Ambulance UK - October 2018

Volume 33 No. 5

October 2018

DEDICATED TO THE AMBULANCE SERVICE AND ITS SUPPLIERS

BRAYDEN JUNIOR

✔ Easy to convert Brayden Adult to Brayden Junior ✔ Cost Effective practical and convenient ✔ Anatomically correct ✔ AHA and ERC compliant Supplied by

In this issue 4 Ways Trauma Pros Can Improve Care For Burn Patients Identifying Pre-Hospital Factors in a Regional Trauma Network Life Connections 2019 5 Regional Events to Choose From

CONTACT US TO FIND OUT MORE Tel: 01252 344007 | www.brayden.co.uk/junior Email: braydenjunior@welmedical.com

Powerful Powerful solutions solutions for forEMS EMScare care

A surgeon A surgeon must must always always rely rely on on hishis or her or her own own clinical clinical judgement judgement when when deciding deciding which which treatments treatments andand procedures procedures to use to use with with patients. patients.

ForFor verifying verifying availability availability of Stryker of Stryker products products in your in your area area please please contact contact your your Stryker Stryker representative. representative.

Copyright Copyright © 2017 © 2017 Stryker.

Stryker.

TheThe products products shown shown above above areare CECE marked. marked.

Stryker Stryker Corporation Corporation or its or its divisions divisions or other or other corporate corporate affiliated affiliated entities entities own, own, useuse or have or have applied applied forfor thethe following following trademarks trademarks or Service or Service marks: marks: Stryker, Stryker, Power-PRO Power-PRO XT,XT, XPS, XPS, Power-LOAD. Power-LOAD. ©2017 ©2017 Physio-Control, Physio-Control, Inc.Inc. AllAll names names areare trademarks trademarks or registered or registered trademarks trademarks of their of their respective respective Specifications Specifications areare subject subject to change to change without without notice. notice.

NotNot all all products products areare available available worldwide. worldwide.

Check Check thethe manufacturers’ manufacturers’ Declarations Declarations of Compliance of Compliance forfor a list a list of products of products andand accessories accessories authorised authorised forfor useuse within within thethe EU.EU.

CONTENTS

CONTENTS 177

EDITOR’S COMMENT

178

FEATURES

178 4 Ways Trauma Pros Can Improve Care For Burn Patients

Ambulance UK This issue edited by: Sam English c/o Media Publishing Company 48 High Street SWANLEY BR8 8BQ ADVERTISING: Terry Gardner, Brenda Pickering

182 Identifying Pre-Hospital Factors in a Regional Trauma Network

CIRCULATION: Media Publishing Company

192

NEWSLINE

Media House, 48 High Street

207

IN PERSON

Tel: 01322 660434 Fax: 01322 666539

210

THE CLASSIFIED SITE

SWANLEY, Kent, BR8 8BQ E: info@mediapublishingcompany.com www.ambulanceukonline.com PUBLISHED BI-MONTHLY: February, April, June, August, October, December

COVER STORY Smart development of Brayden manikins for adult and paediatric CPR training The benefits for CPR training offered by Brayden manikins since their launch were quickly recognised by professionals. The innovative use of lights that give real time feedback of CPR performance and function have proved an invaluable training tool and demand for a paediatric version is now being met with the development of a Brayden Junior conversion kit.

Brayden adult manikins can now be quickly and easily converted for paediatric training through three simple procedures. Users can convert the Brayden adult by changing the face and torso skins and chest spring, with the latter providing chest compression and ventilation that accurately reflects a 10-12 year old child.

There is no need for any other device (phone/tablet) so training is convenient, quick and easy to set up for training and assessment purpose; plus, the intuitive feedback lights on Brayden Junior will work in the same way as on the Brayden adult.

The Brayden Junior package will be available before the end of this year. For further information contact braydenjunior@welmedical.com

Media Publishing Company Media House 48 High Street SWANLEY, Kent, BR8 8BQ PUBLISHERS STATEMENT: The views and opinions expressed in this issue are not necessarily those of the Publisher, the Editors or Media Publishing Company.

Next Issue December 2018 Subscription Information – October 2018 Ambulance UK is available through a personal, company or institutional subscription in both the UK and overseas.

UK: Individuals - £24.00 (inc postage) Companies - £60.00 (inc postage) Rest of the World: £50.00 (inc. surface postage) £75.00 (airmail) We are also able to process your subscriptions via most major credit cards. Please ask for details.

Cheques should be made payable to MEDIA PUBLISHING. Designed in the UK by Hansell Design

AMBULANCE UK - OCTOBER

The advantages are clear for users to see in terms of ease of conversion and cost effectiveness. As important, the conversion upgrade package means that users only require one manikin for both adult and paediatric CPR training purposes.

COPYRIGHT:

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

BUY ONE GET ONE HALF PRICE* SPECIAL OFFER ON NEW DRÄGER OXYLOG® VE300

Built to face your challenges.

Our new Oxylog® VE300 transport ventilator has been designed especially for the emergency services.

Highlights include: • • • • •

Integrated O2 Cylinder Nine Hour Battery Life Intuitive ‘Flip’ Screen Display CPR Mode Bluetooth Enabled Data Export Option

Hurry, this offer is only available for orders placed before the 31st October 2018!

To take advantage of this special offer, please email med-marketing.uk@draeger.com and quote AUVE30018.

www.draeger.com/oxylog O 31S FFER T O EN CT DS OB ER

*T&Cs apply. Offer only valid for Dräger Oxylog® VE300 orders placed before 31st October 2018. Offer is only valid for purchases made in the UK & Ireland. Cannot be combined with any other offer or promotion. Not valid on previous purchases. Whilst stocks last.

EDITOR’S COMMENT

EDITOR’S COMMENT Welcome to this issue of AUK For those of you keeping up to date, the Carter review released today makes for some interesting but concerning reading. Whilst it recognises the key role of Paramedics in admission avoidance, it also spells out some of the barriers, including a need to invest in fleet, more highly skilled staff and a serious review of working practices. I am a humble person, not wise in the mysterious art of finance but even I am trying to understand where this investment will come from and how it might weigh against the savings that everyone is being asked to make. To me, it assumes that there will be overall savings from non-conveyance and a more uniform, efficient, UK wide operating model, but maybe that just moves the problem sideways, since review and refer needs something, or someone, to review and refer to…that might cost more than is saved.

“If we’re totally honest, there’s a lot to be said about educating the public”

It’s not that I don’t believe it. It’s good news that the ambulance sector is at last receiving the consideration it deserves and is rightly placed as a key component of a modern healthcare system. I suppose, in a way, I am a passionate supporter of much of what is being said. It is sensible and set against growing demand probably what most of the NHS, especially the A&E departments, want to hear. I hope that it comes to fruition, it’s just a niggling suspicion that it might not be quite as shiny as we might be led to believe.

That said, the world is changing albeit slowly, I’m currently looking at the role of clinicians much earlier in the patient journey and the numbers look promising in terms of reduced risk and more appropriate disposition. Just my own thoughts, but I wonder how long it will be before HE institutions include modules on telephone triage for aspiring Paramedics or services start to recruit millennials on portfolio contracts which include such wizardry.

Then again, if we’re totally honest, there’s a lot to be said about educating the public, Carter says “the ambulance service is not a taxi service”, true, you have to pay for a taxi...! But even if you start with the youngsters it might take two or more decades before people start to realise it really is becoming a ‘don’t abuse it you’ll lose it’ service. Maybe some more investment here might help just as much as more ambulances or perhaps we just need to occasionally say ‘no’...

Anyway, it will be interesting to see the commentary over the next few days. It will make a change from ... what is it they say on TV? “Winter is coming...!”

Sam English, Co-Editor Ambulance UK

AMBULANCE UK - OCTOBER

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

FEATURE

4 WAYS TRAUMA PROS CAN IMPROVE CARE FOR BURN PATIENTS

BY DAVID W. VOIGT MD, CHRISTI CHAVES MA RN FACHE AND ESTHER RATHJEN MSN RN APRN-CCNS ON AUGUST 18, 2017 About 486,000 people receive medical treatment for burn injuries in

2. Do not delay intubation for burn patients

the United States every year. For the most seriously burned patients,

In our experience, providers are sometimes reluctant to intubate a

this involves transfer to one of the nation’s 66 verified burn centers.

burn patient. Verified trauma centers are usually very good about this

But the vast majority of burn patients are treated in trauma centers

aspect of care, but many ED staff in smaller communities do not feel

and emergency departments without a specialised burn unit.

comfortable with intubation. As a result, they will often wait for the transport team to intubate the burn victim.

As burn specialists, we see the most serious end of the thermal injury spectrum every day. Our hospital, CHI Health St. Elizabeth in Lincoln,

Clearly, however, delaying intubation can have disastrous effects. At St.

Neb., became one of the first verified burn units in the U.S. in 1973.

Elizabeth, we would rather take an endotracheal tube out of a burn patient

Today, we treat more than 150 seriously burned patients every year.

who didn’t need it than to have the patient arrest two blocks from our hospital.

Recently, we were asked what trauma centers, non-trauma EDs and

Our recommendation: If there is any doubt, intubate the patient. The

prehospital providers can do to improve their care for burn patients. The short

airway is only going to get worse as the resuscitation continues and the

answer, in our view, is greater collaboration with your regional burn center.

tissues swell, so early intubation is a critical component of care.

Verified burn centers offer expertise that can improve outcomes for burn patients - even if those patients never set foot in a specialised burn unit.

Again, for all of the clinical management issues surrounding burn care, the best overall solution is to make sure trauma providers take the ABLS Course.

Strong collaboration requires information sharing. Based on best practices and available resources, following are four ways that trauma

3. Use burn center referrals to guide early care

providers can leverage burn center expertise to improve care for burn

The ABA has established criteria for referral to a verified burn center.

victims in every setting.

These criteria include:

1. Avoid “fluid creep”

• Partial thickness burns greater than 10% of total body surface area

In many regions, one of the biggest opportunities to improve burn care

• Burns that involve the face, hands, feet, genitalia, perineum or major joints

is to more carefully manage fluid resuscitation for burn victims. Too

• Third-degree burns in any age group

often fluids are run “wide open” in burn patients. This can lead to the phenomenon referred to as “fluid creep”.[1] The result is increased lung

However, there is some confusion about burn center referral. It

water, which leads to increased ventilatory time and all its associated

is important to understand that referral to a burn center does not

consequences. Fluid creep has also been linked to abdominal

necessarily mean transfer to a burn center.

compartment syndrome.

There are times when a patient meets the ABA criteria for referral, but How can trauma providers avoid fluid creep? First, make sure you are

there is nothing that the burn center would do differently, at least initially. In

following current guidelines from the American Burn Association (ABA)

these cases, referral entails coordination with burn center staff. The burn

for calculating fluid needs. The best way to learn these guidelines is to

specialist can provide advice on different aspects of burn treatment, plus

take the ABA’s Advanced Burn Life Support (ABLS) course. This course

guidance on whether to transfer and when transfer is recommended.

educates trauma and emergency department staff on the most current practices for resuscitating and treating burn victims.

For example, a child touches the hot glass of a fireplace and develops

AMBULANCE UK - OCTOBER

a blister on the palm of their hand. Most of these burns will heal well Second, make sure you understand how to estimate burn size.

without the need for transfer. However, these cases should be referred

Research has shown that inexperienced practitioners often overestimate

for burn specialist consultation. At St. Elizabeth, we often perform these

the size of a burn.[2] Since burn size is a key factor in fluid resuscitation

referrals using telehealth tools that allow us to view the injury. Where

formulas, burn overestimation will result in patients receiving too much

telehealth is not available, a phone consult might often suffice.

fluid, even if the current resuscitation guidelines are used.

4. Understand the resources available at your regional burn center Fluid resuscitation guidelines are constantly evolving, so we also

Here’s a common scenario: A patient presents at a trauma center with

encourage trauma centers and non-trauma EDs to maintain ongoing

mechanical injury and concomitant thermal injury. Surgeons on staff

communication with their regional burn center to stay up to date on the

are able to graft the burns, so the decision is made that the injury is not

latest recommendations.

“bad enough” for referral to a verified burn center.

178 For more news visit: www.ambulanceukonline.com

In some cases, this decision is appropriate. However, we would

Video laryngoscopy FEATURE wherever and whenever you intubate

encourage trauma center leaders to consider the full range of care needs of the burned patient - and the full range of resources available at verified burn centers.

First, treating burn patients is not just about grafting. Burns are best treated by a team approach that can only be delivered at a verified burn center. In addition, burn centers offer treatments that are not available in most trauma centers, and certainly not in smaller critical access hospitals. These include xenografts and allografts that can accelerate the healing process, decrease pain, potentially eliminate twice-a-day dressing changes, and prepare infected burns for final grafting.

Second, verified burn centers also offer follow-up care that can make a big difference in the patient’s ultimate outcome. Resources include specialised splinting, education on scar control, compression garments and now the burn laser. Follow-up care at a burn center is provided by physical, occupational and recreational therapists who are experienced with the special challenges presented by the burn patient.

Finally, burn centers take care of more than just burns. Studies have shown that toxic epidermal necrolysis, a potentially life-threatening skin disorder, is best treated at a burn center.[3] Burn center specialists have also become the experts in treatment of frostbite using intra-arterial thrombolyis. For frostbite patients transferred to a burn center within 24 hours of their injury, we can save many of the limbs that in the past would have been lost to amputation.[4] Seamless care Clearly, a patient with both mechanical trauma and burn injury should never bypass a verified trauma center to get to a burn center.

However, early coordination and consultation with burn center specialists can enable seamless care across the entire continuum and better overall outcomes.

David W. Voigt, MD is co-medical director, Christi Chaves, MA, RN, FACHE is nursing director, and Esther A. Rathjen, MSN, RN, APRNCCNS is clinical nurse specialist at the Burn Center at CHI Health St. Elizabeth in Lincoln, Nebraska.

References 1. Saffle JI. The phenomenon of “fluid creep� in acute burn resuscitation. J Burn Care Res. 2007 May-June; 28(3): 382-95.

3. Palmieri TL, Greenhalgh DG, Saffle JR, et al. A multicenter review of toxic epidermal necrolysis treated in U.S. burn centers at the end of the twentieth century. J Burn Care Rehabil. 2002 March-April; 23(2): 87-96.

4. Gonzaga T, Jenabzadeh K, Anderson CP, et al. Use of intra-arterial thrombolytic therapy for acute treatment of frostbite in 62 patients with review of thrombolytic therapy in frostbite. J Burn Care Res. 2016 July-August; 37(4): e323-34.

www.intersurgical.co.uk/info/iview

AMBULANCE UK - OCTOBER

2. Hammond JS, Ward CG. Transfers from emergency room to burn center: errors in burn size estimate. J Trauma. 1987 October; 27(10): 1161-5.

Quality, innovation and choice

179

NEWSLINE

The new corpuls cpr has redefined the standard for the next gerneation of chest compression devices used by the emergency services and hospitals.

PROTECT YOUR AMBULANCE CREW

USER FRIENDLY

The corpuls cpr has the capability of being able to

The corpuls cpr comes with clearly visible colour

supply fully automated chest compressions, ensuring less

display and easy to access control panel buttons.

strain on rescue workers, particularly when performed in

The compression depth and/or rate, can be manually

a moving vehicle. The corpuls cpr is able to check its

adjusted when required.

position of the compression pad after each ventilation break or 100 compressions (in continuous mode) to compensate for any impact cpr has on the patient’s thorax.

TS S O C G N I N ESSION PADS N U R W O L MPR ABLE

REUS

CO

AMBULANCE UK - OCTOBER

The compression pads come in two sizes and can be disinfected with all common agents, keeping running costs to a minimum. This ensures that the corpuls cpr can be deployed on every CPR job without financial impact.

180 For more news visit: www.ambulanceukonline.com

NEWSLINE

The Tireless Arm that saves lives BLE A L I A V A ES I D U T S E NEW CAS

sales@theortusgroup.com www.theortusgroup.com T: +44 0845 4594705 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.

AMBULANCE UK - OCTOBER

corpuls cpr compliant to current ERC/AHA guidelines.

181

FEATURE

IDENTIFYING PRE-HOSPITAL FACTORS ASSOCIATED WITH OUTCOME FOR MAJOR TRAUMA PATIENTS IN A REGIONAL TRAUMA NETWORK: AN EXPLORATORY STUDY Lee Thompson1*, Michael Hill2, Caroline Davies1, Gary Shaw1 and Matthew D Kiernan2 Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2017 25:83 https://doi.org/10.1186/s13049-017-0419-4 © The Author(s). 2017, Published online 2017 Aug 23 Reproduced with permission from the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Abstract Background Major trauma is often life threatening and the leading cause of death in the United Kingdom (UK) for adults aged less than 45 years old. This study aimed to identify pre-hospital factors associated with patient outcomes for major trauma within one Regional Trauma Network.

Method Secondary analysis of pre-hospital audit data and patient outcome data from the Trauma Audit Research Network (TARN) was undertaken.

The primary outcome used in analysis was ‘Status at Discharge’ (alive/ deceased). Independent variables considered included ‘Casualty Characteristics’ such as mechanism of injury (MOI), age, and physiological measurements, as well as ‘Response Characteristics’ such as response timings and skill mix. Binary Logistic Regression analysis using the ‘forward stepwise’ method was undertaken for physiological measures taken at the scene.

Results The study analysed 1033 major trauma records (mean age of 38.5 years, SD 21.5, 95% CI 37–40). Adults comprised 82.6% of the sample (n = 853), whilst 12.9% of the sample were children (n = 133). Men comprised 68.5% of the sample (n = 708) in comparison to 28.8% women (n = 298).

Glasgow Coma Score (GCS) (p < 0.000), Respiration Rate (p < 0.001) and Age (p < 0.000), were all significant when associated with the outcome ‘Status at Discharge’ (alive/deceased).

Isolated bivariate associations provided tentative support for response characteristics such as existing dispatching practices and the value of rapid crew arrival. However, these measurements appear to be of limited utility in predictive modelling of outcomes.

Discussion The complexity of physiological indices potentially complicate their predictive utility e.g. whilst a Systolic Blood Pressure (SBP) of < 90 mmHg serves as a trigger for bypass to a Major Trauma Centre, the utility of this observation is nullified in cases of Traumatic Brain Injury.

Analysis suggested that as people age, outcomes from major trauma significantly worsened. This finding is consistent with existing research highlighting the relationship between trauma in elderly patients and poorer outcomes.

Conclusion Findings lend further validity to GCS, Respiration Rate and Age as predictive triggers for transport to a Major Trauma Centre. Analysis of interactions between response times, skill mix and triage demand further exploration but tentatively support the ‘Golden Hour’ concept and suggest a potential ‘load and go and play on the way’ approach.

Keywords: Pre-hospital, Trauma, Outcome, Age, Timings, Response

Background AMBULANCE UK - OCTOBER

Major trauma is often life-threatening and is the leading cause of death

Research Network (TARN) [4]. TARN is a national organisation that

in the UK for adults under 45 years [1].

collects and processes data on moderately and severely injured patients in England and Wales. TARN data allows networks, major

In April 2012, after reports identifying the need for specialist trauma

trauma centres, trauma units, ambulance services and individual

care, Regional Trauma Networks (RTN) were introduced across the

clinicians to benchmark their trauma service with other providers

UK which enabled ambulance services to bypass local emergency

across the country. The combination of TARN with the RTN pre-

departments and transport severely injured patients direct to definitive

hospital database enabled the creation of a meaningful dataset and

care at specialist Major Trauma Centres [2, 3].

allowed for a more comprehensive exploration of factors relating to pre-hospital trauma care. A key consideration in this analysis was

Following the introduction of the local RTN a regional pre-hospital

understanding the epidemiology of a trauma system whilst taking

trauma registry was created. This data was combined with outcome

into account the unique geographical features and demography

data from the national trauma registry maintained by the Trauma Audit

of the region. Understanding the local regional major trauma

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

FEATURE epidemiology through this preliminary and exploratory study, with

HEMS doctors within the region are also trained to manage

the intention of providing a baseline from which to evaluate future

cardiothoracic trauma up to and including resuscitative thoracotomy,

performance, would potentially identify trends and ultimately improve

peri-mortem C-section, rapid sequence induction (RSI) and the

patient outcomes.

administration of blood products (although blood products were not on the aircraft at the time of this study).

The aim of this study was to explore the pre-hospital casualty and response factors associated with major trauma outcomes in a RTN.

Hazardous Access Response Team (HART) Paramedics are also available within the region to access patients at height, in water or in remote or difficult locations. At the time of the study there were 58

Methods

ambulance stations throughout the region with over 500 Paramedics who work alongside emergency care assistants and technicians.

The study analysed combined data from TARN and RTN pre-hospital database for the North East (England) Ambulance Service producing a comprehensive dataset of regional major trauma patients. The entry criteria for patient inclusion within the RTN pre-hospital database can be seen in Fig. 1. Ethical approval for the study was granted via Northumbria University Research Ethics Review Panel. Reporting of the study followed the STROBE guidelines [5].

Study period and population The sample comprised of data collected between 1st of April 2012 and 30th September 2012 with each patient record within the dataset containing 69 variables. The study identified two groups of variables:

Data analysis Descriptive statistics were used to characterise the study sample in terms of casualty and response characteristics. Categorical and ordinal variables were expressed as proportions and continuous variables expressed as means with standard deviations.

The primary outcome measure used in causal analysis was ‘Status at Discharge’ (alive/deceased). Independent variables were loosely grouped into two sets;

and

‘Casualty Characteristics’ obtained from patient care records, which included physiological measurements, age, MOI etc.; and ‘Response Characteristics’ obtained from Computer Aided Dispatch (CAD) records, which included response and transport times, crew skill mix and triage

(i) casualty characteristics e.g. age and physiological indices,

(ii) response characteristics e.g. skill mix and transport time.

practices.

Whilst there were multiple recordings of physiological indices

Within the sample there was a small number (n = 36, 3.5%) of

purposes were the observations used by the attending crew in their

for most patients within the study, the set employed for analysis

casualties who were not classified as major trauma at initial triage, but were retrospectively included into the sample because they were later identified as meeting major trauma criteria. All ‘under-triaged’ patients managed at the Major Trauma Centres or Trauma Units were subsequently entered into the database.

The regional ambulance service covers an area of 8365 km2 serving over 2.71 million people in a mixed geography of rural and urban areas and receives over 1.5 million emergency and urgent calls per annum. The RTN, at the time of the study, had 9 Trauma Units and 2 Major Trauma Centres. There are 2 Helicopter Emergency Medical Service (HEMS) bases within the region which are charity-funded and each aircraft is staffed by Doctors qualified in Pre-Hospital Emergency Medicine (20 part-time doctors and 4 in training) and Paramedics (11 full-time equivalents). These aircraft do not fly at night, or when weather restricts visibility, but crews are able to respond to calls via a rapid

pre-alert or alternatively, those observations that prompted the use of the major trauma triage tool shown in Fig. 2. Preliminary bivariate analysis was undertaken in order to explore relationships between these factors and outcome ‘Status at Discharge’ (alive/deceased).

To adjust for collinearity and potential amplification bias a binary logistic regression analysis was undertaken with the outcome ‘Status at Discharge’ (alive/deceased) as the dependant variable. Only independent variables that were individually associated with the outcome ‘Status at Discharge’ (alive/deceased), at a p ≤ 0.05 level were entered into the binary logistic regression model. All candidate predictor variables were entered into the model using a forward stepwise method, and each variable’s contribution to the overall fit was estimated using likelihood ratio tests. Analyses were undertaken using the Software Package for the Social Sciences (SPSS; Version 22, IBM Inc.; Armonk, NY, USA).

response vehicle during these times. At the time of this study HEMS a rapid response vehicle.

Results

Paramedics within the RTN are trained and educated to carry out

The study sample consisted of 1033 patient records that met the

multiple interventions for trauma patients. These interventions include

pre-hospital major trauma triage protocol criteria, as shown in Fig. 2.

advanced airway management (endo-tracheal tube intubation and

Table 1 highlights descriptive analysis of demographic characteristics

supraglottic airways), needle decompression of pneumothoraces and

of the sample group and key emergency response characteristics.

intravenous and intraosseous access. The application of haemorrhage control devices (tourniquets, haemostatic gauze) as well as Tranexamic

Bivariate analysis revealed that a number of variables were

Acid and immobilisation/splinting devices are also available to pre-

significantly associated with outcome ‘Status at Discharge’ (alive/

hospital paramedics.

deceased) shown in Tables 2 and 3.

AMBULANCE UK - OCTOBER

teams were available to respond on a Friday and Saturday night utilising

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

FEATURE

Fig. 1 Criteria for patient entry into pre-hospital database

Binary logistic regression analysis In order to address problems of collinearity and the potential for

Step 2 Nagelkerke’s R2 (59.8%) the model included ‘GCS’ score and

amplification bias, binary logistic regression was undertaken for 571

‘Age’ and indicated a stronger relationship between prediction and

casualties using outcome ‘Status at Discharge’ (alive/deceased) as

grouping.

the dependant variable. Analysis proceeded on the basis of ‘listwise’ exclusion, and this resulted in a total of 462 cases being excluded from

Step 3 the final model included ‘GCS’, ‘respiratory rate’, and

the analysis sample (N = 1033). Variables were entered into the model

casualty’s ‘age’ and indicated that these factors are significant

AMBULANCE UK - OCTOBER

on the basis of the ‘forward stepwise’ method. All candidate variables

predictors of outcome ‘Status at Discharge’ (alive/deceased) (χ2 =

considered for inclusion in the binary logistic regression model were

155.902, p < 0.000). The other four candidate predictors, ‘transport

individually associated with the outcome ‘Status at Discharge’ (alive/

time’, ‘triage’, ‘skill mix’ and ‘systolic BP’, were not significant.

deceased) at the p ≤ 0.050 significance level.

‘GCS’, ‘age’ and ‘respiratory rate’ were all significant at the 5% level A test of the full model against a constant only model was statistically

(‘GCS’ – p < 0.000; ‘age’ - p < 0.000; ‘respiratory rate’ - p < 0.001).

significant, indicating that the predictors as a set reliably distinguished between alive or deceased (χ2 = 103.862, p ≤ 0.000). Collectively, all

The odds ratio (OR) were as follows: ‘GCS’ was 1.587 (95% CI:

seven candidate predictors “explained” 94% of the variability in ‘Status

1.374–1.833); ‘Age’ was 0.923 (95% CI: 0.894–0.952); ‘respiratory

at Discharge’ (alive/deceased).

rate’ was 1.165 (95% CI: 1.067–1.272). The model correctly predicted 99.3% of the variability of an ‘Alive’ outcome, and 67.6%

Step 1 Nagelkerke’s R2 (45.8%) the model included ‘GCS’ score only

of ‘Deceased’ outcome at discharge, giving an overall percentage

and indicated a moderate relationship between prediction and grouping.

correct prediction rate of 97.4%.

184 For more news visit: www.ambulanceukonline.com

FEATURE

Fig. 2 Major trauma triage protocol

Discussion The findings of this study suggest that physiological measures taken

calls) within 8 min regardless of rural or urban location [14]. The rise

at the scene are of greater predictive utility than are emergency

of evidence-based medicine has brought with it the unintentional

services response characteristics. Specifically, GCS, respiration rate,

consequence of ‘therapeutic nihilism’ [15], in which failure to establish

and age formed significant elements of the predictive model. Further

supporting evidence for an intervention is (incorrectly) interpreted as

analysis suggested that as people age, outcomes from major trauma

a warrant for therapeutic inertia. The pressures to ‘do nothing’ are

significantly worsened. This finding is consistent with existing research

further exacerbated during times of fiscal austerity, where being unable

highlighting the relationship between trauma in elderly patients and poorer outcomes [6–8].

Almost all previous studies with regard to physiology and trauma were exclusive to the in-hospital setting [9–12]. The evaluation of prehospital physiological variables as predictors of trauma outcome has, hitherto, been neglected. However, it should be noted that the inherent complexity of physiological indices (and their significance) potentially complicate their predictive utility e.g. whilst a Systolic Blood Pressure Centre, the utility of this observation is nullified in cases of Traumatic Brain Injury (TBI). Recent research [13] has identified that each 10 mmHg reduction in SBP is associated with an 18% increase in mortality

erosion of service standards such as crew response times. In terms of the current study, it would appear that (abnormal) physiological measurements, possibly as a reflection of the severity of trauma and nature of the physiological insult, underpin the most accurate predictive model of mortality outcomes.

Existing research considering the impact of timings and skill mix is markedly limited to consideration of on-scene times and predominately focused on the impact of physician led teams in prolonging ‘on-scene’ times [16–19]. These studies have typically added fuel to the ‘stay and play’ or ‘load and go’ debate and highlight the ‘golden hour’ of

when SBP falls below 120 mmHg. These findings should make us

immediate care [20, 21]. However, the typical lack of standardisation in

reconsider the hypotensive threshold for the isolated TBI patient group.

how ‘on-scene’ times are defined and recorded raises valid questions concerning the potential generalisability of these findings beyond the

Emergency services response characteristics most often form the basis

context in which individual studies were undertaken. In the context of the

for Key Performance Indicators (KPI’s) for ambulance service delivery

current study, HEMS teams took longer to arrive on scene, compared

and evaluation: For example, the UK Department of Health requires

to land based resources, had extended ‘on-scene’ times and longer

ambulance services within England to respond to Red (life threatening

overall mean time from emergency call to arrival at receiving facility.

AMBULANCE UK - OCTOBER

(SBP) of <90 mmHg serves as a trigger for bypass to a Major Trauma

to unequivocally establish an evidence base can underpin the further

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

FEATURE

Table 1 Demographics, crew attendance, timings and triage Age in years

Years [SD] (95% CI)

Mean

38.5 [21.5] (37–40)

Missing

86

Adult/Child <17

n (%)

Adult

853 (82.6)

Child <17

133 (12.9)

Missing

43 (4.2)

Sex

n (%)

Male

708 (68.5)

Female

298 (28.8)

Missing

23 (2.2)

Pre-hospital Traumatic Cardiac Arrest (TCA) – Active Resuscitation

n (%) 30

Died on scene

7 (23)

Transported to hospital

23 (77)

Alive at discharge

3 (10)

Died in hospital

18 (60)

Missing

2 (7)

In hospital deaths from pre-hospital major trauma (Not pre-hospital TCA)

n (%) 43 (4)

Attended by

n (%)

HEMS

168 (16.3)

Land Crews

844 (81.7)

Missing

17 (1.6)

Crew arrival times

Minutes [SD] (95% CI)

Mean

12 [13.5] (11–13)

HEMS

14 [11.5] (12–16)

Land Crews

11.5 [13.5] (10.5–13)

On scene times

Minutes [SD] (95% CI)

Mean

36 [19.5] (35–37.5)

HEMS

51.5 [21.5] (48–55.5)

Land Crews

33.5 [18] (32.5–35)

Transport time

Minutes [SD] (95% CI)

Mean

17 [11.5] (16–17.5)

HEMS

13 [9.5] (11–14.5)

Land Crews

17.5 [12] (16.5–18.5)

Time to definitive care (999 call to arrival at receiving facility) Mean

Minutes [SD] (95% CI) 65 [27] (63–66.5)

AMBULANCE UK - OCTOBER

HEMS

78 [23] (73.5–81.5)

Land Crews

62.5 [27] (60.5–64.5)

Triage

n (%)

Correct triage

744 (72.0)

Under triage

36 (3.5)

Over triage

248 (24)

Missing

5 (0.5)

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

FEATURE Table 2 Relationship of Independent variables associated with outcome ‘Status at discharge’ (Alive/Deceased), obtained using bi-variate analysis Independent Variable

Test Statistic

p

df.

Mean Difference

95% CI(Lower)

95% CI(Upper)

GCS 2 Relationship of Independent t = −10.222 44.15 p ≤outcome 0.000 7.28 points (Alive/Deceased), 5.845 8.715 Table variables associated with ‘Status at scale discharge’ obtained using bi-variate analysis Respiratory Rate t = −5.241 43.55 p ≤ 0.000 8 per min.

5 12 Independent Variable Systolic BP at Scene GCS Age Respiratory Rate Transport Time Systolic BP at Scene Skill Mix Age Triage Transport Time

Test t =Statistic −3.027 t = −10.222 t = −5.464 t = −5.241 t = −2.085 t = −3.027 u = 18,239 t = −5.464 u = 19,959 t = −2.085

df.37.52 44.15 738 43.55 685 37.52 738 685

p p ≤ 0.004 p ≤ 0.000 p ≤ 0.000 p ≤ 0.000 p ≤ 0.037 p ≤ 0.004 p ≤ 0.036 p ≤ 0.000 p < 0.000 p ≤ 0.037

Mean 11.4 Difference mmHg 7.28 scale points 17.8 years 8 per min. −3.78 min 11.4 mmHg 17.8 years −3.78 min

95% CI(Lower) 11.46 5.845 11.47 5 −7.14 11.46 11.47 −7.14

95% 57.7CI(Upper) 8.715 24.24 12 - 0.21 57.7 24.24 - 0.21

Skill Mix

u = 18,239

-

p ≤ 0.036

-

-

-

Triage u = 19,959 p < 0.000 As previously noted, HEMS teams have a wider scope of practice and involved, the potential for collinearity and amplification bias by means of

are able to initiate additional interventions such as RSI. More widely,

multiple comparisons using the same variables would risk Type I errors.

the huge variation in scope of practice between professions in different regions and countries [22] makes direct comparisons difficult. Although

As is the case with all uses of secondary data, analysis is constrained

pre-hospital timings were extended for HEMS teams, compared to land

by the fact that data are collected for purposes other than the

based teams, this study did not examine whether the presence of HEMS

researcher’s intentions [24]. Furthermore, the large number of personnel

improved timings for ongoing management such as time to theatre or

involved in data collection inevitably potentiates the risk of poor inter-

time to Computerised Tomography (CT) scan [23].

rater reliability [25]. Whilst mortality data serves as an absolute binary outcome measure, morbidity data is less tangible [26]. Further research

Significantly, within this study it was noted that those major trauma

is required in order to understand the utility of the predictor variables

casualties who were correctly triaged were more likely to have poorer

considered in this paper in predicting morbidity outcomes, especially in

outcomes. This finding may suggest that crews are using existing

the case of life-changing morbidity.

triage practices in order to correctly classify trauma severity. Whilst some patients are incorrectly over triaged and transported to a Major Trauma Centre and some major trauma patients inappropriately under triaged and transported to local hospital emergency departments, these eventualities did not appear to be statistically associated with significantly adverse outcomes. The tendency to over-refer casualties to Major Trauma Centres is perhaps an artefact of the precautionary principal in action.

Conclusions This study identifies that local pre-hospital major trauma predominantly affects the male population with the mean age of 38.5 years. Further research is required in order to more fully understand the predictive utility of age in determining major trauma outcomes and possibly to allow the generation of age-specific triage criteria.

Limitations

Contrary to current English ambulance performance targets, this study identified that there is greater predictive utility in relation to

The study was conducted during the spring and summer months and

outcome from physiological measures taken at the scene than

does not account for seasonal variations which may have affected

emergency services response times which, paradoxically, comprise key

mechanism of injury, available flying time (daylight in northern UK is

performance indicators for service delivery.

18 h in the summer and 6 h in winter) and driving conditions due to adverse weather during the winter months (snow and ice). There is a

Rather than interpreting this finding as a warrant for the therapeutic

strong likelihood of ecological and confounding relationships within the

nihilist instruction to abandon targets, we conclude that further analysis

current data set. Whilst bivariate analysis such as is reported above can

is required in order to establish the value of response characteristics in

reveal interesting associations, the large number of degrees of freedom

relation to morbidity outcomes and the alleviation of suffering.

Significant Variables the regression predictive model Table 3 Results from binarywithin logistic analysis of Wald ‘Status P Odds Ratio (alive/ predictorVariable variables for outcome at Discharge’ deceased) Step 3 GCS 39.662 p ≤ 0.000 1.587 (95% CI: 1.374–1.833) Significant Variables25.097 within the model Age p ≤predictive 0.000 0.923 (95% CI: 0.894–0.952) Variable Wald P Odds Respiratory Rate 11.553 p ≤ 0.001 1.165Ratio (95% CI: 1.067–1.272) Step 3 GCS

39.662 p ≤ 0.000 1.587 (95% CI: 1.374–1.833)

Age

25.097 p ≤ 0.000 0.923 (95% CI: 0.894–0.952)

Respiratory Rate 11.553 p ≤ 0.001 1.165 (95% CI: 1.067–1.272)

The authors tentatively suggest that given the lack of evidence for emergency services response characteristics as predictors of mortality outcomes, a ‘load and go and play on the way’ approach to patient transport might be advocated.

Acknowledgements The researchers acknowledge the contribution of NEAS Research and Development Department, in particular the assistance of Paul Aitken-Fell and Sonia Byers for their expert support for and guidance in relation to

AMBULANCE UK - OCTOBER

Table 3 Results from binary logistic regression analysis of predictor variables for outcome ‘Status at Discharge’ (alive/ deceased)

the vagaries of the secondary data set analysed here.

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

FEATURE The researchers wish to acknowledge the contribution of Joanne Gray,

Gary Shaw, Email: gary.shaw@neas.nhs.uk.

Reader in Health Economics, Northumbria University Newcastle for her

Matthew D Kiernan, Email: matt.kiernan@northumbria.ac.uk.

invaluable support in relation to statistical analysis undertaken.

Author details North East Ambulance Service NHS Foundation Trust, Trauma Desk,

Funding

1

No funding was sought or obtained for this study.

Bernicia House, Goldcrest Way, Newcastle Upon Tyne NE15 8NY, UK. Northumbria University, Coach Lane Campus, Newcastle Upon Tyne

2

NE7 7XA, UK.

Availability of data and materials The dataset generated for patient outcomes during and/or analysed during the current study are available in the TARN repository available at: https://www.tarn.ac.uk/.

References

Various permissions may be sought via TARN to access the data. The

1. Sukumaran S, Henry JM, Beard D, Lawrenson R, Gordon MW,

specific data used in the study included all the Major Trauma Centre’s and Trauma Unit’s in the Northern Trauma Network.

The pre-hospital data that supports the findings of this study are available from North East Ambulance Service (NEAS) NHS Foundation

O’Donnell JJ, Gray AJ. Prehospital trauma management: a national study of paramedic activities. Emerg Med J. 2005;22(1):60–63. doi: 10.1136/emj.2004.016873.

2. National Confidential Enquiry into Patient Outcome and Death.

Trust but restrictions apply to the availability of these data, which were

Trauma: who cares? : a report of the National Confidential Enquiry

used with their permission, and are not publicly available. Data are

into Patient Outcome and death (2007). London: National Confidential

however available from the authors upon reasonable request and with

Enquiry into Patient Outcome and Death (NCEPOD); 2007.

permission of NEAS.

3. National Audit Office . Major trauma care in England. London: National Audit Office; 2010.

Abbreviations CAD: Computer aided dispatch; CT: Computerised tomography; GCS: Glasgow coma score; HART: Hazardous access response team; HEMS: Helicopter emergency medical service; KPI: Key performance indicator; MERIT: Medical emergency response incident team; MOI: Mechanism of

4. Trauma Audit and Research Network: TARN. [https://www.tarn. ac.uk/]. Accessed 18 Aug 2017.

5. Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC,

injury; MTC: Major trauma centre; NEAS: North east ambulance service;

Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M,

NHS: National health service; RSI: Rapid sequence induction; RTN:

S.I Strengthening the reporting of observational studies in

Regional trauma network; SBP: Systolic blood pressure; TARN: Trauma

epidemiology (STROBE): explanation and elaboration. PLoS Med.

audit research network; TBI: Traumatic brain injury; UK: United Kingdom

2007;4(10):e297. doi: 10.1371/journal.pmed.0040297.

6. Cox S, Morrison C, Cameron P, Smith K. Advancing age and trauma:

Authors’ contributions LT: lead author, collection analysis and interpretation of data. MH:

Triage destination compliance and mortality in Victoria, Australia.

Contributing author, mentor and analysis and interpretation of data. CD:

Injury. 2014;45(9):1312–1319. doi: 10.1016/j.injury.2014.02.028.

Data collection and proofreading. GS: Data collection and proofreading.

MK: Ethics submissions, proofreading and editorial. All authors have read and approved the final manuscript.

7. Kehoe A, Smith JE, Bouamra O, Edwards A, Yates D, Lecky F. Older patients with traumatic brain injury present with a higher GCS score than younger patients for a given severity of injury. Emerg Med J. 2016;33(6):381–385. doi: 10.1136/emermed-2015-205180.

Ethics approval and consent to participate Not applicable. Ethical approval was granted by Northumbria University Research Ethics Review Panel.

8. Kehoe A, Smith JE, Edwards A, Yates D, Lecky F. The changing face of major trauma in the UK. Emerg Med J. 2015;32(12):911–915. doi: 10.1136/emermed-2015-205265.

Consent for publication

9. Lin G, Becker A, Lynn M. Changes in vital signs of trauma

Not applicable.

victims from prehospital to hospital settings. J Paramedic Pract.

AMBULANCE UK - OCTOBER

2011;3(10):558–562. doi: 10.12968/jpar.2011.3.10.558.

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

10. Victorino GP, Battistella FD, Wisner DH. Does tachycardia correlate with hypotension after trauma? J Am Coll Surg. 2003;196(5):679–

Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

684. doi: 10.1016/S1072-7515(03)00128-5.

11. Ocak G, Sturms LM, Hoogeveen JM, Le Cessie S, Jukema GN. Prehospital identification of major trauma patients. Langenbeck’s

Contributor Information *Lee Thompson, Email: lee.thompson5@nhs.net.

Michael Hill, Email: michael.hill@northumbria.ac.uk.

Caroline Davies, Email: caroline.davies@neas.nhs.uk.

Arch Surg. 2009;394(2):285–292. doi: 10.1007/s00423-008-0340-4.

12. MacLeod JBA, Maurico L, McKenney MG, Jeroukhimov I, Cohn SM. Predictors of mortality in trauma patients. Am Surg. 2004;70(9):805–810.

188 For more news visit: www.ambulanceukonline.com

FEATURE 13. Spaite DW, Hu C, Bobrow BJ, et al. Mortality and prehospital blood

20. Harmsen AMK, Giannakopoulos GF, Moerbeek PR, Jansma

pressure in patients with major traumatic brain injury: implications

EP, Bonjer HJ, Bloemers FW. The influence of prehospital

for the hypotension threshold. JAMA Surg. 2017;152(4):360–368.

time on trauma patients outcome: a systematic review. Injury.

doi: 10.1001/jamasurg.2016.4686.

2015;46(4):602–609. doi: 10.1016/j.injury.2015.01.008.

14. Turner J, O’Keeffe C, Dixon S, Warren K, Nicholl J. The costs and

21. Lerner EB, Moscati RM. The golden hour: scientific fact or medical

benefits of changing ambulance service response time performance

“urban legend”? Acad Emerg Med. 2001;8(7):758–760. doi:

standards. Sheffield: University of Sheffield; 2006.

10.1111/j.1553-2712.2001.tb00201.x.

15. Starr P. The politics of therapeutic nihilism. The new critics of medical care. Hast Cent Rep. 1976;6(5):24–30. doi: 10.2307/3561255.

16. Carr BG, Caplan JM, Pryor JP, Branas CC. A meta-analysis of prehospital care times for trauma. Prehosp Emerg Care.

2006;10(2):198–206. doi: 10.1080/10903120500541324.

17. Carr BG, Brachet T, David G, Duseja R, Branas CC. The time cost of prehospital intubation and intravenous access in trauma patients. Prehosp Emerg Care. 2008;12(3):327–332. doi: 10.1080/10903120802096928.

18. Di Bartolomeo S, Valent F, Rosolen V, Sanson G, Nardi G, Cancellieri F, Barbone F. Are pre-hospital time and emergency department disposition time useful process indicators for trauma care in Italy?

Injury. 2007;38(3):305–311. doi: 10.1016/j.injury.2006.10.005.

19. Dissmann PD, Le Clerc S. The experience of Teesside helicopter emergency services: doctors do not prolong prehospital on-scene times. Emerg Med J. 2007;24(1):59–62. doi: 10.1136/emj.2006.038844.

22. Eckstein M, Chan L, Schmeir A, Palmer R. Effective prehospital advanced life support on outcomes of major trauma patients. Am J Emerg Med. 2000;19(5):439–440.

23. Garner AA, Mann KP, Poynter E, Weatherall A, Dashey S, Puntis M, Gebski V. Prehospital response model and time to CT scan in blunt trauma patients; an exploratory analysis of data from the head injury retrieval trial. Scand J Trauma Resusc Emerg Med. 2015;23:28. doi: 10.1186/s13049-015-0107-1.

24. Bulmer M. Why Don’t sociologists make more use of official statistics? Sociology. 1980;14(4):505–523. doi: 10.1177/003803858001400401.

25. Cicchetti DV. Assessing inter-rater reliability for rating scales: resolving some basic issues. Br J Psychiatry. 1976;129(5):452–456. doi: 10.1192/bjp.129.5.452.

26. Bowling A. Measuring health: a review of quality of life measurement scales. Maidenhead: Open University Press; 2004.

WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues.

Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc.

If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com

AMBULANCE UK - OCTOBER

All submissions should be forwarded to info@mediapublishingcompany.com

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

DATES FOR Y

LIFE CONNEC

MORE CHOICE - GREAT VALUE -

We are pleased to announce our plans for Life Connections 2019 are taking shape and that each of our one day regional events have plenty to offer those wishing to attend. The venues chosen were selected to prevent delegates having to factor in travelling time and costs. Next years one day events are being held in:

Harrogate - Thursday March 28 Edinburgh - Thursday May 16 (provisional date) Bristol - Thursday June 20* Kettering - Thursday October 10 (provisional date) Stoke on Trent - Thursday November 28 (provisional date) First Responder Conference - This Half Day morning Conference will include presentations requested by First Responders, suggested topics include: sepsis, the changing role of the first responder and diabetic emergencies.

Sponsored delegate rate: £24 to include VAT, lunch/ refreshments, etc.

ONLY 50 PLACES AVAILABLE. FIRST AID Conference - Life Connections are working with Ian Kershaw MBE from The First Aid Industry Body (FAIB) and the Federation of first Aid Training Organisations (FOFATO) and, Rob Shaloe (QNUK) to present 5 Full Day First Aid Conferences in 2019. Each conference will include a number of topical First Aid presentations and workshops as requested by Members of FAIB, FOFATO and QNUK to ensure that they are both relevant and topical. - Usual Member rate of £96 (Including VAT), Lunch and Refreshments provided.

ONLY 60 PLACES AVAILABLE. Ultrasound Workshop - Supported by NEMUS Education and Training, a very experienced faculty who have experts in the field of Ultrasound, this full day Workshop is covering the common uses of Ultrasound in contemporary Pre Hospital and Hospital Practice. It is suitable for all Healthcare Professionals especially Paramedics, other AHPs and Nurses as this course is covering FAST Scanning, Focused AAA, Echo and life support, How to diagnose a pneumothorax with Ultrasound, Vascular Access, Basic Ultrasound Science, Reporting, Training and Governance plus Lots of Hands on Scanning - Delegate rate: £90 to include VAT, lunch/refreshments, etc.

ONLY 40 PLACES AVAILABLE.

Bariatric Workshop - this half day afternoon workshop is being run by Outreach Rescue and is focusing on dealing with Bariatric Patients. The workshop will be looking at tripods, bipods and other lifting systems that can be used for the extrication of casualties or Bariatric patients from a wide range of locations including domestic situations and RTC’s. The emphasis will be on safe assembly and operation of equipment, minimising manual handling issues and, patient care and safety.

Practical demonstrations and discussions will also be included in this workshop: Delegate rate: £60 to include VAT lunch/ refreshments, etc. ONLY 40 PLACES AVAILABLE. Trauma Management Workshop - Created by Pre-Hospital Care Consultancy, this two hour morning Workshop will be covering: Basic to Advanced Trauma Skills and include Trauma Patient Assessment, Catastrophic Bleeding, Splintage Skills, etc.

Delegate rate: £60 to include VAT lunch/refreshments etc.

ONLY 12 PLACES AVAILABLE.

To view all Conferences / Workshops please visit: www.lifeconn

w w w. l i f e c o n n e

YOUR DIARY

CTIONS 2019

- SOMETHING FOR EVERYONE!!!

Airway Management Workshop - Created by Pre-Hospital Care Consultancy, this two hour afternoon Workshop is covering: Basic to Advanced Airway Skills and will include Positioning, BVM and Basic Adjuncts Done Well!, Direct and Video Laryngoscopy, Emergency Surgical Airway, etc. Delegate rate £60 to include VAT lunch/refreshments, etc.

ONLY 12 PLACES AVAILABLE. Attend both the Trauma and Airway Management Workshops for a special combined rate of £96 (saving £24!).

Haemorrhage Control - Stepwise Approach Workshop* This half day workshop will be running both morning and afternoon, covering: What is Catastrophic Bleeding?, Changes to Guidelines FPHC, JRCALC, ERC, etc., Coagulopathy, Correct use of Direct Pressure, Use of Pressure Dressings & Their Limitations, Haemostatic Devices and the Safe and Effective Use, Tourniquets - The Safe and Effective Use. Delegate rate £36 to include VAT, lunch, refreshments, etc.

ONLY 10 PLACES AVAILABLE ON AM & PM WORKSHOPS Combined Conference / Workshop Offer 1. Attend the First Responder Half Day morning Conference plus an afternoon Airway Management or Outreach Rescue Workshop for a special combined rate of £72 (saving £12).

*Bristol Thursday June 20 This event will include all of the Conferences / Workshops mentioned previously with the following additional workshop being added: 7 ways to die in cold water - latest concepts in drowning, immersion, submersion and hypothermia and their associated treatments. Delegate rate £60 to include VAT lunch/refreshments etc.

ONLY 12 PLACES AVAILABLE AM AND PM. Combined Conference / Workshop Offer 1. Attend the First Responder half day morning conference and choose from an afternoon Airway Management, Outreach Rescue or 7 Ways to Die in Cold Water workshop - for a special combined rate of £72 (saving £12) 2. Attend the morning Trauma workshop plus an afternoon 7 Ways to Die in Cold Water or Outreach Rescue workshop for a special combined rate of £96 (saving £24)

2. Attend the First Responder half day morning conference plus the afternoon Haemorrhage Control workshop for a special combined rate of £48 (saving £12).

3. Attend the 7 Ways to die morning workshop plus an afternoon Airway Management or Outreach Rescue Workshop for a special combined rate of £96 (saving £24)

3. Attend the morning Haemorrhage Control workshop** plus the afternoon Outreach Rescue or Airway Management workshops for a special combined rate of £72 (saving £24)

** T his workshop will only take place in Harrogate and Kettering.

nections.uk.com or call the Organisers Office on: 01322 660434

ctions.uk.com

NEWSLINE SWAST

Weymouth dad meets lifesaving team

At a special event in Weymouth on Thursday 23 August, Pat met the SWASFT team who managed to restart his heart.

absolutely amazing. We’re so thankful to them.”

SWASFT Emergency Medical Dispatcher, Tracy Guilfoyle,

A Weymouth dad has met a South Western Ambulance Service NHS Foundation Trust (SWASFT) emergency response team who saved his life when he had a cardiac arrest.

Pat Moss, 56, was at home on Easter Sunday when his heart suddenly stopped beating.

His wife, Anne, heard him gasping for air and called 999. With guidance from SWASFT Control Room staff and assisted by her daughter Lauren, Anne carried out vital chest compressions to keep Pat alive.

“It came totally out of the blue,” he said. “I was dead and gone.

Without the caller handler, paramedics and hospital staff, I wouldn’t be here. I’m chuffed with all the care I received. It’s amazing to still be alive.”

The former Royal Navy chief petty officer was relaxing on the sofa when he experienced breathing difficulties.

He became unresponsive, and blood was seen coming from his mouth.

assessed Pat’s condition through a phone conversation with the family. Tracy then instructed Anne and Lauren to do cardiopulmonary resuscitation (CPR) to give Pat the best chance of survival.

SWASFT Paramedic, Nigel Cowan, Emergency Care Assistant, Joanne Brown, and St John Ambulance volunteer Community First Responder, Jon Ashworth, arrived within seven minutes. They were supported

by SWASFT Paramedic, Ennio

Anne said: “Our chilled-out Sunday turned into a nightmare.

But the ambulance staff were

The crews provided lifesaving support, including defibrillation, to get his heart beating again.

Tabone; Emergency Care Assistant, Allan Rodd; and Specialist Paramedic, Jim Bradley.

AMBULANCE UK - OCTOBER

192 For more news visit: www.ambulanceukonline.com

Patrick was driven by ambulance to Dorset County Hospital where he remained for six weeks. He has gone on to make a fantastic recovery, and has now returned to work.

Jeff Jones, West Dorset Operations Officer and Weymouth station officer, said: “I am delighted for Pat and his family, that Pat has made such a good recovery. This is part due to early and effective CPR carried out by his wife Anne, and a prompt and rapid intervention by SWASFT staff performing advanced life support, to complete the chain of survival. Pat’s incident highlights that with more people trained and confident to perform CPR, the better the chances of survival.”

NEWSLINE

BRAYDEN JUNIOR

Now you can have two Brayden manikins in one!

Special Introductory Offers – Contact us now!

• Order the Brayden Junior conversion kit

Email: Braydenjunior@welmedical.com

Supplied by

✔ Cost Effective practical and convenient ✔ Anatomically correct ✔ AHA and ERC compliant

AMBULANCE UK - OCTOBER

• Buy a complete package – Brayden plus Junior

✔ Easy to convert Brayden Adult to Brayden Junior

For more information, please see 193 For all your equipment needs visit: www.ambulanceservicesuppliers.com www.brayden.co.uk/junior

NEWSLINE Scotland and Microsoft, in

immediate access to the location

the best possible chance of

British Heart Foundation, Microsoft and the NHS join forces to save thousands more lives from cardiac arrests

partnership with solutions

of defibrillators in their areas, so

receiving early defibrillation if it’s

provider New Signature, will

they can direct bystanders to

required prior to the ambulance

now work together over the

their nearest life-saving device in

services arrival, which is proven

next 12 months to develop

the event of a cardiac arrest.”

to save lives.”

defibrillators across the UK that

Clare Barclay, Chief Operating

Pauline Howie, Chief Executive

can be used by ambulance

Officer, Microsoft UK, said:

of Scottish Ambulance Service,

is expected to help save lives

“There is huge potential ahead

Public defibrillators to be

every day right across the

in the impact that technology

“The role of the public in

country.

will have in digitally transforming

a cardiac arrest scenario

mapped as figures show they’re used in less than 3% of

a comprehensive network of

services. The pioneering project

said:

UK healthcare. This innovative

cardiac arrests

The move is part of a

partnership will bring the power

coordinated strategy between

of Microsoft technology together

Thousands more lives could

the BHF, NHS and other leading

with the incredible vision and

health organisations to improve

life-saving work of BHF and the

the UK’s poor cardiac arrest

NHS. This project, powered by

survival rates by increasing

the cloud, will better equip 999

the application of CPR and

call handlers with information

Microsoft and the NHS.

defibrillation to patients, and

that can make the difference

improving post-resuscitation

between life and death and

The partners are joining forces to

care. There are over 30,000

shows the potential that

out-of-hospital cardiac arrests

innovative partnerships like this

every year in the UK, but less

could make to the health of the

than 1 in 10 people survive. In

nation.”

be saved from cardiac arrests, thanks to a ground-breaking partnership between the British Heart Foundation (BHF),

map all of the UK’s defibrillators, with a shared ambition for the life-saving devices to be made readily available for every out-of-

countries where the public are better equipped to recognise

Professor Stephen Powis,

and deal with cardiac arrests,

national medical director for

The initiative is in response

survival rates are up to three

NHS England, said:

to shocking figures that show

times higher.

hospital cardiac arrest.

“Preventing heart failure and

public access defibrillators are used in less than 3 per cent of

Simon Gillespie, Chief Executive

other cardiovascular illness is

out-of-hospital cardiac arrests,

at the British Heart Foundation,

a priority for the NHS ten year

significantly reducing the survival

said:

plan. This innovative partnership will help people in every part of

chances of tens of thousands of “Every minute without CPR or

the country to access life-saving

defibrillation reduces a person’s

equipment, and will support

One of the biggest barriers

chance of surviving a cardiac

NHS staff and the public when

to their use is the location of

arrest by around 10 per cent.

attempting to save the lives of

these devices is often unknown

Thousands more lives could

the 30,000 people each year

to bystanders and ambulance

be saved if the public were

who suffer cardiac arrest out of

services, despite tens of

equipped with vital CPR skills,

hospital.”

thousands of defibrillators

and had access to a defibrillator

being placed prominently in

in the majority of cases.

people every year [1].

Ambulance services aim to get to cardiac arrests, the ultimate medical emergency, as quickly as possible. But every minute counts, meaning CPR and public access defibrillators provide a lifeline for victims.”

When the network is launched, defibrillator owners, or ‘guardians’, will be invited to register their defibrillator online.

The system will encompass detailed locations of defibrillators across the UK, which will allow Ambulance Services to direct bystanders of a cardiac arrest to the nearest one. It will also act as a network so that defibrillator guardians can support each other in the maintenance of these lifesaving devices.

The network will be piloted by West Midlands Ambulance Service and the Scottish Ambulance Service, before being rolled out across the UK.

NIAS

Anthony Marsh, Chief Executive of West Midlands Ambulance

workplaces, train stations,

should not be underestimated.

AMBULANCE UK - OCTOBER

Northern Ireland Paramedics get formal recognition as Allied Health Professionals (AHP)

leisure centres and public

“Over the last five years

Service and CEO of the

places across the country. The

we’ve made great progress

Association of Ambulance Chief

BHF says this is leading to a

in introducing CPR training in

Executives, said:

needless loss of lives, as 999

more schools. We now need to

call handlers are unable to direct

improve access to the tens of

“We are delighted that the region

bystanders to their nearest

thousands of public defibrillators

of West Midlands Ambulance

defibrillator when someone

across the UK. These life-saving

Service will be leading the way

Paramedics have been

suffers a cardiac arrest.

devices can provide a vital

in this innovative collaboration.

formally recognised as

lifeline for cardiac arrest victims

It’s absolutely critical that we

members of the Allied Health

Combining their expertise in

until ambulance services arrive.

are able to direct cardiac arrest

Professional (AHP) group

technology and healthcare,

This innovative project will

bystanders to their nearest

by the Department of Health

the BHF, NHS England, NHS

give every ambulance service

defibrillator. This gives patients

(DoH).

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

NEWSLINE The move follows recent

daily, the first contact that

discussions with the

many patients have with the

Department of Health

Health Service and often at

Permanent Secretary Richard

times when they are most

Pengelly, DoH officials and the NI Ambulance Service (NIAS).

Richard Pengelly welcomed the change. “Formal recognition of paramedics in Northern Ireland is essential to professionalise

anxious and vulnerable, including requiring the highest levels of clinical intervention due to trauma or medical emergencies. Paramedics are increasingly bringing the initial

the profession so paramedics

treatment to the patient at the

know just how much they are

scene of the emergency.

valued as members of the Health Service.

“This recognition is testament to the increasing role of

“This recognition will align

paramedicine in the provision

paramedics with other AHP

of health and social care within

colleagues and their peers

Northern Ireland. Paramedic

in the rest of the UK, and recognise the contribution paramedics currently make as inter-professional clinicians working across urgent, emergency, primary and community care provision here.

Education has been evolving, and will continue to evolve, as part of the transformation agenda ensuring that those who have need of our service can be confident that their clinical care is delivered

“This change is also in line

by individuals and teams

with the values within the new

operating to the highest

DoH Workforce Strategy. It is

professional standards.

important that paramedics feel supported in their challenging

“I congratulate all paramedics

roles and this move will assist

on having attained this

in that.

“Over recent years paramedics have taken responsibility for greater clinical decision making and are providing an increasing range of

recognition, which brings them into line with colleagues across the UK, and would like to thank everyone involved in bringing about this AHP recognition.”

interventions as part of the

The Allied Health Professions

wider transformational agenda.

(AHP) currently consists of

This is being underpinned by

12 distinct Hazel Winning,

the move to Higher education

the AHP lead in DoH who has

for paramedic practice. By

worked with NIAS to deliver

including paramedics as

this recognition, said: “The

AHPs will enable them to

professional recognition

the wider group of other AHP professions.”

Michael Bloomfield, Chief Executive of Northern Ireland Ambulance Service, also

decision would bring

Video laryngoscopy wherever and whenever you intubate i-view is the new, single use, fully disposable video laryngoscope from Intersurgical, providing the option of video laryngoscopy wherever you might need to intubate.

opportunities across the health service and has the potential to influence patient pathways

www.intersurgical.co.uk/info/iview

and make huge differences to patients’ lives. It can help

welcomed the recognition of

make use of skills to develop

paramedics as Allied Health

a more flexible workforce

Professionals. He said:

and provide more responsive

““Paramedics are, day and

services to service users.”

AMBULANCE UK - OCTOBER

expand their networks within

i-view™ video laryngoscope

Quality, innovation and choice

195

NEWSLINE SECAMB

sugar levels and messaging to a

SECAmb work recognised with HSJ Awards shortlistings

patient’s GP when treated at home.

A system which supports communication and collaborative working between the ambulance service and community care teams has been shortlisted for a prestigious Health Service Journal (HSJ) Award.

to more than 43,000 patient care

The system, which was introduced

by SECAmb in 2011, also provides ambulance clinicians with access plans. Previously in SECAmb, staff would need to speak to a colleague in the 999 control room to access IBIS on their behalf and ‘relay’ information over the phone.

The week of the system being made available on personal issue

South East Coast Ambulance Service’s (SECAmb) work to develop their Intelligence Based Information System (IBIS) to enable frontline clinicians access to patient care plans and complete community referrals on mobile iPad tablet devices, is shortlisted in the ‘Enhancing Care by Sharing Data and Information’ category.

iPads, in October 2017, saw its use

IBIS has several functionalities including falls risk assessment/ referral to community falls teams, notification to community diabetes teams for patients with low blood

in the ‘Community or Primary Care

more than quadruple.

SECAmb, with Surrey Heartlands Health and Care Partnership, has also been shortlisted the work it has done in developing a new Pregnancy Advice Line.

The advice line, which is shortlisted Services Redesign - London and

Launched in April this year, the advice line has taken more than 9,000 calls. It enables pregnant women to access advice and support 24 hours day, seven days a week from a midwife.

The line is available for women under the care of Royal Surrey County Hospital, Ashford and St Peter’s Hospitals and Epsom and St Helier Hospitals during pregnancy, labour and following the birth of their baby.

SECAmb Operations Manager and IBIS lead, Tom Pullen, said: “It’s really great to see SECAmb shortlisted in these prestigious awards, recognising the Trust’s continuing hard work to provide urgent care to patients using a joined up approach. Electronic sharing of patient information between care providers has historically been a challenge for all NHS ambulance services.”

issue iPads has improved both efficiency and information governance. Accessing IBIS at the patient’s side is supporting our clinicians to deliver tailored and safe care to patients, meeting their individual needs and wishes, at home or in the community.”

Tom’s colleague and fellow EOC Operations Manager, Mark Haydon, added: “We’re really pleased to be have been involved in the setting up of the Pregnancy Advice Line, which has already helped so many women and is a great example of collaborative working in the NHS. I’d like to thank everyone in our team and the Surrey Heartlands partnership who have worked so hard.”

Following a judging panel in early October, the winner will be announced at the awards ceremony on Wednesday 21 November 2018.

the South’ category, is based in SECAmb’s Emergency Operations Centre (EOC) in Crawley.

“The work to make the system available to staff on personal

AMBULANCE UK - OCTOBER

196 For more news visit: www.ambulanceukonline.com

Further information on the awards is available at https://awards.hsj.co.uk

NEWSLINE London’s Air Ambulance launch brand new digital campaign for National Air Ambulance Week

Stop, We Stop” will run across

“To deliver our life-saving work we

work of local air ambulance charities

social media platforms during

have to reach more supporters

across the UK giving them a national

National Air Ambulance Week to

and build bigger awareness of our

voice and an opportunity to promote

raise awareness of London’s Air

charity. We hope that this very

the work they do at a local level.

Ambulance’s charitable status.

targeted campaign will help us do

The creative emphasises the

this by growing followers across

urgency of the charity’s mission

Facebook and LinkedIn and

to save lives, whilst reminding its

securing a high engagement with

SECAMB

audience that if they stop donating

our campaign content. This is the

“You Stop We Stop” will highlight

the service will stop running. The

first time London’s Air Ambulance

that London’s Air Ambulance

video can be viewed at https://

has delivered a campaign of this

is a charity that relies on public

www.facebook.com/LDNairamb/

nature and we are excited to see

donations to operate;

videos/1771713006274920/.

how it is received.”

Trust praises staff and emergency service colleagues following Swanley coach crash

• First campaign of its kind for

The charity have chosen to focus

“You Stop We Stop” will focus on

South East Coast Ambulance

London’s Air Ambulance, who

on the concept of “time” for the

Facebook and LinkedIn as they

worked with digital agency

creative materials. It is hoped that

are two platforms that show huge

Zeal to produce the creative

the campaign will make its audience

potential for the charity in terms of

concept;

question if they could afford to wait

targeting those people most likely

if they needed the air ambulance

to support us.”

• The campaign will be highly

and it wasn’t there. London’s Air

targeted focusing on Facebook

Ambulance can be airborne in four

London’s Air Ambulance treats

and LinkedIn to grow social

minutes of a trauma call being

on average five critically injured

media following and increase

received and has an average flight

people in London each day, who

brand awareness of the charity.

time of 6.7 minutes; any longer

otherwise would not survive the

could be the difference between

journey to hospital. We carry out

London’s Air Ambulance today

life and death. It costs £10million

surgery on scene that is usually

launches a brand new digital

to deliver the service the majority of

only found in the accident and

campaign highlighting that without

which comes from fundraising.

emergency department.

Director of Marketing and

National Air Ambulance Week is an

Communications Louise

initiative led by the Association of

Robertshaw said;

Air Ambulances and celebrates the

public donations the lifesaving service would cease to operate.

The campaign, called “You

Service, (SECAmb), would like to thank it staff and emergency service colleagues for their professionalism and actions in responding to an incident on the M25 at Swanley on August 13th.

The incident, which saw a total of 49 patients, including 10 children, taken to hospital, was declared a major incident and saw SECAmb send a significant number of vehicles to the scene, including both of its Hazardous Area Response Teams, critical care paramedics and paramedic practitioners. The air ambulance service also landed at the incident but no one required transporting to hospital by air.

SECAmb incident commander and Operating Unit Manager Will Bellamy said: “This was obviously a significant incident which drew a lot of crews to the scene. Our thoughts are with everyone involved and we wish them a good recovery.

“I was very pleased with the way we responded to the incident and the way we put our well-rehearsed plans into place. I would like to thank both in our emergency operations centres and out on the road for their professionalism in providing patients with the treatment they required.

“I’d also like to highlight the good team work between all the emergency services to manage what was, of course, a

AMBULANCE UK - OCTOBER

every member of staff involved,

challenging incident.”

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

NEWSLINE five involving knives, two involving

Assaults can have a huge

to a decline in confidence, a

firearms and three involving racial

impact on our ambulance

skilled professional leaving

abuse.

crews, including injuries from the

the ambulance service, and a

incident, and stress, emotional

reduction in the quality of service

Mark Ward, Security Management

and psychological issues in

provided for our communities.

Specialist for EMAS, said: “We

the longer term which can

welcome this development and I

affect home life. On occasions

hope the increase in sentencing

when assaults have involved

will act as a greater deterrent to

spitting where spit has gone

Offenders who assault our

anyone who thinks of lashing out

into our staff’s eye or mouth, the

ambulance crews will face a

at our crews.

ambulance crew have to attend

EMAS

We welcome increase in prison sentence for those who assault our crews

doubled prison sentence thanks to a new bill approved by

“Assaults on our staff are

government.

absolutely unacceptable and we

NWAS

Everybody needs good neighbours

A&E for blood tests and may need

Returning from a walk with the

to take a course of antibiotics.

dog turned into a nightmare for Robert Marsden, 43 from

take a zero tolerance approach

Assaults can impact on the level of

Freckleton and his wife Rachel

The maximum prison sentence

towards anyone who verbally,

service that we can provide too. After

when Robert suddenly collapsed

for a common assault has now

physically or sexually assaults

an incident we take our staff off duty

and suffered a cardiac arrest just

increased from six months to one

them.

so that their injuries can be treated,

eight weeks ago.

they receive the support they need,

year, if the victim is a member of the emergency services. In

“Our frontline colleagues, the

and can make a statement to the

Luckily, Rachel lived just down

addition, sexual assaults will

team in our 999 control room and

police. This means the number of

the road from Geoff Hamriding,

also be added to the law as

our volunteers spend their days

ambulances available to respond to

Paramedic for North West

aggravating features of attacks.

helping the public. They deserve

emergencies in the East Midlands

Ambulance Service, and quickly

to be treated with respect and

reduces.

ran to call him for help.

Since April this year, our

we will continue to work with the

dedicated frontline staff have

police and the Crown Prosecution

Ultimately, an assault experienced

Geoff sprung into action and

reported 476 assaults, including

Service to prosecute those who

by one of our crews while trying

began CPR immediately whilst

five incidents involving spitting,

abuse our them.”

to help someone can lead

Rachel dialled 999 where she was

WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues.

Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc.

AMBULANCE UK - OCTOBER

All submissions should be forwarded to info@mediapublishingcompany.com

If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com

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

NEWSLINE directed by Emergency Medical

Paramedic, Geoff Hamriding,

Dispatcher, Frank Cerra, to a

said: “I was shocked when Rachel

nearby public access defibrillator.

banged on my door, it was really lucky because I had just got home

Thankfully after four shocks from

from being out but I didn’t hesitate

the defibrillator and ongoing CPR,

to rush to help.

Robert began breathing again and was rushed to Blackpool Victoria

“Early CPR and defibrillation is

Hospital where he was given

vital in these circumstances as

a stent procedure and allowed

every single second counts in

home just three days later.

saving a life!”

Speaking about the incident

Robert and Rachel live just a

Rachel said: “I didn’t know

stone’s throw away from the

Geoff that well but we said hello

nearest public access defibrillator

in passing and I knew that he

and by dialling 999 they were

worked for the ambulance service.

able to get the access code and information from the call handler.

“I shot over as quickly as I could and banged on his door so hard to get

Frank Cerra, Emergency Medical

him to come as soon as possible.

Dispatcher, said: “Rachel was so calm and collected on the phone, it’s

“It was an extremely frightening

an extremely traumatic experience

situation but Robert and I are so

for anybody to go through but by

thankful to Geoff and the team at

staying calm and listening to my

NWAS for saving Robert’s life. The

instructions we were able to quickly

work that they do is truly fantastic.”

get the defibrillator and give Robert the best possible chance.

Robert and his wife Rachel was able to reunite with Geoff and call

“As a call handler, it’s very rare for

handler, Frank, this week at Lytham

us to get the chance to meet our

Ambulance Station where they

patients and it’s amazing to be

thanked the team for their actions.

able to see Robert so fit and well.”

Mark Lewis, Operations Manager for Fylde, said: “It’s so important that members of the public know what to do in the event of a cardiac arrest, we will always get there as quickly as we can but even the minutes that we’re on the way can cost vital time.

“It’s an absolutely fantastic outcome for Robert, and we thank him for allowing us to share his story and show people that early CPR and defibrillation really does save lives.”

SECAMB

Trust celebrates diversity with largest ever turnout for Pride A huge turnout from South East Coast Ambulance Service (SECAmb) staff, volunteers and representatives from other ambulance services nationally, saw record numbers walk for the Trust in the Brighton and Hove Pride parade on Saturday 4 August.

A total of 187 people walked alongside a specially-decorated ambulance, kindly sponsored by the Trust’s Unison and GMB unions.

The Trust also experienced a busy weekend operationally with staff in its Emergency Operations Centres and ambulance crews on the road working hard to respond to patients.

The continued hot weather saw SECAmb handle some 6,400 calls over the weekend (August 4-5) across its region of Kent, Sussex and Surrey.

SECAmb would like to thank everyone who cheered on its representatives in the Pride parade as well as its operational staff and volunteers who worked throughout the busy weekend.

Chair of Pride in SECAmb Will Bellamy said: “We had an amazing turnout for the parade and the support of the community was very touching. It was great to be joined by colleagues from other ambulance services and NHS organisations as the NHS celebrated its 70th year. We’re very proud of the diversity of SECAmb and it is right that we celebrate it.”

Paramedic and Clinical Supervisor Ruth Copeman-Barnes said: “I have never worked for such an inclusive employer, and this is displayed through the diverse workforce and by the wonderful participation in the Brighton Pride parade. Marching as a NHS Paramedic holding my wife’s hand is the proudest feeling ever and in turn makes me so very proud to work for SECAmb.”

Operating Unit Manager for Brighton, Tim Fellows added: “We know that Pride weekend is always very busy and with the hot weather added in our staff and volunteers worked especially hard. I’d like to thank everyone for their dedication and professionalism.

AMBULANCE UK - OCTOBER

SECAmb Community First Responder Beverly-Jayne Last said: “With 187, we were the biggest entrant in the parade and received the warmest love and support from the crowds. I am honoured and proud to be a volunteer with SECAmb and to walk alongside such dedicated and hardworking colleagues.”

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

NEWSLINE HELP Appeal helps to fund new helipad upgrade at Raigmore Hospital, Inverness With over 500 flights each

Robert Bertram, Chief Executive

time and life saving facility on

The South Western Ambulance

of the HELP Appeal said: “The

which the entire population of

Service Charity (SWAC) was

upgrade of Raigmore Hospital’s

the Highlands and Islands may

awarded £2,235 from Tesco’s

helipad is now our seventh project

depend, not only due to the

Bags of Help scheme, which will

in Scotland, with hospital helipads

enormous area served by NHS

enable the Ilfracombe Community

in Glasgow, Edinburgh and four

Highland but also the distance

First Responders (CFRs) to

Highland and Island helipads

covered and the remote locations.

enhance the level of patient care

under the charity’s belt.

they deliver.

“I am very grateful for these

year it’s quite common to see

“The HELP Appeal is committed

helicopters arriving and taking

to ensuring that this helipad is fit

off from the helipad based at

for purpose, so patients can land

Raigmore Hospital in Inverness

safely and quickly, to access the

and this much used facility is

emergency care they urgently

about to undergo an upgrade.

need. This is why there was no hesitation in completing the

The upgrade will allow the helipad

funding required for this much

to meet the increasing demands

needed upgrade.”

of larger and more frequent aircraft use as well as new

Dr Andrew Rowlands, consultant

standards such as landing lights.

in emergency medicine and clinical lead for the Emergency

donations which will ensure the helipad we have on site is fit for the future.”

The work is expected to be completed by November 2018.

The funding will provide lifting devices for responders to use on patients who have had non-injury falls, but are unable to get up.

It will also be used to purchase other medical equipment, including blood pressure monitors

SWASFT

Coastal resort to benefit from SWASFT charity funding

and thermometers.

Ryan Ware, SWASFT Community Responder Officer for Devon, said: “We are delighted to receive

At a cost of just under £600,000

Department, explained that the

this upgrade is available thanks to

helicopter is an essential feature

A seaside resort is being

us to further support the local

two charitable donations.

for Raigmore and NHS Highland

promised even better

community in a robust and safe

and the investment into upgrading

emergency care after the

way. The new equipment we can

A financial grant of £480,000 has

the helipad will benefit the entire

South Western Ambulance

now purchase will be a great

been offered to NHS Highland

population.

Service NHS Foundation

investment for Ilfracombe.

this funding which will enable

Trust (SWASFT)’s charity

from the HELP Appeal – the only charity in the country dedicated to

He said: “The helipad at Raigmore

won significant funding for a

“Our volunteers give their time freely

funding hospital helipads.

Hospital serves as an essential

community responder team.

to help support SWASFT and our

AMBULANCE UK - OCTOBER

200 For more news visit: www.ambulanceukonline.com

NEWSLINE patients; and this funding will help

Our charitable support covers

Alexis Percival, Environmental

vehicles will run for a year and

them to provide more enhanced

Cornwall and the Isles of Scilly,

and Sustainability Manager at

details of air quality savings will be

care for those in need. Thank you to

Devon, Dorset, Gloucestershire,

YAS, said: “We are so excited

published early in 2019.

everyone who voted for us.”

Somerset and Wiltshire including

to have another world first for

Bristol and Swindon.

an ambulance service to have a

Amanda Lyne, Chief Executive of

hydrogen dual-fuel vehicle in our

ULEMCo, said: “The conversion

fleet.

of the Peugeot Boxer is our first

The Bags of Help scheme sees grants of up to £5,000 – raised

We are funded by donations

from the 5p bag levy – being

and legacies received primarily

awarded to local community

from patients, and their relatives,

“As a public sector organisation,

and shows how flexible our

projects every month. Customers

who wish to say thank you for

we have a responsibility to reduce

dual-fuel technology is to deliver

vote for a local project using a

the care that they, or their loved

our exhaust emissions to improve

practical solutions to emission

token given to them at a store

one, has received from us. In

the health of the people we serve,

reduction.

check-out.

addition, members of the public

and this vehicle takes us further

donate to our charity to show their

down the road to zero emissions.

“We are focused on offering

appreciation for the Trust.

We are looking to expand our zero-

technology to operators that can

emission fleet, as Clean Air Zones

be on the road now and this is

are launched across the region.”

a great example of an essential

The lifting equipment enables responders to move non-injury

example of this make of vehicle,

falls patients from the floor to

If you would like to show your

a sitting or standing position.

appreciation for the care that

The scheme is intended to

you or your loved one has

Chris Dexter, Managing Director

without impacting on service or

received from us in the form of

of the Patient Transport Service

requiring significant change to its

a charitable donation please

at YAS, added: “We are looking

operation.”

visit our online giving website:

forward to testing this technology

http://uk.virginmoneygiving.com/

in our fleet and seeing how we

Meanwhile, YAS is working with

charities/SWASC

can work towards becoming a

ULEMCo to build a prototype

zero-emission fleet for the future.

hydrogen-electric emergency

SWAC is a registered charity in

This heralds the start of a new era

ambulance which will have zero

England and Wales (1049230).

in patient transport.”

emissions.

The vehicle conversion has been

YAS has already introduced

part-funded by the Government’s

several other initiatives to reduce

Office for Low Emission Vehicles

its carbon footprint, which

(OLEV) and Innovate UK,

include installing solar panels

alongside six other partners,

on more than 100 ambulances

to demonstrate the potential of

to keep their batteries charged,

hydrogen dual-fuel vehicle fleets

aerodynamic light bars, greener

to reduce emissions. These

tyres and hydrogen-electric

vehicles include refuse trucks,

support vehicles. It has also won

delivery vans and fire service

several national awards for its

support vehicles. The trial of the

environmental initiatives.

improve care of patients in local communities, and it means more ambulances are freed-up for higher priority calls.

SWASFT was given the Best Care of Older People accolade at the Health Service Journal’s 2018 Patient Safety Awards last month for the initiative.

CFRs are trained volunteers who attend emergency incidents on behalf of SWASFT within their local communities. They respond to particular types of 999 calls where it is essential for the patient to receive immediate lifesaving care. These include conditions such as cardiac arrest, chest pain, breathing difficulties, unconscious patients, fitting and stroke.

YAS

Pioneering Patient Transport Vehicle Joins Yorkshire Ambulance Service Yorkshire Ambulance Service NHS Trust (YAS) is continuing to lead the way with eco-friendly vehicles.

vehicle than can be improved

It is the first ambulance service to introduce a dual-fuel non-

There are around 1,000 CFRs

emergency patient transport

providing lifesaving support to

vehicle, after taking on the

patients across the region.

challenge of driving down emissions in its 1,200-strong fleet

SWASFT covers one of the

over the next few years.

most rural areas of the UK, and is committed to providing the

The Peugeot Boxer has been

population of the South West with

converted to run on hydrogen and

the highest standard of out-of-

diesel, using unique technology

hospital care.

from specialist conversion company ULEMCo. The pioneering project

SWAC, founded in 1995, uses

enables around 35 to 45% of the

gifted monies to benefit those in our

vehicle’s energy to come from

communities who use our service

hydrogen rather than diesel and its

and to improve the welfare of the

carbon dioxide emissions can be

staff and volunteers of the SWASFT.

reduced by the same amount.

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

NEWSLINE South West and I’m humbled

are conveyed to the hospital

Royal Voluntary Service, who

Macmillan’s Chief Exec visits ambulance team

by the professionalism and

emergency department when

then paired local volunteers with

dedication of the staff, so thank

it would be more appropriate

clients. These volunteers visited

you so much.”

for them to remain at home. In

clients in their homes and worked

the first collaboration of its kind,

with them for a period of 6-8

Chief Executive of South Western

the South Western Ambulance

weeks to improve their physical

The Chief Executive of Macmillan

Ambulance Service NHS Foundation

Service and Macmillan have come

function and wellbeing.

Trust (SWASFT), Ken Wenman,

together to combat this gap in

said; “We’re very pleased to have

education and provision.

SWASFT

Cancer Support visited a groundbreaking team of ambulance clinicians who have been working on a new joint project which is benefitting patients across the South West who have cancer, palliative care needs or who are close to the end of their life.

Lynda Thomas met the Macmillan

Following 6-8 weeks of volunteer intervention, the active ageing

welcomed Lynda to Bristol to meet the team and show her how this

Lynda will be hearing first hand

pilot had a number of positive

ground-breaking project between

some of the feedback directly

outcomes. These included a

Macmillan and SWASFT is

from the team and listening to

42% reduction in falls amongst

benefitting patients. Most patients

the patients’ case studies who

clients*, a 45% decrease in calls

prefer to be treated at home and this

have been treated by paramedics

from clients to 999 as a result of a

project reduces hospital admissions

in their own homes, along with

fall and a 29% reduction in clients

to emergency departments”

a show case of the project’s

being admitted to A&E.

outcomes and benefits.

Innovation Excellence finalist project team from South Western

“We estimate that in a typical

Ambulance Service NHS Foundation

shift, each ambulance crew will

Trust (SWASFT) at Bristol Central

attend a patient who has cancer,

Ambulance Station on 2 August.

palliative care needs or who is close to the end of their life. This

Lynda heard all about how the

project enables us to deliver more

ambulance service can now

appropriate care and in many

provide improved urgent and

cases, this means treating them

emergency care for patients

at home. This approach enables

and their loved ones, by either

us to deliver care more in line with

supporting management at home

patients’ wishes. We do of course

or facilitating referrals to a more

still take patients to hospital where

appropriate health setting.

that is in their best interests.”

“So today has been amazing

Ambulance services regularly

meeting paramedics and seeing

encounter patients with cancer,

how the team are supporting

yet they often have very little

people with end of life cancer

training about the illness so may

issues, and what difference South

lack the skills and knowledge

Western Ambulance Service is

to provide the best quality care.

making to people’s lives in the

Sometimes, people with cancer

Clients also showed improved LAS

London ambulance service active ageing pilot reduces 999 calls and visits to A&E

physical function and health and wellbeing. 60% improved on a 30-second Sit to Stand test and almost 70% improved on walking or gait speed in the Timed Up and Go (TUG) test. Furthermore, over one in four felt their health had improved, more than one third felt happier and more confident and

Royal Voluntary Service

one in four said they felt less lonely.

‘mobility volunteers’ provided support to older people at risk

The programme was based on

of falls and social isolation in

Royal Voluntary Service’s ‘mobility

two London boroughs

volunteers’ doing one-to-one chair-based exercises with clients,

AMBULANCE UK - OCTOBER

A seven month pilot run by

as well as providing advice on

London Ambulance Service NHS

hydration and nutrition. At the

Trust in partnership with national

end of the 6-8 weeks of visits,

volunteering organisation, Royal

volunteers then supported clients

Voluntary Service has helped cut

to transition to a community

emergency calls and visits to A&E

exercise programme or other local

amongst frequent fallers in two

activities to help them build and

London boroughs.

maintain their social connections.

The active ageing pilot ran from

During the pilot period, over

November 2017 to May 2018

70 referrals were received from

and was set up to decrease the

London Ambulance Service

number of falls in two London

or falls teams working with the

boroughs, with a goal of reducing

ambulance service. A total of

demand on both the ambulance

31 very frail clients, the majority

service and hospitals as well as

of which were 85+ completed

improving outcomes in later life.

the full 6 to 8 week intervention.

The pilot focused on recruiting

The pilot ran in Merton and

volunteers from underrepresented

Hackney, where need is

groups (e.g. BME backgrounds)

particularly high, and tested a new

and a total of 34 volunteers were

model of ‘mobility volunteers’.

recruited from a diverse range of

Older people who fall frequently

backgrounds during the course of

and call 999 were referred to

the programme.

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

NEWSLINE Dr Allison Smith, Head of Strategy and Development at Royal Voluntary Service said: “Frailty need not be an inevitable part of getting older. We know that targeted resistance-based exercises can significantly help older adults improve their physical function and reduce their risk of falls.

Our volunteers received specialist training to provide 45-60 minute exercise sessions each week to help clients regain their independence.

This included leg strengthening exercises to help them get out of a chair or off the toilet and arm exercises to help them get dressed and out of bed. We are very pleased with these results. Given the age and high levels of frailty of these clients and a relatively short period of intervention, such findings are very encouraging and suggest greater gains might be made with a longer support period.”

a social life outside of her home.

I worked with Anna for six weeks to complete a set routine of gentle exercises. We struck up a friendship and it was a pleasure to be able to spend time helping someone in need become more active. By volunteering I feel I am helping the local emergency services and helping older people to be more mobile and sociable. All of this gives me a sense of pride that I am helping my community.”

starting the Foundation course in Paramedic Science in 2016.

The Kings Fund estimates falls account for around 40 per cent of all ambulance call outs to the homes of people over 65 and are a leading cause of older people’s use of hospital beds. London Ambulance Service estimates that each ‘call-out and convey to hospital’ costs the service approximately £300.

Briony Sloper, Deputy Director of Nursing & Quality, London Ambulance Service NHS Trust said: “We partnered with Royal Voluntary Service to test an innovative way to support what is a particularly vulnerable group.

Recruiting local volunteers to support frail, often socially isolated people within their community has been extremely rewarding for everyone involved. It has highlighted the importance of working with volunteers and the role London Ambulance Service has, with its unique position of working across London, in identifying areas of need which are often hidden to the wider health and social care system. By working in a partnership like this that works across traditional, organisational boundaries, we are able to better connect communities and improve people’s quality of life.”

The funding for the extra 24 places has been agreed by Health Education England (East Midlands), the organization responsible for education provision and training for the NHS in this region, building on an existing funding agreement.

The Ambulance placements are facilitated by the East Midlands Ambulance Service (EMAS).

Royal Voluntary Service is one of Britain’s largest volunteering charities with over 20,000 volunteers supporting thousands of people each month in hospitals and in the community. The simple acts of kindness our volunteers provide, whether popping in for tea and a chat, helping out with a lift to a GP or social appointment or running chair-based exercises on ward to prevent pyjama paralysis, help make communities stronger and relieve the pressure on overstretched public services. The charity is also one of the largest retailers in the NHS, with its network of cafes and shops providing a valued haven in hospitals.

Also on offer are fuel expenses to cover some travel costs as well as a 4 week funded emergency driving course.

Jack Dudley, who gained his Health and Care Professions Council registration in October 2017 and graduated in February this year, said: “The Foundation course has been a great

Students will also have access to the University’s training facilities including a new, model ambulance located at the £330m Waterside campus, right in the heart of Northampton town and due to open to students next month.

The full-time course, which starts on 12 November, covers placements in a variety of ambulance, health and social care settings such as hospital wards and accident and emergency departments.

Jack added: “The last year of university was a whirl of revision, exams and work placements, but it’s worth it every step of the way. I love being part of the team at East Midlands Ambulance Service – I can’t recommend people taking the University course enough.”

EMAS

Paramedic Science students to benefit from extra funded course places University of Northampton has received funding to train extra Paramedics, news welcomed by a graduate who is working in the profession just two years after starting his course.

Jack Dudley, from Leamington Spa, qualified as a Paramedic in February this year after

AMBULANCE UK - OCTOBER

Becky Seaton is 41 and lives in Lower Morden. She donated one hour a week to support the pilot in Merton. “The first person I met was Anna, who was 96 and housebound. She was not what I was expecting! She is bubbly, chatty, full of knowledge and interesting stories from her past and really keen to be on the programme. She finds it difficult to get out and about because of physical ailments but was craving

Foundation course fees are fully funded for the two-year duration and there is the option of applying for a non-repayable bursary for further support.

experience. It’s a more direct route into the role, so the funding for the extra places from Health Education is fantastic news.”

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

NEWSLINE WAST

10m boost to support upgrading of Welsh Ambulance Services vehicle fleet A £10m Government funding boost for replacement ambulances is set to place WAST as the UK’s leading Ambulance Trust for its modern, environmentally friendly and efficient vehicle fleet.

Health Secretary Vaughan Gething announced the £10.23m to replace 100 ambulances and other passenger transport vehicles, when he visited WAST’s Bridgend Ambulance Station to take a look at the first of the new vehicles currently being trialled by WAST across Wales.

The new ambulances will be more manoeuvrable and meet the latest Euro 6 emissions standards.

The new fleet, replacing vehicles that have reached the end of their operational viability, will be deployed across Wales and includes 25 new ambulances, 33 rapid response vehicles, 33 nonemergency passenger transport vehicles and nine specialist emergency vehicles for major incidents.

WAST currently has over 700 vehicles in our fleet, covering an area of more than 8,000 square miles across Wales. Since 2011, the Welsh Government has invested almost £55m in new ambulance vehicles for the Welsh AMBULANCE UK - OCTOBER

Ambulance Service.

Director of Operations, Richard Lee, said:

majority of their working day out

Independent research has

and about in the community.

shown that across the 27 sites offering specialist expertise to

SADS UK 2019 Retreat

“The funding we have received

patients with serious injuries,

from Welsh Government,

1656 additional patients have

particularly in recent years, has

survived. London is home to four

The SADS UK 2019 Retreat

enabled us to ensure that our

major trauma centres, which our

get-together is being held on

ambulances in Wales are some

charity regularly transfers patients

the 1st February to Monday

of the most modern and well

to after providing critical on-

4th February, (3 nights) at

equipped in the UK, and we

scene care; St George’s Hospital,

the Quorn Grange Hotel,

are extremely grateful for the

King’s College Hospital, St Mary’s

Loughborough.

continued support.

Hospital and our base, The Royal London Hospital.

“This new funding will allow us to

It is £80 for a double room per couple, per night, single rooms

continue with the replacement of

Dr Gareth Grier, Lead Clinician at

£50 per night. This price is

our ageing vehicles and, crucially,

London’s Air Ambulance, said:

includes breakfast and evening

the vital clinical equipment they

meal.

carry, as they each reach the end

“London’s Air Ambulance is really

of their operational viability”.

proud to be part of the major

The agenda will include walks,

trauma system in the UK and

candle lighting and balloon

of the major changes that have

releases. Please contact SADS

taken place over the past few

UK in the first instance to register

years. There are many people

your interest in coming along to

involved in a large chain of care

the Retreat.

During his visit to Bridgend, Mr Gething had an opportunity to see for himself the innovative technology leading the way in making Welsh ambulances fit for the future, helping WAST to be recognised as among the most modern and forward-thinking in the UK.

from injury all the way through to rehabilitation.

Please note the Retreat is subsidised by the charity and

“For London’s Air Ambulance

there are limited places.

the focus for 29 years has been

Announcing the £10.23m funding boost, Mr Gething said: “I am pleased to be able to announce this funding to replace some of our ageing ambulances and other passenger transport vehicles with more modern, fuel efficient and greener versions.

“This investment will enable the Welsh Ambulance Service to upgrade its fleet to ensure it has the most appropriate vehicles to deliver the best care for the people of Wales.”

Lead Clinician responds to excellent news regarding major trauma centres

on how we can bring innovative procedures and techniques to patients as close to the time of injury as possible. Early interventions such as delivering

Air Ambulance Awards shortlist announced

an anaesthetic at the roadside

The shortlisted nominees for the

were rare in the UK only a decade

2018 Air Ambulance Awards of

ago and were only provided in a

Excellence, sponsored by BMW,

small number of areas such as

have been announced today.

London.

The winners will be revealed at the awards ceremony to be

“Now, there is widespread

held on 12 November at the

delivery of life saving advanced

Millennium Chelsea Harbour

treatments for much bigger

Hotel, London.

groups of patients across the country. We’ll continue to bring

The independent judging

innovative treatments such as

panel met and considered

open heart surgery and REBOA

all entries made across the

(Resuscitative Endovascular

eleven categories. After lengthy

Balloon Occlusion of the Aorta)

deliberation and discussion, the

to patients very quickly following

panel was pleased to shortlist the

their injury, and we have a

following (shown in no particular

strategy to introduce even more

order):

“Modern ambulances and

Our charity has welcomed

novel therapies for patients over

equipment are essential in

the news that the introduction

the coming months and years.

providing the best treatment

of major trauma centres has

and patient experience possible.

increased the number of

“The results are very welcome and

Sponsor: Babcock MCS Onshore

They are also important to our

patients surviving serious injury

we look forward to making an even

• Winner to be announced on

ambulance staff who spend the

by almost a fifth since 2012.

more dramatic impact in the future.”

Outstanding Young Person Award:

204 For more news visit: www.ambulanceukonline.com

12 November

NEWSLINE Charity Staff Member of the

Air Ambulance Pilot of the Year:

Year:

Sponsor: Safran UK

Sponsor: Bayards Heliport

• Dave Kelly, Essex & Herts Air

Solutions

Ambulance - Float

Ambulance

• Gemma Kidd, Cornwall Air Ambulance Ambulance

Lifetime Achievement Award: Sponsor: Specialist Aviation

Air Ambulance Campaign of the

Services

Year:

• Winner to be announced on

Air Ambulance Paramedic of

Sponsor: Lottery Fundraising

the Year:

Services

Sponsor: BMW Government and

• Essex & Herts Air Ambulance Keep in Touch

• Glenn O’Rorke, Air Ambulance Northern Ireland

• Wiltshire Air Ambulance -

Somerset Air Ambulance

Sponsor: Leonardo Helicopters • Dave Ashton Cleary, Cornwall Air Ambulance

Charity Volunteer of the Year:

MAGPAS Air Ambulance & East

Sponsor: Tower Lotteries

of England Ambulance Service

• Colin Smith, Wiltshire Air • Ally Bally, Scotland’s Charity Air Ambulance

Ambulance

• ECMO - North West Air Ambulance

Jim Fitzpatrick MP, Chair of the Judging Panel, commented: “My fellow judges and I were privileged to read about the very best of the outstanding organisations, teams and individuals that make up our air ambulance services. These Awards give a real insight into the extraordinary work these people do every single day of the year. I believe it is important that we acknowledge this work during these annual Awards, which represent a rare opportunity for us all to recognise their commitment and expertise and simply to say thank you.”

• Gill Andrew, Lincs & Notts Air Air Operations Support Staff

Further details about the

Member of the Year:

awards, including how to book

Special Incident Award:

Sponsor: Allianz UK

a place at the Gala Dinner, can

Sponsor: Airbus Helicopters

• Jeff Glover, Devon Air

be found at: http://www.aoaa.

Ambulance

• Ami Jones, Wales Air

• Student Resilience - Essex & Herts Air Ambulance

• Paddy Morgan, Great Western Air Ambulance

• The McQueen Charter - East & Herts Air Ambulance,

Ambulance Air Ambulance Doctor of the Year:

Innovation of the Year:

Anglian Air Ambulance, Essex

• Jeremy Griffiths, Cornwall Air • Mark Williams, Dorset &

12 November.

Sponsor: Sloane Helicopters

Airbase Appeal

Ambulance

• Midlands Air Ambulance -

• Gavin Rowley, Scotland’s

• Natalie Church, MAGPAS Air

Authorities Division

Ambulance

Traumatic Cardiac Arrest

Charity Air Ambulance

Ambulance

• Paul Smith, London’s Air

• East Anglian Air Ambulance Child Cardiac Arrest

• John Taylor, North West Air Ambulance

• Jen Easton, East Anglian Air

• Dorset & Somerset Air

• Cornwall Air Ambulance - Tin Mine

Ambulance

co.uk/aaae/

AMBULANCE UK - OCTOBER

Last Year’s Winners

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

NEWSLINE NEAS

School children swap the classroom for a lesson is lifesaving Future generations now better equipped to save lives Children as young as eight saw life through the eyes of an ambulance dispatcher when they were faced with life and death scenarios and asked to choose who should get an ambulance first.

The children were faced with a woman in labour, someone having a heart attack and someone with a cracked fingernail, and had to decide whether the ambulance response should be ‘fast, slow or not at all’.

The exercise was part of a long running partnership between North East Ambulance Service (NEAS) and the West View Project, a voluntary funded youth organisation based in Hartlepool.

Having previously spent two days visiting the ambulance service in March and April, groups of school children who are part of the project’s Junior Inspectors programme had already learned how to stop a person choking, what happens when you ring 999 and why NHS111 might be a good place to start if you don’t know which health service you need.

They had also received a tour of the Trust’s Emergency Operations Centre, where the region’s 999 and 111 calls are taken, and got to see the inner workings of an ambulance.

AMBULANCE UK - OCTOBER

The Hartlepool Schools Conference, held at Hartlepool Sports Dome on 27 June, gave even more young people the chance to learn about their local ambulance service and how to save a life, with around 200 school children taking part in group exercises with NEAS. The different scenarios included: someone with dust in their eye, someone who had drank bleach, a woman in labour, someone drowning, someone with a cracked

fingernail, someone with chest pain, someone who was choking, and someone who was bleeding heavily.

As well as deciding what priority – if any – each patient received, the children also had the chance to have a go at CPR and were taught about the consequences of hoax calls.

The teachers were also informed about the benefits of installing defibrillators within their schools and the importance of teaching CPR to their children.

One of the members of staff leading the sessions was NEAS clinical care manager Richard Ilderton.

He said: “These scenarios are just some of the incidents our staff are faced with on a daily basis, prioritising where we send our resources first to help those most in need.

“The kids were really engaged and came up with some really good ideas. When we gave them the options, you could really see them thinking the scenarios through. They also realised that some illnesses could warrant different responses depending on their severity. I think it reinforced what some of them already knew but for others it really gave them food for thought.

“It’s really important for children to know what an appropriate 999 call is and understand what the chain of survival for CPR because you’re more likely to save a life if you get someone who’s willing to start CPR. “Hartlepool residents can be rest assured that their future generations are better equipped to deal with medical emergencies. Hopefully we now have a group of young people who will tell their peers that it’s not scary to start CPR and they can help us save more lives.”

Rebecca Ferguson, senior participation worker for the West View Project, said: “The aim of the conference is to bring together primary schools in Hartlepool with representation from their student councils to explore areas of particular interest to them.

“The forums meet on a termly basis and planned this year’s conference since the beginning of the school year. The themes chosen this year were safety and the environment as those representing student councils felt these were particularly important and current, topical issues.”

LAS

Taxi drivers get life-saving training for ambulance pilot scheme London Ambulance Service is training taxi drivers to help save the lives of cardiac arrest patients in the capital.

Paramedics have taught cabbies to perform cardio-pulmonary resuscitation (CPR) and fitted their black cabs with defibrillators as part of a six-month pilot scheme in partnership with the Licensed Taxi Drivers’ Association (LTDA).

Chief Executive Garrett Emmerson said: “London Ambulance Service has set up this scheme with the Licensed Taxi Drivers’ Association as part of our ongoing work to increase CPR training and the number of defibrillators in the community to help save even more lives.

“More than half the patients who are defibrillated by members of the public before the arrival of ambulance crews survive to be discharged from hospital. While we get to patients reported to be in cardiac arrest in an average of less than six minutes, it’s those vital first few minutes that can make the difference between life and death.”

The LTDA approached London Ambulance Service to explore how its cabbies – who were keen to help – could be trained to save lives before the arrival of medics.

As a result a pilot scheme was set up where cabbies volunteered to receive training in lifesaving skills from London Ambulance Service.

Participating London taxi drivers have also installed the GoodSAM

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

app on their mobile phones. When a 999 call is made for a cardiac arrest patient, an ambulance is dispatched immediately. At the same time, these taxi drivers – and other registered first aiders – are alerted by the GoodSAM app if they are close to the patient.

Although London already has one of the best cardiac arrest survival rates in the world, when a person goes into cardiac arrest, every minute they wait for life saving medical attention decreases their chances of survival by about 10 per cent. The quick response of members of the public such as taxi drivers will help improve survival rates.

Cabbie Shaun O’Meara, a former paramedic, said: “The training we have received has been excellent.

All the drivers are confident and excited to be part of this innovative scheme. Most of us will have come across someone who is very ill – we just want to be able to help.”

Half of the 30 drivers taking part in the pilot scheme are carrying defibrillators, while the other half are relying on the GoodSAM app telling them where the nearest public access defibrillator is located.

Steve McNamara, General Secretary of the LTDA, said: “We are proud to have teamed up with London Ambulance Service to train black cab drivers to respond to GoodSAM alerts.

Deputy Mayor for Transport, Heidi Alexander, said: “London’s black cabs already provide a unique service for residents and visitors all across our city.

This innovative new partnership with London Ambulance Service could make a difference by literally saving lives. For victims of cardiac arrest, every second can make a difference, and I’m delighted that London cabbies are using the latest technology to play their part supporting the vital work of London Ambulance Service.”

IN PERSON SECAMB News

Trust announces appointment of new Chair South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is pleased to announce the appointment of a new Chair.

Following a rigorous selection process involving stakeholders and staff from across the Trust, the Council of Governors formally appointed David Astley as substantive Chair at its meeting at the end of July, subject to references and pre-employment checks.

David will take over from Graham Colbert, who has filled the role on an interim basis since April following the decision of previous Chair Richard Foster to step down.

David, from Kings Hill in Kent, has over 40 years’ management and leadership experience in the NHS and abroad. He will take up his post in late September.

David, who was awarded an O.B.E in 2006 for services to the NHS, has held a number of very senior roles in the NHS including Chief Executive of East Kent University Hospitals NHS Trust between 1999 and 2006 and Chief Executive of St George’s Healthcare NHS Trust between 2006 and 2011.

From 2011 to 2015 David was Chief-Tertiary Hospitals Group of the Hamad Medical Corporation in Qatar. On return to the UK and retirement from full time Executive duties, David was appointed as a Non Executive Director of Liverpool Women’s Hospital NHS Foundation Trust. He will stand down from this

role when he commences as Chair and will continue as a Trustee of Yoakleycare, a charity based in Margate,Kent which manages alms houses and a care home.

David said “I am delighted to be appointed as Chair of SECAmb and look forward to chairing the Board as we continue to consolidate recent improvements and strive to manage increasing demand for our services. I am looking forward to supporting the Executive Team and our committed, skilled staff to do their best for the people we serve. “ SECAmb Chief Executive Daren Mochrie said: “I am pleased we have been able to appoint such a highly-experienced person as David as our Chair. I would also like to thank Graham for his hard work as Interim Chair over the last few months.

“I am looking forward to working closely with David as we continue to improve the service we provide and I know everyone at SECAmb will join me in welcoming him to the Trust.”

EMAS News

Welcome to our new NonExecutive Director A new non-executive director with a background in finance and who is a privacy professional has joined our Trust Board.

Gary Brown, who has worked at Santander for 13 years in a variety of roles including managing operations, transformation and the introduction of General Data Protection Regulations, joined the board on 1 August.

Gary is a qualified chartered accountant with a Master’s in Business from University of Warwick, and has previously been a Finance Director at a variety of leisure and retail companies.

He is also a non-executive director for a Midlands Academies Trust and has previously been Chairman of Wolfhampcote Parish Council, but this is his first role in healthcare.

Gary said: “I like to keep busy, and two areas that I wanted to get more involved in were education and healthcare.

“The opportunity to be a non-executive director at EMAS came up and I jumped at the chance as not only is it working in the NHS, but the ambulance service involves lots of logistics too which I have experience with.

“I’m excited about joining EMAS and being a small part of making things better both in the service and for the patients.”

In his spare time Gary enjoys running and has completed marathons in London, Paris, Stockholm and Amsterdam to raise money for charity.

Gary lives in Leicestershire with his wife and two children, aged 15 and 19.

Mojgan Sani is also joining us as an associate non-executive director which is part of a 12-month development program run by NHS Improvement.

Pauline Tagg, Chairman of the EMAS Trust Board, said: “ I am delighted to welcome Mojgan and Gary to our Trust Board and to EMAS.”

AMBULANCE UK - OCTOBER

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

IN PERSON EMAS News

Volunteer marks 30 years of helping patients A 75-year-old who has helped thousands of patients get to hospital is celebrating 30 years volunteering for East Midlands Ambulance Service.

Ron Haslam, a former taxi driver from Little Eaton known as ‘Rocket Ron’, has given much of his spare time to our Volunteer Car Service since it began in September 1988.

Over the last three decades Ron has driven patients hundreds of thousands of miles across the country to get to a wide range of hospital appointments including mental health support, day care centres for dementia, physiotherapy, kidney dialysis, chemotherapy and radiotherapy.

Ron is known throughout the service as ‘Rocket Ron’ - after the famous motorbike rider.

Despite recently becoming a great-grandfather, Ron has no plans to give up volunteering and would recommend the role to anyone looking to volunteer.

He said: “I just love it – they’ll have to stop me if they want me to give up.

“I get greater job satisfaction from being a volunteer car driver than I did in any other job that I’ve done. When I look back, I wish I had joined the service sooner.

“Obviously you have to be a caring person, but you also need to be a good listener, and able to get people talking. It helps them to relax, especially if they are worrying about their appointment.”

Ron first started supporting the NHS in the 1980s as part of a taxi service for nurses performing home visits, and he was keen join the Voluntary Car Service when it was launched.

He said: “It was the ‘feel good factor’ that first attracted me, and I already knew most of the crews on patient transport so it was lovely to be volunteering alongside them.

“Many of the patients we pick up are very poorly and can feel quite vulnerable, and they are relying on you to look after them.

“When you drop them off at home or at the hospital clinic and they smile and say ‘thank you’, that makes everything worth it.”

As well as transporting patients who live in his local community, Ron volunteers to take patients on longer journeys for specialist appointments in London and Cambridge.

“Ron’s care and kindness has undoubtedly made difficult journeys to and from hospital appointments just that little bit better.

“We’re very lucky to have him and I would like to say a huge thank you to him for volunteering for us for 30 years.”

News

Air Ambulance Appoints New Air Operations Manager Ian Roberts has been successfully appointed as Midlands Air Ambulance Charity’s new air operations manager.

“In the early days I made a fire or two for patients when I had taken them home and their house was cold.

With more than 35 years’ experience in the ambulance service, Ian has a wealth of knowledge to bring to the challenging role.

In 1983, he joined Hereford and Worcester Ambulance Service and began working for Midlands Air Ambulance Charity in 2003 as an aircrew paramedic based at Strensham airbase.

“We’ve always been kept busy as volunteers which is lovely, and I often get to pick up the same patients on a regular basis so I get to know them.

Ian also won the coveted Clinician of the Year award at Midlands Air Ambulance Charity’s Recognition Awards and Charity Ball in June 2018.

“I’ve been doing the role so long now that a lady got in my car the other day and said ‘you used to take my mum to hospital’!”

Hanna Sebright, chief executive officer for Midlands Air Ambulance Charity, said: “Ian has worked with the charity for over 15 years and in that time has demonstrated a breadth of clinical and operational expertise. Ian’s background and leadership skills will help our organisation to remain at the forefront of emergency pre-hospital patient care, offering the very best treatment to patients in critical need of an air ambulance.”

Ron explained that not much has changed over the last 30 years as patients still need help and support to get to hospital.

Many of the patients going for regular treatment are going through difficult time in their lives due to issues with their health. Ron explained he quickly becomes a friend to many of his patients, and is always pleased when they make a full recovery.

He added: “It is such a privilege to get to know the patients and to be a small part of the process that has led to their recovery.

“I took one man in to hospital on several occasions when he was having cancer treatment, and sadly he was told he only had 12 months to live. But he had an operation, recovered well and he is still alive today – and I was able to be a small part of that.”

AMBULANCE UK - OCTOBER

When Ron isn’t transporting our patients, he spends time with his wife and his four grandchildren.

Joy Weldin, General Manager for Patient Transport Services, said that is an pleasure to have Ron volunteering for our service.

She said: “Ron is an incredibly dedicated member of our Patient Transport Service and he is adored by all our patients and ambulance crews.

208 For more news visit: www.ambulanceukonline.com

Ian Roberts, air operations manager for Midlands Air Ambulance Charity, added: “I was incredibly proud to make it through the interview process and achieve the role of permanent air operations manager for Midlands Air Ambulance Charity.

“I’m looking forward to advancing the clinical and operational work of the charity, in line with our strategic objective to work at the height of clinical and operational excellence.”

IN PERSON forward to working closely with Michael and

SECAMB News

know his experience will prove invaluable. I’d

Trust appoints new independent Non-Executive Director

like to thank our Council of Governors for their hard work in finding and appointing the right person for this role.

South East Coast Ambulance Service NHS Foundation Trust (SECAmb) is pleased

“I’d also like to thank Graham and Tim for their

to announce the appointment of a new

commitment to the Trust. Their hard work and

independent Non-Executive Director.

professionalism over the years is very much appreciated and I’d like to wish them both all the very best for the future.”

Michael Whitehouse, who lives in Surrey, was appointed by the Trust’s Council of Governors and will join SECAmb for a three-year term in

the public sector. Until 2017 he was Chief

Newly appointed SECAmb Chair David Astley

office starting next month on 24 October.

Operating Officer of the National Audit Office.

said: “I would like to add my thanks to Tim and

As a qualified accountant, Michael replaces

Michael has also been responsible for a number

handover of the Chair position. Michael brings

Graham Colbert’s skill set as he steps down

of evidence-based reports to Parliament related

a wealth of experience to the Board from his

from his role as a non-executive director and

to the health sector, including on the financial

past work with the National Audit Office. He is

most recently the Trust’s Interim Chair.

performance and sustainability of the NHS,

most welcome.”

Graham for their past work and the smooth

hospital-acquired infection, dementia, end-ofAlso stepping down this month is fellow non-

life care and autism.

Michael said: “I am really pleased to be joining the Board. This is a great opportunity to

executive director, Tim Howe, who has served the Trust since 2010. Tim’s replacement on the

Since retirement, Michael has focused on his

support SECAmb in the incredibly important

board is Laurie McMahon who was appointed

role as a trustee and honorary treasurer of

services which its people provide to local

earlier this year.

Cruse, the bereavement charity.

communities across the region. I look forward

Michael brings with him a wealth of experience

Welcoming the appointment, SECAmb chief

coming months and meeting as many people

of audit and financial oversight across

executive Daren Mochrie said: “I’m looking

as possible.”

to working with my new colleagues over the

WHY NOT WRITE FOR US? Ambulance UK welcomes the submission of clinical papers and case reports or news that you feel will be of interest to your colleagues.

Material submitted will be seen by those working within the public and private sector of the Ambulance Service, Air Ambulance Operators, BASICS Doctors etc.

If you have any queries please contact the publisher Terry Gardner via: info@mediapublishingcompany.com

AMBULANCE UK - OCTOBER

All submissions should be forwarded to info@mediapublishingcompany.com

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

AUK_August_AUK_August_2013 11/10/2013 10:53 Page 254

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

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

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

Life Connections 2014 Exmed Study Day

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

AMBULANCE UK - OCTOBER

210

TIME: A.M

PRESENTATION

TIME: P.M

08.30 - 09.00

Registration

12.00 - 12.30

09.00 - 09.15

Introduction & History of the Course

09.15 - 09.45

The Airway Algorithms

12.30 - 13.30

09-45 - 10.30

Prediction of the Difficult Airway

13.30 - 14.00

10.30 - 11.15

BVM and Laryngoscopy

11.15 - 11.30

Tea/Coffee, Exhibition

11.30 - 12.00

Skills Stations (4 rotations/30 min. each)

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

14.00 - 14.30

Skill Stations Rotation 4

Group 1

BVM, ETI

14.30 - 14.45

Group 2

EGD’s & Rescue Airways

14.45 - 15.00

Group 3

Needle & Surgical Airway

15.00 - 17.00

Group 4

Video Laryngoscopy

17.00

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

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

CPD certificate provider

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

Only 7 places remain available!!

To register call 01322 660434 or visit:

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

PARAMEDICS - SOUTH WEST £23,023 to £36,644 pa (plus unsocial hours payment)* Join us and you’ll find an Ambulance Service that understands the better we look after you, the better equipped you’ll be to look after our patients.

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

• • • •

The most clinically advanced Trust within the UK Permanent and bank opportunities available One of the most beautiful parts of the country Lowest conveyance rate in the UK

Let us look after you better.

For your next career move visit www.betterparamedic.co.uk

• A better work-life balance • Dedicated staff support service • Structured career pathways

/swasFT * Depending on qualification/ registration status

Better you, Better everybody.

WORKING WONDERS Join Us.