Ambulance UK October 2016

Page 1

Volume 31 No. 5

October 2016

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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

225 Do critical care teams prolong on-scene times? CIRCULATION:

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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.

AMBULANCE UK - OCTOBER

“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

212 For more news visit: www.ambulanceukonline.com


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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.

AMBULANCE UK - OCTOBER

Fig. 2 Rating scale descriptors for aeromedical non-technical skills performance

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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

AMBULANCE UK - OCTOBER

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)

AMBULANCE UK - OCTOBER

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

220 For more news visit: www.ambulanceukonline.com


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.

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


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.

224 For more news visit: www.ambulanceukonline.com


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

226 For more news visit: www.ambulanceukonline.com


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

www.intersurgical.co.uk

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


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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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AMBULANCE UK - OCTOBER

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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

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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

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Stoke-on-Trent

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Bristol

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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. • • • •

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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.


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