Volume 34 No. 2
April 2019
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The Ortus Group wins EEAST Asset Monitoring Contract
THURSDAY MAY 16 2019 Doubletree by Hilton, Edinburgh International Airport EH28 8LL For the benefit of Scottish medical staff, the following conference / individual workshops will be taking place on the above mentioned date which we hope will be of interest. First Responder Conference - start time 09.30, finish 12.45. Topics include: Community Defibrillation - The Loch Lomond Model, Airway Management, Epilepsy Awareness, etc. Thanks to the generosity of Future Awards & Qualifications, a delegate rate of £24 will be offered. Only 15 places remain available Ultrasound Workshop - start time 09.30, finish 16.00. Supported by NEMUS Education & Training, this full day workshop is covering: The Common Uses of Ultrasound in Pre-Hospital and Hospital Practice and is suitable for all non doctor clinicians who want to see how point of care ultrasound can actually enhance your practice. Delegate rate £90. Limited places available Plus Size Workshop - start time 14.00, finish 16.00. This half day afternoon workshop run by Outreach Rescue is focusing on dealing with plus size patients and the use of tripods, bipods and lifting systems that can be used for the extrication of plus size patients from a wide range of locations, including RTC’s. The workshop will include a 15 minute presentation being given by Hospital aids. Delegate rate: £60 Trauma Management Workshop - start time 10.00, finish 12.30. Run by MedSkills Academy. This two hour morning workshop will be covering basic to advanced trauma skills and include: Trauma Patient Assessment, Catastrophic Bleeding, etc. Delegate rate £60 Airway Management Workshop - start time 14.00, finish 16.00. This two hour afternoon workshop which is also being run by MedSkills Academy will be covering: Basic to Advanced Airway Skills including Positioning, BVM, Video Laryngoscopy, Emergency Surgical Airway, etc. Delegate rate £60 Pre Hospital Major Incident Workshop - start time 09.00, finish 17.00. Run by MedSkills Academy, this workshop will update and prepare those fulfilling healthcare and professional roles at the scene of a major incident including doctors and paramedics. Delegate rate £90 All of the above rates include: lunch, tea/coffee and, as workshop places are limited, early registration is recommended. To secure your place please visit: www.lifeconnections.uk.com - combined discounted workshop rates are available, call The Organsiers on: 01322 660434. Media Publishing Co, Media House, 48 High Street, Swanley, Kent, BR8 8BQ. Tel: 01322 660434
CONTENTS
CONTENTS
Ambulance UK This issue edited by:
41
EDITOR’S COMMENT
42
FEATURES
42 The Recruitment Drive
44 Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load
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COVER STORY Ortus wins contract to supply Insight Telematics & Asset Monitoring solution to EEAST fleet
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Media Publishing Company Media House 48 High Street SWANLEY, Kent, BR8 8BQ
The Ortus Group is extremely proud and excited to announce that following a comprehensive technical evaluation and detailed procurement process, the East Of England Ambulance Service NHS Trust has selected our Insight Telematics & Asset Monitoring solution to be rolled out across its operational fleet. Over the 5 year contract term, in addition to market-leading telematics functionality, EEAST will now benefit from access to detailed information relating to key assets carried within the vehicle – whether they be high value, high risk or operationally significant. This information will greatly assist the Trust in the areas of medical device servicing, make-ready processes, asset management, risk reduction and operational efficiency. The Ortus team have been working closely with EEAST since 2013, providing and supporting the current vehicle telematics solution as well as the Corpuls3 pre-hospital defibrillator monitor. This latest innovation bridges the gap between the telematics and medical devices technologies and provides a unique overview of the complete inventory and activity of the Trust’s frontline emergency response vehicles. Using the Insight solution EEAST will be at the leading edge of NHS Improvement initiatives, closely aligned with the recent Carter Report, designed to increase ambulance operational productivity, support frontline staff and improve patient outcomes.
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 June 2019 Subscription Information – April 2019 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) We are also able to process your subscriptions via most major credit
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EDITOR’S COMMENT
EDITOR’S COMMENT They say the only constant in the NHS is change. Anyone who has spent time with an ambulance service will agree with that. Policies, processes and procedures are constantly being reviewed and updated, as new evidence comes to light, or as we engage differently with the wider NHS. In my job, I get more opportunity than most to appreciate the background to some of these changes. Whether it’s due to national or trust strategy, or perhaps an individual’s attempt to improve a particular area of work, it is interesting to see how our role continues to develop, as priorities change over time.
One or two other things that are being emphasised at the moment also seem to have similarities with earlier practice. We are now encouraging more timely assessment of seriously ill patients, in order to reduce time on scene. This resonates with the days we would examine every delayed thrombolysis, in order to understand how we could have reduced call to needle times. Similarly, in the treatment of cardiac arrest, we are seeing a de-emphasis of the various advanced techniques that have developed over the years, and going back to basics. Sometimes old lessons are forgotten as we strive to move forward. There is nothing wrong with revisiting things we used to do, as long as we build on the lessons learned first time round.
Matt House, Co-Editor Ambulance UK
AMBULANCE UK - APRIL
“Sometimes old lessons are forgotten as we strive to move forward. There is nothing wrong with revisiting things we used to do, as long as we build on the lessons learned first time round.”
What is also interesting, and is perhaps more apparent as you spend more time in the NHS, is that new ideas often have a familiar ring to them. There have been a few initiatives over recent months that have felt like this. There is a lot of talk at the moment of rotational working; the idea that we can develop our clinicians by allowing them to work in other clinical environments, and allow them to learn from other professions, with the aim of reducing hospital attendances. Those of you who remember the emergency care practitioner roles of the early two thousands will already have noticed the similarities here.
41 For all your equipment needs visit: www.ambulanceservicesuppliers.co.uk
ADVERTORIAL FEATURE
THE RECRUITMENT DRIVE WAS UK has unveiled the ground-breaking 3.5 tonne double crew ambulance (DCA). This is the first DCA in a generation that can be operated at full capacity and still be driven on a standard type ‘B’ driving licence. Director of Operational Services at South Western Ambulance Service NHS Foundation Trust, Neil Le Chevalier, tells us about some of the key issues affecting ambulance trusts in England and shows how the arrival of this new vehicle can address them head-on:
Tom Howlett explains: “As you would be expect from a lighter vehicle, the new 3.5 tonne ambulance provides environmental benefits: it reduces air pollution (CO2) by 20% compared to a current national specification van. This enables our customers to meet the target set by Simon Stevens well ahead of the 2024 target. Fuel consumption is also reduced in line with the emissions reduction, in the case of South Western Ambulance Trust this figure will be hundreds of thousands of pounds.”
Prior to the 1990s ambulances in the UK were based on a 3.5 tonne weight capacity, but with the introduction of more and more life-saving medical equipment the operating weight of ambulances has continued to increase. The WAS innovative lightweight aluminium ambulance body combined with a state-of-the art Fiat based chassis system has enabled this previously out of reach goal once again to be a reality, putting the UK at the very forefront of mobile medical technology.
All of the WAS UK test data has been independently validated by Millbrook testing ground. Emissions and fuel consumption were compared for normal driving, emergency driving and overall.
This launch will enable ambulance trusts all over the UK to address one of the key issues they encounter on a daily basis: that newly qualified paramedics, technicians and emergency care assistants must take a C1 driving licence prior to being able to drive a DCA, at a cost of around £1000. Neil Le Chevalier explains: “With the ambulance service recruiting more younger paramedics now, straight out of university, their driving licence no longer has a C1 category. Until they have their C1 driving licence they can’t drive any vehicle weighing over 3.5 tonne. This can be a limiting factor. There’s also the cost of taking the additional driving test, which new recruits usually have to pay themselves. If we moved to a 3.5 tonne vehicle on a replacement basis we’d solve the problem in the longer term as there is no requirement for any additional license at this weight. “Innovation in design is also critical. The ambulance is the working office of the paramedic and needs to be designed with them in mind. Issues such as infection control, ergonomics and patient and crew safety are all features that have been addressed in the new vehicle.”
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Sales Engineering Manager at WAS UK, Tom Howlett, says: “Our new 3.5 tonne vehicle provides 20% more ergonomic working space than a van conversion. Our users tell us that this additional space is essential to the design of the ‘treatment triangle’, the area where the paramedic is seated. It enables medical equipment to be in arms’ reach while crews remain seated with a seat belt on. The increased ergonomic space also provides 360o patient access for enhanced clinical care - this has been a feature of ambulances operated on the continent for many years.” In February 2019, NHS England Chief Executive Simon Stevens challenged vehicle manufacturers to help “blue lights go green” and cut air pollution by developing more environmentally friendly ambulances. The NHS Long Term Plan also makes commitments to cutting mileage and air pollution by a fifth (20%) by 2024 and ensuring nine out of 10 vehicles are low emission within a decade. Neil Le Chevalier says: “In South Western Ambulance Trust we do 24 million miles a year – we’re a rural service – so we’re always interested in new ways to be greener. The 3.5 tonne vehicle is good for fuel economy as well as for the environment.”
Lord Carter’s report into unwarranted variation in the ambulance service identified the need to make efficiencies in the ambulance service, including development of a minimum standard ambulance specification. NHS Improvement’s recently launched national ambulance specification provided an opportunity to set a new standard for vehicle specification, with a focus on innovation, the environment and to address the practical challenges faced by the service up and down the country. Neil Le Chevalier comments: “Trusts would welcome a lighter vehicle – it’s something that’s been talked about for a number of years. The new specification is a minimum standard currently, it has been designed to be constantly renewed and updated. There are plans for an innovation group to be set up and I hope that they will also take into consideration the benefits of this newer, light-weight vehicle. “In the South Western Ambulance Trust we’d welcome the opportunity to pilot this innovative new 3.5 tonne vehicle. A light weight, 3.5 tonne vehicle helps to address the issues we’re facing in the service in the longer term: recruitment of paramedics and Emergency Care Assistants who are already licensed to drive, together with improved environmental and safety credentials.” Commercial Manager at WAS UK, John Rumsey, explains: “The 3.5 tonne DCA really is the ‘Holy Grail’ in terms of ambulance design. In the future all newly qualified paramedics, technicians and workshop staff will be automatically licensed to drive our vehicles and there will be no need for costly C1 license tests. We hope that this is a significant development in supporting the NHS recruitment of young paramedics into the Ambulance Service. “Our 3.5 tonne DCA was designed to address NHS England Chief Executive Simon Stevens’ challenge for vehicle manufacturers to help “blue lights go green” and our investment in lightweight aircraft grade aluminium extrusions has enabled us to deliver this. Our next step will be working with NHS improvement team to ensure that this design is added to the National Specification to enable Ambulance Trusts to procure this by the end of the summer 2019. Finally, our 3.5 tonne paves the way towards an all-electric version of this lighter-weight vehicle. Watch this space…” If you’d like to find out more information about the new WAS 3.5 tonne vehicle please contact wasukinfo@was-vehicles.co.uk, or contact Tom Howlett on 07496 982199 or 0845 459 2785.
42 For further recruitment vacancies visit: www.ambulanceukonline.com
ADVERTORIAL FEATURE
AMBULANCE UK - APRIL
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FEATURE
IMPACT OF DRUG AND EQUIPMENT PREPARATION ON PRE-HOSPITAL EMERGENCY ANAESTHESIA (PHEA) PROCEDURAL TIME, ERROR RATE AND COGNITIVE LOAD Paul Swinton1,2*, Alasdair R. Corfield3, Chris Moultrie3,4, David Percival1, Jeffrey Proctor1, Neil Sinclair5 and Zane B. Perkins6 Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2018 26:82 https://doi.org/10.1186/s13049-018-0549-3 © The Author(s). 2018, Published online 21 September 2018 Reproduced with permission from the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Abstract Background We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load. Methods This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs. Following a two-week washout period, each team performed the corresponding simulation. The primary outcome was intervention time. Secondary outcomes were safety-related incidents and errors, and degree of cognitive load.
Results In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds; p = < 0.001). The experimental method also significantly reduced procedural errors (0 versus 9, p = 0.007) and the cognitive load experienced by the intubator assistant (41.9 versus 68.7 mm, p = 0.006). Conclusions Pre-preparation of PHEA equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. Keywords Airway, Intubation, Emergency, Patient safety / safety, Human error, Drug preparation, Risk management, Human factors.
Background
AMBULANCE UK - APRIL
The primary purpose of an ambulance service is to provide rapid access
A particular challenge in improving the overall benefit of PHEA is to
to emergency care. This involves prompt, effective pre-hospital care and
reduce the time penalty of the procedure while ensuring that the highest
rapid transport to hospital.
safety standards are achieved [2].
Pre-hospital interventions that delay transport to hospital may worsen
In the UK, thirty pre-hospital services provide PHEA, and perform
outcome [1]. For effective pre-hospital care, it is therefore important
approximately 1600 PHEA procedures a year [6]. There is some
that the likely benefit of any intervention is weighed up against potential
variability between services with regard to the amount of PHEA
risks, including delayed transport to hospital.
preparation that is done prior to tasking, and the amount done onscene. The busiest services pre-prepare equipment and drugs prior to
Pre-hospital Emergency Anaesthesia (PHEA) with oral tracheal intubation
tasking, while the majority of services perform this step on-scene.
is the technique of choice to manage critically ill or injured patients who cannot maintain their airway or achieve adequate ventilation [2]. While
The aim of this study was to evaluate the effect of pre-prepared
a potentially life-saving intervention in this group of patients, PHEA is
equipment and drugs, on PHEA procedure time and safety. In addition,
associated with significant risks and is a recognised cause of prolonged
we assessed the effect that pre-preparation had on the cognitive load
on-scene times [1–5]. Most PHEA complications are predictable, and risk
of clinicians. We hypothesised that the use of pre-prepared PHEA
can be significantly reduced with appropriate preparation [2]. However, it
equipment and drugs could reduce procedural time and risk, thus
is this preparation step that accounts for the majority of procedural time.
improving the overall benefit of the intervention.
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FEATURE Methods Study design This was a randomised, controlled simulation experiment with a
consultant physician, and a retrieval practitioner. When deployed by air,
crossover design. The study design is presented in Fig. 1 with the full
the EMRS team delivers PHEA with a Helicopter Emergency Services
study protocol showing more detail [see Additional file 1].
(HEMS) Paramedic in the role of intubator assistant.
Experiments were conducted between 04 January and 01 March 2017.
The service has strict clinical governance procedures, which includes
The study was reviewed and approved by Queen Mary, University of
an intense training program prior to independent pre-hospital practice;
London Research Ethics Committee (QMREC1839a), Greater Glasgow
adherence to SOPs that govern all aspects of pre-hospital practice,
and Clyde Clinical Research & Development committee (GN16AE762),
including the delivery of PHEA; and regular simulation training in the
and the Scottish Ambulance Service. Written informed consent was
application of these procedures.
obtained from participants. Eligible participants are experts in pre-hospital care, and perform PHEA Participants and setting
as part of their normal working practice. Consultant retrieval physicians
The study was undertaken at Scotland’s national Specialist Transport
were recruited from the Emergency Medical Retrieval Service (EMRS),
and Retrieval service (ScotSTAR). The service exists to provide a
ScotSTAR’s adult retrieval service. As this study was conducted
safe and dedicated transport and retrieval service to the 5.5 million
within the Greater Glasgow and Clyde NHS board (NHS GG&C) only
population of Scotland [7, 8].
consultant physicians currently working for the Emergency Medical Retrieval Service and employed by NHS GG&C were permitted to
The Emergency Medical Retrieval Service (EMRS), ScotSTAR’s adult
participate.
retrieval service is a physician-led team delivering a primary pre-hospital response, working with the ambulance service to provide pre-hospital
Paramedics were recruited from the Scottish Ambulance Service pool of
critical care at the scene of incidents. The EMRS team comprises a
HEMS Paramedics.
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Fig. 1 Study Scheme Diagram
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FEATURE Consultant retrieval physicians were eligible for enrolment if they were: 1) currently working with EMRS and employed by NHS GG&C, 2) had > 6 months’ experience as a retrieval physician, and 3) had been assessed by EMRS to be competent and current at PHEA. HEMS paramedics were eligible for enrolment if they 1) were currently working for the SAS air ambulance division alongside EMRS, 2) had > 6 months’ experience as a retrieval paramedic, 3) had > 8 years’ experience as a paramedic, 4) had completed a recognised PHEA course [9], and 5) were assessed by EMRS to be competent and current at assisting PHEA. All eligible participants were emailed an invitation to participate in the study. Willing participants were randomized using a computerised random number generator to identify which eligible participants would be enrolled into the study. Randomisation and allocation concealment A third party, not involved with enrolment and unaware of the study outcomes, used a computerised random number generator to block randomised participants into 12 two-person (physician /paramedic) teams. In addition, computer batch randomisation was used to establish the first simulation that would be undertaken by the team (standard practice or experimental method). Clinical teams were randomised to either the standard practice or experimental arm. Following a two-week wash-out period, the same clinical teams performed the corresponding simulation. Before each simulation, teams received a standardised briefing, including review of the services standard operating procedure (SOP) [10] and opportunity to prepare and ask questions. Teams were blind to outcomes being measured.
Fig. 2 The Adult SCRAM Bag. “The Adult SCRAM (Structured CRitical Airway Management) Bag is an Emergency Airway Bag which provides a structured reproduceable approach to airway management”[34]. Fig. 2 The Adult SCRAM Bag. “The Adult SCRAM (Structured CRitical Airway Management) Bag is an Emergency Airway Bag which provides a structured reproduceable approach to airway management”[34]. Methods of measurements and outcomes measures
Simulations were filmed, which allowed accurate measurement of outcomes and maintained blinding of participants to the outcomes being measured. Two reviewers independently analysed recordings and extracted study data from the video recording into a pre-prepared spreadsheet. Any discrepancy was resolved by consensus with a third independent reviewer who was blind to the study aims. A full pre-hospital clinical simulation was simulated to reduce moulage artefact and mask the aspects of pre-hospital care that were being measured. Participants were blind to the study outcomes measured during the simulation (intervention time and error rate). Primary outcome was PHEA intervention time (minutes: seconds). Intervention time was
Interventions In both arms of the experiment, the clinical team performed PHEA on a mannequin, presented within a realistic pre-hospital clinical simulation [Additional file 2]. This included the decision to perform PHEA, and the performance of the procedure according to the services SOP. The preparation for PHEA involves establishing an equipment “kit dump” as well as the preparation and administration of drugs (Alfentanil (1 mg intravenously (IV)), Ketamine (2 mg/kg IV) and Rocuronium (1–1.2 mg/ kg IV)). Correct placement of the tracheal tube (ETT) is confirmed by visualising it pass the vocal cords, by auscultation and by the measure of quantitative end-tidal capnography (EtCO2), before securing it in place.
defined as starting at the decision to perform PHEA and ending when correct ETT position was confirmed with the facilitator turning on the EtCO2 simulation software, in response to visualising chest inflation. Secondary outcomes included procedural errors, defined as an unintended/unexpected incident, which led, or could have led to harm. Errors were counted and classified according to Table 1. In addition, we assessed the degree of individual cognitive load (ICL), defined as the amount of cognitive work/energy required by the participant to complete the procedure, including the level of judgements/decisions needing to be made. ICL was measured using Visual analogue score (VAS). At the end of each simulation, participants were asked to indicate the
The fidelity of the simulation required it to be performed accurately in accordance with the ScotSTAR PHEA protocol [10], safely, in real time and with the retrieval consultant physician undertaking the role of intubator, and the HEMS paramedic the role of assistant. AMBULANCE UK - APRIL
The standard practice arm (unprepared), consisted of a drug bag containing all the required drug vials, syringes and labels to prepare for a PHEA, and a conventional airway bag holding all the required airway equipment. In this method, the “kit dump” and drugs are prepared according to the SOP after the decision to intubate has been made. The experimental method consisted of, equipment and drugs, optimally organised and prepared prior to the procedure being required (preprepared), having the kit dump pre-prepared within the airway bag, with individual items held securely in place (Fig. 2), and the drugs pre-
Fig. 3 Pre-prepared anaesthesia medications. Drugs are prepared in syringes that are clearly labelled with the agents name and concentration. Fig. 3 Pre-prepared anaesthesia medications. Drugs are prepared in syringes that are clearly labelled with the agents name and concentration.
prepared in labelled syringes (Fig. 3).
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FEATURE Table 1 Error Classifications Classification
Definitions
Error
Procedural error in the preparation or use of medications or equipment with the potential to result in harm.
Examples Medication:
○ Syringe anaesthesia medication labelled incorrectly Table 1 Errorcontaining Classifications
or not labelled Classification Definitions administered ○ Incorrect medication ○ Incorrect dose administered Error Procedural error in the preparation or use of medications or Equipment: equipment with the potential to result in harm. ○ Sharps injury ○ Procedure performed not in accordance with SOP (i.e. checklist not used, bougie not used) Lapse
A failure to execute an action due to lapse in memory and a routine behaviour being omitted.
Medication preparation: ○ Same needle used to draw up multiple medications ○ No syringe cap ○ Unsafe sharps management Equipment preparation: Lapse A failure to execute an action due to lapse in memory and a ○ Cuff of tracheal not checked routinetube behaviour being omitted. ○ Laryngoscope bulb operation not checked ○ No bougie
magnitude of their perceived cognitive load during PHEA by marking a
Primary outcome: Intervention time
standard 100-mm line appropriately (0-mm representing no cognitive
Overall, the average intervention time was 16:13 (SD 5:17) minutes:
load and 100-mm representing maximal cognitive load). Visual analogue
seconds. Teams were able to perform PHEA significantly faster using
scores have been shown to be effective tools for measuring cognitive
the experimental method compared to standard practice (11:45 (SD
load [11, 12].
1:45) versus 20:59 (SD 3:13); MD 9:14 (95% CI, 7:42 to 10:45) minutes:
Examp
Medic ○ Sy or n ○ In ○ In Equip ○ Sh ○ Pr not
Medic ○ Sa ○N ○U Equip ○C ○ La ○N
seconds; p = < 0.001) (Students t). Statistical analysis Statistical analysis was performed using SPSS 24.0 software (SPSS Inc., Chicago, IL, USA). Shapiro-Wilk test and normal-quartile plots were used to assess normality. Categorical data are reported as frequency (n) and percent (%), and numerical data are reported as mean with Standard Deviation (SD) or median with Interquartile Range (IQR). Sample size was calculated using data from observation of prior EMRS practice: in ten consecutive standard PHEA’s, the mean procedural time was 20:03 (3:26) minutes: seconds. A 20% reduction in procedural time was considered clinically significant. We determined that eleven simulations in each arm of the study were required for the paired t-test to have a 90% chance of detecting a difference in means of four minutes at a level of significance of 5% (two-sided). We adjusted the sample size to twelve each arm to allow for any exclusions. Tablesimulations 2 BaselineinCharacteristics of study participants Characteristics Consultant HEMS Physicians Paramedics Parametric data were compared using the paired t-test and non(n = 12) (n = 12) parametric data were compared using Wilcoxon matched-pair signedAge (years) 43 (34 to 53) 44 (35 to 49) rank test. An absolute (Mean Difference, MD, or Difference of Medians,
Group comparison demonstrated that slow working teams worked slowly in both methods, and faster working teams worked faster in both methods. Despite this, all teams were significantly quicker when using the experimental method. Pre-preparation of drugs resulted in the largest procedural time savings (Table 4). Secondary outcomes Procedural errors Overall, 99 errors occurred during the 23 PHEA simulations (Table 5). Significantly fewer errors occurred when teams used the experimental method compared to standard practice: (0 (IQR: 0 to 2) versus 9 (IQR: 0 to 17); DM 9 (95% CI, 4.5 to 12.8); p = 0.007) (Wilcoxon matched-pair signed-rank).
Table 2 Baseline Characteristics of study participants Characteristics
Consultant Physicians (n = 12)
Age (years)
43 (34 to 53)
44 (35 to 49)
Gender (male)
12 (100)
9 (75)
Emergency Medicine
10 (83)
n/a
Anaesthetists / Intensivist
2 (17)
n/a
HEMS Paramedic
n/a
12 (100)
Twenty-three simulations (11 in standard arm,9 12 in 14) experimental arm) PHEA Experience (years) (4 to 2.5 (0.5 to 7) were*Median completed and the data included in this analysis. Characteristics experience of HEMS paramedics as frontline ambulance paramedics
NHS Consultant Physician Experience (years)
9 (2 to 16)
n/a
of participating clinicians are described in Table 2. One simulation
Paramedic Experience (years)*
n/a
13.5 (8 to 28)
9 (4 to 14)
2.5 (0.5 to 7)
(male) (100) 9 (75) (CI) DM)Gender measure of intervention effect with 95% 12 Confidence Intervals Speciality was Background calculated for primary and secondary outcomes. A two-tailed
P-valueEmergency < 0.05 was considered significant. 10 (83) Medicine
n/a
2 (17)
n/a
HEMS Paramedic
n/a
12 (100)
9 (2 to 16)
n/a
n/a
13.5 (8 to 28)
Results NHS Consultant Physician Experience (years)
Characteristics study participants Paramedic of Experience (years)*
Background Speciality
(standard arm) could not be completed due to operational demands.
PHEA Experience (years)
The outcomes of PHEA simulation using the two methods of equipment
*Median experience of HEMS paramedics as frontline ambulance paramedics
AMBULANCE UK - APRIL
Anaesthetists / Intensivist
HEMS Paramedics (n = 12)
and drug preparation are presented in Table 3.
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FEATURE Table 3 Outcomes - PHEA simulation using standard practice and an experimental method of equipment and drug preparation Outcome
Standard Experimental Method Mean Difference P-value Practice (12 simulations) (95% CI) Table 3 Outcomes - PHEA simulation using standard practice and an experimental method of equipment and drug preparation (11 simulations) Outcome Standard Experimental Method Mean Difference P-value Intervention Time (min:sec) 20:59 (3:13) 11:45 (1:45) 9:14 (7:42 to 10:45) < 0.001 Practice (12 simulations) (95% CI) Errors 9(11(0simulations) to 17) 0 (0 to 2) 8.6 (4.5 to 12.8) * 0.007 Intervention Time (min:sec) Cognitive Load Intubator (mm)
20:59(20.5) (3:13) 49.9
11:45(20.5) (1:45) 49.4
9:14(−16.7 (7:42 to 0.5 to 10:45) 17.8)
< 0.001 0.945
Errors Cognitive Load Assistant (mm)
9 (0 to 17) 68.7 (24.8)
0 (0 to 2) 41.9 (22.4)
8.6 (4.5 26.8 (9.8toto12.8) 43.1)*
0.007 0.006
Cognitive Intubator * DifferenceLoad of Medians with (mm) 95% CI
49.9 (20.5)
49.4 (20.5)
0.5 (−16.7 to 17.8)
0.945
Cognitive Load Assistant (mm)
68.7 (24.8)
41.9 (22.4)
26.8 (9.8 to 43.1)
0.006
* Difference of Medians with 95% CI
Cognitive load Cognitive load of the intubator was similar between groups (49.9 (SD 20.5) mm versus 49.4 (SD 20.5) mm; MD 0.5 (95% CI -16.7 to 17.8) mm; p = 0.945) (Students t). However, the cognitive load of the intubator assistant was significantly reduced when using the experimental method compared to standard practice: (41.9 (SD 22.4) mm versus 68.7 (SD 24.8) mm; MD 26.8 (95% CI 9.8 to 43.8) mm; p = 0.006) (Students t) (Fig. 4).
intubator assistant cut a finger while opening an ampoule, highlighting the risk of sustaining a sharps injury when working under pressure. In another, a Rocuronium syringe was not labelled, and then confused for another agent, highlighting the risk of a drug administration error. These errors and safety-related incidents were, however, eliminated by using pre-drawn-up drugs in labelled syringes, resulting in significantly safer operation. The variance in procedural time was less in the experimental arm,
Discussion
which may suggest an improved workflow. By improving workflow, overall performance was enhanced, and cognitive load was reduced.
Key findings This study demonstrates the effectiveness of a system of prepreparation of equipment and drugs, together with optimal ergonomic organisation of equipment, for PHEA. Our results show a significant and clinically meaningful reduction in 1) the time it takes to perform the procedure, 2) errors during procedure / or significantly safer performance, and 3) the cognitive load of operators.
However, realising where cognitive resilience within a team lies is an important consideration, especially when performing complex, highrisk interventions such as PHEA. In our study, the intubator assistant reported a significantly reduced CL in the experimental method, even lower than that of the intubator. This enables the team to utilise this resilience to their advantage, for example by maintaining the team’s situational awareness “through” the intubator assistant to deliver safe, timely, effective, high quality care as a team.
When aiming for short scene times (< 30 min) a reduction of 9:14 min is clinically meaningful. Two elements contributed to this: 1) the time to set up the equipment “kit dump” and 2) the time to prepare the required drugs, which accounted for most of the time saved.
Time reduction The initial resuscitation and evaluation of critically injured or ill patients begins in the pre-hospital environment, and the care that they receive can have a major influence on subsequent outcome [13, 14]. Providing
Most of the errors and safety-related incidents occurred during the preparation and labelling of drugs on scene. In one incident, the
individualised, tailored care based on injury patterns, means that some patients may require specialised care, such as PHEA to optimize their
Table 4 Component Times Component (min:sec)
Standard Practice (11 simulations)
Experimental Method (12 simulations)
Mean Difference (95% CI)
P-value
Equipment preparation Component (min:sec) Drug Preparation Equipment preparation
05:01 Standard Practice (03:42 to 06:19) (11 simulations) 08:23 05:01 (06:43 to to 06:19) 10:03) (03:42
03:57 Experimental Method (03:13 to 04:41) (12 simulations) 00:16 03:57 (00:07 to to 04:41) 00:24) (03:13
01:04 Mean Difference (− 00:18 to 02:26) (95% CI) 08:07 01:04 (06:26 (− 00:18toto09:49) 02:26)
0.114 P-value
Checklist Drug Preparation
03:50 08:23 (03:02 (06:43 to to 04:38) 10:03)
00:10 08:07 (−00:27 00:47) (06:26 toto09:49)
0.551 < 0.001
Drug Administration Including Onset Time Checklist
01:36 03:50 (01:16 (03:02 to to 01:57) 04:38)
03:40 00:16 (03:12 (00:07 to to 04:08) 00:24) 01:40 03:40 (01:31 (03:12 to to 01:49) 04:08)
−00:04 00:10 (− 00:24 to to 00:47) 00:17) (−00:27
0.702 0.551
Tracheal Intubation Including Onset Time Drug Administration
00:42 01:36 (00:32 to to 01:57) 00:51) (01:16 20:59 00:42 (18:49 (00:32 to to 23:09) 00:51)
00:37 01:40 (00:32 (01:31 to to 00:43) 01:49) 11:45 00:37 (10:34 (00:32 to to 12:56) 00:43)
00:04 −00:04 (−00:07 (− 00:24 to to 00:15) 00:17) 09:14 00:04 (07:42 (−00:07toto10:45) 00:15)
0.407 0.702
11:45 (10:34 to 12:56)
09:14 (07:42 to 10:45)
< 0.001
Table 4 Component Times
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Total Intervention Tracheal Intubationtime
Data presented as mean (95% CI) 20:59 Definitions of Pre-hospital Anaesthesia components [see Additional file 3]
Total Intervention time
(18:49 to 23:09)
Data presented as mean (95% CI) Definitions of Pre-hospital Anaesthesia components [see Additional file 3]
48 For more news visit: www.ambulanceukonline.com
< 0.001 0.114
< 0.001 0.407
FEATURE clinical condition prior to transfer [15]. However, these interventions are known to increase time on scene, [2, 16] while the Association of
Table 5 Characteristics of procedural errors
Anaesthetists of Great Britain and Ireland stipulate that “every effort must
Characteristics
Standard Practice
Experimental Method
p-value
Laps in medication preparation
41
0
0.007
Error in medication preparation
31
0
0.011
Laps in equipment preparation
23
2
0.0027
Error in equipment preparation
2
0
0.317
Total errors
97
2
0.007
be made to keep pre-hospital time to a minimum”[2]. As a service, we aim to spend time on scene and minimise Table 5 Characteristics ofwisely, procedural errors time from incident to definitive care. To spend a large proportion Experimental of this time preparing for Characteristics Standard p-value Practiceill or injured Method PHEA, while caring for a critically patient, is not effective use ofLaps time.in medication preparation
41
0
0.007
Error the in medication 31 0 gains” [17] and 0.011 Using concept of “aggregation of marginal breaking preparation down the intervention (PHEA) into its core components, we identified Laps in equipment 23 0.0027 the preparation phase of a procedure to be2critical in determining both preparation the safety of the procedure and the time it takes to perform PHEA. We Error in equipment 2 0 0.317 were then able to demonstrate a significant time reduction in delivering preparation the intervention. It was also clear that most of the preparation for this Total errors 97 2 0.007 procedure could be done before the procedure became necessary, i.e.
our study shows that 40% of on-scene time was spent preparing drugs for PHEA, and most of the errors that occurred arose during the
in controlled undisturbed conditions at base rather than on-scene with
preparation of drugs on scene. These included (Table 5): drug labelling
all the attendant competing demands on our attention and potential
errors, omission of labels, poor sharps management and inadvertent
for distractions and interruptions. This time saved may be reflected in
“syringe swaps”, all of which can cause serious patient harm [20, 21,
reducing scene times and time to definitive care. However, performing
22]. For example, routine practice is to prepare Rocuronium (100 mg)
an intervention more quickly does not automatically mean that it is
in a 10 ml syringe, and Ketamine (200 mg) in a 20 ml syringe. In one
performed more safely.
observed error, Rocuronium (200 mg) was prepared in a 20 ml syringe, and subsequently incorrectly labelled as Ketamine. This could have
Error reduction
resulted in a neuromuscular drug being administered without prior
Human error is an important problem in health care, contributing to a
anaesthesia, exposing the patient to harm.
high instance of preventable medication errors [18–21]. Preparing drugs is a time-consuming process, requiring precision. Carrying out this
Such incidents are “almost invariably judged to represent sub-
critical task, while at the same time treating a critically injured patient
standard care and litigation is almost invariably successful” [22, 23].
in an uncontrolled pre-hospital environment, is far from desirable and
An anaesthetic practice review of 896 drug error reports that a large
inherently prone to error. Using standard practice of PHEA preparation,
number of errors involve drugs in similar sized syringes, along with
AMBULANCE UK - APRIL
Fig. 4 Box-and-whisker plot presenting the individual cognitive load - Standard Practic
Fig. 4 Box-and-whisker plot presenting the individual cognitive load - Standard Practice Arm vs Experimental Arm
49 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE drug preparation errors, which suggest that this is a frequently
We hope the findings of this study will support a change in practice from
occurring incident. [24] In a systematic review of drug administration
on-scene PHEA drug and equipment preparation to pre-preparation.
error prevention during anaesthesia, Jensen et al. recommends “drugs should be presented in prefilled syringes (where possible) rather than
We believe that the results of our study are generalisable to any pre-
ampoules (either for emergency drugs or in general)” [25]. This is also
hospital situation where PHEA is being delivered, as factors such as
supported by the Anaesthesia Patient Safety Foundation as part of
time, safety and cognitive load are the same regardless of the model of
a “new paradigm” to reduce the number of drug related errors, and
pre-hospital care (physician/paramedic, nurse/paramedic, critical care
improve patient safety [26].
paramedic/paramedic).
Currently, there is wide variation in the way that pre-hospital services
The strengths of this study include the realistic simulation of a pre-
prepare drugs for PHEA, including using pharmacy-prepared drugs in
hospital scenario, allowing unbiased measurement of important aspects
pre-filled syringes, teams preparing the drugs at the start of the shift,
of PHEA, which would likely not be possible under real conditions.
drawing them up en route to an incident, and drawing them up on Our study has several limitations. This experiment was done in a
scene.
simulated setting, so the results may not replicate true clinical practice. Syringes can be pre-prepared by the service or pharmacy. Individual
However, the pre-hospital clinical simulation [Additional file 2] was
services would need to consider the associated costs, waste, and shelf
piloted by clinicians not involved in the study, before the trial recruitment
life of each method [Additional file 4]. A barrier to pre-prepared drugs
began, to ensure that the simulation was reproducible, straightforward,
maybe the additional cost of pre-prepared drugs or concerns over the risk of drug wastage. The additional cost may, however, be offset by the accompanying reduction in the frequency of errors in preparing intravenous drugs and, more importantly, the iatrogenic harm and human cost of such errors [22, 27]. Furthermore, the magnitude of the time reduction to administer the drugs for PHEA using pre-filled labelled
and that it recreated the clinical practice as closely as possible. It is likely that real pre-hospital cases would be even more complex than those simulated, and would result in even more errors. The same pre-hospital clinical simulation was used in both methods of the trial which may have introduced exposure bias or training bias. A
syringes cannot be ignored.
two-week washout period between the first and the second simulation
Reduction of cognitive load
outcomes being measured during the simulation. No difference in
was implemented to reduce this bias, and clinicians were blind to the
Cognitive load can affect human performance. The effect of human performance on the safe delivery of anaesthesia is widely recognised. Over 40% of adverse outcomes reported to the 4th National Audit Project (NAP4) [4] were attributed to human factors. “Cognitive resources, though limited, are under conscious control and can be directed from task to task as necessary” [28]. In the complex and unpredictable pre-hospital environment, the clinician is faced with additional load, beyond that of delivery of the PHEA. The cognitive demands of managing oneself, the team and the environment can exacerbate an escalating workload, risking plan continuation bias and cognitive overload [29]. This can compromise the delivery of safe, effective high quality care [30], as demonstrated in the seminal case of Elaine Bromley, an example of the considerable harm that can result from cognitive overload [31].
performance was seen either side of the washout period. The VAS is used in a wide variety of populations and situations due to its adaptability and ease of use [35]. However, VAS is subjective, and some evidence exists that suggests that it lacks sensitivity and that risks of error exist in some subject groups [36]. We acknowledge that visual analogue scales have not been validated to measure cognitive load in this setting. Nevertheless, we feel that these simple tools are able to provide an unbiased meaningful message, that signal how cognitive resilience could be enhanced during this intervention. A further limitation of this study is that only 23 of the 24 simulations were included into our analysis as one of the simulations (using standard practice) was incomplete and thus excluded. However, even if the quickest procedure time, across both groups, was input as the missing value, the
There are several ways of reducing cognitive load in critical situations,
procedural time using the experimental method remained significantly less.
including the development of strategies such as briefings, flows (workflow patterns), and checklists and limiting the number of critical decisions that need to be made. The cognitive burden can potentially
Conclusion
be further reduced by standardising the equipment and processes required for the intervention, for example by streamlining packaging or AMBULANCE UK - APRIL
numbering various components sequentially. Such improvements could enhance patient safety by contributing to greater reliability, resilience
Pre-preparation of PHEA drugs, and to a lesser extent the prepreparation and organisation of PHEA equipment, significantly reduced procedural time and has the potential to reduce on-scene
and situational awareness [22, 4, 32].
time substantially. In addition, pre-preparation of equipment and drugs
There is a recognised relationship between workflow and cognitive
of the PHEA assistant.
resulted in safer performance of PHEA and reduced the cognitive load
load [28] and this can be influenced by the storage and presentation of equipment [33]. If the method of storing and presenting equipment
Additional Files
for an intervention is designed to reflect more precisely the series and sequence of steps required for that intervention, the method itself
Additional file 1: https://doi.org/10.1186/s13049-018-0549-3
becomes a useful “tool” for reducing the cognitive burden (see Fig. 2).
Research Protocol (PDF 755 kb)
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FEATURE Additional file 2: https://doi.org/10.1186/s13049-018-0549-3
have followed the regulations of our institutions concerning intellectual
Pre-hospital clinical simulation (PDF 358 kb)
property.
Additional file 3: https://doi.org/10.1186/s13049-018-0549-3 Definitions of Prehospital Anaesthesia components (DOCX 77 kb)
Authors’ information
Additional file 4: https://doi.org/10.1186/s13049-018-0549-3
1. PS. Dip IMC, MSc. HEMS Paramedic & Retrieval Practitioner.
Pharmacy-prepared prefilled syringes cost and shelf life [37, 38] (DOCX
2. AC. MPH. Consultant in Emergency & Retrieval Medicine.
14 kb)
3. CM. MBChB, MCEM. Clinical Research Fellow. 4. DP. BSc. Paramedic & Retrieval Practitioner.
Abbreviations
5. JP. BSc, PgC. Paramedic & Advanced Retrieval Practitioner.
CL: Cognitive load; DM: Difference of Medians; EMRS: Emergency
6. NS. BSc, MSc. Consultant Paramedic.
Medical Retrieval Service; EtCO2: End-tidal capnography; ETT: Tracheal
7. ZP. MBBCh, PhD. Honorary Clinical Lecturer.
tube; HEMS: Helicopter Emergency Services; ICL: Individual cognitive load; IQR: Interquartile Range; IV: Intravenously; MD: Mean Difference;
Ethics approval and consent to participate
mm: Milimeters; mm:ss: minutes: seconds; n: Frequency; PHEA: Pre-
The study was reviewed and approved by Queen Mary, University of
hospital Emergency Anaesthesia; SAS: Scottish Ambulance Service;
London Research Ethics Committee (QMREC1839a), Greater Glasgow
ScotSTAR: Scotland’s national Specialist Transport and Retrieval
and Clyde Clinical Research & Development committee (GN16AE762),
service; SCRAM®: Structured CRitical Airway Management; SD:
and the Scottish Ambulance Service. Written informed consent was
Standard Deviation; SHIL: Scottish Health Innovations; SOP: Standard
obtained from participants prior to their participation.
operating procedure; VAS: Visual analogue score Consent for publication Acknowledgements
Written informed consent was obtained from all participants for the
The authors would like to thank the HEMS paramedics from the
composite data collected in this study to be used for publication.
Scottish Ambulance Service, and retrieval consultant physicians from the Emergency Medical Retrieval Service for their participation. As well
Competing interests
as the EMRS Advanced Retrieval Practitioners for their assistance and
We wish to draw the attention of the Editor to the following facts which
support running the pre-hospital simulations.
may be considered as potential conflicts of interest and financial contributions to this work. Authors, PS and NS are co-inventors of the
Funding
SCRAM® bag (Structured CRitical Airway Management) which is an
The cost of consumables used within this study was provided by
emergency airway bag used within this study. The SCRAM® bag is now
Scottish Health Innovations Ltd. (SHIL). SHIL is a publicly owned private
a commercially available product and as such PS and NS receive a
company limited by guarantee, wholly owned by Scottish Ministers
royalty. We confirm that the remaining authors have no known conflicts
and two health boards. Working in partnership with National Health
of interest associated with this publication.
Service (NHS) Scotland to support and develop innovative solutions which address a clearly identified healthcare need; with the proposed
Publisher’s Note
innovations being generated by NHS healthcare professionals.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Availability of data and materials The authors declare that the data supporting the findings of this study
Author details
are available within the article and its supplementary information files.
1
Emergency Medical Retrieval Service, ScotSTAR, Scottish Ambulance
Service, Glasgow, UK. 2Scottish Air Ambulance Division, Scottish Authors’ contributions
Ambulance Service, Glasgow, UK. 3Royal Alexandra Hospital, Paisley,
PS conceived the study and obtained research funding. PS, ZP,
UK. 4ScotSTAR, Scottish Ambulance Service, Glasgow, UK. 5Scottish
AC, CM and NS designed the protocol. ZP and PS supervised the
Ambulance Service, Clinical Directorate, Edinburgh, UK. 6Centre for
conduct of the study and data collection. PS, DP and JP undertook
Trauma Sciences, Queen Mary, University of London, London, UK.
recruitment of participating clinicians, filmed the simulations and
*
Correspondence: pswinton@nhs.net
analysed the video recordings including quality control. CM, ZP, AC provided statistical advice on study design and analysed the data. PS, CM, ZP and AC were responsible for data analysis and interpretation. to its revision. PS takes responsibility for the paper as a whole. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us. We confirm that we have given due consideration to the protection of intellectual property associated with this work and that there are
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CTIONS 2019
s filling up fast!!!
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 (Kettering only) 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 7 ways to die in cold water (Bristol only) - 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 Offers 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). 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 morning Haemorrhage Control workshop plus the afternoon Outreach Rescue or Airway Management workshops for a special combined rate of £72 (saving £24). 4. Attend the Bristol First Responder half day morning Conference and attend the afternoon 7 Ways to Die in Cold Water workshop for a special combined rate of £72 (saving £12). 5. Attend the Bristol morning Trauma Workshop and the afternoon 7 Ways to Die in Cold Water Workshop for a special combined rate of £96 (saving £24). 6. Attend the Bristol 7 Ways to die morning workshop plus an afternoon Airway Management or Outreach Rescue Workshop for a special combined rate of £96 (saving £24).
nections.uk.com or call the Organisers Office on: 01322 660434
ctions.uk.com
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IN LIN INSIGHT E WITH THE CARTE R REP ORT
NEWSLINE 2019, after receiving planning
HELP Appeal is dedicated to
an agricultural location, who had
RD&E helipad will be upgraded thanks to the HELP Appeal
permission last year.
ensuring that all helipads across
suffered chest injuries, after being
the country are fit for purpose and
crushed by a cow.
Work to upgrade the current
Suzanne Tracey, Chief Executive
we are delighted that we could
at the RD&E said: “We are
donate £1million to the Royal
Nigel Hare, Operations Director
extremely grateful to the HELP
Devon and Exeter hospital to
for Devon Air Ambulance said,
Appeal and all those who have
cover the entire cost for a brand
“Due to patient confidentiality
donated. The upgraded helipad
new helipad. It will be built in
we don’t know much about the
will make a huge difference to
the same great location as the
patients we help. For our 27,000th
patients at the RD&E.”
existing helipad just outside the
mission we were deployed at
ED but will be larger, allowing
1531 from a 999 call and were in
Gavin Lloyd, Emergency Medicine
bigger air ambulances to land and
the air at 1534 hours. The flight to
Consultant at the RD&E, said:
it will be fitted with lighting to allow
scene took just 11 minutes.”
“This is a hugely impressive
night landings, which will help to
The donation has covered the cost
financial contribution and,
save even more lives.”
of the redevelopment and will allow
on behalf of the Emergency
the introduction of night landings
Department at the RD&E, I’d like
at the hospital. At the moment,
to say a massive thank you to
the helipad does not have the
the HELP Appeal and all those
capacity to support night landings,
who support this really worthwhile
meaning that its day light operation
charity. Getting seriously ill
is limited, especially throughout
patients and those badly injured
the winter months. The upgraded
to us quickly saves lives, and this
Devon Air Ambulance has
to patient outcome. On this
helipad will also be extended to
money will enable us to continue
reached yet another landmark,
occasion, after assessing the
enable larger helicopters to land in
treating these patients as quickly
by attending it’s 27,000th
patient and assisting the land
the daytime.
as possible.”
mission.
ambulance crew with treatment,
Work is due to be completed and
Robert Bertram, Chief Executive
On 11 February the service was
suited to travel by road to the
fully functioning by November
of the HELP Appeal, said: “The
called to help a rural patient, in
RD&E Hospital in Exeter.”
helipad at the Royal Devon and Exeter NHS Foundation Trust will begin in April, thanks to a £1 million donation from the County Air Ambulance HELP Appeal.
He added “The advantage of travelling by air is that we don’t
DAA
Landmark 27000th mission flown by Devon Air Ambulance
get caught up in traffic jams or in narrow country lanes. This means we get our critical care specialist paramedics and doctor to the patient as quickly as possible, which can make a huge difference
the patient’s condition was best
AMBULANCE UK - APRIL
58 For more news visit: www.ambulanceukonline.com
NEWSLINE Heléna Holt, CEO of Devon
Jodie said: “I thought I was going
Air Ambulance said “The last
to die. I had an awful feeling in
couple of weeks has seen us
my chest like a burning heat. I’ve
reach several landmarks; from
never felt anything like it before.
assisting our 100th patient in
But Ed arrived really quickly, and
the dark, opening the 100th
thanks to him and the other crew
Community Landing Site, to
I made it through.”
announcing that 2018 was our busiest year ever, helping 1,109
Now Jodie is encouraging other
patients. But we don’t have time
people to step in and take action
to rest on our laurels as we are
if they think somebody may be
constantly looking at the service
having a cardiac arrest or heart
and seeing what would make
attack.
our patient care even better.” Jodie said: “At first I struggled She added, “I would like to
with what had happened to me,
take the opportunity to say a
because there was no logical
huge thank you to our amazing
explanation. But since then I’ve
supporters, donors, staff, crews
realised how fortunate I was to
and volunteers across the
survive.
community. None of what we do would be possible without any
On the day of the incident Jodie’s
of them.”
mum Andria called 999 after her daughter had been in pain for
SWASFT
Jodie, 32, Thanks Ambulance Crew After Cardiac Arrest
around 30 minutes. Staff in the SWASFT Control Hub assessed Jodie’s condition over the phone, and organised for crews to respond.
A 32-year-old woman has been reunited with the South
Paramedic Ed Bowyer arrived
Western Ambulance Service
within five minutes to give her
NHS Foundation Trust
routine treatment. But then
(SWASFT) crew who saved her
Jodie’s heart stopped beating,
life when her heart stopped
and she needed urgent help to
beating.
stay alive.
Jodie Prudames, 32, had rapid
Ed led the effort to resuscitate
chest pains and began to
Jodie with the help of Janson.
sweat profusely at her home in
They pulled her onto floor, and
Midsomer Norton, North East
laid her flat on her back. By doing
Somerset in October.
CPR and shocking her with a defibrillator, they managed to get
Then she went into cardiac
her heart beating again.
arrest, lost consciousness and stopped breathing.
SWASFT Student Paramedic Nick Tolson and other SWASFT staff helped to provide post-
resuscitated Jodie, with the
resuscitation care for Jodie.
help of her partner Janson. She survived and has gone on to
Paramedic Ed Bowyer said: “This
make a fantastic recovery.
incident highlights that a cardiac
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.
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arrest can happen to anyone, of Jodie went to Shepton Mallet
any age, and at any time.
ambulance station on Thursday 7 March to thank Ed and other
“Jodie is living proof that people
SWASFT staff for saving her.
can and do survive.”
AMBULANCE UK - APRIL
SWASFT Paramedic Ed Bowyer
i-view™ video laryngoscope
Quality, innovation and choice
59
NEWSLINE Donation funds new helipad for Maidstone Hospital Maidstone and Tunbridge Wells NHS Trust is set to open a new 24 hour helipad at Maidstone Hospital thanks to the generous support of the HELP (Helicopter Emergency Landing Pads) Appeal. Robert Bertram, Chief Executive of the HELP Appeal, presented a cheque to the Trust on
our help. Seriously ill patients
workshops covering Haemorrhage
and Stoke-on-Trent
need hospital care in a matter
Control, Handling Bariatric
(November 28).
of minutes to increase their
Patients, Trauma Management,
chances of survival and recovery.
Airway Management, Pre-Hospital
The workshop will be looking at
Building a helipad with zero risk of
Major Incidents, Handling Minor
lifting systems that can be used
becoming waterlogged will ensure
Injuries and Seven Ways to Die
for the extrication of casualties
this happens, saving time and
in Cold Water. Delegate rates
or plus size patients from a wide
saving lives.’
start at just £36 which represents
range of locations including
tremendous value for money.
domestic situations and RTCs.
finished and ready for use by
For full details on all Conferences/
a 15 minute presentation on
Spring of 2020.
Workshops please visit:
handling plus size patients in the
£150,000 today and a further £150,000 will be donated later in
helipads. Currently helicopters are using a
If you have an interest in
temporary landing site at the rear of the oncology unit at Maidstone Hospital, but this site is frequently waterlogged. The new helipad will permanently replace this and will bring a 24 hour safe landing site
hospital environment, presented
Plus Size Workshop
Limited places are available at
by Hospital Aids.
each event at a delegate rate
the year.
Are you interested in Ultrasound?
dedicated to funding hospital
www.lifeconnections.uk.com. The HELP Appeal has donated
Wednesday 13 March. The charity is the only one in the country
This workshop will also include
The helipad is expected to be
Half day plus size workshops,
of £60 to include VAT, lunch,
run by Outreach Rescue, will
refreshments etc. To secure
be taking place this year in
your delegate place visit www.
Edinburgh (May 16), Bristol
lifeconnections.uk.com or call
(June 20), Kettering (October 17)
the organisers on 01322 660434.
Ultrasound you may be interested to learn that NEMUS Education and Training are running 5 regional one day workshops this year in: Edinburgh (May 16), Bristol
back to Maidstone.
(June 20), Kettering (October
John Weeks, Head of Emergency
(November 28).
17) and Stoke-on-Trent
Planning & Response at Maidstone and Tunbridge Wells
Each workshop will be covering
NHS Trust, said: ‘We are extremely
the common uses of ultrasound
grateful to the HELP Appeal for
in pre-hospital and hospital
generously agreeing to fund the
practice and is suitable for all
landing site which will make a real
health care professionals as
difference to Maidstone Hospital.
they include FAST Scanning, Focused AAA, Echo and Life
Leigh Curtis, Executive Director of
Support, Vascular Access etc.
Service Delivery, Air Ambulance
plus lots of hands on scanning.
Kent Surrey Sussex said: ‘Having access to hospitals, like
Only 40 delegate places are
Maidstone, is vitally important
available on each workshop at
to Air Ambulance Kent Surrey
a rate of £90 to include lunch,
Sussex, as it gives us the ability to
refreshments etc.
MedSkills Academy Trauma Management Workshop Thursday May 16, DoubleTree by Hilton, Edinburgh International Airport EH28 8LL
This continuing education course that teaches the principles of PHTLS is ideal for first responders, EMS practitioners, etc. Topics being covered include: Airway/ Oxygenation & Ventilation, Circulation and Shock, Traumatic Brain Injury & Spinal Trauma.
reduce our patients’ journey time, AMBULANCE UK - APRIL
giving them access to critical care
To register please email:
quicker. This one is particularly
sarah@nemus.org.uk
meaningful to us, as it allows us to
indicating your chosen location.
serve our founding community at
Visit: www.lifeconnections.
its very heart.’
uk.com to register online or call the Organisers on:
Robert Bertram, CEO of the
01322 660434.
HELP Appeal commented: ‘We go where we are needed most
Our one day regional Life
and Maidstone Hospital needed
Connections events also include
Only 12 places are available at a rate of £50.00 plus VAT (50% below normal Course costs). To register please visit:
www.lifeconnections.uk.com
60 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE LAS
Bereaved mum wins 999 control room award
“It’s just too much: it’s too much that
The team – which also runs
“He’s never going to get married,
parents are having to go through
sessions on road safety and
he’s never going to drive a car, he
what I went through by losing a child
careers advice – frequently work
will never have children. He died
– because of knife crime.
alongside the police, courts and
before his life started.
A mother whose teenage son
London Ambulance Service’s public
young offenders or those at risk of
“It’s just all been taken away from
education team is showing the
offending.
him; you bring a child into the
was stabbed to death has won an award for her bravery in taking a
prison service to engage with
stand against knife crime.
children not to carry knives.
Amanda Cassidy has made a film
In the film, Amanda makes a
for London Ambulance Service urging youngsters to stop carrying knives.
world and you’re there to look
film in schools to try to persuade Amanda has been presented with
after them all your life.
the APD Control Room Award 2019 for services to the public.
“You should never have to bury your own children, not
direct appeal to young people, saying, “Pick up your phone, pick
Margaret Luce, head of public
through something so stupid, so
up your keys, pick up your money
education, said: “Amanda was
avoidable.”
but leave the knife at home.
very courageous in coming
Greg was 18 when he died.
forward to tell her story. It is very
The 54-year-old started working as a 999 call handler for the
“If you’ve got a knife in your hand
powerful to hear first-hand about
Almost exactly a year later she
service after her eldest son Greg
you’re going to use it and you’re
her experience and we hope that,
got a job with London Ambulance
was killed.
going to be taking someone’s life
by making the film, we will help to
Service. She started taking
away.
make a difference.”
calls and is now responsible
something more from my life. I
“Or, you’re going to end up dead
Greg had just started training as a
emergencies across London.
needed to do something to make
yourself and your parents are
chef when he went to visit friends
She admits her colleagues in the
a difference; and the job we do -
going to have to go through what I
and family in the north. That night,
control room have helped her get
we save people’s lives.”
went through. It’s got to stop.”
Amanda got a phone call from a
through the dark times.
for dispatching ambulances to
She said: “After that I needed
nurse. She added: “I love my job. I love
When Amanda started in the
In 2018 paramedics from the
call centre 15 years ago, calls to
London Ambulance Service
She said: “We got a call saying
the people I work with. We’re a
stabbings were scarce. Now she
talked to around 8,500 young
he had been stabbed and was at
big team that look out for each
says they are a daily occurrence.
people at 68 events throughout
hospital. By the time we got there,
other. I enjoy what I do and I think
the capital, to tell them about the
he had died. It was a single stab
I make a difference, and we save
consequences of carrying knives.
wound to the chest.
people’s lives.”
Amanda, from west London, said:
AMBULANCE UK - APRIL
61 For all your equipment needs visit: www.ambulanceservicesuppliers.co.uk
NEWSLINE UK ambulance service stands firm with New Zealand counterparts
extremely proud of our colleagues in New Zealand and we wanted to do something highly visible to
show our solidarity, express our gratitude to those who responded to this horrific event and send
Delegates at the Association of Ambulance Chief Executives’ annual conference (#ALF2019) gathered together on 19th March 2019 to form a human ‘NZ’ to show their support for, and solidarity with, their New Zealand colleagues who responded to the deadly terrorist attack in Christchurch, as well as the families and friends of the victims. Anthony Marsh QAM, National Strategic Adviser of Ambulance Services, Chief Executive of West Midlands Ambulance Service and Chair of the Association of Ambulance Chief Executives said: “We are
AMBULANCE UK - APRIL
62 For more news visit: www.ambulanceukonline.com
our love to them, as well as the families and friends of the victims.”
NEWSLINE St John Ambulance purchases state-ofthe-art defibrillators in the fight against sudden cardiac arrest St John Ambulance has announced that it has purchased 30 new ZOLL® X Series® Monitor-Defibrillators for its clinicians to use on ambulances and at events around England to assist in its life saving mission in communities. The ZOLL X Series is about half the size and half the weight (less than six kg) of competitive
From left to right: Alan Weir, Head of Clinical Operations, Adrian Waller, Zoll’s EMEA Strategic Account Manager and Jonathan Dexter clinical manager for East region
full-featured monitordefibrillators, but a lot more powerful thanks to its advanced capabilities. Key among the X Series’ assets
“Once a person is in cardiac
a cardiac arrest no matter where
faster and with accuracy because
arrest, it’s a matter of life and
they are and St John Ambulance
patient data is provided so
death,” said Alan Weir, Head of
is called to treat them.”
quickly. All data is provided in a simple real-time colour display,”
Clinical Operations at St John Ambulance. “The X Series lets
The X Series was designed
said Adrian Waller, ZOLL’s EMEA
us assess, monitor and treat
expressly for healthcare
Strategic Account Manager.
the patient’s needs without any
professionals to meet the specific
unnecessary delay.
demands and extreme conditions
“The X Series is capable of
that St John Ambulance’s
taking automated blood pressure
“The X Series not only helps us
clinicians face regularly. Based
readings, monitoring the heart
save lives, but makes the work of
on a platform for the military and
rhythm and other vital signs, and if
our clinicians a great deal easier
air medical operations, the X
required can defibrillate the heart
without pausing. ZOLL’s Real
by having so many life-saving
Series is ruggedised and highly
by providing a life saving electrical
CPR Help ® provides real-time
capabilities in one unit. With
durable.
shock -- all critical measures
CPR feedback, and with CPR
ZOLL’s technology, we believe
Stat-padz measure the depth,
we are better equipped to protect
“The X Series monitor helps St
rate and effectiveness of chest
the lives of members of the
John Ambulance’s team make
compressions.
public who are taken ill or suffer
better patient care decisions
is the unequalled ability to assist and improve CPR quality to keep oxygen-rich blood flowing. ZOLL’s proprietary See-Thru CPR® lets rescuers reduce interruptions in chest compressions by allowing them to see underlying heart rhythms
®
life savers need to perform to determine a patient’s condition.” Photos courtesy of Stephan Kahn.
AMBULANCE UK - APRIL
63 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE SECAMB
Ambulance team to take on Three Peaks for cancer ward A team of South East Coast Ambulance Service staff will be lacing up their walking boots to take on the Three Peaks Challenge this summer. The team, made up of staff from Polegate and Paddock Wood, as well as staff family from Gatwick Airport security, is raising money for the charity-
The team, who will begin their
ward. Any support or donations
I cannot express how grateful I
challenge on 11 June, chose to
would be gratefully received.”
am to them all.”
several colleagues and their
Anyone who wishes to make
She said: “I was a fit and
relatives were directly affected
a donation towards team’s
healthy 35-year-old who woke
by cancer and some received
efforts can visit https://www.
up in intensive care to find out
treatment on the ward.
justgiving.com/fundraising/
my heart had stopped beating.
raise funds for the ward after
pevenseywardedgh/ Polegate Make Ready Centre Acting Operations Manager Matt Templeman said: “We’re looking forward to what will be a tough challenge. The team are currently training hard for this event, and will be walking under the guidance of Mountain Leader (And Operational Team Leader) Martyn Hall from our
funded Pevensey Ward at
Polegate Make Ready Centre.
Eastbourne District General
Over recent months, we have
Hospital. The challenge will see
sadly seen a number of our
them aim to scale Ben Nevis,
colleagues affected by cancer
Scafell Pike and Snowdon in 24
and we were keen to raise
hours, including driving time.
money for such a vital specialist
Cathy said the incident has SWASFT
Mum thanks lifesavers after her heart stopped A mum has been reunited with the South Western Ambulance Service NHS Foundation Trust (SWASFT) team and bystanders who saved her life when her heart stopped beating. Cathy Angell went into cardiac arrest at Ashdown Riding Centre near Wootton Bassett,
MedSkills Academy Essentials of Advanced Airway Management Thursday May 16, DoubleTree by Hilton, Edinburgh International Airport EH28 8LL
Swindon during her six-year-old son’s lesson in April 2018. The 35-year-old lost consciousness, stopped breathing, and her skin went blue. Fellow mum Stacey Buckland dialled 999, before riding centre owner Chloe Prim and bystander Wes Decker began
Learn the full range of Airway Management techniques, including: The Use of Extraglotic Devices, Video Assisted Intubation and Surgical Cricothyrotomy. AMBULANCE UK - APRIL
Only 10 places are available at a rate of £50.00 plus VAT (50% below normal Course costs). To register please visit:
www.lifeconnections.uk.com
trying to resuscitate her.
changed her perspective on life. She said: “I feel like I’ve been given a second shot at life. I’m not fully recovered, especially mentally. It’s been a slow and difficult journey, but I’m still here.” Cathy writes an online blog to share her experiences of living life after a cardiac arrest and to raise awareness of the condition. Paul Murphy, who was the first SWASFT Paramedic to treat Cathy, said: “Unfortunately a cardiac arrest can happen to anyone, of any age, and at any time. “Cathy is not the stereotypical person to suffer this condition. Many are elderly or suffer with known heart problems, but Cathy was young and healthy. “Cathy survived because people recognised that she wasn’t breathing effectively, and called 999. They followed instructions
SWASFT responders used
from the call handler to do CPR,
a defibrillator to administer
which they continued to do even
electronic shocks in an effort
after the volunteer responder
to restart her heart. Cathy was
and crews had arrived. Cathy
taken to hospital where she was
was given defibrillation at the
given emergency heart surgery.
earliest opportunity, and taken onto hospital where doctors
Cathy, who lives locally,
continued her care.
returned to riding centre on Thursday 21 March to thank
“Cathy is living proof that can
those who kept her alive. She
people and do survive cardiac
has no memory of the incident.
arrests, if they are given the right treatment and the right
Cathy said: “If it wasn’t for all
time. It is hugely humbling to be
these people, my husband
a part of a team that achieves
would no longer have a wife and
such an amazing outcome for a
my son wouldn’t have a mum.
patient.”
64 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE
We offer innovative EMS solutions, helping you provide a high level of care
More power to you
AMBULANCE UK - APRIL
This document is intended solely for the use of healthcare professionals. A healthcare professional must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that healthcare professionals be trained in the use of any particular product. The information presented is intended to demonstrate the breadth of Stryker product offerings. A healthcare professional must always refer to the package insert, product label and/or instructions for use before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area. Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: Power-PRO XT, Power-LOAD, Stryker. All other trademarks are trademarks of their respective owners or holders. The products depicted are CE marked in accordance with applicable EU Regulations and Directives. 08-2018, 2018-18327
65 For all your equipment needs visit: www.ambulanceservicesuppliers.co.uk
NEWSLINE Charles Fowler, attended as the
SECAMB
Long service and achievements celebrated at annual awards ceremony South East Coast Ambulance Service NHS Foundation Trust (SECAmb) staff, volunteers and members of the public have gathered to celebrate long service and achievements. The awards evening, the second of three being held across the Trust’s region, took place on Thursday 07 March at Woodlands Park Hotel, Cobham, Surrey. Chief Executive Commendations were presented across a range of categories including Clinical Excellence and Exceeding Expectations while staff were recognised for 20, 30 and even 40 years’ service.
Queen’s representative to present Queen’s Long Service and Good Conduct medals to frontline A&E staff, while volunteer Community First Responders were thanked and recognised for 10 years’ service. Among those awarded Chief Executive Commendations was paramedic Jennifer HughesGolding who, while still a student paramedic, and working on a non-emergency patient transport vehicle, was flagged down by a police officer to assist a traumatic cardiac arrest in Crawley, West Sussex. Community First Responder, Marc Harrold, picked up a commendation for his voluntary efforts in leading Horsham Community First Responders as well as a 10 year service award
There was a public commendation for Surrey Police PC Mikko Ball and delivery driver Alin Nicola for their quick actions in providing CPR to save the life of Reigate man, Francis Fernandes in July 2018. The Employee of the Year award went to the Trust’s Assistant Company Secretary Isobel Allen while the Team of the Year trophy this year was awarded to SECAmb’s Wellbeing Hub Team – a team launched in January 2018 to bring together a range of previously separate staff support services under one umbrella. SECAmb Chief Executive Daren Mochrie said: “With a total of some 850 years’ service recognised alongside some amazing individual and team achievements, I was very proud to celebrate with staff, volunteers and members of the public.
the perfect example of how it takes a team to save a life. The work we celebrated was, of course, just a small number of examples of the fantastic care which is delivered day-in, day-out, across our region. Well done to everyone. “I would also like to thank the family, friends and loved ones of staff who dedicate their careers and lives to helping others. Working for the ambulance service is a rewarding but also often challenging career.” Details of every award winner can be found below – for further information on each award, please see the awards booklet. Please note that this is the second of three awards ceremonies so only those staff named below received their awards on 7 March. Chief Executive Commendations
alongside his partner Hilary Deputy Lieutenant of Surrey,
Humphrey.
“Our public commendation was
Exceeding Expectations:
“...the moment they turned the camera on, the patient in front of them and their attitude immediately changed - so it is having that deterring effect. “ Mark Cotton, assistant director at NEAS
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08/04/2019 17:32
For more news visit: www.ambulanceukonline.com
NEWSLINE Tangmere-based Jennifer
Team of the Year: The Trust’s
Simon Ramm, Woking
cycle rather than a one off might
Hughes-Golding, who, while still a
Crawley HQ-based Wellbeing
Andrew Latham, Crawley
affect an individual’s mental
student paramedic, and working
Hub Team – The Wellbeing Hub
Catherine Sigournay, Steyning
health.”
on a non-emergency patient
has had recorded approximately
transport vehicle, was flagged
2,500 interactions with staff since
“It highlighted things that you
its launch in January 2018. The
SWASFT
down by a police officer to assist a traumatic cardiac arrest in
hub brings together a range of
Crawley, West Sussex.
previously separate staff support
Paramedics sleep rough for charity
services under one umbrella. Big-hearted Paramedics and
Community/Voluntary: Marc Harrold, Horsham CFR team
Queen’s Ambulance Service
Emergency Care Assistants
leader, for the dedication shown to
medals for Long Service &
from South Western Ambulance
his team of volunteers alongside
Good conduct (20 years) were
Service NHS Foundation
presented to:
Trust (SWASFT) Swindon
classes for public to learn CPR.
Brian McArthur, Worthing
Station slept out rough for 24
David Craddock, Chichester
hours to highlight the issue of
Clinical Excellence and
David Deville, Epsom
homelessness.
the setting up of Heart Start
Quality Improvement: Worthing paramedic, Jamie Webb, for his efforts as part of a team who responded to an imminent birth emergency.
Denise Downham, Staines James Hacker, Worthing
On Thursday 28 February 2019,
Jamie Webb, Worthing
Paramedic Chris Kirby was
John Vivian, Farnborough
joined by colleagues in support
Katherine Crabb, Chichester
of local charity ‘The Swindon
Kevin Cover, Redhill
Clinical Excellence and Quality Improvement: Crawley Paramedic Practitioner, Dan Creton, whose dedication and commitment to a new Paramedic Practitioner pilot in West Sussex has led to positive outcomes for both patients and staff. Clinical Excellence and Quality Improvement: A large group of Chertsey-based staff who responded so well to a major incident in Woking November last year when a number of children were injured falling from an inflatable slide at a fair being held at Working Park.
Paul Biddlecombe, Guildford Paul Stewart, Redhill Robert Margaillan, Godlaming Sarah Jones, Staines
Night Shelter’ which provides emergency accommodation, food and clothing for homeless people. The SWASFT team did the 24-
Warwick Avery, Banstead
hour sleep-out on the steps of
20 years NHS Long Service
the second year running. They
medals Matthew England, Worthing 30 years NHS Long Service Award: Darin Ringshall, Tangmere Nicholas Baird, Brighton Mark Bailey, Crawley Sally Laven, Chertsey Thomas Whiteside, Redhill
Swindon Ambulance Station for
would never even consider such as road noise when you are trying to sleep, foxes coming for a sniff, how cold a pavement gets after a few hours, and the absolute boredom of staying in one place for fear of losing your spot if you move. “The passing public were very supportive and kindly gave us several rounds of free coffee and food. This year, inspired by our new neighbours, the Swindon Night shelter, we shall be raising money for this local charity with a target of £3,000. We have built good relationships with the shelter, and hope to create a referral pathway to them within the coming months. We would actively encourage people to run similar events - it definitely creates an understanding for those who
hope to beat last year’s total
have no option but to sleep
of £2,000 which they raised for
rough.”
Shelter. The SWASFT team sleeping Paramedic Chris Kirby said:
out this year will be: Chris Kirby,
“Sleeping out last year opened all
Ollie Dalton, Charlie Goldsmith,
of our eyes as to what it must be
Adrian Sawyer, and two new
like for those homeless patients
faces: Lee Stagg and the Wiltshire
we treat, and how the thought of
Deputy County Commander Jane
being homeless as a continuous
Whichello.
Tina Shambrook, Tongham Tony Davies, Crawley
Public Commendation: Surrey Police PC Mikko Ball and Mr Alin
40 years NHS Long Service Award:
Nicola for their quick actions in
Anthony Bridges, Worthing
providing CPR to help save the
James Eaton, Redhill
life of Francis Fernandes, who
Phil Hamerton, Crawley
Reigate town centre in July last
Volunteer’s 10 years Long
year.
Service Award Andrew Clark, Horsham
Employee of the Year: Assistant
Pauline Flores-Moore, Southwater
Company Secretary, Isobel
Marc Harrold, Horsham
Allen, who was nominated for
Hilary Humphrey, Horsham
personifying the Trust’s values
Suzanne Martindale, West
and regularly demonstrating them
Wittering
in her day-to-day work.
Angela Small, Southwater
AMBULANCE UK - APRIL
collapsed in cardiac arrest in
67 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE outside their home in 2017.
has been totally dedicated
there to support me through it
Like mother, like daughter: Medic Mum’s pride as daughter follows in her life-saving footsteps
She quickly alerted her parents
throughout. I am so proud of
when I get home.”
Graeme and Tina – who were
everything she has achieved
off-duty – and sprang into action
to this point and much of this
Graeme and Tina met while both
to help the injured teenager.
is due to the wonderful training
working at London Ambulance
officers at Bromley.
Service in 1989.
two, said: “When I joined the
“It is surreal to think that in a few
Tina remains at the Service as
London Ambulance Service, I
weeks’ time Amelia and I may be
a paramedic and teaches life-
remember the training being
crewed together for a shift. I’m
saving skills including cardio
A Coulsdon mum has spoken
tough. However, back then our
sure that as long as she makes
pulmonary resuscitation (CPR)
equipment was quite basic and it
the tea, we’ll get along just fine!”
and using defibrillators.
LAS
of her pride this Mother’s
Tina, 48, and a mother of
Graeme, who worked for the
Day that her daughter is set
was all about getting the patient
to become a lifesaver in the
to the hospital as quickly as we
Amelia, who worked as an
Service for 38 years – including
ambulance service.
could. The role of the ambulance
office administrator and a police
a secondment on London’s Air
clinician has evolved so much
cadet, said: “Growing up with
Ambulance – is now retired,
Amelia Wilkie, 19, completed
and this is clear watching Amelia
my parents working for London
however, works part time in the
her training to be a medic with
go through the rigorous training
Ambulance Service has been
Service’s south east London
London Ambulance Service on
of not only learning the basics
quite normal for me. However,
NHS 111 control room.
29 March, exactly 30 years after
of emergency aid but also
watching them treat a critically ill
her mother, Tina, joined the
how to obtain and read ECGs,
teenager made me realise what
Graeme added: “I’m excited
Service.
administer drugs, and knowing
an important and responsible
for Amelia, although I can’t
how to use and understand the
job they have. Having now
help having parental concern
Amelia, who will be based at
extensive monitoring machines
completed the academic part of
about the situations she will be
Croydon ambulance station,
and equipment that is now a part
my training, I am looking forward
exposed to. However, she has
was inspired to follow her
of every ambulance clinician’s
to working operationally and
a calm and mature manner so
parents into the profession after
working day.
putting my skills into practice.
this job is perfect for her and
I also know that when I get a
I feel she will be an amazing
tough day, my parents will be
clinician.”
watching them help a victim of a serious road traffic collision
“Amelia has worked hard and
AMBULANCE UK - APRIL
68 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE NWAS
Ambulance service praised by minister for apprenticeships Apprentices at North West Ambulance Service (NWAS) met with Rt Hon Anne Milton MP, Minister of State for Apprenticeships and Skills and Chris Green MP for Bolton West and Atherton on Monday as the trust is named one of the top performing apprenticeship employers in the country. Currently employing 272 apprentices in a wide range of roles including frontline emergency medical technicians as well as ICT, finance, communications and fleet mechanics, the trust was thanked for its commitments, enthusiasm and drive for apprenticeships. The ambulance service changed the way it provides training to apprentices in May 2017 when it became an employer provider meaning it was able to deliver its first regulated qualification in-house.
Associate Ambulance Practitioner (AAP) apprenticeship, to become emergency medical technicians with 31 fully completed the course since May 2017.
proud of our apprentices who are really proving to us the value that they can bring to the organisation through their skills and drive for learning.
Apprentices are given 18 weeks of classroom and driver training before heading out on the road to gain hands-on experience working on an emergency ambulance whilst completing the remainder of the 12 to 18 month apprenticeship.
“By embracing government changes, we have been able to invest further into learning opportunities for our workforce widening the depth of skills they have and ultimately improving the level of care we give to our patients.
Successful AAP apprentices are employed by the trust as emergency medical technician 1s.
“Not just on the frontline, we have been able to offer apprenticeships within our corporate services too by linking in with relevant learning providers. This allows us to target a younger workforce and take advantage of junior positions with the hope that apprentices will go on to build a career within the organisation.”
Government reforms have meant that the trust has been able to benefit from using the apprenticeship levy to invest in training apprentices. Celebrating National Apprenticeship Week, NWAS will be showcasing ‘a week in the life of’ a number of apprentices and featuring them on their social media pages across the week. Carol Offer, Assistant Director of Workforce and Development at NWAS said: “We are extremely
Apprentices in other areas of the trust include fleet, learning and development and HR. Apprenticeships and Skills Minister, Anne Milton said: “I was thrilled to kick off National Apprenticeship Week 2019 with a visit to the North West Ambulance
Service, to meet apprentices who help deliver urgent and emergency health care across their region. “The apprentices I met are trained to deliver the right care, at the right time, in the right place – giving them an excellent foundation to progress in their careers, whilst making a huge difference to the lives of others. “Apprenticeships in the North West Ambulance Service are available in a number of different roles including paramedics, call handlers and urgent care assistants – all of which can lead to rewarding and fulfilling careers “Well done to all at North West Ambulance Service!” NWAS is now looking to expand its in-house apprenticeships and is working with ambulance services across the country to develop further apprenticeship opportunities for the ambulance workforce. All NWAS vacancies are advertised on NHS Jobs, www.jobs.nhs.uk.
In her first visit to celebrate National Apprenticeship Week, Anne Milton MP met with apprentices from different areas of the trust and expressed the benefits of offering these learning opportunities to further grow a skilled workforce. Damian Hutton, Emergency Medical Technician 1 in Manchester said: “I have now completed my apprenticeship and it’s given me opportunities that I never would have had otherwise.
Currently, 251 apprentices are enrolled onto the Level 4
Apprenticeships and Skills Minister, Anne Milton (pictured in red) meets with apprentices and trainers from North West Ambulance Service along with Interim Chief Executive, Michael Forrest, Chris Green, MP for Bolton and Chairman, Peter White. (Central L-R)
AMBULANCE UK - APRIL
“I was never interested in learning when I was younger but now have a nationally recognised qualification and have used this to progress onto further training to become a paramedic.”
69 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE NWAS
New research could provide early reassurance to patients with chest pain and reduce stress on ambulance crews and A&E departments
routinely taken to A&E for tests,
Service, we are delighted to be at
portable devices and could
although ultimately most do not
the forefront of this clinical study
become standard procedure
have a health problem that needs
to evaluate a new innovative way
in ambulances, avoiding many
treatment in a hospital.
of working to benefit patients
unnecessary transfers to hospital.
experiencing chest pain.
The PRESTO study will help researchers understand whether
The study aims to see if the NHS can safely avoid many
“This new technique allows us
T-MACS remains accurate inside
of these unnecessary hospital
to undertake more in depth tests
the portable ambulance setting.
attendances, thereby reducing
for patients at home, meaning
stress for patients and easing
clinicians can make more
Rick Body, Professor of
pressure on A&E departments
informed decisions about the best
Emergency Medicine at
and ambulances services, which
care for the patient.
Manchester Royal Infirmary, part of Manchester University
usually come under the greatest North West Ambulance NHS
stress during the winter months.
Trust paramedics in Greater
“This could mean that future
NHS Foundation Trust, and
patients who don’t require
Chief Investigator of the study,
Manchester are part of a major
All participants in the study will
immediate hospital treatment
said: “Every year the pressure
new research study to assess
see no difference to their standard
can be safely cared for in the
on Emergency Departments
whether future patients who
care or diagnosis.
community, reducing unnecessary
increases, and that leads to
A&E admissions and saving vital
patients having to wait longer
emergency resources.
in what are often very stressful
call 999 with chest pain can be safely assessed and managed
Angela Foulkes from South
by paramedics, without having
Manchester suffered a heart
to go to hospital.
attack 26 years ago after
“We are conducting the trial with
already helped to reduce the time
months of experiencing strange
paramedics and emergency
that patients with chest pain must
sensations around her neck.
medical technicians across
stay in hospital for tests.
Paramedics from North West
situations. Our research has
Greater Manchester, with patients
Ambulance Service NHS Trust are aiming to get more than 230
Late one evening, and with no
matching the criteria being given
“Paramedics are highly skilled
Greater Manchester patients to
diagnosis of cardiac problems,
the opportunity to be a part of this
professionals but, until now, they
take part in the trial. Consenting
Mrs Foulkes and her husband
significant project.”
simply haven’t had the equipment
patients are to be drawn from
called the out-of-hours GP, who
across central and north
examined her, then called for an
Manchester, Salford and Bolton.
ambulance to take her to hospital.
they need to be sure if patients How does it work?
have serious heart problems. That means that patients with chest
Researchers have already
pain are routinely taken to hospital
The study is being led by the
It was established that Mrs
developed a system called
for tests, which is inconvenient for
University of Manchester and
Foulkes had suffered a heart
the ‘Troponin-only Manchester
patients and inefficient for the NHS.
Manchester University NHS
attack and she was later
Acute Coronary Syndromes
Foundation Trust and funded by
diagnosed with angina, but she
(T-MACS) decision aid’ to avoid
“If we can now use portable
the National Institute for Health
has since lived comfortably with
unnecessary hospital admissions
blood testing devices to run those
Research. Three other ambulance
her condition.
from A&E. The PRESTO study
important tests without patients
is now assessing whether this
having to come to the hospital,
services nationally will also be involved, with a total of 700
She was invited to be a patient
decision aid is suitable for use
the impact would be huge.
patients expected to participate
representative on the PRESTO
before patients are taken to
Patients who don’t have serious
across three regions.
steering group having been
hospital.
heart problems could receive almost immediate reassurance
involved with HeartHelp Support The study, titled PRESTO (the
Group in Withington since her
T-MACS calculates how likely it
with minimal impact on their lives.
Pre-hospital Evaluation of
episode.
is that a patient has a serious
Ambulances could respond faster
heart problem by considering
to people who most need their
Sensitive Troponin), is part of the
AMBULANCE UK - APRIL
NHS’ ambition to find new ways
Mrs Foulkes, who worked with
their symptoms and the results
help. Emergency Departments will
of delivering healthcare more
children with hearing impairments
of basic tests. Research has
be less crowded, which will help
efficiently without the need for
before retirement, said: “Patients
shown that T-MACS can safely
to reduce waiting times.
hospital treatment.
value rapid, accurate information
reduce unnecessary hospital
about their condition. PRESTO
admissions, enabling immediate
“Patients who agree to take part in
Chest pain is the second most
promises good for patients and
reassurance for almost half of all
the study will see no difference to
common reason why people call
good for the NHS.”
patients having tests. It has been
their standard care or diagnosis,
successfully used in practice in
but will just have a few additional
Manchester since June 2016.
tests and observations to help
999 for an ambulance. However, the symptoms associated
Steve Bell, Consultant Paramedic
with a heart attack and those
and Principal Investigator at the
of non-cardiac conditions are
North West Ambulance Service,
The blood tests used in T-MACS
T-MACS and its suitability for use
often similar. These patients are
said: “At North West Ambulance
can now be carried out using
in ambulances.”
us to calculate the accuracy of
70 For more news visit: www.ambulanceukonline.com
NEWSLINE Researchers are looking to
with basic first aid and splinting
Steve said: “There were some
Tony, 55, recalled: “After it
recruit patients who call 999
skills. It was also quite a physical
businessmen having a meeting
clamped onto my trouser leg I
with a complaint of chest pain
job, with a lot of lifting involved
who got showered with glass
was leaping around like a river
and are subsequently attended
and no motorised tail lifts on the
after the explosion and there was
dancer, trying to get it off. I
by the ambulance service. After
vehicles.”
a security guard who was injured.
eventually managed to shake
the necessary treatment for the
Over the years they have seen
“We took them to Barts Hospital
garden. We’ve done quite a few
patient, paramedics will draw a
the introduction of state of the
but the press were already aware
jobs with animals that have gone
blood sample in the ambulance,
art healthcare equipment, the
we were coming. As soon as we
for us in one way or another.”
comprehensively assess a heart
development of new lifesaving
opened the back doors of the
tracing, and record patients’
skills, driven several generations
ambulance the flashes started
Tony, who is an Emergency
symptoms including details
of ambulances and worn four
going off, we were like rabbits in
Ambulance Technician, said
relating to the T-MACS.
different uniforms.
the headlights.”
building up an intuition with
Both men are fathers, with Tony
They said their most memorable
advantage with working with the
having two girls and Steve two
job was being chased and
boys.
attacked by a “Labrador-sized”
obtaining consent and providing
Investigators will review the patients’ medical records after 30 days to find out the final diagnosis. The actual care given to patients will not differ from today’s standard care. But the data generated throughout the course of the study will allow researchers to calculate the accuracy of T-MACS and its suitability for standardised use in by ambulance paramedics. The study is supported by the NIHR Clinical Research Network: Greater Manchester and receiving in kind support from Abbott Point of Care, LumiraDx and Roche Diagnostics International Ltd.
LAS
Crewmates reach 28 year milestone
it off and outpace it across the
iguana that was in a patient’s “Tony’s second child and my
garden.
first were born within weeks of each other,” said Steve, who is a
Steve said: “We were called to a
paramedic.
house that was surrounded by a bit of land and a big wall. As we
“On the morning of our first shift
were going in we heard a rustling
back after being off on paternity
in the bushes but didn’t think
leave we had to deliver a baby in
anything of it. As I came back out
the footwell of a car!”
to take kit to the vehicle I was met by this iguana which was three
They have spent most of their
and a half foot long, nose to tail.
careers at Battersea Ambulance
It was obviously a pet that had
Station and have attended
been left out in the summer to
several major incidents including
sunbathe. It chased me across
the Baltic Exchange Bombing in
the grass but I managed to
April 1992, which resulted in them
escape. When Tony opened the
appearing on the front page of
door it lunged at him and got hold
newspapers.
of his trouser leg!”
his crewmate was the main same person for so long. “Steve will do his bit and I will do mine and depending on what’s happening one person can get the relevant bits of kit without the other person asking,” he explained. “The job just runs that much easier, and when the patient is in the ambulance you are well choreographed what you say and do.” Clinical Team Leader James Bradley said Steve and Tony are not only the longest serving crew in Wimbledon group but probably in the London Ambulance Service. “Twenty eight years together as a crew definitely makes their
During 28 years as crewmates
working relationship special and
two ambulance staff have saved
definitely the exception these
dozens of lives, delivered more
days,” he said.
than 40 babies and survived several animal attacks.
“I have known them both for nearly 25 years and I can honestly say their consistently professional
Tony West from Croydon joined
approach to their work has never
London Ambulance Service
wavered. They are both top guys
in 1986 and 1987 respectively
who have seen many changes
before becoming crewmates in
at Battersea over the last quarter
1990.
century and as senior members of the station they make all our
“When we joined we didn’t have
new staff feel welcome. Possibly
defibrillators and we couldn’t give
the highest compliment I can
out aspirins,” said Steve, 54.
pay them both is to say if any of my family were unwell, Steve
“Getting blood pressures is
and Tony are the crew I’d want
about all we could do, along
attending to them.”
AMBULANCE UK - APRIL
Steve Redburn from Sidcup and
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NEWSLINE Meet a woman at the cutting edge of critical care This International Women’s Day, Magpas Air Ambulance Doctor Charlotte Haldane, 32, from Cambridge explains why she became a doctor, what drove her to Pre-Hospital Emergency Medicine and what it’s like to work for a lifesaving air ambulance charity. Charlotte says, “I’ve always wanted to be a doctor, ever since I was a child. I got a plastic stethoscope set for my 4th birthday and never looked back! “I first heard of Pre-Hospital Emergency Medicine (PHEM) when I was a medical student. I’ve always been a very active, adventurous person and when I realised there was a specialty
where I could be right at the cutting edge of critical care, and working in unusual environments outside the hospital, I had to get involved.” Charlotte worked extremely hard to get into this field. After over 10 years of training, placements, exams and experience, her hard work paid off and she became Magpas Air Ambulance’s first full-time doctor and now brings hospital level care to seriously ill and injured patients at the scene of their incidents, when time is of the essence.
done to support women during this process. However, being female has never been a barrier to anything for me. I was brought up in a family where gender did not matter and I was told from a very young age that I could do anything I wanted to do, providing I was willing to put the effort in to achieve those goals. I still believe this to be true.” Charlotte continues, “The work Magpas Air Ambulance do is very special. We’re called to people in their very worst moments, when they are at their sickest and really need our help.
Discussing women in PHEM, Charlotte explains “There are
“We know that if we’re there, with
plenty of female doctors in medicine although far fewer in the Acute Specialties such as Pre-Hospital Care and I think it’s important to ask why. Often for women who are trying to juggle young families and complete their Acute training, this is a hurdle too far and more needs to be
the opportunity and the privilege to provide a patient with advanced care, then we are giving them the best possible chance they could have. We use all of our specialist knowledge and skills to try to make a difference and to help them – and when we do, it is truly amazing.
AMBULANCE UK - APRIL
72 For further recruitment vacancies visit: www.ambulanceukonline.com
“Doing this job changes your perspective quite a lot. I am reminded regularly how exceptionally fragile life can be. The beauty of a normal day, where everything is just fine, is not something to be underestimated. In general I think we should focus more time and energy on being happy, laughing and being kind. It’s a cliché, but life really is too short.”
Life Connections Harrogate Over 140 delegates attended the various Conferences and Workshops that took place at this very unique event on Thursday 28 March and enjoyed listening to presentations given on topics such as: Mental Health in the Workplace, Heamorrhage Control, Injury and the Elderly, Epilepsy Awareness, etc., the Ultrasound Workshop
NEWSLINE provided delegates with an
A major achievement is the
Yourself microsite, which has
A quarter (26%) of UK adults
insight into: The Common
increased number of Blue Light
been created for staff to share
think they will be affected by a major emergency, but more than
Uses of Ultrasound in
Champions in post. Champions
their own stories, get tips and
Contemporary Pre-Hospital
are existing members of staff
ideas to help them be happy,
two thirds (70%) admit nobody in
and Hospital Practice,
who offer one to one support
healthy and fit, plus much more.
their household has taken steps
those attending the Trauma
for any mental health concerns
and Airway Management
staff may have, whether that be
Chairman, Peter White, who
to new research from the British
Workshops benefited from
due to attending a particularly
signed the pledge on behalf the
Red Cross.[2]
learning more about: Trauma
traumatic incident, or an issue
trust board said: “I am delighted
Patient Assessment, Essential
which may be happening at
that we’re playing a part in not
The British Red Cross is calling
Airway Skills, etc.
home. In 2016 there were just
only trying to reduce the stigma
on the sector, emergency
four champions, today there
associated with mental health,
services, local authorities and
The next of our one day
are almost 100 across the
but ensuring there is vital
the Government to work better
Life Connections regional
organisation.
support available to all our staff.
together to meet four key needs
The board have a responsibility
identified in the report:
events will be taking place in Edinburgh on Thursday May 16 and will again include First Responder and First Aid Conferences plus Workshops covering: The Common Uses of Ultrasound, Trauma Management and Airway Management. To view all programmes and to register, please visit: www.lifeconnections.uk.com or, call the Organisers on: 01322 660434.
NWAS
NWAS increase mental health support for staff
to prepare[1] That’s according
The trust is also very proactive
to ensure this support continues
in raising awareness on
and I would like to thank all the
mental health and reducing
staff involved for their hard work
the stigma of talking about
and dedication.”
and accountability for their staff’s mental health and overall wellbeing by having
practical needs • communicating essential
it. Local managers are being equipped to take responsibility
• addressing immediate
Most UK adults are totally unprepared for an emergency
information • providing mental health and psychosocial support • helping people rebuild lives
conversations, encouraging take up of health and wellbeing
New British Red Cross report
with access to advocacy,
initiatives, providing information
‘Ready for Anything’ says needs
advice and ongoing support
about mental health support
of individuals and communities
and signposting to other
must be at heart of response
Drawing on a survey of 5,000 UK
support available. The trust
to flooding, terror attacks, and
adults, and insights from those
also has an in-house Invest in
other emergencies
with direct experience of major
The North West Ambulance Service has further extended its commitment to supporting the mental wellbeing of its staff by resigning the ‘Blue Light - Time to Change’ pledge. The trust initially supported the national ‘Blue Light Programme’ led by the mental health charity MIND, and a pledge committing to supporting staff was signed AMBULANCE UK - APRIL
in January 2016. However, a lot has happened since then and to reflect the progress made, and the future aspirations to continue to improve mental health support for staff, a revised action plan has been completed entitled ‘Blue Light - Time to Change’ in order to allow the trust to re-pledge its commitment three years on.
Pictured L-R: Amanda Ferguson - Blue Light Champion Co-ordinator, Peter White – Chairman, Laura Smoult – HR Project Manager, Michael Forrest, Interim Chief Executive
73 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE incidents and emergencies,
house fire, flooding or a terrorist
respond and support people’s
using the report launch to
Ready for anything: Putting
attack is different and those
recovery best. One size doesn’t
highlight some simple steps
people at the heart of
affected will have differing
fit all, and planning together
organisations and individuals
emergency response, looks in
needs which are best addressed
and listening to people’s needs
can take to help prepare for any
depth at what people expect
through a joined up approach
locally can both reassure and
eventuality:
and need when crisis hits.
involving the emergency
empower communities to
services and their partners,
withstand incidents in future.”
It finds that individuals and
response app: receive alerts
including the voluntary sector.
communities can respond very
Download its free emergency
Naomi Phillips, Director of Policy
about incidents like flooding in
differently, so the support they
“The police work closely across
and Advocacy, at the British Red
your area; available in the Apple
are given to plan, cope and
these sectors to ensure multi-
Cross said:
App Store and Google Play.
recover from an emergency
agency response plans involve
should reflect that diversity.
all the right stakeholders and
“When an emergency hits a
Download its free first aid app;
For example, 42% of UK
we welcome this research from
community, it can tear at its very
get first aid advice at your
adults would want support
the British Red Cross which
fabric. If people are prepared,
fingertips; available for Apple via
finding family members they
underlines the value of greater
they can withstand the impact of
iTunes or Google Play.
had become separated from
co-operation to deliver support
shocks and recover over time.
following a bomb threat
to the public when it is needed
And, while a community takes
A person who experienced a
or terror attack. And more
the most.”
time to heal, people should feel
flood speaks in the report about
empowered, supported and
how significant it was for them
younger people say they’d want emotional support than older
Roy Wilsher, chair of the
confident in their own and their
to help their infant daughter.
people, 26% of those aged 18-
National Fire Chiefs Council,
institutions’ ability to respond.
They said: “I realised the extent
24 compared with 14% of those
said: “In the event of an
over 65.
emergency incident occurring,
“Closer collaboration between
my daughter was going to be
the fire service will respond
central and local government,
wearing not her own clothes,
The report also shows providing
along with other blue light
emergency services and
clothes that didn’t fit her,
cash for people to buy what
services, using nationally
voluntary sector organisations
nappies that didn’t fit her, and
they need in an emergency,
agreed principles and guidance
could help ensure people are
that’s when I think it hit home
rather than assuming what they
(JESIP).
as far as possible ‘ready for
with me that our lives had been
anything’ and that their needs
turned upside down. It was silly
need, was often more culturally
of what was happening, that
appropriate and desired. It gives
“The National Fire Chiefs
are met if the worst does
things, I remember the first day I
people dignity and allows them
Council actively works on closer
happen.
got a pink blanket to give her …
to make decisions about their
collaborative working between
own recovery.
all responders to emergency
“Our report offers powerful
incidents. We welcome the work
insights into what people require
A Red Cross volunteer spoke
The British Red Cross responds
undertaken by the British Red
after an emergency, whether
about the importance of talking
to an emergency in the UK
Cross in this report highlighting
a major event or the need to
about traumatic experiences
approximately every four hours.
how people can be supported
evacuate their home for a fire
after an emergency, they said:
The charity and its volunteers
following an emergency
or flood, something that could
“We as humans have a built-in
carry out first aid, run rest
incident.
happen to anyone. We’re inviting
need after a stressful situation
that was a big thing for me.”
emergency responders across
to go and talk about it. It’s part
where they offer emotional and
“I am also supportive of the
all sectors to work together and
of our survival mechanism.”
practical support. Every year,
British Red Cross’s new project
share our learnings.”
it helps around half a million
which aims to prepare local
people in the UK to prepare
communities to support each
The report also looks at the
for, respond to and recover
other and those responding to
needs of those who respond
in this survey as events that
from a crisis. It believes greater
emergencies.”
to emergencies, whether as a
caused significant damage
job or through volunteering. It
and/or required evacuation
centres and provide safe spaces
collaboration between different
References 1 Major emergency defined
AMBULANCE UK - APRIL
agencies and charities, as well
British Red Cross’ Head of
corrects some misconceptions,
and/or significantly disrupted
as sharing local knowledge and
Crisis Response, Simon Lewis,
e.g. a quarter of people wrongly
daily life such as a flood,
insights, will help meet the wide
said: “Major emergencies in the
believe that firefighters and the
terror attack, house fire or
range of individual needs in a
UK are thankfully rare and it’s
police routinely monitor social
severe storm.
crisis.
important to stress the majority
media for people needing
of people won’t be caught up
help, or that posting on social
National Police Chief Council
in one. But, whether it’s a flood,
media is a good way to alert
online survey of 5,008 adults
Lead for Civil Contingencies,
fire, power or water outage or
emergency services.
(18+) carried out by Opinium
DCC Paul Netherton said:
other alert, this report builds
“Every emergency, whether a
on our knowledge of how to
2 A nationally representative
between November 2nd and The British Red Cross is also
74 For more news visit: www.ambulanceukonline.com
12th, 2018.
IN PERSON WAA News
Providing lifesaving care thanks to our fundraisers
specialist critical care paramedics after demonstrating competency in administering drugs for pain relief and sedation,
LAS News
Chair Heather Lawrence OBE reappointed
carrying out surgical techniques as well as Two newly qualified specialist paramedics
completing postgraduate certificates. Fred
Heather Lawrence OBE has been
in critical care at Wiltshire Air Ambulance
has also achieved a postgraduate diploma.
reappointed as Chair of the London Ambulance Service for another term.
have praised people who fundraise for the Their training, which also includes aviation
charity.
skills, has been funded by the charity. Dan Tucker and Fred Thompson say it’s thanks to people who donate and fundraise that they
Before joining Wiltshire Air Ambulance
and their colleagues are able to save lives.
Fred, who is married with two daughters, worked as an ambulance operations officer
Dan, 42, who lives in Melksham, said:
in Bristol and before that was a paramedic
“Wiltshire Air Ambulance is a really important
based at Swindon Ambulance Station.
part of our community that gives the chance of life to many people who would otherwise
He said: “Working at Wiltshire Air
not make it due to the rural nature of Wiltshire.
Ambulance is great. I feel privileged to be
The people who donate and fundraise for us
able to come to work knowing what a great
are literally making the difference between life
team we have and our ability to make a
and death, because without their donations we
difference really counts.”
wouldn’t be able to provide the service we do.” Dan, who is married with three daughters, Fred, 45, who lives in Bristol, has fundraised
joined Wiltshire Air Ambulance after working
for the charity by running the Bath Half
as a paramedic based at Bath Ambulance
Marathon in 2017.
Station for ten years, including as a mentor to other paramedics.
He said: “Every pound counts and the charity makes sure that it supports all its employees,
He said: “Working at Wiltshire Air
volunteers and patients. It’s great to see how
Ambulance is an exhilarating job and
such a small county, in terms of population,
I love working in an environment that
supports their air ambulance.”
challenges me every day. The new airbase, at Semington, is a great place to work and
Both Fred and Dan joined Wiltshire Air
having the whole team together makes day
Ambulance in June 2015 and became
to day operations far more effective.”
The appointment was confirmed by NHS Improvement who are responsible for appointing and supporting NHS trust chairs using powers delegated by the Secretary of State. Chief Executive Garrett Emmerson said: “Heather has played a key role in transforming the Trust since she joined as Chair in 2016, leading its efforts to improve services as well as developing a pioneering strategy to ensure that by 2023 we are the primary integrator of healthcare services in London. “The significant contribution Heather has made to the Trust is reflected in the high esteem she is held by our colleagues across the Service and the wider NHS.” Her significant contribution and leadership steered London Ambulance Service out of special measures last year, leading to a ‘good’ overall rating from CQC. Chair Heather Lawrence OBE said: “I am delighted to be reappointed as Chair of the Trust Board. The Trust has made huge strides forward over the last few years and it’s want to do. “We must sustain what we’ve done and build on it and to that end, I intend to champion a change in our organisational culture to one that is even more collaborative and inclusive, making London Ambulance Service the
Fred Thompson and Dan Tucker, critical care paramedics at Wiltshire Air Ambulance.
AMBULANCE UK - APRIL
a privilege to be a part of, but there’s more I
employer of choice for the best healthcare professionals in the capital.”
75 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON LAS News
Twin paramedics retire after almost three decades caring for Londoners ‘Miracle worker’ twin paramedics are retiring after a combined 56 years of saving lives. London Ambulance Service’s Mark and Chris
Brian’s heart stopped beating and the twins
shame they’re retiring. I am really appreciative
performed cardiopulmonary resuscitation
to all ambulance workers – they do an
(CPR) before taking him to Barnet Hospital.
incredible job.”
Brian added: “They are miracle workers. I
The brothers plan to keep up their paramedic
would not be here today if it wasn’t for them
skills by working a few shifts a month, but will
and I can’t thank them enough for what
spend more time with their families as well as
they did. They were incredibly calm, and
doing hobbies they enjoy – including boxing at
professional and so experienced - it’s such a
Finchley Boxing Club.
McCarthy, 57, have worked their last shift from Friern Barnet station, after treating thousands of patients during their 28-year careers. Chris said: “Retiring was a very difficult decision to make but we do everything together so it seemed natural to retire together. We’ve had incredible careers, met amazing patients and worked with some great people. My wife said I was too squeamish to do this job and I’d only last three days, so I proved her wrong!” The brothers, who were both black cab drivers before joining the ambulance service, say it has changed considerably since they joined in 1991. Mark said: “The training and skills are unrecognisable – paramedics now all have degrees and it’s a true profession. “Years ago, we would literally pick up patients and get them straight to hospital, whereas now we stabilise and treat them on the scene before taking them to a specialist centre – it’s so much better for patients now. “There have been difficult times over the years, and in this job you do see some horrible things, however, we’ve always had each other for support. I’d definitely recommend it as a career – it’s been a real privilege to treat so many patients over the years.” Brian Wilson is one of the patients who owes his life to the twins. AMBULANCE UK - APRIL
The 68-year-old father and grandfather collapsed at his home in North Finchley five years ago and Chris and Mark were there in minutes. Brian said: “I collapsed earlier that day and was taken to hospital but tests didn’t find anything wrong so I went home. I remember thinking I must be sick as I was seeing double – not realising they were twins at the time!”
76 For further recruitment vacancies visit: www.ambulanceukonline.com
IN PERSON NWAS News
Paramedic awarded fellowship to support mental health in emergency services staff Consultant Paramedic for North West Ambulance Service (NWAS), Vinny Romano
which helps to support colleagues who have
knowledge and experiences to continue to
attended traumatic incidents.
make improvements to staff welfare.”
During his trip, Vinny will meet up with his
Vinny’s role as a consultant paramedic specialises
overseas counterparts to explore research
in education, he works alongside NWAS’
they have done around support for emergency
Education Team to provide important clinical
services staff. He intends to bring back his
input into all aspects of training, including newly
knowledge and learning to NWAS so that it can
qualified paramedics and frontline ambulance
be used to make positive changes in the trust.
crews as well as within the trust’s patient transport
has been awarded a prestigious Winston Churchill Fellowship.
service and emergency operations centres. Vinny says: “In life you only get a handful of amazing and unique opportunities, and
Chris Grant, Deputy Medical Director, said:
The Winston Churchill Memorial Trust runs the
I believe this is one of them. The chance
“This is a really exciting opportunity for Vinny
Churchill Fellowships, a unique programme
to travel to parts of the world and explore
to gain from the knowledge and experience of
of overseas research grants. These support
how goals can be achieved and barriers
our colleagues overseas.
UK citizens from all parts of society to travel
overcome will allow me to, not only share
the world in search of innovative solutions for
these ideas, but expand and improve on
“On his return, we will embed his learning into
today’s most pressing problems.
them.
our own system to the benefit of our patients
Vinny, 43, from Penrith has been awarded the
“Colleagues of mine who have previously been
our senior clinical leaders and this award is a
fellowship for 2019 to visit USA and Canada
awarded a Churchill Fellowship were able to
demonstration of how colleagues like Vinny will
to research staff support systems within the
gain a huge amount of valuable knowledge
continue to drive the profession forwards.”
emergency services.
by travelling to other countries and building
and staff. NWAS is committed to developing
After witnessing first-hand the difficulties that
relationships and I’m looking forward to doing
Vinny will start his journey in July when he plans
the same.
to travel to California before heading over to
emergency services staff face as a result of
Canada and New Orleans in September.
the work that they do, Vinny has a passion for
“I am keen to make contacts across
supporting staff and leads the trust’s Trauma
the countries I visit and maintain these
Follow Vinny’s journey on Twitter, @NWAmb_
Risk Management (TRiM) programme
relationships for years to come, sharing
Vinny.
AMBULANCE UK - APRIL
77 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON appointment and I look forward to working
protocols, identified the seriousness of the
Trust announces new Chief Executive
closely with Philip to continue to help drive the
man’s condition.
“I know that his experience at South Central
intervention and the patient was sent to A&E.
South East Coast Ambulance Service NHS
Ambulance Service and his variety of public
Three weeks later the man called Liam to thank
Foundation Trust (SECAmb) is pleased to
and private sector experience will be of real
him for saving his life.
SECAMB News
announce the appointment of a new Chief Executive.
organisation forward. Liam recognised the need for medical
benefit to the Trust. The judges said: “Liam’s passion for his role “I would like to thank Fionna for stepping up to
really shines through and he is a thoroughly
offer her expertise ahead of Philip’s arrival.
worthy winner.
“Philip said: “I am greatly honoured to have
“We were impressed with all Liam has
been appointed to this role and look forward
achieved in such a short time and by how he
to working with the excellent team in place at
used his skills to ensure a caller, who didn’t
SECAmb.
realise he was having a heart attack, received urgent medical intervention. That man believes
I would like to thank both Daren and Fiona for
Liam saved his life – a great example of the
their leadership and I know that we will build
amazing work of control room staff.”
on their successes.” Chris Powell, Area Manager for NHS Direct WAS News
Young Call Handler wins prestigious Control Room Award Philip Astle, will take up the role on 1 September, replacing Dr Fionna Moore, who
Liam Masurier joined the Welsh Ambulance
has acted up as CEO on an interim basis since
Service as a Call Handler for NHS Direct
the departure of Daren Mochrie.
Wales at Thanet House, Swansea, in September 2017, aged just 21.
Philip joins SECAmb from South Central Ambulance Service where he is currently Chief
Having joined from the retail
Operating Officer.
sector, Liam, from Swansea, has been praised for using a host
Dr Moore will remain at SECAmb in her substantive position as Medical Director. Prior to joining South Central Ambulance Service in 2016, Philip enjoyed a successful career in the British Army including a lead role as a strategist and planner for operations in Afghanistan. His final role was as Chief Operating Officer of the Army Training and Recruiting Agency. Since retiring from the Army, Philip held a AMBULANCE UK - APRIL
number of senior operational and leadership roles in both the public and private sectors. These have included director roles in Border Force, on the London 2012 Olympics, as Chief
of transferrable skills, including excellent communication, customer care and team working, to support patients across the country. His drive and passion have seen him excel in many areas, including as the top performing call handler in his team. He has consistently demonstrated his ability to identify emergency situations rapidly and obtain appropriate and timely help for patients.
Operating Officer of Her Majesty’s Passport
One such example was a patient
Office and, most recently, Vice President of
who rang reporting dental pain
Menzies Aviation plc.
when, in fact, he was having a heart attack. Liam used his
Welcoming Philip, SECAmb Chair, David Astley
questioning and listening skills
said: “I am delighted that we have made this
and, following training and
78 For more news visit: www.ambulanceukonline.com
Wales at the Welsh Ambulance Services NHS Trust, said: “This is a fantastic achievement for Liam. The ‘Young Achiever of the Year Award’ recognises his contribution to our service and he is a deserved recipient. “Liam is not only dedicated and passionate about his profession as a call handler but is a kind and caring person too. I know the award will mean a lot to him and his family and he should enjoy and treasure it.”
You could be the most important person they never meet. 999 Clinical Supervisors Salary ÂŁ28,050 - ÂŁ36,644 pa + Unsocial Hours Payment.* Job ref: 202-324-18
As an experienced registered nurse or paramedic, your face-to-face assessment and diagnostic expertise would rival any health care professional. However, delivering these skills over the telephone to a worried patient is arguably the biggest challenge in healthcare. Success relies on the ability of the Clinician to communicate clearly and effectively, working in close collaboration with the wider health and social care network to deliver clinical excellence. Our team expertly deliver this service every day and we are looking for passionate and ambitious clinicians to join us.
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