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In this issue Non-Technical Skills Evaluation in the Critical Care Air Ambulance Do Critical Care Teams Prolong On-Scene Times?
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CONTENTS
CONTENTS 212
EDITOR’S COMMENT
215
FEATURES
215 Non-technical skills evaluation in the critical care Air Ambulance environment
Ambulance UK This issue edited by: Sam English c/o Media Publishing Company 48 High Street SWANLEY BR8 8BQ ADVERTISING: Terry Gardner, Brenda Pickering
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EDITOR’S COMMENT
EDITOR’S COMMENT Welcome to this issue of AUK Hopefully you’re reading this as you enjoy lunch at Life Connections, which this year has some excellent and informative sessions for clinicians with a host of speakers at the forefront of the profession.
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“On the surface integrated care sounds both seamless and in everyone’s interest. In reality it means a change in mindset”
The last couple of months have been quite interesting for the NHS. That’s not just about the junior doctors and their intentions, but more about undercurrents. STPs (that’s integrated care footprints to you and me) are all over the news and there’s a spin on ‘re-nationalising’ the NHS. That got me thinking about the true nature of integrated care and what it means. I’m not a politician but I do spend a lot of time in my day job thinking about ways to make it better for patients. On the surface integrated care sounds both seamless and in everyone’s interest. In reality it means a change in mindset, since while everyone thinks it’s a great idea, no-one really wants to invest part of their hard won budget in someone else’s scheme. Or at least that’s how it sounds to me. I was given an example recently in relation to the Prevention/Promotion agenda. There’s no arguing that this is a fundamental part of reducing demand on acute services and in the best interest of the population at large. However, the example graphs showed local councils and local NHS services investing heavily into a social care scheme which though shown to be cost effective, did not directly result in financial gain for either investor, the gains went primarily to services which had not contributed to the scheme, in this case the criminal justice system. This is fine as long as the public purse reflects this, gives due consideration to all contributors and shares the rewards accordingly. It’s just that I’m not entirely sure that this happens, otherwise there would probably be a lot more truly integrated care and much less emphasis on the type of silo working that seems so prevalent. In yet another example I was involved recently in examining flow through A&E. The issues explored focussed almost entirely on bottle necks moving through the hospital and bed capacity, at no point was there any thought given to how the various units might contribute expertise to schemes or projects that might reduce demand at the front door and thus prevent the associated problems. I could perhaps think of one example from an ambulance perspective which would be the provision of a Geriatric advice line to enable more efficient management of the frail, the fastest growing section of the population and those whose care is usually the most complex. I’m sure it’ll all work out in the end, after all the NHS has rumbled along through about 19 Governments and survived, we must be doing something right! I hope you have a great time at LC this year and that you continue to focus on the important things, the people we provide care for.
Sam English, Co-Editor Ambulance UK
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FEATURE
NON-TECHNICAL SKILLS EVALUATION IN THE CRITICAL CARE AIR AMBULANCE ENVIRONMENT: INTRODUCTION OF AN ADAPTED RATING INSTRUMENT AN OBSERVATIONAL STUDY Julia A. Myers, David M. C. Powell, Alex Psirides, Karyn Hathaway, Sarah Aldington and Michael F. Haney Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine201624:24 DOI: 10.1186/s13049-016-0216-5 © Myers et al. 2016
Abstract
Discussion
Background
skills required by critical care air ambulance clinicians, and distinguishes
This study describes a framework which characterises the non-technical
In the isolated and dynamic health-care setting of critical care air ambulance transport, the quality of clinical care is strongly influenced by non-technical skills such as anticipating, recognising and
higher and lower levels of performance. Conclusion
understanding, decision making, and teamwork. However there are
The AeroNOTS framework could be used to facilitate education and
no published reports identifying or applying a non-technical skills
training in non-technical skills for air ambulance clinicians, and further
framework specific to an intensive care air ambulance setting. The
evaluation of this rating system is merited.
objective of this study was to adapt and evaluate a non-technical skills rating framework for the air ambulance clinical environment. Methods In the first phase of the project the anaesthetists’ non-technical skills (ANTS) framework was adapted to the air ambulance setting, using data collected directly from clinician groups, published literature, and
Key words Non-technical skills, Air ambulance, Intensive care, Patient transport, Clinical training.
field observation. In the second phase experienced and inexperienced inter-hospital transport clinicians completed a simulated critical care air transport scenario, and their non-technical skills performance was independently rated by two blinded assessors. Observed and self-rated general clinical performance ratings were also collected. Rank-based statistical tests were used to examine differences in the performance of experienced and inexperienced clinicians, and relationships between
Background In health care, preventing errors and avoidable adverse events for patients (patient safety) is paramount. High quality clinical performance requires adequate knowledge and technical ability, but also relies on non-technical
different assessment approaches and assessors.
skills such as the ability to adapt to a rapidly changing clinical situation and
Results
“the cognitive, social and personal resource skills that complement technical
The framework developed during phase one was referred to as an
skills and contribute to safe and efficient task performance” [3]. Even though
aeromedical non-technical skills framework, or AeroNOTS. During phase
a high degree of technical expertise in important, this alone is not enough
two 16 physicians from speciality training programmes in intensive care,
to prevent clinician error or mishap. Non-technical skills are more likely,
emergency medicine and anaesthesia took part in the clinical simulation
compared to technical skills, to be sensitive to individual human factors such
study. Clinicians with inter-hospital transport experience performed more
as fatigue and stress [3]. High risk industries with low tolerance for error
highly than those without experience, according to both AeroNOTS
(such as aviation and the nuclear power industry) were early to recognise
non-technical skills ratings (p = 0.001) and general performance
the importance of non-technical skills for safety; these industries developed
ratings (p = 0.003). Self-ratings did not distinguish experienced from
rating frameworks to evaluate crew performance based on observable
inexperienced transport clinicians (p = 0.32) and were not strongly associated with either observed general performance (rs = 0.4, p =
behaviours [4, 5]. This approach has also been implemented in high-risk
0.11) or observed non-technical skills performance (rs = 0.4, p = 0.1).
utilised as part of training or assessment of clinical competence [6, 7].
to function as part of a team [1, 2]. Non-technical skills can be defined as
AMBULANCE UK - OCTOBER
health care domains, where behavioural marker systems are increasingly
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FEATURE The air ambulance environment is a complex and dynamic health-care
reflecting the generic nature of non-technical skills’ categories such as
setting, where clinicians work with limited resources to provide very
situational awareness, decision making, and teamwork [3], however
advanced levels of care [8, 9, 10]. Highly specialised care is centralised
specific skill elements and behavioural descriptors vary according
in many modern health care systems and critically ill patients are
to the clinical requirements of the specific domain [20]. An existing
routinely transported large distances to tertiary hospitals to provide
behavioural rating framework can be adapted to another clinical setting
timely access to intensive care [11, 12]. Air ambulance transport teams
using data gathered directly from the new setting [7]. In the aeromedical
tend to be small and comprise different professional categories such as
setting, the well-established Anaesthetists’ Non-Technical Skills (ANTS)
nurses, emergency medical technicians, and physicians. Challenges for
framework [17] is suitable for this purpose [21, 22]. The ANTS system
maintaining patient safety in an aviation environment include managing
provides a framework for describing the individual non-technical skills of
sometimes acutely life-threatening and rapidly evolving medical issues
clinicians as well as a tool to guide their assessment within the clinical
without the support and facilities available in a hospital environment
workplace for anaesthesia [23]. The overall goal of this study was to
[13, 14]. High noise levels in the cabin may preclude traditional options
assess a newly adapted non-technical skills rating system based on the
for clinical surveillance such as auscultation or audible alarms, and
ANTS system but modified for the air ambulance clinical environment.
make communication challenging. Clinicians cannot always access
Our hypothesis was that a non-technical skills framework adapted to
additional assistance, resources, or expertise, should problems arise or
a critical care air ambulance environment could discriminate between
clinical status change while the patient is in transit. In this context, while
stronger and weaker non-technical skills performances. We aimed
good technical expertise is certainly required, it may be non-technical
to test this with a volunteer cohort of lesser and more experienced
factors such as how well clinicians have planned and anticipated, or
intensive care physicians in a challenging air ambulance transfer
how quickly they recognise, understand, and make decisions, that
simulation, where non-technical skills assessors were blinded to
most strongly influence eventual outcome. Well-designed training for
clinician experience.
air ambulance clinicians should aim to prepare them for the recognised risks to patient care during all phases of transfer, and an assessment framework based on non-technical skills would clearly have a high
Method
degree of relevance for this purpose. However there are no published reports identifying or applying a non-technical skills framework specific
The project was undertaken in two phases. First, a non-technical skills
to an intensive care air ambulance setting.
framework was adapted to the critical care air ambulance setting using the ANTS system as the foundation. The adapted framework
A number of non-technical skills rating frameworks have been
was referred to as an aeromedical non-technical skills framework, or
developed for health-care domains closely related to the air ambulance
AeroNOTS. In the second phase the adapted AeroNOTS framework
setting, including emergency care [6, 15], critical care [16], and
was utilised to evaluate the non-technical skills observed in clinicians
anaesthesia [17, 18, 19]. Each of these frameworks is broadly similar,
working in simulated inter-hospital transport scenarios.
AMBULANCE UK - OCTOBER
Fig. 1 Literature search to identify tasks and non-technical skills associated with safe and effective clinical practice in the air ambulance clinical environment
216 For more news visit: www.ambulanceukonline.com
FEATURE Adaptation of a non-technical skills framework to the critical care air
Australia and New Zealand. Any behaviour not rated by at least 75 % of
ambulance setting
respondents as either “very important” or “essential” was considered
Using the ANTS framework as the starting point, a selected and broadly
to potentially lack content validity [24] and was therefore revised. All
representative group of experienced critical care transport and aviation
free-text comments were reviewed to inform behavioural descriptor
medicine clinicians agreed definitions for each non-technical skills
modifications and confirm they could be coded to an existing skills
category and element as they pertained to critical care air transfer.
element. The prototype framework was also field tested in two critical
They also provided suggestions for good and poor clinical behaviours.
care flight services in New Zealand and Sweden. Transport missions were
This work was initiated with a scoping review of the literature to
observed from start to finish noting essential tasks observed or required
identify skill elements and observable behaviours essential for the air
but not covered by the framework, elements missing from or superfluous
ambulance environment, and to understand the range and nature of
to the four main categories, and behavioural descriptions that may have
existing evidence. A search utilising online databases (Ovid Medline,
needed modifying. A change was made from the ANTS scale to introduce
Ovid Nursing, AMED, PsychInfo and Embase) was undertaken in two
a five-point scale for each element or category and a seven-point global
stages. The following search terms and all derivatives were used for
rating (Fig. 2), following suggestions that the four point ANTS rating scale
the initial search: aero, air medical, air ambulance, transportation of
may lack sensitivity for measuring changes in performance [25] and that
patients, patient safety, error, patient transfer, retrieval, non-technical,
an overall non-technical skills scale may also be a useful addition [18, 26].
crew resource management skills, clinicians. In the second stage of the search the ANTS tool and other derivatives were used as the basis
Evaluation of non-technical skills using clinical simulation: study
for describing specific non-technical skills categories, which were then
setting and participants
added as the following search terms: behaviour, teamwork, decision
The observational study took place in the simulation suite of a New
making, situation awareness, communication, leadership. There were
Zealand tertiary hospital; it was timed to take place around a training
no date restrictions and the search was conducted in March 2014 (Fig.
placement changeover with the aim of recruiting a convenience sample
1) [Additional file 1]. Four focus group interviews were also undertaken,
of minimally experienced intensive care transport physicians. Experienced
three with experienced New Zealand and Australian-based air ambulance
intensive care transport physicians were also recruited and assessed.
clinicians (physicians, flight nurses, paramedics) and one with a group
Prior to the simulations, the intensive care unit (ICU) flight service
from an international post-graduate aeromedical education programme.
medical director categorised all the participants as either ‘experienced’
Open ended questions were used to facilitate discussion concerning the
or ‘inexperienced’ in ICU inter-hospital transport. All participants provided
essential tasks undertaken from beginning to end of a patient transport,
informed consent and completed an enrolment questionnaire which
and examples of the relevant good or poor ‘observable’ behaviours
included details of training, transport and simulation experience.
associated with those tasks. Behaviours and tasks arising out of the focus group data and literature were integrated with the developing AeroNOTS
Simulation scenario
prototype to complete and inform the behaviour descriptions.
Following orientation to the simulator all clinicians completed a critical care inter-hospital transport scenario with a highly experienced flight
A content evaluation survey was undertaken using a purposive sampling
nurse serving as a ‘confederate’ and standardised team member.
method and Qualtrics electronic survey software (version 9340538,
The scenario took approximately 20 minutes, with an initial phase set
Copyright © 2015 Qualtrics., Provo, UT, USA). Clinicians from a range of
in a high-fidelity regional emergency department where the transport
critical care flight services rated the importance of positive behaviours
physician and flight nurse took over care of a ventilated patient requiring
from the prototype AeroNOTS framework and suggested key skills or
air ambulance transfer to a tertiary hospital ICU in another city. The
behaviours they believed had been missed. The services were selected
second phase was set in a low fidelity helicopter fuselage with actual
via contact with our Aviation Medicine teaching section including
transport equipment (stretcher, ventilator, monitors) and comparable
air ambulance organisations associated with previous students
space restrictions, but no aircraft noise or vibration. In the scenario the
and current teachers in our international programme. This included
patient’s condition deteriorated rapidly, and a life-saving intervention
university hospital-based air ambulance services as well as larger and
was required [Additional file 2]. Following the scenario an observing ICU
smaller private air ambulance organisations in the United Kingdom,
consultant facilitated a de-brief, which was not recorded.
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Fig. 2 Rating scale descriptors for aeromedical non-technical skills performance
217 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE Assessment of non-technical skills
air transports would be higher than for less experienced clinicians, and
Clinicians were informed that purpose of the study was to evaluate
that general clinical performance levels would correlate with non-technical
methods for assessing clinical performance. They were not specifically
skills performance levels. Statistical analysis was undertaken using SPSS
told that the key focus for that assessment was on non-technical
software (IBM SPSS Statistics for Windows, Version 22.0. Armonk, New
skills. As recommended when undertaking formal assessment of
York). Demographic variables were compared using t-tests or Fisher
non-technical skills performance, each skill element was initially rated
exact tests. AeroNOTS ratings scores (summed total scores between 4
separately, then final ratings were made at the level of the four main skill
and 20, and individual category scores between 1 and 5) were treated as
categories of task management, team working, situation awareness and
ordinal data and analysed using rank-based methods. These included
decision making [27]. Since communication is required to demonstrate
Mann–Whitney U to test for differences in performance between groups,
skill elements across all categories there was no specific category for
Spearman’s rank correlation to examine relationships between different
communication in the AeroNOTS system, as with the ANTS system
assessment approaches and assessors, and Wilcoxon signed-rank to
[17]. Possible scores for each skill category and element ranged
examine individual scoring from the two assessors. Spearman’s rank
between 1 and 5, where a rating of ‘5’ was “Excellent – extremely good
correlation was also used to test for association between the immediate
performance which could serve as a model example for others; patient
general rating of clinical performance compared to non-technical skills
safety enhanced”, down to ‘1’ which was “Poor - absence of behaviour
rating. The level of statistical significance was set at p < 0.05.
required by the situation; performance endangered or potentially endangered patient safety” (Fig. 2). Category scores were analysed
Ethical approval
separately giving a score for each category of between 1 and 5, and
Ethical approval was provided by the University of Otago (Health)
then added to give a single summed score (providing an overall non-
Human Ethics Committee, New Zealand (HD12/233 and HD14/44).
technical skills score between 4 and 20) [25, 28]. Half marks on the scale were not permitted; assessors were instructed to score at the
All clinicians who participated in the clinical simulation study provided signed informed consent.
lower level if they felt the performance fell between two levels on the scale [Additional file 3].
Results
The assessments were carried out independently by two observers who viewed video recordings of the scenarios; assessors were blinded to the
Non-technical skills framework adapted for the critical care air
experience level of the participants.
ambulance setting The final prototype of the AeroNOTS framework was produced
Assessment of general clinical performance
from expert working group, literature review, focus group, clinician
Immediately after the simulation (prior to the debrief) one of the
survey, and field testing data (Fig. 4a and b). The content
investigators, who was also playing the role of the confederate flight
evaluation survey was fully completed by 38 clinicians; 20 flight
nurse, rated the general clinical performance of each participant on
nurses, 12 specialist transport physicians and six paramedics, who
a five point scale ranging from a highest score of “5 = Excellent -
had a median aeromedical transport experience of 8 (IQR 4 – 13)
performed at the highest level; all issues well managed and patient
years. Based on responses there were no skills or behaviours
safety enhanced”, down to “1 = Poor - performed well below the
added, though five existing behaviour descriptors were revised
expected standard; significant lapses in skills or safety” (Fig. 3).
[Additional file 4]. Field testers expressed a preference for being
Participants rated their own clinical performance on the same five point
able to distinguish between good and exemplary performance
scale slightly re-worded to reflect self-rating, rather than observed rating
preferring a five-point performance rating scale over a four-point
of others.
scale, and they confirmed that a “not applicable” category was required as some transport missions either do not require all skill elements or they just could not be observed.
Statistical analysis The AeroNOTS scores from two assessors for each participant were averaged for further analysis within participant groups. A priori assumptions
Evaluation of non-technical skills using clinical simulation
were that non-technical skills ratings for clinicians more experienced in
A total of 16 physicians from speciality training programmes in intensive care, emergency medicine and anaesthesia took part in the clinical simulation study (Table 1). Eight of the participants practiced at a senior trainee level or higher and were categorised
AMBULANCE UK - OCTOBER
as ‘experienced’, having undertaken a median of 45 (IQR 25 – 51.5) previous inter-hospital patient transports. The other eight practiced at a senior trainee level or lower and were categorised as ‘inexperienced’ in patient inter-hospital transport (median 0.5, IQR 0 – 4.5). The mean age for the experienced group was 36.1 (SD 5.6) years and 50 % of them were male. The inexperienced group were younger (p = 0.009) with a mean age of 29.8 (SD 2.1) years, and all were male. There was no difference in any other baseline characteristics including previous experience of simulator training,
Fig. 3 Rating scale descriptors for general clinical performance
the number of hours they had worked or slept in the 24 hours prior to the simulation, and their fatigue level at the time of simulation.
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FEATURE
a
b
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Fig. 4 a Aeromedical non-technical skill categories and elements; Definitions of skill categories and elements in the aeromedical non-technical skills framework b; Illustrative behaviours for aeromedical non-technical skills; Examples of positive and negative illustrative behaviours for non-technical skill elements in the aeromedical non-technical skills framework
219 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE Assessment of non-technical skills Performance ratings from the two assessors were similar, with a high
skills (AeroNOTS) scores than less experienced clinicians (Mann
degree of correlation (rs = 0.65, p = 0.006) and no significant difference
Whitney U, p = 0.001) (Fig. 5). The experienced clinicians also had
in overall scores (AeroNOTS summed scores, Wilcoxon signed-
higher general performance ratings than inexperienced clinicians
ranks test, p = 0.21). These results stayed consistent across the four
(Mann Whitney U, p = 0.003) (Fig. 6). For all clinicians, ratings for
individual skill categories (correlation coefficients ranging between rs
non-technical skills were highly correlated with general performance
= 0.54 and 0.76, all significantly greater than 0 at p = 0.05). However
ratings (rs = 0.9, p = 0.001). Self-ratings of clinical performance did not
for the category of ‘task management’ the scores from one assessor
discriminate in the same way as ‘observed’ performance measures, and
rated higher than the other (Wilcoxon signed-ranks test, p = 0.02). The
the self-rated performance of experienced clinicians was no different to
averages of the 2 assessors’ scores were used for the analyses.
that of inexperienced clinicians (Mann Whitney U, p = 0.32) (Fig. 7). In addition, self-rated performance was not strongly associated with either
Non-technical skills ratings for all participants (Table 2) showed that
observed general performance (rs = 0.4, p = 0.11) or observed non-
clinicians with experience in patient transfer had higher non-technical
technical skills performance (rs = 0.4, p = 0.1).
Table 1 Clinical simulation study: baseline characteristics of participants Characteristic
Experiencedgroup
Inexperiencedgroup
P value
Age (mean ± SD)
36.1 ± 5.6
29.8 ± 2.1
0.009
Male gender, n (%)
4 (50 %)
8 (100 %)
0.08
Consultant
2 (25 %)
0 (0 %)
Registrar (senior)
6 (75 %)
2 (25 %)
Registrar (junior)
0
5 (62.5 %)
Intern
0
1 (12.5 %)
ICU and Anaesthetics
1 (12.5 %)
2 (25 %)
Anaesthetics
0 (0 %)
3 (37.5 %)
Critical and Intensive Care Medicine
3 (37.5 %)
0 (0 %)
Emergency Medicine
3 (37.5 %)
2 (25 %)
General Medicine
Training level, n (%)
Specialty training programme, n (%)
1 (12.5 %)
1 (12.5 %)
Number of previous inter-hospital patient transports, median (IQR)
45 (25 – 51.5)
0.5 (0 – 4.5)
0.001
Number of previous simulations, median (IQR)
15 (2.25 – 20)
5 (5 – 16)
0.57
Sleep in 24 hrs pre-scenario, median hours (IQR)
7.0 (6.6 – 7.9)
7.0 (7–8)
0.80
Work in 24 hrs pre-scenario, median hours (IQR)
8 (1 – 13.5)
6 (1.75 – 7.75)
0.51
Samn-Perelli Fatigue Scorea, median (IQR)
3 (1.25 – 4.75)
2.5 (1.25 – 3.75)
0.57
a Samn-Perelli Fatigue checklist - possible scores between 1 and 7 where 1 is “fully alert wide awake” through to 7 which is “completely exhausted, unable to function effectively” (Samn SW, Perelli LP. Estimating aircrew fatigue: a technique with implications to airlift operations. Brooks AFB,TX: USAF School of Aerospace Medicine; 1982. Technical Report No. SAM-TR- 82–21.)
Table 2 Assessment scores: Non-technical skills and general clinical performance Performance measure a
Non-technical skills (AeroNOTS) , median (IQR)
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Task Managementb, median (IQR) b
Experienced group
Inexperienced group
P value*
16 (15.125 – 17.125)
11.75 (8.75 – 14.25)
0.001
3.75 (3.5 – 4.375)
2.5 (2.125 – 3)
0.001
Teamwork , median (IQR)
4 (3.625 – 4.5)
3 (2.5 – 3.5)
0.002
Situational Awarenessb, median (IQR)
3.75 (3.5 – 4.375)
3 (2.5 – 3.375)
0.03
Decision Makingb, median (IQR)
4 (3.625 – 4.375)
2.75 (2.125 – 3)
0.02
General clinical performancec, median (IQR)
4 (4 – 4)
2.75 (2 – 3)
0.003
Self-rated clinical performancec, median (IQR)
4 (3 – 4)
3.5 (2.125 – 4)
0.32
a
Median Aeromedical Non-technical Skills rating (summed score, possible range between 4 and 20, higher scores represent a higher level of performance) b Median non-technical skills category rating (possible range between 1 and 5, higher scores represent a higher level of performance) c Overall clinical performance rating (self-rated or observed - possible range between 1 and 5, higher scores represent a higher level of performance) *Mann-Whitey U, two-tailed test
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FEATURE
Fig. 5 Non-technical skills ratings for experienced versus inexperienced intensive care transport clinicians
Discussion
The results of this study indicate that by characterising the non-
This study describes the development and evaluation of a framework
and lower levels of non-technical performance, the prototype AeroNOTS
technical skills requirements for clinicians, and distinguishing higher
to assess non-technical skills in aeromedical transport. The framework discriminated between more and less experienced clinicians, based on
framework could be used to facilitate good education and training in non-technical skills. Published standards (on which training curricula
their non-technical skill performance during simulated transfer of
may be based) from Europe [33], New Zealand [34], and the US [35],
a critical patient. Both technical and non-technical skills are needed in
all mandate crew resource management (CRM) training in areas such
tandem for good medical team performance and patient safety in a
as decision making, communications processes, team building and
high risk medical environment, and both improve with good training [29,
maintenance, workload management, and situation awareness, but they
30, 31]. Necessary elements for improving clinical performance include
include little specific detail to define these skills. The specific behaviours
identifying specific skills directly relevant to performance quality, then
identified in the AeroNOTS instrument can facilitate identification of
measuring or assessing those skills in a standardised manner [32].
specific areas for individuals where further training might be beneficial.
AMBULANCE UK - OCTOBER
Fig. 6 General clinical performance ratings for experienced versus inexperienced intensive care transport clinicians
221 Do you have anything you would like to add or include in Features? Please contact us and let us know.
FEATURE
Fig. 7 Self-rated clinical performance of experienced and inexperienced intensive care transport clinicians
In this study, ‘self-ratings’ of performance were not useful in
to the ‘using authority or assertiveness’ element of Teamwork was:
distinguishing different levels of performance, with inexperienced
“questions others regardless of seniority when they are unsure the right
clinicians tending to over-estimate their performance level. Limitations
decision has been made”; and a negative behaviour for the ‘gathering
in clinicians’ ability to self-assess performance have been reported
information’ element of Situational Awareness: “does not alter layout
previously [36], but it is possible that our findings were partly a
of the workplace to improve data visibility or audibility” (ability to hear
result of recruiting one group of inexperienced clinicians who lacked
in aircraft is limited so clinicians need to be able to see monitors to
appropriate inter-hospital transport experience on which to base their
make up for this). From focus groups a recurrent theme emerged that
self-assessments. It is also possible that self-ratings are more accurate
experienced air ambulance clinicians “plan for things to go wrong” and
at the extremes, such as when performance is significantly degraded
“plan for every eventuality”. They also develop strategies for potential
[36]. Further examination of ‘self-rating’ is warranted in light of the fact
vulnerable points in the transfer, such as communication strategies
that critical care air ambulance clinicians are particularly vulnerable to
for working with unknown team members, being assertive in acquiring
factors like fatigue [37], and risk management systems generally rely on
information when working in unfamiliar surroundings, and ensuring they
clinicians ‘self-identifying’ if their performance is compromised [38].
are being listened to. Results from the clinical simulation study provided support for the construct validity of the AeroNOTS framework as a tool
There is a paucity of literature and no published skills taxonomy, so
for assessing non-technical skills performance. In accordance with the a
collecting additional data from the critical care air ambulance domain to
priori expectations we set, experienced clinicians received higher scores
adapt the well-established ANTS system was essential [7]. Anaesthesia
from blinded assessors than inexperienced clinicians, and AeroNOTS
is a medical speciality with a leading role in addressing patient safety
scores were strongly correlated with general performance scores.
and taking a human factors approach to training and safety [39], and
AMBULANCE UK - OCTOBER
while a behavioural rating system cannot simply be applied to another
One limitation in the study design was that while data from all air
specialty area [27] non-technical skills are broadly generic [3]. As
ambulance clinician groups were informative concerning the phase
previous authors report significant overlap in the non-technical skills
one AeroNOTS adaptation process, only physicians participated in the
requirements of intensive care and anaesthesia [20], it was reasonable
second phase clinical simulation study. It was not possible to recruit
to expect similarity between the skills required of intensive care air
comparative groups containing inexperienced flight nurses or air
ambulance clinicians and anaesthesia specialists. Both function in
ambulance paramedics locally. Ongoing evaluation should therefore
teams of variable professional makeup, and so require frameworks
include all clinician groups routinely involved in critical care transfer.
where the fundamental focus is on the non-technical skills of individual
Another potential limitation is that much of the initial adaptation work
clinicians, but encompassing how they function as part of a team.
and evaluation for the AeroNOTS framework involved clinicians and services based in New Zealand or Australia and it is possible that
A measurement system suitable for evaluating the non-technical skills
roles and responsibilities of air ambulance clinicians, and therefore the
of air ambulance clinicians should provide a true (valid) and consistent
required non-technical skills, are not the same in all countries [40]. We
(reliable) representation of those skills. Face and content validity for the
aimed to provide that international perspective through assessment of
AeroNOTS system were addressed during development by collecting
the literature, content evaluation survey and field testing, all of which
data directly from the aeromedical transport domain (clinician experts
provided support for validity. However more wide-spread evaluation
and relevant literature). For example, based on literature an addition
may be required.
222 For further recruitment vacancies visit: www.ambulanceukonline.com
FEATURE This study was not designed to test the reliability of the AeroNOTS rating system. Based on results from studies of non-technical skills in other
Additional file 4: B ehavioural descriptor modifications based on content evaluation survey. (PDF 259 kb)
domains, some variability between assessor ratings, such as in our findings, was not unexpected [16, 41, 42]. The assessors were trained
Competing interests
in non-technical skills concepts and use of the rating system [23], but
There are no financial or non-financial competing interests to declare.
no attempt was made to calibrate their ratings before the study. This will require further examination if the AeroNOTS framework is to be used for
Author contributions
formal assessment of clinical competence.
Each author contributed to the study. JM conceived of the study, participated in study design, data collection, data analysis and manuscript writing. DP participated in study design, data collection,
Conclusion
data analysis and manuscript writing. AP participated in study design, data collection, data analysis and critical review of the manuscript. KH
An air ambulance non-technical skills framework derived from the ANTS tool is capable of distinguishing good and poor performers in a simulated inter-hospital transport setting. Scores can be highly correlated with observed general performance, and also with the general experience of the clinician. Our findings confirm that self-
participated in study design, data collection, data analysis and critical review of the manuscript. SA participated in study design, data analysis and manuscript writing. MH conceived of the study, and participated in study design, data collection, data analysis and manuscript writing. All authors read and approved the final manuscript.
ratings are not useful for distinguishing between higher and lower levels of performance. This framework could be useful in identifying when specific non-technical factors are likely to break down in the air ambulance environment, and facilitating a more structured approach to training and assessment. The AeroNOTS rating system shows utility and applicability for a critical care air ambulance environment, and further evaluation of this framework is merited.
References 1. Gordon M, Darbyshire D, Baker P. Non-technical skills training to enhance patient safety: a systematic review. Med Educ. 2012;46(11):1042–54. 2. Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand. 2009;53(2):143–51.
Abbreviations AeroNOTS: Aeromedical non-technical skills ANTS: Anaesthetists’ non-technical skills ICU: Intensive Care Unit CRM: Crew resource management
3. Flin RH, O’Connor P, Crichton M. Safety at the sharp end: A guide to non-technical skills. Farnham, UK: Ashgate; 2008. 4. Flin R, O’Connor P, Mearns K. Crew resource management: improving team work in high reliability industries. Team Perform Manag. 2002;8(3/4):68–78. 5. Helmreich RL. Managing human error in aviation. Sci Am. 1997;276(5):62–7.
Declarations Acknowledgements This project was supported by funding from the University of Otago, New Zealand and Umeå University, Sweden. The authors would also like to thank the staff of the Simulation & Skills Centre, Wellington Regional Hospital, for their help with data collection. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons. org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons. org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Additional files Additional file 1: Literature search results. (PDF 342 kb) Additional file 2: Simulation scenario details. (PDF 1453 kb) Additional file 3: Aeromedical non-technical skills assessment form and rating scale. (PDF 266 kb)
7. Kodate N, Ross A, Anderson JE, Flin R. Non-Technical Skills (NTS) for enhancing patient safety: achievements and future directions. Jap J Qual Saf Health Care. 2012;7(4):360–70. 8. Flabouris A, Runciman WB, Levings B. Incidents during outof-hospital patient transportation. Anaesth Intensive Care. 2006;34(2):228–36. 9. Freebairn R. Interhospital and emergency transfers in New Zealand. N Z Med J. 2012;125(1351):7–10. 10. MacDonald RD, Banks BA, Morrison M. Epidemiology of adverse events in air medical transport. Acad Emerg Med. 2008;15(10):923–31. 11. Warren J, Fromm RE, Orr RA, Rotello LC, Horst HM. Guidelines for the inter-and intrahospital transport of critically ill patients. Crit Care Med. 2004;32(1):256–62. 12. Brandstrom H, Winso O, Lindholm L, Haney M. Regional intensive care transports: a prospective analysis of distance, time and cost for road, helicopter and fixed-wing ambulances. Scand J Trauma Resusc Emerg Med. 2014;22(1):36.
AMBULANCE UK - OCTOBER
the original author(s) and the source, provide a link to the Creative
6. Flowerdew L, Brown R, Vincent C, Woloshynowych M. Development and validation of a tool to assess emergency physicians’ nontechnical skills. Ann Emerg Med. 2012;59(5):376– 85.
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FEATURE 13. Hearns S, Shirley PJ. Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems. Emerg Med J. 2006;23(12):943–7. 14. Abrahamsen HB, Sollid SJ, Öhlund LS, Røisli J, Bondevik GT. Simulation-based training and assessment of non-technical skills in the Norwegian Helicopter Emergency Medical Services: a crosssectional survey. Emerg Med J. 2015;32(8):647–53. 15. Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, et al. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation. 2010;81(4):446–52. 16. Weller J, Frengley R, Torrie J, Shulruf B, Jolly B, Hopley L, et al. Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams. BMJ Qual Saf. 2011;20(3):216–22. 17. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists’ Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580–8. 18. Lyk-Jensen H, Jepsen R, Spanager L, Dieckmann P, Østergaard D. Assessing Nurse Anaesthetists’ Non-Technical Skills in the operating room. Acta Anaesthesiol Scand. 2014;58(7):794–801. 19. Rutherford JS, Flin R, Irwin A, McFadyen AK. Evaluation of the prototype Anaesthetic Non-technical Skills for Anaesthetic Practitioners (ANTS-AP) system: A behavioural rating system to assess the non-technical skills used by staff assisting the anaesthetist. Anaesthesia. 2015;70(8):907–14.
31. Yee B, Naik VN, Joo HS, Savoldelli GL, Chung DY, Houston PL, et al. Nontechnical skills in anesthesia crisis management with repeated exposure to simulation-based education. Anesthesiology. 2005;103(2):241–8. 32. Sevdalis N, Hull L, Birnbach DJ. Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress. Br J Anaesth. 2012 Dec;109 Suppl 1:i3–i16. 33. European Aeromedical Institute EURAMI. Standards Version (2013) 4.0. www.eurami.org. Accessed July 22 2015. 34. Ambulance New Zealand. Air Ambulance/Air Search and Rescue Service Standard Version 2. http://www.ambulancenz.co.nz/ standards/ (2013). Accessed July 22 2015. 35. Commission for Accreditation of Transport Services. 10th Edition Draft Standards. 2015. http://www.camts.org/. Accessed July 22 2015. 36. Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006;296(9):1094–102. 37. Myers JA, Haney MF, Griffiths RF, Pierse NF, Powell DM. Fatigue in air medical clinicians undertaking high-acuity patient transports. Prehosp Emerg Care. 2015;19(1):36–43. 38. Lerman SE, Eskin E, Flower DJ, George EC, Gerson B, Hartenbaum N, et al. Fatigue Risk Management in the Workplace. J Occup Environ Med. 2012;54(2):231–58.
20. Reader T, Flin R, Lauche K, Cuthbertson BH. Non-technical skills in the intensive care unit. Br J Anaesth. 2006;96(5):551–9.
39. Gaba DM. Anaesthesiology as a model for patient safety in health care. BMJ. 2000;320(7237):785.
21. Wax R. The ABC’s of Air Medical Resource Management. In: Fredriksen K, editor. Principles and direction of Air Medical Transport. Salt Lake City: Air Medical Physician Association; 2006.
40. Wisborg T, Manser T. Assessment of non-technical skills in the operating room–one assessment tool per specialty. Acta Anaesthesiol Scand. 2014;58(7):773–4.
22. Martinsen J. Observation and rating HEMS Crew in Non-Technical Skills, CRM Medical Simulation in Norwegian Air Ambulance. Scand J Trauma Resusc Emerg Med. 2015;23 Suppl 2:A21.
41. Flowerdew L, Gaunt A, Spedding J, Bhargava A, Brown R, Vincent C, et al. A multicentre observational study to evaluate a new tool to assess emergency physicians’ non-technical skills. Emerg Med J. 2013;30(6):437–43.
23. Flin R, Patey R. Non-technical skills for anaesthetists: developing and applying ANTS. Best Pract Res Clin Anaesthesiol. 2011;25(2):215–27. 24. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007;30(4):459–67.
42. Yule S, Rowley D, Flin R, Maran N, Youngson G, Duncan J, et al. Experience matters: comparing novice and expert ratings of non-technical skills using the NOTSS system. ANZ J Surg. 2009;79(3):154–60.
25. Riem N, Boet S, Bould MD, Tavares W, Naik VN. Do technical skills correlate with non-technical skills in crisis resource management: a simulation study. Br J Anaesth. 2012;109(5):723–8. 26. Jepsen RM, Spanager L, Lyk-Jensen HT, Dieckmann P, Østergaard D. Customisation of an instrument to assess anaesthesiologists’ non-technical skills. Int J Med Educ. 2015;6:17. 27. Flin R, Patey R, Glavin R, Maran N. Anaesthetists’ non-technical skills. Br J Anaesth. 2010;105(1):38–44. AMBULANCE UK - OCTOBER
28. Mishra A, Catchpole K, McCulloch P. The Oxford NOTECHS System: reliability and validity of a tool for measuring teamwork behaviour in the operating theatre. Qual Saf Health Care. 2009;18(2):104–8. 29. Aggarwal R, Grantcharov TP, Darzi A. Framework for systematic training and assessment of technical skills. J Am Coll Surg. 2007;204(4):697–705. 30. Pena G, Altree M, Field J, Sainsbury D, Babidge W, Hewett P, et al. Nontechnical skills training for the operating room: A prospective study using simulation and didactic workshop. Surgery. 2015;158(1):300–9.
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FEATURE
DO CRITICAL CARE TEAMS PROLONG ON-SCENE TIMES? M. Thompson
Background: For many years pre-hospital care providers have debated whether it
it is thought that the critical care teams have the capability to make
is the ‘stay and play’ or ‘scoop and run approach’ that affords trauma
advanced decisions early. This coupled with the critical care skill-set
patients the best outcomes. Broadly speaking, it is perceived that
honed from in-hospital training; advanced equipment; interdisciplinary
doctor and paramedic critical care helicopter emergency medical teams
teamwork and interaction of a doctor and paramedic, ensure that these
(HEMS) will adopt the stay and play approach and will consequently
patients are managed effectively without any unnecessary delays.
prolong their time on-scene and delay patient transfer to definitive care, whilst ground-based paramedic crews (GEMS) might tend to favour a
Interestingly however, despite the faster on-scene times and more
scoop-and-run approach.
severely injured patient group, the 30-day mortality rate between the two groups was neither dissimilar nor statistically significant (HEMS 11.3%,
We decided to see if this was in fact the case for the Great Western Air
GEMS 9.6%, p=0.469).
Ambulance service, which serves both rural and urban populations as part of South West Ambulance Service Trust’s air asset responses. The aim of the study was to determine whether the HEMS team reduces or prolongs on-scene times in trauma cases compared to GEMS crews, whilst also providing critical care interventions that may result in a reduced mortality at 30 days.
Conclusion: Whilst there is no statistical difference in survival at 30 days when comparing trauma patients treated by HEMS or GEMS crews, it is evident that the two patient groups treated by these teams are significantly different in their injury severity, with HEMS teams usually
Methods:
being dispatched to only the most critically ill patients. The critical care skills and equipment, together with the advanced decision
Using the Trauma Audit and Research Network (TARN) database, a
making capability of a critical care paramedic and doctor, enable
retrospective review of all trauma patients (injury severity score (ISS)
faster assessment, pre-hospital management and transfer of the most
>8) presenting to a Major Trauma Centre (MTC) in South West England
unstable trauma patients, and thus a shorter time on-scene.
between 1st April 2012 and 31st March 2014 was undertaken. A total of 1946 cases were identified of which 531 were excluded as secondary
Acknowledgements: I would like to thank Dr N Thomson, Dr P Morgan,
transfers with a further 302 excluded due to incomplete data. Cases
Dr T Renninson, Dr T Hooper and Dr H Pynn for their advice and input
in which patients were trapped for longer than 30 minutes were also
with this work.
excluded as it was felt that this was beyond the control of the attending crews. In total, 213 HEMS cases and 874 GEMS cases were identified for analysis. Statistical analysis was undertaken using SPSS Statistics v22 (IBM) to compare a number of variables between the two groups, including time on-scene, patient age, gender, injury severity score (ISS), new injury severity score (NISS), mechanism of injury, shock index and outcome at 30 days.
As one might expect, the data demonstrated that patients managed by the HEMS teams were significantly sicker with a statistically higher shock index (0.7 v 0.6, p<0.001) and NISS (27 v 17, p<0.001). This is a reflection of the different dispatch criteria applied to the critical care team, whose skill set and charity-funded resources are reserved for the patients who will be likely to benefit most. Whilst the patients were shown to be more unwell as a cohort, the median time on-scene was demonstrated to be significantly shorter for HEMS crews compared
AMBULANCE UK - OCTOBER
Results and Discussion:
to GEMS (44mins v 37mins, p<0.001). So why is this? Predominantly,
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NEWSLINE SCAS
Newbury paramedic swaps CPR for RPM Four-time world champion Scuderia Ferrari Formula 1® ace, Sebastian Vettel, undertook a unique job swap with South Central Ambulance Service NHS Foundation Trust (SCAS) Paramedic, Alex Knapton, who is based at SCAS’ Newbury Resource Centre, after the recent British Grand Prix. Sebastian Vettel’s driving skills passed a unique health check with flying colours as he jumped behind the unfamiliar wheel of a three tonne ambulance to go head-to-head with Alex, who also swapped his usual blue flashing lights for the iconic red of Ferrari.
his Ferrari 488 GTB with a 3.9-litre
in his three tonne ambulance,
The two drivers, acting as both
turbocharged V-8 engine and top
grabbing maximum performance
teachers and students for a day,
Vettel was tasked with sharing
speed of over 200 mph, before
from the vehicle and a modest
coached each other on their
high performance driving tips in
joining Alex on a lap of the track
88 mph.
professional driving style.
AMBULANCE UK - OCTOBER
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NEWSLINE
Resuscitation and Emergency Care
A full range of products for use in an emergency and resuscitation situation. Vettel had the opportunity to share tips from the high octane world of Formula 1 and Alex shared tips from his four years’ experience as an emergency services driver attending over 1,000 real-life emergencies. Fans can find out what happened when the two went head-to-head in some unusual hot laps by watching the video, which sees Vettel getting behind the wheel of an ambulance for the first time to set his fast lap,
• • • • •
Bag-Valve-Mask (BVM) Pocket Resuscitation Mask Oxygen and Nitrous Oxide Delivery Systems Airway Management Oxygen Therapy
while Alex got to grips with the power of the Ferrari engine. The video can be viewed on: https://www.youtube.com/watch?v=oHTXYbtXx44
The complete solution from the respiratory care specialists
Talking about his experience, Alex said: “Getting the opportunity to swap the ambulance for the Ferrari 488 GTB was a dream come true! It was an unbelievable experience to get that close to one of the
the ambulance.”
Find us on Stands 7 & 8 Kettering Conference Centre 18th -19th October
Scuderia Ferrari driver, Sebastian Vettel, said: “Paramedics play an
www.intersurgical.co.uk/info/emergency
stars of Formula 1®. Sebastian was on great form coaching on high performance driving tips and joking about the lack of a stereo system in
1®. They need to perform to such high standards every day because people’s lives depend on them.” Alex and Sebastian were brought together at the event by Shell, whose Innovation Partnership with Scuderia Ferrari, has helped developed new Shell V-Power race fuels that contain at least 99% of the same types
Quality, innovation and choice lnteract with us
of compounds used in Shell V-Power fuels for the road. This ensures that road users, such as South Central Ambulance Service, get the maximum power and performance from their vehicles when they need
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AMBULANCE UK - OCTOBER
essential role in motorsport around the world and not just in Formula
them most.
227 AMBULANCE_UK_09.16_life_connections.indd 1 For all your equipment needs visit: www.ambulanceservicesuppliers.com
07/09/2016 14:53
NEWSLINE NEAS
New ambulance scheme aimed at cutting A&E admissions Paramedic Pathfinder pilot launched in the Sunderland area
confidently choose the most
time ambulance paramedics in
maximising the use of the new
appropriate place for treatment.
the North East will use a face to
Urgent Care Centres.”
As well as A&E departments, this
face clinical triage tool to support
could include referral to a patient’s
their decision-making and mirrors
Paul Aitken Fell, consultant
GP, being managed at home or
how Emergency Departments
paramedic at the North East
by accessing Sunderland’s urgent
operate across the country.
Ambulance Service said: “The
care services, such as an urgent
Paramedic Pathfinder scheme will
care centre or the Recovery at
It’s estimated the scheme could
support our ambulance clinicians
Home Team.
save the NHS around £650k
even further to make the most
annually.
appropriate and safe decisions
Approximately 80% of patients
about patients’ care, which will
in the Sunderland area who get
Jeannie Henderson from
support Sunderland’s system of
A new pilot scheme being
an ambulance are taken to the
Sunderland CCG said: “There
integrated care.
introduced by the North East
Emergency Department. This
has been a 47% increase in
Ambulance Service (NEAS)
is above the regional average
emergency admissions over the
“Currently our ambulance
aims to reduce the load on
of 76.82% but the new pilot is
past fifteen years, costing the
clinicians will err on the side of
Sunderland’s A&E departments
expected to reduce this figure by
NHS £12.5 billion. We need to
caution taking patients with non-
by more than 1,825 attendances
as many as five patients daily.
look at ways to reduce the amount
critical conditions to A&E based
of patients being inappropriately
on their diagnosis. This system
The Paramedic Pathfinder triage
transported to Emergency
will ensure patients get the right
Funded by Sunderland Clinical
tool works by enabling ambulance
Departments and are confident
care, in the right place, at the right
Commissioning Group (CCG),
clinicians to recognise symptoms
this pilot scheme will prove
time by giving our paramedics
the Paramedic Pathfinder will
rather than the need to make a
extremely successful in doing just
the confidence and endorsement
train NEAS ambulance clinicians
definitive diagnosis. Ambulance
that. It has already been adopted
to choose another option. As
working in the area to use a
clinicians work from the top of the
by a number of other ambulance
well as reducing the load on
ground-breaking clinical triage
Paramedic Pathfinder flow chart
services across the UK with the
Sunderland’s A&E Departments,
tool, which helps them to make
to the bottom and must eliminate
overarching purpose of avoiding
this will help improve the patients’
extremely accurate face-to-
all other possibilities before going
long and inappropriate transfers
experience by providing care
face patient assessments and
onto the next step. This is the first
to Emergency Departments and
tailored exactly to their needs.”
every year.
on et re el.n mo erj ad at Re w.w ww
AMBULANCE UK - OCTOBER
Professional burn care, anywhere - anytime!
228 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE North East Ambulance Service
The Trust’s Mental Health
to be in need of urgent mental
have been visiting the north
NHS Foundation Trust (NEAS)
Pathway and End of Life Care
health support. In this case they
Hertfordshire Minority Ethnic
covers 3,200 square miles
Project have both been listed
would be taken directly to a
Forum in Hitchin to talk about
across the North East region.
on the Social Care Institute of
mental health facility.”
It employs more than 2,500
Excellence’s website.
the ambulance service and
The End of Life Care Project
staff and serves a population of
what it can provide for its communities.
2.7 million people by handling
It comes after submissions were
aims to prevent unnecessary
all NHS 111 and 999 calls for
invited to highlight work that has
and unwanted hospital
the region, operating patient
raised awareness and improved
admissions for patients
transport and ambulance
implementation of the Mental
receiving end of life care that
response services, delivering
Capacity Act.
access the ambulance service.
commercial audiences and
Clinical Support Officer Edward
Edward, who is also the Trust’s
presentations including one to
providing medical support cover
O’Brian, said: “It’s fantastic
End of Life Care Lead, said that
children which involved a tour of
at events.
for the Trust to be recognised
999 is often accessed for end
an ambulance.
nationally and for these
of life care patients who are
This is the latest project
initiatives to be published on
suffering from an increase in
operated by NEAS which is
the Social Care Institute of
their symptoms.
designed to reduce the burden
Excellence’s website.
Ambulance Service NHS Trust (EEAST) has visited the Forum twice and delivered a range of
training for communities and
He said: “Prior to the Trust
on emergency services. Others
So far the East of England
Sotu Marshall-Wyer, PPI manager said: “I’m delighted how the first two events have been received; there has been
include the introduction of
“A simple pathway has
making these changes
Advanced Practitioners, who
been designed by the Trust
ambulance clinicians have often
offer a more in-depth triage and
to improve the quality and
had to convey these patients
treatment for urgent care cases,
clinical appropriateness of
to hospital in order to manage
and a system called Flight Deck,
care provided to mental health
their symptoms when they
which helps hospitals manage
patients that access the
would much rather be at home
their demand by providing real
ambulance service.
with their families.
“The primary aim of the pathway
“The Trust has introduced
the black and minority ethnic (BME) people. This include information, advice and
all ages and we are hoping for more of the same this week in our latest visit.” The Forum provides services to improve the quality of life of
time updates on system-wide pressures.
a good level of interest across
is to better assist those who
mandatory training in
In 2015/16 the service answered
need an urgent mental health
recognition and management
1.160 million emergency 999
assessment.
of specific symptoms that are often seen in end of life care.
and NHS 111 calls, responded
guidance on housing, benefits, employment, education, training
to 295,855 incidents that
“A further aim is to prevent
resulted in a patient being
those whose care needs are of
“Clinicians can now provide
taken to hospital, treated and
a less urgent nature being left
further treatment by using
discharged, 19,949 patients with
waiting for hours in Emergency
additional medications within
telephone advice and treated
Departments and then
patients’ own homes, thus
partnership training officer
and discharged 85,021 patients
subsequently being discharged.
preventing unnecessary hospital
Simon Marshall offers a
admissions.
clinical insight and has also
at home. In the same year, emergency care crews reached
“When a paramedic is on scene
132,948 Red incidents within the
with a patient they can ring the
national target of 8 minutes.
Mental Health Crisis Team and a joint decision is then made as
commended interaction levels “By controlling these symptoms
of those attending the forum
at home patients can then
and said: “I’ve been really
remain at home which is often
impressed with their knowledge
their preferred place of care”
that patient which would lead to one of three possible outcomes. “The first would be to leave them at home with signposting to relevant services and the second would be to convey
Two Welsh Ambulance Service
them to the Emergency
initiatives that help patients
Department if an underlying
in need of mental health care
medical condition is suspected.
and end of life care have been
Alongside Sotu, community
Breaking down barriers: ambulance service visit Hertfordshire Minority Ethnic Forum
and attention that they’ve given to the subjects we’ve covered. Each week they’ve really engaged in the activities and have demonstrated some great basic life-saving skills including recovery position and CPR.” He added: “The children have also shown a great
The region’s ambulance
understanding in when
recognised as examples of
“The third would be a situation
service and its Patient and
not to and when to call an
good practice.
in which the patient is deemed
Public Involvement (PPI) team
ambulance.”
AMBULANCE UK - OCTOBER
Welsh Ambulance Service recognised for its initiatives in mental health care and end of life care
to the best course of action for
and health matters.
229 For all your equipment needs visit: www.ambulanceservicesuppliers.com
NEWSLINE Emergency Medical Advisor united with cardiac arrest survivor and his lifesaver
He found Peter motionless and
Peter said: “I don’t remember
colleagues showed their visitors
barely breathing lying in the road
anything about what happened on
how incoming 999 calls are
and immediately rang 999 for
the day but I am so grateful that
triaged and how ambulances are
help. What followed was a phone
Jim was there and took it upon
call Jim will never forget and
himself to help me. When we
dispatched in response to the
which saved Peter’s life.
met afterwards I learned that Jim nearly gave up on me and he said
particular type of emergency and their proximity to the incident. Peter said: “It’s fascinating to see
Lauren McCracken, who was on
he may have stopped had it not
Less than three months after
duty that day in Lewes, triaged
been for Lauren’s determination
suffering a cardiac arrest, a
the call as she would normally
and encouragement. We then
Sussex man has met with the
do but during the call it became
agreed that we should track down
Emergency Medical Advisor
clear that Peter had stopped
the voice on the phone and thank
(EMA) who answered the 999
breathing altogether and needed
her personally.”
roads.”
call made for him by a passer-
life support in the form of CPR
by who also performed CPR.
(cardiopulmonary resuscitation).
Both men finally met Lauren
Peter was discharged from
at the poignant get together in
hospital on 5 June and he was
how the whole operation works, we just don’t know what amazing work goes on behind the scenes seeing those ambulances on the
Survivor, Peter Williams and
Jim, who thought Peter was
Lewes. Lauren, who been a call
back at work surveying buildings
his life-saver Jim Burroughs ,
beyond help, was encouraged by
taker for less than a year, said: “I
the next day. “Climbing the
both from Billingshurst, West
Lauren to start chest compressions
was overwhelmed to see Peter
scaffold was an effort at first,” he
Sussex, met with EMA Lauren
as she instructed and counted a
and Jim standing there in front of
said, “but I have now re-joined my
McCracken, at South East Coast
regular ‘1-2-3’ rhythm and urged
me. It really has put my job into
veteran walking group. My short-
Ambulance Service’s (SECAmb)
him not to stop or slow down until
perspective and is a real reminder
term memory is not as sharp but I
Emergency Operations Centre
the paramedics arrived.
that what I and my colleagues
am a very lucky man.”
do here saves lives. I could not
in Lewes. Jim said: “Giving chest
have done it without Jim making
Peter, 69, a building surveyor,
compressions was really
the call in the first place so I want
collapsed on his way to
exhausting but even though I
to thank him too. When I heard
Billingshurst station while running
had had a shoulder operation a
that Peter had written in to make
to catch a train to London on 25
couple of weeks before I do not
contact, I knew somehow it was
May 2016. Jim, who was out on
remember it being a problem.
about this call, I had not forgotten
an early morning walk, heard
The adrenaline kicked in and I
either of them.”
some commotion a distance
just kept going while listening to
away and ran to see what was
Lauren’s voice and her calm and
Whilst in the Emergency Control
happening.
clear instructions.”
Room Lauren and her
AMBULANCE UK - OCTOBER
230 For more news visit: www.ambulanceukonline.com
“Giving chest compressions was really exhausting but even though I had had a shoulder operation a couple of weeks before I do not remember it being a problem. The adrenaline kicked in and I just kept going while listening to Lauren’s voice and her calm and clear instructions.”
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Think
outside a box with
232 For further recruitment vacancies visit: www.ambulanceukonline.com
NEWSLINE
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outside a box with
233 Life Connections - The Affordable CPD Provider: www.lifeconnections.uk.com
NEWSLINE WAA
Vital blood on board Wiltshire Air Ambulance saves lives Wiltshire Air Ambulance’s
One patient who survived after
visited WAA’s Operations
being given pre-hospital blood
Centre in Devizes to thank the
transfusions by WAA is Mark
crew who came to his aid.
Bryant, 40, of Cirencester, who was seriously injured in a road
He said: “I’m really humbled by
traffic collision.
what Wiltshire Air Ambulance did for me. The pre-hospital
Mr Bryant was extensively trapped in his van and WAA
Critical Care Paramedics and
paramedics suspected he had
Doctors gave pre-hospital blood
suffered major blood loss and
transfusions to 35 patients
gave him two units of blood at
during the first year of carrying
the scene – one unit while he was
blood on board the helicopter
trapped in his van - following the
and Rapid Response Vehicle.
collision near Somerford Keynes, Gloucestershire, before he was
Of the 35 patients given blood
taken to Southmead Hospital,
transfusions, 28 survived to
Bristol, by land ambulance.
hospital. Mr Bryant’s injuries included a Before it began carrying blood
shattered pelvis, bruised aorta
Wiltshire Air Ambulance (WAA)
and head injury and he was in an
estimated that one to two patients
induced coma for ten days and
a month, on average, would
was discharged from hospital
benefit from receiving pre-hospital
after two and a half months.
blood transfusions. But in the first
blood transfusions that I received saved my life. Blood is crucially important to help seriously injured people and I am so grateful that I was able to benefit from the blood being carried by Wiltshire Air Ambulance. “I didn’t know about Wiltshire Air Ambulance before my accident. It is an amazing team that comes together to keep people safe across Wiltshire and beyond and it is a charity funded by public donations.” Each day two units of O
Additional deliveries can be made if required by WAA crews.
12 months of carrying blood (17
The collision, on 3 September
negative blood are collected
August 2015 – 16 August 2016),
2015, occurred just two and a
from the North Bristol Trust
WAA’s crews gave pre-hospital
half weeks after WAA began
Transfusion Laboratory at
blood transfusions, on average,
carrying blood.
Southmead Hospital and delivered to WAA’s Operations
to three patients per month
WAA Critical Care Paramedic Ross Culligan (right) giving a prehospital blood transfusion to Mark Bryant in his van on 3 September 2015. WAA HEMS Paramedic Dan Tucker is pictured left
in Wiltshire and surrounding
Mr Bryant, who owns a fishing
Centre in Devizes by the blood
counties.
bait company in Cirencester,
bike charity Freewheelers EVS.
If the blood is not used it is returned to Southmead Hospital by the volunteer blood bikers after 24 hours. The blood storage boxes maintain the temperature of the blood within very narrow limits for well over 24 hours. Any unused blood units are therefore able to be put back into the Southmead Hospital blood bank, preventing waste. Mel Rowbottom, a trustee of Freewheelers EVS, said: “Our volunteers have done a fantastic job, fulfilling their commitment to provide the essential relay link to move the blood supplies between Southmead Hospital and the air ambulance crews,
AMBULANCE UK - OCTOBER
whether at the base or meeting them en-route to a call out. The volunteers have ensured the delivery occurred every night in all types of weather and get a huge sense of pride knowing they played their part in helping Mark Bryant (third from left) who received pre-hospital blood transfusions from Wiltshire Air Ambulance on 3 September 2015 meets the crew who came to his aid (l-r) HEMS paramedic Dan Tucker, Critical Care Paramedic Ross Culligan and Pilot Matt Wilcock
234 For further recruitment vacancies visit: www.ambulanceukonline.com
to save lives. “There is a great rapport between all the charity partners
NEWSLINE and Southmead which has allowed the service to easily evolve to meet changing operational requirements over the past 12 months and we look forward to developing the service further over the next 12
Midlands Air Ambulance Charity Promotes Commitment To Safe Fundraising
While the lottery is a much relied upon source of income for the service, Midlands Air Ambulance Charity always promotes responsible fundraising. The new Dementia Friend initiative is part of the charity’s wider commitment to its supporters, as
months.” As part of Midlands Air
detailed in its Code of Canvassing
Richard Miller, Critical Care
Ambulance Charity’s
Practise and Donor Promise,
Paramedic at WAA, said:
commitment to the highest
which can be found at www.
“Carrying blood is making a real
standards of fundraising
midlandsairambulance.com.
difference to the care we can
excellence, the charity’s Life
give to patients suffering life-
Saving Lottery canvassers have
Jason Levy, fundraising and
threatening bleeding caused by
recently undertaken training to
marketing director for Midlands
trauma and some acute medical
identify the signs of dementia.
Air Ambulance Charity, said: “The Dementia Friend initiative has
conditions. Being able to give blood transfusions at the scene
The initiative was taken to enable
been welcomed by the Lottery
of an incident gives us extra
the charity’s lottery team to
team and our donors alike. If
vital minutes to get patients
recognise potential symptoms of
one of our canvassers believes a
to hospital for them to receive
the disease and to guard against
person they are speaking to has
emergency care.”
signing up vulnerable people.
dementia, they will leave our Life
David Philpott, Chief Executive
Midlands Air Ambulance Charity’s
them to speak to a family member
of WAA, said: “Carrying
Life Saving Lottery generates
about rather than signing them
blood on board Wiltshire Air
over £3 million each year, with
up straight away. This has given
Ambulance has proven to be
over 60,000 members each week
our supporters and their families
of real benefit to patients and
paying just £1 with the chance
further peace of mind.”
in most cases it has been
of winning £1,000. Following
lifesaving. Working with our
the training provided by the
For more information on Midlands
partners, we are proud to
Alzheimer’s Society, the charity’s
Air Ambulance Charity and for
offer this enhancement to the
canvassers now have ‘Dementia
details on the Life Saving Lottery,
service that our crews provide
Friend’ status, and will wear a
please visit
to seriously ill and injured
distinctive badge when recruiting
www.midlandsairambulance.com
patients.”
new members.
or call the team on 0800 8 40 20 40
Saving Lottery application with
Tel/Fax : 01268 833666
AMBULANCE UK - OCTOBER
30 Brooklyn Drive Rayleigh, Essex SS6 9LW
235
NEWSLINE After years of campaigning, Northern Ireland is set to get not just one, but two air ambulances to provide 24-hour cover all year round
when emergency treatment is
vital new life-saving service to the
monitoring driver behaviour),
likely to be most successful.
people of Northern Ireland. I’m
CCTV (enabling identification of
looking forward to working with
poor driving and improve driver
Dr John Hinds was a 35-year-
AANI and their stakeholders as we
training) and Specialist Training
old consultant anaesthetist at
prepare to get operations under
vehicles. An Ambulance Driver
Craigavon Area Hospital when
way.”
Risk Indexing tool (ADRI) can assess drivers’ behaviours,
he died after an accident while providing medical cover at a
AANI chairman Ian Crowe said:
measuring at-work driver risk
Skerries 100 practice session in
“Having two air ambulances
and delivering a range of
July last year. He was a leading
permanently based in Northern
interventions such as intensified
light in the field of trauma
Ireland will significantly reduce
training to those deemed ‘at
medicine. Dr Hinds worked
maintenance downtime.
risk’.
voluntarily as a road racing medic The campaign hit the headlines
for the Motorcycle Union of Ireland
“Having one helicopter on
Last year SECAmb won the
last year after the tragic death
(MCUI), providing rapid response
duty every day will ensure Air
Blue Light & Public Sector Fleet
of motorcycling medic Dr John
medical aid at road race meetings
Ambulance Northern Ireland is
of the Year at the Commercial
Hinds, one of the flying doctors
across Ireland, and saved many
there for those who need it.”
Fleet Awards 2015. It was also
who provided emergency
lives.
commended in the Green Fleet
trauma care at road racing.
SECAMB
He was also a leading voice in the Now his dream is one step closer
campaign for an air ambulance
to reality as the charity behind
service in Northern Ireland before
the service has announced the
his life was tragically cut short.
identity of its aircraft supplier Babcock Mission Critical Services
The aircraft will be based at
Onshore.
Belfast International Airport, Co Antrim, where they will be within a
Air Ambulance Northern Ireland
25-minute flight time of any part of
(AANI) also revealed it will have
Northern Ireland.
two helicopters, meaning the service will be on duty 365 days
When he announced the
a year.
introduction of the service, the former health minister, Simon
Babcock will also provide aviation
Hamilton, said the service will
training and the pilots for both
initially respond to trauma calls.
helicopters. It has decades of
However, it will expand to help
experience in providing Helicopter
patients suffering from life-
Emergency Medical Services
threatening health conditions,
(HEMS) across the UK and
such as stroke and heart attacks.
currently operates from more
SECAmb Fleet shortlisted in Brake Fleet Safety Awards 2016 South East Coast Ambulance Service NHS Foundation Trust (SECAmb) has been shortlisted in the Brake Fleet Safety Awards 2016 in three categories – the Company Driver Safety Award, the Eco Fleet Award and the Fleet
Awards 2015 and recently missed out on the top spot in the Technical Excellence category at the Motor Transport Awards 2016. SECAmb’s Head of Fleet and Logistics John Griffiths said: “I am delighted for everyone in the Fleet and Logistics Team that our efforts have been selected once again in no less than three categories. It illustrates how much we have steamed ahead recently in developing and
Safety Innovation Award.
innovating our fleet of vehicles
‘Brake’, the road safety charity,
financial efficiencies in mind
organises the annual awards scheme to recognise the achievements of suppliers and operators working to reduce
with safety, operational and as well as reducing our carbon footprint in the process.” Ellie Pearson, Professional
than 20 UK bases, responding
AANI trustee Ray Foran said he
the number of crashes involving
Engagement Manager at Brake
to hundreds of emergency calls
is delighted that they have been
people who are driving as part
said: “We’ve been incredibly
every week.
able to select a company to help
of their work. They also hold
impressed by SECAmb and
provide the service.
an annual safety conference,
their entry into our Fleet Safety
bringing together fleet managers
Awards. It is fantastic that they
the air ambulance will slash the
“After a Europe-wide tender
and suppliers to share best
are making a real effort to end
length of time it takes for critically
process we are pleased to
practice in managing road risk.
the needless crashes on our
ill patients to be transported to
announce Babcock as our HEMS
hospital for life-saving treatment.
provider,” he said.
It will also mean highly skilled
“The contract will initially run
doctors will be on the scene of medical emergencies much
It is hoped the introduction of
AMBULANCE UK - OCTOBER
roads as a result of at-work SECAmb’s fleet, which covers
drivers. Our judges now have
a combined 17 million miles
the difficult task of choosing
per year, has seen a number
winners and we wish SECAmb
for three years with a possible
of ground breaking initiatives
the best of luck with their entries
extension for a further two years.”
introduced through a driver
and look forward to seeing them
safety programme. It has
all at our awards.”
quicker, particularly in rural parts of Northern Ireland, where it can
Tim Shattock, managing director
incorporated new technology
be almost impossible to meet the
of Babcock, said: “I am extremely
including Dynamic Speed
The winner will be announced
‘golden hour’ target. This is the
pleased AANI has selected
Control (to reduce the Trust’s
at an awards ceremony on 29
first hour after a traumatic injury,
Babcock to help them bring this
CO2 footprint), Telematics (to
September 2016.
236 For more news visit: www.ambulanceukonline.com
NEWSLINE Leading operational speakers announced for Pre-Hospital Air Ambulance Conference The Association of Air Ambulances (AAA) continues to make this year’s National Air Ambulance Conference the best yet by confirming an impressive line-up of Operational speakers. The event, which takes place on Monday 14th November at the Millennium Gloucester Hotel in London, is expected to be a sell-out, which is no surprise given the heavy weight speakers which have already been announced. A new streamlined structure to the event’s agenda will focus on the key subjects: Quality, Innovation, Resilience and Horizon with experts within the key colleges of Clinical, Air Operations and Charity sector
delivering presentations on the respective topics, followed by an opportunity for questions and answers. Andrew Haines, CEO of the Civil Aviation Authority (CAA), was appointed as a Board Member and Chief Executive Officer of the Civil Aviation Authority in August 2009 and for a further 5 years in August 2012. He joined the CAA after a wide-ranging career in the rail industry. Keith Prior, Director of the National Ambulance Resilience Unit (NARU) has over 34 years experience with the NHS Ambulance Service. In 2011, Keith was appointed Director of NARU and leads in its liaison with Government, NHS England, NHS Ambulance Trusts and stakeholders. Under Keith’s leadership NARU has grown to become widely recognised as the leading organisation for National Ambulance Service Emergency Preparedness, Resilience and Response.
Thilo Scheffler, Technical Director, DRF Luftrettung (DRF) represents one of the leading European HEMS operations based in Germany. Thilo will be speaking about the future vision of HEMS in Germany and will give a different perspective to the UK model of operation. Organised by the AAA; the leading pre-hospital air ambulance conference has become a firm fixture on event calendars across the world wide air ambulance community and is open to all members and non-members. It aims to inspire, inform and incite debate, providing a platform for the air ambulance industry to come together, share ideas and build partnerships. Andrew Scriven, who manages the event said: “We are extremely excited about this year’s event and plans are coming together extremely well. The fact that leading experts within the Clinical, Operational
and Charity sector are queuing up to play a part is extremely satisfying. Given the fact that the National Conference is seen as one of the leading prehospital events to attend and the level of specialist information available to attendees, the delegate rates are exceptional value, both for our members and non-members alike. Last year’s National Conference saw 90% of the UK Air Ambulance operations attend with a sell-out 275 delegates. The event has grown year on year and has become the pinnacle event to attend within the sector. The conference is followed by the prestigious Air Ambulance Awards of Excellence and Gala Dinner held during the evening. For more information on the programme of events and to register online visit: www.aoaa.org.uk
AMBULANCE UK - OCTOBER
237 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE
x4
x4
AMBULANCE UK - OCTOBER
x4
x4
238 For more news visit: www.ambulanceukonline.com
NEWSLINE put teaching cardiopulmonary resuscitation (CPR) at its heart. The aim was to teach as many people as possible how to perform CPR and create a community of lifesavers to help improve survival rates for out of hospital cardiac arrests. This is one of the UK’s biggest killers and a person’s chance of surviving can be greatly improved when CPR is given within the first few minutes of them collapsing. To show what would happen in an emergency situation if a person does collapse, NWAS staff and volunteer Community First Responders acted out a live demonstration in front of a packed audience in the main arena. It explained that cardiac arrests can happen to anyone Over the past six years the event
An estimated 14,000 visitors
Lifesaving 999 day at the Trafford Centre
has got bigger and better in
came along to watch, ask
showcasing the work of staff
questions and get involved in
The sixth annual 999 Day at the Trafford Centre has once again proved to be an outstanding success in highlighting our hardworking emergency services alongside community
of emergency vehicles, from
safety and support services.
and also the different types North West Ambulance Service (NWAS), Greater Manchester Fire
the range of demonstrations and displays that were on show. In recognition of the collaboration between NWAS activating and
and Rescue Service (GMFRS)
working alongside GMFRS
and Greater Manchester Police
crews to respond to cardiac
(GMP).
arrest call outs, this year’s event
at any time and how absolutely anyone can become a lifesaver by calling 999 and performing CPR until help arrives to take over. Spectators were then invited into the arena to get a hands-on go at trying CPR for themselves as NWAS staff, volunteers and cadets from GMFRS taught them these vital lifesaving skills. Derek Cartwright, NWAS Chief Executive said: “This year’s event once again promoted the fantastic work of the emergency services and how we all work together to serve the people of Greater Manchester. “I am even more delighted that the event featured the importance 500 people of all ages going away knowing how they can help to save a life, which one day could be called upon for one of their family or friends. “I especially would like to thank all our staff and volunteers who gave up their time to help make
AMBULANCE UK - OCTOBER
of learning CPR, with more than
the day such a success.”
239 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE roles within the community.”
Shared facilities mean even stronger partnership working between South Western Ambulance Service and Cornwall Fire and Rescue Service
Paul Walker Chief Fire Officer for CFRCS Service commented: “I am very pleased to welcome colleagues from SWASFT to the newly refurbished Truro Community Fire Station. Working in partnership, we have refurbished the building to accommodate individual service requirements, with shared facilities to support
South Western Ambulance
everyone to deliver an efficient
Service NHS Foundation Trust
and professional emergency
(SWASFT), in partnership
operational response in Truro
with Cornwall Fire, Rescue
and the surrounding area. I
and Community Safety
would like to personally thank
(CFRCS), announces the new
all staff from both services
facilities at Truro Emergency
involved in designing and
Services Community Station.
delivering this project and send my best wishes for a
use of shared resources and
is the second example of
a more efficient response
collaborative working between
station and both organisations
for the community. This is
SWASFT and CFRCS Service.
will share all the facilities.
part of a wider programme
After the success of the Tri-
of work between blue light
Service Station at Hayle, using
Cornwall Council cabinet
This collaborative project
organisations to deliver
Truro Fire station for mutual
member for communities Geoff
began in January 2016 and
collaborative projects
benefit is the most natural next
Brown said: “This is yet another
is an exciting opportunity for
throughout Cornwall.
step. The setting of the new
example of the benefits of
station is ideal and being co-
closer co-operation between
SWASFT will be providing an emergency response from the
the two services to work more
successful future working together from our newly refurbished building.”
closely together, providing
Steve Small, SWASFT
located gives both services an
blue light services and I am
joint benefits including;
Operations Manager for
opportunity to further build our
delighted that the changes will
shared building costs, better
Cornwall and the Isles of Scilly
relationship and gain a better
enhance community safety in
partnership working, better
said: “This community station
understanding of each other’s
the Truro area.”
AMBULANCE UK - OCTOBER
240 For more news visit: www.ambulanceukonline.com
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Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
AMBULANCE UK - OCTOBER
LUCAS® 2 Chest Compression System
241
NEWSLINE Welsh Ambulance Service staff celebrate graduation from university
Successful completion of the
Two cohorts from the Welsh
Those who were recognised
Ambulance Service are
programme has enabled them to register with the Health and Care Professions Council, and thus operate throughout the Trust in a paramedic role.
include: Prys Evans, Rhian Jenkins,
celebrating after successfully
Matthew Lane, Judith Mills, Adrian
graduating from university.
Swales, Ruth Jenkins, Tim Lewis, Daniel Myers, Eleanor Strange,
A group of Emergency Medical
Manon Williams, Patrick Connor,
Technicians (EMTs), who enrolled
Kim Davies, Mark Horrigan, James
on the Diploma in Paramedic
Passmore, Greg Smith, Martin
Sciences programme in order
Woodley and Douglas Wilson.
to qualify as paramedics, have officially graduated from Swansea
Meanwhile, another group working
University.
in various roles within the Trust recently graduated from the
The diploma is the culmination
University of South Wales with an
of 18 months of study, which the
MSc in Advanced Clinical Practice.
students undertook while they continued with their day job as
The course is designed for
EMTs.
healthcare professionals who want to extend the scope of their
The EMT-Paramedic conversion
practice regarding consultation,
programme was set up in 2013
assessment, diagnosis and
by the Trust in conjunction with
therapeutic interventions.
Swansea University, and is designed to support this group of
It enables them to develop their
staff in their progression.
understanding of altered physiology to effectively assess a patient’s
The 17-strong cohort collected their
health or ill health status. In addition
awards at a ceremony in the Great
they studied research methods,
Hall in the University’s new Bay
influences on current health
Campus from the Vice-Chancellor
care practices and independent
Professor Richard B Davies.
prescribing.
David Morris (Paramedic), Georgina Passmore (Advanced Paramedic Practitioner), Eileen Munson (Lecturer), Jeff Price (Senior Education & Development Lead) and Bryn Carwyn Thomas (Advanced Paramedic Practitioner) pictured after graduating from the University of South Wales with an MSc in Advanced Clinical Practice Those who graduated are Bryn
Dr Sian Jones, Deputy Head of
Carwyn Thomas, an Advanced
the School of Care Sciences at
Paramedic Practitioner stationed
the University of South Wales said:
in Porthmadog, David Morris, a
“Advanced practice roles are seen
Paramedic at Gelli Station, Georgina
as key to the delivery of high level,
Cregg Passmore, an Advanced
effective healthcare services across
Paramedic Practitioner at Llanelli
Wales and beyond.
Station, and Jeff Price, Senior Education & Development Lead.
“The MSc Advanced Clinical Practitioner contains innovative
AMBULANCE UK - OCTOBER
Claire Vaughan, the Trust’s Director
learning, teaching and assessment
of Workforce and Organisational
strategies supported by state-of-
Development, said: “Our warmest
the-art facilities in the University of
congratulations go out to both
South Wales Clinical Simulation
groups as studying on top of
Centre and has a long and
undertaking a fast-paced career
successful track record of preparing
with the Welsh Ambulance Service
practitioners to meet the challenges
is no easy task and requires a large
of providing services at advanced
amount of commitment.
practice levels.
“By improving their skills and
“This course has been accessed
knowledge, these individuals are
by paramedics employed by the
seeking to improve the quality of
Welsh Ambulance Service Trust
care that we are able to provide to
since its inception and the School
patients across Wales, and their
of Care Sciences is pleased and
hard work is a credit to them.
proud to work in collaboration with both these students and the
A group of EMTs from the Welsh Ambulance Service, who graduated with a Diploma in Paramedic Sciences at Swansea University
“We would also like to thank both
Trust to improve the quality of
universities for continuing to support
pre-hospital services to patients
the development of our staff.”
across Wales.”
242 For more news visit: www.ambulanceukonline.com
NEWSLINE SECAMB
SECAmb’s electronic ePCR iPad project approved for further rollout South East Coast Ambulance Service’s (SECAmb’s) innovative electronic Patient Clinical Record (ePCR) project will expand further having been given Board approval to be used by all clinicians across the Trust’s Thanet Operational Unit area.
to use the iPad and ePCR
electronic handover notes
SECAmb is currently the only
application. He said: “This is a
makes it quicker and easier for
ambulance Trust in the UK using
really worthwhile innovation. The
them to provide rapid, focused
iPads for its clinical records. A
quality of the documentation is
care. It saves precious time and
bold decision that has drawn
much better and more legible.
can greatly improve safety for
considerable interest from other
With it being electronic there are
patients.”
UK Trusts, especially because a
no constraints to a text box and
corporately owned, personally
you can write as much as you
By consolidating four paper
like without the need to fill in a
forms into one electronic form
continuation sheet as you would have to with the paper system. “It’s also of benefit that data can be captured and audited
enabled policy was adopted.
the Trust eliminates duplicate
This has ensured the device is
information and has a joined-
multi-functional for clinicians and
up system that works on and
will open up avenues for further
offline.
use and development in the future.
instantly and although we’re in the early stages it’s also been well received by our hospital
The project, in which clinicians are personally issued with iPads, enables ambulance crews to complete patient records electronically, streamlining communication with hospitals, as well as saving on paper and time. To date 20 staff in Thanet have been using the iPads and have now completed more than 1,000 ePCRs as part of the extended testing and rollout process. Over the coming weeks and months the iPads will be issued to a further approximately 200
colleagues. Staff also like the fact that with the software operated on an iPad, the equipment is multi-functional.” The scheme is expected to next roll-out across SECAmb’s Ashford operational area in Kent and eventually throughout the rest of the Trust’s region. SECAmb’s ePCR project has been developed with leading UKbased IT provider Kainos utilizing their Evolve software.
clinicians.
Head of SECAmb IT Mark
The project has been continually
important project for the Trust.
Chivers said: “This is an
assessed and improved since its’ operational launch in October 2015 with an improved software
Not only does it improve patient care and efficiency but it also takes us forward on our mission
version deployed recently.
to be digitally mature.”
SECAmb IT Development Project
“The iPad is intuitive and the
Manager Karen Mann said: “The
clinicians use it not just for the
development of our ePCR is
ePCRs but also for messaging,
an important part of the Trust’s
web browsing and more, while
plans to streamline the handover
keeping data safe utilizing the
process with hospital emergency
iOS’ inherent security strengths.”
as reducing the amount of paper
The project team has been
used. It will also be useful for our
working closely with the hospitals
clinicians during assessments for
in the trial area to ensure a
patients not conveyed to hospital
smooth and secure handover
and eventually improve our links
process.
with local healthcare teams and SECAmb’s ePCR Clinical Lead
GP surgeries.”
Steve Topley said: “Providing SECAmb paramedic Mike
a hospital with a seamless
Earl was the first paramedics
handover of accurate legible
AMBULANCE UK - OCTOBER
departments at the same time
243 Do you have anything you would like to add or include in Newsline? Please contact us and let us know.
NEWSLINE Welsh Ambulance Service and Gwent Police launch Joint Response Unit to save lives and free up resources A groundbreaking partnership between the Welsh Ambulance Service and Gwent Police is helping to save lives while freeing up resources. At the start of July, a Joint Response Unit (JRU) was launched after it was found that between October 2015 and March 2016, the two emergency services attended 2,249 incidents together. Under the new pilot scheme, a Paramedic and a Special Constable in a specially marked Land Rover carry out shifts covering the Aneurin Bevan Health Board area, self-selecting appropriate 999 incidents via remote access to calls coming into local control rooms.
attended to respond to members of the public facing potentially life-threatening emergencies elsewhere in the region. It also meant that police officers at the scene were freed up to move on to other cases by not having to wait for an ambulance to be allocated, and receiving support from a Special Constable. Explaining the typical type of incident that the unit responds to and how they are allocated, Chris Hughes, Joint Response Unit Project Lead at the Welsh Ambulance Service, said: “All of the police’s workload is passed through the radio so, for example, say if they were asking any units to attend a car accident in Blackwood then our ears prick up and we can start making our way. “We attend lots of RTCs as we have the information live and what we’re doing is updating both the ambulance and police control rooms, so they already have the job open from us and know they’ve already got someone en route.
During its first month, members of the response unit attended 72 incidents and only required back up from an emergency ambulance on 15 occasions, while the Trust’s Urgent Care Service also provided support five times.
“It’s good for us as we’ve got the Special Constable there who can man the police radio, who knows the terminology, and can help us to communicate with police officers at the scene of incidents.
This enabled ambulance crews who would normally have
“We had a man who was stabbed in the throat. It turned out it wasn’t
Chris Hughes, Joint Response Unit Project Lead at the Welsh Ambulance Service, pictured with Gwent Police Special Inspector Gareth Owen pictured on the first shift of the Joint Response Unit
life-threatening, but the potential for that was that it could have been highly life threatening.
reduction in lost hours on scene, so we’re freeing up police officers who are in high demand on the
“Within four minutes we were on scene and normally, if that had come from the police sergeant on scene, by the time the information had been passed on to police control then to ambulance control and on to a vehicle it could have taken much longer.” Chris, who leads and is part of a team of four paramedics with the unit, decided to pursue the initiative after witnessing a similar operation involving London Ambulance Service, in collaboration with the Metropolitan Police. Currently the Gwent JRU works three 12-hour shifts per week on a Friday, Saturday and Sunday, when the emergency services often experience their highest demand.
AMBULANCE UK - OCTOBER
Once the pilot is completed, its success will then be evaluated.
Gwent Police Special Constabulary Chief Officer Richard Jones and Chris Hughes, Joint Response Unit Project Lead at the Welsh Ambulance Service
“The police are noticing a
Chris said: “We would normally have run 72 emergency ambulances to those incidents in July, but as a result only 15 were needed, so 57 emergency ambulances over 14 shifts were left available for the community in order to attend medical emergencies.
244 For further recruitment vacancies visit: www.ambulanceukonline.com
weekend. “They might only be waiting ten minutes for us so when we get there, as long as the scene is safe and secure to work in, the police officers can leave there and go to other incidents leaving myself and the special officer at the scene so they still have a police presence. “They will obviously stay if there was a concern for our safety or for somebody to go to custody. “It’s not the particular job we’re going to, but the availability we’re freeing up for the police and ambulance services.” Chief Inspector Nick McLain from Gwent Police said: “Partnership working is at the cornerstone of everything we do and allows us to provide an enhanced service to people in need. “On completion of this pilot, we will be in a position to evaluate the impact of this project, to ensure we are providing value for money and improving the satisfaction and confidence of the communities we serve.”
NEWSLINE adopted a safer process in
Medic’s bright idea makes ambulance crews even more accessible to blind patients
which blind and partially sighted patients can verify the identity of ambulance crews through a re-contact call with the emergency operations centre. Our crews will provide patients who question their identity with a unique code, which the patient can then verify
Blind and partially sighted
over the phone.
patients can now identify ambulance crews in their hour
Michael Page, RNIB’s New
of need thanks to a London
Business Manager, said: “RNIB
Ambulance Service medic.
is pleased to be working with the London Ambulance Service to
The Service has launched a new
improve accessibility for blind and
scheme thanks to an idea by
partially sighted people across a
one of the Service’s emergency
number of areas.
ambulance crew Dean Buttery. “It’s really important that blind Dean identified the need for the
and partially sighted people have
scheme after he came across an
confidence in the identity of any
elderly blind man who needed
person who comes to their door,
help while off duty.
and this new initiative is another tool to help people to check this.
He said: “People were trying to
We look forward to continuing
help him, but they were pulling
to work with London Ambulance
him in different directions and
Service to improve services for
trying to get him to the side of
people with sight loss.”
the road. He was swinging his cane about and trying to get people away from him as he felt vulnerable and threatened, and this added to the danger. I walked over and tried to help him, explaining that I worked for the ambulance service, but had no way to prove it.
GNAAS
Sites considered for £1.9m centre of medical excellence for Great North Air Ambulance
“When I was a police officer, I
SEVERAL sites are being
had a warrant card with the word
considered for a new £1.9m
‘police’ in braille, and I realised
centre of medical excellence for
the Service had nothing similar.
the Great North Air Ambulance
In this situation I could have
Service (GNAAS).
RESCUE: The Great North Air Ambulance Service (GNAAS)
provide to the charity’s research
money in order to develop a
and training functions.
feasibility study and expand its plans.
He said: “We are offering more comprehensive care year on year.
Under the current funding
Last year we started carrying
proposal, he said the charity
blood. This year, plasma. But these
would make “considerable
developments – which are saving
savings” as it would not be paying
lives – are only made possible
rent on three different sites as staff
through training and research.
would be under one roof. Having on-site meeting and training
“The new site would give us the
space would also eliminate the
perfect platform to be able to take
need to rent external facilities.
this further, as well as space to share that knowledge with other
He added: “Through the support
emergency services for the benefit
of the public, the service has
of patients everywhere.”
grown into one of the most pioneering emergency response
The charity has applied for
teams in the country. Now we
funding from a pot of money
need to safeguard that and then
levied by the Government on
take it to the next level.”
banks found to be guilty of fixing the inter-bank lending rates.
A public consultation process will begin shortly. Visit gnaas.com/
Last year, GNAAS was successful
our-new-home for the latest on
in accessing £250,000 of the
the project.
identified myself to the patient, enabling him to gain my trust.”
The charity has submitted a bid for funding for the new base, which bring under one roof the
issue with his colleagues, and the
charity’s operational crew and its
Service’s Executive Leadership
fundraising and administrative
team embraced the suggestion,
staff.
leading to a series of workshops and meetings with staff, patient
Grahame Pickering, a former
focus groups and the Royal
ambulance service paramedic
National Institute of Blind People
who launched the charity from a
(RNIB).
back room in his house 15 years ago, said the main benefit of the
As a result, the Service has
move was the boost it would
WINDFALL: The Great North Air Ambulance Service looks set for a £250,000 windfall
AMBULANCE UK - OCTOBER
Dean took action and raised the
245 For all your equipment needs visit: www.ambulanceservicesuppliers.com
NEWSLINE
New Publication: First Responder Care Essentials The publishers of the JRCALC UK Ambulance Services Clinical Practice Guidelines 2016, Class Professional Publishing, are delighted to announce the publication of this exciting new text. First Responder Care Essentials is the perfect resource for Community First Responders. Grounded in practice and covering the full remit of the First Responder role, the book takes you through the skills that you need when working with patients. Topics range from communication skills to manual handling, trauma care and cardiac arrest.
First Responder Care Essentials
meet the team on Stand 14.
you to browse and to purchase.
Chapters include:
is written by Richard Pilbery
We will have a selection of our
Conference discounts will be
and Kris Lethbridge, authors of
latest publications available for
available.
• Photographs to illustrate
the other two acclaimed titles
clinical skills and equipment AMBULANCE UK - OCTOBER
handling • Anatomical diagrams to aid understanding • Extended skills flags to highlight where you should operate within your level of practice • Reference to the latest
available within this Ambulance Care range: Ambulance Care Essentials and Ambulance Care Practice. Richard Pilbery also writes Standby CPD and is the editor for the 7th UK edition of Nancy Caroline’s Emergency Care in the Streets. Class Professional Publishing
legislation, guidance and
will be exhibiting at Life
policy
Connections 2016. Come and
“An invaluable book that is informative and will assist you in the delivery of best practice in attending medical emergencies” NIC MORECROFT, LEAD COMMUNITY RESPONDER MANAGER, SOUTH CENTRAL AMBULANCE SERVICE AND FORUM VICE CHAIR, NATIONAL AMBULANCE SERVICES RESPONDER MANAGERS FORUM
246 For more news visit: www.ambulanceukonline.com
IN PERSON News
Chairman receives Honorary Professorship from Swansea University
Professor Ceri Phillips, who heads up the
The Chairman of the Welsh Ambulance
experience is relevant for the future paramedic
Service has been formally presented with
workforce.
College of Human and Health Sciences, added: “The College is heavily reliant on the Ambulance Service in ensuring that student
“To enable the Trust’s Chair to have an affiliation with the College and University is
Mick Giannasi was officiated at a ceremony
evidence that both organisations are serious in
in Swansea by the College of Human and
investing in future professionals, whose roles
Health Sciences, which has been educating
will become ever more significant.”
paramedics since 1998 and is the sole provider of pre-registration paramedic education in Wales.
Mick joined the Welsh Ambulance Service after a distinguished career with the police force
In his role as Honorary Professor, Mick will work with the University to develop programmes that meet the needs of the everexpanding cohort of students. Mick said: “It was an honour and a privilege to formally receive my Honorary Professorship. “This is an excellent opportunity to strengthen our association with the University, with whom
Civic Awards after amazing careers
co-operation and contribution of the Welsh
his Honorary Professorship from Swansea University.
News
spanning 31 years. During that time, he served in three police forces and ultimately attained the rank of Chief Constable in Gwent. He was appointed Chairman of the Welsh Ambulance Service in September 2013. Tracy Myhill, Chief Executive of the Welsh
we already enjoy a close working relationship.
Ambulance Service, said: “We’re beyond
“I look forward to working with colleagues in
build on the fantastic partnership working that
Swansea to develop our existing collaborations
has already been achieved to date and inspire
and secure mutual benefits for both
the next generation of paramedics to take up
organisations.”
opportunities in our ambulance service.”
thrilled for Mick and have every faith that he will
One half of a duo of paramedics who have almost 90 years of service has retired. It comes only a fortnight after the pair were given a civic award by the Chair of Wychavon District Council. Paramedics Dave Hankins and Phil Crowther were presented with certificates by Councillor Francis Smith at a meeting of the full council. The pair worked on a rapid response vehicle based at Evesham. Dave started with Worcester City and District Voluntary Ambulance Service in July 1969 while Phil is a comparative spring chick having started in London in 1975 before moving to Worcestershire in 1979. But now Phil has hung his radio up for the very last time after 41 years of work with the ambulance service. The pair were honoured by the Council after Councillor Smith saw them receive long service awards at the Trusts Annual Awards Ceremony. As well as being a dedicated paramedic, Phil was a stalwart of the Staff Advice and Liaison Scheme (SALS), which supports ambulance staff who have had to deal with particularly traumatic cases. A large group of staff, past and present joined him last night in Evesham for an appropriate send off. Phil said: “I have had a fantastic career. In particular, I am immensely proud that I helped to train no fewer than 120 paramedics when I worked in the Training Department. “Thank you to all who came to say farewell – a definite throat-lump moment.”
Dave says he has no plans to take life a little easier any time soon. He said: “I am immensely proud to work for West Midlands Ambulance Service. The way we treat patients has moved forward so much since I started. “I know some people don’t enjoy their job, but I can honestly say that I have enjoyed every single day helping people; helping my community.”
AMBULANCE UK - OCTOBER
While Phil will be taking life a little easier from now on, it seemed appropriate that he handed over the keys of the response car to Dave last night.
247 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON Garry comments: “This recognition came as
NWAS News
Ambulance service gives special recognition to mountain rescue volunteer Proud Bolton man, Garry Rhodes MBE, 58, has received special recognition from North West Ambulance Service NHS Trust (NWAS) for his 35 years’ contribution to saving lives as part of voluntary work for Bolton Mountain Rescue Team (MRT). Garry, who joined the volunteer group in 1974 was commended by the Trust in a ceremony during their annual Greater Manchester Long Service Awards which took place last month at The Village Hotel, Bury celebrating the achievements of colleagues who have dedicated over 20 years to the Service. During his time in the Mountain Rescue Team, keen explorer, Garry has been involved in over 2,200 incidents and call-outs and has spent 27
a complete surprise to me and I feel humbled that NWAS very kindly recognised my voluntary service in this manner, particularly as such a wonderful event. “To attend the ceremony in the presence of my partner Ann, as a special guest and to then be presented with the recognition award was a great and very special honour for me, especially in front of such an esteemed audience of NWAS staff and invited guests. “I shall treasure the memory of this special day for many years to come.” The help and commitment of volunteers plays a very important role in the ambulance service
director and trustee. Vaughan brings a range
as it works with a number of voluntary groups
of valuable skills and experience to the role
and also recruits volunteers to help patients in
of Non-Executive Director at Isle of Wight
their local community.
NHS Trust. He was previously a Partner at PriceWaterhouseCoopers and European Chief
More information on how to volunteer for NWAS
Queen’s Golden Jubilee Medal for Voluntary Services and in 2008 was made a Member of the British Empire for services to mountain rescue. Chief Executive of NWAS, Derek Cartwright, said: “Many of our patients owe Garry and his team a great deal – without their rescue, there are people who wouldn’t have had such positive outcomes and I know I speak for all of those and our staff when I say thank you! “To give up so much time over the years to help others is truly commendable and we felt it only right to give Garry special recognition at our Long Service Awards as he passes on the leadership role for a well-earned rest.”
Mr Thomas said: “I am delighted to have the News
opportunity to serve the Isle of Wight NHS
Two new Directors appointed to NHS Trust Board
Trust. It is a real privilege, and I look forward
New expertise has been recruited to the
Jon Burwell, Executive Director of Strategy
Board of the Island’s NHS Trust which
and Planning (appointed by Isle of Wight
oversees the unique integrated ambulance,
NHS Trust)
to working with the rest of the Board and executive team.”
community, hospital, mental health and learning disability services provided on the
Jon Burwell has experience of the NHS across
Island.
a range of organisations having previously worked for Epsom and St Helier University
Isle of Wight NHS Trust and with NHS
Hospitals NHS Trust and University Hospitals
Improvement have appointed a new Non-
Southampton NHS Foundation Trust. Most
Executive Director and a new Executive
recently Jon worked for NHS Improvement, the
Director. The new appointees fill vacancies
NHS Trust oversight body, covering the local
and are:
region which includes the Isle of Wight. As part of this role Jon attended the Programme Board
Although Garry has taken a step back from his Team Leader role within the Bolton MRT, he still actively volunteers for them offering his support and expertise.
Executive at CB Richard Ellis.
can be found at www.nwascareers.com
years as Team Leader resulting in him receiving numerous medals and awards including the
Vaughan Thomas
• Vaughan Thomas, who joins the Trust Board
of the Island’s ‘My Life a Full Life’ programme.
as a Non-Executive Director Mr Burwell said: I am delighted to be joining • Jon Burwell, who joins the Trust Board as
AMBULANCE UK - OCTOBER
Executive Director of Strategy and Planning
Isle of Wight NHS Trust at a particularly challenging but exciting time. I look forward to working with Trust colleagues, partners and
Vaughan Thomas, Non-Executive Director
patients on our improvement journey towards
(appointed by NHS Improvement)
sustainable Health and Social Care for the island’s population. With my Board colleagues,
Vaughan Thomas has been a frequent visitor
I hope to provide the necessary support,
to the Island since 1986 and more recently has
strategic leadership and direction to create an
bought a home here. Vaughan is a Chartered
environment for success.
Accountant with experience as a professional advisor, chief executive, and entrepreneur. He
The Chair of Isle of Wight NHS Trust, Eve
has various roles as director, non-executive
Richardson, said: “I am delighted that
248 For further recruitment vacancies visit: www.ambulanceukonline.com
IN PERSON Vaughan and Jon have joined the Trust Board. I am sure that they will make a big contribution to the work of the Board. Health and care services on the Island face significant challenges and I know that Vaughan and Jon will work Jon Burwell
to support our committed and enthusiastic staff
who deliver some excellent care to Islanders and visitors.” Speaking about the role of Non Executive Directors Eve said: “NonExecutives in the NHS bring a different perspective and insight, together with essential skills developed outside the NHS. That has been very valuable in the past and I am sure will continue to be so. We hope to announce another associate appointment shortly.”
We are recruiting Do you want to work for the UK’s leading independent NHS healthcare provider? Paramedic and ECP vacancies in NHS 111, OOH and Prison Healthcare within the following locations: West Midlands, Surrey, Bristol, London, Buckinghamshire, Worcester, Suffolk and Essex. Bank contracts available in our OOH sites for ECPs alongside our GPs and ANPs. Full-time and part-time vacancies available for paramedics within NHS 111 and Prison Healthcare. Benefits of working for Care UK:
News
O&H VEHICLE CONVERSIONS APPOINTS MARTYN ARCHER AS MANAGING DIRECTOR O&H Vehicle Conversions has appointed Martyn Archer as its new
- Flexible work patterns - Portfolio development / CPD - Extensive Care UK training and development - Career progression - Competitive pay and added benefits
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- NHS accredited Pathways training specific for 111 Martyn is a Chartered Management Accountant and brings over 20 years’ experience gained in senior business leadership positions in different
- Homeworking opportunities specific for 111
organisations. He brings a wealth of knowledge and expertise to the business and will lead the company with a focus on financial, commercial and operational performance, driving our strategy for growth. Martyn comments, “Joining Oughtred and Harrison represents an opportunity to work with a highly experienced and dedicated team of professionals, who create and deliver leading class vehicle conversion solutions. I’m
Rotherham
Stoke-on-Trent
to growing the business and further
Bristol
London
developing its already excellent reputation as a trusted business partner to all its Martyn Archer
For more information please email us at healthcare.recruitment@careuk.com or call us on 0118 952 1874.
AMBULANCE UK - OCTOBER
looking forward
customers.”
249 Do you have anything you would like to add or include? Please contact us and let us know.
IN PERSON News
Welsh Ambulance Service stalwart who became paramedic following Aberfan disaster retires after 41 years A Welsh Ambulance Service stalwart who decided to become a paramedic following his involvement in the Aberfan disaster rescue effort has retired after 41 years. Dennis Moss, who lives in Thornhill, Cardiff, started his career as part of the Territorial Army 158 Field Ambulance division at the age of 17. However, it was joining the rescue team following the collapse of a colliery spoil tip
Station, joined the then South Glamorgan
long, and it feels like losing a loved one now
Ambulance Service in 1975 and is believed to
I’m leaving.
have been the first Asian paramedic in Wales. “I’ve seen a number of changes and a number During his career he studied at the University
of people come and go. After all the years
of Glamorgan to boost his qualifications. He
I can still say that this is one of the best
was also chair of the South Glamorgan staff
services.”
association, and involved in forming the first emergency services staff association.
Following his retirement, Dennis plans to spend time with his wife Pauline, as well as
One of his proudest moments though came
his son Kevin, daughter-in-law Madeleine and
when he joined the National Ambulance
granddaughters Phoebe and Chloe.
Service BME (black and minority ethnic) Committee in 1999.
However, he will still be keeping a foot in the door with all of his friends at the Welsh
This led to him trailblazing the Trust’s first
Ambulance Service by offering support on
equality and diversity policy and delivering
equality and diversity matters, and is planning
training on it to other members of staff.
another trip to India next year to teach first aid skills at a blind school near Delhi.
in the village of Aberfan, near Merthyr Tydfil, a year later in
He will also keep up his
October 1966 which set the
involvement as president and
68-year-old on the path to taking
chair of Thornhill AFC, a football
up a job which he would carry out
club he set up more than 20 years
with dedication and love for so
ago to provide opportunities for
many years.
local children.
The disaster sadly resulted in the
A retirement party is being held
deaths of 116 children and 28
to celebrate Dennis’s career on
adults and Dennis said witnessing
Saturday, where his colleagues
the aftermath triggered his desire
will pay tribute to his years of
to care for people.
commitment.
He said: “I was in the TA and then
Tony Crandon, the Trust’s Locality
of course my mother, being a
Manager for the Aneurin Bevan
nurse as well, tried to persuade
Health Board area, said: “I would
me to join the ambulance service. “But it was only after spending a few days at Aberfan and seeing the extent of the disaster where a number of children and adults lost their lives, that I knew I wanted to work in the medical profession helping others. “I got involved in helping to dig the children out of the school because they were buried there, under the dust and everything else. We had to work out how to dig up the soil, AMBULANCE UK - OCTOBER
using corrugated sheets to shift the coal dust through windows and out of the school. “At times we would have to carry bodies on a canvas stretcher into a makeshift mortuary. The strange thing about it is that we had to cope and get on with it, as there was no such thing as counselling for post-traumatic stress.” Dennis, who is a popular figure among his colleagues at the Blackwood Ambulance
Dennis is also well-known for his charity work and while visiting India with the Asian Fire Service Association in 2015, helped to install drinking water pumps in a number of villages and taught crucial first aid training after hearing about the death of a 15-year-old who choked on food. Dennis said: “I’ve had quite an interesting career, a career in which I’ve had to face many challenges. “This job is one of the greatest jobs you can have though. It’s given me a better understanding of the community and the people we serve and a way of dealing with people’s needs, illnesses and traumas. “It has given me a lot of satisfaction and pleasure helping others. I’ve been married since 1973, and also married to the job just as
250 For more news visit: www.ambulanceukonline.com
like to thank Dennis for giving more than 40 years of care and dedication to the service. “I can’t begin to imagine the changes he has seen and how the role of the paramedic has evolved. “Something else that must be recognised is Dennis’s work with the BME community, not just in Wales but UK wide, and helping the Trust to understand the many different cultures of the people we serve.” Sean O’Connor, Clinical Team Leader for the Anuerin Bevan Health Board area, said: “Dennis is the living legend of the ambulance service, so reliable and committed. “He’s been the father figure of Blackwood Station and he’s going to be missed by all his colleagues.”
PRODUCT SHOWCASE SP Services launch LifePOINT Plus AED’s With nearly 60,000 Sudden Cardiac Arrests occurring outside of hospital in the UK every year, making defibrillators more widely available can potentially save more lives each year. When a defibrillator is used within 3-5 minutes of a Sudden Cardiac Arrest, the survival chance rises from 6 to 74% which shows just how vital these machines are.* In response to this growing awareness of the need for AEDs, SP Services have expanded their AED range to include LifePOINT Plus defibrillators. The LifePOINT Plus AED’s have outstanding specifications and are portable, lightweight, reliable and easy to use. With prices starting at just £795 they represent fantastic value for money and are exclusively available through SP Services. Designed to keep sudden cardiac arrest (SCA) victims alive by directing the user with voice commands, the LifePOINT Plus AEDs can be quickly deployed in the event of an SCA, with a simple three-step operation of simply turning the device on, unpacking the pads and attaching them to the patient’s chest, followed by defibrillation which is administered semi-automatically. A training model is also available at £295. With realtime feedback, the rescuer can provide the best CPR resuscitation possible in a SCA situation. The units have a five-year warranty and come in a heavy duty integrated carry case. Paul Watts, Head of Business Development at SP Services said: “the LifePOINT Plus defibrillators are a great addition to our range and will enable more businesses, schools, sports clubs and the wider community to training, the rescuer can administer CPR with defibrillation promptly without waiting for several minutes for the emergency services to arrive, potentially saving many lives each year.” To see the full range visit www.spservices.co.uk *Source: British Heart Foundation -
AMBULANCE UK - OCTOBER
have access to them. Without the need for
September 2015
251 For all your equipment needs visit: www.ambulanceservicesuppliers.com
PRODUCT SHOWCASE Zoll Medical introduces two new AEDS in the UK ZOLL AED 3 – Even Better Support for Rescuers 12th August, 2016 – Cheshire, UK – ZOLL® Medical Corporation, an Asahi Kasei Group Company that manufactures medical devices and related software solutions, announced today that it is expanding its
said Richard Knell-Moore, Country Manager
ZOLL AED 3: Easy to Use, Easy to Own,
of ZOLL Medical UK “We are pleased to
Easy to Maintain
make these lifesaving devices available
The ZOLL AED 3 is easy to use because full-
to both lay and professional rescuers
colour rescue images illustrate the resuscitation
in the UK. ZOLL estimates there are at
process. Real CPR Help guides rescuers to
least 1 million deaths globally each year
deliver Guidelines-compliant compressions
from sudden cardiac arrest. In the UK, 1
the annual number of such deaths is approximately 100,000.” About Sudden Cardiac Arrest (SCA) SCA is an abrupt disruption of the heart’s
existing product line of automated external
function, which causes a lack of blood flow
defibrillators (AEDs) in the UK with the
to vital organs. It is the leading cause of
introduction of the ZOLL AED 3™ and the
unexpected death in the world and strikes
ZOLL AED 3™ BLS (basic life support).
without warning. When sudden cardiac
www.zoll.com/uk/aed3
arrest occurs, the fact is that only half of the
based on the UK and European Resuscitation Council’s 2015 Guidelines for emergency cardiac care. The CPR Uni-padz™ electrodes and battery last five years, keeping the cost of ownership low and making the ZOLL AED 3 easy to own. State-of-the-art technology makes the ZOLL AED 3 easy to maintain. It features Programme Management Onboard, which instills confidence that the AED will be ready to go when needed because it enables users to cloud-connect
victims will need a shock. But all will require These new AEDs build on ZOLL’s legacy
the ZOLL AED 3 to ZOLL’s PlusTrac™ AED
CPR. Survival is poor in most countries,
of introducing new technology to the AED
Programme Management System. PlusTrac
typically less than 8%; improvements in
immediately notifies users by email after any
resuscitation practices could save as many
failed self-test and provides alerts as the battery
as half of these victims.
nears the end of its useful life.
market to help improve outcomes for cardiac arrest patients. Enhanced Real CPR Help® gives rescuers the power to know when they are providing high-quality chest compressions. ZOLL has also introduced the world’s first 5-year universal electrode for both adult and paediatric patients, further improving cost of ownership. Every ZOLL AED 3 comes with Programme Management Onboard™, which notifies users immediately if the device fails a selftest, or if the battery is due to be replaced, ensuring the device is ready to be used. The ZOLL AED 3 BLS model is designed specifically for the needs of first responders with the CPR Dashboard™ and the ability to deliver the patient record directly to health care providers. “We are extremely excited to add two new AEDs to our market-leading portfolio of automated external defibrillators,” said A. Ernest Whiton, President of ZOLL’s global Resuscitation division. “With the addition of these two new models, our company AMBULANCE UK - OCTOBER
offers an even more comprehensive line of AEDs to meet the needs of both our public
ZOLL AED 3™
access and BLS customers, including the latest tools to better manage their AEDs’ readiness and access to clinical event
• The new ZOLL AED 3™ features enhanced Real CPR Help® to help responders deliver the most effective care.
data.” “This next generation of AEDs extends
• The new ZOLL AED 3™ provides lay rescuers with Real CPR Help® so they know when they are providing high-quality CPR.
ZOLL’s reputation for defibrillators that offer Real CPR Help, real-time CPR feedback, providing even better support for rescuers,”
• During CPR, the screen on the new ZOLL AED 3™ presents a count-down timer showing how long until the next heart analysis.
252 For further recruitment vacancies visit: www.ambulanceukonline.com
PRODUCT SHOWCASE ZOLL AED 3 BLS: The AED for First Responders Designed specifically for professional rescuers, the ZOLL AED 3 BLS is built on a defibrillation platform of unmatched support. The CPR Dashboard shows elapsed time since power on, remaining time countdown for the current CPR cycle, number of shocks delivered, the patient’s current ECG in real time, and the depth and rate of chest compressions. For a
Its health care operations include devices and systems for acute critical care, dialysis, therapeutic apheresis, transfusion, and manufacture of biotherapeutics, as well as pharmaceuticals and diagnostic reagents. With more than 30,000 employees around the world, the Asahi Kasei Group serves customers in more than 100 countries. For more information, visit www.asahi-kasei.co.jp/ asahi/en/.
paediatric rescue, the rescuer just has to push the Child button. The AED 3 BLS is the only
Nolan JP, et al. Resuscitation. 2015:e1-e31.
1
AED to provide paediatric CPR metrics using the CPR Dashboard. Providing a shock in 8 seconds with a new battery, the ZOLL AED 3 BLS is among the fastest AEDs at delivering a shock after chest compressions stop, and once the analysis starts. Because it is WiFi-enabled, first responders can easily export clinical event data to RescueNet® CaseReview, a ZOLL Online product that simplifies clinical event reporting and the viewing and distribution of CPR quality metric analysis. ZOLL AED 3 units are available in many languages, including English, French, Spanish, German, Italian, Dutch, Swedish, Latin American Spanish, and Danish. ZOLL AED 3 units are not available for sale in the United States or Canada. These products are pending regulatory approval from the U.S. Food and Drug Administration or Health Canada. About ZOLL Medical Corporation ZOLL Medical Corporation, an Asahi Kasei Group Company, develops and markets medical devices and software solutions that help advance emergency care and save lives, while increasing clinical and operational efficiencies. With products for defibrillation and monitoring, circulation and CPR feedback, data management, therapeutic temperature management, and ventilation, ZOLL provides
ZOLL AED 3™ BLS
clinicians, EMS and fire professionals, and lay rescuers treat victims needing resuscitation
• Delivering a shock in 8 seconds with a new battery, the ZOLL AED 3™ BLS is among the fastest AEDs at delivering a shock after chest compressions stop.
and acute critical care. For more information, visit www.zoll.com.
• The CPR Dashboard™ on the new ZOLL AED 3™ BLS shows patient ECG, compression rate and depth, a CPR cycle countdown timer, shock count, and total elapsed time.
About Asahi Kasei The Asahi Kasei Group is a diversified group
• The new ZOLL AED 3™ BLS can be used flat or upright for the best visibility during a rescue.
of companies led by holding company Asahi Kasei Corp., with operations in the material, homes, and health care business sectors.
• Reviewable clinical event data on the new ZOLL AED 3™ BLS show key statistics, along with patient ECG data and corresponding chest compressions.
AMBULANCE UK - OCTOBER
a comprehensive set of technologies that help
253 For all your equipment needs visit: www.ambulanceservicesuppliers.com
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
254
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 more news visit: www.ambulanceukonline.com
PARAMEDICS - SOUTH WEST £27,115 TO £35,225 (INCLUSIVE OF ENHANCEMENTS)* 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
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Better you, Better everybody. WORKING WONDERS Join Us.
THE ALL-NEW ZOLL AED 3™ Easy to use. Easy to own. Easy to maintain.
Easy to use with improved Real CPR Help,® clear audio prompts, and full-colour rescue images that together help you deliver the most effective rescue. Easy to own because it has the world’s first five-year universal electrode pads and a battery that lasts up to five years, keeping the cost to own surprisingly low. Easy to maintain because Programme Management Onboard™ notifies you immediately after any failed self-test and provides alerts as the battery nears the end of its useful life. Worry-free readiness with no maintenance inspections required.
For more information, visit www.zoll.com/aed3. MCN PP 1603 0161-05 The ZOLL AED 3 is not available for sale in the U.S. or Canada. The product has not received regulatory clearance/approval from the U.S. Food and Drug Administration or Health Canada. ©2016 ZOLL Medical Corporation. All rights reserved. Program Management Onboard, Real CPR Help, ZOLL, and ZOLL AED 3 are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.