Ambulance UK June 2017

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Volume 32 No. 3

June 2017

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Ambulance UK This issue edited by:







102 Paediatric Cardiac Arrests

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EDITOR’S COMMENT It is a sad time for all of us at Ambulance UK. Barry Johns was well known throughout the Ambulance world and his untimely passing will leave many shocked and saddened. Barry was an energetic and extremely knowledgeable individual who always seemed to be at work somewhere in the world. And, if I had to remember Barry personally, it would be by the email chains that always started with the name of some exotic location he was flying to. At this time my thoughts are with Barry’s family and I would like to pass my heartfelt condolences to them. Though he may have left us, his memory I’m sure will live on.


“As I write this we are in the middle of a cyber attack which has interrupted the day to day running of hospitals because the IT infrastructure was past its sell by date three years ago”

Yes, I know it’s General Election time and it’s really important for relationships at home and in Europe. Whatever happened to good old-fashioned politics and reasoned, mutually respectful, debate. I have my own opinion and have tried hard to see past the logistically impossible promises made on all sides, I don’t really care who wins as long as somewhere in the manifesto there is a genuine promise to put proper investment in the NHS. As I write this we are in the middle of a cyber attack which has interrupted the day to day running of hospitals because the IT infrastructure was past its sell by date three years ago, nurses are threatening strike action and it seems like the only thing the politicians can do is try and out boast each other, good grief...get a grip! Isn’t it about time they all agree to sensible common goals that at the very least ensures the health and security of the population. Stability has to be a priority, changing the goalposts every few years does not help. Who has heard of a really successful business that only has a five year plan? Did I say I had my own opinion? There is a phrase, ‘plus ça change, plus c’est la même chose’ my French is not brilliant, but it means, the more things change, the more they stay the same. In many ways that’s exactly what has happened to the NHS. Countless new plans, iterations, re-badging and schemes, but essentially it’s still working to goals set over fifty years ago. That cannot continue. It’s the reason why we struggle to recruit nursing, medical and more importantly paramedic staff. My father had a saying, “pay peanuts, get monkeys...”, except modern healthcare needs a workforce that is properly skilled, knowledgeable, adaptable and most importantly paid appropriately. We have the former but not unfortunately the latter. I hope at least that someone in whichever party thinks carefully about the NHS for the future or we may find we lose that precious workforce. Aside from the obvious current affair, it’s nearly summer which means holidays... hooray! It also means Life Connections is upon us. This year a move to Telford will no doubt see a different audience attend but I hope those of you that have attended in the past will remember what a great event it is and make the short hop across country. Hope you all have a great summer and remember that politics are only one facet of our existence, life is for living…enjoy the sunshine and the conference.

Sam English, Co-Editor Ambulance UK

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I first met a fresh-faced young ambulanceman, Barry Johns, in 1971 when Chief Officer of the then City of Plymouth Ambulance Service. His well-deserved rapid promotion launched him on a career that would have a significant impact on the national and international development of ambulance services. Over the years I was privileged to be associated with him; in the introduction of air ambulances (HEMS), the early development of command and control systems and accredited paramedic training programmes. We shared conference platforms, collaborated in overseas consultancies and as convenors of CEN European Standards committees. As a former Ambulance Journal editor, I found his editorials topical and insightful. Barry’s winning smile and servant-leadership management style was infectious. His achievements in the West Midlands and, later in the Middle East, South Africa and beyond have left lasting legacies and won him widespread respect and admiration. His tragic departure, at a relatively young age, leaves behind a huge network of colleagues and friends and he will be greatly missed. John Wilby

Publisher’s Comment

Terry and all of the Team at Ambulance UK


We, at Media Publishing, were saddened to hear about Barry who was a great ambassador for the Ambulance Service, a brilliant Co-Editor and a true gentleman, we will greatly miss his input and enthusiasm. Our thoughts and prayers are with his wife and family.

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Authors: Alan M. Batt MSc(c)1-4, Ahmed S. Al-Hajeri BHSc1 Gerard Ward BSc1,5, Carmina S. Pilapil RN BScN1, Shannon Delport MTech1 Fergal H. Cummins MB BCh BAO1,6,7 Author for correspondence/reprints: Alan M. Batt, PO Box 63788, Abu Dhabi, United Arab Emirates Email: Tel: +1-905-973-6497 Competing Interests


Authors have no conflict of interests to declare, and the work was not

This study was a prospective cohort study of all OHCA incidents treated

supported or funded by any drug company. Each author of this paper

and/or transported by National Ambulance LLC ambulance crews

has completed the ICMJE conflict of interest statement.

between February 2014 and March 2015. A subgroup analysis was performed on all paediatric OHCA patients (defined as less than 18 years old) presenting during this period.

Author Declarations The authors declare that this work has not been published elsewhere. Further, the authors declare that they are responsible


and accountable for the accuracy and integrity of all aspects of this

The subgroup comprised of 14 patients (3.6% of the overall cardiac arrest


population). There were six male (43%) and eight female (57%) patients, with a median age of four years (IQR 0.63, 8.75). The majority of paediatric cardiac arrests occurred in patients from the Indian subcontinent (n=6,

Funding & Support No funding or support has been received for this manuscript or study from any manufacturer, pharmaceutical company, grant-awarding or

43%) with UAE Nationals accounting for three cases (21%). Trauma induced cardiac arrest accounted for six cases (43%) with three of these

commercial body.

(21%) as a result of traffic related incidents and two as a result of drowning

Author Contributions

of emergency medical call to arrival of crew at scene (IQR 7:45, 11:30).

(14%). The median response time was nine (9:00) minutes from receipt

AB was the principal investigator for the study, and principal author of the manuscript. AA, GW, CP, SD and FC assisted with study design, validated the dataset, and contributed to the final drafting and editing of the manuscript.

Bystander CPR was attempted in five cases (36%). Two patients (14%) presented in a shockable rhythm on first analysis. An overall out-of-hospital (at scene or en-route) return-of-spontaneous-circulation (ROSC) rate of 14% (n=2) was observed in the paediatric population. Conclusion

Acknowledgements The authors would like to acknowledge the PAROS steering committee and all National Ambulance staff for their engagement with the PAROS study.

A low ROSC rate for paediatric cardiac arrest was identified in the population studied, in line with previous studies. This highlights the need for public education addressing prevention of paediatric cardiac arrest, particularly prevention of trauma induced cardiac arrest. In addition, providing education to the public surrounding the early recognition of


paediatric cardiac arrest and subsequent actions to be undertaken, including early EMS activation and provision of bystander CPR is



an identified priority action arising from this study. Determining the

The objective of this study was to identify the incidence and clinical

baseline data presented in this study is essential in recommending and

characteristics of paediatric out-of-hospital cardiac arrest (OHCA)

implementing strategies to reduce mortality from paediatric OHCA.

cases in the emirates of Al-Sharjah, Ras-al-Khaimah, Umm AlQuwain, Al-Fujairah and Ajman (collectively referred to as the

Keywords: paediatric; cardiac arrest; resuscitation; prehospital care;

Northern Emirates) in the United Arab Emirates.

chain of survival; resuscitation; Middle East, UAE


National Ambulance LLC, Abu Dhabi, United Arab Emirates Fanshawe College, Paramedic Programs, London, ON, Canada 3 Centre for Paramedic Education and Research, Hamilton Health Sciences, ON, Canada




Centre for Prehospital Research, University of Limerick, Ireland Medical School, Royal College of Surgeons in Ireland, Dublin, Ireland 6 Graduate Entry Medical School, University of Limerick, Ireland 7 Charles Sturt University, New South Wales, Australia

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FEATURE Introduction

All cases of paediatric out-of-hospital cardiac arrest (defined as under 18 years old) treated by NA EMT crews were included in this

The United Arab Emirates (UAE) is a country composed of a multinational population with diverse educational backgrounds, cultural practices, and religious beliefs. Only an estimated 15-20% of the total population are UAE nationals, with the remainder comprised of a large proportion of expatriate workers from the Indian subcontinent, the Philippines and neighbouring Arab countries. As part of its commitment to reducing morbidity and mortality from out-of-hospital cardiac arrest (OHCA) in the population in the UAE, National Ambulance is a contributing member to the Pan-Asian

study. Cardiac arrest was defined as cessation of cardiac mechanical activity that was confirmed by the absence of a palpable pulse, unresponsiveness, and absence of spontaneous respirations. NA clinical treatment protocols (based on the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care) during the period of this data collection mandated transport of all paediatric OHCA cases to hospital (unless obviously dead with rigor mortis, decapitation, dependant

Resuscitation Outcomes Study (PAROS - cardiac arrest registry).

lividity, incineration, other injuries totally incompatible with life etc.). Do-

Survival rates for OHCA in the Middle East and Asia are low compared

study were all patients who were not treated by EMTs, due to recognition

to those in North America or Europe. Recent findings published from the United Arab Emirates and Saudi Arabia have confirmed these anecdotal reports of low survival rates for OHCA.(1–3) Paediatric cardiac arrests generally have poorer survival rates associated with resuscitation, even though historically many of these cardiac arrests occur in a home residence and are witnessed by family members. Survival is greater in witnessed events, and even greater in those who receive bystander CPR.(4) Health and healthcare delivery has improved dramatically in the UAE over the past 40 years. Consequently, the infant mortality rate (<5 years) has reduced from 223 per 1000 live births in 1960, to seven per

not-resuscitate orders do not exist within the UAE. Excluded from this of death at scene, and any patient over the age of 18 years. Results from post-mortem examinations were not utilised. Statistical analysis was performed using Statistical Package for Social Sciences (IBM SPSS Version 20, NY, USA). Descriptive analysis was performed to determine distribution and frequency and percentages were used to describe and report variables and patient characteristics.


1000 live births in 2009. In childhood years however, approximately 107

A total of 14 patients were identified in the NA PAROS dataset, using a

children per year die from trauma in the United Arab Emirates. Injury

combination of date of birth and/or age data variables. This subgroup

secondary to vehicular traffic incidents remains the leading cause of

represents 3.6% of all OHCA cases in the full dataset (n=384). Patients

death for children aged 0 to 14 years old (63%), followed by drowning

ranged in age from less than one hour old (new-born) to 17 years old.

and falls (10% each).(5) Reasons for this include poor compliance with

The median age was four years old (IQR 0.63, 8.75). Age and/or date of

traffic laws such as wearing of seatbelts and use of child seats, and

birth data was missing for 12 cases in the full dataset.

inadequate safety measures applied to residential pools, beaches, and high-level windows and balconies.

There were six male and eight female patients (43% and 57% respectively). Five patients (28%) had previous chronic medical

This prospective cohort study aimed to identify the incidence and

histories, which included diabetes mellitus, pulmonary hypertension,

clinical characteristics, including aetiology, of paediatric out-of-hospital

cardiac issues and cerebral palsy. Six patients (43%) were from the

cardiac arrest (OHCA) cases presenting to National Ambulance (NA)

Indian subcontinent, three (21%) were UAE nationals and three were of

crews in the Northern Emirates (NE).

other Arab descent (21%). The most common locations for OHCA in this subgroup were at a


home residence (n=5, 36%), street/highway (n=4, 28%) and healthcare facilities (n=3, 21%). The median response time was nine minutes

A subgroup analysis of a prospective cohort study was applied

(09:00) from receipt of emergency medical call to arrival of crew at scene

investigating all presentations of paediatric OHCA between February 2014

(IQR 07:45, 11:30). The most common aetiology (identified through a

and March 2015 in the NA Northern Emirates service area of the UAE.(2)

review of individual patient care records) was medical. Further patient characteristics are outlined on a case-by case basis in Table 1. All patients were transported to hospital (n=14) by National Ambulance crews. Data

ethical approval from the Office of the Chief Medical Advisor, National

for paediatric OHCA cases presenting to Emergency Departments by

Ambulance LLC. The implementation of the PAROS study has received

means other than NA crews is unavailable for this study period. Further

various IRB approvals from the countries involved in the PAROS study to

patient demographics and OHCA characteristics are outlined in Table 2.

which National Ambulance LLC is a contributing member. The PAROS network has a data sharing agreement that protects the confidentiality of

A total of nine incidents were witnessed by a bystander (63%) and one

all patients enrolled in the study.

event was witnessed by NA EMTs (7%). There were four incidents that were not witnessed (28%). CPR advice was offered by NA Ambulance

EMTs who provided care for cardiac arrest patients completed PAROS

Communications Centre (NA-ACC) call-takers and dispatchers to all callers

data collection forms designed for the PAROS study, which were then

once a diagnosis of cardiac arrest was confirmed or suspected. Telephone

reviewed by the PAROS coordinator in National Ambulance. Data

CPR (dispatcher assisted) had been attempted in five cases (36%) of

requiring clarification such as dispatch and arrival times were cross-

cases as confirmed by NA crews on arrival at scene. All of these cases

referenced with dispatch information before entry into PAROS database.

of bystander CPR were performed by a healthcare provider bystander.


This study complies with the Declaration of Helsinki and received

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FEATURE Table 1. Demographics, characteristics and outcomes of paediatric OHCA cases in Northern Emirates, UAE from Feb 2014 to Mar 2015. Gender Age


1 2 3 4 5 6

Female Female Female Female Female Female

4 13 1 14 6 10

Years Years Years Years Months Years

7 8 9 10 11 12

Male Male Male Male Male Male

17 3 5 1 5 4

Years Years Years hour Months Months

13 Female 4 14 Female 5 a. b. c. d. e. f. g. h. i.

Years Years

Medical History ISCc None Arab None ISC None ISC CPf ISC None Arab Cardiac issue (unspecified) UAE Unknown ISC None UAE Unknown ISC None Unknown TDNBg, PHTNh African Encephalitis, CHDi UAE Hypothyroidism Arab None Race


Location Type

Witnessed by b-CPRa ROSCb

Trauma Medical Medical Medical Medical Trauma

Healthcare Facility Public Building Healthcare Facility Home Residence Healthcare Facility Home Residence

EMSd HCPe Family Not witnessed Family Family

No Yes Yes No Yes No

No No Yes No Yes No

Trauma Trauma Trauma Medical Medical Medical

Street/Highway Street/Highway Street/Highway Street/Highway Home Residence Home Residence

Not witnessed Family Family Family Not witnessed Witnessed

No No No No No No

No No No No No No

Medical Trauma

Home Residence Place of recreation

Witnessed Not witnessed

Yes Yes

No No

b-CPR = Bystander-performed Cardio-Pulmonary Resuscitation ROSC = Return of spontaneous circulation ISC = Indian subcontinent (India, Pakistan, Sri Lanka etc.) EMS = Emergency Medical Services HCP = Health care provider CP = Cerebral Palsy TDNB = Transient diabetes mellitus of the new-born PHTN = Pulmonary hypertension CHD = cyanotic heart defect

Two patients were in an unknown shockable rhythm at time of first rhythm analysis (14%). Five patients presented in asystole (36%) and the remainder (n=7) were in an unknown non-shockable rhythm at time of first analysis.

Discussion Findings from this study support previous studies on the low survival rate for paediatric OHCA in the region.(6,7) The low rate of bystander

Of the 14 patients transported to the emergency department (ED), 12 patients were transported with no record of return of spontaneous circulation (ROSC) at any stage in the pre-hospital setting. An overall out-of-hospital (at scene or en-route) return-ofspontaneous-circulation (ROSC) rate of 14% (n=2) was observed in the paediatric population. These two cases had sustained ROSC on arrival at ED. All patients were transported to tertiary level centres. CPR quality data was not collected for the study period. A total of two patients gained ROSC at some stage in the prehospital setting. Both were female and were six months and one year old respectively. Both of these cases were bystander witnessed, were non-traumatic in nature and both had bystander

CPR may also be attributed to cultural norms, and a lack of knowledge surrounding first aid and CPR in general. Children with a chronic medical illness were less likely to have bystander CPR performed on them, and only one case with chronic illness received bystander CPR. The overall bystander CPR rate for all cases was less than 40%, yet over 70% of these cases were witnessed, the majority by a family member. The findings of this study highlight the need for education of public regarding paediatric chain of survival, in particular, reinforcement of the first link, namely prevention of cardiac arrest. This can be achieved through community-based and systemic efforts to raise awareness of prevention, and increase capacity to respond in the unfortunate event of a paediatric OHCA. Many of the witnessed paediatric OHCA cases in


CPR performed prior to ambulance crew arrival. The mean time

our study had a large delay in time before activation of the emergency

from ambulance dispatch to arrival was eight minutes in both

response system. This is likely due to the fact that many members of the

cases. Neither of these patients had a previous medical history.

public may have trouble identifying the patient who needs immediate

Both were documented as of Indian descent, and both presented

medical assistance, cultural norms, a lack of knowledge surrounding

in an unknown non-shockable rhythm on first analysis. These cases

first aid and CPR in general, fear of litigation and uncertainty.

occurred at a healthcare facility, and both received some form of advanced airway management (one was orally intubated and

However, the issue of potential litigation was addressed in a fatwa issued by the

one had a supraglottic device inserted) along with supplementary

Official Iftaa Centre, General Authority of Islamic Affairs and Endowments who

oxygen delivery. Both received epinephrine IV/IO from a healthcare

have stated that first aid should be administered by all people in accordance

provider at scene (physician or paramedic).

with Sharia law, and this aid provision would not attract any criminal liability.(8)

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FEATURE Table 2. Patient demographics, OHCA characteristics and outcomes of paediatric OHCA cases in Northern Emirates, UAE from Feb 2014 to Mar 2015. Characteristics Age Mean (SD) Median (IQR) Gender (n, %) Male Female Past medical history (n, %) Cardiac condition (unspecified) Diabetes Mellitus Pulmonary hypertension Unknown Location type (n, %) Home residence Healthcare facility Public/commercial building Street/highway Place of recreation Arrest witnessed by (n, %) Not witnessed Bystander First arrest rhythm (n, %) VTb/VFc/unknown shockable Unknown unshockable Asystole Prehospital intervention (n, %) Bystander CPRd Prehospital defibrillation Prehospital advanced airway (n, %) Oral/nasal endotracheal tube iGel None Location of cardiac arrest by emirate (n, %) Al-Sharjah Ras al-Khaimah Ajman Al-Fujairah Umm al-Quwain Outcomes (n, %) ROSCe Survived to admission Survived to discharge Post arrest CPCf 1/2

Population (n=14) 5.52 (Âą5.47) 4 (0.63, 8.75) 6 (43) 8 (57)

Although the incidence of vehicular crashes is decreasing according to police data, the severity of crashes is increasing.(5,10) Three of the children represented in this study suffered severe head injuries as a result of vehicular trauma (vehicle versus pedestrian), and a fourth suffered a severe head injury as a result of a fall from a height. Drowning as a common cause of paediatric death in the UAE is also supported by our findings, and previous literature indicates that occurrences of drowning are vastly under-reported in the UAE.(5) Thus this study likely under represents the issue of paediatric drowning in the

2 (14) 1 (7) 1 (7) 4 (28.5)

country. Of the two drowning cases in this cohort, one was in a pool in

5 (36) 3 (21) 1 (7) 4 (28.5) 1 (7)

the continued need for OHCA system investment, public engagement

4 (28.5) 10 (71)

morbidity from trauma is the establishment of a trauma network in the UAE,

2 (14) 7 (50) 5 (36) 5 (36) 2 (14) 1 (7) 1 (7) 12 (86)

a hotel complex and the other was in a bathtub in a private residence. These six paediatric cardiac arrests (43%) occurred as a result of predictable, easily preventable trauma. The findings of this study highlight and awareness campaigns for both the general public and healthcare professionals surrounding prevention of paediatric cardiac arrest. One of the key factors in the strategy to reduce paediatric mortality and with dedicated trauma centres and an organised trauma system which includes a national registry. Numerous studies have shown that severely injured patients have a greater chance of survival when cared for in an inclusive trauma system (11–14) and the treatment of paediatric cases at a dedicated paediatric trauma centre is associated with reduced mortality and morbidity.(15) National Ambulance LLC has recently been appointed the lead site for the United Arab Emirates for the Pan-Asian Trauma Outcomes Study (PATOS). PATOS is a collaborative research network that aims to inform trauma policies and practices within member states and in the Middle East-Asia-Pacific region in general. This will further the future evidence-based management of trauma in the United Arab Emirates.

7 (50) 3 (21) 2 (14) 0 (0) 2 (14) 2 (14) Not available Not available Not available


Emergency Medical Services b Ventricular fibrillation c Ventricular tachycardia d Cardiopulmonary resuscitation e Return of spontaneous circulation f Cerebral Performance Category

This study was limited to data collected by National Ambulance crews in the prehospital setting utilising PAROS forms and patient care records. Limited data was obtained on other prehospital variables, such as time from arrest to hospital, cases which were transported by other means, and any performed interventions during these transports. The cause of arrest was not confirmed by post-mortem examination because of cultural standards. A significant number of paediatric OHCA cases might still arrive at a hospital via private transport rather than by transport in an ambulance. This possibly resulted in incomplete enrolment of patients into our study. Our own data collection is incomplete for several variables, specifically 12 cases are missing age and/or date of birth data, and thus may have mistakenly been omitted from this subgroup analysis. This analysis may not be totally representative of the true paediatric cardiac arrest situation in the Northern Emirates. Our inability to discuss findings beyond the prehospital care phase, and the missing data on patient outcomes as a

in general is low in the region (3) and anecdotally, many patients are

result, is an obvious limitation of this study.

transported in private vehicles to emergency departments or medical clinics by individuals with limited or no medical training. Based on this, the results of this study likely represent only a percentage of the true


paediatric OHCA issue in the United Arab Emirates. A low prehospital return of spontaneous circulation rate for paediatric Most child injuries are predictable and preventable, and as previously

cardiac arrest was identified in the population studied. This study

identified, traumatic injuries are the main cause of death up to 19

highlights the need for public education addressing prevention of

years old in the United Arab Emirates.(5,9) The primary cause of these

paediatric cardiac arrest, in particular the prevention of trauma induced

traumatic injuries is vehicular traffic, which is supported by our findings.

cardiac arrest. In addition, providing education to the public surrounding


Utilisation of ambulance services for emergency medical conditions

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

FEATURE the early recognition of paediatric cardiac arrest and subsequent actions to be undertaken, including early EMS activation and bystander CPR provision is an identified priority arising from this study. Determining the baseline data presented in this study is essential in recommending and implementing strategies to reduce mortality from paediatric OHCA.

7. Conroy KM, Jolin SW. Cardiac arrest in Saudi Arabia: A 7-year experience in Riyadh. J Emerg Med. 1999;17(4):617–23. 8. Kelly R. “ Good Samaritan ” principles in the UAE : legal liabilities when administering first aid [Internet]. 2014 [cited 2015 Jun 14]. Available from: 9. Thomsen J, Joubert D, Huang D. Monitoring the Burden of Injuries in Abu Dhabi Emirate : HAAD Fatal Injury Statistics. 2013.

References 1. Ong MEH, Shin S Do, De Souza NNA, Tanaka H, Nishiuchi T, Song KJ, et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study (PAROS). Resuscitation. 2015;96:100–8.

10. Grivna M, Barss P, Stanculescu C, Eid HO, Abu-Zidan FM. Child and youth traffic-related injuries: use of a trauma registry to identify priorities for prevention in the United Arab Emirates. Traffic Inj Prev [Internet]. 2013;14(3):274–82. Available from: http://www.ncbi.nlm.

2. Batt A, Al-Hajeri A, Minton M, Haskins B, Cummins F. National Ambulance Northern Emirates PAROS Study Annual Report 2015. Abu Dhabi; 2015.

11. Utter GH, Maier R V, Rivara FP, Mock CN, Jurkovich GJ, Nathens AB. Inclusive trauma systems: do they improve triage or outcomes of the severely injured? J Trauma. United States; 2006 Mar;60(3):529–37.

3. Bin Salleeh H, Gabralla K, Leggio W, Al Aseri Z. Out-of-hospital adult cardiac arrests in a university hospital in central Saudi Arabia. Saudi Med J. 2015;36(9):1071–5.

12. Chiara O, Cimbanassi S. Organized trauma care: does volume matter and do trauma centers save lives? Curr Opin Crit Care. 2003;9(6):510–4.

4. Tress E, Kochanek P, Saladino R, Manole M. Cardiac arrest in children. J Emergencies Trauma Shock [Internet]. 2010;3(3):267– 72. Available from: PMC4150140/?report=printable

13. Lansink KWW, Leenen LPH. Do designated trauma systems improve outcome? Curr Opin Crit Care. 2007;13(6):686–90.

5. Grivna M, Barss P, El-Sadig M. Epidemiology and Prevention of Child Injuries in the United Arab Emirates: A Report for SafeKids Worldwide. Al Ain; 2008. 6. Salleeh H Bin, Al Tom M, Ahmed Y, Leggio WJ, Abdulqader NF. Out of Hospital Pediatric Cardiac Arrest : Prospective Study from Riyadh, Saudi Arabia. Biosci Bioctechnology Res Asia. 2016;13(1):569–72.

14. Twijnstra MJ, Moons KGM, Simmermacher RKJ, Leenen LPH. Regional trauma system reduces mortality and changes admission rates: a before and after study. Ann Surg. 2010;251(2):339–43. 15. Deasy C, Gabbe B, Palmer C, Babl FE, Bevan C, Crameri J, et al. Paediatric and adolescent trauma care within an integrated trauma system. Injury [Internet]. Netherlands; 2012;43(12):2006– 11. Available from: cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=21978766

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FANCY A FREE AND INTERESTING DAY OUT? Diary Date: Tuesday June 6 and Wednesday June 7, The International Centre, Telford REGISTER NOW AS A VISITOR OR DELEGATE at: Ambulance personnel from both the public and private sectors are invited to register FREE OF CHARGE to visit the Life Connections 2017/Emergency Fleet Exhibition where over 100 Trade Stands will be displaying the latest in fleet vehicles, vehicle technology and emergency equipment. For security reasons, those wishing to attend will need to preregister online via our website:

Professor Julia Williams - Can The Fire and Ambulance Services Work Together?, Dr Marc Gillis - Alveolar Ventilation via Continuous Chest Compression - No Pause Should be Your Cause, Dr Simon Le Clerc - Future Haemorrhage Control, Andy Thomas - Using Science to Improve Your CPR... It’s Time for Feedback. John Talbot, Amy Chan-Dominy, Will Broughton, Pete Gregory, Amanda Potterton, Steve Pratten, Nic Morecroft and David Halliwell will also be giving

This year’s confirmed Exhibitors include:

thought provoking and interesting presentations and, with delegate

Amazon Medical, BMW Group, CAPITA, Cartwright Conversions, CM Specialist Vehicles, Distinctive Medical, Eberspacher, Ford Motor Company, Goodyear Dunlop Tyres UK & Ireland Ltd, Honda UK, Hyundai, Intersurgical, Jaguar Land Rover, Medtree, Mitsubishi Motors UK, NMI Safety, Ortus Technology Ltd, RDT Ltd, Simulaids, S MacNeillie & Son Ltd, Vauxhall Motors, Volkswagen Group UK, Volvo Car UK Ltd, WAS, Wel Medical, Yamaha Motor Europe, to name but a few therefore those taking time out to attend as a delegate or visitor will have plenty to see and do. For a full list of exhibitors please visit: both the NAPFM ( and Life Connections ( websites.

rates starting from just £24 (including VAT) to include lunch/tea/ coffee/free parking, etc. this unique multi-conference event offers tremendous value for money - for full conference programme details please visit our dedicated website: By linking these two very unique events we are providing visitors and delegates with the opportunity for cross-communication via the Exhibition areas which bring together all aspects of the emergency sectors. For full conference details, please visit:

Four individual Conferences will also be taking place over the two day period for the benefit of those involved with pre-hospital care, the theme of this year’s event again being ‘Connecting Lifesavers with One Common Goal’. A Paramedic Conference and a First Aid Conference will be taking place on Tuesday June 6 with a Resuscitation Conference and an Emergency First Responder Conference being held on Wednesday 7 June. To date a number of keynote speakers from the UK and overseas have agreed to give presentations which this year include: Professor Sir Keith Porter - Fatal Fractures, Georgina McNamara - Sepsis - The Hidden Killer, Paul Savage OBE - Control of Major Haemorrhage & the Application of Tourniquets & Haemostats,




METHOXYFLURANE (PENTHROX) - A NEW PRE-HOSPITAL INHALATIONAL ANALGESIC History Methoxyflurane gained popular use in the early 1960s as an inhaled

in patients over 18 years of age, a decision that was influenced by the

anaesthetic agent. However, following extensive use reports of kidney

STOP study – a randomised double blinded – placebo-controlled study

damage (nephrotoxicity) emerged(1).

of efficacy and safety of Methoxyflurane in the treatment of acute pain(5).

Methoxyflurane, a fluorinated hydrocarbon was shown to produce

Although restricted to adult trauma in the UK it is worth noting the wider

damage as a dose related complication related to fluoride ions(2). As a

reported use in Australia for over 30 years which includes minor surgical

consequence the drug was withdrawn from use for general anaesthetic,

procedures, medical emergencies and obstetrics.

but was noted to exhibit excellent analgesic properties in much smaller doses than that used for anaesthesia(3). Utilisation of the analgesic properties of Methoxyflurane was taken forward commercially in 1978 with the introduction of a 3mL vial of Methoxyflurane and an inhaler by Medical Development International (MDI) in Australia and subsequently branded Penthrox in 2003.

The Product Methoxyflurane (Penthrox) is available in 3mL ampoules, and is a clear, almost colourless volatile fluid with a characteristic fruity odour.

Safety Since 1978 over 5 million doses have been sold for use in Australia. Only one questionable case of potentially Methoxyflurane related renal failure has been reported as an adverse drugs event in Australia between 1975-2016. It is accepted that the recommended low dose Methoxyflurane is not associated with nephrotoxicity, and no clear cut cases of renal failure have been reported in the literature(4). An understanding of the safety margin for the use of Methoxyflurane was eloquently demonstrated by Professor Dayan in terms of the minimum alveolar concentration (MAC) which is the minimum concentration of an inhaled anaesthetic necessary to produce surgical anaesthesia in 50% of healthy individuals. Using a maximum exposure possible to Methoxyflurane using the Penthrox system the MAC was 0.3 MAC hours which is much lower than the safe AMBULANCE UK - JUNE

upper limit for exposure to Methoxyflurane of 2 MAC hours. In addition the fluoride levels were much lower than that associated with renal damage.

Utilisation Although Methoxyflurane is available in 16 countries worldwide it was only introduced into the UK in 2015 following a successful application to the Medicines and Healthcare products Regulatory Agency (MHRA). The initial license has been granted for use in moderate to severe trauma

108 For further recruitment vacancies visit:

FEATURE Each Penthrox pack contains one 3mL bottle and one activated charcoal chamber to absorb any exhaled Penthrox in the patient’s breath. A second 3mL bottle may be utilised with a maximum of 6mL in 24 hours. No more than 15mls or 5 vials should be used in a week.

Conflicts of Interest Professor Porter was involved in the preparation of the submission to the MHRA for licence approval and is a member of the Penthrox Clinical Advisory Board funded by the UK distributor, Galen.

The Penthrox solution is poured into the inhaler via a one way valve and is absorbed into a wick and following vaporisation is inhaled through a mouthpiece by the patient.

References 1. Crondell WB, Pappas Sg, Macdonald A Nephrotoxicity associated with Methoxyflurane anaesthetic

Key features include: • Rapid onset usually 6-10 breaths(5) • No adverse effect on blood pressure(6) • No adverse effect on respiratory rate(6) • No adverse effect on conscious levels • 3mL inhaler lasts 25-30 minutes if used continuously • Self-administered

Anesthesiology 1966;27:591-607 2. Cousins MJ, Mazze RI Methoxyflurane nephrotoxicity: A study of dose response in man JAMA 1973;225:1611-6 3. Tumi K, Mashimo T, Tashiro C Alteration in pain threshold and psychomotor response associated with subanaesthetic concentration of inhaled anaesthetics in humans Br J Anaesth 1993;70:683-6 4. Dayan AD

• Can be used over a wide range of temperatures

Analgesic use of inhaled Methoxyflurane: Evaluation of its potential nephrotoxicity

• The device is light in weight, easy to use and portable

Hum Exp Toxicol 2016;35:91-100 5. Coffey F, Wright J, Hartshorn S STOP: a randomised double-blind placebo controlled study of

Pre-Hospital Use Penthrox can be used at the first point of patient contact either as definitive pain relief or as a bridge until the patient is successfully cannulated and intravenous analgesics administered, for example the elderly patient with a neck of femur fracture in extreme pain and no visible veins for vascular access.

efficacy and safety of Methoxyflurane to the treatment of acute pain Emerg Med J 2014;31:613-8 6. Oxer HF Effects of Penthrox (Methoxyflurane) as an analgesic on cardiovascular and respiratory function in the pre-hospital setting J Mil Veterans Health 2016;24:14-20

Provision report from South Central Ambulance Service reported quality pain relief and this is supported by the experience of Cheshire & Merseyside Fire Service. (Personal Communication - Mark Forrest) With increasing use (some on trial) by Ambulance Services, helicopter services and BASICS schemes as well as Emergency Departments there is scope for more detailed evaluations and publication.

Methoxyflurane (Penthrox) is a new to the UK self-administered inhalatory analgesic with a proven safety record and a history of over 5 million uses in Australia. With increasing usage in pre-



hospital care and Emergency Departments it is being recognised as a useful adjunct to the choice of analgesia available.

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


Suffolk family’s emotional reunion with medics who saved father-of-two

an emotional reunion with his

Lee in an ambulance, and Dr

lifesavers on Saturday (22nd April)

Alain Sauvage, Advanced Critical

where he thanked the people who

Care Practitioner Mike Hild and

resuscitated him.

Paramedic Dan Phillips from SARs also rushed to his aid.

“It is difficult to put into words, but I would not be here today

Dan, who is also an area clinical

if it wasn’t for these guys. It is

lead for EEAST, said: “The main

overwhelming and it is nice to

thing that made the difference

have the opportunity to meet

was what Nicola did. Immediate

them. I want to give something

CPR is the most important when

back,” he said.

someone is in cardiac arrest.”

Wilding’s life after his heart

Andrew has pledged to raise

Andrew was taken to West

suddenly stopped six months

funds for SARS – the emergency

Suffolk Hospital and transferred


medical charity whose volunteer

to Papworth Hospital where an

doctors and paramedics provide

implantable cardioverter defibrillator

critical care at serious incidents.

(ICD) was fitted in his chest.

The teams also praised

His son Harry, 19, who plays tuba

Nicola Wilding for performing

for the East of England Co-op

He cannot remember going to

cardiopulmonary resuscitation

Band, has already raised more

a church concert with his family,

(CPR) on her husband. She has

than £3,600 for SARS from a

getting a takeaway, driving home

had no first aid training, but was

concert and daughter Lucy, 15,

and going to bed feeling tired but

guided by the EEAST Call Handler

has organised an non-uniform

will forever be grateful to the East

Shane Moulds to do “spot on”

day at Stowmarket High School.

of England Ambulance Service

chest compressions before the

A calendar of Suffolk landscape

NHS Trust (EEAST) staff and Suffolk

arrival of Paramedic Harry Fisk six

photographs put together by

Accident Rescue Service (SARS)

minutes after the 999 call. Andrew

Andrew is also raising money for

clinicians who rushed to his aid.

was resuscitated with one shock

the charity.

“You are worth your weight in gold” A Suffolk family has thanked ambulance staff and volunteer medics for saving Andrew

The 49-year-old from Stowmarket went into cardiac arrest just after midnight on 20th November.

from a defibrillator. The father-of-two, who had a

For more information on the work

heart transplant seven years ago

Duty Locality Officer Ollie Yarrow,

of SARS, visit http://www.sars999.

as a result of a rare disease, had

Benjamin Southam and Terence


Supporting ambulance staff through the good times and bad of mental health Bosses at the region’s ambulance service have thanked colleagues for getting behind a massive programme to support staff and tackle the stigma surrounding mental health. Ahead of next month’s anniversary of signing the MIND Blue Light Time to Change Pledge, the East of England Ambulance Service NHS Trust (EEAST) says nearly 170 people are now practitioners in the trauma risk management (TRiM) process. Peer-delivered, this provides support to colleagues who have suffered traumatic stress at work. The team behind TRiM are a group of specially trained practitioners who base their support on the principles of education, support and mentoring. The practitioners will listen to colleagues’ experiences and offer practical advice and support, signpost them to appropriate resources, and assist them in returning to work. And now it has a team of 165 TRiM practitioners thanks to a drive to increase training, with a recent recruit including Director of Service Delivery, Kevin Brown. The Trust’s Health and Wellbeing Manager Debra Winterson added: “We are passionate about looking after our staff, and along with TRiM,


are currently working on a wide variety of projects that will gradually form a wide-ranging service.” The MIND Blue Light Time to Change Pledge encourages organisations to publicly commit to a series of actions to tackle the Andrew Wilding and his family with his lifesavers

110 For more news visit:

stigma and discrimination around mental health.



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Trust invites schools and community groups to sign up for ‘Restart a Heart’ South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is inviting schools and community groups to register their interest in this year’s Restart a Heart – a CPR awareness campaign. SECAmb took part in the Europewide initiative for the first time last year when staff and volunteers trained close to 8,500 children and some adults in CPR during a week in October. The Trust is now keen to hear from schools and community groups aged Year 6 and upwards interested in taking part this year. The training will once again predominately take place across

“We’re continuing to focus

including pharmacists, hospital

our efforts on schools and

nurses, midwives and people

throughout South Yorkshire

community groups as by giving

who work in social care.

and on-day discharge

young people the confidence in

• Core outpatient services

services in Sheffield

how to act quickly and perform

“It is about speaking up and

CPR, they can take this skill with

having the confidence to stand

them throughout their lives.

up in front of people. It is about

the four South Yorkshire clinical

gaining that confidence when

commissioning groups (CCGs)

“The numbers we trained

an ambulance comes along

last year far exceeded our

and from the other side people

expectations. It was incredible

remember the training and put it

and everyone embraced their

into place,” he said.

new skills with enormous enthusiasm.”


Improving care for people with learning disabilities “Labels go on jars and luggage”.

• Ad-hoc repatriation work for

• GP urgent services in Sheffield. Chris Dexter, Managing Director of the Patient Transport Service

Chris Corbett, one of EEAST’s

at Yorkshire Ambulance Service

education and training officers,

NHS Trust said:

said: “It was great to welcome Opening Doors who gave a

“We are delighted to have

really informative talk. It was

secured the contract in South

really helpful to see their point

Yorkshire and extended our

of view and what we can do to improve the care they receive from us.”

presence in the region. It is a fantastic achievement for the Trust, our staff and South Yorkshire residents for the

People with learning disabilities have been talking about the challenges they face when receiving emergency treatment.

one week – 10-16 October. Members of Opening Doors


core work to remain within the

Yorkshire Ambulance Service Awarded South Yorkshire Non-Emergency Health Care Patient Transport Services Contract

NHS. Our staff provide a high

health care patient transport

SECAmb is also inviting trained

met with student paramedics

healthcare professionals to make

and associate ambulance

contact with its organisers if they

practitioners from the East of

are interested in helping deliver

England Ambulance Service

the training.

NHS Trust (EEAST) to talk to

Yorkshire Ambulance Service

them about their experiences of

NHS Trust is delighted to

More than 30,000 people

the health service and offered

announce that it has been

suffer cardiac arrests outside

advice about how they like to be

successful in securing a new

of hospital in the UK every


five-year contract to deliver

quality service for patients and I’m proud of how they have continued to conduct themselves so professionally against the backdrop of uncertainty during the bid process. “We are looking forward to developing the non-emergency service further over the next five years in partnership with the South Yorkshire CCGs.”

non-emergency health care

Dr Philip Foster, Director of

a bystander, who starts CPR

Four experts by experience

patient transport services

Planned and Urgent Care at

immediately before the arrival

visited the Trust’s training base

across South Yorkshire

Yorkshire Ambulance Service

of an ambulance crew, the

in Norwich on 13th April, and

following a competitive tender

NHS Trust, commented:

patient’s chances of survival are

also taught staff how to sign


significantly improved.

‘hello my name is’ as part

year. If this happens in front of

“This is fantastic news for This process concluded in

Yorkshire Ambulance Service

Today, if someone suffers a

campaign. The group were also

March 2017 and the contract

and I am delighted that we

cardiac arrest out of hospital in

given a tour of the emergency

for more than a quarter of a

will continue to work with

the UK, they sadly have less than

operations centre and were

million journeys per year will

our commissioners and NHS

a one in ten chance of surviving.

shown around an ambulance

commence on 1 September

colleagues to serve the patients

as part of the visit organised by

2017. It includes transport for

of South Yorkshire.”

SECAmb’s Volunteer Operations

the Trust’s Patient and Public

eligible patients to access

Manager Emma Ray said: “We

Involvement team.

outpatient appointments in

This contract follows hard

South Yorkshire and discharges

on the heels of Yorkshire

from hospital in Sheffield.

Ambulance Service winning the

were delighted with the success of our involvement in Restart a

Ian Hubbard, advocacy advisor

Heart for the first time in 2016

for Opening Doors, said the

and we’re looking to build on it

group were talking to as many

Yorkshire Ambulance Service

medical transport services in

this year.

health professionals as possible

has been selected to deliver:

the East Riding of Yorkshire.

contract for non-emergency


of the get the nation signing

113 For all your equipment needs visit:


Good Morning Britain’s Health Star Awards finalist from Isle of Wight NHS Trust

the Emergency Department at

equipped with kits to deliver the

St. Mary’s Hospital on the Isle

treatment and all ambulance staff

of Wight, said: “We knew that

have training to recognise the

treating suspected Sepsis much

symptoms of sepsis and how to

earlier would save patient’s lives

treat it. This novel approach,

and prevents admissions to

integrating front-line ambulance

intensive care – a third of patients

staff into sepsis treatment buys

admitted to intensive care have

previous time and has saved lives.

sepsis. Our integrated services Team behind innovative

here on the Island – all part of

Isle of Wight Ambulance Service

lifesaving treatment for sepsis

Isle of Wight NHS Trust – make

Clinical Support Officer Tholli


it possible for us to develop and

Wood (pictured second from

implement new initiatives quickly.

right) said: “A call to the Trust’s

Staff from Isle of Wight NHS Trust

Previously patients had to wait

integrated care hub on either 999

were one of the finalists for this

until they arrived at hospital to

or 111 activates the service. The

year’s Good Morning Britain Health

receive these special antibiotics

Integrated Care Hub dispatches

Star Awards. The Island’s ‘Pre-pip’

intravenously. For every hours

a rapid response vehicle to

programme delivers high dose

delay in diagnosis and treatment

enable the patient to be treated

antibiotics in the community to

the risk of death from sepsis

at home. This is followed up by

patients who are diagnosed with

increased substantially.”

an Emergency Ambulance to

the killer condition sepsis. Sepsis

transfer the patient to hospital for

is a rare but serious complication

further treatment and tests but

of an infection. Without quick

the important early diagnosis and

treatment, sepsis can lead to

treatment is achieved reducing

multiple organ failure and death.

the longer term problems for the patient.” You can see Tholi Wood talking about the Pre-Pip project

Health services on the Isle of Wight have delivered lifesaving treatment, which previously had only been delivered in hospital,

in film made in 2015 at https://

Sepsis is a life-threatening

to patients in the community

illness caused by the body

Executive Medical Director

since 2013. The Trust’s ‘PrePip’

overreacting to an infection.

and acting chief executive at

project enables specially trained

The body’s immune system

Isle of Wight NHS Trust, Dr

Paramedics to deliver, under

goes into overdrive, setting off

Mark Pugh, said: “This service,

strict guidelines, intravenous

a series of reactions that can

first developed on the Island,

high dose antibiotics to patients

lead to widespread inflammation

underlines the benefits of our

who have suspected sepsis. In

(swelling) and blood clotting.

integrated organisation. In

2013 this was the first example of

Sepsis can lead to shock, multiple

2013 it took just 4 months to

such treatment, in the community

organ failure and death especially

develop and for the first patient

delivered by an ambulance

if not recognised early and treated

to benefit. This innovative

service, in the ‘northern

promptly. Worldwide, sepsis

development has saved lives

hemisphere’. In operation now for

kills thousands of people every

and I am proud of the team

five years the programme saves

single day. In the United Kingdom

behind it. It’s great that their

lives every week.

alone, it is estimated that around

efforts have been recognised

37,000 patients die each year

as finalists in the 2017 Good

from sepsis. To put this into

Morning Britain Health Star

perspective, this means that more


people die annually from sepsis AMBULANCE UK - JUNE

than from lung cancer, or from

In the highlights programme,

bowel cancer and breast cancer

GMB viewers can watch the


winners receiving their awards in the following categories -

The Trust developed guidance

Hospital Health Star, Community

for staff which enables the

Health Star, Lifesaver Health Star,

treatment to be delivered by

Children’s Health Star and Team

Paramedics under Patient Group

Health Star as well as the best

Dr John Pike (pictured being

Directions (PGDs). All the

moments and performances from

filmed for the awards) from

Trust’s emergency vehicles are

the day.

114 For more news visit:

Speaking about the awards, GMB presenter Susanna Reid (pictured) said: “It’s so important to recognise people in the health sector who go above and beyond their duty in helping us and the Health Star Awards puts these people centre stage.” Viewers will also get to see the red carpet arrivals of GMB presenters Susanna Reid, Kate Garraway, Charlotte Hawkins, Ranvir Singh, Sean Fletcher and Dr Hilary Jones along with judges included Trisha Goddard and some special celebrity guests.


Colleagues lost in line of duty honoured on International Workers’ Memorial Day The Welsh Ambulance Service paid moving tribute to two of its colleagues lost in the line of duty. Services for John Clift of the Non-Emergency Patient Transport Service based in Pwllheli, and Phil Williams, an Emergency Medical Technician based in Welshpool, were held to coincide with Workers’ Memorial Day, an international day of remembrance for those who have lost their lives at work. John, who was 54, died following a road traffic collision involving two ambulances on the A499 in Pwllheli one year ago, while Phil, who was 58, died suddenly while on duty in February of last year.

NEWSLINE On Friday 28 April, family, friends and co-workers of the pair gathered to dedicate ambulance vehicles in their honour. Richard Lee, the Trust’s Director of Operations, said: “Between them, John and Phil helped hundreds if not thousands of people, many of whom would not be walking around Wales today if it wasn’t for their skill and commitment. “Dedicating a vehicle in their honour will not bring our friends back, but it will hopefully act as a symbol of just how highly regarded they were and how much we cherish their memory. “We might be one year on, but the shock and sorrow around John and Phil’s death is still very much felt today. “We miss our colleagues dearly, and our thoughts remain with John and Phil’s family at this difficult time.” Father-of-two John had worked as a firefighter in Pwllheli for 26 years before he joined the Welsh Ambulance Service’s NonEmergency Patient Transport Service, a role he held for 12 years. Following his death, his colleagues commissioned a bench in his memory. The bench was paid for by funds raised by John’s colleagues supported by donations from UNISON and Unite the Union, and built by a client who attends Occupational Therapy Rehabilitation Workshops at Llanfairfechan’s Bryn y Neuadd Hospital.

Unite’s Branch Secretary Bleddyn Roberts, a Paramedic based in Pwllheli, said: “A year ago our ambulance service was in great shock, as were John’s family and friends and all those in the community who knew him. “The bench and vehicle dedicated to John will help us all remember him and remember the work he did and the manner in which he did it. “I’d like to take this opportunity to thank those who made the get together possible, especially our Non-Emergency Patient Transport Service staff whose idea and efforts brought us the bench to commemorate John.” Phil Williams had worked for the ambulance service for more than 30 years and lived in Llanfechain with his partner. He died suddenly while out on duty on February 23, 2016. David Watkins, the Trust’s Locality Manager for North Powys, said: “Phil is sorely missed by all of his colleagues in Welshpool and beyond. “He was a true ‘petrol head’ who loved motorbikes, cars and campervans, so we think he’d be both proud and amused in equal amounts that we’d named a vehicle in his honour.”

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Among those who attended the ceremonies were John’s partner Hilary and son Matthew, and Phil’s mother Daisy and partner Meinir.

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Left: Phil Williams, right: John Clift


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115 AMBULANCE_UK_03.17_resus.indd 1 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

22/03/2017 13:12



Welsh Ambulance Service wins award for innovative app to help patients who are deaf or hard of hearing

30 years and counting: Hertfordshire staff celebrate service milestone

An innovative app which helps frontline ambulance staff interact with patients with additional communication needs has won a prestigious award.

ambulance service gathered

A group of staff at the region’s to celebrate 30 years’ service together, amounting to more than 330 combined years. The 11 loyal servants of the East

The Welsh Ambulance Service was presented with the People’s Choice award at Action on Hearing Loss Cymru’s Excellence Wales Awards on 5 May. The Trust was recognised for its use of technology to enable ambulance teams to communicate with people who are deaf or hard of hearing in an emergency. The Pre-Hospital Communication Guide app uses pictures and supporting text, and can also assist patients who don’t speak English as their first language, have learning difficulties, or whose illness or injury affects their communication. Since it was launched in October 2016, it has been downloaded more than 2,200 times and helps staff to find out important information about patients, such as their symptoms and medical history. It can also identify if they use a specific communication method or which language they speak.

Speaking at the ceremony at Cardiff’s St David’s Hotel, Leanne Hawker, the Welsh Ambulance Service’s Head of Patient Experience and Community Involvement, said: “Being able to communicate with deaf people when they’re receiving emergency medical treatment can be crucial, which is why we developed our app. “We know that it has made a difference for both staff and patients so we’re delighted to have won the People’s Choice Award. “We really do recognise the importance of ensuring that we are accessible to everyone and we’re looking to continuing to improve our service in the years to come.” The Trust also finished as runners up in the Excellence in Health category at the charity’s annual awards, which recognise organisations that take steps to make their services accessible to

the 575,500 people in Wales who are deaf or have hearing loss. The app was pioneered by both the Trust’s Patient Experience and Community Involvement and Business Intelligence and Development teams, and is based on a small booklet which was originally developed by The Clear Communication People Ltd and The London Ambulance Service in 2011.

of England Ambulance Service NHS Trust (EEAST) celebrated their remarkable achievement on Friday, 31st March at the west Hertfordshire station in Hemel Hempstead, and reminisced about the ‘old days’ over coffee and cake. Senior Paramedic Tracy Woods, who started 30 years ago that very day said: “Looking back, it does feel like it has gone very quickly, but that’s because I’ve enjoyed my time.”

Richard Williams, Director of Action on Hearing Loss Cymru, said: “All our winners prove that simple changes can make the lives of people with hearing loss more manageable on a day-today basis. “I hope that organisations across Wales are inspired by our winners and start thinking about the simple changes they can make to ensure their services are accessible to the one-in-six people who are deaf or have hearing loss.” The app has also been nominated at the Patient Safety Awards, which take place in Manchester on July 4th 2017.

Following the celebratory coffee, Senior Locality Manager Dave Wright was on hand to present the group with certificates. He said: “It’s a fantastic achievement by all, to provide a duty of care to the people of Hertfordshire for such a long time is a testament to their character, they should all be extremely proud.” Amongst those who also joined at that time included Deputy Director for Service Delivery Dave Fountain who said: “It is great to see the old teams back together, it’s been an amazing service together with these people, I’m extremely proud.” Those who also celebrated the


It is available for staff and members of the public to download on devices using the iOS, Android and Blackberry systems.

milestones were: Emergency Care

To download it on iOS devices search your app store for ‘PreHospApp’, for Android search ‘pre hospital app’ and on Blackberry search for ‘Pre-

Candida Tillson, Richard Griffiths,

Hospital Communication App’.

Delivery Dave Fountain.

116 For further recruitment vacancies visit:

Practitioners John McCusker and Jane Ostler; Duty Locality Officers Barry England, James Wood, and Kevin Wright; Senior Paramedics Stan Brewster, and Tracy Woods; Senior Emergency Medical Technician Andrew Palmer; and Deputy Director of Service



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118 For more news visit:


‘Big thank you EMAS’: Toddler meets first responders who saved his life

and Senior Craftsman David Kerr on Monday, April 24. After being diagnosed with a chest infection, Max was spending quality time with his mum, dad and sister at his family home on Sunday, March 5.

As his second seizure began, the paramedics arrived to take Max to intensive care at Peterborough Hospital. Max was later diagnosed with a septic chest infection and spent a few days at a hospital

(L-R) Colin Maddams, James Crichton, Jess Barnett, Lottie Barnett, Martin Barnett, Max Barnett, David Kerr and James Roper. Photo: Steve Smailes for Lincolnshire Reporter

A toddler who became very ill when at his home in Grantham has been reunited with the first responders and ambulance crew who saved his life. Max Barnett, three, along with his parents Martin and Jess and his little sister Lottie, met up with East Midlands Ambulance Service (EMAS) team members James Crichton and Colin Maddams and Community First Responders PC James Roper

Max’s parents Martin and Jess noticed that he had began to shake after taking a nap with his mum. His eyes began to open and both Martin and Jess realised Max was fitting. After calling 999, first responders PC James Roper and Senior Craftsman David Kerr arrived within two minutes to assess Max.

in Leicester before returning home. Martin told Lincolnshire Reporter: “We were really lucky that the fast response unit was with us within under two minutes. “They were brilliant.” Jess added: “We jumped at the chance to say thank you in person and meet the people who helped Max.”

Tel/Fax : 01268 833666


30 Brooklyn Drive Rayleigh, Essex SS6 9LW Max with his dad Martin

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

NEWSLINE “These people saved my life,”

Woman who suffered cardiac arrest says big thank you to those who saved her life

said Gerry who about 30 years ago had been diagnosed with the inherited disease hypertrophic obstructive cardio myopathy. Gerry spent five days on life support. She was later fitted with an implanted cardioverter

An Amesbury woman who

defibrillator to prevent future

suffered a cardiac arrest while


out shopping says she would not be here today if it was not

She hopes her story will

for the efforts of everyone who

encourage others to learn

came to her aid.

life-saving skills or consider becoming community first

Gerry Hibberd suffered a

responders. She also praised

pulmonary embolism and a

the “marvellous” work of the air

cardiac arrest in Amesbury on


October 12 last year.

Gerry Hibberd when she met Dr David Sutton of Hampshire and Isle of Wight Air Ambulance who was on duty that day for all our staff as you never

Hampshire and Isle of Wight Air

“I was saved because people

know when you may need it. We

Ambulance Service’s life saving

She stopped her car at Spire

volunteered and people had

believe it is very important to


Glass in Amesbury after suffering

learnt CPR and that people care

have these basic skills which can

shortness of breath. Luckily for

and that is the most important

be used anywhere at any time.

her trained first aider Ian Locke,

thing,” she said.

An air ambulance trust spokesman said: “It is only

the managing director of Spire

“We are just every pleased that

thanks to the generosity of the

Glass, who knew Gerry realised

“It is just to impress upon people

the out come was good and

communities that we serve

something was wrong and came

you can save a life whether it

Mrs Hibberd survived due to the

that we are able keep the Air

to her aid and started CPR.

be learning CPR or volunteering

early intervention of the CPR. We

Ambulance flying and saving

or giving money to the air

cannot stress how important it is



to have these basic skills.”

for ordinary, everyday people to do

Mr Locke added: “We have

It currently costs in excess

a community first responder go

CPR,” said Gerry.

always done first aid training

of £9,000 a day to maintain


“I want to thank everybody that was involved and say how important it is

To find out more about becoming

“There is no way [I would be here today] if I had not had initial assistance. I was so lucky.” The first ambulance arrived along with Community first responder Fred Fox. Community first responders are volunteers trained by South Western Ambulance Service.

SIMULAIDS LTD EMP House Telford Way Coalville Leicestershire LE67 3HE

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treating Gerry and once stable she was flown to Southampton General Hospital by air ambulance. The Wiltshire Air Ambulance helicopter was already in use meaning the Hampshire and Isle of Wight Air Ambulance was


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NEWSLINE Cornwall Air Ambulance helicopter was sent to Newquay after a chilling hoax 999 call A chilling hoax 999 call led to all the emergency services including the air ambulance helicopter rushing to Newquay while the bogus caller claimed to be doing CPR on a heartattack victim.

A crewed ambulance and fire engine rushed to the scene.

A 30-year-old man from London called 999 on Easter Monday to

Street for alleged malicious

such calls wasted its precious

report that a woman had suffered

communications offences.

donated funds.

a result the air ambulance, a

“The man stayed on the phone

paramedic in an ambulance

“As a charity, Cornwall Air

stating he was doing CPR on the

service fast response vehicle,

Ambulance relies on donations

patient and police located him in

a crewed ambulance, the fire

a shop while he was still on the

to keep the air ambulance flying

service and police rushed to the

phone to emergency services,”

scene to treat the patient.

the spokesman said.

But after the helicopter landed

“A 30-year-old man from London

and the other emergency

was arrested and taken into

services arrived there was

custody, but was released

nobody to be found at the

without charge due to mental

location and it became clear the

health issues. There is no

call had been a hoax.

likelihood of prosecution at

a heart attack in Newquay. As

and save lives, so it is very disappointing to hear that this was a hoax call,” he said. “Not only do hoax calls waste precious charity funds, they can also potentially put lives at risk if an

“Not only do hoax calls waste precious charity funds, they can also potentially put lives at risk if an emergency happens elsewhere.”

emergency happens elsewhere.”

this time. Police urge members After police spent nearly an

of the public to only use the

hour searching the area for

999 system in a genuine

the hoax caller - who remained


on the phone throughout the manhunt - a the caller was

A spokesman for the Cornwall

found and arrested in Bank

Air Ambulance charity said

AMBULANCE UK - JUNE Air ambulance mission in Newquay was a chilling hoax 999 call

A fire engine at the scene

122 For more news visit:


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Congratulations to the ECP car team honoured at community awards Two Emergency Care Practitioners are celebrating after being honoured with a community service medal. Richard Holt and Gary Clark from EEAST were presented with an award for their work on the Emergency Care Practitioner car in Essex. The car was set up last year to treat more patients at home, rather than taking them to hospital. Richard and Gary joined the other nominees at the Epping Council Civic Awards last month. Richard said: “We were thrilled to have been nominated, let alone to win it! It’s the scheme that has won the award and it’s lovely that it has been recognised within the community.”


124 For further recruitment vacancies visit:


Prince William visits ambulance staff who treated patients in Westminster attack

His Royal Highness the

Prince William met with ambulance

Duke of Cambridge visited

crews who treated patients in

ambulance staff to thank

Westminster. He also spoke to call

them for their response to the

handlers who answered the initial

terrorist attack in London.

999 calls from the public.

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Massive thank you for paramedic team

crew mate paramedic Alexander

ambulance to Brighton’s Royal

making a cup of tea,” said Daniel.

Hudson soon arrived at the scene.

Sussex County Hospital. He was

“But I have been so extremely

Scott said: “Daniel had suffered

later transported to St. George’s

lucky that I received immediate

severe trauma and showed

hospital in London where he

help from two members of the

obvious injuries across his body.

received specialist treatment for

public, then the ambulance and

A Sussex man who fell from

When we got there Liam had

the next six weeks followed by a

air ambulance teams were with

approximately 40 feet into a

already prepared him for receiving

further four weeks in the Royal

me so quickly and I did not have

basement flat area in Hove

drugs to combat his pain and to

National Orthopaedic Hospital

assist with blood clotting, in case

(Stanmore) in spinal rehabilitation.

of internal bleeding. We boarded

It was found that Daniel had

him and we were ready to move

suffered a spinal cord injury from

him. Although he was semi-

a broken back, multiple fractures

conscious, we were satisfied his

to his left arm and wrist, and

condition was stable enough.”

numerous fractured ribs.

Air ambulance medics carried

“I needed four weeks of

out further checks and treatment

rehabilitation to re-learn the

before Daniel was taken by road

smallest of things like walking and

was delighted to meet two paramedics who were part of the team who responded to his neighbour’s 999 call. Just over two years ago, Daniel Cheetham from Hove, now 30, a recruitment agent for the pharmaceutical industry, fell from the window four floors up, in the early afternoon. “I really don’t

any internal organ damage.” “I will have to live with the life-long consequences of the accident and I have learnt to accept that. I was a keen runner before but due to my injuries I’m no longer able to do that, so I’ve now taken up cycling which I’m really enjoying. I have learnt a lot about myself over the course of my recovery, and the whole journey has helped

remember anything at all of the

me refocus on what is important

incident itself,” said Daniel, “but it

in life. I have realised that, over

has been on my mind ever since

everything, what’s most important

to thank the medical people who

is friends, family and unrelenting

came out to rescue me and now

positivity. That’s what’s helped

that I have recovered enough, I

me come back to as normal a life

wanted to thank them in person.”

as possible. I hope to be raising money through my cycling this

A neighbour, who is a firefighter,

year to support the SECAmb

saw Daniel’s fall and raised the

services who looked after me in

alarm rushing out to help him. An

those critical first minutes.”

off duty doctor had just walked After two back operations and three

passed and also stopped to help.

operations on his left arm, Daniel Clinical Team Leader Liam

received the all clear last December.

McDine, who normally works

He’s back to working all the hours

in the Worthing area had been

he did before his accident and has

sent to a job in Brighton but he

accepted a move to Boston, USA

was stood down, and on his way

with his company.

back to base he received a call


that a man was unconscious.

Both Scott and Liam were amazed

Liam, who reached the incident

to see their patient in such

in less than two minutes after

remarkable good health following

receiving the call said: “This is a

the traumatic injuries they dealt

job that I can distinctly remember

with. Liam said: “We were just

from being first on scene.

doing our job and somehow

When I arrived I didn’t know yet

you get used to not knowing,

what had happened and to be

not having feedback about your

confronted with a crowd around a

patients. It’s great to see how well

seriously injured man was totally

Daniel has recovered and how

unexpected. It was immediately

positive he is about everything.”

clear this was serious and that I Scott added: “It’s been fantastic

needed urgent back-up.”

to see him face-to-face and to Several other ambulance crews

know that our interventions made

were dispatched to attend,

a difference and helped Daniel to

including the air ambulance

get back to where he wants to be.

service. SECAmb student

We wish him all the very best for

paramedic Scott Fraser and his

his new life in Boston.”

126 For more news visit:



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

NEWSLINE Brighton’s life-saving helipad receives first instalment of £500,000 from HELP Appeal charity

Robert Bertram, Chief Executive of the HELP Appeal, said: “The new helipad at The Royal Sussex County Hospital will help to ensure that patients get the fastest access to the often lifesaving treatment they require.

The 3Ts Redevelopment of the Royal Sussex County

“Life-saving infrastructure such

Hospital, in Brighton, has

as this doesn’t just save time,

received its first donation - an

the seamless transfer process

instalment of £500,000 of its

into the hospital’s Emergency

£1m pledge - from the HELP

and Trauma department will

Appeal, the only charity in the

help to prevent any further

UK dedicated to providing this

patient trauma or longer term

essential funding.

complications, that can often arise from secondary road

The new helipad, which will be


situated on the roof of the Thomas Kemp Tower, will allow direct and

Duane Passman, Director of

time efficient access into the

3Tsat Brighton and Sussex

hospital’s Emergency Department

Hospitals NHS Trust, added:

- ensuring patients from across Brighton & Hove, Sussex, and the

“The Royal Sussex County

wider region receive emergency

Hospital is the Major Trauma

attention as quick as possible.

Centre for the area. The 3Ts Redevelopment will significantly

Heart failure more fatal than common cancers

life-threatening as the most common forms of cancer, in both men and women. Lead author Professor

A study led by Keele

Mamas Mamas, Professor of

University, in collaboration

Cardiology at Keele University

with the Universities of

and Consultant Cardiologist

Aberdeen and Manchester,

at the Royal Stoke Hospital,

shows that men and women

University Hospital North

suffering from heart failure have a higher risk of death than people with most common types of cancer. The primary care database study if the first of its kind to compare survival of them,

Midlands Trust, stated: “The findings of this study are important, our study shows that despite advances in the treatment of heart failure with newer drugs and

separated by gender. Heart

devices, mortality rates remain

failure is a leading cause of

significant and heart failure

death globally, and the result

remains as malignant as many

of this study will be vital in

of the common cancers.”

working towards improving the outcomes of heart failure

Professor Phyo Kyaw Myint,


University of Aberdeen, said:

Anonymised data was collected

“Older patients with heart

between 2000 to 2011 from 393

failure also have other co-

The new helipad will be served by

improve the trauma facilities

general practices in Scotland.

a new lift on the south face of the

available in the hospital.

The dataset (PCCIU) used

tower, which will give quick access

Through its generous donation

included patient information

from the roof of the building to

the County Air Ambulance HELP

for approximately a third of

emergency, resuscitation and

Appeal is ensuring that a key

the Scottish population and

trauma services.

aspect of these improvements, a

represented a mixture of age

helipad on site with fast access

and gender, as well a range

As the only charity in the UK

to the Emergency Department,

of people geographically and

research because clinical trials

dedicated to hospital helipads,

can proceed without delay.”


do not include the typical older

on individual and organisational

3Ts Redevelopment

For men, the four most

donations to provide the funding

The new helipad at the Royal

common cancers are prostate,

required to delivering helicopter

Sussex County Hospital will

lung, colorectal, and bladder;

Dr Matt Sperrin, Health

landing pads at Major Trauma

open in 2018. The first stage of

while for women, they are

Centres and key A&E hospitals

the 3Ts Redevelopment, which

eResearch Centre at The

breast, colorectal, lung,

across England and Scotland.

incorporates the major trauma

University of Manchester,

and ovarian. Diagnoses of

improvements will open in 2020.

cancer and heart failure were


morbid diseases, and therefore understanding of outcome in this patient group is important for clinicians. This study also reminds us that observational studies are important in clinical

people we manage in day to

the HELP Appeal relies solely

Golden Hour

at similar ages in men, but


After an accident, the first 60

To learn more about the HELP

women typically experienced

minutes are vital. Known as the

Appeal, and to get involved visit

heart failure later in life. Only

‘Golden Hour’, if a trauma patient

5.5% of either gender suffering

receives medical attention in

Donations can be made by

from heart failure did not

these 60 minutes, chances of

calling the donation helpline

have another disease as well,

survival increase significantly.

on 0800 389 8999, visiting the

compared to 20-38% of cancer

website or donating by text, just


day clinical practice.”

“This study highlights how anonymised data from general practices can be used to uncover evidence that helps us understand how patients can be best managed. The comparison will hopefully highlight the potential impact of

Helicopter helipads reduce transfer

type HPAD22 plus the amount

time and ensure critical patients

into the message box and send

Despite advances in

heart failure to the public, who

receive the immediate and specialist

it to 70070. Donation will be

healthcare, the study showed

can take proactive steps to

medical attention they need.

charged to your mobile bill.

that heart failure remains as

prevent it.”

128 For further recruitment vacancies visit:

Paramedic Practice Conference Programme


Tuesday 6TH June 2017 The International Centre, Telford, TF3 4JH.

Thanks to the generosity of our Sponsor, RDT, we can offer the first 50 registered delegates a reduced rate of only £30 (incl VAT) to include lunch, tea/coffee, etc. Topics & Speakers correct at the time of press but may be subject to change





Professor Julia Williams

Professor of Paramedic Science

David Halliwell

MSc Paramedic Flfl

Amy Chan-Dominy

Paediatric Consultant

John Talbot

Professional Lead Paramedic


09.30 – 09.45


09.45 – 10.15


10.15 – 10.45

Extracorporeal Cardiopulmonary Resuscitation

10.45 – 11.30


11.30 – 12.00

Overdose – First Line of Treatment

12.00 – 12.30

Paediatrics: Should We Just Take Them All In?

Will Broughton

Education Director (Paramedic)

12.30 – 13.00


Pete Gregory

Head of Allied Health

13.00 – 14.15


14.15 – 14.45

Fatal Fractures

Professor Sir Keith Porter

Professor of Clinical Traumatology

14.45 – 15.15

Sudden Death in Athletes

Amanda Potterton

Critical Care Nurse

15.15 – 16.00


16.00 – 16.30

Alveolar Ventilation via Continuous Chest Compression (AV-CCC) – No pause should be your cause

Dr Marc Gillis

Head of Emergency Service Imelda Hospital, Bonheiden,Belgium

16.30 – Close

Can the Fire & Ambulance Service Work Together?

Professor Julia Williams

Professor of Paramedic Science

To register please visit: or call: 01322 660434 For all your equipment needs visit:


08.30 – 09.30


Focus on Emergency Services in Crisis




Devon Air Ambulance crew show their skills with tough landing The Devon Air Ambulance made quite an impression on its Emergency Service colleagues, when its crew made a perfect landing in difficult conditions. A series of photographs were taken by Bude community fire station after an emergency call on Friday afternoon. The ambulance services requested their assistance on the B3254 at Red Post, near Bude, at 14.16pm. Bude Community Fire Station shared the pictures on its Facebook page and told of the moment the helicopter managed to park on the confined stretch of the road. A spokesperson for the fire crew


Contact us for further information and brochures AMBULANCE UK - JUNE

130 For more news visit:

said that on arrival a single-vehicle crash was discovered and Devon Air Ambulance was also called to the scene. The car involved was overturned, but fortunately the driver was safe and well. Bude Community Fire Station shared the pictures on its Facebook page and told of the moment the helicopter managed to park on the confined stretch of the road. A spokesman said: “We received a call from the ambulance service requesting our assistance, after a car had rolled upside down on the B3254 near Red Post. “On arrival the casualty had been released from the vehicle, so our crew made the vehicle safe. Devon Air Ambulance Trust also attended and impressively parked their big red helicopter in a very confined space on the road - a very impressive effort!”


Devon Air Ambulance highly commended in Apprenticeship Awards Devon Air Ambulance is passionate about investing in their staff. They believe that the team can only be as good as its skill sets, so actively encourages its entire staff to undertake training and development to help them carry out their roles to the best of their ability. Recently the Charity was nominated for the Education and Training Skills Employer of the Year Award by Catherine Walker, Fundraising Administration Assistant. The Annual Apprentice and Employer of the year Awards ceremony is held during National Apprenticeships Week, which was also celebrating ten years of the National Apprenticeships Scheme. Catherine said “I joined Devon Air Ambulance in November 2015, as a temp. My role was made permanent in March 2016. I’m privileged to be part of such an amazing dedicated team and forward thinking charity.” She added “The Charity has helped me in so many ways; from helping me to gain confidence on the phone, to helping me improve and update my knowledge and encouraging me to push myself to succeed in things that I am less confident in.” Caroline Creer, Fundraising Director of Devon Air Ambulance said “Investing in the training and development of our team is extremely

important to us. It’s essential whatever your business that your team has the right skills to be able to do their job. When Cat asked if she could further her knowledge, by undertaking the Advanced Apprenticeship in Business Administration, we were delighted. This apprenticeship includes the BTEC Level 3 Diploma in Business Administration, and Functional Skills Level 2 in English, Maths and ICT. Cat has recently passed her ICT exam.” Caroline added “We were delighted that Cat decided to nominate us for this award and honoured to be highly commended in the Employer of the Year category, which recognises the Charity as supporting lifelong learning within the workplace.”

LAS News

London Ambulance is pleased to announce that Garrett Emmerson has been appointed as its new Chief Executive Garrett, who was previously Transport For London’s Chief Operating Officer for Surface Transport, took up the role on 30 May. London Ambulance Service Chairman, Heather Lawrence OBE, said: “Garrett brings a wealth of experience of management, leadership and logistics in the capital.

Simon Mills, General Manager for Education and Training Skills said “The Apprentice of the Year Awards is a particularly special event for us, where we are able to celebrate the achievements of those learners who have been nominated for the Apprentice of the Year Award and the employers that have been nominated for the Employer of the Year Award.”

“He’ll work with me, the board and executive

“ETS is a strong advocate of employer engagement and we recognise that it is a key element in maximising the opportunities that an apprenticeship brings, to attract new talent, to offer progression for current staff and to develop a motivated and highly qualified workforce. Devon Air Ambulance have been highly commended for being fully engaged in supporting Cat with her programme of learning. We are very keen to continue to develop our productive and mutually beneficial working relationship with DAA.”

and control room staff and learning more

colleagues to build on improvements we have already made for the benefit of our patients.” Garrett said: “I am tremendously pleased to be joining the Service at such an important time for the organisation and am looking forward to the challenges and meeting frontline, support about the valuable jobs they do to care for Londoners every day.” Andrew Grimshaw – who has been undertaking the role of Chief Executive since Christmas – will be leaving the Service in June to become the Chief Financial Officer at St George’s University Hospitals NHS Foundation Trust. Heather said: “I’d also like to thank Andrew for taking on the role since Christmas and wish him every success in his new appointment.” Andrew said: “It has been a privilege to lead the organisation in recent months and I will be very sad to leave, but I’m looking forward to the opportunity to lead the finance function at a major London teaching hospital.”


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


London Ambulance Service medic honoured at Buckingham Palace Tooting born medic Paul Smith, who has dedicated more than forty years of his life to saving Londoners, has been honoured by HM The Queen at a ceremony at Buckingham Palace on 25 April. Paul, who helped saved countless lives in major incidents and played a key part in the capital’s response to the Olympic Games in 2012, was presented with the prestigious Queen’s Ambulance Service Medal. The award also praised Paul’s continual commitment to patient care and staff progression as part of his role as a sector delivery manager. Peter McKenna, Deputy Director of Operations at London Ambulance Service said: “Paul has spent two thirds of his life dedicated to serving the population of London, saving countless lives. “In his first appraisal in 1976, Paul’s supervisor said he would make a ‘good and reliable ambulance man’. “More than forty years later, we can all agree that a truer word has never been spoken.” Speaking of his award, Paul said: “Starting out in the Service as a young boy from Tooting, I never expected to receive an award from HM the Queen.

“Over the last forty years, it has been an honour to work alongside our emergency service family and to see the members of staff I have helped to develop move on to greater things.

“To have been able to attend a ceremony at Buckingham Palace and to see the venue in all its glory was a once-in-a-lifetime opportunity, for which I am extremely grateful.”

“I’m incredibly humbled to receive such high recognition for my career with the Service.”

Andrew, who has been with the service for almost 30 years, has led many significant educational projects that have resulted in substantial improvements for patients and staff alike.

The Queen’s Ambulance Service Medal (QAM) honours a very small, select group of ambulance crews and control room staff who have shown exceptional devotion to duty, outstanding ability, merit and conduct in their roles within NHS Ambulance Services. WAS News

Welsh Ambulance Service leader’s pride at Queen’s Ambulance Service Medal award A Welsh Ambulance Service leader has spoken of his pride after being awarded the Queen’s Ambulance Service Medal. Andrew Challenger, Interim Head of Education and Training, was presented with the medal at a ceremony held at Buckingham Palace on Friday 5 May 2017. It comes after he was recognised in the New Year’s Honours List 2017 for distinguished and meritorious service. Andrew, who is based in Swansea, said the occasion was made even more memorable by receiving the honour from the Queen.

His distinguished career has seen him evolve from being a part-time Patient Care Service operative to Senior Education and Development Lead. Andrew’s achievements include co-writing the Swansea University Diploma in Paramedic Science and he is currently leading the transition of paramedic education from diploma to degreelevel, in collaboration with the university. He has led driver education within the Trust for 13 years, designing and developing two innovative driver training vehicles, the concept of which has since been shared and adopted by other ambulance trusts. He is also a valued member of the Trust’s Senior Management Team and UK National Education Groups. Welsh Ambulance Service chief executive Tracy Myhill said: “Andrew has played a pivotal role in the modernisation of ambulance education and that’s why he’s so highly deserving of this award. “We would all like to congratulate him on his investiture and are delighted that he and his family enjoyed their special day.”

The presentation was made on Her Majesty’s first full day of engagements since the announcement that Prince Philip is stepping down from public duties. Andrew, who attended the palace with his fiancée, Ann, and parents, Margaret and Vernon, said: “To be nominated for and to receive the Queen’s Ambulance Medal is a very humbling experience.


“I am extremely proud to have been awarded this honour in recognition of my career with the Welsh Ambulance Service. “I share this award with all those with whom I have had the pleasure of working throughout my career. “We were all overwhelmed by the experience and the friendly nature of the palace staff. I was also surprised by the attendance of two of my sons, David and Michael, and my stepdaughter, Georgia.

Andrew Challenger, Interim Head of Education and Training at the Welsh Ambulance Service, with his Queen’s Ambulance Service Medal at Buckingham Palace.

132 For further recruitment vacancies visit:

PRODUCT SHOWCASE Restyled Cartwright Ambulance at NAPFM Exhibition Cartwright Conversions has developed a new patient transport service (PTS) ambulance which will be unveiled at NAPFM’s Emergency Fleet Exhibition in June. The restyled ambulance has a unique moulded lining that’s easy to wipe down and reduces the overall conversion weight without

The new design gives patients

scores of new vehicles are

patient care at the forefront of

more room inside the vehicle and

being added to the hire fleet

their vehicles by combining new

is still capable of carrying a full

every month. The restyled PTS

advancements in the industry

stretcher, wheelchair and carry

ambulance will be available to

with tried-and-tested designs.

chair. It also comes with a ramp

hire from the middle of the year

and winch, and for unaided entry

on flexible terms.

to the vehicle there are fold-out grab handles fitted. Every conversion can be tailored to a customer’s individual requirements from the choice of vehicle chassis to the seating and wheelchair configurations. Fleet of PTS Ambulances Available to Hire Cartwright Conversions has

compromising on the number of

a fleet of PTS ambulances

passengers or equipment.

available to hire and one NHS

Gary Stephenson, Engineering Manager at Cartwright

Visitors to the NAPFM

Conversions explains: “Our

Exhibition will be able to see

total aim is to create cutting

the new PTS ambulance, a

edge designs using advance

police vehicle and a frontline

production techniques while still

ambulance van conversion on

retaining a familiar look and feel

the Cartwright Conversions’

for the end user.”

stand (112) at The International Centre in Telford

The redesigned PTS vehicle

on the 6 and 7 June.

is built to the standards of BS EN 1789 (CEN) and European

Engineers at Cartwright

Community Whole Vehicle Type

Conversions are keen to put


Trust already benefiting from this Finished in a classic green

service took delivery of their five

and white colour scheme with

brand new vehicles in March.

recess locations for key medical equipment, the interior has a

The ambulances were built at

more modern, sleeker look than

Cartwright’s Doncaster-based

traditional PTS ambulances.

conversion facility where


133 For all your equipment needs visit:

AUK_August_AUK_August_2013 11/10/2013 10:53 Page 254


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

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

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

Life Connections 2014 Exmed Study Day

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



08.30 - 09.00


12.00 - 12.30

09.00 - 09.15

Introduction & History of the Course

09.15 - 09.45

The Airway Algorithms

12.30 - 13.30

09-45 - 10.30

Prediction of the Difficult Airway

13.30 - 14.00

10.30 - 11.15

BVM and Laryngoscopy

11.15 - 11.30

Tea/Coffee, Exhibition

11.30 - 12.00

Skills Stations (4 rotations/30 min. each)

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

14.00 - 14.30

Skill Stations Rotation 4


Group 1


14.30 - 14.45

Group 2

EGD’s & Rescue Airways

14.45 - 15.00

Group 3

Needle & Surgical Airway

15.00 - 17.00

Group 4

Video Laryngoscopy


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

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

CPD certificate provider

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

Only 7 places remain available!!

To register call 01322 660434 or visit:

134 For more news visit: | Hall 5 | NEC | Birmingham | 20-21 September 2017 | | Hall 5 | NEC | Birmingham | 20-21 September 2017 | | Hall

“It's a great place to see all the new vehicles and latest kit.”

Photograph © ESS

Adam Wright, Ambulance Driver, Yorkshire Ambulance Service

The Emergency Services Show 2017 – it’s all about you A unique event for everyone who works in the emergency services. Over 400 exhibitors, free seminars and product demonstrations. Hall 5, NEC, Birmingham. Wed 20 – Thu 21 September 2017. Free entry at

Event partners

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Does he need a trauma centre or the local hospital? Twenty-year-old male in a motor vehicle accident. Airbag has deployed. Car has significant front-end damage. Is he bleeding internally? Will he need a trauma centre? These are some of the questions you need to answer on a suspected trauma call, as haemorrhage is the leading cause of death after injury.1 The new trauma parameters on the ZOLL X SeriesÂŽ help you accurately and quickly assess your patients so you can feel more confident in your treatment decisions.

Insight for informed decisions. Acosta JA, et al. Journal of the American College of Surgeons. 1998;186(5):528-533.


Š2016 ZOLL Medical Corporation, Chelmsford, MA, USA. X Series and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. MCN IP 1601 0092-05

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