.952)
Respiratory Rate 11.553 p ≤ 0.001 1.165 (95% CI: 1.067–1.272)
The authors tentatively suggest that given the lack of evidence for emergency services response characteristics as predictors of mortality outcomes, a ‘load and go and play on the way’ approach to patient transport might be advocated. Acknowledgements The researchers acknowledge the contribution of NEAS Research and Development Department, in particular the assistance of Paul Aitken-Fell and Sonia Byers for their expert support for and guidance in relation to
AMBULANCE UK - OCTOBER
Table 3 Results from binary logistic regression analysis of predictor variables for outcome ‘Status at Discharge’ (alive/ deceased)
the vagaries of the secondary data set analysed here.
187 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE The researchers wish to acknowledge the contribution of Joanne Gray,
Gary Shaw, Email: gary.shaw@neas.nhs.uk.
Reader in Health Economics, Northumbria University Newcastle for her
Matthew D Kiernan, Email: matt.kiernan@northumbria.ac.uk.
invaluable support in relation to statistical analysis undertaken. Author details North East Ambulance Service NHS Foundation Trust, Trauma Desk,
Funding
1
No funding was sought or obtained for this study.
Bernicia House, Goldcrest Way, Newcastle Upon Tyne NE15 8NY, UK. Northumbria University, Coach Lane Campus, Newcastle Upon Tyne
2
NE7 7XA, UK.
Availability of data and materials The dataset generated for patient outcomes during and/or analysed during the current study are available in the TARN repository available at: https://www.tarn.ac.uk/.
References
Various permissions may be sought via TARN to access the data. The
1. Sukumaran S, Henry JM, Beard D, Lawrenson R, Gordon MW,
specific data used in the study included all the Major Trauma Centre’s and Trauma Unit’s in the Northern Trauma Network. The pre-hospital data that supports the findings of this study are available from North East Ambulance Service (NEAS) NHS Foundation
O’Donnell JJ, Gray AJ. Prehospital trauma management: a national study of paramedic activities. Emerg Med J. 2005;22(1):60–63. doi: 10.1136/emj.2004.016873. 2. National Confidential Enquiry into Patient Outcome and Death.
Trust but restrictions apply to the availability of these data, which were
Trauma: who cares? : a report of the National Confidential Enquiry
used with their permission, and are not publicly available. Data are
into Patient Outcome and death (2007). London: National Confidential
however available from the authors upon reasonable request and with
Enquiry into Patient Outcome and Death (NCEPOD); 2007.
permission of NEAS.
3. National Audit Office . Major trauma care in England. London: National Audit Office; 2010.
Abbreviations CAD: Computer aided dispatch; CT: Computerised tomography; GCS: Glasgow coma score; HART: Hazardous access response team; HEMS: Helicopter emergency medical service; KPI: Key performance indicator; MERIT: Medical emergency response incident team; MOI: Mechanism of
4. Trauma Audit and Research Network: TARN. [https://www.tarn. ac.uk/]. Accessed 18 Aug 2017. 5. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC,
injury; MTC: Major trauma centre; NEAS: North east ambulance service;
Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M,
NHS: National health service; RSI: Rapid sequence induction; RTN:
S.I Strengthening the reporting of observational studies in
Regional trauma network; SBP: Systolic blood pressure; TARN: Trauma
epidemiology (STROBE): explanation and elaboration. PLoS Med.
audit research network; TBI: Traumatic brain injury; UK: United Kingdom
2007;4(10):e297. doi: 10.1371/journal.pmed.0040297. 6. Cox S, Morrison C, Cameron P, Smith K. Advancing age and trauma:
Authors’ contributions LT: lead author, collection analysis and interpretation of data. MH:
Triage destination compliance and mortality in Victoria, Australia.
Contributing author, mentor and analysis and interpretation of data. CD:
Injury. 2014;45(9):1312–1319. doi: 10.1016/j.injury.2014.02.028.
Data collection and proofreading. GS: Data collection and proofreading. MK: Ethics submissions, proofreading and editorial. All authors have read and approved the final manuscript.
7. Kehoe A, Smith JE, Bouamra O, Edwards A, Yates D, Lecky F. Older patients with traumatic brain injury present with a higher GCS score than younger patients for a given severity of injury. Emerg Med J. 2016;33(6):381–385. doi: 10.1136/emermed-2015-205180.
Ethics approval and consent to participate Not applicable. Ethical approval was granted by Northumbria University Research Ethics Review Panel.
8. Kehoe A, Smith JE, Edwards A, Yates D, Lecky F. The changing face of major trauma in the UK. Emerg Med J. 2015;32(12):911–915. doi: 10.1136/emermed-2015-205265.
Consent for publication
9. Lin G, Becker A, Lynn M. Changes in vital signs of trauma
Not applicable.
victims from prehospital to hospital settings. J Paramedic Pract. AMBULANCE UK - OCTOBER
2011;3(10):558–562. doi: 10.12968/jpar.2011.3.10.558.
Competing interests The authors declare that they have no competing interests.
10. Victorino GP, Battistella FD, Wisner DH. Does tachycardia correlate with hypotension after trauma? J Am Coll Surg. 2003;196(5):679–
Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
684. doi: 10.1016/S1072-7515(03)00128-5. 11. Ocak G, Sturms LM, Hoogeveen JM, Le Cessie S, Jukema GN. Prehospital identification of major trauma patients. Langenbeck’s
Contributor Information *Lee Thompson, Email: lee.thompson5@nhs.net. Michael Hill, Email: michael.hill@northumbria.ac.uk. Caroline Davies, Email: caroline.davies@neas.nhs.uk.
Arch Surg. 2009;394(2):285–292. doi: 10.1007/s00423-008-0340-4. 12. MacLeod JBA, Maurico L, McKenney MG, Jeroukhimov I, Cohn SM. Predictors of mortality in trauma patients. Am Surg. 2004;70(9):805–810.
188 For more news visit: www.ambulanceukonline.com
FEATURE 13. Spaite DW, Hu C, Bobrow BJ, et al. Mortality and prehospital blood
20. Harmsen AMK, Giannakopoulos GF, Moerbeek PR, Jansma
pressure in patients with major traumatic brain injury: implications
EP, Bonjer HJ, Bloemers FW. The influence of prehospital
for the hypotension threshold. JAMA Surg. 2017;152(4):360–368.
time on trauma patients outcome: a systematic review. Injury.
doi: 10.1001/jamasurg.2016.4686.
2015;46(4):602–609. doi: 10.1016/j.injury.2015.01.008.
14. Turner J, O’Keeffe C, Dixon S, Warren K, Nicholl J. The costs and
21. Lerner EB, Moscati RM. The golden hour: scientific fact or medical
benefits of changing ambulance service response time performance
“urban legend”? Acad Emerg Med. 2001;8(7):758–760. doi:
standards. Sheffield: University of Sheffield; 2006.
10.1111/j.1553-2712.2001.tb00201.x.
15. Starr P. The politics of therapeutic nihilism. The new critics of medical care. Hast Cent Rep. 1976;6(5):24–30. doi: 10.2307/3561255. 16. Carr BG, Caplan JM, Pryor JP, Branas CC. A meta-analysis of prehospital care times for trauma. Prehosp Emerg Care. 2006;10(2):198–206. doi: 10.1080/10903120500541324. 17. Carr BG, Brachet T, David G, Duseja R, Branas CC. The time cost of prehospital intubation and intravenous access in trauma patients. Prehosp Emerg Care. 2008;12(3):327–332. doi: 10.1080/10903120802096928. 18. Di Bartolomeo S, Valent F, Rosolen V, Sanson G, Nardi G, Cancellieri F, Barbone F. Are pre-hospital time and emergency department disposition time useful process indicators for trauma care in Italy? Injury. 2007;38(3):305–311. doi: 10.1016/j.injury.2006.10.005. 19. Dissmann PD, Le Clerc S. The experience of Teesside helicopter emergency services: doctors do not prolong prehospital on-scene times. Emerg Med J. 2007;24(1):59–62. doi: 10.1136/emj.2006.038844.
22. Eckstein M, Chan L, Schmeir A, Palmer R. Effective prehospital advanced life support on outcomes of major trauma patients. Am J Emerg Med. 2000;19(5):439–440. 23. Garner AA, Mann KP, Poynter E, Weatherall A, Dashey S, Puntis M, Gebski V. Prehospital response model and time to CT scan in blunt trauma patients; an exploratory analysis of data from the head injury retrieval trial. Scand J Trauma Resusc Emerg Med. 2015;23:28. doi: 10.1186/s13049-015-0107-1. 24. Bulmer M. Why Don’t sociologists make more use of official statistics? Sociology. 1980;14(4):505–523. doi: 10.1177/003803858001400401. 25. Cicchetti DV. Assessing inter-rater reliability for rating scales: resolving some basic issues. Br J Psychiatry. 1976;129(5):452–456. doi: 10.1192/bjp.129.5.452. 26. Bowling A. Measuring health: a review of quality of life measurement scales. Maidenhead: Open University Press; 2004.
WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues. Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc.
If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com
AMBULANCE UK - OCTOBER
All submissions should be forwarded to info@mediapublishingcompany.com
189 Do you have anything you would like to add or include in Features? Please contact us and let us know.
DATES FOR Y
LIFE CONNEC
MORE CHOICE - GREAT VALUE -
We are pleased to announce our plans for Life Connections 2019 are taking shape and that each of our one day regional events have plenty to offer those wishing to attend. The venues chosen were selected to prevent delegates having to factor in travelling time and costs. Next years one day events are being held in:
Harrogate - Thursday March 28 Edinburgh - Thursday May 16 (provisional date) Bristol - Thursday June 20* Kettering - Thursday October 10 (provisional date) Stoke on Trent - Thursday November 28 (provisional date) First Responder Conference - This Half Day morning Conference will include presentations requested by First Responders, suggested topics include: sepsis, the changing role of the first responder and diabetic emergencies. Sponsored delegate rate: £24 to include VAT, lunch/ refreshments, etc. ONLY 50 PLACES AVAILABLE. FIRST AID Conference - Life Connections are working with Ian Kershaw MBE from The First Aid Industry Body (FAIB) and the Federation of first Aid Training Organisations (FOFATO) and, Rob Shaloe (QNUK) to present 5 Full Day First Aid Conferences in 2019. Each conference will include a number of topical First Aid presentations and workshops as requested by Members of FAIB, FOFATO and QNUK to ensure that they are both relevant and topical. - Usual Member rate of £96 (Including VAT), Lunch and Refreshments provided. ONLY 60 PLACES AVAILABLE. Ultrasound Workshop - Supported by NEMUS Education and Training, a very experienced faculty who have experts in the field of Ultrasound, this full day Workshop is covering the common uses of Ultrasound in contemporary Pre Hospital and Hospital Practice. It is suitable for all Healthcare Professionals especially Paramedics, other AHPs and Nurses as this course is covering FAST Scanning, Focused AAA, Echo and life support, How to diagnose a pneumothorax with Ultrasound, Vascular Access, Basic Ultrasound Science, Reporting, Training and Governance plus Lots of Hands on Scanning - Delegate rate: £90 to include VAT, lunch/refreshments, etc. ONLY 40 PLACES AVAILABLE.
Bariatric Workshop - this half day afternoon workshop is being run by Outreach Rescue and is focusing on dealing with Bariatric Patients. The workshop will be looking at tripods, bipods and other lifting systems that can be used for the extrication of casualties or Bariatric patients from a wide range of locations including domestic situations and RTC’s. The emphasis will be on safe assembly and operation of equipment, minimising manual handling issues and, patient care and safety. Practical demonstrations and discussions will also be included in this workshop: Delegate rate: £60 to include VAT lunch/ refreshments, etc. ONLY 40 PLACES AVAILABLE. Trauma Management Workshop - Created by Pre-Hospital Care Consultancy, this two hour morning Workshop will be covering: Basic to Advanced Trauma Skills and include Trauma Patient Assessment, Catastrophic Bleeding, Splintage Skills, etc. Delegate rate: £60 to include VAT lunch/refreshments etc. ONLY 12 PLACES AVAILABLE.
To view all Conferences / Workshops please visit: www.lifeconn
w w w. l i f e c o n n e
YOUR DIARY
CTIONS 2019
- SOMETHING FOR EVERYONE!!!
Airway Management Workshop - Created by Pre-Hospital Care Consultancy, this two hour afternoon Workshop is covering: Basic to Advanced Airway Skills and will include Positioning, BVM and Basic Adjuncts Done Well!, Direct and Video Laryngoscopy, Emergency Surgical Airway, etc. Delegate rate £60 to include VAT lunch/refreshments, etc. ONLY 12 PLACES AVAILABLE. Attend both the Trauma and Airway Management Workshops for a special combined rate of £96 (saving £24!). Haemorrhage Control - Stepwise Approach Workshop* This half day workshop will be running both morning and afternoon, covering: What is Catastrophic Bleeding?, Changes to Guidelines FPHC, JRCALC, ERC, etc., Coagulopathy, Correct use of Direct Pressure, Use of Pressure Dressings & Their Limitations, Haemostatic Devices and the Safe and Effective Use, Tourniquets - The Safe and Effective Use. Delegate rate £36 to include VAT, lunch, refreshments, etc. ONLY 10 PLACES AVAILABLE ON AM & PM WORKSHOPS Combined Conference / Workshop Offer 1. Attend the First Responder Half Day morning Conference plus an afternoon Airway Management or Outreach Rescue Workshop for a special combined rate of £72 (saving £12).
*Bristol Thursday June 20 This event will include all of the Conferences / Workshops mentioned previously with the following additional workshop being added: 7 ways to die in cold water - latest concepts in drowning, immersion, submersion and hypothermia and their associated treatments. Delegate rate £60 to include VAT lunch/refreshments etc. ONLY 12 PLACES AVAILABLE AM AND PM. Combined Conference / Workshop Offer 1. Attend the First Responder half day morning conference and choose from an afternoon Airway Management, Outreach Rescue or 7 Ways to Die in Cold Water workshop - for a special combined rate of £72 (saving £12) 2. Attend the morning Trauma workshop plus an afternoon 7 Ways to Die in Cold Water or Outreach Rescue workshop for a special combined rate of £96 (saving £24)
2. Attend the First Responder half day morning conference plus the afternoon Haemorrhage Control workshop for a special combined rate of £48 (saving £12).
3. Attend the 7 Ways to die morning workshop plus an afternoon Airway Management or Outreach Rescue Workshop for a special combined rate of £96 (saving £24)
3. Attend the morning Haemorrhage Control workshop** plus the afternoon Outreach Rescue or Airway Management workshops for a special combined rate of £72 (saving £24)
** T his workshop will only take place in Harrogate and Kettering.
nections.uk.com or call the Organisers Office on: 01322 660434
ctions.uk.com
NEWSLINE SWAST
Weymouth dad meets lifesaving team
At a special event in Weymouth on Thursday 23 August, Pat met the SWASFT team who managed to restart his heart.
absolutely amazing. We’re so thankful to them.” SWASFT Emergency Medical Dispatcher, Tracy Guilfoyle,
A Weymouth dad has met a South Western Ambulance Service NHS Foundation Trust (SWASFT) emergency response team who saved his life when he had a cardiac arrest. Pat Moss, 56, was at home on Easter Sunday when his heart suddenly stopped beating. His wife, Anne, heard him gasping for air and called 999. With guidance from SWASFT Control Room staff and assisted by her daughter Lauren, Anne carried out vital chest compressions to keep Pat alive.
“It came totally out of the blue,” he said. “I was dead and gone. Without the caller handler, paramedics and hospital staff, I wouldn’t be here. I’m chuffed with all the care I received. It’s amazing to still be alive.” The former Royal Navy chief petty officer was relaxing on the sofa when he experienced breathing difficulties. He became unresponsive, and blood was seen coming from his mouth.
assessed Pat’s condition through a phone conversation with the family. Tracy then instructed Anne and Lauren to do cardiopulmonary resuscitation (CPR) to give Pat the best chance of survival. SWASFT Paramedic, Nigel Cowan, Emergency Care Assistant, Joanne Brown, and St John Ambulance volunteer Community First Responder, Jon Ashworth, arrived within seven minutes. They were supported by SWASFT Paramedic, Ennio
Anne said: “Our chilled-out Sunday turned into a nightmare. But the ambulance staff were
The crews provided lifesaving support, including defibrillation, to get his heart beating again.
Tabone; Emergency Care Assistant, Allan Rodd; and Specialist Paramedic, Jim Bradley.
AMBULANCE UK - OCTOBER
192 For more news visit: www.ambulanceukonline.com
Patrick was driven by ambulance to Dorset County Hospital where he remained for six weeks. He has gone on to make a fantastic recovery, and has now returned to work. Jeff Jones, West Dorset Operations Officer and Weymouth station officer, said: “I am delighted for Pat and his family, that Pat has made such a good recovery. This is part due to early and effective CPR carried out by his wife Anne, and a prompt and rapid intervention by SWASFT staff performing advanced life support, to complete the chain of survival. Pat’s incident highlights that with more people trained and confident to perform CPR, the better the chances of survival.”
NEWSLINE
BRAYDEN JUNIOR
Now you can have two Brayden manikins in one!
Special Introductory Offers – Contact us now! • Order the Brayden Junior conversion kit
Email: Braydenjunior@welmedical.com
Supplied by
✔ Cost Effective practical and convenient ✔ Anatomically correct ✔ AHA and ERC compliant
AMBULANCE UK - OCTOBER
• Buy a complete package – Brayden plus Junior
✔ Easy to convert Brayden Adult to Brayden Junior
For more information, please see 193 For all your equipment needs visit: www.ambulanceservicesuppliers.com www.brayden.co.uk/junior
NEWSLINE Scotland and Microsoft, in
immediate access to the location
the best possible chance of
British Heart Foundation, Microsoft and the NHS join forces to save thousands more lives from cardiac arrests
partnership with solutions
of defibrillators in their areas, so
receiving early defibrillation if it’s
provider New Signature, will
they can direct bystanders to
required prior to the ambulance
now work together over the
their nearest life-saving device in
services arrival, which is proven
next 12 months to develop
the event of a cardiac arrest.”
to save lives.”
defibrillators across the UK that
Clare Barclay, Chief Operating
Pauline Howie, Chief Executive
can be used by ambulance
Officer, Microsoft UK, said:
of Scottish Ambulance Service,
is expected to help save lives
“There is huge potential ahead
Public defibrillators to be
every day right across the
in the impact that technology
“The role of the public in
country.
will have in digitally transforming
a cardiac arrest scenario
mapped as figures show they’re used in less than 3% of
a comprehensive network of
services. The pioneering project
said:
UK healthcare. This innovative
cardiac arrests
The move is part of a
partnership will bring the power
coordinated strategy between
of Microsoft technology together
Thousands more lives could
the BHF, NHS and other leading
with the incredible vision and
health organisations to improve
life-saving work of BHF and the
the UK’s poor cardiac arrest
NHS. This project, powered by
survival rates by increasing
the cloud, will better equip 999
the application of CPR and
call handlers with information
Microsoft and the NHS.
defibrillation to patients, and
that can make the difference
improving post-resuscitation
between life and death and
The partners are joining forces to
care. There are over 30,000
shows the potential that
out-of-hospital cardiac arrests
innovative partnerships like this
every year in the UK, but less
could make to the health of the
than 1 in 10 people survive. In
nation.”
be saved from cardiac arrests, thanks to a ground-breaking partnership between the British Heart Foundation (BHF),
map all of the UK’s defibrillators, with a shared ambition for the life-saving devices to be made readily available for every out-of-
countries where the public are better equipped to recognise
Professor Stephen Powis,
and deal with cardiac arrests,
national medical director for
The initiative is in response
survival rates are up to three
NHS England, said:
to shocking figures that show
times higher.
hospital cardiac arrest.
“Preventing heart failure and
public access defibrillators are used in less than 3 per cent of
Simon Gillespie, Chief Executive
other cardiovascular illness is
out-of-hospital cardiac arrests,
at the British Heart Foundation,
a priority for the NHS ten year
significantly reducing the survival
said:
plan. This innovative partnership will help people in every part of
chances of tens of thousands of “Every minute without CPR or
the country to access life-saving
defibrillation reduces a person’s
equipment, and will support
One of the biggest barriers
chance of surviving a cardiac
NHS staff and the public when
to their use is the location of
arrest by around 10 per cent.
attempting to save the lives of
these devices is often unknown
Thousands more lives could
the 30,000 people each year
to bystanders and ambulance
be saved if the public were
who suffer cardiac arrest out of
services, despite tens of
equipped with vital CPR skills,
hospital.”
thousands of defibrillators
and had access to a defibrillator
being placed prominently in
in the majority of cases.
people every year [1].
Ambulance services aim to get to cardiac arrests, the ultimate medical emergency, as quickly as possible. But every minute counts, meaning CPR and public access defibrillators provide a lifeline for victims.” When the network is launched, defibrillator owners, or ‘guardians’, will be invited to register their defibrillator online. The system will encompass detailed locations of defibrillators across the UK, which will allow Ambulance Services to direct bystanders of a cardiac arrest to the nearest one. It will also act as a network so that defibrillator guardians can support each other in the maintenance of these lifesaving devices. The network will be piloted by West Midlands Ambulance Service and the Scottish Ambulance Service, before being rolled out across the UK.
NIAS
Anthony Marsh, Chief Executive of West Midlands Ambulance
workplaces, train stations,
should not be underestimated.
AMBULANCE UK - OCTOBER
Northern Ireland Paramedics get formal recognition as Allied Health Professionals (AHP)
leisure centres and public
“Over the last five years
Service and CEO of the
places across the country. The
we’ve made great progress
Association of Ambulance Chief
BHF says this is leading to a
in introducing CPR training in
Executives, said:
needless loss of lives, as 999
more schools. We now need to
call handlers are unable to direct
improve access to the tens of
“We are delighted that the region
bystanders to their nearest
thousands of public defibrillators
of West Midlands Ambulance
defibrillator when someone
across the UK. These life-saving
Service will be leading the way
Paramedics have been
suffers a cardiac arrest.
devices can provide a vital
in this innovative collaboration.
formally recognised as
lifeline for cardiac arrest victims
It’s absolutely critical that we
members of the Allied Health
Combining their expertise in
until ambulance services arrive.
are able to direct cardiac arrest
Professional (AHP) group
technology and healthcare,
This innovative project will
bystanders to their nearest
by the Department of Health
the BHF, NHS England, NHS
give every ambulance service
defibrillator. This gives patients
(DoH).
194 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE The move follows recent
daily, the first contact that
discussions with the
many patients have with the
Department of Health
Health Service and often at
Permanent Secretary Richard
times when they are most
Pengelly, DoH officials and the NI Ambulance Service (NIAS). Richard Pengelly welcomed the change. “Formal recognition of paramedics in Northern Ireland is essential to professionalise
anxious and vulnerable, including requiring the highest levels of clinical intervention due to trauma or medical emergencies. Paramedics are increasingly bringing the initial
the profession so paramedics
treatment to the patient at the
know just how much they are
scene of the emergency.
valued as members of the Health Service.
“This recognition is testament to the increasing role of
“This recognition will align
paramedicine in the provision
paramedics with other AHP
of health and social care within
colleagues and their peers
Northern Ireland. Paramedic
in the rest of the UK, and recognise the contribution paramedics currently make as inter-professional clinicians working across urgent, emergency, primary and community care provision here.
Education has been evolving, and will continue to evolve, as part of the transformation agenda ensuring that those who have need of our service can be confident that their clinical care is delivered
“This change is also in line
by individuals and teams
with the values within the new
operating to the highest
DoH Workforce Strategy. It is
professional standards.
important that paramedics feel supported in their challenging
“I congratulate all paramedics
roles and this move will assist
on having attained this
in that. “Over recent years paramedics have taken responsibility for greater clinical decision making and are providing an increasing range of
recognition, which brings them into line with colleagues across the UK, and would like to thank everyone involved in bringing about this AHP recognition.”
interventions as part of the
The Allied Health Professions
wider transformational agenda.
(AHP) currently consists of
This is being underpinned by
12 distinct Hazel Winning,
the move to Higher education
the AHP lead in DoH who has
for paramedic practice. By
worked with NIAS to deliver
including paramedics as
this recognition, said: “The
AHPs will enable them to
professional recognition
the wider group of other AHP professions.” Michael Bloomfield, Chief Executive of Northern Ireland Ambulance Service, also
decision would bring
Video laryngoscopy wherever and whenever you intubate i-view is the new, single use, fully disposable video laryngoscope from Intersurgical, providing the option of video laryngoscopy wherever you might need to intubate.
opportunities across the health service and has the potential to influence patient pathways
www.intersurgical.co.uk/info/iview
and make huge differences to patients’ lives. It can help
welcomed the recognition of
make use of skills to develop
paramedics as Allied Health
a more flexible workforce
Professionals. He said:
and provide more responsive
““Paramedics are, day and
services to service users.”
AMBULANCE UK - OCTOBER
expand their networks within
i-view™ video laryngoscope
Quality, innovation and choice
195
NEWSLINE SECAMB
sugar levels and messaging to a
SECAmb work recognised with HSJ Awards shortlistings
patient’s GP when treated at home.
A system which supports communication and collaborative working between the ambulance service and community care teams has been shortlisted for a prestigious Health Service Journal (HSJ) Award.
to more than 43,000 patient care
The system, which was introduced by SECAmb in 2011, also provides ambulance clinicians with access plans. Previously in SECAmb, staff would need to speak to a colleague in the 999 control room to access IBIS on their behalf and ‘relay’ information over the phone. The week of the system being made available on personal issue
South East Coast Ambulance Service’s (SECAmb) work to develop their Intelligence Based Information System (IBIS) to enable frontline clinicians access to patient care plans and complete community referrals on mobile iPad tablet devices, is shortlisted in the ‘Enhancing Care by Sharing Data and Information’ category.
iPads, in October 2017, saw its use
IBIS has several functionalities including falls risk assessment/ referral to community falls teams, notification to community diabetes teams for patients with low blood
in the ‘Community or Primary Care
more than quadruple. SECAmb, with Surrey Heartlands Health and Care Partnership, has also been shortlisted the work it has done in developing a new Pregnancy Advice Line. The advice line, which is shortlisted Services Redesign - London and
Launched in April this year, the advice line has taken more than 9,000 calls. It enables pregnant women to access advice and support 24 hours day, seven days a week from a midwife. The line is available for women under the care of Royal Surrey County Hospital, Ashford and St Peter’s Hospitals and Epsom and St Helier Hospitals during pregnancy, labour and following the birth of their baby. SECAmb Operations Manager and IBIS lead, Tom Pullen, said: “It’s really great to see SECAmb shortlisted in these prestigious awards, recognising the Trust’s continuing hard work to provide urgent care to patients using a joined up approach. Electronic sharing of patient information between care providers has historically been a challenge for all NHS ambulance services.”
issue iPads has improved both efficiency and information governance. Accessing IBIS at the patient’s side is supporting our clinicians to deliver tailored and safe care to patients, meeting their individual needs and wishes, at home or in the community.” Tom’s colleague and fellow EOC Operations Manager, Mark Haydon, added: “We’re really pleased to be have been involved in the setting up of the Pregnancy Advice Line, which has already helped so many women and is a great example of collaborative working in the NHS. I’d like to thank everyone in our team and the Surrey Heartlands partnership who have worked so hard.” Following a judging panel in early October, the winner will be announced at the awards ceremony on Wednesday 21 November 2018.
the South’ category, is based in SECAmb’s Emergency Operations Centre (EOC) in Crawley.
“The work to make the system available to staff on personal
AMBULANCE UK - OCTOBER
196 For more news visit: www.ambulanceukonline.com
Further information on the awards is available at https://awards.hsj.co.uk
NEWSLINE London’s Air Ambulance launch brand new digital campaign for National Air Ambulance Week
Stop, We Stop” will run across
“To deliver our life-saving work we
work of local air ambulance charities
social media platforms during
have to reach more supporters
across the UK giving them a national
National Air Ambulance Week to
and build bigger awareness of our
voice and an opportunity to promote
raise awareness of London’s Air
charity. We hope that this very
the work they do at a local level.
Ambulance’s charitable status.
targeted campaign will help us do
The creative emphasises the
this by growing followers across
urgency of the charity’s mission
Facebook and LinkedIn and
to save lives, whilst reminding its
securing a high engagement with
SECAMB
audience that if they stop donating
our campaign content. This is the
“You Stop We Stop” will highlight
the service will stop running. The
first time London’s Air Ambulance
that London’s Air Ambulance
video can be viewed at https://
has delivered a campaign of this
is a charity that relies on public
www.facebook.com/LDNairamb/
nature and we are excited to see
donations to operate;
videos/1771713006274920/.
how it is received.”
Trust praises staff and emergency service colleagues following Swanley coach crash
• First campaign of its kind for
The charity have chosen to focus
“You Stop We Stop” will focus on
South East Coast Ambulance
London’s Air Ambulance, who
on the concept of “time” for the
Facebook and LinkedIn as they
worked with digital agency
creative materials. It is hoped that
are two platforms that show huge
Zeal to produce the creative
the campaign will make its audience
potential for the charity in terms of
concept;
question if they could afford to wait
targeting those people most likely
if they needed the air ambulance
to support us.”
• The campaign will be highly
and it wasn’t there. London’s Air
targeted focusing on Facebook
Ambulance can be airborne in four
London’s Air Ambulance treats
and LinkedIn to grow social
minutes of a trauma call being
on average five critically injured
media following and increase
received and has an average flight
people in London each day, who
brand awareness of the charity.
time of 6.7 minutes; any longer
otherwise would not survive the
could be the difference between
journey to hospital. We carry out
London’s Air Ambulance today
life and death. It costs £10million
surgery on scene that is usually
launches a brand new digital
to deliver the service the majority of
only found in the accident and
campaign highlighting that without
which comes from fundraising.
emergency department.
Director of Marketing and
National Air Ambulance Week is an
Communications Louise
initiative led by the Association of
Robertshaw said;
Air Ambulances and celebrates the
public donations the lifesaving service would cease to operate. The campaign, called “You
Service, (SECAmb), would like to thank it staff and emergency service colleagues for their professionalism and actions in responding to an incident on the M25 at Swanley on August 13th. The incident, which saw a total of 49 patients, including 10 children, taken to hospital, was declared a major incident and saw SECAmb send a significant number of vehicles to the scene, including both of its Hazardous Area Response Teams, critical care paramedics and paramedic practitioners. The air ambulance service also landed at the incident but no one required transporting to hospital by air. SECAmb incident commander and Operating Unit Manager Will Bellamy said: “This was obviously a significant incident which drew a lot of crews to the scene. Our thoughts are with everyone involved and we wish them a good recovery. “I was very pleased with the way we responded to the incident and the way we put our well-rehearsed plans into place. I would like to thank both in our emergency operations centres and out on the road for their professionalism in providing patients with the treatment they required. “I’d also like to highlight the good team work between all the emergency services to manage what was, of course, a
AMBULANCE UK - OCTOBER
every member of staff involved,
challenging incident.”
197 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE five involving knives, two involving
Assaults can have a huge
to a decline in confidence, a
firearms and three involving racial
impact on our ambulance
skilled professional leaving
abuse.
crews, including injuries from the
the ambulance service, and a
incident, and stress, emotional
reduction in the quality of service
Mark Ward, Security Management
and psychological issues in
provided for our communities.
Specialist for EMAS, said: “We
the longer term which can
welcome this development and I
affect home life. On occasions
hope the increase in sentencing
when assaults have involved
will act as a greater deterrent to
spitting where spit has gone
Offenders who assault our
anyone who thinks of lashing out
into our staff’s eye or mouth, the
ambulance crews will face a
at our crews.
ambulance crew have to attend
EMAS
We welcome increase in prison sentence for those who assault our crews
doubled prison sentence thanks to a new bill approved by
“Assaults on our staff are
government.
absolutely unacceptable and we
NWAS
Everybody needs good neighbours
A&E for blood tests and may need
Returning from a walk with the
to take a course of antibiotics.
dog turned into a nightmare for Robert Marsden, 43 from
take a zero tolerance approach
Assaults can impact on the level of
Freckleton and his wife Rachel
The maximum prison sentence
towards anyone who verbally,
service that we can provide too. After
when Robert suddenly collapsed
for a common assault has now
physically or sexually assaults
an incident we take our staff off duty
and suffered a cardiac arrest just
increased from six months to one
them.
so that their injuries can be treated,
eight weeks ago.
they receive the support they need,
year, if the victim is a member of the emergency services. In
“Our frontline colleagues, the
and can make a statement to the
Luckily, Rachel lived just down
addition, sexual assaults will
team in our 999 control room and
police. This means the number of
the road from Geoff Hamriding,
also be added to the law as
our volunteers spend their days
ambulances available to respond to
Paramedic for North West
aggravating features of attacks.
helping the public. They deserve
emergencies in the East Midlands
Ambulance Service, and quickly
to be treated with respect and
reduces.
ran to call him for help.
Since April this year, our
we will continue to work with the
dedicated frontline staff have
police and the Crown Prosecution
Ultimately, an assault experienced
Geoff sprung into action and
reported 476 assaults, including
Service to prosecute those who
by one of our crews while trying
began CPR immediately whilst
five incidents involving spitting,
abuse our them.”
to help someone can lead
Rachel dialled 999 where she was
WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues. Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc. AMBULANCE UK - OCTOBER
All submissions should be forwarded to info@mediapublishingcompany.com
If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com
198 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE directed by Emergency Medical
Paramedic, Geoff Hamriding,
Dispatcher, Frank Cerra, to a
said: “I was shocked when Rachel
nearby public access defibrillator.
banged on my door, it was really lucky because I had just got home
Thankfully after four shocks from
from being out but I didn’t hesitate
the defibrillator and ongoing CPR,
to rush to help.
Robert began breathing again and was rushed to Blackpool Victoria
“Early CPR and defibrillation is
Hospital where he was given
vital in these circumstances as
a stent procedure and allowed
every single second counts in
home just three days later.
saving a life!”
Speaking about the incident
Robert and Rachel live just a
Rachel said: “I didn’t know
stone’s throw away from the
Geoff that well but we said hello
nearest public access defibrillator
in passing and I knew that he
and by dialling 999 they were
worked for the ambulance service.
able to get the access code and information from the call handler.
“I shot over as quickly as I could and banged on his door so hard to get
Frank Cerra, Emergency Medical
him to come as soon as possible.
Dispatcher, said: “Rachel was so calm and collected on the phone, it’s
“It was an extremely frightening
an extremely traumatic experience
situation but Robert and I are so
for anybody to go through but by
thankful to Geoff and the team at
staying calm and listening to my
NWAS for saving Robert’s life. The
instructions we were able to quickly
work that they do is truly fantastic.”
get the defibrillator and give Robert the best possible chance.
Robert and his wife Rachel was able to reunite with Geoff and call
“As a call handler, it’s very rare for
handler, Frank, this week at Lytham
us to get the chance to meet our
Ambulance Station where they
patients and it’s amazing to be
thanked the team for their actions.
able to see Robert so fit and well.”
Mark Lewis, Operations Manager for Fylde, said: “It’s so important that members of the public know what to do in the event of a cardiac arrest, we will always get there as quickly as we can but even the minutes that we’re on the way can cost vital time. “It’s an absolutely fantastic outcome for Robert, and we thank him for allowing us to share his story and show people that early CPR and defibrillation really does save lives.” SECAMB
Trust celebrates diversity with largest ever turnout for Pride A huge turnout from South East Coast Ambulance Service (SECAmb) staff, volunteers and representatives from other ambulance services nationally, saw record numbers walk for the Trust in the Brighton and Hove Pride parade on Saturday 4 August. A total of 187 people walked alongside a specially-decorated ambulance, kindly sponsored by the Trust’s Unison and GMB unions.
The Trust also experienced a busy weekend operationally with staff in its Emergency Operations Centres and ambulance crews on the road working hard to respond to patients. The continued hot weather saw SECAmb handle some 6,400 calls over the weekend (August 4-5) across its region of Kent, Sussex and Surrey. SECAmb would like to thank everyone who cheered on its representatives in the Pride parade as well as its operational staff and volunteers who worked throughout the busy weekend. Chair of Pride in SECAmb Will Bellamy said: “We had an amazing turnout for the parade and the support of the community was very touching. It was great to be joined by colleagues from other ambulance services and NHS organisations as the NHS celebrated its 70th year. We’re very proud of the diversity of SECAmb and it is right that we celebrate it.” Paramedic and Clinical Supervisor Ruth Copeman-Barnes said: “I have never worked for such an inclusive employer, and this is displayed through the diverse workforce and by the wonderful participation in the Brighton Pride parade. Marching as a NHS Paramedic holding my wife’s hand is the proudest feeling ever and in turn makes me so very proud to work for SECAmb.”
Operating Unit Manager for Brighton, Tim Fellows added: “We know that Pride weekend is always very busy and with the hot weather added in our staff and volunteers worked especially hard. I’d like to thank everyone for their dedication and professionalism.
AMBULANCE UK - OCTOBER
SECAmb Community First Responder Beverly-Jayne Last said: “With 187, we were the biggest entrant in the parade and received the warmest love and support from the crowds. I am honoured and proud to be a volunteer with SECAmb and to walk alongside such dedicated and hardworking colleagues.”
199 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE HELP Appeal helps to fund new helipad upgrade at Raigmore Hospital, Inverness With over 500 flights each
Robert Bertram, Chief Executive
time and life saving facility on
The South Western Ambulance
of the HELP Appeal said: “The
which the entire population of
Service Charity (SWAC) was
upgrade of Raigmore Hospital’s
the Highlands and Islands may
awarded £2,235 from Tesco’s
helipad is now our seventh project
depend, not only due to the
Bags of Help scheme, which will
in Scotland, with hospital helipads
enormous area served by NHS
enable the Ilfracombe Community
in Glasgow, Edinburgh and four
Highland but also the distance
First Responders (CFRs) to
Highland and Island helipads
covered and the remote locations.
enhance the level of patient care
under the charity’s belt.
they deliver. “I am very grateful for these
year it’s quite common to see
“The HELP Appeal is committed
helicopters arriving and taking
to ensuring that this helipad is fit
off from the helipad based at
for purpose, so patients can land
Raigmore Hospital in Inverness
safely and quickly, to access the
and this much used facility is
emergency care they urgently
about to undergo an upgrade.
need. This is why there was no hesitation in completing the
The upgrade will allow the helipad
funding required for this much
to meet the increasing demands
needed upgrade.”
of larger and more frequent aircraft use as well as new
Dr Andrew Rowlands, consultant
standards such as landing lights.
in emergency medicine and clinical lead for the Emergency
donations which will ensure the helipad we have on site is fit for the future.” The work is expected to be completed by November 2018.
The funding will provide lifting devices for responders to use on patients who have had non-injury falls, but are unable to get up. It will also be used to purchase other medical equipment, including blood pressure monitors
SWASFT
Coastal resort to benefit from SWASFT charity funding
and thermometers. Ryan Ware, SWASFT Community Responder Officer for Devon, said: “We are delighted to receive
At a cost of just under £600,000
Department, explained that the
this upgrade is available thanks to
helicopter is an essential feature
A seaside resort is being
us to further support the local
two charitable donations.
for Raigmore and NHS Highland
promised even better
community in a robust and safe
and the investment into upgrading
emergency care after the
way. The new equipment we can
A financial grant of £480,000 has
the helipad will benefit the entire
South Western Ambulance
now purchase will be a great
been offered to NHS Highland
population.
Service NHS Foundation
investment for Ilfracombe.
this funding which will enable
Trust (SWASFT)’s charity
from the HELP Appeal – the only charity in the country dedicated to
He said: “The helipad at Raigmore
won significant funding for a
“Our volunteers give their time freely
funding hospital helipads.
Hospital serves as an essential
community responder team.
to help support SWASFT and our
AMBULANCE UK - OCTOBER
200 For more news visit: www.ambulanceukonline.com
NEWSLINE patients; and this funding will help
Our charitable support covers
Alexis Percival, Environmental
vehicles will run for a year and
them to provide more enhanced
Cornwall and the Isles of Scilly,
and Sustainability Manager at
details of air quality savings will be
care for those in need. Thank you to
Devon, Dorset, Gloucestershire,
YAS, said: “We are so excited
published early in 2019.
everyone who voted for us.”
Somerset and Wiltshire including
to have another world first for
Bristol and Swindon.
an ambulance service to have a
Amanda Lyne, Chief Executive of
hydrogen dual-fuel vehicle in our
ULEMCo, said: “The conversion
fleet.
of the Peugeot Boxer is our first
The Bags of Help scheme sees grants of up to £5,000 – raised
We are funded by donations
from the 5p bag levy – being
and legacies received primarily
awarded to local community
from patients, and their relatives,
“As a public sector organisation,
and shows how flexible our
projects every month. Customers
who wish to say thank you for
we have a responsibility to reduce
dual-fuel technology is to deliver
vote for a local project using a
the care that they, or their loved
our exhaust emissions to improve
practical solutions to emission
token given to them at a store
one, has received from us. In
the health of the people we serve,
reduction.
check-out.
addition, members of the public
and this vehicle takes us further
donate to our charity to show their
down the road to zero emissions.
“We are focused on offering
appreciation for the Trust.
We are looking to expand our zero-
technology to operators that can
emission fleet, as Clean Air Zones
be on the road now and this is
are launched across the region.”
a great example of an essential
The lifting equipment enables responders to move non-injury
example of this make of vehicle,
falls patients from the floor to
If you would like to show your
a sitting or standing position.
appreciation for the care that
The scheme is intended to
you or your loved one has
Chris Dexter, Managing Director
without impacting on service or
received from us in the form of
of the Patient Transport Service
requiring significant change to its
a charitable donation please
at YAS, added: “We are looking
operation.”
visit our online giving website:
forward to testing this technology
http://uk.virginmoneygiving.com/
in our fleet and seeing how we
Meanwhile, YAS is working with
charities/SWASC
can work towards becoming a
ULEMCo to build a prototype
zero-emission fleet for the future.
hydrogen-electric emergency
SWAC is a registered charity in
This heralds the start of a new era
ambulance which will have zero
England and Wales (1049230).
in patient transport.”
emissions.
The vehicle conversion has been
YAS has already introduced
part-funded by the Government’s
several other initiatives to reduce
Office for Low Emission Vehicles
its carbon footprint, which
(OLEV) and Innovate UK,
include installing solar panels
alongside six other partners,
on more than 100 ambulances
to demonstrate the potential of
to keep their batteries charged,
hydrogen dual-fuel vehicle fleets
aerodynamic light bars, greener
to reduce emissions. These
tyres and hydrogen-electric
vehicles include refuse trucks,
support vehicles. It has also won
delivery vans and fire service
several national awards for its
support vehicles. The trial of the
environmental initiatives.
improve care of patients in local communities, and it means more ambulances are freed-up for higher priority calls. SWASFT was given the Best Care of Older People accolade at the Health Service Journal’s 2018 Patient Safety Awards last month for the initiative. CFRs are trained volunteers who attend emergency incidents on behalf of SWASFT within their local communities. They respond to particular types of 999 calls where it is essential for the patient to receive immediate lifesaving care. These include conditions such as cardiac arrest, chest pain, breathing difficulties, unconscious patients, fitting and stroke.
YAS
Pioneering Patient Transport Vehicle Joins Yorkshire Ambulance Service Yorkshire Ambulance Service NHS Trust (YAS) is continuing to lead the way with eco-friendly vehicles.
vehicle than can be improved
It is the first ambulance service to introduce a dual-fuel non-
There are around 1,000 CFRs
emergency patient transport
providing lifesaving support to
vehicle, after taking on the
patients across the region.
challenge of driving down emissions in its 1,200-strong fleet
SWASFT covers one of the
over the next few years.
most rural areas of the UK, and is committed to providing the
The Peugeot Boxer has been
population of the South West with
converted to run on hydrogen and
the highest standard of out-of-
diesel, using unique technology
hospital care.
from specialist conversion company ULEMCo. The pioneering project
SWAC, founded in 1995, uses
enables around 35 to 45% of the
gifted monies to benefit those in our
vehicle’s energy to come from
communities who use our service
hydrogen rather than diesel and its
and to improve the welfare of the
carbon dioxide emissions can be
staff and volunteers of the SWASFT.
reduced by the same amount.
201 For all your equipment needs visit: www.ambulanceservicesuppliers.com
NEWSLINE South West and I’m humbled
are conveyed to the hospital
Royal Voluntary Service, who
Macmillan’s Chief Exec visits ambulance team
by the professionalism and
emergency department when
then paired local volunteers with
dedication of the staff, so thank
it would be more appropriate
clients. These volunteers visited
you so much.”
for them to remain at home. In
clients in their homes and worked
the first collaboration of its kind,
with them for a period of 6-8
Chief Executive of South Western
the South Western Ambulance
weeks to improve their physical
The Chief Executive of Macmillan
Ambulance Service NHS Foundation
Service and Macmillan have come
function and wellbeing.
Trust (SWASFT), Ken Wenman,
together to combat this gap in
said; “We’re very pleased to have
education and provision.
SWASFT
Cancer Support visited a groundbreaking team of ambulance clinicians who have been working on a new joint project which is benefitting patients across the South West who have cancer, palliative care needs or who are close to the end of their life. Lynda Thomas met the Macmillan
Following 6-8 weeks of volunteer intervention, the active ageing
welcomed Lynda to Bristol to meet the team and show her how this
Lynda will be hearing first hand
pilot had a number of positive
ground-breaking project between
some of the feedback directly
outcomes. These included a
Macmillan and SWASFT is
from the team and listening to
42% reduction in falls amongst
benefitting patients. Most patients
the patients’ case studies who
clients*, a 45% decrease in calls
prefer to be treated at home and this
have been treated by paramedics
from clients to 999 as a result of a
project reduces hospital admissions
in their own homes, along with
fall and a 29% reduction in clients
to emergency departments”
a show case of the project’s
being admitted to A&E.
outcomes and benefits.
Innovation Excellence finalist project team from South Western
“We estimate that in a typical
Ambulance Service NHS Foundation
shift, each ambulance crew will
Trust (SWASFT) at Bristol Central
attend a patient who has cancer,
Ambulance Station on 2 August.
palliative care needs or who is close to the end of their life. This
Lynda heard all about how the
project enables us to deliver more
ambulance service can now
appropriate care and in many
provide improved urgent and
cases, this means treating them
emergency care for patients
at home. This approach enables
and their loved ones, by either
us to deliver care more in line with
supporting management at home
patients’ wishes. We do of course
or facilitating referrals to a more
still take patients to hospital where
appropriate health setting.
that is in their best interests.”
“So today has been amazing
Ambulance services regularly
meeting paramedics and seeing
encounter patients with cancer,
how the team are supporting
yet they often have very little
people with end of life cancer
training about the illness so may
issues, and what difference South
lack the skills and knowledge
Western Ambulance Service is
to provide the best quality care.
making to people’s lives in the
Sometimes, people with cancer
Clients also showed improved LAS
London ambulance service active ageing pilot reduces 999 calls and visits to A&E
physical function and health and wellbeing. 60% improved on a 30-second Sit to Stand test and almost 70% improved on walking or gait speed in the Timed Up and Go (TUG) test. Furthermore, over one in four felt their health had improved, more than one third felt happier and more confident and
Royal Voluntary Service
one in four said they felt less lonely.
‘mobility volunteers’ provided support to older people at risk
The programme was based on
of falls and social isolation in
Royal Voluntary Service’s ‘mobility
two London boroughs
volunteers’ doing one-to-one chair-based exercises with clients,
AMBULANCE UK - OCTOBER
A seven month pilot run by
as well as providing advice on
London Ambulance Service NHS
hydration and nutrition. At the
Trust in partnership with national
end of the 6-8 weeks of visits,
volunteering organisation, Royal
volunteers then supported clients
Voluntary Service has helped cut
to transition to a community
emergency calls and visits to A&E
exercise programme or other local
amongst frequent fallers in two
activities to help them build and
London boroughs.
maintain their social connections.
The active ageing pilot ran from
During the pilot period, over
November 2017 to May 2018
70 referrals were received from
and was set up to decrease the
London Ambulance Service
number of falls in two London
or falls teams working with the
boroughs, with a goal of reducing
ambulance service. A total of
demand on both the ambulance
31 very frail clients, the majority
service and hospitals as well as
of which were 85+ completed
improving outcomes in later life.
the full 6 to 8 week intervention. The pilot focused on recruiting
The pilot ran in Merton and
volunteers from underrepresented
Hackney, where need is
groups (e.g. BME backgrounds)
particularly high, and tested a new
and a total of 34 volunteers were
model of ‘mobility volunteers’.
recruited from a diverse range of
Older people who fall frequently
backgrounds during the course of
and call 999 were referred to
the programme.
202 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE Dr Allison Smith, Head of Strategy and Development at Royal Voluntary Service said: “Frailty need not be an inevitable part of getting older. We know that targeted resistance-based exercises can significantly help older adults improve their physical function and reduce their risk of falls. Our volunteers received specialist training to provide 45-60 minute exercise sessions each week to help clients regain their independence. This included leg strengthening exercises to help them get out of a chair or off the toilet and arm exercises to help them get dressed and out of bed. We are very pleased with these results. Given the age and high levels of frailty of these clients and a relatively short period of intervention, such findings are very encouraging and suggest greater gains might be made with a longer support period.”
a social life outside of her home. I worked with Anna for six weeks to complete a set routine of gentle exercises. We struck up a friendship and it was a pleasure to be able to spend time helping someone in need become more active. By volunteering I feel I am helping the local emergency services and helping older people to be more mobile and sociable. All of this gives me a sense of pride that I am helping my community.”
starting the Foundation course in Paramedic Science in 2016.
The Kings Fund estimates falls account for around 40 per cent of all ambulance call outs to the homes of people over 65 and are a leading cause of older people’s use of hospital beds. London Ambulance Service estimates that each ‘call-out and convey to hospital’ costs the service approximately £300.
Briony Sloper, Deputy Director of Nursing & Quality, London Ambulance Service NHS Trust said: “We partnered with Royal Voluntary Service to test an innovative way to support what is a particularly vulnerable group. Recruiting local volunteers to support frail, often socially isolated people within their community has been extremely rewarding for everyone involved. It has highlighted the importance of working with volunteers and the role London Ambulance Service has, with its unique position of working across London, in identifying areas of need which are often hidden to the wider health and social care system. By working in a partnership like this that works across traditional, organisational boundaries, we are able to better connect communities and improve people’s quality of life.”
The funding for the extra 24 places has been agreed by Health Education England (East Midlands), the organization responsible for education provision and training for the NHS in this region, building on an existing funding agreement. The Ambulance placements are facilitated by the East Midlands Ambulance Service (EMAS).
Royal Voluntary Service is one of Britain’s largest volunteering charities with over 20,000 volunteers supporting thousands of people each month in hospitals and in the community. The simple acts of kindness our volunteers provide, whether popping in for tea and a chat, helping out with a lift to a GP or social appointment or running chair-based exercises on ward to prevent pyjama paralysis, help make communities stronger and relieve the pressure on overstretched public services. The charity is also one of the largest retailers in the NHS, with its network of cafes and shops providing a valued haven in hospitals.
Also on offer are fuel expenses to cover some travel costs as well as a 4 week funded emergency driving course.
Jack Dudley, who gained his Health and Care Professions Council registration in October 2017 and graduated in February this year, said: “The Foundation course has been a great
Students will also have access to the University’s training facilities including a new, model ambulance located at the £330m Waterside campus, right in the heart of Northampton town and due to open to students next month. The full-time course, which starts on 12 November, covers placements in a variety of ambulance, health and social care settings such as hospital wards and accident and emergency departments. Jack added: “The last year of university was a whirl of revision, exams and work placements, but it’s worth it every step of the way. I love being part of the team at East Midlands Ambulance Service – I can’t recommend people taking the University course enough.”
EMAS
Paramedic Science students to benefit from extra funded course places University of Northampton has received funding to train extra Paramedics, news welcomed by a graduate who is working in the profession just two years after starting his course. Jack Dudley, from Leamington Spa, qualified as a Paramedic in February this year after
AMBULANCE UK - OCTOBER
Becky Seaton is 41 and lives in Lower Morden. She donated one hour a week to support the pilot in Merton. “The first person I met was Anna, who was 96 and housebound. She was not what I was expecting! She is bubbly, chatty, full of knowledge and interesting stories from her past and really keen to be on the programme. She finds it difficult to get out and about because of physical ailments but was craving
Foundation course fees are fully funded for the two-year duration and there is the option of applying for a non-repayable bursary for further support.
experience. It’s a more direct route into the role, so the funding for the extra places from Health Education is fantastic news.”
203 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE WAST
10m boost to support upgrading of Welsh Ambulance Services vehicle fleet A £10m Government funding boost for replacement ambulances is set to place WAST as the UK’s leading Ambulance Trust for its modern, environmentally friendly and efficient vehicle fleet. Health Secretary Vaughan Gething announced the £10.23m to replace 100 ambulances and other passenger transport vehicles, when he visited WAST’s Bridgend Ambulance Station to take a look at the first of the new vehicles currently being trialled by WAST across Wales. The new ambulances will be more manoeuvrable and meet the latest Euro 6 emissions standards. The new fleet, replacing vehicles that have reached the end of their operational viability, will be deployed across Wales and includes 25 new ambulances, 33 rapid response vehicles, 33 nonemergency passenger transport vehicles and nine specialist emergency vehicles for major incidents. WAST currently has over 700 vehicles in our fleet, covering an area of more than 8,000 square miles across Wales. Since 2011, the Welsh Government has invested almost £55m in new ambulance vehicles for the Welsh AMBULANCE UK - OCTOBER
Ambulance Service. Director of Operations, Richard Lee, said:
majority of their working day out
Independent research has
and about in the community.
shown that across the 27 sites offering specialist expertise to
SADS UK 2019 Retreat
“The funding we have received
patients with serious injuries,
from Welsh Government,
1656 additional patients have
particularly in recent years, has
survived. London is home to four
The SADS UK 2019 Retreat
enabled us to ensure that our
major trauma centres, which our
get-together is being held on
ambulances in Wales are some
charity regularly transfers patients
the 1st February to Monday
of the most modern and well
to after providing critical on-
4th February, (3 nights) at
equipped in the UK, and we
scene care; St George’s Hospital,
the Quorn Grange Hotel,
are extremely grateful for the
King’s College Hospital, St Mary’s
Loughborough.
continued support.
Hospital and our base, The Royal London Hospital.
“This new funding will allow us to
It is £80 for a double room per couple, per night, single rooms
continue with the replacement of
Dr Gareth Grier, Lead Clinician at
£50 per night. This price is
our ageing vehicles and, crucially,
London’s Air Ambulance, said:
includes breakfast and evening
the vital clinical equipment they
meal.
carry, as they each reach the end
“London’s Air Ambulance is really
of their operational viability”.
proud to be part of the major
The agenda will include walks,
trauma system in the UK and
candle lighting and balloon
of the major changes that have
releases. Please contact SADS
taken place over the past few
UK in the first instance to register
years. There are many people
your interest in coming along to
involved in a large chain of care
the Retreat.
During his visit to Bridgend, Mr Gething had an opportunity to see for himself the innovative technology leading the way in making Welsh ambulances fit for the future, helping WAST to be recognised as among the most modern and forward-thinking in the UK.
from injury all the way through to rehabilitation.
Please note the Retreat is subsidised by the charity and
“For London’s Air Ambulance
there are limited places.
the focus for 29 years has been
Announcing the £10.23m funding boost, Mr Gething said: “I am pleased to be able to announce this funding to replace some of our ageing ambulances and other passenger transport vehicles with more modern, fuel efficient and greener versions. “This investment will enable the Welsh Ambulance Service to upgrade its fleet to ensure it has the most appropriate vehicles to deliver the best care for the people of Wales.”
Lead Clinician responds to excellent news regarding major trauma centres
on how we can bring innovative procedures and techniques to patients as close to the time of injury as possible. Early interventions such as delivering
Air Ambulance Awards shortlist announced
an anaesthetic at the roadside
The shortlisted nominees for the
were rare in the UK only a decade
2018 Air Ambulance Awards of
ago and were only provided in a
Excellence, sponsored by BMW,
small number of areas such as
have been announced today.
London.
The winners will be revealed at the awards ceremony to be
“Now, there is widespread
held on 12 November at the
delivery of life saving advanced
Millennium Chelsea Harbour
treatments for much bigger
Hotel, London.
groups of patients across the country. We’ll continue to bring
The independent judging
innovative treatments such as
panel met and considered
open heart surgery and REBOA
all entries made across the
(Resuscitative Endovascular
eleven categories. After lengthy
Balloon Occlusion of the Aorta)
deliberation and discussion, the
to patients very quickly following
panel was pleased to shortlist the
their injury, and we have a
following (shown in no particular
strategy to introduce even more
order):
“Modern ambulances and
Our charity has welcomed
novel therapies for patients over
equipment are essential in
the news that the introduction
the coming months and years.
providing the best treatment
of major trauma centres has
and patient experience possible.
increased the number of
“The results are very welcome and
Sponsor: Babcock MCS Onshore
They are also important to our
patients surviving serious injury
we look forward to making an even
• Winner to be announced on
ambulance staff who spend the
by almost a fifth since 2012.
more dramatic impact in the future.”
Outstanding Young Person Award:
204 For more news visit: www.ambulanceukonline.com
12 November
NEWSLINE Charity Staff Member of the
Air Ambulance Pilot of the Year:
Year:
Sponsor: Safran UK
Sponsor: Bayards Heliport
• Dave Kelly, Essex & Herts Air
Solutions
Ambulance - Float
Ambulance
• Gemma Kidd, Cornwall Air Ambulance Ambulance
Lifetime Achievement Award: Sponsor: Specialist Aviation
Air Ambulance Campaign of the
Services
Year:
• Winner to be announced on
Air Ambulance Paramedic of
Sponsor: Lottery Fundraising
the Year:
Services
Sponsor: BMW Government and
• Essex & Herts Air Ambulance Keep in Touch
• Glenn O’Rorke, Air Ambulance Northern Ireland
• Wiltshire Air Ambulance -
Somerset Air Ambulance
Sponsor: Leonardo Helicopters • Dave Ashton Cleary, Cornwall Air Ambulance
Charity Volunteer of the Year:
MAGPAS Air Ambulance & East
Sponsor: Tower Lotteries
of England Ambulance Service
• Colin Smith, Wiltshire Air • Ally Bally, Scotland’s Charity Air Ambulance
Ambulance
• ECMO - North West Air Ambulance
Jim Fitzpatrick MP, Chair of the Judging Panel, commented: “My fellow judges and I were privileged to read about the very best of the outstanding organisations, teams and individuals that make up our air ambulance services. These Awards give a real insight into the extraordinary work these people do every single day of the year. I believe it is important that we acknowledge this work during these annual Awards, which represent a rare opportunity for us all to recognise their commitment and expertise and simply to say thank you.”
• Gill Andrew, Lincs & Notts Air Air Operations Support Staff
Further details about the
Member of the Year:
awards, including how to book
Special Incident Award:
Sponsor: Allianz UK
a place at the Gala Dinner, can
Sponsor: Airbus Helicopters
• Jeff Glover, Devon Air
be found at: http://www.aoaa.
Ambulance
• Ami Jones, Wales Air
• Student Resilience - Essex & Herts Air Ambulance
• Paddy Morgan, Great Western Air Ambulance
• The McQueen Charter - East & Herts Air Ambulance,
Ambulance Air Ambulance Doctor of the Year:
Innovation of the Year:
Anglian Air Ambulance, Essex
• Jeremy Griffiths, Cornwall Air • Mark Williams, Dorset &
12 November.
Sponsor: Sloane Helicopters
Airbase Appeal
Ambulance
• Midlands Air Ambulance -
• Gavin Rowley, Scotland’s
• Natalie Church, MAGPAS Air
Authorities Division
Ambulance
Traumatic Cardiac Arrest
Charity Air Ambulance
Ambulance
• Paul Smith, London’s Air
• East Anglian Air Ambulance Child Cardiac Arrest
• John Taylor, North West Air Ambulance
• Jen Easton, East Anglian Air
• Dorset & Somerset Air
• Cornwall Air Ambulance - Tin Mine
Ambulance
co.uk/aaae/
AMBULANCE UK - OCTOBER
Last Year’s Winners
205 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE NEAS
School children swap the classroom for a lesson is lifesaving Future generations now better equipped to save lives Children as young as eight saw life through the eyes of an ambulance dispatcher when they were faced with life and death scenarios and asked to choose who should get an ambulance first. The children were faced with a woman in labour, someone having a heart attack and someone with a cracked fingernail, and had to decide whether the ambulance response should be ‘fast, slow or not at all’. The exercise was part of a long running partnership between North East Ambulance Service (NEAS) and the West View Project, a voluntary funded youth organisation based in Hartlepool. Having previously spent two days visiting the ambulance service in March and April, groups of school children who are part of the project’s Junior Inspectors programme had already learned how to stop a person choking, what happens when you ring 999 and why NHS111 might be a good place to start if you don’t know which health service you need. They had also received a tour of the Trust’s Emergency Operations Centre, where the region’s 999 and 111 calls are taken, and got to see the inner workings of an ambulance.
AMBULANCE UK - OCTOBER
The Hartlepool Schools Conference, held at Hartlepool Sports Dome on 27 June, gave even more young people the chance to learn about their local ambulance service and how to save a life, with around 200 school children taking part in group exercises with NEAS. The different scenarios included: someone with dust in their eye, someone who had drank bleach, a woman in labour, someone drowning, someone with a cracked
fingernail, someone with chest pain, someone who was choking, and someone who was bleeding heavily. As well as deciding what priority – if any – each patient received, the children also had the chance to have a go at CPR and were taught about the consequences of hoax calls. The teachers were also informed about the benefits of installing defibrillators within their schools and the importance of teaching CPR to their children. One of the members of staff leading the sessions was NEAS clinical care manager Richard Ilderton. He said: “These scenarios are just some of the incidents our staff are faced with on a daily basis, prioritising where we send our resources first to help those most in need. “The kids were really engaged and came up with some really good ideas. When we gave them the options, you could really see them thinking the scenarios through. They also realised that some illnesses could warrant different responses depending on their severity. I think it reinforced what some of them already knew but for others it really gave them food for thought. “It’s really important for children to know what an appropriate 999 call is and understand what the chain of survival for CPR because you’re more likely to save a life if you get someone who’s willing to start CPR. “Hartlepool residents can be rest assured that their future generations are better equipped to deal with medical emergencies. Hopefully we now have a group of young people who will tell their peers that it’s not scary to start CPR and they can help us save more lives.” Rebecca Ferguson, senior participation worker for the West View Project, said: “The aim of the conference is to bring together primary schools in Hartlepool with representation from their student councils to explore areas of particular interest to them.
“The forums meet on a termly basis and planned this year’s conference since the beginning of the school year. The themes chosen this year were safety and the environment as those representing student councils felt these were particularly important and current, topical issues.” LAS
Taxi drivers get life-saving training for ambulance pilot scheme London Ambulance Service is training taxi drivers to help save the lives of cardiac arrest patients in the capital. Paramedics have taught cabbies to perform cardio-pulmonary resuscitation (CPR) and fitted their black cabs with defibrillators as part of a six-month pilot scheme in partnership with the Licensed Taxi Drivers’ Association (LTDA). Chief Executive Garrett Emmerson said: “London Ambulance Service has set up this scheme with the Licensed Taxi Drivers’ Association as part of our ongoing work to increase CPR training and the number of defibrillators in the community to help save even more lives. “More than half the patients who are defibrillated by members of the public before the arrival of ambulance crews survive to be discharged from hospital. While we get to patients reported to be in cardiac arrest in an average of less than six minutes, it’s those vital first few minutes that can make the difference between life and death.” The LTDA approached London Ambulance Service to explore how its cabbies – who were keen to help – could be trained to save lives before the arrival of medics. As a result a pilot scheme was set up where cabbies volunteered to receive training in lifesaving skills from London Ambulance Service. Participating London taxi drivers have also installed the GoodSAM
206 For further recruitment vacancies visit: www.ambulanceukonline.com
app on their mobile phones. When a 999 call is made for a cardiac arrest patient, an ambulance is dispatched immediately. At the same time, these taxi drivers – and other registered first aiders – are alerted by the GoodSAM app if they are close to the patient. Although London already has one of the best cardiac arrest survival rates in the world, when a person goes into cardiac arrest, every minute they wait for life saving medical attention decreases their chances of survival by about 10 per cent. The quick response of members of the public such as taxi drivers will help improve survival rates. Cabbie Shaun O’Meara, a former paramedic, said: “The training we have received has been excellent. All the drivers are confident and excited to be part of this innovative scheme. Most of us will have come across someone who is very ill – we just want to be able to help.” Half of the 30 drivers taking part in the pilot scheme are carrying defibrillators, while the other half are relying on the GoodSAM app telling them where the nearest public access defibrillator is located. Steve McNamara, General Secretary of the LTDA, said: “We are proud to have teamed up with London Ambulance Service to train black cab drivers to respond to GoodSAM alerts. Deputy Mayor for Transport, Heidi Alexander, said: “London’s black cabs already provide a unique service for residents and visitors all across our city. This innovative new partnership with London Ambulance Service could make a difference by literally saving lives. For victims of cardiac arrest, every second can make a difference, and I’m delighted that London cabbies are using the latest technology to play their part supporting the vital work of London Ambulance Service.”
IN PERSON SECAMB News
Trust announces appointment of new Chair South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is pleased to announce the appointment of a new Chair. Following a rigorous selection process involving stakeholders and staff from across the Trust, the Council of Governors formally appointed David Astley as substantive Chair at its meeting at the end of July, subject to references and pre-employment checks. David will take over from Graham Colbert, who has filled the role on an interim basis since April following the decision of previous Chair Richard Foster to step down. David, from Kings Hill in Kent, has over 40 years’ management and leadership experience in the NHS and abroad. He will take up his post in late September. David, who was awarded an O.B.E in 2006 for services to the NHS, has held a number of very senior roles in the NHS including Chief Executive of East Kent University Hospitals NHS Trust between 1999 and 2006 and Chief Executive of St George’s Healthcare NHS Trust between 2006 and 2011. From 2011 to 2015 David was Chief-Tertiary Hospitals Group of the Hamad Medical Corporation in Qatar. On return to the UK and retirement from full time Executive duties, David was appointed as a Non Executive Director of Liverpool Women’s Hospital NHS Foundation Trust. He will stand down from this
role when he commences as Chair and will continue as a Trustee of Yoakleycare, a charity based in Margate,Kent which manages alms houses and a care home. David said “I am delighted to be appointed as Chair of SECAmb and look forward to chairing the Board as we continue to consolidate recent improvements and strive to manage increasing demand for our services. I am looking forward to supporting the Executive Team and our committed, skilled staff to do their best for the people we serve. “ SECAmb Chief Executive Daren Mochrie said: “I am pleased we have been able to appoint such a highly-experienced person as David as our Chair. I would also like to thank Graham for his hard work as Interim Chair over the last few months. “I am looking forward to working closely with David as we continue to improve the service we provide and I know everyone at SECAmb will join me in welcoming him to the Trust.”
EMAS News
Welcome to our new NonExecutive Director A new non-executive director with a background in finance and who is a privacy professional has joined our Trust Board. Gary Brown, who has worked at Santander for 13 years in a variety of roles including managing operations, transformation and the introduction of General Data Protection Regulations, joined the board on 1 August.
Gary is a qualified chartered accountant with a Master’s in Business from University of Warwick, and has previously been a Finance Director at a variety of leisure and retail companies. He is also a non-executive director for a Midlands Academies Trust and has previously been Chairman of Wolfhampcote Parish Council, but this is his first role in healthcare. Gary said: “I like to keep busy, and two areas that I wanted to get more involved in were education and healthcare. “The opportunity to be a non-executive director at EMAS came up and I jumped at the chance as not only is it working in the NHS, but the ambulance service involves lots of logistics too which I have experience with. “I’m excited about joining EMAS and being a small part of making things better both in the service and for the patients.” In his spare time Gary enjoys running and has completed marathons in London, Paris, Stockholm and Amsterdam to raise money for charity. Gary lives in Leicestershire with his wife and two children, aged 15 and 19. Mojgan Sani is also joining us as an associate non-executive director which is part of a 12-month development program run by NHS Improvement. Pauline Tagg, Chairman of the EMAS Trust Board, said: “ I am delighted to welcome Mojgan and Gary to our Trust Board and to EMAS.”
AMBULANCE UK - OCTOBER
207 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON EMAS News
Volunteer marks 30 years of helping patients A 75-year-old who has helped thousands of patients get to hospital is celebrating 30 years volunteering for East Midlands Ambulance Service. Ron Haslam, a former taxi driver from Little Eaton known as ‘Rocket Ron’, has given much of his spare time to our Volunteer Car Service since it began in September 1988. Over the last three decades Ron has driven patients hundreds of thousands of miles across the country to get to a wide range of hospital appointments including mental health support, day care centres for dementia, physiotherapy, kidney dialysis, chemotherapy and radiotherapy. Ron is known throughout the service as ‘Rocket Ron’ - after the famous motorbike rider. Despite recently becoming a great-grandfather, Ron has no plans to give up volunteering and would recommend the role to anyone looking to volunteer. He said: “I just love it – they’ll have to stop me if they want me to give up. “I get greater job satisfaction from being a volunteer car driver than I did in any other job that I’ve done. When I look back, I wish I had joined the service sooner. “Obviously you have to be a caring person, but you also need to be a good listener, and able to get people talking. It helps them to relax, especially if they are worrying about their appointment.” Ron first started supporting the NHS in the 1980s as part of a taxi service for nurses performing home visits, and he was keen join the Voluntary Car Service when it was launched.
He said: “It was the ‘feel good factor’ that first attracted me, and I already knew most of the crews on patient transport so it was lovely to be volunteering alongside them. “Many of the patients we pick up are very poorly and can feel quite vulnerable, and they are relying on you to look after them. “When you drop them off at home or at the hospital clinic and they smile and say ‘thank you’, that makes everything worth it.” As well as transporting patients who live in his local community, Ron volunteers to take patients on longer journeys for specialist appointments in London and Cambridge.
“Ron’s care and kindness has undoubtedly made difficult journeys to and from hospital appointments just that little bit better. “We’re very lucky to have him and I would like to say a huge thank you to him for volunteering for us for 30 years.”
News
Air Ambulance Appoints New Air Operations Manager Ian Roberts has been successfully appointed as Midlands Air Ambulance Charity’s new air operations manager.
“In the early days I made a fire or two for patients when I had taken them home and their house was cold.
With more than 35 years’ experience in the ambulance service, Ian has a wealth of knowledge to bring to the challenging role. In 1983, he joined Hereford and Worcester Ambulance Service and began working for Midlands Air Ambulance Charity in 2003 as an aircrew paramedic based at Strensham airbase.
“We’ve always been kept busy as volunteers which is lovely, and I often get to pick up the same patients on a regular basis so I get to know them.
Ian also won the coveted Clinician of the Year award at Midlands Air Ambulance Charity’s Recognition Awards and Charity Ball in June 2018.
“I’ve been doing the role so long now that a lady got in my car the other day and said ‘you used to take my mum to hospital’!”
Hanna Sebright, chief executive officer for Midlands Air Ambulance Charity, said: “Ian has worked with the charity for over 15 years and in that time has demonstrated a breadth of clinical and operational expertise. Ian’s background and leadership skills will help our organisation to remain at the forefront of emergency pre-hospital patient care, offering the very best treatment to patients in critical need of an air ambulance.”
Ron explained that not much has changed over the last 30 years as patients still need help and support to get to hospital.
Many of the patients going for regular treatment are going through difficult time in their lives due to issues with their health. Ron explained he quickly becomes a friend to many of his patients, and is always pleased when they make a full recovery. He added: “It is such a privilege to get to know the patients and to be a small part of the process that has led to their recovery. “I took one man in to hospital on several occasions when he was having cancer treatment, and sadly he was told he only had 12 months to live. But he had an operation, recovered well and he is still alive today – and I was able to be a small part of that.”
AMBULANCE UK - OCTOBER
When Ron isn’t transporting our patients, he spends time with his wife and his four grandchildren. Joy Weldin, General Manager for Patient Transport Services, said that is an pleasure to have Ron volunteering for our service. She said: “Ron is an incredibly dedicated member of our Patient Transport Service and he is adored by all our patients and ambulance crews.
208 For more news visit: www.ambulanceukonline.com
Ian Roberts, air operations manager for Midlands Air Ambulance Charity, added: “I was incredibly proud to make it through the interview process and achieve the role of permanent air operations manager for Midlands Air Ambulance Charity. “I’m looking forward to advancing the clinical and operational work of the charity, in line with our strategic objective to work at the height of clinical and operational excellence.”
IN PERSON forward to working closely with Michael and
SECAMB News
know his experience will prove invaluable. I’d
Trust appoints new independent Non-Executive Director
like to thank our Council of Governors for their hard work in finding and appointing the right person for this role.
South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is pleased
“I’d also like to thank Graham and Tim for their
to announce the appointment of a new
commitment to the Trust. Their hard work and
independent Non-Executive Director.
professionalism over the years is very much appreciated and I’d like to wish them both all the very best for the future.”
Michael Whitehouse, who lives in Surrey, was appointed by the Trust’s Council of Governors and will join SECAmb for a three-year term in
the public sector. Until 2017 he was Chief
Newly appointed SECAmb Chair David Astley
office starting next month on 24 October.
Operating Officer of the National Audit Office.
said: “I would like to add my thanks to Tim and
As a qualified accountant, Michael replaces
Michael has also been responsible for a number
handover of the Chair position. Michael brings
Graham Colbert’s skill set as he steps down
of evidence-based reports to Parliament related
a wealth of experience to the Board from his
from his role as a non-executive director and
to the health sector, including on the financial
past work with the National Audit Office. He is
most recently the Trust’s Interim Chair.
performance and sustainability of the NHS,
most welcome.”
Graham for their past work and the smooth
hospital-acquired infection, dementia, end-ofAlso stepping down this month is fellow non-
life care and autism.
Michael said: “I am really pleased to be joining the Board. This is a great opportunity to
executive director, Tim Howe, who has served the Trust since 2010. Tim’s replacement on the
Since retirement, Michael has focused on his
support SECAmb in the incredibly important
board is Laurie McMahon who was appointed
role as a trustee and honorary treasurer of
services which its people provide to local
earlier this year.
Cruse, the bereavement charity.
communities across the region. I look forward
Michael brings with him a wealth of experience
Welcoming the appointment, SECAmb chief
coming months and meeting as many people
of audit and financial oversight across
executive Daren Mochrie said: “I’m looking
as possible.”
to working with my new colleagues over the
WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues. Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc.
If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com
AMBULANCE UK - OCTOBER
All submissions should be forwarded to info@mediapublishingcompany.com
209 Do you have anything you would like to add or include? Please contact us and let us know.
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 - OCTOBER
210
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
Group 3
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
CPD certificate provider
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 £23,023 to £36,644 pa (plus unsocial hours payment)* 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. • • • •
The most clinically advanced Trust within the UK Permanent and bank opportunities available One of the most beautiful parts of the country Lowest conveyance rate in the UK
Let us look after you better. For your next career move visit www.betterparamedic.co.uk
• A better work-life balance • Dedicated staff support service • Structured career pathways
/swasFT * Depending on qualification/ registration status
Better you, Better everybody. WORKING WONDERS Join Us.