Working Together February 2015 by SCAS

South Central Ambulance Service NHS Foundation Trust

BRINGING AN INTERNATIONAL PERSPECTIVE TO SCAS

FEBRUARY 2015

Team work

Innovation

Professionalism

Caring

BRINGING AN INTERNATIONAL PERSPECTIVE TO SCAS

SOPHIE’S 111 CHOICE

PRAISE FOR SUPERHERO LUKE

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START A HEART AT THE UNIVERSITY OF PORTSMOUTH

PARTNERSHIP WORKING THAT SAVES SECONDS AND SAVES LIVES 3

SOPHIE’S 111 Sophie Kayani from Bourne End, Bucks, had used the NHS 111 service on a number of occasions for her children so when she awoke suddenly in excruciating pain having simply rolled over in bed early one morning last December, that was the number her husband Kass called straight away. “I have an ongoing knee condition”, explains Sophie “that causes my meniscus cartilage to lock – which basically means my knee joint completely locks and is very painful. Whilst on previous occasions I was able to ‘pop’ the joint back fairly quickly, on this particular morning I couldn’t and the pain was far worse than it had ever been before.” Having got through to SCAS’ 111 call centre, husband Kass was taken through the standard pathway questions and had to answer on behalf of Sophie who was, by her own admission with the intensity of the pain, ‘completely out of it’. This in itself was a major concern for Kass as he knew Sophie had a very high pain threshold and her reaction was completely out of character. “I think Kass was very relieved when he was told that an ambulance had been despatched”, remembers Sophie, “and the call handler had obviously briefed Maria and Alex well – the paramedics who arrived – as they had the gas and air ready as soon as they came in. And I certainly needed it!”

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1 CHOICE

AT LAST THE PAIN – WHICH WAS ME – SUBSIDED AND A TRIP TO The paramedics explained that they would try and manipulate Sophie’s knee in order to ‘unlock’ it but were unable to do so. Having given Sophie as high a dose of the painkiller, co-codomol, as they were allowed, they gave her the bad news that they were left with little alternative than to prepare her for a trip to her local hospital as it wasn’t getting any better and Sophie was still in extreme pain. “Obviously being in such extreme discomfort”, says Sophie, “Alex and Maria decided to get a line in and I was then also given a small dose of morphine as nothing else seemed to be working up to that point and this, they explained, was necessary in order to transport me downstairs, into the ambulance and off to hospital.” Whilst waiting for the morphine to take effect, Alex and Maria prepared the equipment they would need to get Sophie off her bed and downstairs. With that ready, they then began manoeuvring her very carefully into position. “This involved lifting the affected leg straight up”, remembers Sophie, “and just as they did that – ‘pop’ – it went back in! At last the pain – which was far worse than childbirth believe me – subsided and a trip to A&E was thankfully avoided.”

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S FAR WORSE THAN CHILDBIRTH BELIEVE A&E WAS THANKFULLY AVOIDED. Having given her morphine, Alex and Maria knew that they couldn’t simply walk away and on to the next job. They needed to ensure that Sophie was fine to be left and having got her out of bed and walking, albeit very slowly, to and from the bathroom, the next stage was to get her ‘discharged’ by an out-of-hours GP. “In order to do that they had to go back through the 111 call centre themselves to get the out-of-hours GP on the phone who could then discharge me remotely from their care. All-in-all, from the time they arrived they were probably with Kass and I for around two to three hours”, says Sophie. “I can’t thank them enough – they were absolutely excellent – as was the person my husband spoke to on the 111 phone line. Whilst I was in extreme pain, we knew it wasn’t life-threatening which is why we chose to call 111 not 999. And obviously the call handler was able to understand the seriousness of my condition and despatched Alex and Maria anyway to help.” Sophie is now waiting for a further scan on her knee and a follow-up appointment with her knee consultant.

THE ESSENTIAL GUIDE TO 111 Q1

How does a 111 call handler diagnose down the phone when they can’t visually see me?

Why are there so many questions?

èè We don’t diagnose, we rule out POTENTIAL diagnoses and once we get to a point where we cannot rule something out, the assessment ends and you are referred to the relevant level of care based on your symptoms. The referral could be either to an ‘in-house’ clinician, for further assessment/advice or to an ambulance response or to an external health care provider e.g. primary care service, a midwife, a dentist and so on.

èè The 111 service uses a nationally recommended NHS Pathways assessment tool. This has been approved by the Royal Colleges and Department of Health for use by 111 services in order to reduce patient risk and reduce life threatening issues first i.e. ABC (Airway, Breathing and Circulation). Some of the questions may not always seem relevant but are needed to provide you with a thorough assessment and the best outcome and care with your presenting symptoms. We then match you with a service in your local area that can deliver the care within the recommended timeframe.

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Are there any clinically trained staff in the 111 service?

Can I still contact my GP directly or do I have to use the 111 service?

èè Yes, we have a number of clinically trained staff working in the NHS 111 service they are qualified nurses and paramedics. They support a number of calls following the call handler assessment process, if it requires their skills and experience.

èè You can of course contact your GP during the day, but many symptoms may require an onward referral to another service. During the Out of Hours period the 111 service will signpost you to the right care at the right time, first time.

Call handlers are trained to use an ‘NHS Pathways assessment tool’. This has been approved by the Royal College of Medicine for use by all NHS 111 services. It determines the ongoing care and timescale required to ensure the caller receives safe, effective care.

Q4 Is the 111 service free from my telephone?

Q6 Does my GP know if I have called the 111 service? èè As long as you are registered with a GP, we will electronically send your details to your GP at the end of the assessment.

èè Yes, it is free from both landline and mobile networks in the UK.

What do I do if you recommend contact with a GP outside of GP surgery opening times

If you refer me to a ward for treatment, will I have to wait for ages to get seen?

èè If the recommended timeframe falls outside of your GP surgery opening times, we will refer you to the Out of Hours GP service. In Oxfordshire, the call handler can directly book an appointment for the patient while they are still on the call. Please note that South Central Ambulance Service do not run the Out of Hours service.

èè We do not directly refer patients to a hospital ward. This would be the decision of a GP or doctor in the Emergency department. We do not have specific information regarding hospital waiting times.

Q8 Isn’t it better if I just self-present myself to an A&E department instead of using the 111 service? èè No as these departments are for emergencies only and in many cases, we may refer you to a local minor injury unit or other primary care service that may actually have more capacity for you to be treated more quickly in the first instance.

Q10 Who has designed the system used to assess me? èè The system is wholly owned and designed by the NHS for the NHS. It has been overtly designed with the help of the BMA (British Medical Association) and the Royal College of Medicine, its clinical content is overseen by the National Clinical Governance Group.It has been the subject of a rigorous academic evaluation carried out by three universities (Sheffield, Southampton and Swansea) who declared it safe and appropriate.The system and our operations procedure are constantly reviewed to keep up with any new practices.For more information please go tohttp://systems.hscic.gov.uk/ pathways.

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Over 60 and feeling under the weather? A minor illness can get worse quickly. This winter see your local pharmacist for quick health advice or visit www.nhs.uk/asap Early advice is the best advice.

999 Ted says well done Luke!

Photo courtesy of Get Reading / Peter Bloodworth.

999 TED

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SCAS PRAISES LUKE THE LITTLE SUPERHERO SCAS has praised a four-year old boy who phoned 999 for his mum after she had a diabetic fit. Luke Stock from Tilehurst, Reading was about to be driven home after gym practice by his mum Helen on Monday 12 January, when Helen’s blood sugar levels dropped too quickly. Helen who has type 1 diabetes quickly began having a fit. Quick thinking Luke, who had been taught about his mum’s diabetes from a young age, did the right thing by phoning 999. Helen explained: “I’m just so proud of him and I want to get across to all parents it’s never too early to teach children the basics.

“Luke knows how to call 999, what his address is and to tell them his mummy is diabetic and has gone wobbly. He saved my life.” Mrs Stock was treated at the scene by SCAS crews. Mark Ainsworth-Smith, pre-hospital care practitioner for SCAS, said: “We commend Luke’s actions. “His prompt and sensible decision to phone 999 in a genuine life-threatening situation is testament of how even young children can help play a part in saving someone’s life. “We remain committed in encouraging and educating children and young people across SCAS communities about the importance of only dialling 999 in life-threatening emergencies.”

THINK BEFORE DIALLING 999 14

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South Central Ambulance Service NHS Foundation Trust (SCAS) encourages member of the public to think before dialing 999. We need your help to get to those who really need us most. Before dialing 999 THINK about whether you need an ambulance many everyday illnesses can be easily treated at home. Before going out, can you get telephone advice from the national 111? (please see section on 111 or your local GP) Alternatively, if that is not an option, you can attend your GP surgery (or if out of hours talk to your out of hours GP service), local walk in center, or speak to a pharmacist. Non life-threatening injury or illness If you are not suffering from a life-threatening emergency but require medical advice or treatment there are several different options available to you. You can: ÙÙ ÙÙ ÙÙ ÙÙ

Call your Out of Hours GP Service Go to your local Walk-in-Centre or your minor injuries unit Visit NHS choices website Call 111 (24hrs).

Life-threatening emergency If you are suffering from a life-threatening emergency, such as a heart attack, severe loss of blood, difficulty breathing or a serious accident, dial 999 immediately. REMEMBER If ambulance crews are called out to those people suffering from minor illnesses or injuries, they cannot get to those who really need their help.

THINK BEFORE YOU DIAL

BRINGING AN INTERNATIONAL PERSPECTIVE TO SCAS

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LAST SEPTEMBER, SCAS PARAMEDIC RICHARD DEAR WHO IS NORMALLY BASED IN THE TRUST’S NURSLING STATION IN SOUTHAMPTON, SPENT TWO WEEKS ON DEPLOYMENT WITH THE UK INTERNATIONAL EMERGENCY TRAUMA REGISTER (UKIETR) IN EAST TIMOR. UKIETR is hosted by UK-Med and brings together surgeons, doctors, anaesthetists, physiotherapists, paramedics and other trained healthcare professionals who are interested in responding to large scale emergencies. In November 2013, UKIETR deployed to the Philippines following the devastation caused by Typhoon Haiyan that killed over 5,000 people and in summer 2014 a team was also deployed to Gaza during the seven week conflict between Israel and Palestine. Currently, UKIETR is co-ordinating and leading the UK Government’s response to the Ebola crisis in West Africa. “There are over 1,000 qualified NHS clinicians on the register now”, says Richard, “and having recently finished my Masters Degree in Disaster Healthcare, being part of UKIETR gives me great opportunities not just to practice the skills I use every shift, but also to put the theory of my academic studies into practice in the field too.” Fortunately, Richard’s deployment to East Timor was part of a regular training exercise rather than in response to a local natural disaster.

Each year, in partnership with AUSMAT – the Australian Medical Assistance Team, UKIETR sends a team of UK healthcare professionals to work with Australian colleagues to provide emergency and medical support to the Tour de Timor, billed as the toughest mountain bike race in the world. “Because of the remoteness of the terrain, the heat, the altitude and the lack of local infrastructure, the Tour de Timor provides an excellent annual training event for UK-Med and AUSMAT teams to put some of the skills they would use in responding to a natural emergency, into practice”, says Richard. Richard was one of a team of four people from the UK, selected from around 25 applicants for the posting, with the other three members comprising an A&E nurse, a physiotherapist and a consultant anaesthetist. Having flown to Darwin with his UK colleagues, Richard met up with the team from AUSMAT. All equipment and uniforms were supplied and from Darwin, the team of 25 flew to Dili, the capital, on the north coast of East Timor. On arrival in Dili, the first task was to break out all the equipment from its containers, assemble it then load it on to the vehicles that the team would be using to follow the five day race.

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“Facilities in East Timor were limited”, remembers Richard. “The country only has nine ambulances for a population of over one million and when we were there, only three were roadworthy. If an ambulance is called for, then it needs to pick up a doctor from the hospital in Dili as there are no paramedics either. The ambulances are obviously all four-wheel drive vehicles given the country’s terrain but it is only doctors who carry and can give any drugs, which is why they need to be on the vehicle when it is called out.”

The Tour de Timor itself is one of the highlights of the year for the local population who all come out to support the event and cheer on the riders as it passes through the nation’s towns and villages. Just like the Tour de France, the route changes each year and it is seen as a great honour for a village to either host the start or finish of one of the five stages.

“It’s a bit like the Olympics for the local population”, says Richard, “and the kids really love it. They line the streets when the Tour comes to town and love seeing the international riders, who make up about a third of the competitors, as well as cheering on the locals.

As the support team, we followed the riders and camped at the start and finish points, but the riders themselves would stay in local guesthouses so with around 100 riders it also puts some much needed money into the local economies.”

A typical day for Richard and the team on the tour was like this: 4am

Get up and pack down personal kit before packing down the bulk of the medical centre (leaving a minimal amount of kit to deal with an minor complaints from riders that had developed overnight).

5am

Half the team would then move off and drive to the day’s finish point and re-assemble the medical centre in preparation for the riders returning later in the day.

7am

2pm

Race starts. Three support vehicles followed the race – one at the front with the lead riders, one in the middle and a sweep up vehicle at the rear. There was also a local ambulance in support along with two motorbikes, the riders of whom were from the Tactical Response Unit of the Northern Territories Police Force in Australia who had done the race before and were able to access riders and areas of the course that even the 4x4 support vehicles couldn’t reach.

First rider would cross the finish line of the day’s stage.

5pm 6pm

Last of the stragglers would cross the finish line.

10pm 11pm

Last assessments and treatments in the medical centre would be completed.

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The full UKIETR and AUSMAT team for the Tour de Timor, 2014. Richard is seated in the boot of the van on the right, wearing a dark shirt. Photo: AUSMAT.

The Medical Tent - set up, dismantled and transported each day. Photo: AUSMAT.

THE 25-STRONG TEAM SWAPPED ROLES SO EACH DAY RICHARD AND EVERYONE ELSE WOULD FIND THEMSELVES IN A DIFFERENT VEHICLE WITH DIFFERENT RESPONSIBILITIES. THIS ENSURED THAT EVERYONE ON THE TEAM WAS ABLE TO GET A MORE COMPREHENSIVE TRAINING EXPERIENCE.

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MR2 - the mid-race support vehicle on one of the stages.

“The medical centre we set up and took down each day had the capacity for carrying out surgical procedures, resuscitation and other interventions. Luckily we didn’t have any major injuries or incidents”, says Richard. “An Australian rider went over his handlebars on the first day injuring his neck. The local ambulance got to him first and after repatriating him back to the hospital in Dili – which took four hours alone and gives you an idea of the rough terrain – he was checked over and no lasting damage had been done. Aside from that, we had a few riders complaining of sore knees, sore backsides and occasionally chest pains but with no ECG facilities it was a case of listening to the patient, assessing the symptoms and making a call as to what, in our experience, needed to be done. Some riders we gave drugs to and they continued, others we recommended they call it a day.” With temperatures reaching 30ºC on the ride and the competitors cycling 100km a day on testing routes that often involved climbs of over 1,500m, all riders had to go through a cooling process at the end of each stage. In addition, all competitors were weighed at the start and end of each stage and had to maintain their body weight within certain parameters (+/- 2%), to avoid being pulled from the race due to dehydration. “As a qualified paramedic we have huge transferable skills, such as A&E triage, patient assessment and monitoring, so organisations like UKIETR are very supportive of getting more paramedics registered so they could be deployed on their assignments when needed”, concludes Richard. “For me personally, working with colleagues from Australia was extremely beneficial as they have a very well developed intensive paramedic system.

“I’ve picked up lots of ideas and different ways of doing things, and hopefully passed on some of my knowledge and expertise to them too.” With a new young family at home, Richard knows future deployments will be difficult but despite this, he is on call to respond within 24 hours to any natural disasters or emergencies UKIETR is asked to respond to. In the case of NHS professionals going to Sierra Leone to help with the Ebola crisis, for example, the deployment could be for a minimum of 6 weeks with a further 3 weeks in a non-patient facing role on return. However, he would encourage any of his colleagues to look at registering with UKIETR. “The East Timor experience I had was a unique training opportunity, and something that happens every year so in 2015, another UK paramedic could be able to do what I did. In addition, UKIETR has many amazing opportunities that previously didn’t exist for paramedics and these would open up a side of pre-hospital care that I’m sure many of my colleagues would aspire to.” With future international deployments possibly being limited to planning a good family holiday, Richard continues to work with the organisation and Save the Children to develop a portable surgical platform, which is now commissioned and stored in Cardiff. This can be deployed to anywhere in the world to deliver vital medical and surgical intervention to any relief effort whenever and wherever it is needed.

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The start of a stage - the menâ&#x20AC;&#x2122;s race was won by Canadian, Cory Wallace.

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START A HEART AT THE UNIVERSITY OF PORTSMOUTH 27

WITH OVER 23,000 STUDENTS AND 2,500 STAFF, THE UNIVERSITY OF PORTSMOUTH IS ONE OF THE UK’S MOST POPULAR FURTHER EDUCATION CENTRES AND ONE OF THE LARGEST EMPLOYERS IN THE SOUTH CENTRAL REGION SERVED BY SCAS.

FEB 15 With over 23,000 students and 3,000 staff, the University of Portsmouth is one of the UK’s most popular higher education institutions and one of the largest employers in the South Central region served by SCAS. As part of the University’s commitment to the health and wellbeing of its students, staff and members of the public who use its facilities, in summer 2014, the University allocated funding of £17,000 in order that the Health & Safety Office could install 11 Automatic Emergency Defibrillators (AEDs) in a number of locations across the University’s large estate. The funding would cover the purchase of the units, storage, installation and training costs. Laura Smithson, Health and Safety Audit and Compliance Administrator at the University of Portsmouth, explains how the team determined where to locate the new AEDs: “We identified high risk areas across the campus based on criteria such as what people do in the buildings or surrounding area, whether any activities carried out increase the chances of a person suffering a sudden cardiac arrest or locations where accessibility can be a little more challenging for emergency services personnel to attend. Seven of the new AEDs would be located at these high risk areas and the remaining four would be mounted on the University’s security vehicles which would allow enhanced coverage across the remainder of the campus.” The new AEDs were installed at sites in the centre of the city that are used by both students and members of the public, such as the Spinnaker Sports Centre, St Paul’s Sports Hall and the Dental Academy that can treat up to 300 NHS patients a day.

Other AEDs were located at the University’s Langstone Sports site that houses eight football pitches, two rugby pitches and a multi-use game area, as well as at the Langstone Campus Halls of Residence and at the University’s Institute of Marine Sciences (IMS). The IMS building is in an isolated location at Marine Harbour, and accessible only by a single road in and out. Simon Rushby, Technical Manager at the University’s Dental Academy, said: “Going to the dentist can be extremely stressful for some people and a time of great anxiety. With 20 dental surgeries in our building and 24 hygiene booths, this is probably one of the busiest dental practices in the country. We had one AED already but our new one is suitable for use both on children and adults, giving our staff additional confidence that if a medical emergency were to happen, we have the equipment that can make the difference between life and death before the emergency services arrive.” The University has over 300 staff first aiders and the Health and Safety team has been busy running a familiarisation programme over the last few months to ensure that those staff are confident in how to use the AEDs in a medical emergency. Laura Smithson explains: “The whole rationale of AEDS is that you don’t need to be trained to use them so our focus has been to ensure that no-one is scared of them and knows what to do in an emergency as every second really does count when you are in cardiac arrest.” The University worked with the SCAS Team SE04 based in Portsmouth, to choose the final models that were installed across the campus. On advice from the Trust, the University ensured that the new AEDs included a child model for use at the campus nursery. The AEDs were also added to the SCAS AED Locator app once installed.

OVER 30,000 CASES OF SUDDEN CARDIAC ARREST OCCUR EACH YEAR OUTSIDE THE HOSPITAL ENVIRONMENT 30

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GOING TO THE DENTIST CAN BE EXTREMELY STRESSFUL FOR SOME PEOPLE AND A TIME OF GREAT ANXIETY

Emma Vince, North Harbour Team Leader in Portsmouth, knows the value of having such equipment close to hand in an emergency. “Over 30,000 cases of sudden cardiac arrest occur each year outside the hospital environment and every minute without effective CPR (cardiopulmonary resuscitation) and defibrillation reduces someone’s chances of survival by 10 per cent. The AEDs installed by the University are simple and safe. Once you open the machine it gives clear spoken instructions so you don’t need any training to use one. Once you have the pads in position, the machine detects the heart’s rhythm and it won’t deliver a shock unless one is needed.” With an AED in each of the four security vehicles used by the University, security staff follow a procedure of bringing the AED to any reported incident in case it might be needed. Thankfully, none of the AEDs have been used at the time of writing but with eleven additional AEDs installed across the University estate, the campus is now a much safer environment and when called upon, the minutes saved in treating a patient suffering a cardiac arrest before an ambulance arrives could mean the difference between life and death.

EXCELLENT PRAISE FOR SCAS STAFF STRAIGHT FROM THE HORSE’S MOUTH! 32

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When we think of what would happen were we to be involved in an accident or emergency, we don’t often imagine that we’d find ourselves completely alone. However, that’s exactly the situation that Rhiannon Rogers from Wokingham, Berkshire, found herself in last summer. “Being the proud owner of Conker, a nine year old bay Welsh gelding, I can be found most mornings at his stable, turning him out and generally making sure he is his usual contented self”, explains Rhiannon. “As any horse owner will testify, even though they love us as much as we love them, we all tend to suffer the odd accidental kick – and I’ve certainly had my fair share of those!” But on this particular morning in July 2014, when Conker kicked Rhiannon in the ribs, it felt far worse than any kick she had suffered previously. “Having been kicked before – on the arm and leg for example”, says Rhiannon, “it obviously hurts but like a bad bang or knock the sharp pain soon starts to fade. Only this time it didn’t. Conker kicked me on my right ribs and not only did I feel my sight, hearing and balance were affected, I was also breathing with difficulty as if my right lung wasn’t working properly.” Having her mobile phone to hand, and with no-one else around at the stables or adjoining fields to help her, Rhiannon called 999 as she felt her adverse reaction to the kick from Conker had done her some serious damage that would need further urgent medical attention. Rhiannon describes what happened next: “The call operator asked me some basic details – why I was calling, what had happened, where I was, for example.

“And on hearing my symptoms told me that help was on the way and then asked me to stay on the line until the ambulance arrived. But with loose horses now in the field, I had to make another call to tell the yard owner to send someone else down urgently to check the horses were ok and secure them in the right fields if I was going to be taken away.” The SCAS operator made sure that Rhiannon would call back immediately should her symptoms or condition change, and she then phoned the yard owner to tell her what was happening. Having completed the call and hearing the approaching sirens of the SCAS ambulance, Rhiannon then realised the next problem would be the paramedics actually finding her. “I was in a field a little obscured from the main entrance to the stables”, she says, “so somewhat painfully and very slowly I made my way to the car park and just about got there as the ambulance turned in.” Having been helped into the ambulance, Rhiannon was given a thorough assessment at the scene by the SCAS team. “Ade and Marie – my paramedics – were excellent. Good humoured, obviously very dedicated to making sure their patients receive fantastic care and their response time was excellent. They were with me in about 10 or 15 minutes I think. They gave me some painkillers and took various assessments – my blood pressure, an ECG on my heartrate for example – and also listened to my lungs very thoroughly to check for any fluid.” Following her assessment at the scene, Rhiannon was conveyed to the Royal Berkshire Hospital in Reading for an x-ray and further tests.

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Fortunately there was no obvious damage to the ribcage or any vital organs so she was discharged from hospital a few hours later with instructions to rest at home and take a strong dose of pain relief. “I couldn’t have asked for a better or more professional service from the person who took my 999 call or from Ade or Marie who looked after me so well – I was very impressed!”

Rhiannon went to see her GP five days after the kick as she was still in agony and was prescribed stronger pain medication. “Whilst there was no lasting damage, it took me a good three to four weeks to get back to full health. “And during that time I had to be very careful trying not to laugh, cough, sneeze or knock my ribs as they healed.” Luckily, at the time of writing, Conker hasn’t given Rhiannon a similar kick to the one that left her needing an ambulance. Just the odd ‘friendly nudge’ she says with a smile.

PARTNERSHIP WORKING THAT SAVES SECONDS AND SAVES LIVES

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When SCAS Medical Director, Dr John Black, drove up to the John Radcliffe Hospital in Oxford on 8 May 2013 to attend a regular Trauma Clinical Governance meeting he was not expecting to have the meeting cut short and within minutes be on board the Thames Valley and Chiltern Air Ambulance (TVACAA) flying to attend a serious road traffic accident deep in the Berkshire countryside. But that’s exactly what happened and Jack Scott, the patient’s life that John helped save, was very glad Dr Black was at the John Radcliffe that day. Jack had been involved in a serious road accident in Finchampstead, Berkshire, a location that was not only some distance from a hospital, but nowhere near a hospital with a major trauma unit that Jack’s serious injuries required. He had sustained severe brain haemorrhage, multiple fractures to his face, neck and back and a collapsed lung. His life was in the balance. The first air ambulance on the scene was the Hampshire & Isle of Wight Air Ambulance (HIOWAA) as the TVACAA was on another call at the time the request came in to attend Jack’s accident. HIOWAA was manned that day by two SCAS paramedics who, on arrival and appreciating the seriousness of Jack’s injuries, immediately requested additional medical backup. As there was also no doctor available that day on TVACAA, a pager request was sent out to all local British Association for Immediate Care (BASICS) doctors from Tracey Alden, working in the SCAS Emergency Operational Centre in Bicester. All BASICS doctors carry a pager which allows them to be notified immediately if their skills and expertise is needed to be called upon at a moment’s notice.

Which is how John Black was alerted to this emergency during his meeting at the John Radcliffe hospital and, fortunately, he was able to make his way to the hospital’s helipad where he was picked up within minutes by the TVACAA and was on route to Jack’s accident. “We arrived just as the unconscious and physically trapped patient was safely removed from the vehicle”, says John. “This was no easy task in itself as he had hit a tree at high speed and, as you can imagine, the resulting injuries were severe. Jack was then anaesthetised and transported straight to the John Radcliffe’s Major Trauma Centre by the TVACAA.” Jack’s condition was so severe on arrival that he was given just a 2% chance of survival. Jack’s partner, Holly Atkinson, who had been collected by police to be able to attend the John Radcliffe takes up what happened next. “The original outlook wasn’t good, but I was assured he was in the best possible place, but was told that he would probably never be the same again.” The extent of his injuries meant Jack was placed in an induced coma for 12 days to allow his brain to heal properly and wore a neck and back brace for two months to allow his bones to align properly. He was dubbed ‘a walking miracle’ by his doctors when he was well enough to be transferred to a hospital in his hometown of Basingstoke. Once there he recovered slowly but steadily continued to improve, physically and mentally, until he was finally well enough to go home. Something Holly had thought, on the day of the accident, might never happen.

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IN CASES LIKE JACK’S SPEED IS A KEY FACTOR IN HOW WELL SOMEONE RECOVERS 39

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“I have no doubts”, she says, “that it was the expert care Jack received on the scene from the specialist trauma doctor and the fantastic paramedics on board the helicopter that saved him. They made Jack stable enough to fly and he was in the John Radcliffe trauma unit in no more than 20 minutes of arriving. “There would have been no other way where this kind of speed would have been achieved. In cases like Jack’s, speed is a key factor in how well someone recovers.” John, just like all those who raced to the scene, was happy to help and is as delighted as Jack and Holly about how well he has recovered.

“The local people we serve”, he says, “really do benefit from the truly integrated response we have been able to achieve between SCAS as the regional ambulance provider and our two partner air ambulance charities. Unfortunately, this degree of integration is not as well established in many other parts of the country but Jack’s survival is a glowing testament of how such integration can save lives.” Six months after his accident, Jack and Holly visited RAF Benson, the home of the TVACAA and met his saviours – Ges Charlton, Clive Stevens and Gerry Lea. Having proposed to Holly in Paris earlier in 2014, the couple are now planning their wedding in 2015.

What others say about us I would like to thank the 2 Paramedics who attended my mother. They arrived before I had finished speaking to the 999 operator and were very efficient and professional. They were extremely supportive to me and I thank them for their prompt actions and understanding.

Thank you for everything you did for my dad. Thank you for calming me down too.

I just wanted to write and thank you so much for your care, expertise and reassurance following my husbands fall. In a word you were all wonderful!

I was admitted following a serious cycle accident. The treatment I received from the ambulance crew was nothing short of inspirational. The care, knowledge and communication I received from every health professional highlighted how supportive, motivational and dedicated your staff areâ&#x20AC;?.

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I would like to pass on huge thanks to Emma, Leah and Eric for dealing with me after my fall from a horse. They were so kind and caring whilst maintaining a high level of professionalism.

To the crew that responded to a gentleman who was injured after the tree he was felling fell on him, “I can’t praise them highly enough, they were both highly professional, capable, caring, friendly (with a few well-deserved jibes about tree felling) and looked after both my wife, who is disabled, and myself perfectly. Ten out of ten or more if allowed.”

To the staff that responded to a patient suffering an adverse reaction to her medication, “The care I received from all of them was the best. Wonderful”.

My wife and I want to express our relief and appreciation of the way in which the ambulance personnel dealt with the situation so promptly and calmly. Without their service, I would not have survived to write this letter

HOW WEâ&#x20AC;&#x2122;RE DOING DECEMBER 2014 FIGURES TOTAL 999 ACTIVITY

47,692

111 CALLS ANSWERED

125,961 NON CONVEYANCE

NON CONVEYANCE %

19,917

45.97%

What does it mean? Total 999 activity equates to the number of calls which received a SCAS response or were dealt with by our clinical support desks. Non conveyance is the number of incidents we responded to where the patient was not taken to hospital.

Non conveyance % is the percentage of incidents we responded to where the patient was not taken to hospital. Red 1 - Red 1 calls are the most time critical and cover cardiac arrest patients who are not breathing and do not have a pulse, and other severe conditions. Red 2 - For Red 2 calls, which are serious but less immediately time critical and cover conditions such as stroke and fits.

FEB 15

RED 1 [8 mins]

69.94% RED 2 [8 mins]

70.13%

RED 1 [19 mins]

96.23% RED 2 [19 mins]

93.60%

CFR RESPONSES

3,282

PTS JOURNEYS

41,700 111 calls answered is the number of calls answered through the non-emergency healthcare service. CFR stands for Community First Responder. PTS stands for Patient Transport Service.

All figures are provisional.

T E E W T ion of Tweets ct le se ll a sm a is re e H y received from tl n ce re ve a h e w t a th olders and the h e k a st , rs e n rt a p r u o read more and to re e h k lic C . lic b u p to follow us!

stevenbuckley Jan 13, 10:50am Good to see a positive Care Quality Commission report for @SCAS999, one of the first ambulance trusts to be reviewed.

MrGarySwan Jan 13, 2:18am Essex lad working along side @SCAS999 past couple of months. Canâ&#x20AC;&#x2122;t fault the dedication, patient care and professionalism

FEB 15 HayleyJA Jan 28, 9:43pm Thank you @SCAS999 for amazingly prompt and reassuring service this evening, fixing 3yr old at home rather than hosp. M_F_Hand Jan 18, 12:31pm The #NHS is a wonder of the world & a triumph of civilization over selfishness. Special thanks today to @ SCAS999 and all your lovely people.

Eastleigh_news Jan 16, 10:35am @LittleMissAspie wants to thank @SCAS999 and all those who helped her Mum after accident 7pm last night at Swan Centre by Prezzo steps :)

NurseHayleyB 1 Feb 2015 10:03 am

7 3 4 6fo,llowers

@SCAS999 your crew last night were brilliant and canâ&#x20AC;&#x2122;t thank them enough for their help, patience and kindness with me.

TWEET US 48

@ s ca s 999

FEB 15

DATES FOR YOUR DIARY Date

Event

Location

Time

Patient survey Roadshow BASINGSTOKE

The Festival Place, Basingstoke

10am - 4pm

Friday 6 March

Patient survey / Health Awareness Roadshow OXFORD

Westgate Shopping Centre, Oxford

10am - 4pm

Friday 16 March

Patient survey / Health Awareness Roadshow PORTSMOUTH

Commercial Road Precinct, Southsea

10am - 4pm

February Friday 27 February March

13,153

Foundation Trust membership

13,000

public members to date

12,000 8,000

You can make a difference!

5,000

For more information, email getinvolved@scas.nhs.uk or phone 01869 365126.

NUMBER OF FOUNDATION TRUST MEMBERS

or ou f y t nk Tha suppor your mbers! me

The Communications team is always keen to promote stories in Working Together. Please email any news, stories or comments to: communications@scas.nhs.uk South Central Ambulance Service NHS Foundation Trust Units 7-8 Talisman Business Centre Talisman Road Bicester OX26 6HR www.scas.nhs.uk

16 FEB

DEADLINE for copy for the next issue: 16 February. Please keep articles under 250 words.

Design Âť Ben Hennessy - ben.hennessy@scas.nhs.uk