St John Review (1972)

First Aid Training Is Essential

ST. JOHN

REVIEW

Order of St John 1 Grosvenor Crescent, London S W .1.

Not the Grand Prior's Trophy but 17 -years old Pauline Powell of Liscard N u rSI ng DIvIsion, Wallasey, is just as delighted to wi n the Cecil Robinson challenge trophy for the member of the year in Cheshire. Pauline joined SJA when she was nine. (Photo: Cameracraft, Wallasey)

A NEW MONTHLY COLUMN AT RANDOM

by the Deputy Commissioner-in-Chief

'WE MISSED OUR WAYS years ago and found a wide, comfortable road , fine for sleep-walkers but it had the major drawback of wandering just anywhere , at random' (from Random. Han est, by James Hilton).

As one of the latest arrivals at Grosvenor Crescent Headquarters 1 soon found myself let in for the job 0 f patrolling through the medium of a monthly page in the ReView, the wide, comfortable road that wanders at random up and down the face of the country , and of trying to provide a rescue service for those who had missed their ways and to guide them back on to the less comfortable but more adventurous trail that leads to our St. John objectives

There are not many sleep-walkers in our ranks , but like many eccentric minorities their behaviour attracts a great deal more attention than it deserves espe c ially when they wander off the trail and lead a whole host of innocent followers in their train. One of their chief characteristics is to imagine that Headquarters is peopled by a strange race of mortals called Them' , who lead a totally different life and even speak a different language from the rest of mankind (known as Us'). So let me assure you that after spending 32 years on the St. John trail, I came up to London and found Grosvenor Crescen t full of extremely friendly and hard-working colleagues , many of whom had started their St. John life in just the same way as I did myself.

There are two facts about these people which are not, perhaps , very widely known by those who are out on the trail: first, that when someone joins Brigade Headquarters without previous St. John experience, he or she always starts by taking an Association first aid course at the earliest possible opportunity, and then frequently (if a man) , or always (if a woman), follows this up with a nursing course : secondly, that all members of Brigade Headquarters staff, from the Commissioner-in-Chief downwards. regularly maintain their ' efficiency' requirements according to Regulations. including taking their re-exam which - as I was delighted to find by first-hand experience only this week - i very far from being any mere formality.

As to their speaking a different language, I can only say that it sounds the same to me but I think it often gets distorted , through bad communication as it passes down the line, after the manner of a children's party game that we used to call 'Russian scandal'. Let me give you an example that has recently come to my notice.

In mid-October the Commissioner-in-Chief asked me to look into the hi tory and future prospect of the Bexhill camp, and to present a report, fir t to him, and then to the meeting of the Brigade commi ttee on ovember 10th. This led, by a form of 'Russian scandal', which can be very funny at a children's party but i tragic when applied to matter of important policy, to the most irresponsibl e and inaccurate rumours being spread like wildfire among previou camper before the Brigade committee had even met and resulted in a spate of le tter, orne of them very sensible , helpful and restrained. others hy terically abu ive. but all of th e m bas e d o n t o tally in co rrect in fo mzari o ll. ince they all took it for granted that the Bexhill camp 'had been lopped ' and one of them even claimed that the ite was in proce of being sold to another organisation!

I fancy that ome of the writer thought that the n e w Deputy C-in-C was the nigger in the woodpile' a view which hardly fit in with the fact that 1 wa a junior member of the cadet

AT RANDOM (Cont.)

camping advisory committee formed in 1946 under the chairmanship of Miss Virginia Cunard (as she then was), and which (a) launched the BexhiB camp, (b) drew up the conditions of the original St . John camping warrant , and (c) approved the award of one of the first of these warrants to Mrs Rose , who has done such magnificient work as ca mp commandant at Bexhill throughou t the ensuing years.

The 1972 Bexhill camp for the cadet jubilee year is definitely 'on', as you will read in your copy of January Brigade Orders But none of the letters to which I have referred reached the hands of anyone at Headquarters till after my report had been made : they therefore did nothing to influence any immediate issue that was supposed to exist, though the more constructively responsible among them will be a useful guide in det e rmining fu ture policy. One of the sayings that I was brought up on was 'Never beli eve anything that you hear , and only half of what you se e'. Without taking that old saw too literally , I'm sure that a good deal of sound sense lies behind it, especially when applied to irresponsibly alarmist rumours circulated by 'Us' about the scandalous machinations of 'Them'. Those who are not sleep-walking will know quite well that in St. John there is no 'Us' and Them' - or, should I say , no We' and ' They '? - drawn up like opposing arm ie s in threatening array We are all one family with but one cause at heart - th e best interests of the family as a whole.

As to the more distant future, all that] can say with absolute certainty is that happy and adven turous training through the experience of living together in camp will definitely be in the forefront of cadet activities , though it may to some extent take on a 'new look '. Gradual change, as the years go by, is an essential condition of the health of any living organism; it is only when change has been too long delayed that when it co mes its effect is felt to be traumatic ; and if it never comes at all, then anoth e r kind of change sets in and the organism die s. Talking of old sayings, there's much wisdom in one used by th e French: 'Plus change, et plus reste la meme chose' Speaking personally , I fee l sure that in whatever direction our camp training activities may develop during the coming years , it will be a direction that the younger members of our St. John family will welcome and in which they will be glad to follow .

Poor George Woodhill has just gone down with mumps. We ve always known how young he is at heart , and he needed to suffer no such youthful ailment to prove it. ] know you'll join me in hoping that by the time you read this he'll be fully recovered and back in charge of the Registry once more. And my secretary, Miss Hardinge , who for many years has served Admiral WeBby and others with such devoted efficiency , wen t in to hospital for an operation six weeks ago , since when I've been living from hand t o mouth (more hand than mouth) in the matter of correspondence. She is already much recovered , and I hope will be back by Christmas

A very happy New Year to you all, and I look forward to writing to you again next month , and to meeting as many of you as possible in 1972.

Grand Prior 's Trophy

MEN I SJAB (Bo isover Colliery)

2 Pollee (Metropo lit an Z Dlv .)

3 Elect. Supply Amb. Centre (Battersea)

4 MOD AviatIon Supply Amb. Centre (ROF Burghfield)

5 Nat. Dock Labour Board Amb. Centre (Hull)

6 NCB lIliners Senior Compo (Parks id e Coil )

7 Nat. In d u stria l Compo (lCI Ltd. Winnington)

8 Gas In dust ry (NF Gas Board)

9 PO Amb. Cen tr e (Scotland R eg. I:.ng. Trg. choo l )

PRINCESS

CHULA CHAKRABONGSE

TilE BRI GADE in Cornwa ll suffered a most grievo u s loss in the death on November 27 of their County Superintendent (N ur sing) Prince C hul a, at the ear ly age of 55. In the Sl. J ohn Ambulance Brigade, to which he devoted much of her li fe, she wa · soon recognised as a born eade r and shortly afte joining in 1947 she was appointed County Officer fo r Nursing Cadets. In 1954 , on the re tir ement of t h e then Co unt y Supt., Mrs N e lli e Oakley, was invited o lake th is a pp oin tm en with supervision of bo th N ur sing and Nursing Cadet She hesitated to accep this promot ion as she felt that her age in so hi gh a post might not be acceptab e to the m ore ma tu rc membe r s and she did no t wish t o reduce' h e r activities for h e r beloved ca d e s. S h e re-assured on both point · and for 17 years she was the leader of both nur sing m embe r s and cade t s, receiving th e ir devoted loya l t y and gra ti tude. A s for th e I. J o hn Nursing Cadets it IS no exaggera ti o n o say that th ey adored their lov e ly, a en ed an d fric11llly leader. One cannot

The death of the Lady Joan ewman. Chairman of the SI. J ohn Council for ES e,<, occurred on Octobcr 28 after a short illnes and a funeral service \\ a held at the Chelmsford Cathedral on ovember 1. The Lady Joan ("wman was the daugh tcr of the Sixth Earl of Clarendon, and wik of Commander George Chnstopher cwman of Panfield Hall. Braintree. he \\as a Dame of the Order of St. John. and for many year, \\ Vice-President (Nursing) of the I. John Ambulance Brigade for the county. he \\a5 a so for orne t im e a eading figure on the a ional Appeals Committee of the Order of t. John. \\ hen she organized major even ts in the co u ntry in aid of t. John fund',he Will be sadl) missed by everybody connected with t. J ohn, \\ho kne\\ they could a lw ays turn to her for advice and asslstancc. 3

The SJAB ( Bol sov er Colliery) teamthe

LADY JOAN NEWMAN

Duty Ambulance Crew

A LOCAL NEWSPAPER REPORTER

SEES SJA WORK FOR HIMSELF

IT W AS just after lOin the evening when my telephone rang and the voice of R ay Songhurst came through saying: 'You've got a run. Be down at the ambulance station in five minutes.'

Divisional Superintendent R ay Songhurst, in charge of SJ A Horley and Gatwick Division, was answering my request to be allowed to stand in with the duty ambulance crew.

Horley and Gatwick Division maintain a voluntary duty ambulance crew every night between 7pm and 7am and throughout every weekend. Day-time cover during week-days is provided by members of the Brigade who can make themselves available if required. The duty crew :;ystem was adopted eight years ago to provide a service to the airlines at Gatwick airport.

The request for the services of the duty ambulance is normally made by the airline carrying the sick or injured passenger to the Divi sional Superintendent or his deputy. Many such passengers travel to and from Gatwick during the year and a larg e number req uire some form of ambulance transport.

The winter months bring a crop of skiers from the winter sports resorts nursing their broken limbs and the summer months see the return of the holiday makers with accident injuries or serious illnesses.

The destinations of the patients differ considerably and during the past year crews have travelJed to Cardiff, Exeter, Bournemouth, Oxford, Southend, Hasting s and many other places apart from frequent short distance journeys to London

It took me four and a half minutes to get to the S t. John Ambulance station, but when I arrived, Ambulanceman Ernie Wannell was already there swinging open the garage doors. A few seconds later Ray Songhurst arrived with Nurse Margaret Day , whom he had collected on the way to the station. It is usual St. John practice 4

ever-ready ambulance (Photo: East Surrey

for a nurse to accompany the two-man crew, especially when female pati e nts are carried.

'What have we got?' , asked Ernie. ' One male stretcher from Gatwick to Birmingham General ,' replied Ray , 'due to land in IS minu te s'. I was surprised that no one seemed concerned that they had a 200 mile round trip ahead of them and that it would take most of the night.

[n a few minutes we arrived at Gatwick airport and while Ray checked with the airline requesting the ambulance, Ernie went to the police office to get clearance to enter the restricted area where the aircraft park

'Stand Nine' said Ray when he returned, 'it's a One-Eleven.' The BAC 1-11 aircraft has a rear exit under the tail with a passageway just wide enough to take a stretcher if it is raised above the level of the hand rail.

' If we have a heavy patient we really have to work, so [ make sure I get the head end,' said Ernie jokingly.

We waited for the passengers to disembark and for the Customs and Immigration Officers to clear the patient and then Ernie swung the ambulance out to the rear of the aircraft while Ray and Margaret went aboard. The patient was a middle-aged man who had broken his leg while on holiday in Majorca and he was on a special stretcher at the rear of the aircraft. With a friendly word for the

blanng, for we se ld om havc cuu<;e to drive in such a munner,' replicd Ray 'I suppose It is s imply the desir e to give a helpIng hand to so m eo n e who needs it'.

Pati ents who truvel by SL J ohn ambulances pay a fixed price per mile, bu tin many ca. es this is covered by m edicul insurance. The money earned in tllis direction is used to off-set the cost of mall1taining and renewing ambulances and eq uipm ent.

Horl ey and Gatwick Divi sion crews do not attend roud traffic accidents unless requested to do so by (he Surrey Ambulance Service who, normally. maintuln suffiCIent vehicles for such emergencies. I hcy clo, however, prOVide first aid cover for motor-cycle scrambles, horse shows , carniva ls, etc, and at onc s u ch event recently 1 5 ca ualties were treated and of these eight were taken to h ospital with assorted fractures, head injunes and burns.

Major disasters such as air crashes and floods are not unknown to H orley and Gatwlck Division and the record show their prompt and efficient turn-oLlt when tragedIes of this nature occur.

It was just af t er :2.30am whe'1 we arrived at BIrmingham General lI ospita l and it was a clear, fmc moonlIt night. R uy contacted the 111ght sister and then quickly and competently the patient was

patient and a reassuring word for hi Wife, Ray and Ernie soo n had him tr ans ferred to their stretcher, down the aircraft s teps and into the ambulance.

Nurs e Margaret made sure her charge was comfortable for the long journey ahead and then , 45 minute after Ray Songhurst had telephoned me, we gently moved off heading for L ondon and the Ml.

'Often our first greeting from the patient or hi wife is 'It's good to be home again', Ernie told me as he threaded his way through the late-night traffic around Hyde Park-corner. ' We hear some pretty hair-raising stories about the co t of medical treatment abroad and we can well understand why our patients are pleased to be back'.

While Ernie concentrated on driving along the M I, [ talked to Ray about his work and family. Ray Songhurs , aged 39, is married with three children and lives at Horley He works for a frozen food firm in Redhill. Ray has only recently been promoted to Superintendent after years as Divisional Officer.

[asked Ray what it is that makes a man give up a night's sleep after a hard day's work to take an ambulance all the way to Birmingham and back for no monetary gain.

'From my point of view it certainly is not for the thrill of rushing through the streets with blue light flashing and siren

taken to the r eceiVIng ward. Sister instructed a nurse to make us a pot of tea.

Ju st after three o'clock Ih (; ambulance with R ay now behind the wheel slid quietly out of the grounds headIng for home,

This gave me an opportunity to talk to bnie Wannell, aged 47, married with three chi ldr en and living at Horl ey. I::rnie works for APY Param ount, Crawley, and is also a member of the works' first aid team. H e jOll1ed the St. John Ambulance after eight years in the Civil D efence Corps, and hIS wife, Iv y, and son, Trevor, are members of the ursing and Cadet DiviSIons respectively.

'We could do with about four more drivers in the diviSIon to take the load off the rest of us,' saId I:rnle as we sped back a l ong the MI. 'SpeCIal occaSIOns, holidays, etc, mean some crews doubling up in order to maintain a full cover. Of course, you don't have to be a driver to join the Sl. J ohn Ambulance, but it helps.'

urse Margaret Day was busy all the way to Birmll1gham making sure her patient was comfortable and talking to his wife. On the return trip she could relax and, perhaps even snatch a little leep. Mnrgaret is an attractive young lady and hns been with the Horl ey and

NEW MOBILE RESUSCITATION UNIT

A COM PA l Y SPLCIALlZI G In mobile medical unit s ha d eve l oped a vehIcle which is tully equipped for emergency, on-the-spot aid In as cardiac arrest. Thi<; enahles medical attention and resuscitation to he given dunng the critical period between the time of illness or accident and twnsporting the patient to a hospital intensive care ward. A number of deaths could be prevented If this type of immediate aid wa available.

The unit, which is based on a stan dard Bedfo rd cr 1250 chas is, carries al l the equipment and fittings required in an eme rg ency, and it can al 0 be u 'e d as a conventiona l ambulance at other times. Seating is provided for four patients and an attendant, which can be folded down to mak e pace for a second stretcher. In addition th ere is ::J combi nati on stretc h e r /ch::J lr adaptable for patients in either a sittIng or lying position.

Th e muin resuscitation and medical eq uipm en t IS con t ained in a compact trolley close t o th e pntient's head nt the front of the vehICle. ThiS includes an electrocnrdiograph machine nnd a monitor f ixed to th e bulkhead a defibrillator, eme rg ency requirements' for intravenous therapy nnd intubation, and a suction pump. All th e m e dical controls are conveniently placed so that th ey can be observed during treatment. Locker space is provided for oxygen bottles, bedding and o ther eq uipm e nt.

Gatwlck urslng DIviSion sInce I (J(l7 Sill at Horley and i'> employed as a pnvate secretary.

'Some of our nurses and ambulancemen are traIned AIr Attendant'> and means that there IS the occasional escort duty to or trom places abroad :lccompanying sick or injured passengers.' Margaret told me 'We. too, could do v.. ith some new recruIts and now that we are starting ambulance driving we feel <;ure more ladles will want to join us.'

I t was about 7am when we arrived back in H orley and after tidying the inside of the ambulance and compleling the report sheet. the duty crew made their way home. Fortunately. it v.. as Saturday mOfl1l1lg. but it does not always work out that way.

J was Impressed by the co n cern the crew had shown for their patient. by the teamwork from three very different individuals: by the high standa rd of driving and, particularly. their great Sense of humour.

ext time I see a St. John ambulance from H orley and Gatwick DIvision. I shall wonder where they are going. wish them luck and a safe return. Th ey carry the name of the town to distant places and are fine ambassadors for one of our greatest traditions voluntary ervlce.

CCold W:lter is connected (0 ::J sink unit and independent electricnl power supplies are aV:li lable.

Access at the rear is through full l ength doors open in g to 250 degrees. and a further door connects the cab to the main body the passenger seat tip up to allow easy entry. The bodywork i of tw o part, two skIn co nstruction The framework is built with lin. aluminium sec tion s, panelled exte rnally in 16g a Iu m inium. Plastic faced hard board panels are Llsed on the lower half of the interior and roof, and the upper section co nsi ts of three fibreglass moulds both sides and the bulkhead. Fibreglass insulation i fi tted between the two skins.

Th e fibregla s ide mould Incorporate the window frame. mea uring 36in. '( 18in ., to prevent the infiltration of dust. The sliding top part of the windows are in clear gla s, the lower in frosted glass as are the two fixed windows in the reJr door. Darkened glass can al 0 be fitted. Int erior layout can be modified to meet the specific reqUlrement of ho pltal boards. local authoritie or other emergency organizations. Design c hange can al 0 be built in to meet the particular need of operators overseas.

Full details of the new emergency resuscitation unit are available from the maker : Ibis MJ Ltd. AVI Way. ewhaven, us ex.

Skilful hands transfer a pati ent from a Gatwick airliner to an

Newspapers)

FOCUS ON FIRST AID

Chemical splash

Eye

REAL LIFE

I hear that S]A orthern Area, West Riding 0 f Y orks h ire, recen tly organised an exercise for their ambulance and nurs\ng cadets in which incidents were dealt with on the basis of improvisation. o bandages were available, but an assortment of jumble was readily to hand, so it was up to the young first-aiders to make the most of these real life conditions. Also to create the atmosphere of real emergency, the cadets did not wear uniforms.

Under the supervision of area training officer J. McManus , about 100 cadets took part in the exercise together with a tea m of casualty make-u p a sis tan ts.

The experiment proved a great success.

RUNNING A CENTRE

The following piece was sent to me by Ambulance Member F. G. Isaac 305 Bromley (Combined) Division , London District:

With the nationalisation of the Cable & Wireless Ltd. U.K. assets and the later transfer of these to the General Post Office (as it then was) a branch of the Post Office Ambulance Centre came into existence at Electra House, Victoria Embankment, the London station of the international telegraph system.

As the assistant secretary of this branch, primarily responsible for minutes of meetings and an occasional newsletter, it occured to me that the numerous difficulties in running a branch under conditions varying from the impossible to the miraculous may be of interest to readers

Firstly , there has always been the problem of arranging meetings , routine training, competition practice or any other function in view of the twenty-four hour nature of the busines of the department. This ca n be unbelievably comp licat ed. If some members are on the 'right' shift, others are off duty and many 8

AROUND and ABOUT

WHAT'S GOING ON - IN THE WORLD OF ST. JOHN

BY THE EDITOR

APPOINTEMENTS

Au tralia: Dis1. Supt. Tasm a nJa :

Mr K. J. Milbourne.

Cheshire : Mr. H. Wat so n to be Chalfman, S1. John Counci\.

Guyana : Mr R C. Butler to be Co mm issioner. The R ev. ] A. Phoenix resigned.

Ghana: Mr. I moru Lafia to be

Com miss ion e r. Mr. W. C.

Adjemang resigned.

Uganda: Co mmissioner : Mr. B

Ochieno Del1 Commissioner: Lt. Col. (Dr.) Gideon Bogere.

Wrocs: Lt .-Col. C. P. Vaughan

DSO , to he Chairman of Council.

miles away at home, or perhaps on leave

Also there is the probl e m of obtaining a room in whi c h to hold either practices or meetings , as the accommodation available is always at a premium.

Secondly, the organisation of the department has been far from static. It has suffered from several changes of name, necessitating re-registration of the name of the branch (at pr esent P os t Office

Int ernational Telcgrarh Services). It has also along with the remainder of the General P ost Office come ou t of the Civil Service and is now part of a CorporatIOn ( Th e Post Office).

Thirdly, the situation has heen lurther exacerbated hy the setlll1g up in London of 'Area' Int ernatio n a l Telegraph Offices to cover variOUS main London area. and this has increased immeasurably the strain on the organisers of arranging anything, as each office has its own shift system, staff and travel peculiarities.

Small wonder, then, that the Branch has not heen the most ou tstanding H owever, thanks to the ma rathon efforts of the principal officers, it has been kept running remarkably well in the face of all these adver ities.

Although the members vary Jlmos! annually, most years have seen both a male and a female first-aid competition team in operation and mouerate successes have been achieved.

Training has been maintained at a remarkably high level, a nd an Jverage of 100 first aiders has been maintained throughout the various offices for some

years. For those interested, initial nursing has been included in the courses available and the re-training of members in both subjects has also been a mammoth problem! Re cently courses have been held on an 'own time' basis in higher first aid, and there are a number of qualified lay instructors.

Th.ere have been many obstacles and still are - these are largely met and dealt with in the best way, varying with the circumstances, through the dedication of a few stalwarts to the continued interest of whom the Branch largely owes its continued existence. Believe me, they deserve medals for not having given up years ago!

As a member of both the Brigade and of the P.O Int ernational Telegraph Services Branch, Po st Office Ambulance Centre, my own sincere thanks are due to the Branch and to the Post Office as a whole for enabling me to keep in touch with my first aid whilst shift duties prevent regular attendance at my unifonned division practices.

We now have a full time first aid liaision officer who is part of Post Office structure; he has taken on much of the Post Office paper work formerly performed by the secretary.

Lastly , we as a Branch dealt last year with 8326 cases in the various offices. DUring office hours a state enrolled nurse in on duty at the Head Office Medical Centre.

UNDER SAIL

I hear that one of the boys on the west coast of Scotland maiden voyage of the Adventure Cruise schooner Captain Scott was 17-years-old Errol Cunningham who is a cadet captain of the Prospect Training Centre, Ocho Rios, on Jamai ca's north coast.

Errol is a fully qualified S1. .John first aider (I haven't heard whether his training was needed on the 26-day voyage under sail) and holds a lay instructor s certificate for teaching.

Headquarter's Registrar George Woodhill found a new friend on his visit to Jerusalem last Easter (a rti cle The Holy Land) George, we are sorry to hear, is now down with the mumps. Humps - mumps. Any connection?

The Pr ospect Cadet Training Centre, founded by Sir Harold Mitchell, trains boys in citizenship.

AWARENESS

Ben Jarm an, district staff officer (cadets) (A), West Riding of Yorkshire writes : The scene was one of utter confusion. Two large and ferocious dogs had entered a sea-front cafe and apparently run amok.

Several tables were overturned and broken glasses were strewn about the

ANOTHER SJA FAMILY

floor. Two young people were hurt quite badly and there was a good deal of blood around.

I saw it all happen. A young man who must have known quite a lot about first aid immediately took charge of the situation. And [ heard the questions he asked while he was tending the injured. My attention was riveted on what he was saying and the things he was doing. He got three other chaps to assist him (he must have chosen them because they looked the reliable type), and he gave

UK v. CANADA

each a job to do with such clear instructions that he obviously knew what h e was doing. Had he been a little older, this young man might have been a medical student, for he knew exactly what to ask both the injured and the people hanging around.

WillIe he was tending one of the casualties, who had a nasty flesh wound o n the hea d he asked someone: 'What's ha ppened to the dogs? Where did they go? Have they been caught yet? This was it. Not only was this young first-aider extremely practical, taking charge of the incident, arranging first-aid treatment, giving instructions to his pals to remove bits of glass in case they should cause further injuries to those in the cafe, and

righting the tables but he was demonstrating an awareness not only of dangers which were obvious - those seen - but equally important - those unseen.

In reality, it was the team test for ambulance cadets at the Finals of Yorks No. 2 Region, which were held at Hull during 1971.

The team I was watching with interest turned out to be the Grimethorpe Ambulance Cadets, from the Southern Area of the West Riding District. Their leader (the youngest boy in the team) was Cadet Sergeant Kevin Lyle, 13 years old , who joined the Grimethorpe Division just over two years ago. Their coach was Divisional Officer L. Yoxall, whose patience, enthusiasm and devotion during

special evenings of training has raised such an outstanding team of cadets. It is most useful to have other knowledge and skills apart from first aid , especially in dealing with a casualty found indoors and who may be alone in the house . Awareness is needed , which will cause a first-aider to ask himself almost automatically: 'Has she (the casualty) left an electric iron switched on?' or 'Is the electric blanket on?' 'Was the gas oven turned on but not lighted when the accident or sudden illness occurred?' or Is there an electric or gas fire on , or the TV or a I 00 lather thing s which are potential dangers in the hom e if left unattended. The efficient first-aider with this quality of awareness will find out

CADET TRAINING

the answers to these questions at the earliest opportunity and will know how to deal with them

Remember the question put about the dangerous dogs? It's worth emulating , this 'awareness'

These are some of the many good reasons for taking advantage of our Proficiency Subjects , which should be a must for every cadet division . It is easy to imagine how a subject like Knowledge and Care of animals could have helped in the 'cafe in c ident' , for instance.

Fire-fighting (especially for ambulance cadets) ; the Handyman subject ; swimming and life-saving from water , and map reading and signalling are other obvious skills which may be very useful when it comes to coping with complicated emergencies.

But dogs apart, I suppose fire or an escape of gas would be two of the most urgent things to deal with, especially if there was a seriously injured person in the building. A cadet with knowledge of these subjects could deal with such situations in the early stages.

It was when the team leader asked : 'What's happened to the dogs?' that it was brought home to me that so often at an accident (for real or in competition) we think of just first aid to the injured, and perhaps the immediate surroundings, and give no thought to what's happening in the other room.

Well done , Kevin! You already have this quality of awareness. By your example as team leader, lead others in the same way.

RALLYING

Divisional Superintendent C. H. Carpen ter, Worcester A mbu lance DiviSIOn, tells us:

The Worcester City Ambulance Division, by kind permission of the Priory of Wales, recently undertook an unusual an d very enterprising weekend commitment in the mountains of central Wales at the request of the organisers of the event the Senior Service International Hillrally Have you ever seen the mountains of Wales in pouring rain, thick fog or again in brilliant sunshine, or the rivers Afon Ystwyth, the Wye and Severn as mountain streams gusillng through the rocks, miles from any road, and marked only on the Ordnance map as tracks not suitable for motor vehicles?

Such was the weather and the terrain of the event for which we were to provide first aid cover. The Officer in charge, Div. Supt. C H. Carpenter , decided to leave the division's mobile unit and V W. ambulance at home and take only the L. W. B. Continental Land-Rover ambulance, with a full kit and the Minuteman, especially as we could call if further help were needed on the Aberystwyth Area Ambulance Service and the Helicopter Rescue Service.

Our first post on Saturday was at Strata Florida , about 7 miles from Pontryhdfendigaid, by a rough Bailey bridge used only by the Forestry Commission. The Rally crossed the river and swamp three times in this sector.

Never have I seen motors cut such antics; all that is claimed for Land-Rovers and Range Rovers is surely correct. During the morning session we were astonished to see our Div Officer Terry Wakefield and Cadet Duncan Stock trudging down the mountain track towards us. They had left Worcester at six by Mini-van, trailed us as far as the Mini would go because of the rough track, and then walked the last five or six miles to our post, about 120 miles from home.

After lunch we had to shift to the Dyliffe area, about 35 miles from Strata Florida on the Foel Fadian Mountain. 1856ft high. Our post was on the edge of a quarry over half-a-mile wide and with what looked to be no bottom, with the rally cars running right along the edge of it. We looked in amazement and thought 'If anything goes over there it won't be first aid or an ambulance they'll be needing!' And then , down came the fog.

The cars still slithered and jumped by ; we put our flasher on to give the lads a guidance to the ambulance ; by six o'clock we had accounted for all the cars so we inched our way back to the roads and to Llandrindod Wells for the night.

On Sunday we were back on duty at 7.30am before our hotel had come to life, so no breakfast, and we took up station by a lake and then on to Pawl Hir on the mountain for a fast stretch, where we

suffered a broken half-shaft. However, we carried on with front wheel drive only, and Sunday afternoon saw us back at Strata Florida for the final test.

The rally carne to an end at about 3pm and as soon as we had the all clear, and with the helicopters dipping in salute, we made for home, stopping only for steak and chips, and petrol. We had treated 19 cases, travelled over 400 miles, and as AIM Rich Evans said, 'Blimey Gaffer, what a duty! Are they going to do it again next year?'

TV PROGRAMME

A new series of TV programmes entitled Seventy Plus starts on Monday, January 10 at 7.05pm on BBC-2.

The programmes look at some of the professional and voluntary services which, working in co-operation with family and relatives, help with the problems of the aged. The first part of each programme is film of a particular service in a particular town ; it concentrates on what that service aims to offer and what some of the customers - the over seventies - think of it. The second part of the programme considers the national situation and the variations in quantity and quality of services available in different parts of the country.

CORRECTION

In the Contents of the December Review 'New Commissioner-in-Chief' should of course have read 'New Deputy Commissioner-in-Chief'. My apologies.

A HAPPY NEW YEAR TO EVERYONE !

Bebington Nursing Cadet Division, Cheshire, (left), won the 1971 first aid competition which has been held for three years between U.K. and Canadian cadet divisions. Four Canadian teams took part in Hamilton, (right) the runners up Mohawk Division; seven in Wallasey, Cheshire; and seven in Southwick, Sussex

120 ambulance and nursing cadets from Hampshire were enrolled recently at a service at Winchester Cathedral SJA Commander for Hampshire, Commander E A. Morrison RN, conducted the enrolment (Photo E A. Sollars)

IHI HOLY LAND

CONTINUING THE JOURNEY MADE BY 22 ST . JOHN MEMBERS

LAST EASTER THROUGH THE CENTRE OF RELIGIONS

by Joyce Hamilton

with his hands behind his back. Some of the sheep had worry-beads attached to their tails! J nstead of the traditional flute the shepherd now carries a transistor radio

On Saturday we drove to the Mount of Olives east of Jerusalem The temple area drops 'i nto the deep valley of the Kidron until the slopes of Olivet are reached. In our Lord's day there was a viadu ct across this valley Near to the broad summit of Olivet the road levels out and it is supposed at this point J esus mounted his colt and made his triumphal entry into the city From here we had a wonderful view of Jerusalem . To th e west over the city; to the east across the desolate wilderness reaching to the Dead Sea and the Mountains of Moab Gazing upw ards, one thinks of the Ascension.

conspicous tombs or monuments , one of which is associated with Absolom and the other with Zechariah We then visited the Spring of Gihon (Virgin's Spring), to see the tunnel dug by Hezekiah under the mountain whi c h brought water inside the city to the Pool of Siloam This narrow tunnel, over 1,700ft long , ha s two shafts to the surface, and it is bent probably to avoid obstruction. In 1881 an inscription in ancient H ebrew was found on the walls of the tunnel about 19ft from the outlet into the Pool of Siloam. It tells how , working at opposite en ds , the two groups of workmen managed to meet in the middle. It was to the Pool of Siloam, inside the city walls, that Jesu s sent the blind man to 'Go wash in the Pool of Siloam'. So he went, and wa shed , and came ba ck seeing.

Manas se h who offered worship to Molech by making their children pass through fire For this reason it was defiled by the good king Jo sia h and there after became the tip-heap for the city's refuse. It thus became known as black Gehenna, the type of hell written of by Milton in Paradise Lost

The Assumptioni st Fathers have excavated a flight of ancient steps which lead from the Pool of Siloam towards Mount Zion These slabs of stone may have been ther e in the time of our Lord and this is the shortest way from Gethsemane to the Upper City. They lead in the direction of the Church of St. Peter Gall icantu (Church of the Cock Crow)

AWAY TO THE SOUTH-EAST of Bethlehem are the Shepherds Fields which perhaps belonged to Boaz. There we walked through the yellow flowers of the mu stard seed and the bright lilies of the field , growing where 2,OOO-year-old olive trees stand as in the days of Christ. Wa s

Ruth one of our guide's favourite Biblical characters? He had di scovere d that one of our party's name was Ruth and presented her with a single branch of bourganvillea covered in rich purple blossom and other picked flowers, which resulted in an armful of blossoms being carried into the hotel when we arrived back in Jerusalem!

A shepherd was in the field attending his flock, as one always imagined in the Bible stories. He threw stones at his donkey's feet directing it to round up the sheep. Mr. Elias always carried a string of orange worry- beads , which he worried

We next visited the Pater Noster Church. The present c hur ch was built in 1875 over Crusader ruins and 'Eleona', the first church built on Olivet by H e lena, wife of Constantine in the 4th century. On panels of tiles around the quadrangle the Lord's Pr ayer is painted in thirty- two languages Our Lord taught his disciples this prayer for the second time on the Mount of Olives Looking across the Kidron Valley we saw the blocked up Golden Gate in the eastern wall of the city. This stands near the site of the former Gate Beautiful. The Moslems blocked this gate in order, it is said, to prevent the Lord Jesus from en tering in triumph when he comes again. We passed over Olivet , down the steep, rocky path across the Kidron Valley and came the way Jesus made his triumphal entry into Jerusalem on Palm Sunday.

We arrived at the beautiful Garden of Gethsemane , where Jesus was betrayed. It is an enclosed garden where beauty and pra ce are found amidst a variety of flowers and singing birds. Ther e stand eigh t ancien t olive trees and it is not impossible that they date back to the time of Christ. Passing south through the valley of Kidron we came to four

A little south of the Pool of Siloam the Kidron Valley runs into th e Vall ey of Ainnom. The two valleys meet at what is calle d Job's Well. Here it was that Adonijah, aspiring to succeed David as king , sacrificed shee p and oxen by the Serpent's Stone. On the southern slope of the Valley of Hinnon is Akeldama , the Field of Blo od, bought with the thirty pieces of silver, the price of Juda s' betrayal.

The Valley of Gehenna, at the foot of Mount Zion , is a deep gorge which was used by the apostate kings Ahaz and

The Grotto of Nativity , in the Church of Nativity , Bethlehem

The Shepherds Fields , to the south east of Bethlehem, Shepherds are stili there

The Augustinian Fathers believe that this church of theirs is built on the site of the hause of Caiaphas and that it was here that Peter denied his Mast er. We spent some time in this beautiful ch ur ch and in the caves below which are said to have been guard rooms One pit -like dungeon , reached only by a hole above through which a prisioner was hauled by a rope, is said to be the dungeon where Christ spen t some hours that night.

That afternoon we travelled by coac h to Bethany to visit the chur ch and tomb of L azarus. In the 4th century a Byzantine Church was built to commemorate L azurus and his two sisters, and of this building part of the

Photographs Israel Government Tourist Office

The Mount of Temptation, near Jericho, and the monastery built over the grotto where the temptation took place

apse and mosaic pavement still remain. A second church was built a little later and then a third by the Crusaders. The present church, built in 1953, stands on the foundations of these buildings Inside it contains beautiful mosaic pictures, and one outside depicting scenes in the home of Lazarus at Bethany and the raising of Lazarus from the dead. We went along a rocky path outside the church to the alleged tomb of Lazarus, negotiating twenty-four steps down into the rock. We stooped and entered the gloom, just managing to squeeze through a narrow horizontal aperture.

On we went to Jericho, descending from Jerusalem at 2,300ft above sea level to 1,300ft below sea level. In twenty miles or so the road drops 3,pOOft, but the highway winds like a serpent, twisting through rocky hills and barren gorges with only the occasional goat and sheep in search of grass and the Bedouin with his tent. An occasional stork alighted on the hillside.

Jericho, or 'City of the Palms', was 14

cover the ruined cities of Sodom and Gomorrah. Some of us swam in the sea, crossing the sharp-stoned beach in bare feet. It was an unusual experience and we were warned not to put our h eads under the water. This sea is the lowest point on the earth's surface and is the most salt-saturated water in the world. Here we sa w the Qumran Caves, where a semi-Bedouin boy, Muhammad Adh-Dhib of the tribe of Ta'Amireh, discovered the Dead Sea Scroll, one of the most startiing find s of this ::en tury.

On Easter Day our itinery stated that we were free in the morning. Did this mean that bre akfast cou ld be a little later than 7 am! There was a dawn ervice at 4 am in the area of the Garden Tomb and a later one at 6 30am. At the services the voices of the blind girls of the Helen K eller choir sang melod iously and clearly, as they did later in the morning at the cat hedral.

That afternoon we drove to Mount Zion, visiting the trad itional tomb of King David We ascended from the Valley of Hinnom up long flights of steps until we came to the Coenaculum, or supposed room of the Last Supper.

colourful and green - an oasis in the desert. The old Jericho belongs to the Stone Age, between eight thousand and ten thousand B.C., and its city walls are the oldest in the world so far discovered. They are outside the present Jericho. The air was hot and oppressive. Nearby is the 'Fountain of Elisha,' the spring whose bitter waters were made sweet by the prophet's handful of salt.

A short distance beyond Jericho is the River Jordon. The Gospels give no clear indication of where Jesus was baptised but the place is traditionally located here

Our Lord's baptism was immediately followed by his temptation in the wilderness. His days of fasting took place on the mountain of Jebel Qarantal , which rises beyond old Jericho. Over halfway up this mountain and built partly into the rock is the Greek Orthodox monastry said to be built over the grotto where the temptation took place

Not far from Jericho the River Jordon flows into the Dead Sea. This desolate slate-coloured stretch of water is said to

Lebonah and Sheckem. After the Northern Kingdom had fallen to the Assyrians in 722B.C. the Israe lites who had not been taken away into captivity int erma rried wi th the Assyrian co loni sts, forming a mixed face of Samaritans. Nehemiah and Ezra , in their zeal for racial purity, rejected the offer of these Samaritians to help rebuild the Temple of Jerusalem. The Samaritians never forgave lhe Jews for this rebuff and built their own temple on Mount Gesizim about 432B.C. Although this temple was later destroyed the Samaritans continue to worship on this spot. A week before Passover the whole Samaritan commu nity camps out on the top of Mount Gesizim near the site of the old temple and to this day sacrifice sheep th ere. They are a tiny dwindling community, physically weakened by intermarriag e, yet regarding themselves as the only true Israel.

Sebastia, a few miles north west of Nablus , has been in habit ed since the Bronze Age. It is said to be the site of the burial place of John the Baptist.

On we wen t to view the Dead Sea Scrolls at the Shrine of the Book In the spring of I 947 the Bedouin shepherdboy dis covered a cave at Qumran containing light eart henwar e jars. In side the jars he found bundles of parchment wrapped in linen which turned out to be ancient Hebrew manuscript. Gradually the histori cal worth of these manuscripts became most significant as scholars began to study them. They were found to contain complete manuscripts of the Books of Isaiah and a co m men tary on the biblical book of Habbakuk (Jewish prophet of 7 BC). Since, the fragments of every book of the Hebrew Bibl e have been identified except Esther. The State of Israel has acquired several of the scrolls. The Shrine of the Book has been especially built and cleverly inspired to house the Dead Sea Scrolls and related finds.

Ein Karem, just west of Jerusalem , is a pretty hamlet where John the Baptist was born to the High Priest Zacharius and his wife Elizabeth.

We were invited to tea that day with the 'Archangel Gabriel' and his wife Delia. We met their delightful children; Belinda (aged 6 years) graciously entertained us with a solo dance to Arabic music, and was eager to hand to each of us a scroll stating we had visited Jerusalem. We learnt that we wer e the first British group to be handled by the agency since the six day war of 1967

After dinner we went off for a chat with our friends in the book shop opposite the hotel. Oh for a bottomless purse , a greater weight allowance on planes, and more time for reading!

On Monday we drove north in the pouring rain through the plains of

We came to Nazareth, visiting the boyhood home of J esus. At the church of Annunciation, we were told that it was built over a grotto where the Angel Gabriel is sai d to hav e mad e the announcenent to the Virgin Mary that she was destined to be the mother of the Messiah. The present church is new. The one built in 1730A .D. had been removed. The excavations for the new church revealed remains of an earlier church built by the Crusaders. It is strange to think that here Jesus reminded hi s own townsfolk that a prophet is never honoured in his own country

The Lake of Galilee usually reflect the deep blue of the sky but the rain eased only for a little as we tepped out of the coach and dashed into a lakeside

We were given an adequate meal of fISh caught in the lak e and served with a salad. The fish is called Peter's perch because of the rna rked pouch under mouth which held the coin that Peter found there to pay the taxes. The two most adventurous of our group i)wam in the Sea of Galilee in spite of the rain.

Tiberias, the only town on the lakeside today, was founded by Herod Antipa 18 to 20A.D., naming it after Tiberius the Emperor.

On our homeward jo urney the rain eased and at last we co uld see the beautiful countryside. On most of the we had peered through coach wwdows beaten with heavy

So we came to Cana , a small squalid village where J esus transformed the wa ter Int? wine There is a Franciscan church built. over the supposed site of the marnage feast.

saw the Mount of Beatitudes , the tradItlOnal site of the Sermon recorded in Mathew 's Gospel. The arms and points of the Cross of St. John are associated with the cardinal virtues prudence,

temperance, justice and fortitude and the eight beatitudes

Mr. Elias was determined that we should visit Ja cob's Well at Sychar. Even though the gates were closed to the public he managed to rouse the warden and gain entrance for us. The rain had stopped. It was her e that our Lord met the women fron Samaria. This site of Jacob's Well is truly authentic. It is located in a dark crypt of a church and is by ico n s. In the 4th-century a Byz ant111e chur ch was built over the well whi ch was damaged and fell into decay.

The Crusaders built another churc h there which wa s destroyed, but in 1860 the Greek Orthodox Church gained

We returned to Jerusalem We

who hav e visited Jerusalem are now Hadjis The name also applies to a Mohammedan who has visited Mecca. He is .received as a wise man. We may not be WIse men or women but none of us will forget the deeply moving experience of reliving the scenes of the Bible in the Holy Land , brought alive by our very competent guide and mentor Mr. Elias.

Mary's well at Nazareth of the ruins, restored the crypt and 111 t 914 began restoration of the Crusaders church.

Christians

Books referred to: The Dead Sea Scrolls by John Allegro. In the Holy Land by C. R obinson and Stephen F. Winward.

The St John party, now Hadjis, home again. More tours are organised for 1972

APPEAL

from Dr. D. Hardy Kinmont, area commissioner (rtd.) I have just received by December copy of 'The Review'.

I was most disappointed to learn that our much publicised Christmas Day TV Appeal is to be pu t on at 11.40am. This of course is in the middle of Church time and means that I and many others like me, will not be able to watch it

I should have thought that on such an important occasion , the Appeals Committee or someone with more weight could have pulled a few strings and asked the BBC to let the appeal be shown at a time when everyone would have a chance to see it.

I sincerely hope that the public will respond to this most worthy cause.

Southwold, Suffolk D Hardy Kinmont

MY A FT E R CA RE from Mrs. Christine Witterick With reference to the article entitled After Care n the November Review.

Although I do not have the technical qualifications of Miss Morris, I do have considerable practical experi e nce of the problem, having been happily married for the past ten years to a paraplegic. My husband was injured in a very similar accident to Mr. Smith's, the spinal cord being severed between the 5th and 6th cervical vertebrae. This allows him slightly more movement than Mr. Smith and in spite of the fact that his hands do not work at all and that technically he cannot raise his arms above shoulder height, with the aid of trick movement h e is able to shave himself with an electric razor, brush his teeth , comb hi s hair and wash his hands and face.

During the early period I did have to get up during the night to turn him, but over the years with the help of extra pillows , pads and an air-ring we ha:ve devised a method of posit io ning whi c h allows him to remain undisturbed for eight hours , thus ensuring a full nights rest for both of us We have a normal double divan-b e d with a spring interior mattress. Apart from the obvious problems of avoiding pressure sores and the problems of coping with spasm (he is also on valium), my husband has the additional hazards of a scar from a plaster sore on his sacrum and an eight-inch post operational scar on his left hip. During th e past ten years he has never had a pressure sore.

I would not deny that restrictions to ones social life are inevitable, but I do feel that the avenu es that r e main op en to one should be explored to the full. I am an area nursing officer in St. John and my husband accompanies me on most of my visits official or unofficial to the numerous divisions in my area. He is very popular with the members, particularly with the cadets with whom he seems able to form a special relationship I quote this as one example of the many activities in which he is involved.

I disagree entirely with the statement that there is most hop e for those who never totally accept; It is my firm conviction .that those who do accept , and concentrate 100% on making the mo s t of what they have, will achieve far more than those who live in hope of the miracle that never comes. I am sure it serves no useful purpose to encourage a patient to hope for the impossible

Please may I appeal to all those readers who may have b ee n influenced by the suggestion of putting zips into pyjama trouser seams of a paralysed patient who has no feeling to refrain from doing so. While thi s practic e may be useful for clothes worn over calipers or plasters , I c an think of very few things more ca lculated to induce sores in the paraplegic In my experience , whi ch is not limited to my husband , I have n ever known a paraplegi c who wore pyjama bottoms in bed.

While I can see no problem with the use of urinals in bed , bed pans for paraplegics are totally useless and positively dangerous. The only method which works in practice is a regular digital evacuation which in time proves to be 99 % safe and effective.

Incidentally , if Peter wears a bag during the day, why does h e not make use of a night bag or a glass urinal during the night ?

This would remove the need for a nappy whi ch can only hav e a detrimental effect on a boy of ten and a lso help to so lve the problem of soreness

16

READERS VIEWS

Readers' views and opinions, which should be sent to the Editor, although published are not necessarily endorsed by the Editor or the Order of St John and its Foundations Although readers may sign published letters with a pen -name, writers must supply their name and address to the editor

Why is Mr. Smith n ot transported from his bed to a suitable wai t ing wh ee lc hair ? Thi s w ou ld at least allo w him to be move d from room to room, and eve n into the garden or street. H ow soul destroying it must b e to liv e, eat and slee p perpetually within the co nfines o f a few square yard s. Wh o would not become morose and uncommuni cative i n su c h a situation?

No one a ppr eciat es mor e than myself the problem s an d diffi c ulties of co ping with a d isa bl e d person , and my un qu alifie d a dmiration go es to those who d o manage so well , often in far more diffi cu lt cir c um stances than my own. I do realise how lucky I a m to h ave suc h an exceptionally well-adjusted an d remarkable person as my hu s b and.

In conclusion may I suggest that many people in a similar situatio n to that of Mrs. Smith might very much a ppr eciate a few hours each w eek when they co uld l eave their di sab ed relatives in the care of a r espo n si bl e person thu s enab ling them a sh ort period of relaxation free from constant w orry. I h ope this may provid e food for thought for many SJAB members.

St Columb , Cornwall Christine Witterick

OLD PROBLEM?

from K. W. Simmonds , divisional superintendent

Congratulations to the London Di strict officers on their c h oice of subject for their l ea dership co urse. I feel sure, h o w e ver , t hat they wer e fairly certain what the result of th e disc u ssions would b e. Every year at Nottingham or wh ere ver ca d et office rs get together , the que stio n s of transfer or n o n transfe r , t o th e adu lt division s are di scusse d tog et h e r with ways of sto pping th e l e akage from ca d et divi sio ns, an d th e results are alwa ys th e same.

We know what ca u ses t he leakage. The r eal pr ob le m is what ca n w e do about it? Every tim e th is subject is brought up someone says it is a n o ld problem, but if so m et h i ng had b een don e about it year s ago it would not be a problem today.

Several c ountie s have differing forms of adventure training, a ll meeting with variou s d egrees of effectiveness, but all units hav e the advantage that th ey co nsi st of a larg e number of boys and girls in the older age br acke t parti ci pating in for m s of adventure training not pos sible for younger childr e n With a numb e r of older childr e n under the c harge o f a

forwar d-looking leader there is n o doubt that a large amount of officer material would be availab l e In a few years time.

[t is necessary for the Brigade to recognise the need for such training, otherwise counties will f orm breakaway groups, all sporting different uniforms, who will not be recognIsed ?y ·the public as members of St. 10hn. We already have the organlsatlOn for dealing with this section SInce every county should have area and co unt y staff officers (cadets) who are officers specially picked for their ability t? .deal cadet ,:",ho could now provide the addItIOnal traInIng that IndIVIdual dlVlSlOns are unable to provide.

It is vital that persons participating in such training should sti ll belong to their own divisions, but one or two persons from each division would be able to gel together to form a group of persons of a like age who wou ld by the fact thaL they had a common Jnterest stay on to be our future officers.

Ken SImmonds

EaslbOLlrne

COMPETITIONS

from Miss M. Lawton , B EM, a r ea staff office r (N) IIaving read in the Review the various articles on competitions 1 thought Mr. J. R. Davis summed up the situation very well. While 1 agree with Illany of his observatIOns, I cannot wholeheartedly agree with all.

Per onally I feel the present technique IS one whIch WIll be difficult Lo better.

The well-tramed team will conSIder the casualty In spite of the tIme limit and I do feel that lTI may competItions ktnd remarks, etc, to the casually are never heard, thus it is assumed that nothing has been said. T was under the impression that all casualtIes were questioned as to the general handling and comfort of the treatment applied.

'POInt grabb1l1g'. Yes, It IS done, Jnd what team wouldn't do it anyway. I recall the Brigade Finals IJ1 1956 when we were faced with the lift operator trapped by the gates and had been there for a 'long time'. He was lying face down and trapped by both thighs. Hi gh marks were given for diagnosis of shock, comforting words,

HEY-WATCH IT!

and the treatment for crush injuTles. On release fractures had to be dealt WIth and we did not get the casualty Into the ambulance, which caused our supporters a lot of worry. When the mark sheets became available we lost only three marks for not getting the casualty into the ambulance, but gaIned many others for treatment and we were the wInners.

All Finals tests have been wonderfully staged and if a team uses something detrimental to the casualty they should get a penally. 1 remember our ambulance divislOnal leader refusing to use a door for transport of a fractured spine in his opInion the door was too short but other teams used it. The result was our team lost the day and the final round in the competition.

1 he sprained ank le. I s it, or is it not a fracture? It would appear that some judges use it as a red herring and hope the competitor wIll fall Into the trap, and yet, faced with the same problem they would have a X-ray done.

The mark sheet with '1 note'. 1 would agree WIth thIS, as to me it IS the first aider's mind workmg and on an accident we would note mentally all the things we voice in competitions.

Questions to the judge, no, apart from eyes and control of bleeding. A team leader will talk to his/her team and so much good work can be done through this.

Again I think all finals tests are set out so well that approach, examination, diagnosis, treatment, and disposal are marked very well and all the powts Mr. DaVIS makes are well covered. Perhaps some of the preliminary competitions do not follow these lines at all.

The casualty should be the best first-aider available. He will then moan at the correct time to rough handling, etc.

Bl ock marks I do not like, because if one gets 5 out of 10, for say the treatment of a wound, one never knows where the bad work came in unless it is written on the mark sheet. Perhaps It does mean more work for the judge and more work 111 preparing the mark sheets but I feel it is worth it If a team has a bright thought. which is not on the sheet but is considered good. there are usually marks for general efficiency which covers this.

Good, well-staged competitions are the best grounding for the

Kent cadets ID tralDing for who know -? Judo classes, taken by Mrs. 1. Robertson, dIviSIonal officer of SIttingbourne urslDg Cadet DiVIsion, who represented Britain In the ladlcs European Judo champiomhlj1s, were included ID a recent cadd training weekend at Dymchun:h ew Beach Holiday centre fhe weekend also included films, lectures, a sWImmIng gala in the indoor heated SWImming pool. u discotheque with hot dogs and coke, and competItIons. The 160 cadets, officers und friends present seem to have enjoyed themselves including from the picture Mrs. Robertson.

Photo Kent Messenger

'real thing', and while there are many who say that good competitors are useless 'on the field', I would not agree with this. I have spent a number of years in the competition field and ten seasons in industrial first aid, and without competition work the latter would have posed more problems than it has done.

Our finest critics are those who sit in 'the stalls' and are always able to tell you exactly how you should have done the test. Perhaps they have never been 'on the floor'

The aim of first aid is to dispose of the casualty as soon as possible, in order that he may be in the hands of those with higher qualifications than ourselves. The IS-minute team test is a good example of this. Beyond that time, apart from resuscitation, any work we attempt can only be meddlesome first aid in many cases.

There will, I hope always be those willing to compete and so learn how to work quickly and gently

In conclusion, our thanks are due to the many doctors and nurses for giving us their time, not only on the day of the competition, but in preparing the tests and their tolerance of our endeavours. Also to those many people who are responsible for the Brigade' and other Finals, and the preliminary rounds prior to the 'Great Day'.

Spalding, Line. Mary Lawton

FRUSTRATING

from Miss Jacqueline Sampson, nursing officer

By adhering to the rules and regulations of St. John , I find it very frustrating to maintain an efficient membership and at the same time venture into new fields of knowledge or higher ranges.

I am referring to the first-aid and hom e nursi ng requir ements for adult nursing members. Once these two certificates have been obtained within 12 months of each other then re-examinations are necessary preferably with a refresher course in 2 to 3 years, thus allowing time for instruction in child welfare, hygiene or advanced first-aid and home nursing.

Written in books, this idealistic approach to training together with time to train for competitions, visits of observation, or social and fund-raising evenings, is fine BUT consider an average Brigade unit who meet once weekly for 1 Y2 to 2 hours The membership is not always static, since (I hop e) new members arrive at different times of the year, and each member has to meet the requirement of 'the bible'.

Consider also members 'staggered' holidays together with Bank holidays and summer recesses, and it is soon obvious that the best time for running courses is Jan to April or Sept. to Dec, especially with an 8 to 10 week course.

From this attendance pattern emerges the nightmare leading to the frustration which many officers are experiencing due to the constant courses of first aid and home nursing repeated year after year to the boredom of everyone concerned.

The answer, of course, is to have a differen t course running simultaneously in another room, but how many divisions have another room available?

My solution would be to retain the annual requirements for first aid but lengthen the gap between the initial course to 2 years, thus allowing the freedom to co ntinue and encourage more in terest in all aspects of S t. John work A typical four years could then be:

1 yr. First Aid and Home Nursing

2 yr. Child Welfare and First Aid

3 yr. Home Nursing and First Aid

4 yr. Hygiene and First Aid

First aid is held annually as necessary but home nursing bi-annually.

I should very much like to konw what others in a similar position to myself, and of course cadet officers, have to say about this suggestion. Longton, Staffs. Jacquelin e Sampson

NOT PEN PALS

from E. T Carroll

Early this year ( sent a list of people who would like pen-friends, 18

which was published in the Review What is di sap pointing however , is that no overseas divisions , or for that matter local divisions, have followed up this idea.

From the original letter on this subject published earlier, we got a good response, but this came from two areas only and not from the whole of St. John in Britain as we had hoped.

We in New Zealand are wondering ther efore if the majority of ca dets and seniors are just not interested in this proposal of corresponding, or are they just too plain lazy to write?

A uekland

VISUAL AIDS

Teaching Slides

E. T. Carroll

Ed: Ideas, alas, do not often immediately bare fruit. They must be tempered with mulish obstinacy.

GRAND PRIOR'S BADGE

from John A. Alderson

My idea for a certificate to accompany the Grand Pri or's badge is:

ST. JOHN AMBU LANCE

CADET. Miss Dolly Right The Right Division Right Town. SUR REY

I has been brought to my notice that you have performed outstanding good service, and shown great Devotion to Du ty.

I award you this Certificate together with the Grand Priors Badge, as a token of my appreciation and have given instructions that this shall be noted in you r Record of Service.

Date The Lord Prior

This could be signed by one of the following: The Queen, Princess Margaret, or the Lord Prior R eigate, Surrey John A Alderson

RESPONSE to req uests received from teachers of first aid, the Medical Record i ng Service Foundation has recently produced two sets of teaching slides. These slides are by no means a comprehensive collectIOn and no suggestion for treatment are given, but they do however demonstrate a variety of injuries which any first-aider may be confronted and some of the traps for the unwary.

These slides are photographs of actual injuries treated at the Birmingham Accident Hospital and are re-produced by kind permission of Mr. P. S. London, MBE., MB., BS., FRCS., LRCP., who is, of course, a member of the St. John Ambulance Medical Board.

FILMS

Teaching Slide Set. 28 (T.S. 28/71)

This series of 41 s lides shows pictures of serious injuries meant for exhibition to advanced first-aiders: special note must be made that some of these slides are very gruesome viewing and that they should be screened solely to selected audiences. The series includes fractures, crash injuries , bleeding, stove-in-chest, industrial injury, head and abdominal injury and motor and motor-cycle accidents.

Teaching Slide Set. 30 (T.S. 30/71) The Visual Aids Committee working party felt that some of the slides notably fractured zygoma (12), head injUry (16), shattered ankle (22) are a little confused and that once again, the colour is not perfect; nonetheless, this teaching set is strongly recommended as a very good acquisition specifically for the in tructor who wishes to build his own collection.

This set includes fractures, industrial injuries, dislocation of the elbow and shoulder, head injuries and injuries due to motor accidents. Of the 28 slides, the Visual AIds Committee working party considers about 15 to be first class,S to be of fair use and the remaining 4 a shade confusing. The colour too is not all that might be expected possibly the photographs were not taken at the stage at which an on-the-spot first-aider might be expected to be present. The shade of blood on the slides, for example, is somewhat on the brown side.

Price. £4.92 mounted plus postage; £3.28 unmounted plus postage. From: The Medical Recording Service Foundation Kitts Croft, Writtle, Chelmsford, Essex (Phone 0245. 421475).

Nonetheless, this set is recommended as a valuable teaching aid. These sets may also be hired for a maximum period of 14 days at a fee of SOp each plus postage - usual MRSF service.

Price. £2.88 mounted plus postage; £1.92 unmounted plus postage.

The St. John Ambulance Film Appraisal Panel which meets fortnightly at Headquarters, consists of doctors, first aiders and visual aid experts who offer their services for this important aspect of visual aids. It is intended to publish monthly reviews of those 16mm films recommended by the panel.

FIRST AID FLASHES (1971) (Colour 12 mins)

Distributed by : H Q St. John Ambulance and British Petroleum (U.K.) Ltd

Produced by : B.P. (Australia)

The six below named fla he are each of about :2 minutes in length.

'If only I had Known What to Do': a trained first-aider applies his skills to a road accident victim. 'A Bum's Best Friend': cold water treatment applied to various cases of burn. 'Coma': checking the airway and placing the unconscious patient in the recovery position. '240 Volts': artificial respiration and closed chest cardiac massage applied to a home accident casualty. 'Only Ten Pints' the treatment of haemorrhage - direct pressure. 'Please Don't Move Me': the treatment of fractures with emphasis upon treatment of the fractured spine

The panel was,very impre sed with the e ix flashes, They are excellently produced, the colour is very good and the length perfect for a flash. These filmlet present basic first aid concepts an d will have a great impact on laymen; from a medical view-point they are accura te and up-to-da teo

These flashes are perfect for exhibition and PR ituations and also will have great value for short course revision purposes. Audience: Universal.

VENOMOUS SNA KES (1950) (Colour 15 minsl.

Distributed by Wellcome Film Library, 183 Euston Rd London, SW1.

Produced by Wellcome Film Library.

A general discussion of venomous nakes which, by means of diagrams and pictures of living snakes, de cribe their characteristics, the venom and their effects, and the treatment of snake bite.

The panel considered this film even though in age it has reached its majority, to be an excellent production with beautiful snake photography. However, it is addressed to a specialised rather than lay audience and the first aid treatment of snake bite portrayed although accurate is not of great length. Audience: Advanced first-aiders in tropical and sub-tropical regions.

ROOM FOR HYGIENE (1961) (Colour 16 mins).

Distributed by : Central Film Library, Govt. Building, Bromyard Ave , London , W3

Produced by : Unilever Limited

This film shows the harm which uncontrolled bacteria in the home can do, and the various simple ways in which the danger of contamination an be reduced to a minimum.

The panel considered this film till to have great value. Its presentation of bacteria in the kitchen i tartling and the film i competent ly produced. Useful as a programme 'filler' and specifically prior to hygiene courses.

ANTISEPTICS IN HOSPITALS (1970) (Colour 18 minsl.

Distributed by Imperial Chemical Indu tries, Millbank, London, SW 1.

Produced by Imperial Chemical Industrie

The film stre ses the importance of the use of antiseptics in a hospital, and by showing examples of preparation of the skin for urgery and the washing of lockers and bed frame, demonstrate the suitability of the sponsor' own antiseptic.

The panel considers this a well-produced film that makes its point with both force and clarity. It is up-to-date and factual although, in e sential, it is an advertising film. udience: To workers in ho pital environment but aloha application to home nursing.

NEWS from SCOTLAND

Pr

iory

OUR A NUAL REPORT and accounts

are to be published in a more ambitious form from now on, because of a decision made by Priory-Council to follow the same practice with regard to publications as the English branches of the Order. Future reports will contain sections on the history of the Order in Christendom and in Scotland and a description of the work we now do. They will be amply illustrated

Torphichen

On November 12 a very successful wine and cheese party was held in St. J ohn's Hall. The Chancellor, Sir Andrew Murray gave a talk about the work of the Order; and the party raised no less than £105. Members of Torphichen plan to hold a candlelit carol service in the church on Decem ber 23. Next year the)' are hoping to acquire a site and to draw up plans for the Young People's Home they want to establish.

Publicity for the Review

We have been able to get from the

editor back-numb e r of the St. John Review which are being circ ulated throughout the branche s of the Association in Scotland with a view t o increasing the numbers of subscribers. It has become increasingly clear that, in spite of letter to the co mmitt ees and r e feren ces in pu bl ic both by th e Chancellor and mys e lf to the importance of the R e view, a lot of memb ers of th e Order and the As ociation do n ot even know of its ex isten ce. ] t looks as th o ugh t here has been a break-down in communication between those of us inter e sted in this matt er and o ur members, and this may partly explain why I still find great difficulty in extracting information about what i going on in Scotland. ] readily admit that I myself must be partly to blame for thi lamentable tate of affairs, but it also underlines a very unfortunate fact: while r have orne conscientious correspondents, there is still among some Scotlish members a r efus al t o take the publicisation of our activities seriously. I have already fu lm inated against thi in

WALES

DURING the past six months four events have highlighted the activities of the St. John Council for Pembrokeshire.

In May, the Council presented an ambulance to the Newport Division. A congregation drawn from all parts of the county attended a service in St. Mary's Church, Newport, following which the presentation was made by Mr. Ri chard Hayes, Chairman of the Council and the dedication performed by the Rev. D T Owens. The am bulance has already proved its worth in this busy holiday area in dealing with over fifty casualties. It is also a focal point of interest, particularly for the cadets of the division.

I n June the Annual Service of Thanksgiving was held in the ruins of the Old Church at Slebech, a place which has been associated with the Order since the twelfth century and was in fact the only house of the Order situated in Wales. The natural beauty of the site provided an impressive setting for the service which was attended by ,250 people mcluding the Lord Li eutenant of P embrokeshir e, Col.

The Hon. Hanning Philipps MBE , CStJ, JP. Music was provided by the Pembroke Borough Band and the preacher was the R t. Rev E. M. R oberts MA the newly installed Bishop of St. Davids.

20

In July a barbecue was held at the house of the chairman at Cosheston. Plans for the evening in this delightful riverside setting included f]oodht bathing and tennis and dancing in an old bu t tastefully decorated barn Unfortunately fate was not kind, after days of gl orio u weather it chose that evening Lo produce torrential rain and one of th e most spectacular d is play s of lig htnin g seen in the area for a long time. This led to a complete electrical bla ck out but fortunately an ample supply of candles was available. The barn was large enough to accommodate all th e gu es ts and the gallant cooks, in no wit dismayed, carried on under the canvas sheller and produced the most delectable food. Despite nature 's contrariness, the evening was a great success and raised £ 193 for Council funds.

One more fund raising activity took place in August. By kind permission of Lady Dunsany, a fete was held in the grounds of the ancient castle at Manorbier. This time the weather was good and the event attracted many holiday visitors who quickly cleared the produce offered on the stall s run by members of the Brigade and other helpers. County funds benefited by .0 14

print and 1 do not want to become a bore about it, but Jusl do not know how otherwise I ;)111 going to persuade pe op le that th e R e view whi c h i s after all only a mean s by wh ich o ur mem beTs can inform each other about their activities i vital to us. To sit on one's own pat c h , oblivious of and unint ereste d in what IS going on el sew h e re, i t o be comp la cent because t implies thaI o n e thinks o n e ha s nothing to learn and will ea d, a s ur ely as night follow , day to a d ec line in sta ndards of se rvi ce because one IS n ot open to th e c hall e ng e of those new id eas and approaches that hClv e been tried e sewhe r e. I have no compu n ction 111 sayi ng that I belIeve that every member of the Order and th e ASSOCiation s hould at l ea t have the opportunity of reading the Revi ew each month And If Cl member of our Ord e r sho uld know what others are doing h e s hould also inform th em about his activities: otherW is e the traffic in id eas is merely one-way. 10 be f)"-A I to th e achievements of ot h ers and DUHB about one's own is t o be BLIND to the pos ibilities of improvement And make no mistake about it. the on ly people who in the e nd will s uff er are those whom we are privil eged to se rve the s ick an d the poor.

Overseas News

CANADA

GIBRALTAR

Gibraltar's connection with the Ord e r of St. goes ba c k to the 16th-cen tury wh e n the Knights had a property on the Ro c k including a the ite of whi c h has only recently been Identified.

More recently work was tarted in Gibraltar Sl. John :'mbulance Association in has c ontmued With varying degrees of enthUSiasm eve r since.

Both Sir Otto Lund and Lad y Mo un tbatt en, Commissioner-in-Chief and G Supenn tenden t-in-Ch ief of the Brigade visi ted Ibral tar seve I ..' rat I m e s g I V I n g g r ea t e7couragement to work here. So it wa a W p easure to wel co me Rear-Admiral R S ellby th I when' e Deputy Commissioner-in-Chief, Exc IJ he amved to stay as the guest of His S' ency the Governor, Admiral of the Fleet II I aryl Begg during October.

10 In three days the Rear-Admiral met ca autho fltl es and the St. John Co 1 discussed at I un c I, J h I ength the site of a possible I o n leadquarters, presented awards and

inspected th e Polic e and Fire Brigad e Divi s ion s and the Cadet Ambulance and urslng Divi ion.

Watching the demonstration of first aid by the Centra l Ambulance Division Rear-Admiral WeBby remarked that the stoical ilent endurance of th e lad acting as the casualty robbed his helpers of any c hance to co mfort and reassure him as they should have done.

Admiral WeLiby was most anxiou to see the rai ing of open divisions here, and either the reviyal of the nursing divi ion or the creation of a mix e d divi sion in which people from different walks of life could work together in th e interest of first aid and the alleviation of suffering

La c k of premises ha long hampered th e work of the Brigade in Gibraltar but now it i hoped thai a t. John headquarters \vill soon be built at Montagu Bast ion. Portifications having been very mu c h the concern of the knights of old, it is fitting that our sile shOUld be on top of one of the strongest bastions defending th e Rock when besieged in days of yore.

D. M. Ellicott

A mock up casualty in the demonstration given by Gibraltar's Fire Brigade Division during Rear Admiral Wellby's visit

(Above) At the proposed site of SJA Gibraltar's new headquarters L to R) Mr C G Gaggero, Chairman St. John Rear Admiral Well by, CaPt. W H K Hoare

News from the Divisions

At the annual inspection of Darl i ngto n divisions Area Commissioner P. Blunt presents a Long Service medal to Divisional Officer K. B. Settle

Kettering mixed cadet team won the Northants Stone Cup for 1971

Transferring to the reserve after 30 years in the Brigade Mrs. Ethel Maslin (left) is presented with a teamaker by Mrs. Deadman, divisional superintendent, with Mr A. Wall superintendent (Photo: Herts Advertiser)

Johanniter Unfall Hilfe members from Celie, Germany, who have been visiting Richmond, London, Division present a picture to Div Supt. George Healy (Photo: Times Photographic Service)

DERBYSHIRE -Derby Nightingale Ambulance Cadet Division prides itself on being a lruly mulLi-racial division. Under Div. Supl. Bell, a thriving group of boys of English, Jamaican, Indian and Pakistani nationalities all work happily togethcr in the cause of St. John A an area staff me e ling at Bol\ove r NCB IIQ during Octobcr a presentation wa, made to the former Area Supl. L. E. Hetchcr, to mark his promotion to County P.R O. in the spring of ast year. lIe received a 400 day ciock for Mrs. Flet c her and a radio set and a pair of binoculars for him se lf. Area Commissioner D. Jenkins, maklI1g the presentation spoke of the work of Mr. Fletcher in the N. Derby hire Area over the last 19 years In reply Mr. F letcher said he had enjoyed every minute of it, but added that he could not be a uccess as P.R.O. unle he was given information from all parts of the county and he hoped this would be forthcoming.

As part of the 1972 Jubilee Celebrations for the cadet movemen in Derbyshire, Bakewell, Buxton, Matlock, Dronfield, Staveley, Tideswell, and Glossop have all agreed to have speciaJ flower beds arranged, and Buxton have also arranged a com petllion among cadets for the best de ign for a flower bed.

Speaking to the annual county conference of the Brigade, and association held at Che terfield on Oct. 3 1 Lt. Gen. Sir William Pike said the numbcr of Grand Prior award granted last year to Derbyshire ambulance cadets was the highest in the country. lie was especiaJly pleased with this achievement as it showed that Derbyshire was assuring the con tinued uccess of the movement by a strong inflow of youngsters. He urged aJi adult members to fight' for the retention of the .e young peoplc by reviewing training and operational programmes to make them as interesting as possible.

On Novem ber 13 a one-day conference for SENs and SRNs of the Brigade in Derbyshire (25 attended) was held at Che tcrfield, the first time that such a conference had been held. It was organised by the coun ty nursing officer Mi ss E. Horton, matron of the Royal Hospital, Chesterfield.

SJA Langwith ce lebrated its 50th ann iversary with a special dinner and presentation of awards attended by 130 member, wives and guests on November 20.

LINCOLNSHIRE-At the county training day held during Septem ber for officers, mem bers in po ssession of valid home nursing certificates, and ay instructors, Dr. E. C. Dawson MB BS, area surgeon London District (Prince of Wales) S - E Area, chairman of Casualties Union, Mrs. e. M. Stretton SRN, RCNT, asst. area nursing officer Miss. M. Murphy MBE, senior instructor and Hon. Gen. secretary Casualties Union With members of the team, gave lecture demonstrations. The theme of the lectures was the use of the trained casualty in the tea c hing of first aid and home nursing. The aim being to show that the trained casualty can be used at divisional level by the officer to make teaching more meaningful.

LONDON- 'One of the happiest events in the St. John year is the great family feeling found at the annuaJ presen tation of awards', so said the Commander of London District, Group Captain Gordon PiIie CBE, DL, JP , in his introduction to the ceremony held at the Priory Church, C1erkenweU during November. On this occasion 55 service medals and an equal number of Service Bars were presented by Rear Admiral Royer Dick, CB, CBE, DSC, c hairman of the St. John Council for London, in front of a large audience of members, relatives and friend.

Among the high ligh ts was the prese n tation of the Meritorious Service Certificate to Sergeant David Bouchard of the Hackney Division who 'i n total disregard for his own safety' wen t to the rescue of a man completely enve lop ed in flames as the result of cutting an electric power cable with an axe. The final recovery of the patien t was greatly due to the action of Sergeant Bouchard who also suffered bums.

YORKS-In recognition of 50 years service, reserve divisional officer G. W Midgley , of the Brigade was presented with a clock at the Brigade's Scarborough headquarters recently.

Mr. MidgJey (68) joined the Armley and Wortley branch of the brigade in 1921, became a corporal in 1933, and was transferred to Scarborough in 1938.

He was promoted to ergeant in 1947, was divisional secretary from 1949 to 1953, and was promoted to divisional officer in 1949. Last year he became reserve divisional officer. He was admitted to the Order of St. John as a serving brother in 1956.

At the end of this year Mr. Midgley will receive the seven th bar to his service medal awarded to him after 15 year service in 1936:

Tribune)

REVIEW CROSSWORD No.1 (72) Compiled by W A. Potter

ACROSS

1. Post-operative exercise useful for divers? (4.9) 9. Pituitary disorder tending to make one a great person. (9) 11. Less superficial in first part of nerve. (5) 12. Overdressed dandy from female out-patients. (3) 13. Sound of muscle? (4) 14. Six going around ill in small intestine. (5) 15. Spleen of client who has 10 t head and tail. (4) 18. Scale to use for milk sugar. (7) 19. Considerably lessened by a partial gastrectomy. (7) 2 O. oisy breathing of patient in apoplexy. (7) 23. Baby unborn after 280 days pregnancy. (7) 25. Railway in early stage of tuberculosis. (4) 26. What one would be without blood? (5) 28. Was conscious of material used by chiropodist. (4) 30. Fear of Scottish loch. (3) 32. Physician, remembered for his nodes, changes roles. (5) 33. Press suit for respiratory tract infection characterised by its noise. (9) 34. Surprisingly, not a school for studying anatomy of upper limbs. (7.2.4)

DOWN

1. Rapid control of auricular fibrillation beginning with arteries of fingers and toes. (14) 2. Aimed at improved well-being of future generations. (7) 3. Hard connective tissue. (4) 4. Large , pretentious building. (7) 5. Dedicated buildings where the hair begins to go grey. (7) 6. Regulates the amount of light entering the eye. (4) 7. Giving a malformed tissue in 16 Down. (7) 8. Chronic chest condition with copious putrid sputum. (14) 10. Colloidal dispersion in diatonic scale. (3) 16. By which 29 Down medicines are taken. (5) 17. Seen by the gynaecologist. (5) 21. Drug used to produce uterine contractions and, perhaps , abortion. (7) 22. Set-back in convalescen c e. (7) 23 Note the signs carefully, especially in head injuries. (7) 24. Surgeon's assistant in the kitchen (7) 27. Farm animal however one looks at it. (3) 29. Not a suitable test for the dumb. (4) 31. Inflated recording blood pressure. (4).

SOLUTION T O CROSSWORD No. 12 - 71

ACROSS

1. Vi.tals; 4. Adenoids; 9. Ch.or.ea ; 10 and 13. Inguinal canal 12. Ivan: 14. Stun ; l7. Iliac; 18. Incite; 21. Bursa.r; 22. Bro.o m; 25. Ach.e; 26. T.in.ea; 27. Etna; 30. Insomnia; 31. Throat 32. Accident ; 33. In.tend

DOWN

1. Vaccinia; 2. Thoracic; 3 Lien: 5. Dental caries; 6. Nous ; 7 Innate; 8. Sahne ; II. Babinski sign ; 15. Sc.rub; 16. Stabs ; 19 Footsore; 20. Imp.acted ; 23. Saliva ; 24. Physic; 28. Amid; 29. Chin. 24 NEWS from

DIVISIONS (c o ntd )

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ST. JOHN REVIEW

AT RANDOM

by the Deputy Commissioner -in -Chief

THE FIVE 'worthy and well beloved' members of St. John Ambulance in the British Isles whom Her Majesty The Queen was pleased to honour on New Year's Day deserve our most sincere congratulations. They themselves would undoubtedly be the first to disclaim any purely personal right to the honours that they have received, maintaining that they were in the lucky position to be chosen as representatives to receive awards given in recognition of the work of St. John as a whole , rather than of individuals. Be that as it may, the rest of us will have no hesitation in replying that whatever we have collectively achieved could not have been done without their leadership and example , and that we are justly proud of our representatives.

An OBE was awarded to Major Idris Williams (Headquarters Staff Officer) for his outstanding service as leader of the St. John Ambulance relief teams in Nigeria. When the Nigerian S O.S. for relief work reached us at the beginning of 1970, Major Williams immediately volunteered and was sent out at short notice in charge of a reconnaissance party. On returning home with his assessment of the situation and his proposals for dealing with it, he was sent out in charge of the St. J ohn relief teams and remained in Nigeria for about a year. During this time he and his fellow-workers (both expa triate members of the relief teams and members of St. John Ambulance in Nigeria) were beyond praise in the way that they cared for the sick, the wounded, the homeless and the famine-stricken, and organised the rehabilitation of refugees. The whole of this work was undertaken without salary, in a difficult climate , and in circumstances which involved travelling long distances by the most rudimentary and uncomfortable forms of transport. Major William's example and devotion to duty were an inspiration to those who worked under him , and won the affection and respect of the Federal Government and people of Nigeria.

The award of an MBE was made to Miss M. E. Garrett (Commandery Staff Officer for ursing Cadets, Commandery of Ards) and to Mis M. Sale (County Staff Officer for Training, Bucks) Miss Garrett, who has been a Brigade member for 30 years, spent the first nine years of her St. J ohn service successively as a nursing member, superintendent of a cadet division, and corps superin tenden t in Belfast, before being appointed to her present post in which she has worked for 21 years. The recognition of her devoted service to St. J ohn Ambulance in Northern Ireland at this time of trial will be a source of special joy to us all.

Miss Sale's contribution to the work of St. John extends far beyond her activities during the 41 years of her membership of the Brigade in Buckinghamshire. Not only was she primarily responsible for the inauguration of Mobile Training Teams and of various forms of 'Adventure Training' which encouraged older cadets to seek promotion to adult divisions in which they rapidLy proved their worth as potential leaders, but she has been a vital member of the staff of all the 'Nottinghams' and of the sixty King George VI Memorial Leadership Training Courses held during the past 15 years. Over 3 ,000 members of the Brigade in the 18-25 age-group (of whom at least 40 % have since been promoted to officer rank) have been inspired and encouraged by her contribution to these courses and will take a special pride and joy in this recognition of all that she ha done for them and for the realistic practical training of St. John Ambulance member a a whole.

Finally, the BEM has been awarded to Mr. R. W. Joplin (Divi ional Superintendent of the Lowestoft mbulance Division, Suffolk) for his services to the community in Lowestoft

Continued on next page )

ABOUT ONE YEAR in every five is especially important to the first aider, because a new edition of the First Aid Manual is then published. The beginning of this year sees the appearance of the 3rd Edition of the J oint Manual of First Aid, a combined effort and agreed text by St. John and St. Andrew's Ambulance Associations and the British Red Cross Society. Each Organization sells the same text in a common cover which only differs in the name and emblem that is on it.

The first textbook of first aid, called 'Aids for Cases of Injuries and Sudden Illness', was written by Surgeon-Major Peter Shepherd, MB and published by St. John Ambulance Association in 1878, so by the time that the next or 4th Edition is due, it will have been in existence, in one form or another, for about one hundred years. The first Joint Edition sold nearly 2 million copies and the 2nd J oint Edition nearly Ph million, so the statement one often hears that the First Aid Manual has sold more copies than any other book but the Bible is probably

AT RANDOM (Contd

.)

not far from the truth.

A new edition is looked forward to with mixed feelings: eagerly on the one hand for the new and interesting changes that may be expected; on the other by man y , particularly those keen on competition work, who hope there will not be too much change in all they have so painstakingly learnt by heart But (as those of us responsible for the tex t weU know) you can't please everybody. To do so would produce a manual impossible for the first aider to work from , as it would contain too many 'if s' and 'buts' ; in fact , too much uncertainty to give clear cut guidance.

I am often asked why explanations and reasons are not given for various procedures which may appear unusual or differ from those in the previous edition that were well accepted There are three reasons for this attitude - firstly , the size of the manual would be nearly doubled if everything was explained like this , secondly, the cost would be greatly increased, and thirdly, with the text spread out in this exaggerated form , it

and especially through St. John Ambulance of which he has been an outstanding dedicated member for 30 years; and to Mrs. A. Whalley (Divisional Superintendent, Poulton-Ie-Fylde Nursing Division, Lancs) who became a founder member of that Division 36 years ago and has dont:: exceptional service as its Superintendent for the past 22 years. We offer to Mr. Joplin and Mrs Whalley our sincere congratulations on being honoured as worthy representatives of that most vitally important post in the whole of the St. Jolm structure - the Divisional Superintendent.

FIRST AID MANUAL

- 3rd EDITION 1 97 2

FIRST

AID MANUAL - 3rd EDITION 1972

by Professor H. C. Stewart, DL, MD, PhD, FRCP, FFA, RCS. Chief Medical Officer, St John Ambulance A sso c iatio n Chairman Joint First A id Manual Revision Committee

would make it much more diffi c ult to learn from such a book . Many letters have been re c eived by the three organisations fr o m first aide n offering helpful suggestions or criti cising various st a temen ts on pro c ed ur e s All these have been carefully considered b) the Revision Committee and if in an y instance there was not unanim om

agreement about the right choice of procedure , outside advice has been taken on the matter. In particular , industry has been consulted abou t their first-aid problems more extensively than in previous editions.

Cost and Purchase

The c ost of th e new book will be 40p plus postage from the Store s Department, Order of St. John , St. John s Gate , Clerkenwell London , ECIM 4DA

Higher and Advanced Certificates

produ c tion of a better, clearer type which reads more easily The illustrations are new and of a high standard, and the casualties shown are fully representative of the persons in the countries in which the manual is widely used.

2

I was reading today the report of a press interview given by a London probation officer on his retirement after 35 years' service. Among many encouraging things that he said, he added this solemn warning: 'The recent increase in paper work is a bad and dangerous thing. There is a very real reason for worrying now whether we are meant to be more interested in paper or people'. This very real danger of excessive concentration on paper work and statistics, to the exclusion of the human element, is one of which we should all be a ware. I was reminded of this a few weeks ago when an application came to the Registry for the Commissioner-in-Chiefs sanction for the retention of a certair. 80-year-old ambulance member on the Active List. No personal reasons for extension were given, and the only supporting evidence was the member's BF4 card which happened to show very few hours' public duty during recent years. In response to the Registrar's comment on this fact and request for further information, a letter was received, accompanied by a medical certificate of fitness for Brigade duties (most important), giving a most glowing account of the dedicated service, enthusiasm and splendid example that this member gave to all fellow-members, young and Old, in his Division. It presented a human picture of a man who, though old in years, was brimming over with vitality and inspiration, and it ended with a pathetic appeal to Headquarters to treat individuals as people and not as statistics.

When this was presented to me for decision on behalf of th e Commissioner-in-Chief , I immediately countersigned it Extensi on granted' , adding a note to the Registry that a cov e ring lett er should be sent to inform the Divisional Superintendent c on ce rn ed that nothing was further from the intention of Headquart e rs than to treat people as statistics , but that it was very diffi c ult to treat people as people if no supporting eviden c e was sent to us except sta tistics.

The question of a retiring age from active service is always a difficult one , because one man (or woman) may be young in mind and body at 70 (or sometim e s even 80) while anoth e r is old at 50 Nor is jt necessary to assum e that an individual memb e r's 'St. John life' ends when they retire from the Activ e List , fo r there are so many useful jobs to be done - and oft e n better don e - by members of our 'family' when age and infirmity have m a de normal Brigade duties beyond their scope

What really do es. matter is that promotion to positi o ns of responsibility and leadership should not be blo c ked by older members hanging on to them , and I personally consider that anyone holding an officer appointment at the age of 60 should make it one of their first responsibilities to train a su c cessor to take over within the next five years , and when the momen t comes , should be prepared to hand over the reins

In my own experien c e , some of our members whose e xampl e and inspiration to the younger genera tions has been greatest hav e been those who have voluntarily reverted to ambulance or nursin g member during their sixties and, while allowing younger members a chance to lead have gained immensely in stature and respect by recognising that what matters most in St. John is not the numbe r of pips or chevrons that one wears but the job that one happen s to be doing in relation to one ' s age opportunities and phy sic al capacity.

*

George Woodhill is back in the saddle , but not that of a camel. can assure the Editor that there is no inevitable connection between humps and mumps, for a closely similar photograph to that published last month of myself on a camel was taken in Tangier exactly a year ago, and I have suffered no ill effects!

It should be noted that the new manual contains only the material necessary for the Adult Certificate the material whi ch formerly was in c luded for the Higher and Advanced Courses having been omitted. Alternative arrangements for achieving s u ch supplementary qualifi c ations will be announ c ed separately ; but until February 28 1973 , re-examinations for existing Higher and Advanced Certifi cat es will b e c arried out on the material contained in the 2nd Edition.

Examinations and Competitions

Examinations for the Adult First Aid Certificate may be c arried out on the 3rd Edition as from Mar c h I 1972 and both the 2nd and 3rd Editions of the manual may be used for in s truction and examination purposes until February 2 8 1973. It is imperative that applications for examinations must indi c ate clearly which edition has be e n used for instruction during the course con c erned

From Mar ch 1 1973 all Adult First Aid examinations will be condu c ted on the 3rd Edition only. For c ompetition purposes, the 2nd Edition of the First Aid manual will continue to be used until December 31 1972. For all competitions held after January 1 1973 the 3rd Edition will be used.

Changes of a General Nature

The main changes in the 3rd Edition are as follows : the size of the manual is the popular one of roughly 8 x 5 Y21Os which is the same as the new NurSing Manual and has assisted in the

The new edition is confined to the Basi c First Aid course for the Statutory Certificate and instructional material for th e Higher and Advanced Certificates has been omitted It was said of the 2nd Edition that the inclusion of this material put off a number of would-be students who were deterred by the size of the book, and the degree of knowledge required in those two sections, even though they only wished to take a First Aid Certifi c ate c ourse In addition , some felt they were being for c ed to pay for som e thing they did not require , and would never use.

There was much dis c ussion about the merits of the respective words ' patient' and ' casualty' and when these should be used. It was finally de cided that casualty' was the better word as far as first aid was con c erned and ' treatment' has largely replaced the word 'managelllent' in the 2nd Edition , a s it is a simpler and better understood word.

In c ontent , style and other ways the 2nd Edition took a jump into the future to an extent greater than is normally taken in a single edition, and thus was unpopular with may people who felt it was too much of a departure from the traditional form of the First Aid Manual.

It has been our object to retain all that was best of these advan c es while at the same time simplifying the wording where possible , remedying certain deficiencies of instruction , and sometimes altering the order of priority Tn addition the traditional order of chapters has been slightly altered because it is felt it is more sensible this way One additional c hapter (14) , called 'Procedure at Road Accidents', has also been included, as it was felt that this was such an important and commonly occurring problem that it merited being dealt with separately.

St. John is sometimes criticised because the First Aid Manual is less 'with it' or less attractive than some of the

of first aid orbiting around St John (Editor: Good design)

popular books on this subject, which have no 0 ff i cial standing . It must be remembered that this First Aid Manual is a textbook for a course in first aid at the end of which after a satisfactory examination, a certificate of proficiency is granted, which has Government recognition. Consequently it is not possible, or perhaps even desirable, to produce the manual in what some would think is a more popular style. Further , it is much easier to write this way be c ause such books are usually written from the point of view of the ' calculated risk', which means the ignoring of certain difficult problems if they occur infrequently enough e.g. the absence of a method of resuscitation for a prone casualty who cannot be turned on his ba c k ; or, the choice of which procedure to adopt when, whichever is chosen , may expose the casualty to some risk For the first time, this 'calculated risk' is mentioned, in one place only , in the new chapter 14.

The introduction of a new edition of the manual means a lot of work and has a number of repercussions. It has taken the three organisations abou t three years from the start to publication , with meetings almost every week during that ti me. In c onsequence , changes are necessary , the examination question sheet has to be altered, comptetitions also are affected and the Essentials of First Aid have to be brought into line with the new edition , as also First Aid Questions and Answers Book.

Changes - Chapter by Chapter

Now to take the manual chapter by chapter and indicate more of the important changes :

The AUlhorised Manual of ST JOHN AMBULANCE ASSOCIATION & BRIGADE

The cover of the new manual ; the world

Chapter 1: Stress has been laid on the responsibility of the first aider.

Chapter 2: This chapter now deals with 'Action at an Emergency' and takes the place of the old chapter 13.

It was felt that giving details of action to be taken at an inciden t logically should come early in the manual, which would make it easier for the student to understand some of the instruction given in later chapters.

The coma or semi-prone position has been renamed the 'recovery' position. It is a better term as its use is often life saving and the casualty may not be in a coma any way; it gives the position more importance and is generally thought to be more suitable. Instruction in turning a casualty has also been included.

Priorities are divided into three main headings: (1) danger to the casualty; (2) urgent needs of the casualty; and (3) other needs. Instruction regarding multiple casualties is most important and a course of action is laid down The correct use of bystanders is also stressed.

The most important two words in the chapter and probably in the whole manual are those of 'common sense', which is specifically mentioned for the first time in the sentence 'common sense is essential on every occasion'. In the past this has been hinted at but not actually mentioned. The repercussions, importance and implications of these two words will be missed by many if I did not stress them here. Although many would say it is obvious that the first aider must use his common sense, it is the freq uency of multiple casualUes with multiple injuries in recent years which has really made it important to mention it like this. It was first so stressed in the Essentials of First Aid, published in 1967.

Both in real life (e .g for crashes on motorways) and consequently in competitions, multiple casualties and injuries have become much commoner in the last decade. It is no longer enough for the first aider to know his subject well. He must give the right priority to the right casualty, and the right priority to the right injury, or he won't score many marks in competitions however good is his first aid. Treatmen t of an injury may have to be altered from that in the book , because the treatment given for two injuries, perhaps close together, cannot be carried out without the treatment of one injury interfering with that of the other. Because of this the permutations and combinations of first aid and common sense are endless. In fu ture the first aider has to think far more - and not only to remember his first aid!

Chapter 3: (Structure and Function of the Body)

Some knowledge of both the structure and function of the body is necessary to understand and apply first aid correctly but the contents compared with that of the same chapter in the 2nd Edition have 4

been reduced. Instructions include the correct way to take the pulse and illustrations show the position of the radial and carotid pulses. The 'covering' or 'lining tissue' has been omitted, as has much of the digestive process.

Chapter 4: (Dressings and Bandages)

There is little change from previous instructions. The application of the R oller Bandage has been increased to include certain parts of the body ; also, included for the first time are referen ces to Tubular Gauze Bandage and Elasticised Net Bandage. Note reference to the arm sling which is only effecUve when the casualty is in the sitting or standing positions.

Chapter 5: (Asphyxia and Emergency Resuscitation)

The most important change here is the introduction of 'chest thumping' as a preliminary procedure for restarting the heart before attempting external heart compression. The latter is better at maintaining circulation to the brain until the heart restarts, but the former (thumping) is more likely to restart it. In addition, chest thumping tends to cause less damage to the chest wall than heart compression.

Page 76 should be read very carefully and particularly note what is stated under the sub-heading 'Remem ber'.

The Holger Nielsen method of artificial respira tion has been reinsta ted and has replaced the Silvester method, which is now in Appendix I. The reason for this is that though the Silvester method is a good one, there was no provision in the 2nd Edition for a casualty who could only be resuscitated in the prone position, if he was pinned down in that position. It is necessary to retain the Silvester method for those cases where an alternative to Holger Nielsen is required - when there is extensive injury to the mouth and face, and the mouth to mouth method is not possible or perhaps desirable.

Dry drowning has been omitted, but 'Electrical Injury from high and low voltages has been included, having been transferred from the chapter on 'Burns'.

Chapter 6: (Wounds, Bleeding & Circulatory Failure)

The alteration to the heading of this chapter should be noted. Once again the 'c1assification of wounds' has been included and information given of built-in mechanisms of the body which tend to stop bleeding.

Treatment of external bleeding is divided into slight' and 'severe'; and two pressure points (brachial and femoral) are described and illustrated. The ring pad in certain treatments has been re-instated . Internal bleeding is given greater notice; the instances of 'concealed' and 'subsequently visible' are stated.

Crush injuries take the place of 'crush syndrome' and 'sips of iced water'

replace the instructions of 'one pint of fluid immediately and further drink in small quantities'.

Bruise (contusion) from the old Chapter 7 and acute heart attacks from the old Chapter 10 are now included in this chapter for obvious reasons.

Chapter 7 : (Shock)

The causes of. shock are more plainly stated as is also the treatment. Fainting and impending faint with lheir respective treatments are both included.

Chapter 8 : (Injuries to Bones)

There are only two causes of fractures direct and indirect; muscular contraction as a cause now rightly comes under the second heading.

There are now also two type of fractures - closed and open; complicated coming under either heading

In the treatment of fractures emphasis is laid on dealing with a phyxia bleeding and evere wounds (if present) before dealing specifically with any fracture.

Special F ractu res

Lower jaw: The jaw is now supported on a soft pad by the hand or suitable bandage, bul no actual bandaging instruction is given. The jaw can be broken in different ways in a varying number of pieces and is often accompanied by other damage to the face or mouth, making it difficult to word 3 bandaging instruction which would be suitable for most of the injuries of thi type. Here is an instance where the u e of common sense will tell you whether or not to bandange, and if 0, how to bandage in any individual case.

Ribs: If the fracture is uncomplicated an arm sling is u ed; if complicated, a triangular sling.

Breast-bone: This fracture was not dealt with separately in the 2nd Edition but is given a separate heading and trea tmen t.

Collar-bone: The treatment no\\ advocated is merely the revival of that commonly used when the First Aid Manual was only a St. 10hn publication A well known surgeon who had suffered at different time a fractured collar-bone. and had both collar-bones broken, staled that this was the only comfortable treatment. Subsequently, confirmation was obtained following research at the S p 0 r t sIn j uri esC e n t r e , M 0 nash University, Australia. Two narrow bandages are applied round the shoulders and the ends tied between the shoulder blades (thus bracing the shoulders back) and support is given to the limb on the injured side by the use of a triangular sling.

Upper limb : In most cases, after applying a sling (arm or triangular) further support is given by the application of a broad bandage round the limb and chest, tied on lhe uninjured side.

Lower 1imb : Clear instructions are given of the difference in treatment for short and smooth, or rough and longer journeys.

Knee cap: The narrow bandage above and below the fractured knee cap,. crossed behind the splint, has been omltted. It apparently does \i We good in many cases and can be most painful to the casual ty. Instead , an extra broad bandage IS now applied round the splint and lower leg.

Chapter 9: (Injuries to Muscles, Ligaments and 10ints)

Strain: Muscles may swell and cause severe cramp: no active movement now encouraged.

Sprain: Inability to move a joint; alternative treatment includes use of cold compress.

Chapter 10: (The Nervous System and Unconsciousness)

Notes on the nervous system, briefly referred to in Chapter 3, are given here in more detail.

Certain causes of unconsciousness are given, and the level of consciousness again stressed.

Head injury: The term 'contusion of the brain' has been omitted.

Diabetes: This subject has been clarified simply by dividing the two serious conditions into 'Insulin Coma' due to insulin overdose and 'Diabetic Coma' due to inadequate doses of insulin.

Chapter 11 : (Bums and Scalds)

This chapter now follows 'unconsciousness' instead of precedlOg it. The causes are more plainly given.

Chapter 12 : (PoiSOnIng)

The ways in which poisons may enter

the body are given in greater detail.

Special poisons include industrial gases, pesticides, rat poison; while travel sickness tablets and laburnum pods are added to the list of some common poisons.

Chapter 13 : (Miscellaneous Conditions)

We have tried to tldy up some of the problems in the previous edition about heat and cold, under the heading, 'Extremes of Temperature'. Under 'effects of cold' will be found 'cold exhaustion', 'accidental cooling of the body' (hypothermia), and 'frostbite'.

Under 'effects of excessive heat' will be found 'heat exhausUon' and 'heat stroke'.

The acute abdomen, foreign body in the throa t, psychia tric emergencies, attemped suicide, retention of urine and radiation sickness have all be omitted for various reasons. They may be difficult to diagnose or to treat adequately within the limits of first aid knowledge, or both. 'Stitch', however, is a common condition and has been included.

Chapter ] 4: ( Pro cedure at Road A.ccidents)

This is an entirely new chapter. Traffic density increases every year, and the motorways contain more and faster moving traffic than ever before, thus the incidence of motor vehicle smashes and pile-ups IS continually growing. Thus we felt the time had corne when this menace had to be dealt with as a separate problem.

No one can ignore this problem whether he be an ordinary road user a

member of a local authority, or of the government itself.

The subject is complex and cannot be covered completely in a book of this size, but various procedures are explained and their importance stressed, which if carried out correctly will diminish the number of persons involved and thus the seriousness of the incident.

Instruction is given on the immediate action to be taken, the use of the calculated risk and common sense, when some danger to the casualty, rescuer or both is inevitable whatever the first aider decides to do. These accidents often involve pedestrians as well as motorists, multiple casualties are common, and rarely do they have only single injuries, so the first aid problems are complicated and correct priorities perhaps very difficult to establish.

There is probably no example of a first aid problem in which so much harm can be done to so many by hasty and incorrect action, but no greater opportunity also exists for the saving of lives by correctly applying first aid principles in the handling and treatment of these casualties with speed and care, and once again, with great common sense.

Chapter 15: (Han dling and Transport of Injured Persons)

This chapter has undergone very little change.

Appendices

1 Deals with the Silvester method of emergency resuscitation

2 Deals with emergency childbirth

3 Deals with first aid equipment in the home, also in offices and in industry.

"

MANUAL LABOt/R.

ONE HEARS that a new First Aid Manual will shortly supersede the present handbook, and it can be assumed that it has long passed the stage when any part will be re-written to suit any suggestions from the 'rank and file'. All the same, the new manual will raise a host of criticisms, suggestions and queries - and one hopes much praise, since we should not decry the dedicated effort which is put into such a task by the unknown workers in the background, all probably quite as expert as any vociferous critic. It is, surely, a sign of vigorous life that the manual is short-lived nowadays , albeit most of us are conservative enough to complain that before we can thoroughly absorb the manual it becomes superseded.

The Review provides a useful forum in which we can discuss, argue, disagree and mutually enlighten each other. In the process we can get some wrong ideas corrected by those who know better. And the experts who write the handbooks can say to themselves in astonishment, 'Goodness, is that what Brigade members think we intended? We'd better re-write these pages for clarity'.

One injury that I feel is not dealt with as well in the current as in 'Black Books' is 'Fracture of the Bones of the Lower Limb', page 108 In passing, can I say that my previous understanding proved to be in line with, and was

6 confirmed by , a fairly -extensive NHSR training and considerable experience helping in busy Accident and Emergency Departments The signs and symptoms of a fractured femur (at least the closed version) are accurately des cribe d at the top of page 109 and again just below the middle of that page, and what I am convinced is the correct initial procedure is described and illustrated on page 110. There is, however , no warning - as was given in previous Black Books - that traction should never be applied, in the case of an open fracture, to such a degree as would bring protruding ends of bone back under the surface or into juxtaposition with the other end of the bone. This is a serious omission - but wha t is far worse is the absence of any warning that, once the everted foot has been brought back to natural position , this must be maintained since relaxation would cause agony and probably drastic aggravation of injury - even turning a closed into an open fracture or causing arterial haemorrhage (An aspect of fractures which the manual does not mention is the fact - so unforgettably obvious when one has witnessed or endured such trauma - that once a major bone is broken the 'antagonistic balance of extensor and retractor muscles' - as a doctor would, no doubt describe it - is completely upset and whether or not there is shortening or displacement , muscles go into spasm and the pain of

THE MANUAL IS SHORTLIVED NOWADAYS

- SURELY A SIGN OF VIGOROUS II FE?

this is often worse than that due directly to the fractured bone).

Nowadays it is standard practice in 'Casualty' to apply a Thomas Splint for practically every type of fracture of the lower limb and I think the first-aider should bear this in mind and endeavour to facilitate its eventual application If this premise is accepted the current treatment with splints as laid down for a fractured femur on page I 12 , is far worse than the former drill which called for one bandage to be applied to secure the feet , (retaining extension and avoiding any possiblity of eversion), before one sought for 'splints or material to improvise'. The earlier procedure gave the casualty officer the opportunity to undo the other bandages and remove the splints without 'losing traction' or letting the foot fall away.

Anyone who has helped with Thomas Splint procedure in hospital will appreciate the advantage of being able, when the team is assembled , to have someone hold the foot on the injured side and main tain its position whilst the boot is removed and the splint applied - a procedure greatly facilitated if the 'first aid' splints can be removed without undoing the figure-of-eight bandage holding the feet together. This was provided for by the 8 bandages we used to apply. Can someone co nvince me that the current method , using 7 bandages, has any advantages, from the patient's point

of view, over the earlier method? And , if it has, do these outweigh the difficulties of applying this drill? I have watched competition teams on many occasions making a tremendous fumble of dealing with splints and a foot (which the trained 'casualty' will allow to evert if support or ex tension is relaxed) whilst the ankle bandage is applied - and this with a skilful quartette; how much more difficult it would be for a single first-aider working alone or with untrained helpers?

Then there's the triangular slingwhat a silly title! They are all triangular slings. One can understand the chauvanism which caused the old title 'St. John Sling' to be dropped from the agreed Joint Manual, but why not call it the 'Raised Forearm Sling' , which is just what it is? Anyway call it what you like, it's the standard application for a fractured collar-bone or hand injury (see page 53). Ignore Fig. 58 - it's at variance with the text - as must have been reported many times since 1964 But examine that script (page 105). It advises, for a fractured clavicle:' Hold the forearm across the chest so that the finger-tips lie on the opposite shoulder' - and Fig. 29 purports to show this. I've spent a lot of time considering this and experimenting with our division's full-size skeleton and I think, if the collar-bone were broken, it would cause

arm is allowed to hang vertically (as in Fig. 57) and the elbow is flexed and a raised forearm sling is properly applied, then:-

(a) the fingers lie on the breast-bone,

(b) the elbow is close in to the side and not raised out and over the chest,

(c) the unstrutted acroniumJ humerus joint is not allowed to sag forward

(d) the broken collar-bo ne is kept in a straight line and the broken ends can be separated slightly by the fulcrum pad in the axilla and the levering broadfold bandage around the tip of the elbow and chest.

(e) The rise and fall of the ribs in breathing is not hampered nor does this movement get communicated to the fracture site to cause crepitus.

The suggested change is in line with the old 'three-handkerchief' methodwhich very definitely braced the injured shoulder backwards and upwards.

Moreover, it allows the reef-knot to be tied in the hollow of the uninjured clavicle withou t the fingers poking out of the wispy, narrow end just where it is knotted, and - dare I attempt this explanation? - it is much more suitable if the patient is a well-endowed female.

Combinjng Fig. 29(3) and Fig. 58 in the light of the above tentative proposals and with some knowledge of the 'attitude of injury' - so very typical in this caseI offer Fig. 1 in substitution

additional pain if someune put the arm in this position (I've even heard a lay instructor say 'You must get the finger-tips on the rim of the opposite shoulder-blade'! !) I think this is wrong.

Fig. 57 illustrates what must occur if you do so; the broken clavicle is spirally-rotated upon itself. If the upper

N B For severe bleeding of the hand it would no doubt be preferable to have the hand well-raised so , for this injury, the present script and illustrations seem to be quite right. For fracture of the humerus, forearm (if elbow can be bent) or wrist I think an 'arm sling is preferable to the 'triangu lar sling' The present manual offers thjs as an alternative.

JOHN GORDON SILVER, BEM

IT IS with deep regret that we report the death of J ohn Gordon Silver , Secretary of the Order of St. John. After a major surgical operation in the autumn, we had thought he was making a wonderful recovery but further complications meant his return to hospital, resulting in his death on November 22.

John Silver joined the Chancery at St. John 's Gate in February , 1946, soon becoming the Assistant Secretary of the Order until he succeeded to the office of Secretary in 1963.

With his high adminstrative ability and his conscientious devotion to the Order , he became the very linch-pin of its central administration in the Chancery. He was gifted with a most retentive memory an d a natural sense of what was fitting which enabled him to provide precedents and comparisons, and to suggest a suitable solution for almost any problem which

arose. Not only those most closely associated with him, but Members of the Order from allover the world counted him their friend and wise adviser. For 25 years John Silver was never absent from a meeting of the Chapter-General, or from major St. John occasions, and it is there that we shall remember him, always on the spot, always unruffled, and always ready with a quietly spoken word of help and advice .

A sincere Christian he had a particularly personal devotion to the Grand Priory Church in Clerkenwell, in the restoration and subsequent upkeep of which he closely concerned himself. It is fitting that his ashes are to be deposited in the crypt there.

He is survived by his wife, Eve, and two married sons, to whom the sympathy of his colleagues and friends goes out. 7

Author A M Sciolist is lost for words (for once) and resorts to illustrating his po int

TAPE HIRE

The Medical Recording Service Foundation , Kitts Croft, Writtle , Chelmsford , Essex (0245-421475) which is a non profit-making charity, informs us that the cost of hiring tapes has been increased. The new minimum charge for one tape is now £ I plus postage for 2 or 3 tapes at a time , 7Sp each plus postage

The cost of teaching slide sets (ie without tapes) is SOp plus postage. The cost of permanent Joan of any tape / slide set is £3 for the tape or cassette and 12p for each slide.

The M.R S F publish an up-to-date library list which may be obtained direct from the Foundation at a cost of SOp, which includes mail information of all new titles as they become available

A FIRST

I hear that administration of the Brigade was the main theme of the first Eastern Area residential leadership training conference held recently at Disley , Cheshire , and attended by officers, members and senior cadets from many divisions within this Area

The speakers included Inspector J. Dyas, Area Commissioner E. Mason and Area Staff Officer C. Farrow , both of the Duke of Lancaster's District , and Mr. H. R. Dick, North West Regional Development Officer.

The conference dinner held on t h e Saturday evening , was attended by County and Area staff and was followed by a show of colour slides taken recently in Malta and Rhodes , depicting various periods of the History of the Order. The second day of the 3-day conference commenced with a service in Lyme Hall Chapel conducted by the Rev. Malcolm F Jones, Curate of Prestbury Church, who is himself an ex-cadet of Hazel Grove Ambulance Cadet Division.

The conference closed with an Open Forum consisting of Area Commissioner

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

BY THE EDITOR

IN THE SWIM

APPOINTMENTS

Barbados: The Commissioner Major H. R Daniel has been promot ed to Lt Col.

Essex : Dr. Well er (at present Cty. Sgn .) to Comm. Northern Area.

Dr. Paros to Cty Sgn. vice Dr. Weller

Kent: Mrs J M Mercer to Comm. No .3 Area.

Lines: Squadron Leader M Griffit h resigned as Comm Central Area.

Northants: Mr. H. R . Townshend resigned as Dep Comm.

North Riding : Col. J. M. Forbes to Dep. Comm.

Staffs : Dr. Pringl e to Cty. Sgn.

I. Cross Pedley and members of his staff.

The Course Dire cto r was Area Staff

Offi cer R A Fielding, assisted by a co mmittee comprising Divisional Superintendents F. W Barton, G. Bradburn , Miss K M Paxton and Mrs. S. R Fielding

T his co urse is a follow-up stemming f r om the Commissioner-in-Chiefs

Training Co ur se held in Manchester in 1969

BACK PAl N CLUB

J hear that a Back Pain Club to promote the study of back pain, its cause s, prevention and management has been set up under the sponsorship of the Bath ln stitu te of Medical Engineering and th e In stitute of Directors

At the club's inaugural meeting it wa s stated that 18 million working days are lost to industry in the U K every year due to back pain Ten per cent of all working men (1,500,000) seek medica l aid for back pain, and four per cent (500 ,000) go absent from work with thi s complaint.

Lost productivity costs industry .£ 100 million , an average of £7 per worker per year. The average for dock workers is £5 0 per head annually , and back pain IS particularly common in young dockers due to inexperience in handling diffi c ult loads.

Dr. R. J Blow , of the National Dock Labour Board, London, recounted that the firm of Johnson Matthey, typical of the heavy metal industry had a 65 % fall in working hours lost due to back pain after workers were advised on spinal problems. Key workers were given a full day ' s 1I1struction, and others on the shop floor a one-hour demonstration a nd lecture. This was warmly welcomed by union officials and workers on the hop floor and a repeat VIsit was requested. It was suggested that jobs should be evalua ted 111 t erms of the stress they produce on t he spine Recognisable syndromes make up only d s mall percen tage of back pains

Pr o f. D J Jackson of the U niversity of Manchester told the meeting that he hopes to develop a test which will make it possible to distinguish between disc di sease and muscle stram.

The need for evaluation of different types of treatment was pointed out , together with a need for improved design of beds and car seats and more attention by industry to working conditions.

Manipulation was considered often to provide immediate relief for back pain. However , there is a natural tendency for acute back pains to improve so that by seven days, backs that are manipulated are no better than those that have receive d conventio n al treatment.

As a layman and a recent back sufferer myself, I welcome this news

A VISIT

Wiltshire SJA writes :

Last summer six ambulance cadets, one nursing cadet and four officers left W estbury (Wilt s ) to visit the J oha nn iter-Unfall-Hilfe in Dortmund, Germany. We travelled in two vehicles , taking camping equipment and food , and boarded the 3.30 ferry from Dover to

Ostend, eventually arriving at the JUH HQ on J uly 29.

The party was made very welcome by the Commander , Mr. Martinschledde, and the Second in Command , Mr. Miller, who showed us around their well equipped HQ

Next day after breakfast we were taken on a tour of a large sub-Fire / Ambulance station with a British corporal from the nearby Army camp acting as interpreter.

This highly mechanised station is run on a 24-hour shift system and has all mod cons' plus swimming pool and dance hall. We saw a demonstration of immobilisation of a spinal injury by using a mattress on which the casualty is placed. The mattress is tucked well in around the casualty , and all air is then drawn out, leaving a rigid mattress in which the casualty cannot move. We were also given a demonstration of a self-adjusting heart massage machine.

Bucks' H igh Wycombe Ambulance and Police Division was being inspected when this accident occurred outside their HQ Rescued from the car was a woman, her child and a dog; from the van the driver njuries were not serious, but the casua ties were taken to hospital. Phot o Robert Me ad High Wy com be )

GOOD AIR ?

During the evening we were challenged to an enjoyable game of c razy golf, which is one of their favourite pastimes

On Saturday , two official guides took us on a tour of Dortmund , and Westfallen Park with its beautiful Stadt Theatre , which has a cleverly engraved fire curtain of solid steel. Made in Dortmund , this curtain weighs several tons and can be dropped in a few seconds in th e event of fire.

We saw the tropical flower pools and

IN THE FAMILY

clever garden arrangements, rode in a very fast lift to the top of the post office tower (218 metres high), and visited a very efficien t first aid sta tion.

On the Sunday morning we were invited to take communion at the parish church, after which the pastor Mr. Mix invited us to a mid-morning drink and a pleasant chat.

We r e turned to barbecue in Headquarters our where D ortm und for a honour at the we met other

members of JUH The Commander presented us with a JUH pennant, and in return we pre ented JUH with a St. John shield.

On Monday we visited the Government offices of Dortmund where we were officia lly welcomed by th e Governor and were each presented with a wnting case and books about Dortmund

The Division as a whole was presented with very e legan t stee l tray on whi c h was engraved a picture of the old city of Dortmund

Tuesday was shopping day and then a trip to the Saverland where the cadets went swimming and the officers had an enjoyable lunch with Mr. Miller at th e sailing club. Back at Dortmund HQ there was a surprise farewell party awaiting us . Wednesday was departure day. After breakfast the lady house-keeper at th e co ll ege where we had stayed said: 'Give my love to England'.

We lo aded the vehicles and headed for home, after five very pleasant if hecti c days as guests of JUH , Dortmund.

THE SEC'S DAY

A M.

He hasn't come in yet'.

'I expect him in any minute'.

'Hejust sent word he'd be a little late'

'He's been in, but he 's gone out again'.

'He's gone to lunch'.

P.M.

' I expect him in any minute'.

'He hasn't come back yet. Can I take a message'.

' H e's somewhere in the building His hat is here?'

'Yes, he was in, but he went out again'.

'1 don't know whether he'll be back or not'.

0, he's gone for the day'

for Gloucestershire Lt Col F. Williamson, makes the presentations ( Photo Cheltenham Newspaper Co Ltd .)

Th e above com ment is from Pakistan s SJAA (Karachi Branch) magazine Sufaid Sitara

The Hon. Mrs. Ingham Whitaker

Just before Christmas an old lady of 94. who had been connected with St. John since the first World War, and who wa s tireless in her work for the Brigade, died Mrs. Whitake r was a well known and highly respected figure in Hampshire. She was responsible for the formation of several Nursing Divisions , including th e one at New Milton. At one time Lady County Officer (Western Area , Hampshire) , on her retirement from executive work Mrs. Whitaker became an active and energetic President, first of the Lymington Corps, and then of the Lymington Nursing Division, as well as being appoin ted County Vice-President in 1939. She was created a Dame of the Order as ear ly as 1933.

Hilda, as she was known to her many friends, was a lady of determination fortunately for the Brigade for her daughters had no option but to join uS at

an early age! During the last war their mother gallantly returned to executive work and deputised as County Officer for her daught er Penelope , who was one of the first V AD's to join the 8 th Army in North Africa.

Mrs. Whitak er's retirement as County Vice-Presiden t in 195 I , and from the Lymington Nursing Division in 1958 , were events much regretted by St. John in Hampshir e. To its members she was a magnificent example over many years.

DROP ONE, AND,

From Dor et come news of A few months ago the Dorchester Nursing Division agreed to hold a sponsored 'Knit-In' in aid of the Medi ca l Comfort/Garage extension fund. We expected to raise £20 to £30.

The idea was for members to knit , and to get their families and friends to sponsor them at so much an inch; but many of the friends offered to knit too, and in their turn obtain some sponsors. In all we had 35 knitters with many sponsors each, at YI p, I p 2p, or even 5p an inch.

One evening we all met at St. John Hall and commenced the 2-hour knit-in with No. 9 needles , a good supply of double knitting wool (supplied by the knitters and the division) , and 30 sts cast on. We had a most enjoyable two hours swapping jokes and stories, and having tea and biscuits And knitting , of course. In the end, between us we had knitted 441 :y,; inches.

After having the strips measured, most of us t ook them home to make into 36in lengths , for as well as raising money we wished to give blankets to the Iv y Club, Maiden Newton (which is a club for the elderly affiliated to the division) , and to the Day Centre, Rowan Cottage, where members of the division help weekly.

Our knit-in raised £175.32p. - so all told it was a huge success, and the idea is now being followed in other parts of the county.

Anyone requiring more information should write to me : Mrs. B. M. Hedges , 56 Prin ce of Wales Drive Dorchester Dorset. "

STOP PRESS APPEAL

The Order is pleased to announce that the Christmas Day TV appeal has , up to going to press, produced a total of £58000 nearly £6,000 in cash and producing £7,500 a year over the next seven years_

Congratulations everyone throughout the coyntry for this magnificient effort of publicity!

The Editor

Gladys Day,

Miss

Superintendent of Bletchley Nursing Cadet Division since its formation in 1942 was surprised at her recent SJA retirement party with a This is your St John life' appearance Gf old friends and colleagues. 44 of Miss Day's ex-cadets took up a nursing career.

(Photo: Bletchley & Milton Keynes Gazette)

Kent s Area Commissioner H E Caplin, in charge of a SJA training school in first aid for industry at Maidstone, watching a student in examination ( Photo Kent Messenger)

See story DROP ONE AND Dorchester's knitters at the end of the 2 - hour session

Some Of tne :>JA team. The author

Dr. Weller is on extreme left

THE POP FESTIVAL at Weeley, near Colchester, on August 28-29 was yet another duty on the calendar of engagements for the Essex divisions of the Brigad e during the busy summer. At first little attention was paid to it as the organisation responsible for running the event, the Clacton-on-Sea Round Table seemed to have the medical care of attending it well in hand , and were not pressing for much 'outsi de help. Indeed it had originally been suggested that the divisions immediately neighbouring Weel ey would be the ones to be calle d if necessary.

However , as spri ng gave way to summer it became clearer to a few in authority in Essex, notably the Assistanct County Ambulance Officer , that his resources might well be severely strained, and as he is also a St. John county staff officer he was in a good position to suggest to his brother officers that perhaps this was going to be a bigger duty than was first thought, and that the county staff organisation should be invo lved. How right he was!

So it came about that the first conference on the rain-soaked one hundred and fifty acre site at Weeley took pla ce on the evening of July 28, only a month before the estimated 20,000 fans were du e to arrive!

However Dr. Richard Farrow from Clacton, the general practitioner in charge of the medi cal arrangements, had obviously organised the Medi cal Tent' 12

AND NOW THE FACTS AND FIGURES OF THE POP FESTIVAL AT

WEELEY '71

Throughout there was a n atmosphere of nervous tensio n that further af fray s with the HeJl 's Angels would occur, each rum our of further trouble happily proving false. One of the Assistant County Surge o n's ca ll s was to attend someone thought to be dead in the cent r e of the site. It took him and two ambu lance members twenty minutes to step over the mass of people lying li ste ning to the music to reach his patient, only to find he was peacefully fast asleep!

Sunday dawned : weary but excited members were sti ll on active duty. A 'phone ca ll to the County Surgeon from Dr. Farrow announced the festival programme to be running eight hours late. Could the Brigade provide medical , ambulance and nursing cover throughout Sunday and into Monday if possible?

by M. A. WELLER , FRCGP , Coul1ty Surgeon

well. At this meeting it was suggested that the Brigade should provide personnel and transport vehicles continuously from the evening of Friday, August 27 until lunch-time on Sunday 29.

It was decided to request Yellow Column of Essex, one of the three columns into which the cOunty has been divided for major disaster planning, to undertake this planned forty-two hour co ntinuous duty. The Assistant County Surgeon, the County Duty Officer, the Column Commander and an officer from Clacton Divi sion in close touch with Dr. Farrow were put in charge of detailing the arrangements, drawing up a rota, etc.

A further meeting took place on August 18 at Elmstead Division headquarters (the Column Commander's division) at which final details were worked out, and another inspection of the site made At this meeting it was suggested that 40 - 80,000 might be present. The duty rota was planned.

The Event

The nearer the Bank-holiday weekend approached the greater became the estimates of numbers likely to attend. As it became clear it was a popular festival so it became clear that more cover would be required from St. John members. Clacton were the first to be involved with this, and extended their duty forwards to 8am on the Friday. The Assistant County Surgeon visited the site from nine to midnight on Friday, and reported by phone from the medical tent to the County Surgeon the magnitude of the

event 'hke Waterloo on the eve of the battle'. His words proved to be prophetic when, at about 3.30pm on the Saturda} there was a f]urry of activIty, as th e results of the affray between Hell 's Angels and Festival Security Guards were bDught in on stretchers to the medIcal centre. Leather-Jacketed casualties with severe injuries, a compound fractured skull, fractured radius and uln a, fractured humerus, etc., stimulated the members on duty from Braintree, commanded by CSO T. Lytham, to feverish activity. An unpleasant few moments ensued when aggresive young men burst in threateningly as if to interfere with the doctors, medical students, volunteer nurses, St. John and Red Cross members at their work.

Soon the casualties were tended and transported to the designated hospital at Colchester, about twenty minutes drive away, and the centre carried on with the steady stream of 'casualties' with headaches, abdomina l pain, minor burns, foreign bodies in eyes, and requests for sanitary towels, baby bottle teats, and even for the care of an injured kitten!

Each event was recorded in a large book in the cen tre of the ten t. En try upon entry was made at an ever increasing ra te on the evening of Saturday, the main festival eveni ng , until by midnight over 1000 entries had been made; and still they kept coming in, interspersed with requests for ambulance transport to pick up another case of co llapse on the si te itself or behind the stage.

(4) Keep carefu l records of those on duty, casualties, vehicle journeys, etc.

(5) Plan for two ambu l ance entrances for an ' in unloading, parking and out' arrangemen t.

(6) Keep reserves of Brigade members and vehicles on an alert system so that they may be ca lled in quickly if the event does not proceed as planned.

(7) Plan a shift system of duty, and see that it is carried out A tired first-aider is a bad first-aider.

APPENDIX

Details kindly provided by Dr. R. Farrow and Supt. Cobb:

Estimated number at the festival 100,000

Number of recorded patients 1,700

Number of male patients 1,070

Number of female patients 630

Wh at a probl em on a holiday weekend for volun tary service! All other divisions had duties on that Sunday. Rapid re-arrangements, however, with telephone conferences resulted in the calling in of reserves from Thaxted, Braint ree, Clacton and Harwi ch. It was as well for, at about IOpm on Sunday a 21-year-old man became severly ill with asthma, so severe that respiration ceased. He became blue and pulse-less and for a moment was feared to be dead. Finally he responded to the intravenous injections given by the three doctors attending him and to oxygen rapidly brought by a St. John divisional superintendent. He was transported as a full emergency to hospital where, ten days later , he was discharged alive and well.

Have you ever driven on a bank holiday at fifty miles an hour down the ce ntre lane of a three lane highway, with headlights on and klaxon sounding? If so you know the feeling experienced by the SJA Brigade driver and crew as they raced through the nigh t to save a life!

To the relief of us all the festival finished at dawn on Monday, seventeen hours and four hundred more patients later than at first planned.

This duty for St. John had come to an end , and members set about enjoying what was left of their bank holiday.

They carried home with them memories of an unusual event: of crowds of well-behaved young people; of the extreme courtesy and respect shown them and their uniform; of many patients on 'bad trips with LSD; of the sudden and unexpected cal ls for extreme skiJl an d actio n; of an even n one will forge t.

Some lessons which might be helpful to others when planning similar events are:

(1) Plan early, with involvement of full County Staff.

(2) in uniform with Brigade flags to aSSIst identification of areas eg medical centre. '

Have adequate rest facilities for Bngade members, with plenty of reserves of coffee, milk and biscuits.

Attended by 13 doctors (including 3 Brigade surgeons), 1 dentist, 15 medical students, 4 local SRNs, 75 Brtgade personnel, and 19 Red

CONFUSED OVER HYPOGL YCAEMIA AND HYPOTHERMIA ?

THIS ARTICLE SHOULD HELP YOU SORT THEM OUT

HOW WOULD YOU lik e to find your elf in this predicament?

It is a frosty January day and you are going to visit Mrs. O 'Go rman , an elderly diabetic fri e nd of yours who lives by herself. There is no answer t o the doorbell but you turn the handle and let yourself in. The hous e is cold and cheerless and from the living-room comes a faint moaning which you recognise as Mrs. O'Gorman 's voice. You go in there to find the old lady , clad in her nightdress, lying on the floor in a confused and almost unconscious state with cold sweat on her face. On the table is a syringe, apparently recently used , a nd an insulin bottle.

If you are a good first-aider your mind will work like this: a diabeti c person ca n get into a semi-comatose (or indeed completely unconscious) state when there is too much sugar in the blood (hypoglycaemia), or too little sugar in the blood (hypoglycaemia). Insulin has the effect of bringing down the blood-sugar and hypoglycaemia is therefore unlikely in a patient on insulin treatment, especially as this condition usually comes on gradually and takes a considerable time to reach crisis point

The evidence is that Mrs. O Gorman has been giving herself her injection s so hyperglycaemia is very unlikely . Hypoglycaemia , on the other hand , can come on extremely quickly if the blood-sugar goes below a ce rtain point due to an overdose of insulin or a failure to balance the insulin taken by s ufficient of some carbohydrate food or drink. This , then , is the likely diagnosis and, since sweating is a prominent feature of hypoglycaemia, the cold sweat on the patient's brow is confirmatory evidence.

Sugar by mouth is the treatment urgently required. It can be given in the form of ordinary table sugar in a sweet drink or, if available, glucose There is no time to make tea or for any other delay because the patient may lapse from s e m i-consciousness to complete unconsciousness at any moment and would then be unable to swallow at all, in which case she will need treatment by stomach tube or intravenous drip.

If sugar is given to a patient with hypergl ycaemia, it will of course not help

Puzzling it Out

by J. Twomey, NIB, BCh, BAO, NUl, DTM & H, DPH

but neither will it do any appreciable harm Wh e n the diagn osis of hyperglycaemia is made the proper treatment is insulin but a doctor 's exa mination is needed before this treatment is given and it is very ikely that the patient will have to be admitted to hospital. I f, however, insulin is given in error to a patient with hypoglycaemia, the results be disastrous. So there are two rules for first-aiders in any diabeti c crisis: do n ot hesitate to give sugar and never co nsider injecting insu lin unless a doctor says so.

So you find sugar in some shape or form and get Mr s. O 'Gor man to take it. If it is a straightforward case of hypoglycaemia the results are rapid and she begins to come round almost at once.

But suppose this does not happen?

Suppos e th e old lady do es not respond but remains mentally confused, weak, and unable to get to her feet: either the diagnosis of hypoglycaemia was wrong or there is some additional complicating factor. You must try to work it out.

Has Mrs. O 'Gorman sustained a head injury? Perh aps she bumped her head when falling. You look for evidence of thiscuts or bruises - but there are none.

Has she had a stroke? It is impossible to be absolutely cer tain but there are no positive signs such as paralysis of the face or limb s on one side of the body compared to the other.

You sme ll the breath for alcohol: this is nega tive. You look around for an y thing to suggest that there has been an overdose of drugs, eit her accidental or deliberate, but again draw a blank: the tablet bottles in the medicin e cupboard are neat a nd appear undisturbe d From your own knowledge of Mrs O'Gorman she is not likely to have attempted suicide. Neither is she subject to epileptic attacks. Apart from her diabetes and allowing for h er age, she has always kept reasonably well. Why then is she collapsed and on th e verge of unconsciousness?

Hypothermia is a distinct posssibility

Remember , the weather is very cold and Mrs O'Gorman has been lying for an unknown length of time in an unheated room wearing nothing but her nightdress. She is an old lady, in one of the two

CADETS VIEWS

THEIR ANSWERS TO SOME OF THOSE QUESTIONS

age-groups at risk from this condition, th e other being mall babie Thi i be cau e at the two extremes of life we do not adjust so well to low temperatures A person suffering from hypothermia i) pale , very co ld to the touch has shall 011 breathing, and, unless treatment forthcoming lo ses consciousness. 01 cour e it co nfusing to come across patient suffering from hypoglycaemia and hypothermia at the same lime, but thi \1 li able to happen as either condition rn a) lead to the other Mr. O'Gorman rna ) have failed to take food to balance her insulin injection because her menta l proces es were already affected by the cold, making her forgetful. Whether or not this occurred her collapse dressed al he wa , would be very likely to result \n hypothermia. If your rea oning i correct she collapsed because of low blood suga: but It might equally well have been , stumb le resulting in a hip injury or an) one of a hundred other things whi ch immobili ed her on the floor, l eaving her a helpless prey to the murderously cole temperature in the hou e. Your next problem is treatment. Y ou have covered the old lady with blanke t' and now you quickly make her a hot cup of tea, putting in a little extra sugar just for lu ck. You must not on any account use hot water bottles or electric blank eb as these draw the blood to the skin and away from the vital organs where it \) needed. For the same reason it is best nol to light a fire. Reheating must be gradu al and un less there i a quick re pan e, mor t complicated medical measures may be necessary. Hyp othermia is a very seriou) and quite often fatal condition but in the present case it is an encouraging sig n th at the patient is still partly can ciou

You have done all that a first-aider can do for Mrs. O'Gorman. The most urgen t thing now is to get her to hospit al without delay You go to find J telephone and ca ll an ambulance.

If she recovers you can be quit e certain tha t a lif e has been saved by your timely arrival and the fact that you had the knowledge a nd presenc e of mind to carry out the correct tr eat ment.

R eprinted from Th e Electricity CouncilJ Ambulance Bull e tin

THE FOLLOWING ANALYSIS, supplied by Assistant Area Nursing Officer Mrs. 1. F. Radl ey, of a questionnaire \Vhich cadets were asked to fill in anonymously at a r ecent one-day conference for East Surrey cadets is of interest.

General Facts : 43 cadets completed the questionnaire, of whom 31 were nursing and 12 were ambulance cadets.

Age range: Nursing cadets 12-18 years (yes 18), average 14 years 4 months ; ambulance cadets 11-15 years, average 14 years 2 months.

Question: Reasons for becoming a cadet : urSll1g Ambulance cadets cadets

Int erest in first aid or nursing 10 5 Training useful in lat er life 6 2 Influen ce of a friend 5 0

No specific rea son 10 5

The replies to this question were spread throughout the age range no particular age group showed a bias to any particular reason.

Question : Nmber of Proficiency Certificate held Age N/C A/C 11 years 2 ( 1 cadet)

12 6 ( 6 cadets) 0 ( 3 cadets)

13 26 (11 cadets) 7 (4 cadets

14 28 ( 6 cadets) 15 (3 cadets)

15 15 ( 4 cadets) 4 (I cade t)

16 20 ( 3 cadets) 0 (0 ca det s)

18 " 0 ( I cadet) 0 (0 cadets)

These figures give an average of 3 certificates per cadet and include one 14-year-old with 8, one 15-year-old with 10, and one 16-year-old with 12 certifica tes.

For A. cadets the average i fractionally over 2 and includes one 14-year-old with 11, and five cadets with no certificates

Question Parts of meeting enjoyed most :

Training sessions

Games sessions

Drill sessions

Discussions

Preparing for fairs , etc N/C A/C 13

Question : Parts of meeting enjoyed least :

Drill sessions

Practical sessions

Question : Attitude to combined meetings with Juniors: N/C A/C

Compare the attitude t o mixing this age range with the attitude to joining Ad ul Divi sions.

Question : Will you join the Adult Division : IC

This question was

Replies given fall into 4 clearly defined groups: i) Expected pressure of stu

ii) ot given the matter any thought. iii) Members of Adult Divisions are too old. iv) at enough young members of Adult Divis ions and the jump is too great.

Reasons iii) and iv) can be linked to a suggestion from two of the cadets that there sho uld be an intermediate section.

Que tion : Membership of other

Question : Other useful comments:

The 1a t item reflects feeling at the rumoured camp ite cIa ure in 1973.

It is recognized that the ample size is too mall for any rigorou analysis and is not statistically significant. But doe, we feel. give some pointers to cadets' thoughts and food for thought for all who are concerned with cadet.

An unusual prcture of nursing cadets of the St Audries School Division, near Minehead, Somerset, who took part in a Christmas concert sponsored by St John in Somerset (Photo Brian Walker, Glastonbury)

FOR THE SERVICE OF MANKIND

from R O T Po vey, D ivis io na l Vice- Pr esident, Keighley

One senses through the pages of St. John Review, through remarks made at conferences, and from other sources, th:lt the uniformed branch of St. John has lost its sense of direction. Members are not clear where they are going. New recruits do not come forward because they cannot quite see what it is all about.

What does the Brigade exist for? True, we are all trained first-aiders and are prepared to help our fellow men in any way we can, but are the opportunities there? How often can we really put our first-aid training and knowledge into practice? Even on many public duties we have a policeman standing alongside us who can call up an ambulance over his walkie-talkie within minutes, leaving us with the realisation that the best thing we can do is leave the patient alone (almost) until the ambulance arrives.

It is also noteworthy that the spread of public duty is uneven over the country. Our colleagues in London do magnificent work on great public occasions and undoubtedly derive great satisfaction from doing it, bu t out in the rural provinces there is little or nothing to bring great crowds together and many members in those districts can go for years on end withou t even having to treat a nose-bleed or a faint.

Why do cadets not bother to get themselves promoted to th e adult divisions? Because there seems to be no earthly reason why they should! There is a feeling, often mistaken but often true, that the members of some adult divisions meet more for social reasons than for 'professional' reasons. As the cadets feel no social affinity for the adults they do not wish to join the adult divisions. If they could be assured of a professional job to become involved in , I am sure they would view the situation differently'

I suggest that the opportunities for improving our image , improving our effectiveness, improving our usefulness and providing ourselves with a sense of purpose are there - but probably not in the places where we are looking for them.

So what are we going to do about it?

We cannot do better , I think , than remember the mottoes of the Order. For the Faith, and For the Service of Mankind J am sure we are all faithful to our beliefs and faithful to our ideal s of useful service, otherwise we would not be associated with St. John. Let us then consider how we can be of better service to mankind.

First aid is only one way of being prepared to help our fellow creatures There are many others. To be consistent we will be looking for ways of being of service which have a 'medical' aspect and there are many opportunities available. Most hospitals now have a ready acceptance of voluntary workers and can give them meaningful jobs to do. There are clubs for physically disabled and mentally handicapped persons all needing help If there is no c lub in an area , one can be started. Many old people , particularly in groups of special dwellings, are lonely or unable to cope with life as they used to. Family Planning clinics need volunteers. P ersons recently discharged from hospital may need some help in the home, in the garden or with personal toilet. There are many people who are virtually tied to the house by reason of caring for an aged or crippled relative - give them a night out sometimes by sitting-in with the patient. There are dozens of similar opportunities for service if only they are looked for.

I know that many, many readers of Review will be doing work of this sort already but I suggest that it should be organised as a divisional effort ; that those who do this work should learn all they can about what they are required to do; that cadets be involved in these activities; that regular discussions and exchanges of views and experien ces should form part of divisional meeting s; and that we be seen to be offering ourselves in the service of mankind.

Find a job, roll your sleeves up and get it done ; and people will want to join you. Cadets will want to stay on and you will feel that your membership of the Brigade has a meaning and a purpose.

READERS VIEWS

offers will be ignored, but in spite of that 1 wonder if I might add some weight to what Mr. Dubut says and develop the su bject?

Readers' views and opinions, which should be sent to the Ed itor although published are not necessarily endorsed by the Editor 0' the Order of St. John and its Foundations Although readers mal sign published letters with a pen -name, writers must supply the ir name and address to the editor.

I agree that a plaintiff would have show that a first-aider on public duty had shown a hlgh degree of neglIgen ce before he could succeed. I agree also that SJA holds itself out as expert in its field; and that being so the public are entitled. to expect a high s tandard o f knowledge a nd a.s hlgh indeed as SJA advertises ltself to be; and I thmk that If SJA member , excluding qualified personnel, strays very far from the treatment laid down in the text book he may find himself if difficulty because that text book is the ex tent to which SJA holds itself out as expert. Presumably the text book treatment is right because of the qualification and authority of the Advisory Committee who consider the treatments advocated. If this is right the first-aiders skill and knowledge flows from that book , and as a SJA member he must be presumed to have knowledge of that book since he was examined on his knowledge of its co nt ents before he was enrolled as a member. Regula tions require that he must keep his knowledgp up-to-date by re-examination. Therefore if he moves far from that book he may be liable, and I think that others may have come to that co nclusion because of the recent note regarding the administration of aspirin. A f urther illustration is the treatment of wasp and bee stings. I have seen personnel on duty using several new aerosol treatments. That is not the treatment laid down in the book. What would be the position if the patient had an allergy? Has the SJ A member been negligent? Is the patient not entitled to say: 'I went to the first-aid tent because I knew St. John were on du ty and I expected they would follow the treatment laid down in their text book'? There is no doubt in my mll1d that SJA is vicariously liable for the acts of its members. The strength of m y arg ument stems from the fact that the Brigade is a disciplined body. It is not democratic; one is obliged to carry out instructions whether they are right or wrong and 1 am sure that because of this, if for no other reason, the master/servant doctrine applies. Regulations set o ut that the senior person present is in charge and also how the se nior person is defined.

The responsibility for treatment administered must rest with the senior person there, and if anyone gives the wrong treatment the responsibility will reach him , but he should be able to pass it upwards through the channels of communication.

But what if that person is carrying out the duty in breach of Regulation s? How well defined are the areas of responslbllity within a particular rank? Can a sergeant agree to undertake a duty without the consent of the Div Supt? Can a Div Supt. without the consent of his Corps. Supt? If he cannot but does, is it not open to SJA to say: We accept responsibility for the negligence of ambulance member X' but we are entitled to be reimbursed our outlay by Sgt 'Y' because he ought to have had his Div. Supt's permission which would not have been forthcoming if the Div. Supt. had known that member 'X' was going to be on duty, because member 'X' had been working nights that week and in addition had undertaken a transport duty and a lecture, and obviously was too tired to be on duty again.

The question whether SJA would seek in demnity is not a decision which SJA would take, it would be taken by the insurance company concerned under the power of subregation contained in every insurance policy and SJ A would have to do what the insurance company said in that regard. I am, of course, assuming that there is a policy of insurance in force covenng damages claims by patients I rather fear there is not.

The next aspect is claims by member s against SJA. Being a diSCIplined body with officers and NCOs etc, I think it goes without saying that it is expected that our officers have all the qualities associated with officership; judgement and leadership particularly. If therefore an officer does anything, or gives an instruction to do a thing or omits to do anything which one would expect an officer to do or not do, as a result of which a member is inju red , then SJA will be liable, always subject to the insurers righ of su brega tion under the policy.

Which brings me to the point I wish to make and that is that for too long promotion to officer rank has been the reward for loyal service and/or ap plication of 'the Old Pals Act'. We must

LARGE DRESSING

from Ben R. Jarman, District Staff Officer (Cadets) (A)

The November Review gives some exce ll ent instructions on thr preparation of 'an extra large dressing for first aid use 1 am wondering if a word from Headqua rters might find SO!l1t person or dr essing manufacturer who would be willing to make supply of these at a reasonable charge, including the necessa r sterilizing, for Brigad e purposes? I feel sure there would be a hug, demand. 1 for one would like a small supply for my specia l kit If the car.

Halifa x, Yorks. Bell R. Jann o

PHEW!

from D L. Williams, County Staff Officer

1 hav e s p e nt a good many years in Law, mainly involved If litigation in private practice, and I have read with interest ant perhaps more appreciation than most the article by David Du bu 'First Aid and the Law ' in the De cember Review.

Over the years 1 have very carefully looked at the aspe ct which Mr. Dubut ha s co nsider ed, and have reached the sanlt conclusions for the same reasons.

Lawyers are naturally treated with suspicion; our training an experience lead us to anticipate difficulties and to avoid pitfalls

The lay public (including SJ A member s) is more prep a red to le ar r from experience than listen to advi ce and, of cour::e, our subjecl lends itself to barra c k-room' dis c ussions and the 'k now-aIls' (01 which SJ A seems to have more than its share) have their OWf interpretations. No doubt all the good advice which Mr. Dubu l

There's nothing like starting young

Under the watchful eye of Mum, the winner of a Plymouth baby show shows his appreciation to the judge, Plymouth County Staff Officer Mrs. M. Miner

really give proper thought to the qualifications of the people appointed. They must be able to 'carry' the rank. I am afraid I am unable to accept the argument which I have heard advanced so many times - 'This is a voluntary organisation, we cannot expect people to comply with Regulations if it is inconvenient to them, and Bill Smith has been in for 20 years, his father was in for 40 years and his lad is a cadet'. To this I say most stronglyeveryone signs a BF I on joining, indicating that they have read and agree to abide by Regulations, and if they are not so prepared then they should not join or they should resign. Promotion to officer rank is not a reward; those who need rewarding should be admitted as members of the Order. The bulk of administration expense is spent on chasing inefficient officers and the extent of their inefficiency is reflected in the extent of the postage account, taking in that amount of expense incurred at various levels which is never charged to Brigade Funds.

FinaJly, the point which ought to receive very careful considera tion is the value of the insurance cover. At present Regulations say £5,000 for death, etc, going to £10 per week for 52 weeks. This is ridiculous, of course, in this day and age when damages awards of £40,000 are not unusual and awards of £15,000 to £20,000 regular. Whatever the deficiency between insurance cover and award has to be found by the Brigade - and that is you Remember then - if you order a member to immediately 'phone for an ambulance and that member in his haste to obey you runs into the side of a car and is severely injured so that he cannot work again, someone has to foot the bill; and if the insurance company payout they can ask you for it. And whatever the Brigade has to pay will also be paid by you because the Order gets out of it in the first sentence of appendix 'A' of Regulations

Sutton Coldfield D. L. Williams

WORKING GEAR

from Bruce M. Coltman

I was interested to read in December issue Readers' Views that Mrs. Smith would like to see some GLO markings introduced into our uniforms.

As a motor patrol officer I can only agree with her whole heartedly . All traffic regulating organisations and emergency services face the same problem, and as Mrs. Smith so rightly states the fluorescent orange vest cannot be regarded as smart. Also its reflective values are questionable, especially when a wearer vanishes down the road on the bonnet of the car driven by a short sighted motorist.

There is however a grey material available which has fluorescent propertieos and is supplied in belt form. This material is visible in headlights and clearly seen in poor street lighting at a distance of two hundred yards. I am sure it could be used to our advantage and so cut down the risk of near misses.

Further to the letter from Mr. D. R. Brown, the example shown by the police in t'he use of a checked hat band, officially known as Sillito tartan: This hat band was introduced for the purpose of distinguishing a policeman wearing a cap from all other military cap-users in a crowd .

St. John officers whom I know have been quite often stopped by members of the public who are under the impression that they are senior police officers If we follow Mr. Brown's suggestion we are going to have even more cases of mistaken identity, because from a distance the hat band of two white and one black band looks very like the Sillito tartan.

In looking for an answer to this problem, I have noticed that certain regiments of the British Army have a hat band for their dress caps. This hat band is worn by all ranks from rooky to colonel of the regiment.

So let us have no second rate snobbery in St. John If we want to show ourselves to be all of the one and the same intention, TO SERVE MANKIND, let us ail put on one distinguishing hat band. A white one. This has been our distinguishing headgear mark for a long time, so why change now? I would, however, suggest that the band be made of washable material so that it could be removed for cleaning. 18

While so far having disagreed with Mr. Brown, I would agrel with his remarks on Brigade caps. They are awful; and can on l) be described as cheap and nasty, I am sure our makers car turn out better hats than those we get. Our's should be stamp ec First Aiders, For Torture Of, Mk.l.

So as well as having one hat band throughout the organisation let us also have comfortable hats.

Newcastle-on- Tyne Bruce M Coltmo'

SHORT SPINAL SPLINT

from Dr. A. J. Pim, Sec, Road Accident Emergency Care Scheme Thames Valley

f am rather concerned that there seem to be one or two errors u the article on the short spinal splin t and spinal injury wh ic' appeared in the October Review

Before we adopted these splints in our local road accid er scheme, I consulted the Director of the National Spinal Injur Centre at Stoke Mandeville who, like Dr. Dawson agrees th, there is no set procedure for removing these patients from cars.

There are 2 basic rules Firstly, it is generally safe to return bent spine to the correct anatomical position ; but this must n( be over-corrected , and having once been corrected, must not f allowed to relapse Secondly, the spinal board must not be USt for lumbar fractures as this increases the risk of flexion.

Figure 2 to the article shows the man with his arms inside It. straps. This is incorrect and was an error in the original drawing the British Medical Journal. However , the head of the patient Figure 2 is seen to be much more in the normal anatomical Iin than in the photographs where the head is held forward too f, by the sponge padding.

When the patient has been transported to the stretcher, it wau normally be much easier to keep him stable if, when his buttod are on the stretcher, the straps are released and the board allow! to slide upwards as the patient lies down on to the stretcher. the amount of padding between the head and the board minimal, there is no untoward movement of the neck at th stage. At the same time, there is more give from the canvas of In stretcher which is still firm enough that the danger of pressu sores is decreased. The cervical collar of course would stay I position until the patient has been X-rayed. Henley- on- Tham es A. 1. Pil

The author of the article referred to in the previous letter, Dr I C. Dawson, replies :

I am grateful to have had the opportunity of replying to Dr. A J. Pim's letter following my article in the O ctobe r Review

It is a pity that I did not stress the importance c overcorrection of the spine when it is returned from the ber position to the correct anatomical position Over correction of th cervical spine could occur if no padding was placed behind th head. I feel that some padding is indicated and it would proba bl be wise if a small variety of sponge padding was available in th kit, so that the correct thickness of padding could be appli e without over extending the neck

In practice with a trained casualty I have found no difficu lt in keeping the casualty on the splint when eventUally placed 0: the stretcher. In fact it has been a great asset when the casual!· has been unconscious and needed to be turned into the com position. The turn is easily accomplished without any movem er of the spine and thereby producing no further damage to th spine or cord.

On arrival at hospital the casualty can be kept on the split thereby being an aid during the frequent lifting and turning un O after X-ray has either confirmed or disproved a fracture of th spine. This of course assumes that the casualty is going to be in hospital within a matter of 30 minutes to 1 hour. Any longe period on the board may necessitat e regular turning of th casualty to obviate pressure sores occuring and this can be mOl easily carried out while the casualty is immobilised to the spin splint

I see no reason , as I understand, why the splint should t b sed for lumbar or lower thoraclc fractures. Good no e u .' II f immobilisation can be carried out by 1tS use espeCla y 1 a difficult movement is required for rem?vmg the from a car or position I would not consider usmg the splInt for fractures of the sacrum.

Apologies must be given for applymg the belts the s and hands but I did not see the correctiOn made m the Medical journal I agree that better immobilisation can be obtained with the hands and arms outside the straps.

BIG IN HEART

from

A. J. Burton,

Secretary, Rugby Centre

After the recent TV documentary Born to be Small by Lord Snowdon, I thought it might be of interest to members of St. John, to know how useful these people can be to our organisa tion

In our Rugby Centre we have as our St. John Review secretary Miss Kathy Flint, who was born to be small in stature only. For she is responsible for the distribution of the Review in this area. She keeps the records of subscribers, and each month addresses and posts them to our members

This work is a great help to us and gives much enjoyment to Kathy.

Yesteryear is back again everwhere in fashion - skirt lengths and hairstyles - but St. John has not yet ventured through the 'mini age'.

Why, oh why can't we be modern? Who on earth wants to be jeered at for wearing the 'old style ' uniform apron? Halters and such have been 'out' since the days of Florence - and should remain so. Who decides on SJ uniforms? And what is their age group?

They may think that the right decision has been reached , but give the younger ones a chance. After all , it's the younger members who are to be our new generation in the Brigade And how on earth do such styles help the 'modern' image of St. John?

Wake up to life, not relive the past , should be our theme.

Longton, Staffs Jacqueline Sampson

RULED OUT

from Mrs. A. Green, Divisional Superintendent

With reference to the December Review cover picture , Nursing Member Jean Dennison is apparently wearing an engagement ring when rendering first aid . I have always understood it is a rule of the Brigade that nursing members do not wear ' dress' rings or other jewellery when on public duty . The photograph is not entirely clear , but it would appear she may also be wearing ear-rings.

This photograph is not a very good advertisement for our rules!

London, W3 Amy Green

PEN PALS

from Mrs Irene Lappage

On looking through some of last year's Reviews , I see that the subject of pen-pals crops up several times. I would welcome letters from other St. John members in any part of the world. I am 30 years old, married, and have 2 sons, who are now in the cadet division as juniors. My interests apart from St. John work are stamp collecting and classical music Also, I am trying to start a post card album for our juniors, as I think this will prove educational as well as interesting for them

So please you members in other lands, do write and tell me all about yourselves , your work , and hobbies and your country.

76 St. Alban's Road,

Kingston-upon-Thames, Surrey Irene Lappage

CORRECTED

from I. F. Colwell, Ambulance Control Officer

Rugby Centre 's Review secretary M is s Kathv Flint

I am sure there are similar people in many areas who could be found something to do in our organisation. Although small in stature, I can assure you they make up for this in kindness and enthusiasm. Kathy helps at most of our social functions, bazaars and sales, and is an expert at selling raffle tickets She is always cheerful and can crack a joke as well as the next.

Surely here is another branch 'For the Service of Mankind' which can well be used by St. John?

We would never regret it, I am sure.

Rugby

UNIFORM - NEW STYLE?

from Miss Jacqueline Sampson, Nursing Officer

A. J Burton

On ordering a new-style uniform recently I realised what a retrograde step had been taken by the people who authorised this 'new style'. I am of course referring to the apron 'halter'

The November Review states on page 23 that Ambulance Members R. Youill and B. Shaw were the first Brigade members to win the two-man Ambulance Officers First Aid National Finals. This is untrue Mr. B. J. Jupp and I won this in 1970 ; also Mr. Weaks , a West Sussex Brigade Member , won in 1967. Lewes, Sussex 1. F. Colwell

GIVE ME A RING

from L. J. Avis, Divisional Superintendent

In various 1971 issues of the Review I read with great interest of the Divisions that passed through Harwich en-route to Germany. Their point of embarkation was within a 100 yards of the Harwich Division's HQ. The man who owns the Harwich Dock Co ., is Vice President of our Division and the Dock first-aid men train with us.

Those who went via Parkeston Quay again passed through big first-aid territory. A team from the Parkeston Quay Division represented B R. London Trans & B.T. Docks in the 1971 Grand Prior's

To members who plan this journey in the future, I ask them to note my telephone number, Harwich 2200, and should they ever find themselves stranded in Harwich to give me a ring.

I will compile a list of accommodation and transport etc. and always keep it to hand.

696 Main Rd, Harwich, Essex L. J. A vis

NEWS fpom SCOTLAND

Edinburgh

ON SUNDAY December 5 members of Chapter attended in their full regalia the St. Alldrews Day Commemoration Service in St. Giles' Cathedral. As members of an Order of the Crown they had, as usual, precedence over all other institutions after the officers and knights of the Most Noble Order of the Thistle.

The E x e cut i ve Com mitt e e in Edinburgh is organising a booking for as many members of the Order and Association and their friends as possible on British India S.S. Uganda for a Crusader Cruise from November 23 to December 7 1972. The ship will be visiting Malta, Nauplia, Athens, Rhodes, Dubrovnik and Venice. Those interested should get in touch with Miss G. Graham (24 Ba1carres Street, Edinburgh EHI0 SJD) as soon as possible.

A sale of work held recently raised over £1,100 for the Order.

OVERSEAS NEWS

Glasgow

Thanks especially to the foresight and drive of Dr. W. Ferguson Anderson and Mr. Matthew Taylor the Order has now found a worthy and very ambitious project to replace the hospital which was closed down a year or two ago. Priory has now approved the scheme for the establishment of 'protected hou ing'. A site has been acquired and plans drawn up for the building of 24 flatlets for elderly people - couples and single persons with communal facilities and provision for a resident warden. It is hoped that the building - of three stories with a liftwill be finished early in 1973.

On October 29 the Ladies ' Committee of the Association arranged an evening show of 'A Century of Fashion 1830 1930' in the Renfield Church Hall, Bath Street. Mrs Kinniburgh presented in a most professional way the clothes, which ranged from wedding dresses to bathing

costumes and from sportswear to staYI All the dresses were genuine and the accessories were carefully chosen to fit the periods The models included two 01 Mrs . Kinniburgh 's daughters, and Song were chosen and sung by the you ng ladieas an accompaniment to each costume 3\ it was belOg shown. In the interval tea coffee and horne-made biscuits wer served, a nd during the evening, which W3' a financial success, a raffle was drawn fOI. Mrs Leggat Smith , the chairman of Ladies Committee, gave a brief talk the work of the Order. It is hoped that bl organising evenings like this the OId e' will be co me better known in the city.

Stirling

The new Bran ch of the Association ha now been established in Stirlingshire wit! the following office bearers:

Chairman: Wm MacFarlane Grey Esq., OBE OStJ, DUniv , FCCA , FCIS JP.

Han Treasurer : George J Winni ck Esq., LLB , BS c.

Han Secretary: Archibald Russe Esq., MStJ

Chaplain: The Rev R G. Lawrie MA,OStJ.

Youth Offi cer: David W. Law, Esq. MStJ , JP J R-S

NIGERIA

Dr. E. W Lonsdale-White, who was the St. 10hn Am bulance Brigade Surgeon for the Lagos police Area, has recently retired He actively for St. John throughout hIS .stay 1I1 Nigeria before leaving finally retuement after twelve continuous years servlce. Brigade members will continue to remember this able surgeon who has done so much over the years to raise the general standa.rd of our competitions, and for the donatl?n of a well-treasured si lv er cup for the lOdlVldual winner of the all-Nigeria First Aid competition. Dr. Lonsdale-White 's loyal service will ever remain indelible in the history of the igeria Poliee District of the St 10hn Ambulance Brigade. We wish him well!

H

recently (Left) Area Commissioner L Tranquilte MBE and (centre) Commissioner G Ohis

SOUTH AFRICA

The nter - Oistrict

KENYA

News from the Divisions

BERKS - The first Area cadet football tournament took place recently at West Wood hay House. 11 teams , each of six players , two of whom had to be girls. from 7 of the 8 western Berkshire divisions took part ; the winner wa, Abingdon A team, Hungerford A bei n! the runners-up.

The winning team received a cup, t be held for a year. and a wallet for ead team member. The runners-up received a ball-point pen All the priz e' were given and presented by Mrs. J Hend erson, Berkshire's assistant superintendent, at whose home the tournament was held Players, offiCJah and supporters were entertained to tei after the rna tches by Mr. and Mrs Henderson

It is hoped the tournament will become an annual event.

Regretably, no pictures of the girls in action are available. Perhaps nex year

LlNCS - The first Grand Prior badge' awarded in the northern area were recently presented to Gainsborou gh Ambulance Cadet Division membe r Cadet Sgt. A Lytwynchuck , now trainee nurse , and Peter A. Crompton now in the Adult Division, by Dr. L Geriis the area commissioner.

12-year-old Cadet Paul Manning, alsc of Gainsborough Div1sion, won the Cadel of the Year trophy.

NORTHUMBERLAND - Results of thl 11 th County First Aid Competition:

MEN

For a cup presented by Mr. and Mrs. R L. Bellwood

1. Cen. Elect. Gen Bd (Blyth Power St.) 147

2. North'd Constab. (A team) 13Q

3. SJA (Lynemouth Div.) 13' 4. City Ambulance Div. 134

WOMEN

For a cup presented by Miss J. Fearnside

1. North'd Constab (Po li cewomen)

2. SJA (Shiremoor Nursing Div.) 12l

OBITUARY

A. R Cummings Divisional Superintend' ent, No. 7 (Toynbee Hall) Division London District. Joined division in 1940

See report LINCS : Dr L. Gerlis • congratulates

R EVI EW CROSSWORD No.2 (72) Compiled by W A. Potter

ACROSS:

1. Convulsive inspiration in early stage of gas-poisoning. (4) 7. Foolish diagnosti c feature of measles, for example. (4) 10. Late cure for unhealthy slow-healing lesi on. (8) ] 1. Intravenous infusion in hospitaL (4) 12 Not to be repeated in concert. (4) 13. Angry about outfit to wash-out abscess cavity or conjunctiva l sac. (8) 14. Sounds healthy to greet a co ld shower. (4) 16. In correcting proof transpose ten for three. (4) i7. Wrongly take another's place. (5) 19. Down on the bed. (5). 20: May b.e prescribed for support of abdomen or spine. (6). 21: A httle .spmt for snake in 1 Across. (3). 22. No rags in functlOnal umts of body. (6). 23. One of the auditory ossicks. (.5). 24 0ften comes before aid to the injured. (5) 26. Try out diagnostIc procedure. (4). 28. Deep voice of bachelor with silly fellow. (4) 3.0' Requiring a chiropodist after a long walk? (8) 31. Its vestigial remnant is the coccyx. (4). 32. Source of blood In 9 Down. (4). 33. Glands that make one weep! (8). 34. Form of punishment for producing sugar. (4). 35. Steers badly havmg a tropical disease. (4).

DOWN:

2. Its first branches are the coronary arteries. (5) 3. Stud.ent reaction noted in observation of head injuries. (5). 4. We object to a car for scabies parasite. (6). 5. Was the powder traditionally given for gastro-intestinal upsets devised by the Great Pope? (8.7) 6. Condition resulting from bad taste. (5). 8. Before Nero takes a case wrongly characterised by the chronic aicohohc red nose (4.7) 9. Coughing-up of bright red, frothy blood. (11).14. Drug or appliance for arrest of (11). 15. Pamful result of dietary indiscretion. (11). 17. Exammed for routme control of diabetes. (5). 18. Five omit to regurgitate stomach contents. (5). 25. Story in which Frenchman appears makes rough weather. (6). 27. Cords in the throat. (5). 28. Central part of long muscle , such as biceps. (5). 29. Sebaceous cyst is upward directed tendon. (5).

SOLUTION TO CROSSWORD No.1 (72)

ACROSS:

1. Deep breathing; 9. Gigantism; 11. In .ner; 12. F.o.p; 13 Tone; 14. V.ill.i; 15. Lien; 18. Lactose; 19. Stomach; 20. Stertor; 23. Overdue; 25. Tube; 26. Flesh; 28. Felt; 30 Awe; 32. Osler ; 33. Pertussi s; 34. College of Arms.

2. Eugenic; 3. Bone; 4. Edifice; 5. Temples 6

Iris 7. Gingiva; 8. Bronchiectasis; 10. Sol; 16 Mouth; 17 Women; 21. Ecbo li c; 22. Relapse; 23. Observe; 24. Dresser ; 27 Ewe; 29. Oral; 31. Cuff.

THAT WAS THE CAMP 1971 THAT WAS

BERKSHIRE COUNIY CAMP

FOLLOWING THE SUCCESS of last ye::n's cou nty ca det cam, Berkshire held its second consecutive camp in recent year Landguard Manor Farm, Shanklin, Isle of Wight, during the fir week of August. Sixty cadets altended the camp.

With this increased number compared with last year, man hours were spent in preparation by the camp commandan t an his deputy CSO H. F. Knott, and ASO R. Penfold , assisted r camp officers. This entailed visits to the island as well as U production of a comprehensive 'camp folder' for officers.

This year, to keep expenses to a minimum,joint arrangemen were made with the SJA Dorset camp organi er to share the sail site on weeks. Certain equipment was al 0 hired fro Dorset and its transport costs shared, co-operation which w appreciated. Other equipment was hired on a j,oint basis.

An advance party , consisting of 10 officers and. 4 cade : arrived at the site on the Friday to prepare for the mam party rear party stayed late Sunday to restore the site after

The transport to camp for 85 people and equipment v. resolved by a collecting together various vehicles, belonging to the officers. The advance party In cars. BMC J4 van, a camping trailer, and a horse-box trailer.

The main party travelled to Southampton in two 0 of which , hired from SJ A Wokingham, was to remall1 With us the island for the week The party with the coach crossed Cowes on the car ferry, with a fine grand-stand view en rout.e ocean liner s, huge tankers , hov ercraft and hydrofoils, s.adJ boats everywhere dotting the Solent for this was the beginnIng Cowes Week , complete with the Royal Ya ch t Britannia and Ii

naval escort.

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During camp a full programme of training. was carried 0. ut, b. Full-Length Conway Stewart Ball Pens die-stamped In gold with your Brigade or Charity for only £1.95p. 144 Printed Royal Sovereign PenCils there was also plenty of time for relaxatlOn. fnstrll ctlOll II £2.10p (42/-1. Please print your slogan (maximum 30 letters) and add 23p carried out in groups, covering all a peets of camp life as well (4/6) standard carraige. J. E. Thomas & Son (Cuffley) Ltd 2a Handsworth studying the proficiency subjects. Examinations held at the atl. Road, London N 17 600. end of camp resulted in I 15 awards. Hence , work and well together. And not only did the cadets work: some offllt (93) successfully qualified for campi ng warrants and quartermast certificates.

Play included swimming trip, visits throughout the area 31 trips around the island in the coac h

FUND RAISING - 1972 Big profits on Printed Ball-Pens & Pencils _ available now on 'Sale of Return' terms. Send lOp for 4 different printed samples & brochure to SCR IPTAPRI NT 3 Manley Terrace Station Road, Liskeard, Cornwall.

A night expedition, aimed at testing th e cadets' map was arranged in which groups of cadet accompanied?y offw were set down in a semi-circle of about 5 mil es radIUS aroLi camp, and asked to find their way back by using footpaths, Ill. references and compass.

Nightly camp sing-songs were followe.d by hot drinks (sou p cocoa not a ShankJin cocktail!); these slng- ongs caught on ve well proved useful for the highly successful camp·11 gathering which was held on the last evening.

Other camp fun included Top of lhe Pops' a fancy dr' show, a camp shower constructed by orne officers, a.nd cadt (which also proved useful) , an obstacle course, LInd a Wide gam

On the first Sunday, all 85 of our camper marched tI:ro uf Shanklin to the lo ca l church service, ca using quite a sUr In

ORGANISERS OF FETES AND FUNDS We welcome both personal buyers and mail orders for our extensive range of Toys and Stationery and Christmas Cards at wholesale prices, send for pr ice lists. ALSO pre-selected parcels.- 144 2%p Toys OR 72 5p Toys OR 38 lOp Toys OR selection Stationery. Each Parcel £2.70 plus 27p postage. Two or

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Then a friend recommended Complan. And he got the nourishm ent h e needed in a form that was easy to take . Complan p rovides the right kind of nourishment and is easy to digest even during illness. When someone vou know needs nutritional help, recommend Complan.

The breath of life.

The new 'Resusci Folding Bag MK II' has been specially designed to be operated under the most arduous conditions with the minimum of training. It has the full approval of hospital anaesthetists, the armed forces, ambulance and other well -known authorities in the field of rescue and resuscitation.

The unit is easy to handle, non -tir ng over long periods, and sensitive to air way resistance. The transparent masks, in two sizes, have large inflated vinyl cuffs for close fit to faciElI contours. There is immediate visual indication of effective ventilation, each exhalation will briefly cloud the mask dome . The equipment s unique and simple nonrebreathing valve continues to operate in the presence of blood or vomitus, and in extreme climatic conditions. It is easily sterilised. There is no forward or backward leak.

Air enriched with oxygen can be administered by using a separate oxygen supply reservoir. The addition of an extension

tube perm its effective resuscit ation to be carried out in confined locations.

The unit is available in various comb i nationswith a compact impact- resistant plastic case or tra n spa rent contai ner for storage or wall mounting at strategic points ' Mod u la ide' Resuscitator / Fi rst-a id Kit s are available in hand casesof3 diffe rentsizes, with space for inst ruments, drugs , bandages and 'Resusci Folding Bag MK II'.

REVIEW

AT RANDOM

with

9S(F). :vfy

is

when

years in some capacity that doesn't involve a technical knowledge of first aid or nursing, sooner or later we wake up to the fact that he or she deserves some kind of recognition and we set in mobon their appomtment as an auxi iary. B ut this is all wrong what they deserve at this stage (provided that they've been helping us for at least three years) is ho n orary membership in accordance with Regulation 95(G). They ought to have been made auxiliaries at the very start of the time when they began to help us, and if we fai l to make them auxilianes right from the start and to give them an auxiliary's badge which they will be prou d to wear, we're missing an opportunity of roping into the ranks of the 'SI. J ohn family' an immen e number of well-wishers and helpers and of thus greatly strengthening our corporate membership. Secretaries. treasurers, au d itors, instructors, examiners, members of parents' committees, h elpers with hospital car services and medical comforts depots and the Like all come within this category. What 1 think we need to do is to look for ways in which people who are friends of st. John can help us even if they haven't the time or mclination or ability to become qualified in fmt aid and nurSing, then find suitable people to fill these posts and immediare/v make the m auxiliaries. T his is e n tire ly in accor d a n ce wi th Regul atio n s, an d a lt h ough we do n 't appoi nt t h e m p r imari l y wit h a v iew to their taking any further step forward, It's amazing the number of people who, after being roped into the family circle in this way, later o n decide to take an Association cour e and perhap even become full members of the B r igade.

At the moment I' m involved in two ve r y excitmg pilot scheme about which I hope you ll soon hear more both of them are schemes which we're exploring with a view to giving voluntar) help i n co-operation with the Department of H ealth and SOClal S ecurity. One (ba ed on a project already developed by Divi ion i n the I sle of Wight) is a scheme for running minibus and or p r ivate car se r vices for taking people to vi It thei r relation and friends in hospital if t h ey can't get there by pub lic transport; the oth er (based o n a project already developed by the S t. Margaret' H ospita l Co m bine d Divi ion at EpplIlg. Es ex) a scheme for the air tran port of organ (such as kidney) for emergency tran plant operation if they can't be conveyed in time by other mean. Both cherne depend e entially on the help of Lluxiliarie of t. J ohn w h o, witho u t being qualified fir t Jider are willing to give us their ervice a car d rivers and air pilot '. These are of course very pecial ca e but I felt that they high-lighted the need for us to do m ore abo ut roping i n the willi n g help of many members of h e p u b l ic in a ll orts of u sef u l ways. W e mu tn't let t. J ohn become a 'closed shop', and I offer you the challenge of seeing ( COl/l i llI/ cd 0 1/ page 11 )

ANA TOLlA is the ancient name given to that part of Turkey which lies on the Asiatic side of the Bosphorus. And on a lofty plateau in the centre of Anatolia is an old Roman province known to us from Bible times as Cappadocia. Here at the edge of a series of wide valleys, narrow ravines and depressions covering approximately fifteen square miles is the small town of Urgup , once the See of a Bishopric in early Christian times. From a hill top can be seen several remarka ble valleys including that of Goreme, which is perhaps the most famous. There are several small villages nearby and many smaller valleys, some branching off from the dried bed of a river.

This picturesque town of Urgup is one of the gateways through which can be made a startling entry into a strange land with an eerie lunar landscape which resembles some fabulous world of science fiction. The Valley of a Thousand Churches.

The incredible scene is the amazing resul t of a million years of nature's handiwork. Beginning with eruptions from a nearby volcano, which completely covered the whole of this area with volcanic ash and mud to a great depth, thus forming a plateau of soft sandstone, or pumice known locally as 'tuff', and

VALLEY OF ATHOUSAND CHURCHES

A PROFUSION OF 8-POINTED CROSSES IN A STRANGE SETTING

IN TURKEY'S ANATOLlA, A SJ MEMBER SEE S

By Dorothy Bingham - Hall

The author gets her first view of the strange valley The ro ck shape is thought to have been a mo nastery cut in soft stone. The outer rock cover h as fallen away through erosion.

where ash and mud mingled with liquid rock, a hard outer covering of rough volcanic stone was given to the strange shapes which lay buried in the volcanic dust.

Then, in course of time, nature began to destroy part of the plateau by the age-old process of erosion; in this case, a relentless erosion of soft sandstone, using her tools of penetrating rain and great winds, to cut out, inch by crumbling inch, the deep wide basin of these valleys.

Gradually, through the ages, the loosened soil and blown dust exposed the remarkable shapes of volcanic cores with hard outer coverings which we see today. Nature, continuing her unhurried process of disintegration, now began to break down the protective outer covering of these shapes, using earthquake cracks and rain infiltration to open the inner core to erosion. The process continues today.

Among the photographs which brought back from a recent visit to this strangely landscaped area can be seen cones with caps of hard rock on top of them, which are in fact all that remains of the outer covering, and we note that the erosion is eating away the soft sandstone centre. When it can no longer support the

weight of the stone cap, this will fall and the cone will soon disintegrate.

Today thi i an off-white world of cliffs and ndges , formed from volcal1h ash, with thousand of my teriou shape in the forms of tall towers , spirel columns, domes and pyramids, from 3( to lOO ft. high, rising from the valle) floor, with a veritable army of greal cones which appear to be marching ir formation like Daleks in a science fictlOD film.

Having thus carved out the countryside, na ture then awaited the neXI phase, man.

Christianity came early to Anatolia Hermit s who came here in the firsl century were followed by the firsl Christian missionaries. St. Paul, who was born at Tarsus on the coast, came Ie Cappadocia on his journeys. St. Peter's first colonial church was a cave at Antioch on the Syrian border, where the name Christian was used for the first time.

The austerity and remoteness of these hidden valleys attracted the hermits seeking sanctuary and peace. Here they cut out their cells in the soft inner rock, sometimes high up inside the very peak or large cones, only to be reached by crude steps and hazardous hand or elbow-holdl cut inside the rock like a chimney linking the cells from floor to floor. When the Christian Church became organised during the 2nd and 3rd centuries, largel communities began to be established here.

In the course of time the rock hapel became riddled with small openingl which gave little indication of the remarkable interiors to which they gave access. These included c hurche s, monasteries, shrines for the sai nts , homes for the living, and sometimes graves fOI the dead, all carved from the core of sofl sandstone. In some places, they contained seven floors, and one, a monastery, no than 23 floors.

The furniture of these pJaces was eq ually remarkable Altars tab les, chairs, benches, bunks and alcoves, together with cooking places, wine presses and other equipment, were cut out from the soft rock but not separated from the floor.

Niches and she lve s were scooped out from the walls; windows were cu t through the outer rock face; and doors were closed by rolling wheels of stone across their entrances, some of which like great millstones, can be seen in situ today.

The exposed soft stone has eroded to slender pillars , the stone caps soon to fall. Note in the central pillar a doorway and the steep approach to it.

The doorways cut into the outer rock face give no indication of the remarkable interiors

Primitive drawings and a profusion of eight -pointed crosses decorate the inside and entrances of the 8th century churches.

Looking across the valley The far rock ridge is riddled with simple openings to remarkable interiors including c hurches

We are told that at one time ther were a thousand churches here Of t he$! 365 are known today in and about th Valley of Goreme. They are referred to, the 'Rock Churches of Cappadocia ' an are classified as 'Rupestrian', or hand- cu rock churches They are probably unique and should not be confused with tho e r caves or natural grottos , uch a S: Peter's church in Antioch

Today some of these rock chur c he ar practically inacces ible and to visit the r involves being let down into holes, or bi crawling through a complicated ystem 0 handhewn corridors ; passing up, down 0 underground , by means of rough st ep and footholds , to dark sanctuaries, so m dimly lit by soft twilight , which h: wonderfully preserved the vivid co loU' of the pain tings.

Apart from the miracle of the sto n' cutter's craftsmanship , the churches a outstanding for their architecture an, decoration, so much so that experts n OI declare them to represent 'a new provu!l of Byzan tine art'.

Architecturally , the interiors conforr to the Byzantine tradition Althoug every de tail is cutin to the stone an hollowed out to form domes, apse' naves and aisles the normal church pla n of brick and stone structures are followe o

The decorations have histori cJ significance also, as traditional art revea l· interesting local influence at vario u stages It can be seen that periods o' stability gave the painters time to devel oi this art, while spasmodi c periods persecu tion, and various edicts Wit. regard to religious pain tings of figures an icons, forced the artists to continue the work in secret and may account for th labyrinthal approach to some of thl underground churches.

(continued /lext mO/l

LOOking across the volcanic basin to the ridges on the far side from capped shapes half. buried in the hillside

Giant cones still wearing their rock caps - ke science - fiction Daleks marching in formation across the valley The ower soft rock has eroded where the outer volcanic stone has fallen away To get an impression of the size of these cones , notice the figure in the centre foregrou nd

According to a EM} article, 36.4% of lInconsciolis patients arriving at a hospital were carried in all llnsatis!actOJ:1' or dangerous position A

NEW TYPE STRETCHER

terrible accident, he saw a patient in pain from ifting. Stevens thought the requirements of a suitable accident stretcher were:

(a) The ability to move a badly injured patient with minimal changing of position.

(b) No friction between body and stretcher.

(c) A simple operation that can be performed by even untrained persons. After design and experimen t, Duphar produced the Lifelift stretcher, which consists of a 40ft moving belt on rollers operated by a turning handle to produce two opposing movements of a conveyor

DUPHAR LlFELIFT WILL SAV E

WORSENING OF AN INJURY

WHEN MOVING A CASUALTY

belt in an aluminium frame. One movement alone brings the patient on to the stretcher without disturbing or moving his position in any way. The Li felift is then lifted manually. At the hospital the patient is lowered on to a trolley or operating table by turning the handle in the opposite direction. The stretcher supplies firm support for the patient, and artificial respiration or cardiac massage if necessary.

The Lifelift stretcher is well-designed and machined; it is 2 metres in length, 55cm. wide, lOcm. deep at one end, and about 2 1/2cm. deep at the other. It weighs 22 kilos. The manufacturer claims that the metal rollers would withstand corrosion. the nylon PYC belt is rot proof and their mechanical bearings are well-nigh indestructible.

Thi equipment has been accepted by the St. John Ambulance Medical Board as being constructed on sound principles and one such stretcher i currently unger trial by a Sl. John diviSIOn.

The Lifelift stretcher, for St. John personnel, costs a little over £200 and is available from Messrs. Duphar Medical Ltd., Telford Road, Basingstoke, Hants.

Fi rst Aid (A DITTY FOR CADETS )

THE FORERUNNI:.R to the mode rn tretcher was of course the liller, which was used in ancit'nt civilisations and referred to in Roman literature and the Bible, when medicine itself was omewhat primitive. De pite the advances ot medical knowledge and practice since then, the basic design of the stretcher ha remained the same. Of course, meta frames instead of wood and man-made fibres in tead of natural material for support are now used, hut these changes are minimal.

One major difficulty at all accidents IS the prevention of further injury, or as the Joint Manual says: 'To prev(;nt patient's condltion from becoming worse'. This is specifically of importance where the spine is fractured or even like!} to be damaged. In such cases it is essential to keep all movement of the patient to a minimum.

Simon Stevens, a Dutch engineer, real· iscd the drawbacks of conventional lifting of accident victims when, at the site of a

from Mr D. Leake, East Runton, Norfolk.

First Aid is all that help which we must trive

To give before a Doctor can arrive.

Somebody hurt is called a 'casualty' by name,

But don't forget he is a Person just the arne.

A Person has thoughts and fears and feeling;

It's not a broken toy with which you're dealing.

A kindly voice and confidence will prove

More helpful than a very sudden move.

Don't rush at him and act before you pause

To think what's hurting him, and what's the cause.

Don't leave him with a weight upon his toe

Or Sitting on an ants' nest down below.

Ask him what happened that is called 'the history';

Until you know the answer there' a mystery. him for signs of pain or broken limb;

WIth sharp eyes search for wha t is hurting him.

Listen what he says, when you ask how he feel , If any movement hurts him, and if his head reels.

Anyone when hu rt is be lter for a rest

So keep them lying quietly, 'tho' they may protest.

Don't hesitate to ask for help from other people ncar,

!ust tell them what to do and that they neL'll not rear-

Please hurry to the telephone' or 'Help keep back the crowd';

Tell them to dial 999 and speak up clear and loud. Then

At hospital or surgery the patient can be lower ed on to the couch or trol ley and the Lifel ift extracted by simplv turning its handle in the reverse direction

A Lifelift stretcher is under trial at SJA Worthing Here Prince Tomislav of Yugoslavia, SJA Sussex Commissioner (second from right) receives the stretcher (Photo Even ng Argus)

APPEAL

Copies of the St. John Christmas Day BBC /T V film, in 16mm colour and running for 5 minutes, are available on loan from the Medical Secretary, SL John Am bulance H eadq uarters, 1 Grosvenor Crescent, London, SW 1.

TV TEST

Mrs. D 0 rot h y B ear d , D i vis i 0 nal

Superintendent of London's Highgate Nursing Cadet Division, appeared in uniform on the Hughie Green show 'The Sky's The Limit' on J anaury 28 to answer questions on first aid - and won £ 100 and a colour TV set.

Good viewing, Mr Beard

MOTOR ISTS' COURSE

Appalled by the pictures and reports of 'Multiple Pile-Ups' shown in the press and on T.V. during the past few weeks, London District's Ha ckney Division has decided to try and do something to help lessen this awful loss of life. What set them thinking was an interview with a motorist who managed to avoid being involved in the accident himself, when he said: '1 could hear bang after bang, followed by screams of the injured, but I did not know what to do'. With a motor-way type of road nearing completion in Hackney, and realising that lives can be saved during the wait for ambulance services, the Division has arranged a course of lectures on first aid and rescue, designed especially for the motorist, although all adults are welcome.

The course, which started at the Division's HQ on February 2, will run for about 12 weeks on each subsequent Wednesday, starting at 8 pm

AROUND and ABOUT

WHAT ' S GOING ON IN THE WORLD OF ST. JOHN

BY THE EDITOR

HAPPY FAMILY

APPOI NTM ENTS

Bermuda : It is reported with regret that the Chairman of Council, The Hon. Edmond Gibbons, died recently.

New appointments: Chairman, Association: Lt. Col. J. Keeffe.

Secretary to Council: Dr. Joy Mair

Bucks: Mr. P. L. Hendry to be Commissioner Southern A rea vice Dr. Piper.

Durham: Mr. P. Blunt, Commissioner South Area.

Essex: Chairman of Council: Lord Abinger in succession to the late Lady Joan Newman.

Notts: Mr. K. D. Williamson to be Chairman St. John Council vice General Ralfs, who is leaving the county.

SJA SUFFOLK STANDING BY

ST JOHN HOUSE

The 22nd AGM of the St. John House Club, London was held recently.

Chairman Rear-Admiral R. S. Wellby , reported: Sadly, our Deputy Warden Sandra Kirk - left us in May; the new Deputy Warden is Miss Garbutt. I am Sure everyone will be glad to hear that Richard the club's chef, has been made an Associate Serving Brother of the Order in recognitio n of 21 years devoted service to the clu b . He was also awarded a bonus.

CAREERS

A brochure giving details of summer schools for future nurses to be held during 1972 is available from NCF Sum m er Schools Registrar, urse s Christian Fellowship, 24 Bartholomew 'l Road, Reading, Berks.

These weekly courses, held from Jul) 29 to September 2, at an average charge of £ 12 a week, are designed for 14 to 19 year-old, girls and boys, who want to know more about nursing as a career. Ir holiday settings, the centres give visitor every opportunity to learn everythIng about a nurse's life with experts on hand to answer questions.

I am pleased to report that some 77% of our members accepted the raising of subscriptions. Of the remainder, 14 % resigned and the other 9% are an enigma, as most of them have paid by Bankers Order at the old rate We have already written to them twice Turning to the material side, the exterior of the building has been repainted in accordance with the lease. Secon dIy, we have amalgama ted the office and the reception desk, thereby increasing the bedroom accommodation by a single room. Three bedrooms have been re-decorated and re-furni hed with the help of Mrs. Boothman and her husband the chairman of Peerless Ltd., who were most generous financially. We have also brought the lift up to full safety standards and installed an in ternal telephone exchange for the benefit of the staff.

In presenting the accounts for the year ending September 30 1971 the Hon Treasurer announced that the deficit had again been reduced to the lowe t amount yet achieved ie £7 5 I This was In spite of the spending of £590 in exterior renovating, £322 for rc- lting of the office and Some £250 on improvements to three bedrooms.

XMAS PRESENT

Rolf Harris , 1 hear, on his BBC Christmas Day show spoke to a Clive Berkley of Balham who had been a patient of Roehampton following the 10 s of both hi legs in a train incident. During the talk the lad mentioned his great keenness for football and that Manchester United was his favourite team; he was also I understand, presented with a hat and scarf of the Manche ter club.

Following the show a fitter at Roehampton obtained two ticket for Clive and a friend to attend the match versus West Ham on January I . .The problem then aro e of getting him from Balham to West Ham His surgeon at Roehampton (Dr. Ian Fletcher, a surgeon in t he Brigade) offered to make arrangements for his transport to the grOund. Doctor Fletcher co ntacted London Distri c t' Eastern Area

Commissioner Robert Bax and between them it was agreed that Clive would be conveyed to St. Paul 's Cathedral and there be picked up by an SJA ambulance and conveyed to West Ham United football ground. Before the match he was taken to the Manchester team's dressing room and introduced to all the players. They al 0 autographed his

NEW TOUR

Much

Brother and sister Eric and Anne Brocklehurst of D roylsden (Lancs) Division both passed their final examination for the Grand Prior 's badge at last summer's district camp.

(Photo. Gorton & Oppenshaw Reporter)

programme Following the match he was taken home by the Brigade. Mr. Bax wrote of these developments of the Christmas Day programme to Rolf Harris.

interest was shown in Hamilton 's article 'The Holy Joyce Land'

(December and January Review L so readers will be interested to know that another tour is being organised for May 1972, visiting Rhodes, Cyprus, Lebanon, and Syria. As with last year's Holy Land tour, this new tour will be led by Headquarters' Registrar G. Woodhill: already about IS bookings have been made. The size of the group is limited to a maximum of 30 people, so if you are interested I suggest an early booking.

The tour leaves London on Sunday May 14, returning to London on Sunday May 28. 5 nights will be spent in Rhodes, a beautiful island of great historical interest to all members of St. John.

Following Rhodes, Cyprus will be the next stop for three nights, where old acq uaintances from last year's tour can be renewed. Three nights will also be spent in both Beirut and Damascus. Interesting excursions will be arranged to other parts of each country, including a visit to B yblos, which gives its name to the Bible.

T h e inclusive cost of the tour is 1 hear £ 177.50. Details can be the tour leader, Mr. G. Woodhill

( R eg is t r a r S t. J a h n Am b u la n ce H eadquarters I, Grosvenor Crescent, Lo n don, SW I) or from the travel agents Express Travel & Transport Co. Ltd., 25/27 Farringdon Road, London EC I M 3 H E.

We look forward to another article nex t win ter.

AN IDEA

The prob em of getting a standard size fi r st aid stretcher into a private car has caused Mr. Ron Parnell (photo above) a member of Norfolk's Mundford Division 10

STRETCHER PROBLEM SOLVED

and c8tches is an 8dvant8ge when used hI women first-aidns, the stretcher kept taut by nylon parachute cord.

The stretcher carne through its finl test with flying colours when used in recent Brigade exerci e, earning higt praise from those wllo took part.

An officer said that he envisaged th l stretcher having wide 8pplications. I could be carried in police cars, Ir motoring organisations patrol vehicle' and even buses and lorries.

Mr. Parnell has no plans at present fOI making the stretcher commercially. 'It was so simple', he says, 'I never gave itl thought'.

PRESIDENTS

Mr. Ron Parnell, a member of Norfolk SJA, with his sectionalised stretcher See story AN IDEA (Photo R W G. Graves, Mundford)

many frustrating moments when taking part in rescue and fir t aid exerci e .

Now the problem has been solved. Mr. Parnell has devised a sectionalised stretcher which can easily be packed in a car boot or on the back seat and which can be assembled in econds.

Mr. Parnell ha made hi stretcher from welded tubular steel. The rubber handles and feet are commercially made.

The patient IS carried on a nylon strip which standard equipment used in ancillary caravan bunk beds. The main steel bearers are pushed through hems running along each side. The total absence of mechanical clip

Training with the Army

SJA Co. Durham's open day at Raby Castle last summer. County Comm issioner Alex ande r Burns and County Su r geon Dr. W. F. Hall relaxing on the ramparts in the sun. (Photo: Northe n Echo)

A from March 1972 all St. Johr Counties in the UK will be au thomed Ie have one president whose responsihilitle' will cover hath Brigade and Associatiof matters. There will be a Slf1lI1a: joint-presidential appointment at Art levels. And In future there will be onl1 one vlce-preSlllent to J diVIsion, excer where there arc already two when the' will continue in office.

Marg8ret, up till VIce-President SJ A, has accepted the ne'! enior Sl. John Ambulance presidcnli appointment to be tyled Gran , President, which is u new appointmenl HRH has Sll1ce approved the apPOlntmen of Lady Brecknock as Chief PreSIdent also a new uppointment.

CORRECTION

In the article Puzzling It Out, puhlished It Feb r II a r y Rev lew , the w 0 r hypoglycaemia on line 6 and 9 01 paragraph 3 should, of course, have bee! hyperglycaemia, ie loo much sligar In til blood. My apologies to the author, Dr. J Twomey.

AT RAN DO M

(c ont inued fr o m page 1)

what you can do, within the wide range provided by Regulation 95(F), to keep the door wide open!

Last year, during the first nine months of which I was C.SU.A. and CommiSSIOner for Bucks, I made two conditions for all the annual inspectIOns in the county : (I) that all DIVISIons in anyone place hould be Inspected on the ame evening even if they weren't officially 'combined' or 'multiple', and that If the cadets paraded and dlsml sed at earlIer times than the adults there must still be an overlap period when all were pre ent together to gIve them a sense of family splfit, and the pre entation of awards and the ll1spectlng officer's remarks would take place during this period; (2) that at some time during the evening's programme there would be an unrehearsed SImulated 'incident'. On one such occasion in Slough, whIle was actually gOll1g rounti the ranks inspecting personnel, the simulakd incident parked off by a hystericJl and bleeding young woman rushmg onto the parade ground from behind, clutching one of the ambulance members in the rear rank round the w8ist and screaming 'Oh stop them, they're fightIng" She was followed by a chap with a knife sticking out of this chest, who staggered along for a few yards and then collapsed. It was then up to those on parade to take action as detailed by their officer. On this occas!on the inCident was very well dealt with the right number of SUitably experIenced fir t-aiders were Immediately detailed to cope with the casualties, the rernamder did not hreak ranks (but after a few moments I gave them the order to fall out and watch from distance), the Division's ambulance was brought out and the exercIse was earned through tIll the casualties had been loaded and the ambulance drove off to 'hospital'. Later, commen ts were made by one of the surgeons present on parade. An Important point to note in planning any incident of this kmd IS that any doctors or nurses present II/llst be briefed beforehand (and this is particularly important if the incident involves for example, a simulated heart attack).To fail to do this would' not be a di courtesy but might place them in a very embarrasing POSItIOn and we must never fail to guard agam the milltonth chance that Someone detailed to simulate a 11eart attack might have a real one.

On no less than three occasions when I wa in pectlIlo last year, stepped in and provided genuine incidents in addItion to the slmulated ones. One summer evening at HIgh Wycombe there were five Divisions on parade (two cadet and three adult,

the latter mcluding a police DIVision) , when there was a resoundIng crash a few yards down the road, caused by a car and van collidmg at a road Junction and the car overturnmg. WIthin seconds there were UnIformed St. John members (male and female) on the scene, accompanied by police m uniform (Including a polIce motor-cyclist with short-wave radio) and a photographer, and shortly followed by a St. J ohn\mbulance vehicle. Mercifully the casualttes were not enous, so one could enjoy the fun of hearIng a by stander remark to his neighbour 'How did they all get here so qUickly?' I'm sure that thIS intervention of fate (of which two photographs appeared in last month's Review) was by far the most Important part of the Il1Spectlon evening, beLause it provided us WIth an opportunity of doing and doing well precisely what we eXlst to do

But events of this kind , though alas all too common. don't uually happen in the middle of a dl'dSlOnal inspection, Are vou able, at any moment and anywhere, to prOVIde immediate 'and clearly VIsible proof that you are a qualified first-aIder? Because If you aren't, you ought to be. EJ'eI')' melllber oJ rhe Bngade should u/wuys carry In his wallet, or Il1 her handbag a Brigade armlet which in a m<.ltter of seconds can be \\ hIpped out and put on the arm to give 11l1medtate eVldenL' e of fIrst aId qualification. You never know when) ou may need it. If yOU Jre not so prepared, please do something about It at once and try to ee that all members of your DIVISIon do likewie.

Headquarters has suffered for the past two or three months the absence through Illness of both our Surgeon-tn-Chief and our Chief ursmg Officer. It's good to ee Dame Barbara Cozens back and looking \.\ell agam after more than l\\ 0 month ' (lllcludll10 several wee!.. in hospItal) suffenng from J back Il1jury \\ hieh \\ no doubt the legacy of many) eJrs' de\oted lifting of heav\, patients Colonel Olleren haw has been effect of an old war inJur) ever -1I1ee he came hack "'from his \ lsit to Khartoum in ovember, but he's rnaklJ1g tead) progre -s and [ hope that by the time you read this he'll he hack \\ lth us ag:lin. Muy I on behalf of us all expres to both of them our hest for a complete recovery and atid the ruther lovel) conkmporan greetlJ1g 'rake carel' -

ROAD ACCIDENTS

OF THE CASUALTIES THAT DIED MANY MIGHT HAVE BEEN

SAVED

by R Snook, MB, ChB

D r. 1. S. Binnin g, SJA Deputy Chief Medical Officer, writes:

I n this article Dr Snook very rightl), gives priority to the safety of the first aider at the scene of the road accident; this is very sound commonsense in [his day of high speed motoring.

Any disagr ee m ent with his priorities is mildly a cad emic: bleeding or breathing ?

Those \Vho have dealt lI'ith e m ergencies at the roadsid e o r elsewhere will appreciate that to think of the one problem is to realise the presence of the other. B oth are important; both are interrelated. No air no life. No blood - no oxygen - no life.

I is as simple as that , and that is how the trained person thinks i n emergencies, thinking of the vital life cycle as one big priority.

Lastly, how very sensible is Dr. Snook's approach to unn ecessary handling or moving of motor car acciden t cases unless some benefit will result to the casualty.

S o very often the first aider does his best work by doing little or nothing. 'D on't move a casualty ou of a car unless it is going to help him', is a classical example.

THIS AGE of modern technology tran spo rt , which is a vital part of our way of life , unhappily leaves many problems in its wake

Th e most serious of these is, of course, the rising accident rate. In the last t e n years or so the number of people killed on the roads of this country is approximately equal to the population of a city the size of B ath, 85,000, and during the same period more than en times that number were seriously injured.

Of the casualties who died many might have been saved with earlier treatment, and there ca n be no doubt that every effort must be made to reduce this terrible toll. The Emergency Services mu st be kept up to date with new

Dr Snook is the Sellior Casualty Officer at the Ro),al Ullited Hospital, Bath , alld Accident'Medlcal Officer to the Balh Fire Brigade alld Ambulance Sen ice

Dr Snook has just completed a ul7il' ersi tl research projecl all el'aluatioll and cos ting the proJlisiol1 of medical aid at road accidents, and the illl'estigatlOl1 of medical aspects of ambulance deslgll : olle of his particular interes ts is the training of ambulancemel1.

Dr Roger Snook is also th e DiI islOn Surgeon to the Bath Dil'ision of St John.

equipmen a nd methods of training, and new ideas suc h as the use of the new short spinal board and straps, introduced by an American orthopaedic surgeon, must be put into practice.

In the orth Riding of Yorkshire a group of thirty family doctors has established a scheme to bring medical aid to an accident. In Bath a similar scheme is hospital-based and involves an Accident Flyi ng Squad which carries to the scene medical eq uipment, including refrigerated '0' Group (Rhesus egative) blood and a pain relievmg gas.

How eve r sophisticated these services are, there is a lway s the period of time after the c r ash a nd before the arrival o[ the Emergency Services when ordinary road users who come upon the scene hav e to tak e responsibi li ty for the casua lt ies. Thi s period, in many cases, will be vitally important for the surviva of the cas ualty Memb ers of the general public are often co nfused and poorly prepared to deal with suc h events, but respond to ea der ship from the co nfid e nt first aider.

[n urban areas this time may be o nly 5 - 10 minu t es, bu t in rural areas where more se rious injuries and poor pr evai ling co ndition s are likely, it may well be 20-30 minut es before an ambu lance a rrive s [t is most important therefore

t hat every first aider shou ld carefully consider the problems beforehand 0 that he can take positive action without delay

To protection on the scene of the accident as the first action may seem a mistaken priority, but from pra c tical experience this IS definitely not so. I n the Bath area alone in the last two years there have been two deaths and four serious injuries involvlJ1g people at the scene not injured in the initial crash. [ t cannot be too strongly recommended that all motorists should carry a reflective triangle and a powerful hand tourch, with either a red 'dome' or red gelatine paper to shine the torch through If pos ible, park your ca r well off the road leaving the side lights on at night. If alone, run back along the road on the Side that is blocked and stop the traffic If accompanied, <;end one person off in each direction to 'wave down' the traffic. The fir t driver to be stopped hould be asked to go and dial 999 at the nearest phon e and give details. Stress three things for him to remember and there 1. le ss likelihood of anything being forgotten Dia[ 999 and ( 1) ask for the Ambulanc e Service; (2) tell them accurate l y where the accident is (3) give them brief tletaJl s of the accident e.g. a crash between lorry and a car, the ca r wedged under the back of the lorry, and ITIclude any information about pecial hazards , for insta n ce persons trapped, smo ulderIng, or petrol spil lage The ambulance control will automatically inform the Police, and, if necessary the Fire Service.

I t IS most important tha t the service with the life equipment is alerted without delay. If the accident is severe with cas ual tie lying in the road partly blocking it, it may be as well to get the traffic to stop co mpl etely until the police arrive and can arrange for a si ngl e line traffic flow. This d o ne return immediately to the crashed vehicles and make them safe by turning off the

ignition and li ghts and applying the handbrake. If you d e tect s mouldering at this stage, ke e p calm and look for the so u rce. Th e three mo s co mmon sources are from the hot exhaust pipe scorc h i ng grass or fo li age fro m a hedge undern ea th the car, e lectrical s hort circui ling behind he dash board or something untoward in the engine compartment. Electrical s mould e ring is best co ntroll ed by disconnecting the battery leads, while the actua l site of burning s hould be smo thered by th e use of a dry powder fire extinguisher, dry sand or ea rth , whichever is available. Try to prevent a draught from fanning smou ld ering in to flame and as a last reso rt use a blanket to smother the source Rem ember, however , that to put any flammable materials on to smo uldering may increase the volume of smoke produ ce d and co uld affect the cas ualty if he cannot be removed. It must also be remembered that dry powder ex tingui s her s produce a den e cloud of powder which, in a confined space, could lead to asphyxia, and even some chemical types can, under certain circum<;tances, produce tOXIC gases.

To mention all these points before conside ring the casLla ltt es is not to imply leavi ng th e human prob lem until last. From the onset the casualtie can be assessed for actual Ide-saving priorities, but the danger of going straight to them and becoming In their detailed prob lems to the exc lu sion of ba ic safety precautions cannot be overstressed.

The prioritie of first aid treatment sho uld be directed to tho 'e who are bleeding to any extent, those who have stopped breat h ing or are breathing noisily, or those found to he unconscious.

Conservation of blood volume III the injured is very important. Clmical shock from blood loss will not usually make itself apparent until about one-third of the blood volume IS lost. The deterioration can then be rapid and can be effec tively rever. ed only by blood volume replacement. Pr ofound shock can lead, in a relatively short time, to kidney or brain damage. Bleeding wounds be .covered complete ly by 3 firmly app iJ ed dressing. Fractures hould be immobilised as soon as possible to reduce further blood loss Into the fracture site and it should be remembered that an; patient Showing signs of shock has a bet.ter chance of L1rvinl if lying down RalSlng a b leeding limb not only helps to redUce local swelling and bleeding but also drain s the venous blood back into the main circ ulati on

Interference wit h breathing should also receive urg ent (Jtlention. Where bre th' a .a lllg has s t opped, mouth-to-mouth rtlflcla l respiration shoul d be started as SOo n as pO SSib le, and care must be t(Jken to ensure that it is effective by watching the chest rise and fall. Ju st a importan t is the care of th ,'. e airway III h e unconscIous

By the time a patient is showmg signs of cyanosis his brain is a lr eady hort of oxygen. In head mjuries, shortage of oxygen can be very serious, especially in the in tance of brain tis ue that is damaged but still viable. The unconscious patient and the coma position should be inseparable, and the danger arising from the pre ence of denture s h ould always be borne in mmd whatever the age of the patient. Wh ere there is any bleeding in the mouth or nose or any suggestion of vomiting there can be no medical reason, In the absence of a doctor' specific direction, for the patient being in any position other than the coma pOSItion. Even a spinal injury does not preclude the correct treatment of the unconscious patient with respiratory emba rra sment.

Spinal injuries must, of cour e, be treated with great care and hould be moved 3S littl e as pos ible, avoiding particularly movements of rotation and flexion, 3nd t'xten ion especially of the neck When considering s u pee ted pinal InjUfleS, tho e without signs of spinal cord damage need ju t a much care as those that are s h owing obvious igns and in whom the diagno is would seem more certain.

Aft er dealing with the priorities, exa min e each casua lt y thoroughly and

always follow the same pattern, such as examining the head , then the neck and remainder of the spine, the chest, the abdomen, pelvis and limbs. Fir t ask, then look, then touch. Consider the whole patient and nothing will be overlooked. If any casualty , previou Iy conscious, la ter becomes unconscious make sure that this fact, together with any observations about spine of trunk injuries noted whilst he was conscious. is recorded and taken to ho pital via the ambulance staff. Such information will be of great help to the casualty doctor in assessmg the ca e. If at all possible. try and find out from one of the ca ualtie how many people there were in his particular vehicle 0 that number can be accounted for. It is not unknown for ca ualtie to be ejected some distance from the vehicles, one in thi locality even being recovered a live from a tree after a high peed cr3sh. When moving the ca ualty make ure you have adequate help to support all parts of the patient properly and aim to make the movement from the car to the stretcher or blanket one continuol!, smooth operation. R escue service recogni ing the importance of thi will often CLl parts of the vehicle a way to allow proper access to, and removal of.

Bath's accident flying squad and its medical equipment

the critically injured. The w ea rin g o f hea vy clo t h i ng in w in t er ca n often make the examination of casua l ties seem d ifficult, b u in practice sh ould not prese n t too many difficulties as th s will be mainly a question of overcoats. Unbuttoning will allow examination of t h e trunk and, by slipping the hand around to the back, of the pine. Only the arms will be inaccessible; if they can be moved by the patient and no bleeding can be seen then their further examination may be delayed; if injured, slings can still be app lied and the pulse felt. B leeding from an arm will present the only real problem and here it may be necessary to cut the sleeve up the seam. If conscious the patient can give consent, if badly injured and unconscious my feeling is that blood soaked clothing is of secondary importance, and I have yet to encounter comp laint. Comp lete removal of difficult articles of clothing is rare ly necessary outside hospital except perhaps in the instance of boots. Really the only point of removing boots is to look for bleeding and to stop interference with circulation from swelling. Wellington boots being relatively inexpensiv:e and oose p resent little proble m Laced boots can be easily loosened by cutting the laces a ll the way down. The real problem is pr ese n te d by leather ridi n g boots and ladies' knee-length boots, in particular

those without zips. I f uncomfortably tig h t or if preventing attention to bleeding of any consequence, the only compromise is to r u n a sharp knife carefu ll y down the seam stitching and release the constriction. This was the method resorted to recently for the member of a foxhunt with a compound tibia and fibula whose hand-made riding boots cost over £50!

When dealing with the ea ualties, look for the medicall y r eco gn ised patte rn s of nj ur y a nd ve h icle d amage to help your own a e sment and diagno is look for such things as damage to the parcel shelf dashboard and associated fractures of the patella; deformity of the floor or penetration of the wheel-arch and lower limb damage to, and dl tortion of, the steering wheel or column and major chest injury. The overturning of a vehicle may lead to spinal fractures, impaction of the side of a car may be associated with internal injuries such as a ruptured spleen, liver or diaphragm in the occupants on that ide of the vehicle

Remember also that some injuries can occur in 'pairs'. Damage to the forehead may be associated with extensIOn fractures of the neck; in the case of someone being thrown out of a vehicle the reverse may be found, that is, a wound on the back of the head and J flexion fracture of the neck. A fracture of

Entenox

THE ENTONOX apparatus, ma nu factured by the British Oxygen Co m pany, is a breathing apparatus designed to give an equal mixture of oxygen and nitrous oxide by se l f administration.

It consists of a small (15 inches by 4 inches) cylinder which contains 500 litres of the two gases in equal proportions.

T his cylinder is always painted blue with a whi te segment at the neck, this colour code indicating the nature of the contents according to the international colour code specification. The cylinder is equipped with a non-interchangeable pin ind ex valve which is accommodated in a yoke integral with the breathing unit. This, in turn, consists of a pressure gauge (indicating the amount currently in the cy linder), a reducing valve and a demand va l ve. A piece of wide flexible tubing co nn ects this unit to the mask unit which a so incorporates an expiratory valve.

the sternum may be associated with a fracture of the thoracic spine, and a fracture of the lower with a dislocated hip.

At night a goo d strong torch is essential to be able to examine patients properly. If lighting IS poor it is quite easy to overlook or undercstimate SLlch important sIg ns as facial pallor in shock, of cya no is and laboured breathing in a 'stove-in chest'.

No' casua ty sho u ld b e moved unless it is of direct benefit to do so, and ther e is no substitute for practical familiarity with the basic techniques of fir aId even if they have to be practised on the healthy I dentification of your elf at the scene IS important not only to the ca ualties but also to the Emergency Service personnel when they arrive; thi" is, after all, one of the reasons why they wear uniform Identification can be synonymous with reassuranc e.

R eassurance is not to be underestimated You may be helpin g someone to cope with the most unplca ant crisis of his life. onfidence, sympathy and co mfort towards those experiencing emotional and physical tre s should be the alln of all dealing with emergencies.

(Reprinted/rom the Red Cross News Review The research 011 which this article has heel1 hased IS supported hy the Peel Medical R esea r ch Trust

a man lies hurt.

There's a fire.

He's unconscious. He's twisted.

There could be an explosion. You've got to get him out of there.

But you know that to move him could hurt him more.

You know manhandling people onto stretchers can kill them.

The demand valve ensures that gas only flows when the patient breathes in with the mask pressed to the face. If the patient should, for any reason, become unconscious during self administration the mask will fall from the face and administration ceases. The black rubber face mask supplied makes a good face seal but a clear plastic mask with a soft latex rim is equally good. The latter allows changes in the colour of the casualty's lips and skin to be more easily seen, as well as the presence of food or vomit in the mouth should this be present.

Entonox can be given to patients in pain whether the pain arises from acciden t or illness (e.g. heart a ttack). It can he given to children although a smaller mask may be necessary.

[t must always be self administered by the patient himself unless he is unab le to do so, e.g., he is trapped or has broken both arms. If you have to give gas, make

sure the patient's chin is up and that you have an airtight fit between face and mask. You must remove the mask once a minute to make sure the patient is still conscious.

ever gIve it to someone uncon CiOLlS. or someone with a smashed face or pw. or who .b.as head injuries and is restless.

Inflammability : Entonox is not inflammablc, although the gao as It contains oxygen will support combu tion. Care should however be taken if conditions imply a special risk of ignitIOn e.g. when metal cutting equipment is being used to free a cas ualty

Lastly there is one warning which must be remembered [n freezing , or ne ar freezing conditions, the gases separate and it is theoreti ca lly po sihle to administer pure nitrous oxide. So the cylinders should be protected again t cold and, as a precaution, inverted at least three times before use.

But the fire, the fire's getting nearer. what

To find out send for our brochure about the Llfellft It's an entirely new mechanical principle USing it, you can move injured people Without manhandling them onto stretchers. Injured people arrive for treatment In the position in which they fell ; they aren't injured by the transfer procedure , and essential first aid can be continued.

SELF ADMINISTERED BREATHING APPARATUS by R. M Archibald , MB , ChB , DIH

WHAT CAN WE DO?

from Mrs. D. Westland. Divisional Superintendent (Reserve)

My husband and 1, both members of St. John in this area, are a littl e p u zz led by the item in Brigade Ceneral Ci rcular No 5/7 1, regarding Administration of Drugs

We agree that the indi criminate giving of A pirin for various ache and pains suffered by peop le encountered whilst on duty can be dangerous dut' to tht' well known effects of this drug, but we wonder whether the same applies to Paracet o mol, which ha larg ely superseded aspirin both in sales and effect?

We hav e both at times been asked for 'something' for a variet y of conditions ranging from toothach e to dy menorr h oea, and according to what we have read Paracetomol is a very safe analgesic for most people and freely avai ab le in chemists' shops. If we cannot offer this little white tablet for re lief - what can we do"?

Chathalll, K e nT. D oreen Westland

The Surgeon-in-Chief replies:

The notes in Brigade Circular No 5/71 are quite explicit. It has never been the policy for Brigade personnel other th an doctors, to administer any drugs to cas ualties irrespectiv e of whether or not they are freely available in a chemist shop. The onus for medication must rest entirely with the individual even with really innocuous drugs, and the advice given in the Circular regarding Aspirin applies to all drugs, including Paracetomol, which though not likely to cause the problems that arise from the administration of Aspirin is known to have toxic effects in some cases. Although Par acetomol ha some advantages over Aspirin it has not replaced it nor is it likely to, since it is not such a good analgesic as Aspirin.

EX-CADETS

From R. B. Hames

We are on ly a small division at West Mersea so it is most gratifying to us to know that a number of our ex-cadets have taken up nur sing as a career.

They are: M a lvin Mussett, now serving with the RAF as a male nurse Rodney Chatters, now in the adult division and a full-time nurse in the chi ld rens' ward at Turner Village, Co l chester; Jackie Ganderton, a nurse at Romford H ospital; and Anne Hockaday now in the adult division and doing part-time duties at Essex County H ospital, Colchester, in readiness for a full-time nursing career.

Thi s is encouraging and rewarding to us their officers and make s us realise how worthwhile it all is. West Mersea, Essex. R. B. Hames

CONTACT LENSES

from Audrey D Green, BSc

I w ork in an industrial food laboratory and have a problem which occur;ed recently with regard to a potential hazard on which I should appreciate guidance.

We now have two or more people who are wearing contact lenses. I have personally been uneasy about their use when handling chemicals. ] should like to know the correct procedure for th eir removal in the event of contamination. Are the lenses of glass or of a ny form of plastic which might be particularly likely to be attacked? One of the compounds which we use with frequency is Formaldehyde.

I s h o uld also like to know if I am wrong in feeling that there is a potential hazard with these lenses which is not present with co nv entional spectac es?

Co leford, Glou c. Audrey D. Green

The Hospitaller of the Order and member of the Medical Board

Mr. T. Keith Lyle , the ophthalmic surgeon replies

I have given the matter careful consideration and also sought the help of Mr. Montague Rub en, FRCS , who is in charge of the Contact Len s Clinic at Moorfields Eye H ospita l High Holborn.

Certain che m icals have particularly serious effects on the eyes when a patient is w earing contact lenses because the chemical gets

READERS I VIEWS

It was decided to buy the se flares after the division had had a two- hour lecture by the poli ce on th e use of the motorways and the role of t h e e mergency services.

Eac h ambu lance a lso carry: I set of blow-up sp lin ts, 3 Roehampton burns dressings , I mat e rnity pack, 1 oxygen set, I suction pump , 1 spinal board, 1 set carrying poles 1 set rescue tools, 2 extinguishers, 2 road flares, 2 fluorescent jackets, 1 lamp an d d etailed map of M3 (local motorway).

Both ambulances are fitted with radio telephones.

The Divisio n has strict rules, which have been in use for four years, for members driving ambulances. The rules are:

I Drivers mu st have at l east two years driving experience.

2 H ave attended po l ice lec tur es on driving.

3 Have taken a driving test in an am bulance with the local Road Safety Officer.

Carrol from Auckland has few pen-pals in Britain! I will draw this to our cadets' attention to see if they are interested in writing to Sl. John people in New Z ealand. Meanwhile I am interested in becoming a pen paJ. [ write regularly to JUH members in Germany and have gained a great deal of knowledge and pleasure from this correspondence.

20 Loval Road, Preston Lan es. John R Brown

Readers' views an d opinions, which should be sent to the Editor , although published are not necessarily endorsed by the Editor Or the Order of St John and its Foundations Although readers may sign published letters with a pen -name, writers must supply thei r name and address to the editor.

If your Divi sion ha s any other specia l ambulance equipment we should be pleased to hear about it. Likewise, details of the above eq uipment can be supp li ed to anyone interested.

12 Orchard Close, Ash Vale, Aldershot, Hants J. Robinson

PEN PALS

from John R Brown , Divi siona Officer r was sorry to read in R eade rs' Views January R eview that E. T.

ST. JOHN IS from Eustace A. Alliottt I was waiting in Brigad e uniform to cross Valletta's main street Kingsway It was 1959, the year of the Golden Jubil ee of Brigade Malta District. 'Great Siege Day' was being celeb rated a nd I was held up as group after group marched by in seemingly endless procession - trades unions local organisations , youth clubs, and the like. All seemed to be chanting 'Mintoff is best, Mintoff is best'.

As I seized an opportunity and crossed the street, the leader of the approaching group raised his arm and the cry changed to 'St. John is best', St. John is best!' Amersham, Bu cks. E. A. Alliott

under the contact lens and remains in a concentrated form in contact with the corned.

From the first-aid point-of-view the mo important thing is:

(a) To remove the contact lens at once (most wearers of contact l e n ses know how to do this themselves, but if it is to be done by someone else the simplest way is to separate the eyelids using thumbs and then for somebody e se to pour tap water on to the eye, this will soon dislodge the contact lenses).

(b) The eye should be thoroughly irrigated with tap water.

The writer is quite right in saying that Formaldehyde i a vel! potent irritant as it has a rapid chemical action on the epithelium of the cornea.

There i no doubt that the wearing of contact lenses may be dangerous to people wh o are doing a job in which a spray from chemicals may enter the eye, whereas a per on wearing ordinary spectacles has the advantage of some degree of protection of the eye due to the spectacles.

AMBULANCE EQUIPMENT

from J Robin so n Tr ans port Corporal

The Farnborough and Cove Division has just equipped both of Its ambulances with road flares. These flares are for use at RTA' s on major roads and motorways

Farnborough and Cove Division's ambulance at the ready

I've been asked (editor speaking):

I've had to answer: NO Then I was asked: WHY NOT?

I replied (after some thought): WHY DIDN'T THE CHICKEN CROSS THE ROAD?

I'll be asked another question soon. But, meanwhile, will you ask ordered as official divisional reading your Division if the Review is matter, which it should be?

If you get any other answers, I should be delighted to here 'em.

The First Year of a New Division

EPPING, ESSEX , DIDN'T HAVE AN SJA DIVISION UNTIL

by Robert A. Peedle

D U RI NG THE early part of 1970 , I was a redundant divisional superintendent on the London District Pool and co ntemplating resignation. I had given up my last divi sio n when I moved to Waltham Abbey in Essex, being too far away to be an effective superintendent. I wrote to the District Secretary seeking advice. His reply was that no suitable appointment existed in London , and now that I lived on the borders with the co unty of Essex I might like to offer my services to them.

This I did, and received a surprisingly prompt reply that there were n o vacancies, but as there was no d ivision in Epping would I like to form one? Now how does one go about that? I didn't have a clue. I didn't even know anyone in Epping.

My problem was, however, simple. All I had to decide wa s 'yes' or resign At the toss of a coin I said 'Yes'. My first bit of luck.

The reaction to this decision left me breathless. I was instantly transferred to the Essex County Pool, and within a couple of days Captain R. J. We nly TD then the Commissioner and Commander of Essex, visited me at my home in Waltham Abbey.

ot on l y was this the first time during my few years as a brigade o fficer that I had personal dealings with an officer over the rank o f area superintendent, but here was someone who gave me a completely free han d D o what you think best,' he said. You have my full backing'.

This rea ctio n was fantastic! My initia l impression of my new Commander, since well confirmed, was that here was a man with great interest and e n ergy. We'll be O.K. in Epping, I thought.

The term 'we' at that time was a misnomer , for there was only me.

My first moves at creating a division included writing to large lo cal business conce rn s, sen ding lett ers to loca l papers and, most important, asking an o ld friend living in Walth am Abbey to help me J im Clifford, a Metropolitan Police first aid

18

instructor and member of the Order simply said ' Yes ' to my request.

From my letter writing and pUblicity I received only one reply, however. A police sergeant from the Essex and Sou thend Constabulary sta tioned at Epping thought the suggestion of starting a local division might be a good idea.

So we had a meeting three policemen from two forces. I was a brigade officer, Jim Clifford a very well qualified and e xperienced instructor, a nd Bill B orley a local man with a proven administrative and organising ability.

We were not too hopeful of any great success. But we decided to have a go, and agreed to run a public first-aid course in Epping to start things off. But where do we hold the course? We had no members, no money, no room

One day Bill Borl ey was chatting to Mr. Pat Bowen the secretary of Epping St. Margaret's Hospital , and mentioned our

ideas. The response was another boost.

Wo uld we like to u e a room in the hospital free of chargt'?

This left us with only lack of members and money to worry about. We distdbuted posters in Epping, Ongar , Loughton, Waltham Abbey, Theydon Bois , and orth Weald ; we pu t an advertisement in the local press; borrowed some first-aid equipment; a nd late in September 1970 we went to the hospital for the first class of our first course with our fingers crossed.

We couldn't believe our eyes! Soon forty people had walked into the room asking to take the course. Forty! Now we really had a chance. For eight week it was a hard slog and we ended up with twenty-nine people passing the exa min ation, and sixteen of them wanting to become member.

De cember 3 1970 was the day the registration form was igned and sent off

to put our new division on the map. Mr. Bowen consented to be our Pr eside nt. Being a mix e d division our next task was a nursing cou rse. St. Margare t's Hospital hou ses the Nurses Tea c hing Unit for th e group. Mr. R oe, its Principal, asked if we would like to use the teaching unit premises for this co urse, and co uld he arrange th e instruction, for his nursing tulors had a ll expressed an interest. I said, 'Yes please'.

This course was a tremendous success and led to an increase in membership, and our firm establishment as part of the hospital.

r wanted something different for this new division. Already we were lu ckily unusual in that we were attached to the hospital, a nursing training unit, at that. One day our president told me he had flown to Germany recently with a very sick boy. There existed n o officia l funds to take the boy home in this way and his parents could not afford it. The aircraft used was a Britten orman Islander owned by Thur ton Airways of Stapleford airfield, only a couple of miles from the hospital. Captain Eric Thurston, the owner of the firm, flew the aircraft himself. This plane i a very versatile machine; it easily converts for ambulance use and ha a hort take-off and landing capability. These points started off a train of thought.

[ went to ee Captain Thurston and asked if it would help if he had some trained air attendant at his beck and call locally. He was most enthusiastic. I therefore arranged an Air Attendants course , the lecture being given by a cons ult a nt at the hospital, Dr. A. Braverman, a former R .A.F. medical officer. Six teen or o ur mem bers successfully passed the course, and Captain Thur ton provided his aircraft for part of the training.

Our next task was to become mobile. An article in the St. J ohn Review recently about SJ A Birmingham' mobile unit solved the problem. We now have a converted coach a a mobile unit and also an ex-W.D. ambulance.

The coach is a Leyland Beadle, which to date we have tripped of eats and equipped with examination couches, trolleys and chairs. The building of sink unit, toilet, gas burner, cupboards and working sufaces will be done when we have more experience of its use. For we don't want to lumber our e lve with a hastily-designed unit. The ambu lance is an ex-W.O. Morris Commercial L.C., anu, although quite old, i still very servicable and reliable. Our transport sergeant, Mr. George Cook, and four of our member are full time ambulance personnel, so o Lir ambulance training will be of the best quality.

On the other h an d driving our coac h is an expe rien ce for mo t of LIS for it has a cras h gear box and no steering; also it is eight foot wide and thirty feet

long. My first roundabout at its wheel was taken in neutral, I couldn't find third gear!

W e had no problems over the equipment for either vehicle. The hospital has loaned us old but useful equipment, and the S.A.F.E. Fire Equipment Co, of Jersey, Channel Islands, through their London agents provided the fire fighting equipment for both vehicles. I was very pleased with thi as r was worried about the use of other types of extinguishers in the confined space of the ambulance and mobile unit. S.A.F.E. is non-toxic, and has no effects on the user.

To extend our flying services we are now forming a parachute section under the guidance of A Corporal C. Martindale , a former para-medic. When members are fully trained we shall form a parachute rescue team.

The division is now getting involved in the formation of an air service of St. John. Members have volunteered to staff a 24-hou r con trol room for arranging flight by volunteer pilots to deliver organs blood, tissue, drugs and personnel needed for emergency operation. More of this in due course however.

The R oyal Air Force is investigating the po iblitie of helping to improve the tandards of our air attendants.

A cadet divi ion was formed by one of our member and this is al 0 flouri hing. J ames Bond (not 007) i its uperin ten dent. This, of course, bodes very well for the fu ture, a a good cadet division provides an Adult Divi ion with a steady upply of recruits. December 1971 was ollr first birthday, and looking back I feel very pleased with progress. It needed a ot of ha r d work from many people, a lot of help, and quite a bit of luck. But it was done.

fy work on the formation of an Air Wing has meant that I have had to give up the division, and the new superintendent is Bill Borley: the transport officer is Jim Clifford, who also acts as divisional instructor: Janet Woodall, our nursing sergeant, is being appointed divisional officer.

I would like to take this opportunity of thanking everyone who helped us and pay tribute to every member of the division. Our President de erve pecial mention, our Vice President Mr. Roe, and our Divisional Surgeon Dr. H. Gryll

If you are contemplating rai ing a new division, or re-vitalising an old one. the best tip that I can give from my ex p eriences in Epping is to ba e yourselves on a hospital. Then you have every chance of uccess.

Epping's Transport Officer Jim Clifford and SJA Commander of Essex Capt. R. J. Wenley TD at the dedication of the Division's mobile unit and am bulan ce

At first 'we' were just one, says the author. Now, Capt. Wenly WIth Divisional Superintendent James Bond, of the Cadet Division, meet Cadet Sergeant Susan Welford

NEWS from SCOTLAND

Did we need an Ambulance Brigade?

FOR A LONG TIME members of the Order in Scotland have regretted that they cannot operate an ambu l ance service and have felt themselves to be labouring under a disadvantage not shared by their confreres and associates in the rest of the UK. This month wou ld like to concentrate on this subject and, because it is often a good thing to look at a problem from another angle I will as k whether we should not consider ourselves fortunate in not being involved in ambulance work.

No-one would deny that the establishment in 19-century England of the St. J ohn's Ambulance was a stroke of genius. It fulfilled the aims whi ch moved the members of the Order while providing a much-needed service. It was a means of bringing the Order's work to the attention of the public , because the ambulances and the ambulancemen in their distinctive uniforms could be seen eve rywh ere. Above all it attracted and continues to attract years of devoted service from people from all walks of life and it has proved itself to be a superb instrument for mobilising men and women to the service of the sick: so much so that to the English public the name St. John is synonymous with the

Ambulance Brigade All this must be admitted but it must a l so be understood t hat ambulance work is not a nd should not be , the only way by which the ideals of the Order can be served.

In the modern Welfare State our commitment to the care of the sick must lead us to search for areas in whi c h the infirm are for one reason or another not covered by the protective umbrella of state paternalism [n Scotland th ere is 11 0 need for additional ambulance service, for existing organisations carry out the ir duties well. We must recognise that had we in 19 47 started willy-nilly an ambulance brigade of our own this would in the circumstances have been a waste of our resource and therefore a betrayal of our ideals. And it would h ave made u look ridiculous. With hindsight we must say that even had we been in a po ition to found a St. John Ambulanc e in Scotland we should not have done so.

More important is the effect this has had and is having on us. Bluntly we have had to look for other things to do and so we have been forced to be original.

Within our priory we run many different projects: old peoples homes , hospi ce, a m 0 u n t ain rescue service, protected

OVERSEAS NEWS

hou sing, th e care an d training of the young This diversity is a virtue. ] n the twenty -five years since our inception some sc h emes have failed a nd some have done better than others, but we are in the position to harness a ll sorts of enthusiasms and new ideas to a common cause. The Priory of Scotland is an exciting organisa tion to be in and there is no end to the plans in which we might be come involved.

Aft e r a l ong period in which were lai d the foundations for expansion our priory is now beginning to grow. Two new branches of the Association have been founded in the last three years and a thud may be in the offing. It is possible that we would have developed more rapid ly and at first attracted more public support if we had started an ambulance service. But this I am sure would have led us up a c ui de sac and in the end we wou ld have regretted it. And we owe our originalit) and the diversity of our act ivities directl) to the fact that circumstances made us searc h for other ways to fulfil our commitments.

Mountain Rescue Team

The t ea m took part in the search for the party of children who died c tragically in the Cairngorms disaster recently.

New Projects

Two important ceremonies will take I place thi pring On February 23 and April 19 the foundation stones will be laid of the new wing of the nursing h ome in Aberdeen and the block of fla tlets fo r old people in Glasgow.

CANADA

When you 'seJf-su fficie n t' meaning. are blind, the hold a very word special

Thank to special training courses, however, offered by such organisations as the Canadian ational Institut e for the Blind, the Igh tie s learn to develop their ta lents an d acq uir e a elf-su fficlency that enables them to take their place in their co mmumty, virtually as independent as

those pos es ing the precious gift of sight.

To some the idea of blind persons ak i n g first-aid training, let alone qualifying for an Emergency First-Aid Certificate, may sound almost impossible.

But this is exactly what took place last summer in a pecial, and spectacularly

Firstaid training for the young blind organised by SJA Winnipeg

NIGERIA

IBADAN : On October 6 1971 there wasa terrible building co ll apse in this city. The Chief Fire Officer and men of the city's fire service, a ll St. J o hn ce rtifi ed first-aiders, worked on the disaster site for 72 hours and r escue d 38 people from the concrete debris , two other people subsequently dying from internal injurie.

M a ny occupants of the bui ding were found dead. On e man had hi s arm amputated on the si t e. The Chief Fire Officer writes: I n all my 26 years in the Fire Servi ce have I been so thankful that we adopted the policy of our men being certified St John first-aiders. They were superb'.

Eight of I badan Fire Service personnel r ece ived Commissioner'S Commendations, and th e Chief Fire Officer a letter of commendation from the Military Governor.

successful, fir t-aid training course organised by the Wmnipeg St. John Ambulance Brigade. The course wa conducted by Michael Keenan, Reg. ., Provin cial Training Officer, with the very capable assistance of dedicated Winnipeg Crusaders.

The scene of the Tragedy at Ibadan

On the scene of Nigeria's te rr ible badan disa ste

News from the Divisions

CHESHIRE -On January l4 Area held a formal dinner at the Athenaeum, Liverpo ol. as pa r t of the Sl. John in appeal te I45,OOO.

The was His Honour Judge r D. Paterson, who spoke of the links between the Knights of t. John, the Law and Church.

The Dinner, with the Commander lor Cheshire, Lt. Col. D. II. S Pain in the chair, \\3, very well allended and the guests Ineludeu three Chief Constable" of CheshIre. Liverpool and Manchester. I

The Athenaeum, which one of the finesl private libraries In the country, had on displal in the library il collection of books on the history of the Order.

CUMBERLAND -At the Workington Dlvision \ presentation night held recently Count)

Superintendent T. H Abbott presented a warrant of appointment to Staff Sergeant Davi d Tay lor and commended him on hiS aLlion in dealing wi th a mo torcycle aCl.:iden t whcn a po l iceman was fatally injured. Warrants 01 appointment were also presented to Divisiona Officer Mrs. Dorothy Fisher and Divi,iona Vice- Presiden Mr. George Pra l.

The award of the year for the best all-round member was presented to Nursing Corporal Sybil Metcalfe by Divisional Officer MISS K. D Wilon.

The

a recent training day at SJA Cumberland and Westmorland, meets cadets. Later the Chief Commander recorded a 5-mlnute talk for Border TV

OBITUARY

Fletcher, L:dith Mary , rtd divisional superintendent, Nottingham<;hire. Harm, Idward Albert, rtd divisional superintendent, Andover, lIant-.. Scrvlllg Brother.

Ruckledge, O\\'en, diVISional supcrlntendent, London Distri c t I 0.41 (Royal \rsenal and Woolwich) DIVISion Serving Brother

REVI EW CROSSWORD No.3 (72) Compiled by W A. Potter

ACROSS :

ST JOHN REVIEW

To the Treasurer , Order of St John , 1 Grosvenor Crescent , London S W 1

Please sup p y/rene w * v ears su b scription to he St. John

Rev ew commencing w t h the .issue. I enclose for """

I Drastic treatment for an injured member. (10) 6. Young animal in muscular part of leg. (4) 10. Correct lack of comprehension. (7) II. Works wearily round poles in the pharynx. (7) 12 Fit person? (9) 13. Secretion eliminating nitrogenou s waste. (5) 14. Turn aside for results of using one's brains. (5) 15. Feeling of well-being unjustified by the patient's true condition. (8) 19. Be around ervant with periorbital bleeding. (5.3) 20. Do return our stimulus to the first cranial nerve. (5) 22. Pomt lost giving aid to mountaineer. (5) 24. Cult following which four upset tea to improve ground. (9) 26. Bitter tonic from West Indies. (7) 27. cat together in a Sicilian town. (7) 28. Wicked live in turmoil. (4) 29. Condition preventing one from readily taking a long VIew. (5-5) DOWN :

I. Gene found in Asia for failure of normal development. (8) Slight operation on polite pal behind the knee. (9) 3. :vJ:alady incompatible with d plea ant journey. (6.8) 4. Pal1ndromic doctrine. (5) 5. lerve of out-patient with habit spa m. (5) 7. Elemen t of secretory glands in Pacinian corpuscles. (5) 8. Become infected and form pus concealed by safe steroid. (6) 9. Chronic inflammation and fibrosis of due to long-continued inhalation of irritant dust. (14) 15. Girl from Severn WIthout nursing qualification is no different on return. (3) 16. Confu ed type baked ta ty dish. (3) 17. Preventing spread of mfection from affected patient. (9) 18. Pos ibly misleading appearances on X-ray film. ( ) 21 leal given for X-ray vi UJli ation of alimentary tract. (6) American oldier follow 10 t art producing cartilages and hairs of outer ear. (5) 24. A number with kin condition collapse suddenly (5) 25. Primate holding trange bird in both hand. (5)

SOLUTION TO CROSSWORD No 2 (72 )

ACROSS :

I. Gas.p; 7. Rash 10. Ulcerate: 11. Dnp: 12. Once; 13. [r.ng.ate: 14. Hall; 16. Trjo: 17. Usurp: 19. Eider: 20. Corset: 21. A. p; 2_.

Organ: 23. I ncus : _y.. First; 26. Test: 2 B.ass: 30. Footsore: 31. Tail: 32. Lung: 33. Lacrimal ; 34. Cane; 35. Yaw

from

DOWN : 2. Aorta; 3. Pupil: 4. A.car.us: 5. Gregory's fixture : 6. tate; A .c. ne rO. acea: 9. Haemopty i: 14. Haernostatic; 15. [ndige tion: 17. Urine: 1 V.omit: 25. Stor.lll.y: 27. Vocal: 28. Belly; 29. Sinew.

Chief Commander, arriving at

SPRING TOUR TO RHODES CYPRUS

Following last year's successful tour to the Holy Land, a repeat tour has been organised, and as last year, will be led by Mr. J. Woodhill. The tour cost is:

ROYAL ALFRED HOTEL

ADVERTISEMENTS

SUPPLIES

Of First Aid manuals , or any teaching book relating to courses organised by St John Ambulance. Teaching aids generally include First Aid Film loops. Uniforms for the St. John Ambulance Brigade, including badges and insignia.

new uniform as Commandant·in-Chief of Ambulance and Nursing Cadets.

A T RANDOM

by the Deputy Commissioner-in-Chief

TRUST THE YOU G to get cracking when presented with a challenge! Latest reports from all over the country give an inspiring picture of the way cadetswith help from many adults who are young in mind are taking the initiative in making Cadet Golden Jubilee Year their OlVn affair at local level, and showing their keenness in celebrating this landmark of St John hi tory in the best traditions of the two mottoes of the Order. Report already received tell of Thanksgiving Services to be held in a dozen cathedrals and many other churches ; and the programme of at least two of these cathedral service is being almost entirely planned and carried ou t by cadets themselves. Many counties, as well a the Priory of Wales. are holding special jubilee cadet camps, orne of which will include overseas visitors. Most of the big towns and cities in England and Wales will have pecial floral displays in their parks and public gardens; and among many other schemes afoot , the cadets in one county are planning to decorate the homes of handicapped persons. One of the best po sible ways of celebrating Jubilee Year will be by a big increase in our service to the community, especially to the old, the ill , the lonely, the disabled and the handicapped; and the mo t enduring memorial to our Jubilee will be found in our adult divisions of 10, 20 or 30 years' time if they are largely peopled by the cadets of 1972.

Belfast

I've ju t heard by phone from Belfast that two l5-year-old nurs i ng cadets of the Forth River IC Division were on their way to the Abercorn Restaurant on March 4 when the bomb went off. Police and the army instantly formed a cordon but they went up to a oidier and sald 'We re first aider s , so he chu cked them a first aid kit and let them through. At that stage they were the only first aiders on the spot, and they treated eight of the first casualtie to be extricated. Well done, Hilary and Lee !

New Journal

A very warm welcome to the British Red Cross Society's new monthly journal Crosstalk, of which the first number appeared in January. ['m sure that we and the BRCS (who are our very near neighbours in Grosvenor Crescent) can gain a great deal from each ( Co ntinued 011 page 11 )

SUMMER IS COMING, AND IN BRITAIN'S WATER -SPORT AREAS

PROBABLY THE USUAL SPATE OF ACCIDENTS INVOLVING

DROWNING

by Stanley Miles, CB, MD, DTM&H

Dea ll of Postgradlla fe }\Jedical S il dies, UI/il'ersity of Mal/ c hester

D E ATH BY DROW I G s t il l remains a

m ajor threat to life, claiming each year in the United K ingdom abo u t 1,500 victims.

T he m ajority of these are re ative y young

a nd active peop l e enjoy i ng holiday and r ec r ea t iona l pursuits. B y no means nil dr ow n in the sea. [ n fact 75 per cent of the d eaths occur i n in l and waters

Process of drowning

Th e majority of men and women will sink i n water and even the strongest swi mm ers wi ll ultimate y become ex h a u sted. Dr owning is primarily a co nd ition of asphyxia, for when the head is und erwate r breathing is impossible. At first th e b r eath is hel d but soon water e n te r s t he mouth. This is immediate ly swa ll owed i n copious amounts which may lea d to v omiting d uri ng recovery if rescue is pr o mp t.

In the healthy individual brisk reflexes a t fi r st close the l a r ynx and prevent the n h a la t ion of water into the lungs. I n a b o ut 2 0 pe r ce n t of these cases this pr o ect i o n pe rs sts unti l consciousness is l os t a nd p a r a ys is of t he bra i n centre whi c h con t r o i s respiration stops

br ea t h i ng. T hese are the lucky one w hose u n gs remai n d ry and who have the b es cha n ce of comp l ete recovery. I t is h ese w h o may r ecall p easant dreams of pa s t e v ents and who have litt le

r eco ll ec ti o n of the actual mishap O n the o th e r ha nd those w h o i n h a le water may, if th e y d o r ecove r , r emem b e r sea ri ng pa i n in th e c h es an d extreme distress. Th ese

a r e th e cases of 'wet' d r ow n ing who a r e n da n ger of co m p l icatio n s an d need specia

ca r e.

2

Wet drowning

The water which enters the lungs may be salt or fresh. Theoretically if it is salt It may draw water out of the blood stream to concentrate the blood and the heart action. Fresh water on the other hand may be quickly absorbed into the stream which it would dilute causing destruction of the red blood cells with the liberation from them of potassium which immediate y upsets the heart rhy th m an d rende rs it ine ffec ti ve. Heart failure in this case would be more rapid than in the former. [ n actual practice, however, when water, salt or fresh, enters the human lung there is immedwte distortion of the alveolar pattern so that any tran. fer of fluid either way is minimal. The major effect is one of irritatJon which produces an exudate containing plasma and cell followed by comp l ete obliter:.ttion of the air spaces. This sequence of events closely resembles that of an 'acute pneumonia. As are, ult of this inhalation of water it is possible, and not infrequent, that a patient who is rescued and adequately resuscitated may apparently recover only to show, hours later, severe respiratory distress with pain in the chest, rapid breathing, and blueness of the lips. Unless vigorous treatment is given death may quickly follow. This in known as 'econdary' drowning.

I t must also be remembered that fresh water gives less bouyancy than ea water a nd hence more rapid drowning. Frequently too, the water may be far from c lean, containJJ1g additional irritants and impurities such as oil, sand, mud, or di l uted sewage, all of which if inhaled further comp l icate the condition.

resusci t ation before this it may be life sav i ng, but this must not unduly delay reaching shallow water or a boat. Th is effective employment of exhaled air resuscitation demands a clear airway. It may tlluS sometimes be ne cessary to remove water , debris, sand, weed etc., from the upper air passages. This must be done without delaying re lIscJt a tion It is not possible to empty water from the l ungs themselves and there is always a risk that undue manhandling may cause emptying of the stomach which would increase the danger of further inhalation of fluid

The major advan tage of exha led air resuscitation is its gentleness. [t enables effective ventilation of the lungs to be carried out with the minimum disturbance of the patient, an JInportant factor if vomiting is to be avoJded. In shallow water the patlent is ea'iily supported and It may be possible, if one is available, to pass a stretcher beneath him to facilitate his beJl1g brought ashore.

It is most important in drowning, where the threat of vomiting is a major one, to ensure that, as soun as resuscitative procedures have restored natural breathing, the patient IS placed in, and remains In, the 'recovery' positJon.

Di a gno s is of drowning

When a per on is brought out of the water unconsciou and not breathing, drowning must first be presumed even If other gross InJllfles are present It is, however, quite Impossible at thJS to know whether any water has JJl fact heen inhaled into the lungs I t is therelore ab olutely e sential to assume in every ca e that it has been inhaled until proved otherwi. e. This can only be established by examin::ltion In hospit a l. l.:.ven If the fast-aid resuscitation produce'> an appJrent recovery t1us is no guarantee that secondary drownJJ1g will not occur.

I t cannot therefore be too trongly emphasised that in every case of drowning, whatever the outcome at first-aid treatment, the patient must be admitted 10 hospital without delay.

F ir s -ai d trea tm e nt

Once drowning has cauosed breathing to stop the heart will fail within two to five minutes If this occurs death I inevitable unks the heart can be re- tarted a chancy business even with closed chest cardiac mas age. I t is thus essential tha t artificial re piration must be commenced a t once. There i" not a second to waste.

The appltcation of first aid is complicated by the need to remove the drowning person from the water or at least keep him afloat. In the latter case, without the aid of some form of lifebouy, only thc strongest swimmer in sea water is able to give exhaled air resuscitation

The po licy therefore hou l d be to get the patient ashore or in a boat a soon as possible If it is po sib l e to give an occasional breath of exhaled air

If, after half a do/en or so inflations there is no improv e ment in the pallen t's appearance, no palpable pulse in the neck or wnst and the pupils of the eyes are widely dilated, It may be assumed that the heart has stopped beating. This JS an all too common result in drowning, but It is in dr ow ning that the applJcatJon of clo ed chest cdfdJac massage IS most rewarding ThiS tech niq LIe, however , should neveJ be applled unless indicated by the signs descrJbed and then only by a first aider who has been adquately trained and is competent to do so.

Attempts at re cue and resu Citation should not be abandoned too readily. even when dea th seems certain there wtll be friends and relatives who refuse to give up hope. Where both exhaled air resuscitation and closed chest cardiac massage are used they should be contlllued. there J. recover), until the patient reache hospital. I n the ambulance It may be possible to supplement the treatment by giving oxygen. Indee d many beach rescue Llnits also have this facility. The use of mechanical apparatus for the first-::licl administration of oxygen IS an Llnnece sary luxury. The simple self-inflating hand-controlled bags with oxygen supply cylinders :.tre quite adequate If additional money is available it is a much better to purchase a battery-driven mechanical Slicker which is invaluable for maintaining i:I clear Jir wny.

Further treatment

On arrival 111 hospItal every case of drowning will be treated as an acute

medical emergency until it has been established by X-ray and clinical examination that no water has been inhnled. [f it has, further treatment will be necessary to avoid econdary drowning. This will include continuing administration of oxygen, intravenou injection of plasma and the giving of :.Intibiotic drugs to protect the lungs from infection Tn extreme cases where there has been delay In restarting the ileMt there may be eVidence of br:.lln damage resulting from lack of oxygen_ This may be distressingly severe in some case, but recovery is most encouraging. The fear of thi complication in the delayed application of clo ed che t cdrdi3c ma age must therefore not discourage any attempt at revival.

Prevention of drown i ng

Tho e who are likely to be called upon to give first aid in drowning mlly well

have opportunitJes to emphasise the need for all who are at risk to develop a rational attitude to water safety. Drowning could indeed be a very rare occurrence if simple common-sense precautions were taken. The e include learning to swim well from an early age, observing local warnings, wearing lifejacket and safety line in boat, and rememberlllg that to risk one' own life by careless behaviour may well imperil the life of other who attempt a re cue. I t is equally important that a many individual a pos ible are well trained in the fir t-aid treatment of drowning and every encouragement given to local authorities where a water hazard exi ts, to support the life-saving organization which nre active or prepared to be active in their areas.

(Reprinted /rol/l rhe Red Cross elt'S Rel'iclt' )

Are you as ready for water accidents as Miss Joan COllyer, at the SJA first·aid beach hut, Walberswick, Suffolk? See AROUND AN D ABOUT for more details (Photo : East Anglian Dally Times)

CONTINUING A VISIT TO ANATOLlA'S FASCINATING

VALLEY OF A THOUSAND CHURCHES

The outer skin of this gigantic rock cone has eroded to reveal the remnants of a large pillared hall. The portions of the pillars remaining show that they were cut in one piece with the ceiling from the rock

By Dorothy Bingham - H all

At one time, the de coratlOns COIl isted of geometflcal or linear designs only. Pillars doors, arches and dome were au tlined with stripes and Llg zag

patterns; crosses of every type were displayed; and everywhere there were white Maltese crosses on red medallion s, or red crosses on a white surface.

Then, many of these details began to be painted over to make a rich brown, red or blue background for murals upon which , through the ce nturies , were painted angels, apostles, saints, in cide nts in the life of Christ, the miracles,church festivals , and portraits of Constantine the Christian Emperor. Large heads of Christ looked down from domed or vaulted ce ilings, and the full length figures which covered the walls were elongated and slender.

Today 11 th ce ntury pall1tings sometimes reveal a lower level of linear de co ration dating from the 8th ce ntury , as the top lay er fades away.

Inside one of th e great cone was a hermit cell with a small square window in the rock face one of many cells at levels. Cut Simply In the soft rock, it seemed to be hewn out of time Itself to house the nucleus of a Christian settlement or to protect a religious stronghold hidden and remote , yet so near the great highways of the ancient world along which the apostles themselves trav e lled on their missionary journeys in the 1st ce ntury

While I was 111 these place ther e was so much to think about as my mind drifted back to the pages of the ew Testament, which contai n no les s than 38 reference to places in Anatolia Down on the eastern border was Antioch a

renowned Christian city, once the capital of Roman Syria, where St. Peter had hi S first mi ssio nary church in a grotto , and SL Paul was called to his mission by the Holy Spirit. Only thirty miles away from the Coremc valley was Cacsarea (now Kayseri). On ce the capital of Roman Cappadocia, it became one of the great Christian cities to which St. Paul came on hi journeys. Strangely enough one of these journeys started from another Caesarea on the coast of the Holy Land , where , at one time, he was imprisoned for two years. In many of the old Roman province s of the Mediterranean, other towns were called Caesarea as a tribute to Caesar.

Along these ancient roads came con querors, barbarian invaders and later th e c ru saders Via Constan tindple old Byzantium at one time not only the centre of the Roman Empire but the administrative and spiritual centre of Eastern Christian ity The first Crusade was led by Godfrey de Bouillon, who is said to have visited Caesarea, which had a co nsiderable portion of its city enclosed to contain a famous Christian medical centre for illness and treatment, and one of the earliest Christian hospitals, associated with St. Basil.

What of the first occupants of the hermit cells in the hidden valleys in the 1st cenlury'? I often think of them. Although enclosed in their narrow world, they lived in a upreme moment of history, under the burning zeal of the apostles, just as their successors through

the ages continued to spread Christianity and take part in the developmen t of the Christian church until the ]4th century.

Later there would be similar cells in the religious houses, as some of the ridges and cliffs contain complete monasteries where monks would make and occupy their cells, copy rituals and festivals , and be caught up in the findings of the great Church Councils (like the one at Nicaea), and in the acrimony of so-called Christian heresies which at one time were so bitter as to threaten to split the Christian world.

Among the most interesting of the valley occupants would be those of tile Schools of Pain ting, with their background of centuries of sharing experiences , discussions, appraisal, and criticism. I could imagine an artist's pride in his work in the 8th century as I entered the small chapel of St. George, where the mural depicting St. George slaying his dragon can still be seen today and is reputed to be the oldest portrayal of this popular saint. So far away in time and space, one wonders how he came to be the patron saint of Merrie England.

After the Turkish conquest and the coming of Islam the Christian stronghol d in the valley lost its significance and the population dwindled. The few people remaining used the caves for houses and stables. Later, villages of small quare houses , pale blue, yellow or pink began to be built around some of the larger rock formations - the caves in the rear being used as s tore rooms.

Jn the course of time large areas of the

outer rock-face broke away from the soft crumbling texture of the interior rock, and these fallen facades in and cones reveal church mteriors of surpn mg architectural quality, together with the vivid colours of the paintings soon to fade in the sunlight. This breaking-away process con tinues t.oday.

Looking out of the cell window, I could see hundreds of such windows in the rock face across the valley, and deep in small ravines vines were flourishing in the volcanic soil fertilised by guano from pigeons whose lofts were made by walling up the caves near by. A few poplar trees softened the harshness of what is practically a treeless scene, as the wind lifted a delicate cloud of pink dust from the valley floor.

In that simple act of looking out of the rock window, as the sun went down at the end of the day, I seemed to share a moment in time with all the former occupants, linked together in an ancient ever-recurring wonder, as the ash-whiteness of the valleys and rocks broke up mto spectrum colours, leaving the afterglow of vivid blue, pink, violet and orange, to fill nature's palette and inspire centuries of painters. A strange, evocative land indeed.

nterior decorations of some of the rock churches.

This painting of St. George slaying his dragon

The small town of the valley, Urgup. Modern houses and

(background).

MEDICAL CONFERENCE

The SJA Medica l Conference 1972 takes place at Nottingham University April 2 1 to 23 inclusive and is residentiaL The theme of the conference is 'F un and games R isks to life a nd limb in sport and leisure .'

Among the speakers will be the Baroness Masham of Ilton, talking on sports and leisure activities for the dis able d ; CoL LM. Adam , commanding officer of the R oyal H erbert Hospital , who will talk on the three R s' of climate; Surgeon Commander MacKay will talk on the hazards of underwater activities; Dr. J. Ogilvie will lecture and demons t rate on mountain rescue ; and Dr. C. Bainbridge, chair man of the working party of the enquiry into the Ibrox stadium disaster , and some of his colleagues will talk on m aj or accidents.

The Surgeon-in-Chief is very anxious to meet as many divisional surgeons as possibl e at the conference.

Application forms for the conference can be o btained from county secretaries or the Conference Se cretary, 1 Grosvenor Crescent , London, SW1X 7EF.

BEACH HUT

Miss Joan Collyer, seen on page 3 of this issue at the SJA Suffolk's bea c h-hut at Walb erswick, is now a county staff officer. She lives at Walberswick , a small coastal resort south of Southwold which attracts two to three thousand people to its b each during Sundays in the summer and on Bank H olidays. And it was this influx which led to Miss Collyer to have a first aid hut at the beach during the summer season. She started it five years ago.

The hut is open on Sundays during the season from lOam to 6 pm and it is providing a very useful public service. It is equipped with everything necessary for first aid treatment including a stretcher. Oc casional assistance is given by nurses from Becc es.

But the service does not stop there. In fact Mis s Collyer finds herself ca ll e d on fo r all so rt s of things such as inquiries for

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

lost children lost property, and water for dogs

It is almost a first aid post, 10 t pro p erty office, general store and information bureau rolled into one.

Miss Collyer says the publi c is grateful for the services provided but the fir t public acknowledgement came la t summer when she received a letter of appreciation from the Parish CounciL

It had been informed by a lady swimmer that she had cut her leg on an iron stake which became un covered by the tide when she was swimming at Walberswick and that she had been treated by Miss Collyer. The writer expressed appreciation and added what a fine idea it was to have a f irst aid hu t there.

The hut was made available by the vicar but last year it changed hands and now b e longs to Mr. A.H. Harwood and his wife Mary, who is county superintendent SJA, and they are co ntinuing to make it available as a first aid post.

HISTORY MADE

Hist ory has been mad e, eyebrows perhaps raised, and members of Women 's Lib ' have probably cheere d - on the appointment of Mrs Jeanne Mer cer as the first woman SJA Area Commissioner in the country. The appointment, I h ea r, has met with nothing but favourable approval in the Area to which she has been

Surrey's retiring SJA Commander Capt. F. J Cart w righ t, CVO OBE, RN CStJ. r ight), with (L to R Commission Barry Robinson Dr. R. J. Southern Mrs R Southern, and Lady H ea ld

BY THE EDITOR

APPOINTMENTS

Bucks: Rear Admiral R. S. Welby to C SU.A.

Barbados: Reported at S.M. l74 that Major Daniel had been promoted to LL CoL Inform ation has now been received that thi s W:lS incorrect and his Army rank remains as formerly, i.e. 'Major'.

Cornwa ll Mrs. Pott s to Cty. SupL( )

Cumbo & Wstm ld: Dr. P.A.M Weston resigns as Dep. Com.

East Ridding: Mr. C. Jackson to Dep. Com.

Essex: Mr. J. Bird to County Director

Herts: Mr. C.J.N. Longmore to C'SU.A retaining appo intment of CommiSSioner.

Mr. W. Appleton to Deputy County DIl'ector

Jamaica: Miss M. Stephens

MBE appointed Secretary of ouneil

Kent Lt Col. G. Ialler-llowat to C SU.A.

Lanes: CoL 11.1. Darlington LO C SL J.A.

Captain TN. Callow to County Director

Major .J. Clarkson-Webb to Dep County Director.

Region X II : Sir George Scott appoin tcd

Representative CSt.1.A. Mr. B. Robinson appointed to Bngade Committee vice Major Barrow.

St. Lucia: Mr. S H Hrookes re\lgncd as Com. 0 sliccessor yet appointl'd.

Somer et: CaptulI1 J.B.S White to Commissione r Western Area

Staffs: Mr. M.A Simmons to Commissioncr. Col. G. lligg s to Dep. Com.

Suffolk: Dr. Hardy Kinmont retire s as Area Commissioner.

Surrey: Sir George Scott to CSt.1.A.

Worcs: Mr. K IL Billingham appointed Dcputy Comm issioner.

appoin ted. Mrs Mercer takes over as Area Commissioner of Kent NO.3 Area on the promotion of Mr. L eslie A shman to Deputy Commissioner for Kent.

A lett er to Mrs Mercer from Lt. Gen. Sir William Pik e, Chief Commander SJ /\, who sent his congratulations and best wishes said he would follow her career with the greatest intere st. Mrs Mercer sees the job as 'a real ch a llenge' particularly with the ever growing importance of home nursing.

Jeann e joined SJA as a cadet with Herne Bay Divi sion during th e war, and a

few years later led a cadet team 111 the first post-war Brigade hnals, when she was presented to the late Duchess of Kent.

In 1949 slle wa chosen as the nursing cadet to represent Kent at the 40th annIversary celebrations of the Brigade in Malta. The following year she was transferred to the H erne Bay Nursing Division. In 1952 she was elected a member of the 'O rd er of the Knights of the Road' for rendering first aid in a road accident.

M 0 v ing to faversha m a fter her marriage in 1953, Mrs Mercer was appointed divisional Superintendent in 1954, holding that rank with Faversham Nursing Division, City of Canterbury Nursing Division, Petersfield (Hants) Nursing Cadet Division (which she started in 1961), H orsley (Surrey) Nursing Division and Farnham ursing Cadet Divi ion. On her return to Kent in 1968 she was appointed assistant area superintendent ( ) and promoted to area superintendent ( ) in Jun e, 1969.

Mr Mercer wa admitted to the Order as a Serving Sister in 1970.

Du tie he ha carried ou t ove r the years have been of a varied and interesting nature, including attendance on royal occasions, cathedral dutie , hop garden clinics, nood disaster work, horse shows, county agriculture shows, military

HISTORY MAKER

open days, at skating rinks, sports grounds, county cricket matches, lo cal events and fetes.

A member of the National Hospital Reserve for many years, Mrs Mercer served as the Surrey representative on the Farnham Group Hospital Service R eserve Training Committee, and also as a youth leader on Youth Council Committees.

Always keen to encourage as many people as possible to learn first aid, Mrs Mercer has given talks to the WRVS , Young Wives groups, Wom ens Institutes , Girl Guides, Boy Scouts and Grammer Schools.

PILOT TEST

A different type of home nursing test, not confined to nursing members, was tried out in London District recently at

the request of Brigade Headquarters For teams of 4 peopie, each holding a Home Nursing Certificate, it included, male members of combined divisions.

The idea behind this pilot competition, sponsored by Dame Barbara Cozens DBE , RRC , Chief Nursing Officer, was to relate home nursing and first aid, tested in a situation which cou ld arise in a communal disaster.

The after-effects of a flood at an old-people's home were simulated and three old ladies needed treatment; one was blind, confused and needed toilet guidance; one was totally deaf, with a foot needing dressing, and one was a very breathless old lady with curvature of the spine, who needed a blanket-bath.

A separate judge for each patient adjudicated on the team's effort. On e team from each of the five Areas of London Distri ct took part and found the competition much more realistic than the usual individual home-nursing test. It is hoped that this type of competition will be included in future competitions.

BREWERY VISIT

At the Duke of

Following the first aid courses given thi autu mn by SJA Dorchester, the fir t-aider of a local brewery arranged with the Casualty Union and Dor che ter ursing Division to give reali tic demon trations of incident at the brewery.

Member s visited the brewery on three co nsecutive Friday afternoons, demonstrating in three department: bottling , wines and spirits, and brewing. Accident chosen were those which had or could occur in the deparments.

[n the bottling department, for instance, one casualty was not wearing 9

IN THE BREWERY

h er protective goggles when a bottle exploded; had she been wearing them the injury to her eye would have been avoided. The - second casualty was protected by goggles but unluckily flying glass cut her on the neck. (See photograph above)

T he organiser of the demonstrations has some difficulty in siting incidents.

T he First Ai d Manual says carbon dioxide poisonin g can occur from vats. But in this brewery the vat room was very well v entilated, and electrical equipment was so p l aced that shou l d emergency maintenance be required no one could r emote ly be ove r come by fumes. But one e l ectrica l incident, u sing R esussie Anne, was stage d O t hers inclu d ing burns from chemica s or steam, crushing by fork-lift truck, and injury to the hands through c ru shing in machinery or wrong handling of meta l b arrels.

The members who took part in the dem onst r a tions found them most interesting and learnt a great deal. The

PRIZE NURSES

brewery staff showed how much they appreciated the visits , which had more impact than any lecture.

THE LETTER

It is perhaps rather unusual for an 'established' Ambulance service to pay tribute to an individual trained first-aider but this happened recently in London.

When the GLC Ambulance Service answered an emergency in Penfold Street N.W.l they found a patient with an injury to the head being cared for by Raymond Cutler, a l2-year-old member of the Rutherford/Paddington Cadet Division. So impressed were the GLC crew with the way Raymond handled the situation that the South West divisional ambulance officer wrote the following to St J ohn Ambulance, Western Area:

'We wish to highly commend this young lad for the way he had looked after this boy and the useful information which he gave to us and and all ex -Grand Prior cadets from Bletchley Division. It was annual prize -giving at Stoke Mandeville H ospital. The nurses (L to R) Cynthia Hethrington, Dorothy Massey (D.O Wendover) Va e r ie P acey (D.O. Wendover) and Susan Tink.

also that h e had no hesitation when asked if he would accompany the patient to ho pita!. He was in complete command of the ituJtion.

'The assistance afforded by Raymond Cutler was greatly appreciated by tillS Service.

This tribute to St John is all the more worthwhile since it co mes from people who are not only knowledgeable about such matters but who are al<;o accustomed to meeting widely varying emergencies.

SHORT COURSES

Now that the Short Course s for Householders has been successfully launched on a national basis. the Chief Commander has decided that it shou ld be confirmed as one of the overall range of S1 A cou rses rn future these uncertificated courses will be administered as follows: Association: responsibl e for the subject-matter and publi ca tion of the syllabus and any associated technical instructions . Brigad e: responsible through nursing channels for the lo cal organisation and running of courses.

Correspondence with Headquarters on these subjects should be addressed to the Superintendent-in-Chief but requests for the syllabus, Record Cards or posters should in future be sent to the Registrar.

This new course introduced by Lady Brecknock has got off to a good start in many Counties and is proving to be very popular among a wide section of the general public . There is already considerable evidence to show that many of the people who have taken the course have followed it up with a certificated course and quite a few have subsequently j 0 in edt h e B rig a de. The Chi ef Commander hopes that senior officers in counties will continue therefore to give it their full support and encouragement.

Fareham, Hants - SJA meet the chairman of the Council. (L to R) W.A. O iver, Development Officer No.4 Region, Mrs V. Evans, Mjr Reyno l ds, Development Officer No. 6 Region, Mrs J.S. Doney, Cnty. Dir Association, Councillor G RobInson, Mr. W. H Ayling, Association, Fareham, and Mr. D. E. Gawtry, sec. Portsmouth Centre (Photo: D.W Young).

AT RAN DO M

(continued from page 1)

other by exchange of ideas and views, and that in this way both Crosslalk and the Review can together make a big contribution to the service and the vitality of both Society and the Foundation. I wa particularly impressed by the leading article in the February issue of Crosstalk on the implications of the Local Government Bill affecting county boundaries. However loudly we claim to favour change, when it comes to something that really affects our normal way of life most of us show a built-in conservatism that makes it hard to look objectively at changes imposed on us by any governmental or other authority of no matter what political colour. Have you taken a close look at the boundaries of the county in which you'll be living in a couple of years' time, and considered how any changes may affect your local St John Ambulance set-up? If, having done so, you feel 'Oh well, we'd rather tay as we are, and I expect we can persuade Headq uarter to let us do so', have you seriously considered the confusion and the disadvantages that could result - especially in an emergency - if the administrative boundaries of St John Ambulance are different from those of Local Government Authoritie regional hospital groups the police and ambulance services and other voluntary societies? If 11ot, the time to look calmly at the whole question in I/OW, because if the changes take us unaware some of us will find ourselves in a state of chaos if we aren't ready to conform to the new pattern

The temptation (which ['m sure we must resist at all costs) is to say 'We've never done it that way before', which is one of the worst 'killer phrases' in our language Even if there are very rare cases and they should be very rare in which our own future ad mini trative boundarie differ from those of Local Government, many of us, if we are faithful to the spirit of the Order, will have to accept with good grace the transfer of local loyalties if we are to co-operate most effectively in helping those whom we exist to serve.

Tr an sport for th e elderly

One of the monthly item in theReview that [specially enjoy is the half-page headed 'News from Scotland' rn January, it ended with the following statement: 'To be DEAF to the achievements of others and DUMB about one's own to be BLIND to the possibilities of improvement. And the only people who in the end will suffer are... the sick and the poor'. This theme was further developed in March, when the opportunities for welfare work were stressed 'areas in which the infirm are for one reason or another not covered by the protective umbrella of state paternalism'.

There are none so blind as those who will not see, and recent experiences have driven me to the sad conclusion that many of us

do not see (a) the immense gaps in our welfare system that could still be filled by our voluntary service, and (b) that welfare services of this kind are at least as much a part of the statutory objects of the Order and of our Foundation as the more conventional services of first aid and nursing.

My recent visit to the Is le of Wight proved an inspiring contrast to this blindness. The I sland runs a fleet of five St J ohn Ambulance minibuses for the aged and infirm who cannot use public transport. Carrying a total of at least 6 or 7 thousan d passengers a year, they take old people to visit their relatives in hospital once or twice a week, carry them to and from all the local churches every Sunday morning throughout the year, and bring them in from outlying villages to do their shopping on market day. The service is run by members and auxiliaries of St John, with willing help from the BRCS, the WR VS, the Sa lvation Army and local churches, and with the strong support of all local Councils. And, far from regarding this as an act of piracy, the Southern Vectis Bus Company gives one of our minibuses a free garage and services two of them without making any labour charge. All five minibuses are financially 'in the black', and some of them are pu tting aside reserves for eventual replacement. The Secretary of State for Health and Social Security has asked us to develop this scheme in other parts of the country, and I'm sure there are many places where the need is at least as great, and its fulfilment could be as effectively achieved, as in the I sle of Wight.

Air Transport

The other scheme to which I referred last month, the St John Ambulance Air Wing, developed out of the difficulty experienced (but eventually overcome) by the hospital at Epping, which sponsors a St John division, in finding a n y means of air transport for a seriously injured casualty who would benefit by being transferred to a hospital in his native Germany. The Air Wing, formed of St John members and auxiliaries, made history last November when it flew a kidney from Heathrow to Nancy in time for a successful transplant operation. And at a meeting held at the Department of Health and Social Sec u rity in February it was agreed that the Wing should be used for the emergency transport of kidneys when all normal methods failed. Within four days of that meeting St John flew a kidney from Booker airfield (Bucks) to Manchester hospital in the early hours of a Sunday morning, in time for a succes ful transplant. Three days later a second call came , bu tat the moment of take-off the flight was cancelled because the prospective recipien t in Copenhagen had died. The spirit of the Knights of St J ohn is undoubtedly alive today, and one of the best ways to keep it flourishing is - as well as practising our ancient skills - to open our eyes to new and challenging forms of service.

The Mechanics of Joints

A UNIQUE BIO-ENGINEERING GROUP ARE STUDYING THIS SUBJECT AT LEEDS UNIVERSITY

by V. Wright, MD, FRCP

The author is Professor of Rheumatology, University of Leeds; Consultant Ph ysician in Rheumatology, United Leeds Hospi tal Board, and Leeds

Region al Hospit al Board

THE HUMAN -JOINT is a magnifi ce nt bearing (fig 1) Essentially it comprises cartilage (gristle) capped bone ends, lu bricated by synovial fluid enclosed within a joint capsule. The caps ule is fibrous, but on the inner side is lined with synovia l membrane which produces the lubricant fluid. The coefficient of friction of the joint is better than glass on ice and far excells anything produced in engineering practice, a remarkable tribute to its designer! It has to function under a great variety of conditions and for many people gives a lifetime of trouble-fr ee operation. Nevertheless in certain in d viduals this bearing wears and produ ces degenerative joint dise ase (osteoarthrosis), with consequent pain , disability and crippling.

T o investigate the functioning of normal joints and the reasons for the damage to joints from an engineering point of view a unique combination of disciplin es has developed at the University of L ee ds , resulting in a Bio-engineering Group for the Study of Human Joint s. On the engineering side it co mprises the In stitute of Tribology of the Department of Mechanical Engineering, whose head Professor Dun ca n D owson was the first Pr ofessor of Tribology in Great Brit ain.

Tri bology is a newly coined word meaning the study of lub rication, friction and wear ; it stems from the Greek 'tribos' meaning 'to rub'. On the medical side the Rheumati sm Re sea r ch Unit of the Department of Medi ci n e has formed the

second part of this consortIUm. More recently the Group has expanded to include a number of orthopaedic surgeons , metallurgist, physical educationists and even the physiCian to Leeds United!

Normal Joints

The first consideratIOn of the Group was to determine the mechanism of lubrication in normal joints. [n such a study the following factors must be taken into account:

I. The operating conditions (loads and speeds).

2. The lubricant (synovial fluid).

3. The bearing surfaces (articular cartilage).

It is not generally realised that in ordinary walking weight-bearing jOll1ts, such as the hip and knee, are subjected to a load of more than four times body weight. One of the values to a patient with pain in one of these lower limb joints using a walking stick is that th e redistribution of the load is such that in the hip, for instance, it comes to just over one and a half times body weight. Much work remains to be done in the magnitUdes of loads in more vigorous activities such as jumping off a bus. Using a fo r ce platform and high speed ci n e mat ograp hy we are at the present investigating the forces produced in dropping from a height. It could well be tha t these forces are importan t in the initiation of wear in the human joint The lubricant fluid is watery (being similar to blood without the red cells) with the addition of a long chain molecule (hyaluronic acid) attached to protein.

This hyaluronic acid-protein comp lex co uld be lo oke d on as an additive, similar to the additives put in the oi l of car engines. The viscosity (stickiness) of the fluid changes with the rate at which it is Sheared, so that when the joi nt is moving

quickly the fluid is less sticky, an obvious advantage. The additive, hyaluronic acid-protein complex, has a very large size in molecular terms being about 0.4 micron and thiS has important implications in lubrication.

The bearing surfaces articular cartilage, to the naked eye appear glistening in their smoothness, and until very recently it was thought that this was definitely so. We have used sophisticated measuring techniques, however, to study this surface and they have shown that the appearance of smoothness is illusory. A talysurf instrument has drawn a diamond tipped stylus across acrylic castings of the joint. We have found that by engineenng standards articular cartilage is surpnsll1gly rough To look at this directly, an instrument only very recently developed, the scanning electron microscope, which gives extremely high powered views of the surface of structures in a three dimenSIOnal way, has con Fi rmed that the cartilage surface is uneven. It presents an undulating appearance like the Sus ex Down! Further experiments of friction have shown that thi is significant as far as lubrication is concerned I appears that the joint IS lubricated by a mechanism completely unknown to the mechal1lcal engineer, which we have termed 'boosted lubrication' by fluid entrapment and enrichment. During the load-bearing phase of standing or walking synovial fluid is trapped in the hollows of the undulations of the articular cartilage. The watery phase escapes sideways and through the cartilage, which is sponge- like. The pores of the articular ca r tilage, however, are very fine and not large enough to allow the long-chain hyaluronic acid-protein complexes to escape. Thus the fluid is enriched at precisely the moment when the joint requires the thickest lubricant. ThiS thick lubricant also forms gels on the urface of the cartilage, so that, where the peaks co m e into contact, skins of the complex form an effective protective barrier that keeps the surfaces apa r t. Engineers do use porous bearings in machinery, but these do not in any sense act as a filter, leaving behind the long-cham additive. The synovia fluid also has another fun ction that of nourishing the articular cartilage. There a r e no blood vessels in the carti lage, so that it receives its nutrim e n t from the synov ia l fluid, being pumped in and out during the joint action.

Wear of Joints

Just as a mechanical bearing may wear, so join ts may d egenera te (fig 2). This is particu larly true in joints s u ch as the hip and the knee. The wear process may be analysed [rom a m ec h a n ica point of view. There are t hr ee basic types of wear:

1 Adhesiv e.

2. Abrasiv e.

3 Fatigu e.

Adhesive wear occurs when adjacent surfaces rub together and stick. As they stick, a piece is torn f r om the opposing surface. Abrasive wear occurs when particles come between the bearing surfaces and s c ore them. The introduction of sand into an engineering bearing would be an obvious example. After adhesive wear, bearing sufaces may also be abraded by particles torn from the opposing surface Our post-mortem studies have shown human joints in which abrasion has undoubtedly occurred. The third type of wear is fatigue Where a bearing surface is exposed to repeated cyclic loading it may crack at that point

due to the fatigue of the surface. Fluid may then be forced into the crack and lift off a piece of the surface. In all these conditions further wear may be prevented or slowed by the introduction of a lubricant (hence the oil in our car engines ' ). Wear is a difficult problem to analyse, but the attempt must be made if we are going to understand this process in degenerate joints of human beings.

Arthritis

There are different types of a rthrit is. Some arise from an inflammation of the lining, the synovial membrane, and damage between the joint surfaces is

Wear in the moving parts of an engine"

Fig 3

Fig 2

Don't try and take short clils t o a cure"

secondary to this inflammation. [n osteoarthrosis, however, the primary damage is of the joint surfaces themselves. Th ere may be some inflammation of the lining, but this is seco ndary to wear d e bri s being trapped in the m em bran e and irritating it.

Ou r Group has approached the problem from three points of view.

Firstly, in norm a l joints that are going to devel op disea se we have wanted to determine the factors that ca use this Damage to the articular surface may be evidently due to inflammatory con dit ions

s u c h as rh eu matoid arthritis o r gout.

There is anot her ve ry rar e but very intriguing type ca ll e d K ashin-Beck dis ease, in which joints become inflamed during the Spring because the

inhabitants eat mouldy grain infected with the fungus Fusaria. They develop al: inflammatory arthritis and this goes on to osteoarthrosis. [ n other forms of osteoarthrosis occupational factors are important. We know from animal work that certain joints that are subject to stress develop degenerative c hanges The famous ra ce horse Arkle was put down because of osteoarthrosis of its knees. R ace h orses use their forelegs in a different way from norma] horses and produce tremendous stress on these joints. Hamsters deve op such changes in their fore legs, and serving bull s in their hips. As far as human beings are concerned, pneumatic drillers get the disease in their elbows, coal miners in their knees, and boxers in their hands. We Fig 5

have been interested in the reaSOll why professional footbal l ers develop prematur e joint disease and a re making a study of these players co mp ared with those engaged in non-contact sports. These st udies may give a c lue to the types of load which initiate degenerative jomt changes.

Abnormalities of shape of joints may a so predispose to osteoarthrosis. One ees thi in congenita l disease such as conge nital dislocation of the hip, P erthe' disease of the hip, etc. Likewise, patients who have one leg longer than the other are liable to develop osteoarthrosis.

In the econd place we have been concerned wilh those joint that show mild to moderate change, in which it would be hoped that more adequate lubri cation would pre long the life of the joint. A number of water-soluble long chain polymers are now available and we are testing a number of these in the laboratory and in other ways. Certainly many patients would agree that improved lubri ca tion would be beneficial to their c reaking joints, as evidenced by the following extract from a letter sent by a courageous Y o rkshire lady

'O ffered one body, slightly stiff, especially around the knees and ankles. Any type of oil accepted from light to heavy. Quite willing to go from oiling to boiling. This offer genuine'.

For years we have resisted this suggestIOn (fig 4), but with newer techniques and materials there is a possibility that this may be achieved.

The third case is that where joint damage i so severe that the only hope is replacement with an artificial joint. Very good work ha been done on total replacement of hips, although not all these have been entire ly sati factory. Fig 5 was kindly made available to me by the Marquis of Exeter, who has had hi hlP prosthesis removed and made into a mascot for the front of his R ol ls Royce! A lot of work remains to be done 111 relation to other joints, however, particularly the knee and the shoulder. At the moment studies are proceeding In our Group with a view of developing replacements and it is hoped that it will produce increased mobility in patient suffering severe damage to these important joints.

NEW SCOOP STRETCHER

THE FOUNDATION'S medical board has accepted the Ferno-Washington 'Scoop' stretcher model No. 66 for St. John Ambulance. A t demonstration the board noted that the folding verSlOn of this stretcher fits an ambulance floor compartment and weighs only 7 Ibs; this portable stretcher has the advantage of facilitating casualty pick-up in the position found.

The stretcher is marketed in two verSlOns, foldlJ1g and nOn folding, and the choice is therefore relative to the space for stowage. The stretcher , constructed of lightweIght aluminium, is sturdy and easily cleaned. The two sections of the stretcher, of tubular frame with special wedge-shaped sections attached, join at foot and head with special automatic latches. The minimum length is 65\4ins and can be extended by a telescopic action to in four steps, thus accommodating patients of varying size. A special l ocking device preven ts slipping from any of the four positions selected. The automatIc end latch allows either or both ends to be quickly released or coupled. The halves of the latch line-up automatically for easy re-coupling and the positive snap lock closure makes the stretcher completely rigid when both ends are coupled. Three 2in nylon webbIng straps are provided with each stretcher.

In the foldi ng ve r ion the two metal head scoops are replaced by a padded head ection with Velcro closure.

The scoop stretcher represents a big advance in emergency patient handling equipment. Dependant on the circumstances one or both ends of the stretther may be uncoupled and the two halves eased un de r the pa tien t in orde r to effect the scoop action. Consideration must be given to the terrain in which the casualty or patient is found, as the stretcher is designed to function effectively on level ground. Small amounts of debns or rubble should be cleared (carefully, if under the patient) for a short distance in order to provide a clear working area. Emphasis must be placed on the need for care, because in certain conditions and with certain patients the closing of the stretcher has been known to pinch. First-aiders will reali e the importance of immobilising the head during pick-Up and transfer. Hard and fast rules cannot be laid down regarding the retention of a patient on the stretcher. Where a fracture of the s pi ne is known or suspected and ambulance transport is necessary the patient could, if desired, be transferred to the ambulance tretcher bed, previously firmed by fracture board. [n the ultimate, what is be for the patient should be the deciding factor.

MADE IN TWO PARTS WHICH ARE EASED UNDER THE PATIENT AND THEN LOCKED TOGETHER

The MarquIs of Exeter's Rolls Royce with the artificial hip joint as a mascot. An a r thritis sufferer, the Marquis wore the joint or ten years until this former O ly mpic champion replaced it last year. The mascot bears the Inscription: 'A Devoted Supporter 1960·1970'

It is ou r con vic tion tha t the close collaboration of engineers and physicians is essential for the successful pursuit of studies like this, and the effective co-operatIOn of specialists in the disciplines is likely to lead to the alleviation of suffering in many patients with osteoarthrosis. The disease is never going to be eliminated entire ly , unless we find a cure for old age, but if symptoms can be alleviated and the ear li er onset prevented, much will have been achieved.

( R eprinted from St. John County Year B ook, Somerse{).

There is no doubt that this stretcher eliminates the need for rolling, sliding, twisting or lifting the patient as With a conventional stretcher. In addition the risk of complicating the original injury during multiple handling is considerably reduced.

Rem ember:

I Decide the length of stretcher necessary and adjust.

2 Rel ease one or both end-latches.

3 Rem ove obstacle likely to impede smooth positioning of casualty on stretcher.

4 Complete positioning.

5 Ensure end-la tches are properly closed, head immobilised, and where necessary retaining straps applied.

6 Transfer to ambulance stretcher bed; if decided to remove scoop, release both end-latches and withdraw two halves individually.

The Scoop Stretcher is marketed in this country by:-

F. W. Equipment & Co. Ltd., Whitehall Properties, Town Gate, Wyke, Bradford York s.

BREAKFAST BREAKTHROUGH byAlanMcGlashan

IT IS a curiou thing, this ever-increasing care and protection that medical research now devote to our faulty dietary. Scienti ts in all part of the world are daily discovering unsuspected dangers in Our diet. One gets the feeling that, like an anxious mother with her only child, they will not rest till every conceivable risk ha been eliminated. We should sure ly be grateful for a ll this solicitude or should we?

For a good many years medical research wa content with occasional warnings to the public, of which few took any noti ce: that children should not eat sweets, that white bread was not nut ri t ious, that refined ugar wa upsetting to the metabolism, and 0 on. We carr i e d on much a before, on the lighthearted a sumption that a little of what you fancy does you good.

Those care le ss days are over. The do c tors now strike a sterner and more

menacing note. That valuable but dangerous new toy, th e com pu ter, has enormously extended the scope of medical research, and statistics of unprecendented range and di quieting import are pouring down upon us. Death, in sudden or insidious forms, lie hidden, it would seem, in the most everyday article of diet.

Scientific re ear h mLlst not be hackled. If such things are dangerous to health we had better be told so. Agreed, agreed. But shou ld not someone tell these eager beaver of researchers that the atmo phere of anxiety and mi giving that is being created about almost everything that we put into our mouth ha it own profound effect upon our health? It is strange that we hear so little about the effects of anxiety. For in the long run it is anxiety not tobacco or coffee or soft water - that is the hidden destroyer in the conte mporary world Anxiety

treacherously open the door to every kind of accident and physical disea e, cripp le s efficiency, murders happiness. In wartime, it was an indictable offence to 'spread alarm and despondency' even if the facts were true. It was recognised then that human survival d epended on morale. I t sti ll does.

[ do not know the answer to this dilemma; but I do know that medical r esearchers shou ld open their eyes to the danger of activating anxiety, thi insidious cancer of the human mind, this grey enemy of life, and should devote at least a part of their research to the aim of redu cing rather than increasing it.

(Digest 0/ all article ill The Lancet).

AGE LIMIT

from W. E. Street, Divisional Officer

1 was particularly interested in the article At Random (Feb. Review) by the Deputy Commissioner-in-Chief referring to the age limit of officers of St. John and their retirement from leadership.

This has been a sore point for years, particularly with younger members, and several letters have appeared on the subject in the Review. r wrote 5 years ago suggesting that officers stand down at 60 to give younger members the chance of promotion, but said that if they wished to continue St. John work they should retain their uniform after replacing their badges of rank with a small 'R'; then fall-in in the ranks with the same status as ambulance members , where their experience would be available to the you nger officers.

This subject cannot be completely covered by letters to our magazine the Review rt is obviously, as with the relationship between cadet divisions and adults, and the almost continuous changing of some uniforms, etc, causing concern throughout SJA, and a national conference should be called to discuss the setting up of a more modern S1. John movement Exmouth W E. Street

HOW OR WHY?

from J ac', ambulance member

Am 1 too late to reply to Mr. Meads (Review, December 1971 page 16)?

Surely divisional and corps loyalties and rivalries keep us on our toes? We must have local competition to produce our best, which is what we all want.

r n Birmingham all divisions and areas a ppear to work together happily and efficiently when duties allow or require us to do so.

Why have different regulations in differ e nt parts of the country? Areas vary, duties vary; the public at events vary; transport to and from duties differ in type, frequency and reliability. Local regulations can allow for circumstances that are local or temporary in nature.

Even in the armed forces local regulation s upplement Queen 's Regulations.

If the Review is able to spotlight difference in practise in its columns it can surely resolve them in the same way. Write in and ask how or why. Birminghalll 'Jac'

VIEWS ON

fro m Miss K. D. Wilson, D ivisional Officer

Crossword : plea to Mr. Potter, - please destroy your nurses' dictionary and use the First Aid Manual (the new one, preferably) when compiling your crossword. No doubt some medi ca and nursing personnel can and do enjoy completing your crossword as it is, but for the majority of Review readers here it is beyond them.

Books and films: I am wondering how useful members find these pages devoted to new books and films. The books recommended are mostly on medical and nursing subjects and although I am sure many readers are nurses and doctors we can read reviews of these books in other magazines This m agazine is the St. John Ambulance Review The film section is use fu l but comments on films the panel does not re co mmend for SJ audiences could be more hrief , highlighting thos e which are recommended.

Thanks to our new Deputy Commissioner-in-Chief for his article

At Random in January issue It seems he will bring some fresh air to headquarters, and it is helpful and interesting to know that all headquarters' staff maintain their efficiency, even if some of us already knew this. Also for his proof that individuals matter by his action in the case of the 80-year-old r11ember. [ hope that will also apply to other active and capable members of 65 years old.

The point made by County Staff Officer D. L Williams (January issue) regarding promotions is a good one. I have always felt that many members' interpretation of the words 'vo luntary

READERS VIEWS

Wounds for Casualty Make-up

by C.J. Cobb

THE MODERN TRE 0 with training sessions, competitions and first-aid courses is to use prefabricated wounds in casualty make-up. The wounds are m.ostly of the plastic variety fixed in position with adhesive, while some people make them of plasticine or bread pulp.

Readers' views and opinions, which should be sent to the Editor, although published are not necess arily endorsed by the Editor or the Order of St. John and its Foundations Although readers may sign published letters with a pen-name, writers must supply their name and address to the editor.

orgamsation' was wrong and [ agree with ML Williams. 1 also wonder if this policy applies to admissions to the Order, ie Serving Officer Brothers and Sisters? I know of mnny members who have given much more service to the Brigade, without recognition, than some county staff and others who seem to be admitted to the Order after only a year or so. By saying this r am not d ecrying the good service given by many county staff officers.

Contrary to what Ja cqueline Sampson ay about our uniform (Feb issue), all our nursing member now have the new tyle and often it has been admired by the general public I agree about the apron halter, but we now so seldom wear apron urely that i a minor point. Our member wear apron only when on hospital or home nursing duties, and possibly at blood donor es ions I like our new-style dresses and think they look very smart. Workington K. D Wi/son

We have used atex for many years and find it to be uperior in many ways. The use of plasticine or bread is a time con LIming and mes y method that can take up valuable training time , while with pia tic wounds, although quicker to make, the edges are thick and do not blend into the surrounding contours. If you can spare a few hours (there are not many left for members of S1.. John) you can produce your own latex wounds for a small cost. The materials required to make enough latex wounds to last the average division 3 years are·

lib plasticine

I eye dropper

2 or 3 Jam jars

] tin of french chalk (the wife's talc will do fine)

I quart of Revultex M.R. (a self-curing latex), ohtainable from the suppliers mentioned below.

14 lbs pia t e r of Paris

I square of I /8i n hardboard

5ft x 2in x I /2i n planed wood

8 I Y2 In x 0.6 brass screw

1 jar vaseline

1 I /2 1n camel hair paint bru h

R evultex M R. is available from Me srs Bellman , Ivey & Carter Ltd 358B Grand Drive , West Wimbledon, London , SW 20 and is supplied in quarts, 1 /2, I and 5 gallons.

THE CASTING BOX

The first tep in making wounds is the casting box

Cut two peice of 2i11 x 1 /2i n wood II in long.

ut three pieces of 2in x 1/2 in wood lOins long

Assemble as in Fig. I. When the frame is placed on the hardboard it will leave a border of 1/2in all round The third lOin piece is u ed for reducing the size of the box for making sma ll er wound.

B Do not fit the hardboard to the frame.

MASTER PATERN

Soften plasticine by rubbing in the hands, for it needs to be very pliable. Make a wound or swelli ng on the hardboard ( mooth face), bu remember the natural h ape of the body is not flat

So make the s h ape of the wound to suit the body. Smooth it with the vaseline (but not too gren y) down to the

Fig. 1

Fig. 2. j[

Fig.3.

Fig 4.

hardboard. There should be no visible edge. See Fig 2.

Place the frame on the hardboard and fix in po ition with plasticine , See Fig. 3.

Fix the trip in the box with pia ti c ine if you require to use a smaller space, a this will al 0 save pia teL

THE CASTING

You can now make the ma ter mould

Fill a I Ib Jam jar I f3 with cold water and add plaster of Paris lowly. miXIng continuously until the mixture is like thin cream. Then pour into the casting box making ure the plasticine mould IS covered by at lea t I in. See Fig. 4

Leave to set for 48 hour You can then remove the frame by gently ea ing up from the hardboard: it hould come away cleanly.

The next step is to ease the hardboard away from the plaster mould. Great care i needed here or all your work can be destroyed. The mould should come away complete with base. If for any reason the plasticine shape is left in the pia ler ca t,

leave it for a further 48 to 72 hours to harden before removaL N.B. Do not varnish casting.

MAK1NG THE WOUND

The method of casting wounds is straightforward if you follow the instuctions.

I. Stand the mould on a flat level surface.

2. Fill the eye dropper with Revultex MR and run into the centre of the mould.

3. Spread the solution with the came l hair brush ou twards, keeping the edge thin.

4. The amount will depend needed This of solutIOn required on the thickness will be a matter of trial and error to suit your own needs. More solution can be added even when the first lot has cured.

5. Leave the moulding to cure from 2 to 48 hours, according to size.

REMOVING THE WOUND I. Dust the urface of the moulding with french chalk.

2. Rub up the edge of the moulding with the finger tip. Do this very gently as the wound will stretch if it is pulled too hard.

3. Grip the edge of the moulding and pull gently. It should come away easily.

The mould is now ready for the next casting.

DO NOT BE TOO AMBITIOUS

There are many pitfalls so do not be too ambitious at the beginning. Make simple wounds and swellings. More co mplicated open fractures and foreign bodies can come with experience.

FlXING THE WOUND

The wound is fixed to the casualty with adhesive e.g. U.H.U. or spirit gum. This can be removed with indu trial methylated or urgical spirit, but caution i needed. Keep the meth away from the eyes. After the wound is removed du it with french cha lk. It is then ready for re-use

COLOURING

The wound can be coloured with grease paint and blended in with the surrounding skin, and if you have fixed the feather edge down correctly it will be the most natural imitation wound you have ever seen fter completely ma tering the technique of making and fixing wounds, no injury or condition will be beyond faking

LAUGH WITH DAN )THE' FU<ST Alb MAN

FOR THE SERVICE OF MANKIND

Furley, Lechmere, and Ducan, St. John Ambulance Founder.

By Joan C li fford. Robert Hale London

£2.5 0 "

Mrs. Clifford had the happy idea for her book of electing three remarkable 19-century individualist whose pas ion for alleviating the distress of the sick and wounded unit e d them in the Order of St. John; their subsequent endeavours culminated in the formation of what was to become the St. John Ambulance

The first, Sir John rurley, wa a civilian said to be deli cate but with the heart of a lion, who was to be found in the forefron t wherever there was fighting. riot or bloodshed As a non-combatant, welcomed by the antagonists on both sides, he never took part in fighting: but his determination to succour the wounded of both sides led him into many desperate adventures when his life was worth hardly a moment's purchase.

Colonel Francis Duncan , the second man, was a soldier equally restless and dedicated to bettering the lot of the sick and wounded. Both these men were gifted with a talent for invention improvisation, and an absolute refusal to take 'No' for an answer. They travelled widely and Mrs. Clifford's colo urful pen takes us effortlessly with them to almost every country in the world ; to understand their feelings in conditions of hardship and near-starvation , at their reception at the courts of kings, into the battlefields, dressing-centres , and improvised hospitals , and into the council c hamb ers of Europe Colonel Francis Duncan was to become the first Director-General of the St. John Ambulance Association ' Sir John Furley succeeded him as the The third man, Sir Edmund Lechmere became Secretary-General of the Ord e r of st. John and knitted together the work of the other two men, supporting t hem in their enthusiasms and endeavours providing them with the means and material to create an ambulance service. In many ways, this quiet scholarly man was perhaps the greatest of the th ree. Mrs. Clifford's book is a labour of love and admiration, which opens o ur eyes to the value of traditions which make men and women serve others without regarding the cost to themselves.

It is an inspiring book which all should read.

A GENERAL TEXTBOOK OF NURSING (18th ed tion )

B y Eve yn P earce.

Fa b er £3. 00

When I was in training (in what my students consider to be the Dark Age s ) Evelyn Pearce's General Tex t book of Nursing was our 'Bible', whi c h we studied assiduously and referred to when 111 doubt. I have 170 doubt that it helped us 18

NEW BOOKS

all to pass examina tions. Much later, I had the pleasure and privilege of meeting Miss Pear ce, then in her seventies, and I was amazed at the breadth of her outlook and her quick, forward-looking mind.

It gives m e great pleasure to r ev iew this edition of her famous textbook. It was finished shortly before her death and was completely revised, many c hapters being contributed by experts in their own bran c h of medicine and surgery.

The general set-out is excellent a nd the illustrations carefully chosen. Some of the chapters seemed to me of special value, notably that on the nursing of patient suffering from di eases such as fits, uncons cio us states, incontinence an d anxiety, where the special needs of such pa tien ts a re discussed with great sympathy and understanding Another chapter of great value is thut on the nursing care of the gravely ill and dying patient, laying tr e s on the l one lines so often met in i llness and on the help which can be given to th e dying and lo their relatives This subject is often glossed over in m any books and the wise advice given here would be of help to anyone caring for a seriously ill person.

The section on medical conditions is necessarily rather bri ef and felt that the social aspects were not sufficiently stressed.

The chapter on psychiatric cond ili ons, their treatment and nursing care is very well presented and the one on poisoning and its treatment would be of specia l interest to SJA members.

There is an excellent section on Geriatrics, with stres on rehabilitation and prevention of acciden ts.

Another chapter of int erest to SJA personnel is that by Mr. M Hobsl ey on Life threatening Conditions, where the rel evant physiology is clear ly and simp ly described.

Surgical nursing. pre- and post-operative care, the indi cations and hazards of oxygen are well covered and individual surgical conditions are dealt with by spec iali s s in each field. There are some useful appe ndi ces on metri c measures, the ide effects of endocrinological preparations, the Ilursing code of ethics and example of questions set in rec e nt state examinations for the Final General Regi s t e r It may seem a bit carping but there is one omission I would like to see r e medi ed in future e ditions and that is the addition of a suggested reading li st at the end of each chapter, such as we hav e in our Sl. John Nursing Manual.

AU T I STIC, PSYCHOTIC and BRAIN INJURED ADOLESCENTS

PPWAPPA, 31 Uxbridge Rd, Kingston Surrey £ 1.05

£.3.00 may see m a lot to pay, but for a r eference book such as his r feel thal one is really getling valu e for mon ey. I would r eco mmend it to all SL John nursing officers preparing lectures for their members, to St. John members who are student or pupil nur ses, or who are working regularly in hospital: it cou ld be co me for them what a prevIous edition was to me, their nursing 'Bible' always there to be cons ult ed or studied.

Kati e M. Pfister

SPO RT S I NJUR I ES

By David S Muckle, MB, BS, FRCS

Oriel Press, Newcastle upon Tyne £2.50

This sma ll book IS written by an enthu iast and much of the advice given is eminently practical in nature. Bul if, JS the fir t foreword states, it is for 'football trainee' then the lise of medical terms should be redu ced, eg, 'osteochondntls di ssecans' on p. 73.

The fir chapter IS baSically first aid plu brief references to artery Jnd nerve damag e. the latter is beyond the scope of the first-aider. The sugge tion on p. 16 that steroid injection might even be considered, and therefore have to be prohibited. is disturbing

The picture or a lin ear fracture of the sku ll on p 26 wi ll have little meaning 10 non-medical readers as will that of J fractured calpoid on p. 58. There is a danger that the over enthusiastic layman, reading this, mighl attempt 100 much

There is an 1I1dex and the production IS very good.

R McL. Archibald

M EDICAL ASPECTS OF FITNESS TO DRIVE

Medical Commi sion on Accident Prevention, 50 Old Brompton Rd , London, SW7 3EA. SOp a copy.

ThiS report by the Medical ommlSSlon on Accident Prevention gives advice in J concise manner on the several medical conditions lik ely to affect safe driving and each chapter has a useful paragraph entitled. 'Suggeslions for udvict' 10 patients'

In tillS he 2 nd edit ion, uddl ti o nal advice is IIlcluded on mentul 11l11(,ss and personallty disorder as they affect driving ; a lso there is un appendix on the law us related 10 medical i"ilness ul llle present t im e.

For d oc t ors undertaking examination of patients for fitness to drive cars lhi') is a most valuable gUIde.

Dr. J. S. Binning

This booklet gives the main speeches und discLlssion of a conference devoted to the ne eds of a particularly vulnerable handicapped group The general problems of adolescents are greatly magnified in very disturbed children whose physical development, accompanied by mental frustration, cause many parents to find their management dIfficult and adequate care impos Ible. The lack of supporting facilities leads to great stress, of len to the point of breakdown, in their families.

The doctors, teachers, psychologists and, especial y, parents at the conference considered the available services and suggested improvements for the support of fami li es with slich mentally handicapped children. The need to

SJA

AFLOAT

de vel 0 p t heir Intellectual potential through the provision of on-going educationa l services was emphasised. There was no lack of ideas and belief in the pOSSibility of rescuing these c hildren from a life of idleness and misery III custodial care by providing speCIal training and occupation, but the enormity of the whole problem of proVISIon of money , services and trained peop le must be understood by everyone. Meanwhile, much can be done by Interested individuals whose concern could be c hannelled into practical help. Thi booklet will provide a useful background (and addresses) for any members of SJA who would like to use their special kills in an area of human

need where It wdl be greatly appreciated. A.Hutt

PARR'S CONCISE MEDICAL ENCYCLOPAEDIA

By J. A. Parr and R A. Young Elsevier, London

(no price given)

This book is apparently aimed at nurses, medical auxiliaries and laymen. A reviewer can only select a number of words or terms at random and assess the accuracy of the II1formation given. On this tesl the book does not perform too well ; the student who quoted the description of 'pneumoconiOSIS' on p. 297 would score very few marks. At best it can be described as patchy and cannot be recommended with confidence.

SJA Gloucestershire recently launched its first rescue craft at Tewkesbury for operation on the increaSingly popular Inland waterways, In this case on the River Avon (Photo Cheltenham Newspapers)

NEWS fpom SCOTLAND

Where do we go from here?

Last month I suggested that perhaps the fact that in Scotland we did not undertake ambulance work was for us a b oon and I boasted that w e were in a h ealthy state beca use we were forced to b e original and to participate in different kinds of charitab e work. Later in the year I hope to consider in this co lumn what might be called the ideological b ackground to our activities: the ki nd of rul es we shou ld apply when judging whether a particular project is in accordance with the ideals of our Order.

Bu t this month I would like to dis c uss a more practical issue, which is of growing impor tance as new branches of the Order are founded and the new committees begin to plan what tasks they should undertak e. It is right that we should all think deeply.and critically about what we do so as to ensure that our efforts and enthusiasms have the greatest possible effects

It i s a truism, whi c h ha s been stated many times before in this co lumn , that the National Health Service is not everywhere and in all things as efficient as it might be and that there are a lway s types of person or kinds of illness which are not adequately treated by the state. And since the Welfare umbrella lets through the rain in many place s my readers might be forgiven for thinking that i t is r ea lly quite easy to find some exciting and worthwhile proje ct for memb ers of our Order to undertake. But in fact the question is rather more complicated than it appears to be at first and on the practical level there are, I beli eve, two criteria which mu t be applied to any proposal that i put forward.

The first of these can be summed up in this question: Wh ere is the greatest need? But this can be answered only when expert advice is taken. Most members of our Ord er are not medical men and they d o not have a professional day-to-day r e lat ions hip with the Health Service. Very f ew of them are civ il servants with a knowledge of the intricate workings of th e We lfare State . The failure to seek the advice of those in the know ca n have two un fo rtun ate results It can lead to the adoption of a project which is superficia ll y attractive but div erts attention enthusiasm and cash from an area where the needs are grea te r: and it can result in a boring uniformity in that people a r e inclined to fall ba ck on the same comfo rt a bl e and unex c iting schemes that othe r s have undertak e n in the past.

The seco nd of my crite ria can be expressed as fo ll ows: Wh at project wi ll h ave o n g-lasting beneficial effects? It s very mu c h harder to app l y, bec<luse it 20

requires guesswork as w e ll as knowledge, but it is important if only because money and time shou l d be invested wh ere there will be the maximum returns. The problem here is that every now and then some striking failure of th e N<llional H ealth Servi ce comes to light a nd attracts a public outcry which, in turn, leads to governmental efforts to provide adequale cover. For examp l e, our Order and other charitable organisations have known for years that the field of gerialrics was one that was much ign ored: we have several old peoples' homes and now in Aberdeen and G asgow we are involved in important new schemes concerning lhe care of the e ld erly. This is and will remain a proper activity for us. But in the distant fu lure th e situation may be different One has a feeling that now public and profe sional interest in geriatrics has been aroused, thanks largely to a member of the Order Professor W Ferguson Anderson. It is too early to say what effect public pressure will have on an already overburdened Health Servi ce and certai nly at the moment we are in a plendid position to take advantage of the growing interest in the subject It is also questionable

whether the state cou ld ever rivul the charities in this very personal and sympathetic kind of care. But by 1997 our fiftieth anniversary - we may well be dis co ur aging furlher projects in a field by then becoming overcrowded

From a consideration of my two criteria r am inexorably led to the conclusion that the time is approaching when the Order in Scotland should have some sort of regular profe sional advice available to it. Of course doctors and othe r are consu lt ed before our committees embark on schemes, but I have a feeling that the present informal proces es of consu ltati on shou ld be formalised and that it is the job of Priory to establi h a panel of doctor., civIl servants and members of the Order from whom advice could be o ught. We would have to be careful not to allow thi s group to become a sort of politbureau issuing di rectives: local member know local condition and no more could be provided from he centre th a n criticism and general guidelines. But since in Scotland we must rely on the diversity of our activitie s it is important that these should be as effective as possible. J O-S.

NATIONAL FIRST AID COMPETITION

POLICE

PORCHESTER

: \1ctropulitan P oliL·e 'Z'

yte Challenge Cup (third): Liverpool & Bootie Constabulary WOMEN

City of London Rose Bowl ( c h ampionship): Dorset & Bournemouth Constabulary Susse x Constabu l ary Rose

(runners-up): Cheshi re Constabul:JrY

OVERSEAS NEWS

CANADA

R ock festivals were strenuous affairs for the St. John Ambulance Brigade in Ontario this past summer. Two three-day festivals demon trated the efficiency of the Ontario Emergency H ealth Services plan for such occasions.

Dr. N. II. Mc a ll y, Director of Emergency H ea lth Services, co-ordinates tile health services for all rock festivals. A field hospital and treatment cenlre is set up on th e site for the duration. It has a medical and surgica l unit, staffed by doctors and nurses, a treatment ce ntre for drug abusers, staffed by the Alcohol and Drug Addi c tion Re sea rch Foundation and a fir t-aid unit, manned by the St. John Ambulance Brigade.

Satellite first-aid posts are set up around the grounds where they are required. St. John Ambulance vehicles operate wlthin the festival site tran. ferring patients from the first-aid posts to the field 110 pitat. Emergency H ealth Service provide ambulance service to nearby ho pitals and in serious emergencies, transports cases to hospital by helicopter.

At the Rockhill Fe tival, a Combined Division operated three mobile units and provided 12 Brigade members for duty 24 hours a day. They trea ted 500 cases.

At another Rock Festival 335 ca e were looked after by members of Brigade from Belleville , Trenton and Picton, Ontario

Dress for th e Brigade at Llch affairs is casual. Nursing members sometimes wear uniforms although they can be uncomfortable on extremply hot days. The men usually take off their jackets and the only SL J ohn identification is through shoulder flashes or armbands.

Mo t co mmon aliment was sunburn. Other were minor lacerations, burn , dehydration, sliver, thorns, thistles, bli ter , abra ions, in eet bites and stings, dirt in eye, toenail damage, poi on ivy and nose bleeds

In expressing hiS appreciation for the St J ohn Ambulance partiCipation, Dr. N. H. McNally said: In spite of long hours, their cheerful and efficient handling of the first-aid problems reduced the workload of the EHS medical facility and staff a great deal. With this and past experience, it i felt that this type of operation, handled in co-operation be t w een the St John Ambulance organisation and Emergency Health Services, is what we want to encourage and develop.'

SJA at Rock festiva lsi n Ca nada last summer (Right)

The SJA centre prepared and ready to go (Below) Scrapes, lacerati a ns, sun burn - all in a day's war k for the Brigade (Photos : Toronto Star)

News from the Divisions

CO R WALL ewquay IS proud of its members and rightly so. Divi s ional Superintendent W P. Pearce who reti red at the end of year, has completed 38 years with the Division. Percy Jomed the e\\'quay Dlv In 1933; nine years later he was promoted [0 sergeant, 111 19 57 he became a Serving Brother of -the Order, and three years IJter a divisional officer. In 1966, on the de a th of W II. Ja cob, he \\ 'a\ apPointed Div Supt. Three years ago he was invested \\ Ith Officer Brother of the Order ;\ ay instru cto r , Percy holds the Royal Humane Certifica te for life savll1g at Porth Beach. At a recent DIVISion dinner/dance. tile County Commissioner (R) 1 A. Boutwood prescnted Percy with a transistor radiO from a ll members a[ ewquay.

Nursing members were also honoured at thc dinner. secretary i\11" K t·. l ('aguc. \\Jto was with a thanks on vellum, JOlncd St. J ohn Jt Waterloo Liverpool. In 1914 but becausc of her full-time job resigncd in 1917 She rejoined at e\\'qu,l) III 1954 .lnd left in 1956 \\hen ,he moved to Cheshire. The love of sea bree7es saw her back m ewquay In 1959 Since 1960 Ilss Teagu e has been nursing assistant and clerk of the aner-care cliniC at c"'quay hospital.

Mr. L. A. Bout\\'oo d s,lId that coun t y record showed [hat \1iss Teague and ollr other Ilurse wc're proud of. :'Ilrs l Cook. hJt.! completed over 4.000 hours du t) Mrs Mary Eli zabeth Cook, from t. Columb Major. 7 miles from Ne\\'quay, \\'ho has been with th e Ne\\'quay NUf';ing DiVision for some fifteen} ears. Joined L\ at Sidmouth. Devon.

In 194 2. A holder of the Advance and II lghe r I Irst-Aid Cert ifi cate, her malll duties arc at the beach-hu t on Towan beach and a [ the Coun ty

CO LI nc il I1

0me for th e e lderl y

Witil th e Ordcr\ th anks on vellum a lso prese nt e d to Mrs. Cook, Newquny Division wish thesc h ree members a very h appy reti re m en t.

LO DON - The pilot run for a new !l ome Nursing Team Test II1trodu ce d by Dame Barhara Cozens, DEE , RRC, S R , the Chief Nursing Officer, held at the Royal I ree London W.C I on January l5 Each of t he 5 Areas of London Distri c t cn tered a team.

Thc seLtlng for the co mpetition was a bedroom in a rcs id en ti a l homc for [he aged In which 3 e ld er ly adies, variously incapacitated , were to be attcnded for th e afternoon by 4 nursing members

Thc Winning team was p rovided by No. 5H (Woolwich) Nursing DiviSion, South Eastern Area, which has had a very successful record in prevIOus London District co mpetitions It compmed Sgl. Mrs. D Reid, N/M Mrs A I"oley, N/M \1rs P Taylor, N/M Mrs. L. Phillr ot, and ( reserve) N/M Miss Prl CC (sce photo)

Tile S [ Lont.!on Area Commi\sioner, Mr. A G. R 130ne , and Area Surgcon, Dr l: C Dawson, JP , MB, BS, werc present to see their t ea m sco re yet anothe r vi c tory I n the ab,encc of Dame Barbara , who \vas Indl'>posed , the prill'S were presented by Miss C. J Lewis , Chief Nursing Officer of the Royal hec Il osp tai.

IL is Intended tilat tillS ne\\ nursing test shall eventually be extended to a Brigade competi ti on. to be com peted for at national level.

O BITUARY

Miss Dora Andrews, divisional office r(N), Rh odes DiVision, Bath Scrvmg Sister In 1963 Albert E. Bruck , founder member Wharncliffe S ll kstone Ambulanct' Division. Yo rks (V, .R.J. Co rps officer in 1937. Serving Brother in 1949 Albert Rqpnald Collms, ambu lancc mcmb e r , Hatfield, then St Albans DiVISion, Il erts Reginald W. CO'(, diVisional superintendent. Pl ymstock. Devon Formely of Plymouth Central Ambulance Division

CLASSIFIED

ADVERTISEMENTS

REVI EW CROSSWORD No.4 (72) Compiled by W A Potter

ACROSS:

1. Not a breath-taking caress (4.2.4) 6. Part of vertebral co lumn is in district of Columbia (4) 10 Left with nine upset in a small room of the ward. (5) 11. Cast worth alteration (5) 12. Is a ble t o preserve food. (3) 13. Top-grade performer with mu s cle characteristic present in urine in di a betic c oma. ( 7) 14. Bones i n banana salad. (5) 16. Metabolic disorder in which the br e ath m a y smell of 13 Across. (8) 18 Scandinavian races (6) 21. Nothing the senior service consumed is richly embellished. (6) 22. Tag of skin predisposing to parony c hia (4-4) 24. Syphiliti c ulcer up in turbulent air. (5) 26. Human species and mink appearing differently. (7) 29. Craft in heart and arteries. (3) 30. Tar is ba c k in cartilaginous plates of eyelids. (5) 31. Use habitually in Yorkshire river. (5) 32 Does take in c orre c tly the presc r ibed amount of a drug. (4) 33. Ancient bicycle for an orth o paedi c surgeon? (4-6)

DOWN:

1. King taking intoxicating liquor for vegetable. (4) 2. Affer e nt nerve impulse making news (9) 3. Animal of small we ight. (5) 4 This soil produces a type of pneumokoniosis. (8) 5. Tongue of constipated patient. (6) 7. Anvil-shaped ossicle. ( 5) 8 Microscopic blood passages in compact bone. (10) 9 Final wo rk of composer or artist. (4-4) 15. Seat for so c ialist coun cillor in th e maternity hospital? (6.4) 17. Keeps on going when the r es t hav e stopped. (8) 19. In alcoholic c oma. (4.5) 20 Yellow peril? ( 8 ) 23 Young organism developing more by mutation. (6) 25. In the first degree, a fracture of the lateral malleolus only (5) 27 Stew made from part of the eye and a small atom . (5) 28. Give birth to a stock-market speculator. (4).

SOLUTION TO CROSSWORD No.3 (72)

ACROSS:

1. Amputation;6.Calf; 10. Explain; 11. To.ns.ils; 12. Epileptic ; 13. Urine; 14. Ideas; 15 Euphoria ; 19 B lack ey e; 20. Od.our ; 22 Pit on; 24. Cultiv.ate 26. Quassia ; 27 Mess-in.a ; 28 Evil ; 29 Short-sighted.

DOWN: 1. A.gene.sia ; 2. Popliteal; 3. Travel sickness; 4. Tenet ; 5. Op . ti c; 7. Acini ; 8. Fe ster; 9. Pneumoconiois ; 15. Eve ; 16 Pie ; 17 Isolating; 18. Artefact; 21. Opaque ; 23. Tra.gi ; 24. C.rash; 25. Lemu.r.

( Below)

ClaSSified

ADVERTISEMENT MANAGERS Dennis W. Mayes Ltd., 69 Fleet Street, London EC4

November. SpeCial PDrty rates for clubs, senior Citizens, e'c. throughout season, and special terms for those connected with the sea Administered by the Royal Alfred Merchant Seamen's Society (108)

BAZZARS GARDEN FETES. SPORTS EVENTS etc Send fo r

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ST. JOHN

REVIEW

AT RANDOM

About, by the Editor p 8

Blood Loss and its assessment p 12

Films p.15

Readers' Views p 16

I n every cadet's haversack by Body Doctor p 17

Pop and the Br gade down under, by Dr J. Peter Bush p.18

News from Scotland p.20

Overseas News p 21

News from the Divisions p.22

by Watkin W. Williams Deputy Commissioner -in- Chief

THE MOYlE T has co me fo r me t o lift th e very thin veil 0 1' anonymity that has so far s hroud e d the author<;hip o f thi m o nthly co lumn; for the Commi<;<.,ioner-in-Chi e f now has two Deputies, and J am M

WANTED

EDITOR : FRANK DRIS COLL 26 Pem bro k e Gard ens. L o n d on , W8 6HU 01 ·60 385 12)

ADVERTISEMENTS : DenniS W Mayes Ltd

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COVER : 69 Fleet St ., London, EC4 (01 -3534447 and 4412)

£1 70 p er ann u m. In c lu di ng p o stage. f rom Tr easurer Order of S t. J o hn 1 Gro sve nor Cr esce nt Lond o n SW1X 7EF

Hardly anyth,ng but a winner s smI e MISS Jennifer Up)ohn, nur SIng member of Leicester's Southfields Library D,viSion. had just won the Linda Barrongton Trophy for the first-year holders of the adult certificate at the county annual competItIons (Photo P Jackson)

very happy to welcome and introduce \1ajor-GeneraJ D. S. Gordon, CB, eBE, DSO, wh o j o ined Headquarters to share with me a ta ' k which I could only very inadequately perform alone.

General Gordon brings with him the experience of a long and distinguished army career which, among many other appointments, ha included tho C of Commander of the 16th Independent Parachute Brigade Group, Chief rmy Instructor at the Imperial Defence College, and Col o nel of the Green Howards. A point o f special interest to us in St. John is that his command of the Parachute Brigade Group involved the formation of a Medical De ert Rescue Service which patrolled the desert from the air, ready to drop doctors and medical orderlies and supplies whenever and wherever they were needed.

It's still to o early to define at all closely how we hall divide our duties between us; but at thi ' tage] don't think that really matters, becalLe we are haring tile same o ffice and working together in clo e collaboration and that" the most important thing of all.

( Co ntinu ed o n pag e 11 )

THERE ARE FEW people who do not have a fairly vivid and accurate picture of what a good leader should be; few have any doubts what sort of qualities he should possess But to most, a lead er is someone who is born' to lead and possesses certain innate qualities by which he naturally emerges as a leader. The idea of making' leaders is often thought to be, if not impossible , exceedingly diffi c ult. And so it is.

Nevertheless leadership training is daily becoming more and more important in every walk of life. It is perhaps especially important within the Brigade because of our organisational structure where we need leaders at every e vel. This is particularly so at Divisional level where the quality of leadership will undoubtedly reflect in the efficiency of the Division. There are far too few 'born' leaders to meet the needs and something must therefore be done to fill the gap. This is the problem. How do we teach people to become leaders?

At this point, stop to reflect for a moment, and consider how you would set about it.

Probably you will reali se that you cannot teach le a der ship in the same way as you can teach maths or geography. The vadous characteristics of a leader canand indeed must be explained in any form of leadership training, but I doubt very much if it is possible to change radically a person's q uali ties or teach him 2

Training our Leaders

PART 1

by Pat Adams

( Colonel P A Adams recelltly joined H ea dquarters' Staff to be respollsibl e for leade rship trainillg within the Brigade).

process throughout life, and we can only provide the basis on which further progress wiJl depend on PRACTICE and EXPERIENCE.

WHAT I S LEADERSHIP?

On many leadership courses one of the fir t things students a re asked to do is to write down their definition of 'Leadership'. Some repli es are quite remarkable Befor e commencing, therefore, any treatise on leadership it is perhaps as we ll to be clear about what we are talking

Let us first take definition given by two well-known organisations on le adership courses:

The art of persuading other to do what you want them to do.

The art of influencing people to achieve a desired object.

Poth of these are good, in that they im',ly the necessity of producing an ot,edience in others whi ch is th e basis of teamwork leading to the uccessful ac ill evement of any task 'Persuading' is perhaps better than ' influencing ', but is either definition enough to effect and ensure good leadership? After all, a person can be influenced by bribery or persuaded at the point of a gun! I suggest that neith e r definition is complete as neither d efi ncs c learly how obedience is obtained.

One of the best definitions I have seen is given by John Casson an expert in

Management Training and in the Art of Comm uni cating. J n his book, 'Using Words' he describes Lead ership as:

The art of persuading people to want to do what you want them to do.

The all-important extra 'want' implies a willing acquiescence on the part of the team to follow their leader, uninfluenced by any less worthy inducements ; it implies the requirement to satisfy the team's needs, producing in each individual the desire to work with and obey their leader.

J suggest that in all lead ership training - as well as in its application this definition is always borne in mind. Always remember that the aim is to get others to WANT t o follow.

THE LEADER

There are perhap s two main types of leader the ' dictatorial' or authoritarian type: and the 'democratic' type [n the first category obedience is normally obtained by the use of authority, and there are indeed occasions when this type of leadership is necessary - In emergencies, when we have to act quickly and reason afterwards. But there i a tenden cy if used too often - for this type of leadership to develop into the abuse of power leading to the use of threats, fear or even force by which to elicit obedience. Unfortunately, it is this kind of leadership of which we see too much the e days in the dictators, thugs

and leaders of crime, many of whom have achieved considerab le success in their own spheres and, indeed, even fame. Their motives may be unworthy and their methods brutal, but they are nevertheless leaders , and often successful ones at that. But both their motives as well as their methods fail to satisfy our definition of leadership.

At the other end of the scale, we have the leader who inspires in his followers a desire to work with him: who satisfies their needs and achieve s success through his integrity, understanding, respect and example.

THE BASIC PRINCIPLES OF TRAINING

For many years the popular belief was that leaders were 'born' not made' Consequently training was virtually restricted to those who appeared to possess the necessary innate qualities of a leader. ( The Qualities Approach). These qualities are so numerous that I do not intend to cover them in this article. Some are common to all types of leaders whilst 0 thers are particularly relevant to the type of leadership req uired or to the task involved.

Probably lhe most important qualities common to all types are integrity, knowledge and example. Integrity invol ves tru th fulness, honesty, slllcerity, diligen ce and loyalty. Knowledge is important as no-one can aspire to

A great many articles hape been writren on 'Leadership Almost lVithout exceptiol/ thel ' stress (he imm ense difficulty of it. Yet so many deJlore most of th eir pages to describing the qualities required in a leader whilst skirting the more importallt task of holV to train one.

This anic/e deals more especiall)1 wLfh the problems met ill leadership fr;illillg, and it is hoped that it will prollide food for rhought to those illlloh 'e d ill carrying it Olll

new ones; it is not easy to teach a 'se nse of humour to a person entirely devoid of one, or t o teach him to have 'courage' if he is a born coward. You can teach what leadership qualities are, but can you teach a person how to acquire them?

Indeed , 'teac hing implies le a rning a new skill or subject of which the student n eeds no previous knowledge. But where qualities are concerned , if he doe s not already possess at least an element of a particular quality, he is unlikely to acquire it by teaching.

Perhaps therefore you are now more than ever convinced that a le a d e r will only 'e merge' according to the qualities he possesses If they are strong, h e will naturally develop as a born leader.

Luckily however, no-one is perfect and no-one is likely ever to possess all the

qualities required of an ideal leader. But everyone almost certainly posse ses at lea st one or two of those qualitie which go to make up a leader. Furthermore, not all leaders have emerged naturally.

How often have we heard this sort of remark? I f it were not for the War X would never have become a General" or 'Y would never have mad e hi name;f it hadn ' been for the earthquake'. [n other words a per on often emerges as a leader as a result of a particular et of circ umsta n ces.

Jf, therefore we can create circumstances which will help a person' leadership qualities to emerge, we will be on the way to achieving our object.

This basically is Ihe function of leadership training I t implies producing situations where a student must exercise his qualities ; it suggests a practical approach and experience, in which the instructor c an help the student discover his qualities, and develop them [t is a practical 'training' and not 'teaching' for just as 'teaching' implies learning a new ski ll , 'training' implies practice and development of an exi ting one.

Thus a person is train ed and n ot tallght to be a leader and this is perhaps the first basic concept to be understood in leaders hip training

The second concept to remember is that we can only start off the processes from which eaders will ultimately emerge. Leadership training is a continual

The aim - to get others to want to follow .

leadership if he is not sufficently proficient in the skills required for the task ; without it he will neither have confidence in his own ability, nor inspire it in others.

Certain qualities, however, may be more inportant in one type of leadership than another, and their priori tie may vary accordingly. For example, 'courage' ranks highly in the qualities of an army officer, but perhaps not so highly in the captain of a cricket team.

To discover what qualities a lead e r should h a ve, considerable research has been carried out, and, after listing those possessed by many past and present leaders, it was found that no two list corresponded. Certainly no leader possessed all the de ired qualities.

Moreover it was evident that a great number emerged a leaders quite lat e in life, having exh ibited little or no signs of leadership at an early age. Sometimes this was due merely to their being 'late developers' , whil st in other cases - as we have already seen - their leadership qualities came to the fore as the result of a special set of circumstances such as prevail in an emergency. In ei ther case it proved one thing; that in most people there is a desire to lead; that nearly everyone possesses ce rtain qualities of leadership , though they may lie dormant until something happens or is dUIle' to help them to emerge. No doubt this was in the mind of the co mpany commander who reported on one of his ca dds : 'Smith is not a born lead e r - yet!'

Thus came about the situational approach to leadership training , in whi c h it was re co gnised that it was the situation which often determined leadership r a ther than the mere possession of qualitie

A further advance in the approach to leadership training has recently been made and developed by Dr John Adair, formerly of the Royal Military Acad e my , Sandhurst. The jUllctional approa ch, as used at Sandhurst is now also extensively used in industry (where it is known as Action Centred Leadership) It re co gnises that leadership is not only dependent on qualities and the situation, but also on the job or task to be performed.

Whereas the Qualities Approach depends on what a person IS, t he Functional Approach is based on what he DOES. The latter results from considerable research into the psychology of small working groups - for leadership can only apply to groups that have to take action.

In this approach we must consider three distinct requirements of a each inter-dependent on the other two. These are: to define and achieve the task ; to form and train a team to do this ; and to satisfy the needs of the individuals in the team.

emerges where orders have to be given and obeyed promptly to ensure successful execution of the task, even at so m e expense of the t ea m's and individual s' needs. Tile latter, h o w eve r, must never b e ignored : they merely take second place in thes e cir c umstance s, b ein g subordinated to th e ne e ds of th e task.

From the foregoing, we ca n make the following deduction

I That most p eo ple are born with certain qualities of lead e rs hip

2. That these qualities may lie hidden till either (a) an emergency arises, or (b) they are brought out and developed through training

3. That training involves di<;covering these qualities in the first place , :lnd then trying t o develop them.

4. That a leader must not on ly dev e lop hi qualitie, but must understand the needs of the task, the team, and the individuals in it.

5. That training Implies 'practice'. Our approach must therefore be practical one in which students develop their powers by exercising their brains, practising the art of comm uni cating, supervising their teams, and u ing their abilitie to contro l progress of the task

Princess Anne at Norwich

Prin cess Anne's first public duty as Commandant-in-Chief, Ambulance and ursing Cadets, was early this year when she opened the new orfolk Brigade headquarters at Norwich. During the visit she inspected 60 Brigade officers, men and women, toured the new headquarters and chatted to members on duty , and enrolled 100 cadets at a ceremony at Norwich Cathedral.

In conside ring the needs of the team, he must b e capa bl e of welding a group of people into a team, which be comes an ent ity working with a common motive and tow ar ds a common object. If it does not work as an entity it may we ll fail, ju t as eleven star soccer players all individualists may often b e b eaten by e leven lesser players, playing together as a well co-ordinated team. The eader must be able to develop within the team a team spirit, a sense of purpose, and a sense of discipline

Each individual in the team, however has his own particular needs, which the leader must al 0 be able to satisfy. Each wants to know what he has to do, and likes his efforts to be re cog nis e d If he has a parti c ular skill, he likes it to be properly used. There are other more physiological needs which may hav e to be satisfied s u ch as food , shelter, clothing and money.

A leader must be able to recognise these areas of need and satisfy all of them. For the se th ree areas are inter-related, and lack of attention to one set of needs will almost certainly affect the other two.

Nevertheless , although they overlap, one need may take priority over another, and it is the leader 's job to decide which need is greatest. For example, where the 'task' is of first priority, th e 'authoritative' type of leadership often

To fulfil the requirements or 'needs' of the task, a leader must consider the task itself and its 0 bj ect; the skills required; 4 his plan: and control of progress. If he cannot do this, and the task is not accomplished successfully, the team will become f ru st rated

6. That a leade rship cOLirse can only set off the motions. that leadership trainlllg is a continual proce· throughout life: Jnd the leader will only emerge as a result of extensive p ra ctice and experience, hoth during the course lind sllbsC(ltlCnll1'.

In the n ext issue of The R eview, we will consider in more detail how we can set about training leaders in view of what has already been said. We will consider The Instruct or, The Team. and In particular The Art of Communicating a subject intricately connected With Le a d ership, with method of instructIOn and with oLir lives in general.

(Continued Ilex t !nOll lh)

Phot os Keystone Pr ess Agency. London. EC4

(Above) Pr incess Anne. escorted by Brig. F. P Barclay. the County Commissioner arrives at the new St. John H/Q (Left) I nspecting guard of honour. (Below left) At the enrolment ce remon y. (Below) Farewell

A BREAKTHROUGH FOR THE HANDICAPPED

The Chairmobile

LORD SNOWDON'S IDEA FOR INSTANT MOBILITY WHICH CAN BE BOUGHT WITH TRADING STAMPS

The n vention, announced recently, by Lo r d Snowdon of the Chairmobile a m otorised platform on which a chair is mounted soc o l ogical people. represen ts a major advance for handicapped

T he ba ic d esign of the mobi le chair for the d isabled has scarce l y changed in pr i nciple since it was first produced.

Even the advance from the heavy

woo d en affairs to models which co llapse

a nd a r e m ade of chro m e, sti ll hasn' t

d is p e n se d w th t he perennia l problems

h a so m uch distresses the handicapped

pe r son: hi s conspic u o u sness and a l most

co m p lete r e lia n ce on other people.

F o r the d isabled the Chairmobile

m eans mob i li t y at a touch By simply pr ess ing a k nob at the head of an

a d j u s t ab l e stee r ing col um n, the

handicapped person is on the move by himself in home, office or factory.

More than this, the design of the Chairmobile takes into account that the inva l id may have a r m as well as trunk disability. The steering column can be a l tered easily to suit a variety of cases. It is perfectly pas ible to drive the machine with only one arm and there is no need for finger mobility. Indeed in certain circumstances, the chair may be driven by a person with no hands at all.

What prompted Lord Snowdon to design such an app liance?

H aving been a polio victim, he has a specia interest in the problems of the disabled. He had long looked upon the conventional wheelchair as 'a bit of old plumbing'. Moreover, he was concerned about the fact that the same chair had to serve most disabled people as an office

chair, a dining chair and one to relax in

This is where his Chairmobile IS unique. For it is a self-propelling platform on which a whole range of different typ es of chair ca n be used

Lord nowdon began by making a prototype for his old friend, writer and journalist Quentin Crewe, who has relied on wheelchairs for most of his life.

Crewe found that he had motive power at a light touch and that he cou ld speak to friend face-to-face 1I1stead of from 'down under' I was a breakthr o ugh that he felt should be hared by all people similarly afflicted.

The story of the development of Lord Snowdon's invention i a long one, but now the Ch<Jirmobile i in production for the benefit of all handicapped people. As well as, of course, for the in f irm, the fruil and the old.

(L) Fitted with the Leabank chai r upholstered in foam ru bber with stain resistant nylon fabric, adjustable back and hinged arms fo r easy access. (Below) With Hille chair a poly p ropylene moulded swivel ch air, cushions and covers as optional extras

My Life is transformed by Quentin Crewe Wr iter and journalist Quentin Crewe is disabled by muscu la r dyst r ophy and has been wheelcha ir-bound for many years.

'Quite sudden ly , I have found myse lf liberated to do things I have not done for years.

'Above all, can talk to people at their own leve l. [ select a high chair or stool I am then at the same height as the average person when standing.

In stead of having to look up to peop le I can l ook them straight in the eye.

'The controls are simple. A detachable joystick with which you steer and control the motor. One knob only for start and stop, forward and reverse

'That is all there i to it. What an obvious idea. Yet like so many simple things no one seems to have thought of it before Lord Snowdon.

'The affect of the platform on other people is pleaSing 111 two ways. f [ am not on the move they don t notice my chair as being different from anyone else's.

Above all they treat me as a normal human being. One of the odd things about being In a wheel c hair is that official assume that because one is disabl e d one mu s t be an imbecile.

'They alway talk to whoever is pushing me as If I were not there On my platform I am in command.

'All in all, my life is transformed.'

Some question and answers

Q. Is the Chairmobile complete in itsel f?

A. Ye s. The complete outfit consists of the mobile platform, the control column, a 12v non-spill battery, a battery charger and one of two types of chair according to choice. One chair is the Hille plastic non-adjustable, the other, the Leabank fabric-cushioned seat. The Leabank has hinged arm rests and adjustable for both rake of back re t and height.

Q. Can one use chairs other th a n those supplied?

A. Yes, any chair can be be lIsed that will tund on th e platform.

Q. I s the machine easily transportable?

A Very. Control column, battery and chair are all ea ily disengaged and the p l atform will fit in the boot of most medium-range cars. The platform, including the motor, weighs 641bs. A lifting handle is built in

Q How long will the battery give motive power?

A. Mea urement is in distance, not time. On full charge the platform will travel over a mile before recharge is necessary.

Q. H ow is it recharged?

A. The supplied charger is plugged into the battery and then connected to an

ordinary power socket.

Q. How long does it take to recharge the battery fully?

A. Overnight about eight hours.

Q Can the battery be overcharged?

A. o. There is an automatic cut-out device incorporated in the charger which comes into operation once the battery is fully charged.

Q. Can the battery be rep laced?

A. Yes.

Q. Can the chair, platform motor or steering column be replaced 111 the event of damage?

A Yes.

Q Can the Chairmobile be used out of doors?

A. Basically, it is designed for indoor use - in the home, office, factory, department store and supermarket. It can be used out of doors on r eas onably flat, hard surfaces.

Q How manoeuvrable is the Chairmobile'l

A. It turns round easily in alma t any s pace The knob at the top of the control column is merely pu hed in the desired direction and the machine literally pivots on its own axi a taxi-driver' dream. Reverse effected by drawing the knob on the control co I u m n toward you and then depressing it a light, easy movement. The machine tops when hand or arm is lifted off the knob.

Q. Does the chairmobile have variable speeds?

A. No. I t is governed to one peed in the interest of afety and economy. A two-speed machine would enormously increase the price

Q Are furniture and walls likely to be damaged should the machine make contact?

A. T h er e is a rubbe r buffer round the platform to prevent this

Q. H as t h e Chairmobile been tested by the type of disabled persons w ho would be expected to u e it?

A Thoroughly. The Group Research and Development Division of Rubery Owen, in co njunction with Alcan Booth Industries Ltd., spent over two years developing the Chairmobile. Various prototypes were designed and then tested by a panel of disabled people with handicaps which included cerebral palsy fractured cervical spine, paraplegia, brittle bones and haemophilia. Their overwhelming view was that the Chairmobile offered an ease of mobility and independence they had never known before.

Q. What sort of adjustments can be made to the control column and seat?

A. The control column is telescopic and can be positioned to suit the height of all users, ta ilor small. Similarly, the standard seat can be raised and lowered. The po ibility of exchanging the supplied chair for any reasonably sized chair gives the opportunity for many additional comforts. A disabled person can, for instance, sit at a level where he can talk to standing companion or sit in a low easy chair and yet be mobile.

Q. What is the appearance of the platform?

A, It is finished in a neutral hade re in coating which is scratch resistant.

Q. What doe the Chairmobile co t?

A. IPC is making the machine available for £99.50 - nearly half the price of any other powered chair for the disabled. The mo d el i being ponsored on a non-profit basis by the I nternationa l Publishing Corporation New paper Division (The Sunday 1irror) and the IPC Magazine and Busine s P ress Divisions. Orders and sales enquiries should be made to Chairmobile office, R oom 126, 79 Camden Road, London, W I 9 T. Inciden tally, the Chairmobi le can b e bought with trading stamps and detai ls of the heme can be obtained from the ale office.

AT DOWNING STREET

The Chance ll or of the Exchequer, M r. Anthony Barber, and Mrs. Barber were hosts at a small party for ome 50 me mb ers of London District at I I Downing Street recently. The party was in recognition of the work done by the members during demonstrations in and around Downing Street during the past few months.

M rs. Barber said to the members: 'It is comfo r ting to know in these days when v i olence breaks out so easily, that S1.

J o h n is a l ways at hand to provide first aid to the injured. And it is even more heartening to know that they clon't charge for the i r services.'

PASSED TO YOU

M rs. M. Brain, Divisional Superintendent.

B u s h ey H eath Nursing Cadet Division, writes:

O u r C h ristmas Fair fell on the same

d ay as the Ladies' Ci r cle's, and in a hall

j u st acros the road from u their posters were ten times larger than ours; ] knew we wou d be the losers. So I sent a letter to the chairman with the e facts and said as thei r posters stated that proceeds from {he L adies' Circle would go to local charit ies would they like to give us a d onat ion.

The chairman Mrs. Dell phoned me and said she wou ld put it to the committee, and as 1972 was the cadets' Go l den J ubilee Year they would try to donate towards a R esusie-Annie, for thi" w as my goal for the cadets.

Some weeks passed and had forgotten about this when Mrs. Dell

AROUND and I ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

BY THE EDITOR

phoned me: 'We'll buy YOll and your cadets 'the doll', she said. I was overjoyed and later spent an evening with Ladies' Circle members telling them about Cadet Divisions and the Brigade in general. They were arranging a visit to the Gate by the time I was about to leave! If they have not done so, other divisions should seek out the local Ladies' Circle, for you could not meet nicer people raising money ror good causes.

FILM CATALOGUE

Every other Tuesday evening at H eadquarters for the last three years, a devoted band of doctors, nu r ses, first aid experts and visual aid officers have been

President Kenyatta of Kenva, President of the St. John CounCil in Kenya, after his investiture as a Knight of Grace of the Order. The President was invested by Marjorie, Countess of Brecknock (on his right). To the Pr esident's left is Mr. Humphrey Sladp., Chairman of the St. John Council in Kenya.

appraising 16mm film The purpose of this appraisal panel has been to review every l6mm film on circulation that has a bearing on first aid, nursing or allied topics. The result of their labour of love is now apparent. A new 16mlll film catalogue i-; on sale at the Stores for 35p. Tilis catalogue will be inv;:Jluable to all instructors, as it gives film titles, appraisals and the libraries rrom which they may be obtained. It should be acquired by every Division and lnstruclor.

We dre most grateful to the Li fe Assurance Trust ror rlnancilll assistance to the l'atalogue, and to the British Industrial and Scientific Film Association for their co-operation In arranging appraisal viewlIlgs.

PEDALLING ON

I hear the 7th International Pedal Car race, organised by BrIStol UniversIly Rag Com mittee, ca ught the ;) ll'n tlon of Bristol's Filton Ambulance Cadet Division tl1lS year. The cadets declded to enter a car which had been abandoned from last year's race. A car, it seel1ls. tllJt had wheel trouble. The had to either find new wheels for the vehicle which could stand LIp to the 24-hour continual stress, or rind enough old wheel to keep them going when changes were necessary

With no cash for the project and new wheels costing £040 a sel, they opted for o ld wheels, and eventually collected 16 assorted pram wheels.

A the race drew near the organisers allocated the cadets' car number 50, most appropriate since it's their jubilee year. /\. good race omen? The car was named P ro-ride' (for the Faith). 'We'll need it,' said a cadet.

At the race circuit , a disu ed airfield at Bristol, the cadets set up a temporary workshop in the pits area on the morning of the race, and made some practice laps on the circuit. Their team of six drivers and a mechanic were then briefed by the

team manager, 1nd at 3pm the count down began and then they were off. They were committed to 24-hours of pedalling!

Each lap was a third of a mile, and practice had shown that one lap was about as much as a cadet could manage

so drivers were changed each lap.

After the first hour the cadets were successfully plodding along , and after three hours the wheel were holding up very well, contrary to all expectations. But tilen trouble truck elsewhere. A pedal broke. This was a welding job, but fortunately their neighbouring pit team was from Rolls-Royce, Bristol Eng.ine

JERUSALEM VISIT

FORSYTH SAGA

Division, who came to the rescue. With the pedal repaired, the cadets were back in the race and settled down to pedal on into the night. Oh those aching But round and round they went. Lap after lap. At about 4am, when at their lowest ebb of fatigue, the father of a cadet arrived to take the helm of car o. 50.

Lay Douglas·Home who recently visited the S1. John OphthalmiC Hospital in Jerusalem, meets a young patient being held by the Superintendent, Mr. Marogi Foreign Secretary Sir Alec also intended to visit the hospital but had to leave unexpectedly for London for a cabinet meeting

This gave the lads new hope, and with an occasional wheel change and servicing, they pushed on. At 8am when no doubt the driver was wistfully thinking of eggs and bacon came another failure: the rear axle broke. But the Rolls-Royce team was still there, and the cadets were soon back in the race. But with only 30 yards of the next circuit completed, the old axle packed up again in the same place. Was this the end? Even Rolls-Royce were beaten this time. The axle just wouldn't repair. But then a parent (who'd had a (Yood night' sleep) had an idea. He got into the car, and with his right foot tied to the pedal to achieve a pulling action, and with a drive rod in hi hand to achieve a pushing action, car o. 50 set off again with the team manager pu hing from behind. But it was obvious the organiser wouldn't allow them to continue like that for a further six hours. So they were finished - flagged out of the race by an official. But then Roll -Royce lent them one of their abandoned cars. There was a quick change of numbers (against the rules, of course) and they were off again. Parents and upporter delivered oup to the circuit to sustain the cadets and at the fini h at 3pm they had completed 82 miles, by pedalling.

The team achieved their aim: maximum publicity from press and TV, and that Filton A m bulance Cadet Division can uphold all the traditions of the Order - above all P er everance'. SJA B ristol also had 6 member on duty at the event under Ambulance Member Alan EJeroyd S R They treated

Cumberland's E gremont Division is p r oud of its Forsyth family, all seven of whom are members of the Brigade. Eldest daughter Janet (centre) has just won the Cadet of

bl ee d ing, a n d by a ll accou n ts her treatmen t was effective because t he patien t sai d she felt better. S u ddenly a stranger dec lar ing hImself to be a doctor advised against p inching the soft part of the nose, saying it was a ve r y dangerous procedure and recommended the application of a cold co III press

Severa l points ar ise:

( I ) Doctors will readily offer their

AT RAN DO M

Grim Reality

253 competit o r s a nd s p ec t a t o r s, 9 0 b ei ng t a ken to hospit a l w i th m ys t e rious bu rns to the fa ce a nd eyes, caused, say some auth o r ti es, b y d us t an d d irt from the tra ck. But th e cause has not b een positiv el y i denti fi e d

LOCAL RADIO

During t h e rece nt p o w e r cn Sl S, he 'F' Corps N o r t h Derb ys hir e sec r e a r y appro ac hed th e l oca l r a di o s t a ti o n , R a di o Derby , a nd aske d if th ey w o u l d b roa d cas t an appeal fo r ca ndl es t o ena b le he Cor p s' competiti o n to car r yo n sh o uld t he r e b e a pow e r c ut. Rad io De rb y ag ree d and made two app e als , th e fi r s t o n Frid a y e ve n ng , the se c ond o n Sa tu r da y of t h e competition F o ur offe r s of he p we r e r ec eived th e f ir s t withi n f o rt y mi n u tes of

I k eston Nu r sin g C a d e Division's tea m that won the F Co r ps N orth Derbyshi e's com petiti 0 n -by - can d Ie-I ight. See story L OCA L R ADIO P hoto. Fr ank Statham Il keston)

the fi r st appeal. A letter of thanks for their h el p h as been se nt to R a d io Derby.

T he u se of loca l ra d io s ations may i n te r est othe r PR Os in their St. J ohn w o r k. 'F' Corps will continue to relay to Rad io D erby any worthwhile news item of S t. J o h n activities. Are 'F' Corps the first t o u se this m edium i n the county of D e rb y? T hey found the station personnel m ost h e l pfu l a nd inte r ested in St. John activi ti es.

THE DIAGNOSTIC COMPETITION

b y Miss E. Beall

H is face is pale, his pulse is sl ow

H as he fallen or had a b low?

Y o u look for f r actures, feel each bone

The p atient d oesn't even m oa n He has n o wo un d upon his head

Inaugural m eet ing o Hill ngdon SJA C ent e, Lo n d on. L to R) Lt. C o l. John Coates, Are a D re c o

Perhaps the poor olt.l fe l low's dead

You rack your brains & think so hard

Perhaps somewhere he's got a card

But this is easier said than done

You'd think they hid the things for fun

H e' coming round. Oh, this i fine

But now alas they're calling time

For him you ain't got no diagnosis

But you're heading your e l f for corona ry throm bosls.

Author Nur ing Member Miss E. Beall. of Mi d dlesbrough Central Nursing Division. wrote this poem about a competition at which she won the Individual Cup!

NO NOT THAT WAY

The Association Deputy Chief Medical Officer Dr. J S. Binning writes:

One of the hazards of rendering first aid in public p laces, particularly when not in uniform, is to wIthstand the torrent of unsolicited advice from by-standers.

I do not lIke the term 'by-stander' but it applies very aptly to those members of the pu b lic who are untrained in first aid frightened and worried by the sight of a' sick or injured person and possibly some of them are secretly ashamed of their hel p lessness

My o w n experience of these people is that for the first few minutes after any accident one spends a lot of time and energy letting the by-standers know that you d o in fact know what you are doing. [ can recall viv id l y two episodes in wh i ch the cries of D o n t touch him I' ' D o n t m ove him!' an d 'Leave him took a l ot of s il e n cing.

R ecent l y i n ess dr a m atic circumsta n ces a n urs ng membe r was dea ing efficient y with a case of nose

se rvi ces n pub lic if the situation d emands. In such a r elative l y minor case a lready rece lvll1g treatment r co n s i der such an int erruption unwarranted.

(2) The first aider has no means of proving that any person who says he is a doctor is in fact a doctor. Most doctors wou ld reassure the first aider that the treatment was correct and move on.

(continued from page 1)

The tragic pile-up on the M I near Newport Pagnell in Buck1l1ghamsilire , shortly before 0900 hrs on March 16 when 9 people died and 51 were injured in crashes involving 15 I vehicles, gave SJ AB in North Bucks a chance to test the efficiency of their Emergency Disaster Ca ll -out scheme in all too grim reality. The ca ll -out was receIved at county office at 0942 and was re layed to the two St. John area contact at 0944 and 0947, to the County Commissioner at 0950 and the Area Superintendent (A) at 0955 The two area contacts shared between them (according to a prearranged plan) the passing on of the call to all divisional contact. and then cross-checked with each other to ensure that every dlvision had been covered. The first to be contacted at 0950 WJ.S the Olney Combined Division, some of whose members were approaching the disaster area by 1000 ; the British Railways carriage-works at Wolverton instantly released all their Brigade members as well as orne of their Association-trained first aid parties, and sent an ambulance ; the Ambulance and Nursing Divisions at Bletchley mustered 75 % of their total membership. Throughout the area, members of all divisions were leaving their homes or being released from factories, offices , shops and even schools to respond to the call in one school a teacher and two sixth form pupil were let out of class and within an hour of the call being received at county office a total of at least 50 St. John volunteers (many of them wIth equipment) had reported to the I ncident Officer and about 20 more arrived soon after.

Some of the men were sent down onto the motorway to do first aid. while others were used as stretcher partIes or held in re erve, the nursing personnel were mainly used at the casualty cleanng post, to help and comfort the very arge number of motorists suffering from shock. Most of tho e who responded to the call-out were dismissed soon after 1300 Ius.

When the call-out came, some of those who turned out had Brigade arm lets with them, and these were a great help in making them instantly identifiable by the po lice; a few others (men) were able without delay to snatch their uniform caps and jackets as they set off. But those who were sent down onto the motorway reported that, compared with other services, they were at a disadvantage (especially in view of the fog) in not having lightwelght orange dayg low Jerkins to Iip on for indentification Thi is a matter which we are looking into, and [ hope that a suitable garment (which may also be very important for the personal safety of the wearer, especia ll y in fog or darkness) will soon be avai lable for Brigade members to carry in their cars.

One of those present wrote afterwards : 'The I ncident Post was well marked and a ll the personne l reported to the St. J ohn officer in charge. The sight of the ma crash was sickening, and after waiting for Instructions some of the male personnel went down onto the road and the nursing member were asked to tand by for further orders. The B. R . a m bu ance was used on the road as a first aid po t, and the Wo lverton Division's ambulance on stand-by at the Incident Post. It is now four days since the ca ll -out (which worked perfectly), and the comment i till the u tter waste of human ife and the shocke d condition of the lorry drivers not di rectly injured, and also the steel nerves of the fi r emen ancl po lice as they were sent in teams onto the m otorway to prize open the mass of steel to extract the victims.'

Fo r tunate l y our member stuck to her guns and carried out the correct procedures. She di d a good job of first aid. J think the answer in such cases if unusual advice is offered is to say firmly: J am a qualified first aider. I am applying the recommended treatment.'

Finally make an appeal to the patient as to how he or she feels as the resul t of your treatment. Difficult, of course, if the patient is unconscious!

The procedure for initiating an emergency call-out to voluntary services varies from one county to another ; in some it is initiated by the police, and in others (such as Bucks) by the county ambulance service. There is bound to be a time-lag (in this case about 45 minutes) between the occurrence of the disaster and the actual call-out of voluntary services, partly because the caU-ou t of statutory services and medical teams and the warning of hospitals takes priority, and partly because the police and ambulance service must reach the scene and assess the situation before they can decide whether they need further help. This makes it all the more important that our own Emergency Call-ou t schemes should be so well organised , practised and k e pt up to dat e tha t we can be sure that our contacts really will work efficiently and that we can respond in s a ntl y when the call comes. It doesn't take much imagination to think of a variety of tragic causes which might send that call to any of us, anywhe r e, at any hour of the day or night; so I hope that th is will be a salutary reminder to every St. John county to overhaul its call-ou t arrangements and do its best to ensure that if the call shoul d come, it will not come in vain.

Rar e Privilege

I 've just heard the thrilling news that the four divisions (A, N, CI A, C/N) in H elston. Cornwall, have been granted the honour of collectively receiving, on April 30, the Freedom of the Borough of Helston in recognition of their outstanding services to the loca l community This rare privilege is an honour not only to the Helston divisions but to St. J ohn Ambulance as a whole, and I 'm ure we shall aU wish to express our warmest congratulations to our colleagues in Helston on deserving this honour and our most incere thanks to the Mayor and Corporation for according it.

Let Mr s. Corles s Spe a k

One of our most recent and most enthusiastic Auxiliaries of St. J ohn i Mrs. J E. Corles , newly appointed Director of the Ex-Service War Disabled Help Department of the St. J ohn and Red Cro s Joint Committee. Mr Corless is extremely anxious to make St. John contacts , to learn more abou t the work of the Foundation and to tell us omething about her Department which doe uch splendid work for which the Order, together with the BRCS, i jointly re ponslble; and he willing, if available. to go anywhere to speak about it. Now is the time when the programme of many local conferences to be held next autumn and winter are being planned_ May [ sugge&t that, if it's not already too late and the theme fits in with their programme, the planners should consider inviting Mrs. Corless to speak? The addre of her Department i 6 Grosvenor Crescent, S W.l.

Ladies of Ryde

And, speaking of Auxiliaries, I met recently in R yde three ladies who had for nine month run a very successful St. J ohn shop (on similar lines to Oxfam shops) in premises kind ly lent during a vacant tenancy. When a ked what they would do w hen the hop was re-let, they aid: 'Oh, we'll easily find anothe r. Bu t their most significant remark was that since Christmas D ay t hei r cu tomers had shown a far greater kno w ledge about w hat we are and what we do , alld had beC'/l far morC' gel1C'rOllS. Well done, ladies of R yde; and thank you, my Lord Prior!

BLOOD LOSS ... and its assessment

mat er ia l, e tc ., ca n abso rb 8 ounces per square foot, cotton and linen stuffs 4 ounces, and nylon and simi lar "man-made fibres" somewhat less.

In cons idering open wounds it is obvious that the factors to be taken into account in assessing the blood lost from the circulation are the blood spilt and the extent of tissue damage. A very useful unit of measurement for the laller fac tor is the pati ell 's hctnd. A wound about the size of the patient's own hand could be estimated to account for a lo ss of about 10 % of his total blood amount. So, taking an example at this stage, an adult of average height (say 5ft 8in) and build (11 stone II Ibs) for whom you have estimated a spillage of one pint, with tissue damage equivalent to two hands, would have probably lost about 30% of blood from his circulation and may well be on the verge of collapse although not exhibiting the signs given in the Manual, Page 86, to any marked degree.

A PATieNT CAN APPEAR REASO ABLY WELL WITH A BLOOD LOSS OF ABOUT 30 %, BUT, IN MANY CASES, A VERY SLIGHT FURTHER LOSS WILL PRODUCE A SIG IFf CANT CHA GE, EYE COLLAPSE. THIS IS TllE 'CRITICAL LEVEL ', AND VARIES fROM INDIVIDUAL TO I ID IVJDUAL.

ADULTS

AS FIRST-AlDERS we must be ever-conscious of the task which the casualty officer will encounter when the ambulance reaches hospital. Any information we can pass on to him via the ambulance crew will help him in his diagnosis. Much of the signs and symptoms he will e licit for himself but for history he will depend very much on those who were first on the scene.

One aspect in which we can be very helpful is in assessment of blood loss. The casualty officer, in his diagnosis, will have means of guessing this from the patient' condition faint, giddy. cold skin clammy and be-dewed with sweat, quick feeble pulse, possibly extreme restlessness maybe collapse. But these are signs and symptoms of a reduction of blood in the circulatioll, not necessarily of total blood lo ss. (Of course, it is blood in circulation which is all-important to sustaining life)

Hence the childish jingle of the title if it helps you remember it's served its purpose.

We have all heard of shocking accidents where bystanders declare the victim was 'lying in a pool of blood', or 'the gutters were running with blood' (it was on a steep hill and raining at the time when people say tllis, usually). In actuul fact, it is most unlikely that more than 6 pints dmin away, however badly the body is injured, since internal organs ilnd the capillary bed retain their quota. Also, it is particularly noticeable that a mangled limb often bleeds very little, inCised wounds are usually the ones that bleed most.

Now let us consider the milk bottles analogy again; imagine that you are bringing in the milk early one morning and you drop a bottle on the door-step. Visualize the mess it would make' But it was only one pint and illl who are

We are told, Manual Page 34, that an adult has about ten pints of blood. This rough-and-ready estimate suffices for all first aid purposes; more accurately, o ur blood accounts for just less th,ll1 one-tenth of our body weight, so we have 12 for every stone of our weight just over a pint of blood. Unless we are bleeding somewhere it is all in circulation although its movement through the various parts of the body differs very considerably. (It has been computed that, whereas in the ilortil the rate of flow is about 12 inches in a second, in the capillaries it probably moves at I to 11'2 inches in a minute: and the time taken up in performing the entire circuit is about 20 - 30 seconds.)

bl oo d donors know, it usually has no appreciable ill-effect to 'give a Pll1t of blood' (Actually, it's not reu lly a pint, it's 540 millilitres and a pint is 568.25 millilitres, which is immctterial until we enter the Common Market and won't miltter very much then when it's blood one is considering!) At this jundure rea d the Manual , Chapter 6 ; this gives a very good indiciltion in general terms but it is not strictly accurilte nor doe it take into consideration the age, SC'(, physique, etc, of the subject.

Within the general assessment of I pint per stone of weight, a more accurilte statement based on physique is given in Table I. It is far easier for a first aider to judge the patient's height than his weight, in order to gauge the blood loss, fortunately there are simpler "Rule of Thumb" methods :

On an imperviolls surface, such as linoleum, blood will cover ilt a rate of 4 ounces per squilre foot.

J\ road surface is nearly as non-absorbent, so you could say 41h ounces per square foot (for tarmac) up to 6 ounces per square foot for more gravelly surfaces,

For clothing the estimation is more complicated depending upon the material; heavy woollens, overcoat

I n closed wou nds of the lim bs it is pos ible to a se the amount of blood lost into the tissues (and, therefore, out of circulation) by the amount of swelling. I knew a Divlsional Surgeon who, to impre s upon us all the dangers accompanying what used to be called a Simple(l) Fracture now more realistically called a Closed Fracture of the Femur, had a piece of felt \/2 in thick cut to size so as to just encircle his thigh. He would wrap it around his thigh (no, madam, he kept his trousers on!) and invite the class to consider whether or not this made a significant enlargement. Then he would unwrap it, place it into a flat pan and pour 3 pints of water (from a measure) over it and, in very little time, this was nearly all absorbed; a rough-and-ready analogue but very impressive A closed fracture of Femur, with hardly noticeable swelling, could have 1 or 2 pints lost into the ti ue, whilst, with severe swelling, the loss could be 5 or 6 pints since the Femoral Artery could easi ly be ripped open longitudinally or severed altogther.

A Closed Fracture of the lower leg, of the upper arm or of the forearm, with moderate swelling, may cause I to 2 pints to be 10 into the ti ues and a fractured ankle with moderate swelling suggests up to I pint lost from the circulation.

It may be worthwhile to consider, in ita pplicability to blood-lo , the procedure in the Accid ent and Emergency Department (a 'Casualty' is now ca lled) when the ambulance reaches hospital. The casualty officer considers

any evidence of blood loss and the clinical tate of the patient. He will know that, over and above 'apparent haemorrhage' there is always the likelih ood of internal haemorrhage, which can be very considerable since most of the internal organs have very large blood-vessels supplying them and conducting blood away from them and are, in themselves, reservoirs holding a significant amount of blood - which, understand, is not stagnan t bu is con tinously passing through - e.g. the liver holds one pint of blood at all times a nd since it also has such large b 10 0 d-vessels connected to it, can drastically reduce the amount of blood in circulation should there be severe or extensive rupture of this organ. Some internal bleeding reveals itself eventually, ego blood in the urine, but ome of the sites of 'occult internal h a e morrhage' can cause the worst possible haemorrhages, ego a ruptured aorta. Internal haemorrhage is often a baffling fea ture in the fir aid stage As non-medical people we must always be ready to assume that where the evidence

of increasing shock is out of all proportion to the apparent Injuries internal haemorrhage must be suspected. The casualty officer will know that the loss of 10% blood volume will almost certainly not indicate itself by the well-known signs of shock: a loss of 20% will cause increased pulse-rate with blood pressure remaining normal and the fingers and toes still warm and pink. A loss of 30% will cause the extremities to become cold and grey (especially finger- and toe-nails) with blood pressure not significantly altered, BUT, AT THIS POINT, the 'critical level' there may well be a sudden and dra tic change for the worse, until at 50% loss the patient's blood pressure may not be assessible, the pulse rate may be over 100, the veins will have collapsed (making it a matter of great difficulty to insert a cannula for intravenous transfusion), the patient is likely to vomit, become unconscious, have air hunger (once seen, never forgotten!) - and die.

Aware of the likely deterioration, the hospital staff will apply the standard drill to anticipate and, if possible, prevent decline to the critical level; a small amount (20 millilitre syringe) of blood is withdrawn from the patient's veins (if not contraindicated by injuries, a vein at the back of the hand is usually selected) and ent, at once, to the Haematology Department for the patient's blood-group to be ascertained.

Whilst wounds are being assessed, X-rays taken, etc, a most careful watch is maintained and, at the least sign of deterioration, oxygen is admini tered (so that whatever quantity of blood is circulating will be of good quality) and, to restore blood I'olume pending ad m inistra tion of whole blood by transfusion, an intravenous drip is set up whereby a saline solution with 5% glucose added (or a proprietary substance called Dextran, made by all the leading manufacturing chemists and given a trade name which contains the syllable Dextra ) is allowed to make up at l east for the plasma-loss. (All such solu tions are a close approximate to plasma, the liq uid part of the blood; the dextrose additives give it a viscosity equivalent to blood and provide large molecules which assist in keeping veins expanded and the heart-action sustained. In other words, it is homologou) Of course it is not a complete substitute for the real thing, lacking red and white ce lls platelets, etc., so, as soon as the patient's blood group is established which usually takes 20-30 minutes - if the clinical condition

warrants it the casualty officer authorises the r equ iste number of bottles of hlood and, ufter the essential drill of establishing that the correct blood has been drawn from the Blood Bank (where it is kept at a constant 4°C) has been swiftly carried out, the transfusion of blood is substituted for the saline drip usually using the sume vein-insertion. In emerge n cy, where the heart-action is we ak and ineffectual, the casualty officer may decide on another udditional transfusion at a site (eg: since the left elbow is Llsually the spot selected for such intra-venous injections, a second transfu ion would, most likely, be set up at the right unkle).

To conclude, to help any first-aider recognise shock, which, although unforgettable once seen, is somewhat hard to describe, here is a word-picture : Picture of Shock

Giddy and faint, co ld and unwell

Dismayed and perplexed at what befell

A drawn , pale, anguished, clammy face (He's likely to vomit ull over the place!)

Slow pulse, becoming fainter and faster

As hi system reucts to the sudden disaster

Worri ed, apprehen ive and talkative, soon

He 'll quieten and lapse into a swoon

If nothing is done he will very soon fade

To a point beyond even Medical Aiel.

WOMEN'S LIB COMES TO SJA

FILMS

The

consists of doctors first aiders and visual aid experts who offer their services for thiS important aspect of visual aids

Previews of those 16mm. films recomm ended by the panel are regularly published in the St. John Review.

THE AIR ·- MY ENEMY (1971) (Colour 25 mins) Free

Distributed by: The Gas Council, S9 Bryanston St ., London WL

Produced by : The Gas Council

This film demonstrate air pollution; it also shows pollutIOn of lund, sea and waterways and how various fuels and operations such as coal dumping, oil, sewage, factory chimneys add to all form of pollution affecting life today

The panel considered this a well-prod uced film of great general interest. [t is beautifully photographed in excellent colour, its mes age of anti-pollution comes across loud and clear, the dialogue is first-class and although a shade lengthy it is a notably topical film thut could be screened to all and sundry. one the less, in this year of grace it seems that not a few large industries find it de rigueur to have their own anti-pollution film each in subtle ways laying the majority of the blame for pollution elsewhere. One of ollr punel living in the shadow of a gasometer, was heard to murmur, 'Methink the lady' Of universulll1terest.

THE MECHANICS OF LIFE (1971)

(Colour 10 mins. each, of five) Hire

Distributed by : Guild Sound and Vision Ltd Kingston Road, Merton Park London SW19

Produced by: Eothen Films (International) Ltd.

These five short films display

u) Blood & Circulation · an introductIOn to human biology, the composition of blood and the functIOns of its major constituents are explained.

b) Breathing & Respiration-hows how our rate of breathing is dependent on our oxygen requirements, and also the methods by which the body obtainS and transports oxygen and disposes of carbon dioxide The mechanic,> of breathing are demons! rated.

c) Digestion & Food We Eat: explains the body's food requirements The mechunic of the digestive tract in its relationship to the actual movement of the food is hown.

d) Bones and Joints · what bones and joints do, and why they are constructed in particular way Comparison are drawn between the skeleton of reptiles, animal, birds and humul1s

e) Muscle and Movement ' the different types of muscle found in the human body are shown and their functions and mode of action explained.

The panel conSidered this a good series of films all having value to the first aid movement. The fi lm s are each of ideullength and well produced; however, the instruction offered is uneven at times far too simple it does not seem to be pitched at one intellectual level. These films will be of value when screened prior to the appropriate lecture but pre-screening introduction and after viewing discussion are essential

Audience: Fir t year medical students, nurses induction training,Jir t aiders and econdary schools.

THE SELF RESCUE BREATHING APPARATUS (1971)

(Colour 4 mins) Free

Distributed by : National Coal Board Films, 68 Wardour St, London WI

Produced by: National Coal Board

The film draws atte nti on to the fatal consequences of not c arrying a se lf rescurer, which is a deVice designed to protect men against the inhalation of carbon monoxide.

This animated cartoon, an accident prevention filmlet,

presents its point with clarity. I will be of great value screene d prior to safety lectures to appropriate audiences.

Audience: National Coal Board employees only.

CLAREMONT (1959) (Colour 12 mins) Free

Distributed by : B M A. Film Library, Tavistock Square, London WCI

Produced by: S. W. Regional Hospital Board

This film shows a home for cerebra l palsied chi ldren in Bri stol and how they are cared for and taught.

ThiS splendid little film has not dated and shows the work of Claremont both with clarity and compassion; it might be a shade shorter but the message of hope in the film shines like a beacon.

Audience: Specifically for social workers, nurses and parents concerned with the medium subject but also of general interest.

THE SENSES Part I, 'Feeling a:ld Hearing' 1962 (B/w 20 mins) Hire

Di tributed by: Educational Foundation Visual Aids, Paxton Place Gipsy Road, London SE27 9SS

Produced by : B B C

This film a TV transmission in the schools programme for children, and this part of the series the structure and functions of the human body deals with the ear, etc.

This black and white film with diagrams contains the faults of the orginal media i.e. too much talk and not enough visuals. one the les s it is a clear and concise lecture well put across and very suitable for an audience of school children in the age bracket 13 14.

Audience: Could be used universally as background information but i specifica ll y suitable for cadets and schoo l children.

THE SENSES Part II, 'Seeing and Balancing' (B/W 20 mins) Hire - see above.

Part II of the series, 'The Structure and Functions of the Human Body' deals with the eye, etc.

Although a ten-year-old filmed TV lecture in B/W, somewhat verbo e, it does pre ent a clear and lucid lecture. It is well put across and very suitab e for the intended audience.

Audience cadets and school child ren but could be used universally as hackground information.

ALL OU R MISS STEADMANS (1970) (Colour 27 mins) Free

Distributed by Concord Film Council, Nacton, Ipswich, Suffolk

The holiday resort towns, espeCially around the South Coast, attract large numbers of retired elderly people. Usually on fixed pensions, and poor in health, they impose a heavier than average burden on the health and welfare ervices of these areas. Miss Steadman is an only too tYPIcal case.

Thi i · a well produced TV programme di tributed as a film; the basic difference in technique i apparent ina much as the film is very long and somewhat too verbal. The film i informative and highlights a very important ocial problem_ [t emphasizes one of the shortcomings of the 1 ational Health Service but attempts no solution to that problem. The call on ho pital bed is not adequately portrayed and that certainly is an important facet of the near breakdown of the Social Services as is suggested in the programme.

Audience: of general illtere t to St. J ohn member and very useful for stimulating di cussion.

St. John Ambulance Film Appraisal Panel which meets fortnightly at Headquarters

OTHER COMMITMENTS

from Lt. Col. R B. R o b inson, CSO Cadets

I wa s very int e rested in the Deputy C-in-C's e ditori a At R a nd o m in the March issue. I feel , however , that a note of warning should be sounded with regard to the implied advi c e

p

ge 11 that all divisions in one place should be inspected o n the

If, a fter proper consideration this is pr ac tical , of co urs e it is highly desirable As well as saving the inspecting s

travelling - a minor point - it make s

emphasises the unity of the Briga d e.

However, it must be rememb

weekly practice on,

and to ask this division to

to fit in with another division

that half of th e members, perh

including

rintend

nt and se c retary, c annot turn up.

This sort of thing applie s just as mu c h to ca d e t s as o a dult s. Many of ea c h ca tegory have overriding co mmitment s o n ce

ai n days of the week , whi c h they c ann

bre

k without seri o us disloyalty to the other organisation co n c ern e d. Thi s may r a ng e from a sister philanthropic b o dy such as th e S

educational or vocational course, failure t

ma y result in failure to obtain a qualific a tion

It is unfair on members and on other o rganis a ti o n s t o as k members to bre a k their engag e m e nt s, at howev e r lo ng notice , in this way. The ' proper c onsider a ti o n m e n tio ned i n m y second paragraph thus involves c ar e ful inquiry int o the a bility o f the divisions to accept s u c h a date Pewsey, Wilts. R B R o b in s on

AUXILIARIES OF ST . JOHN

fr om P M. Keen, Auxiliary of St. J ohn and member of Exeter R oya l B ritish Legion

I write in a ppre c ia tion o f the Depu y C o mmi ss i o n e r -i n-C h i ef's article At Random in the M a rch Rev ie w o n th e va lu e of th e Auxiliaries of St John to the Order.

Through the kindness of th e a te Brigad ie r C o lin B ro wning , KStJ , when he w as County Director f o r Devon I w as mad e a n auxiliary for my work as his se c ret a r y a nd f o r C as u a lti es' U ni o n in Exeter.

My 'button' is my most valued treasure and in a ll t he vicissitudes of life sin ce the de a t h o f m y b e l o v e d e mploy e r it ha s been my comfort. It has be e n a s truggl e at time s o uphold it s tenets but with his example in mind I hav e man a ged Th e y a re, as I understand Prud e n c e Justi c e Temp e ran c e and Fortitud e.

I wish th a t many more men and w o men o f g oo dwill c ould b e given the encouragement my badge h as b ee n t o me Exeter Phyllis Mary K een

FIRST AID MANUAL

from M iss K D W il son, Div isiona l Officer

Three cheers for the new manual! It l o ok s go o d at f rs t gl a n ce , but why oh why, has ther e been so m a ny diff e r e nt d a t es giv e n for its use for competitions examinati o n s, e tc ? When it has been needed for s o long ca n it a nd sh o uld it n ot be used immediately? Or if a dministrati o n of examin a ti o ns is really so difficult then surely one date no la ter than June c ould b e given instead of so many option s and deadlines? Six month s should be long enough

Workington K. D. Wil so n

LINGUISTS

from ' J a c ', ambulan ce m e mb er

On duty some while ago I had a diffi cult 2 0 minute s with a vi s itor to this country who wanted minor first aid and much advi ce but who spoke very little English. I passed him eventually to a civilian.

L ater that day I found that a St. John member on duty at the event and not very far away spoke th e language need e d and 16

READERS VIEWS

In every cadet's haversack ...

by Body Doctor

mingh am ·lac·

THANKS , SAY RU N NERS from John Newsome , Divisional Superintend e nt May [ tha n k t h ose m e mb e rs of S t. J ohn Ambulance Brigade who w e r e o n d u ty at the National Cross-Country Championships at Sutt o n Co ld fie ld o n Sat urd ay Marc h 6? Cond tions were the w o r st I h a ve m e in 14 yea r s of run ning and, although not rece iv in g tr ea tm ent m yself, I ha d many of t he s igns and sy mpt o ms of exposure by t he time I had finished the race.

V e r y f e w o f th e thousa n d athletes n this event did not suffer, a nd co m petito r s fro m afa r apa r t a D erby, R otherham,

Ma i d e nh ea d a nd S alfor d have wr i tten to A thle t ics Weekly' e xpr essi ng t h ei r a dmir a t ion of the St. J ohn personnel. As few of th e Brig a d e will r ea d a n ath l etics magaz ne may I throug h the R e vi e w , th a nk th e m pe r sona ll y on beha l f of a ll the competitors?

Th e wh o le sce n e re mi n d e d m e o f a bat tl ef ie ld ma d e worse by bli zza rd co ndi tio n s. Train e d a thl etes we r e r ed u ced to t h e ve rge of co ll a p se, s h a king vio l e ntl y w it h co ld o rn e c r ying with h e lpl ess n ess. I w as so numb w i th co ld th at I co uld not zip up my tr ac k -s uit top, n o r p ut o n t h e r o u sers. Y et I am an interna t iona l

I n every cadet's haversack lies a stethoscope'. I l ow many youngsters who join Sl. John at the age of I I or 12, Or younger, hear those words tossed around by their instructors and eventually by some presenting officer? Yet, this is our versIon of that old aying about the field marshall's baton. Well, I want to tell you about aile cadel who heard those words and set out to make them come true.

lI arold RIchardson, Associate Professor Designate of the Department of MIcrobIology at the School of MedicIne, McMaster University, Hamilton, Ontano, senior lecturer at the Department of Microblolgy, Univer Jty of ewcastle upon Tyne, Consultant Bacienologist at the Royal Victoria Infirmary, was born 111 that Durham stronghold of St. John F-erryhIlI. In thIS windswept VIllage at the top of a steep bank on the old A.I. Road, mid-way bel ween DarlIngton and Durham City, young boys had a choice of after school activitIes: brass bands or St. John.

The St. John Cadet Division is the famous 'Dean & Chapter' whose cadet's and men's teams have attained national competition honours.

H arry RIchardson was not very musical (although he kids himself that he l'an whistle) sO he joined the 'Chapter' in I l)4Y and began his career of service to the SIck and injured After a stay of a few years he went to study medICine at the School of Medicine in Newcastle, and from lY56 to 1962, by necessity his St. John activities were shelved. In 1959 he ohtained a dcgn:c in physiology and qualIfIed III medICIne In 1962.

A fter qualIfying he continued to work in cwcastle, and after the usual run-of-the-mill hou eman's jobs he began to "pecialise in microbiology. I t was at this juncture that H arry took up the reins of his St. John work again. H is boss at that time was a very keen Association lecturer, and when he could not attend <l lecture, Harry was sent instead. This is how he later becLlme senior medical Instructor to the Newcastle Centre of the As ociation and came into contact with the secretary, J ohn ]) onkin, and his staff of police f irst-aiders. A fter listening to Harry ecture one night, it was decided that he h ad someth ing thut the po lice required. The ability to make people sit up and rca ll y be interested. So after being

detained for questioning and some gentle persuasion, H arry became first-aid examiner for the Newcastle City Police Force. H e later did the same for the new Northumbe r land Constabulary.

I n 1969 his services to St. J ohn were recognised when he was admitted to the Order as a Serving Brother. I n that same year came another branch to his service to S t. J oh n. The write r of this a rticle, a member of the City Division, Newcastle upon Tyne, found that his division was about to be without a divisional surgeon. He spoke to Harry, used some very rare charm, and so H arry became divisional urgeon at City Division.

This was when the sparks started to fly, for H arry was still very closely attached to Dean & Chapter, and at that time they and City were close rivals for all first-uid competitions in orthumberland and Durham. But, after many friendly bouts of combat, the two division settled their differences over H arry.

As a divisional surgeon, Harry excelled himself: no specialist at the ewcastle School of Medicine was safe from his per uasive tongue. Once a month along would come a guest peakcr to give the usual one hour talk, which would begin at

seven-thirty; at ten o'c l ock the questions would still be rolling in and, much later, the members would go away enlightened about the queries that a r ise from the Manual, and othe r points which had arisen in study.

As a divisional team-trainer, H a rry was ruthless. On mo r e than one occasion he blasted off at the team, and the next day they would do wonders. H is labours were rewarded in May last year, when 'CIty' were successful at the North East championships. Unfortunate l y, H arry is with us no mo r e to goad us into a competitlOn spirit, for he has now settled into his new home in Canada.

Yes, this fo r mer cadet has reache d the top of the tree, and his associates at City Division and the Newcastle Centre are very sorry to have lost him.

If anyone in Ontario Province wants a damn good divisional surgeon, contact him at the McMaste r Medical School, for he intends to carryon with St. J ohn. City Division are open to offers re transfer fees and say that they can accept nothing less than three half crowns.

Good luck, H arry, in your new venture! We hope that other cadets will read of your success and do just the sa m e. For there is a stethoscope in every cadet's haversack.

Pop and the Brigade - down under

by Dr. J. Peter Bush , DistrictSurgeOIl, Victoria

AS THE BRIGADE has already d iscovered in other parts of the world, a du ty at a P op Festival is likely to produce fresh experiences, interesting incidents, p lenty of action and many other 'firsts'.

W oo d stock, Weeley in Essex, Rockhill, O nta r io, were merely names to us in Australia. We saw reports of these Pop F estivals and read of the experiences of t h e Brigade at Weeley in August 1971 ( R eview, October 1971) and at Rockhill ( St J ohn News, Canada, December

1 97 1 ).

I n spite of these reports, little did we know what was in store for us when in early January 1972 a req uest was received

a t D is tr ic t H eadquarters in Melbourne to provi d e first aid and medical cover for a

t hr ee -day music festival to be held on a

fa rm at S u nbury, 15 miles from

M e lb o urn e, ove r the Australia Day

h o li day w eekend. A visit to the scene

thre e w eeks before the date enabled

D ist r ict Officer Harry Woodall (a Pommy

ex- M e r chant Navy migrant from Bury, L anes) to p an in detail the manner in whi c h the duty would be organised.

N o b o d y appeared to have any idea of the numb e r s expecte d , but from reading of th e Bri gade's exper ences elsewhere we

ties.

Diving from the upper branches of overhanging trees on to submerged rocks meant severe sca p wounds for some

knew we must prepare for anything. We received every co u rtesy and consideration from the farmer and the o r ganises, and were ab e to select the best site for our Field Hospital. Thi transpired to be the ideal site, sufficiently far away from the source of the 'music' to make it almost inaudible in the hospital for most of the weekend.

This Sunbury duty was one which no member of the Brigade who participa ted will ever forget. Squads were required to be on duty early Friday night, January 28, for the erection of hospital and accommodation tents. On my arrival Dr. Frank Archer was already there, and work soon commenced. Seven doctors, 10 nurses and 130 other members of the Brigade were involved in the weekend duty. The Brigade provided its own power for lighting, and radio communications system, the only communication we had with the outside world. In all nearly 3000 casualties were attended by members of the Brigade at the static first-aid posts throughout the festival area or at the field hospital. 25 cases were sent to hospital in Melbourne.

The Duty Officer, District Officer Harry Woodall, was in charge of the Brigade at this duty. His organization,

leadership, and tireless energy were responsible in no sma ll measure for the success of the operation. The members were rostered in 8-hour shifts until the final day, when because of other standing commitments by some of the participating Divisions our numbers were reduced to 68. On the Monday the final shift was 12 hours, which began at 8am, when Harry Woodall told everyone about to go on shift that they would get two hot pies and a can of orange juice at mid-day, but they could expect no relief until 8pm. Despite their tiredness, lack of sleep and near phy ical exhaustion, there was not one murmur of di content a tribute to their loyal ty and devotion. 0 one member of St. John can be singled out for special mention that week-end. They were all superb. The leadership of Harry Woodall and June MacRae, the officer in charge of the nursing members, wa first class, and everyone considered themselves fortunate to be a member of such a team. The injuries and conditions treated were legion. Apart from snake-bite any self-respecting snake took off for the hills and quieter pastures early on Friday night as the noise started and frost-bite (the temperature throughout the weekend was in the upper eighties) every condition in

the First Aid manual and many medical textbooks were encountered. Cuts, b ru ises, splmters, prickles, sunburn, scratche., lacerations, fractures, burns, scalds, exhaustIOn, coma due to alcohol, drugs or a combination of both, possibly With the effects of head injury as well; renal colic, appendicitis, labour, asthma, epilepsy and a variety of other condition were seen.

Many of the cuts were sutured by Brigade <;urgeons working under difficult conditIOns in the tent field ho. pita!. It would have been 11l1posslble to send them all to hospital the nearest was in Melbourne but several severe lacerations were con idered too extensive to be sutured other than m a hospital theatre.

On one occasion I remember sitting on the floor of the ho pital tent suturing a young lad with cut on his scalp, shoulder, hands and arm He expIJined that a ·friend' had broken a flagon of claret over his head. On thiS occasion I iJad the benefit of the best natural spotlight I have ever used. The sun, coming over the hill and shining through the door of the tent, provided perfect illumination. rhis was as well, for on the lad's shoulder was an intricate tattoo. It was not eilSY under these conditions to approximate the torn parts of the cagle's wings and to avoid entwining them too closely with the other parts of the design.

Certainly there was Violence. We saw the effects of it the fractured cheekbone, from some over-vigorou reaction by the karate-trained 'bouncers', lacerated scalps from diving into the muddy creek with its submerged rock There was also grog and drugs. The

16-year-old girl who was brought in on Friday night having allegedly consumed a bottle of gin: the young lad who came in unconscious his mate said he had had a bottle of whisky and a fev. beers in a quarter of an hour. But these were the exceptions. The enormous piles of di carded Coke and Orange Fanta cam were sufficient evidence that the drink merchants were haring in the bonanza. Some of the kids were experimenting with drugs, others \\ere well-known u er but In 3000 casualties from a populat ion of 25 ,000 we h_ltI 49 mixed \\ hllh inLiudcd alLuhol. drugs. sulphuflc aCid, kerosene and several othL'f\ fhi\ figure ruh the \ltUJtlon II1to rcr"peL"lIH' Drugs Jnd JiLolh)1 creJted a slgnlllL ant probkm, they warned that thL' problem Will grl)\\ hut they did not "pod the wt'dend nor tarlll'.,h the iIllage of the vast mJlority of the ) Otlllg who went to tl) enjoy thl'rnselves in their own wa). to appreCiate their music, to have peace and love, to participate in the bathing In the creek. nude or clad a they fancied. ThL' kids were all right. Their response to by the organisers of the Festival or Brigade officers was without exception sympathetic and helpful. They moved out of the way of our ambulances, they allowed us to jump the queues in the meal tent, they cheered the name of St. John when an announcement was made from the stage. These are the memories which will remain, and these together with the enormous sympathetic press, radio and TV coverage given to the Brigade made this weekend perhaps one of the greatest exercise In public relation for the

Bngade In Victoria.

Other memories which will remain the old man (he must have been 70) sitting In the front row of the crowd by the stage and a Brigade officer remarking that thi'> was probably the first time in years he had heard anything. The lass who appeared at the field hospital in the evening of the second day. she was obviously pregnant and it was soon l'quall) that she was in labour, although prematurely. We prepared for our Sunbury baby, but also summoned an ambulance. (In Victoria St. John is not permitted to transport patIents on the rO(Jds except in a State Disaster or emergency situation, although the Brigade has many vehicles wholly suitable for this purpose,) Dr. Frank Archer and Sister Joan Hutton travelled to hospital with the mother-to-be. She arrived in time to have her final contraction as she entered the labour ward. I he child, a 31b 100L girl, wa reported on the third day to be dOll1g well, but lying In her cot with her hands over her We were later informed that the mother was the 'uIlofficial wife' of one of the leaders of Melbourne's Hell's Angels. These and many other memories will remain. But above all those members of the Brigade who partiCipated in this duty will remember the wonderful 'en e of complete physical exhaustion, yet mental stimulatIOn and satisfaction 111 the knowledge that a difficult job had been well and truly done In the spirit of the Order of St. John. The praise ;:lI1d tributes paid to the Brigade during and after this weekend were almost embarras lI1g in their volume. The team wa a credit to the Brigade.

NEWS from SCOTLAND

S i r Andrew Murr ay

AT A MEETING of Priory-C o un ci on Mar c h 2 0 th e Prior announced that Sir Andrew Murray , ou r Chancellor and Registrar, had also been appointed Preceptor of Torphichen. This news will delight all those who know what has been going on in Scotland over the last decade.

Sir Andrew, a former Lord Provost of Edinburgh, wa chairman of the Edinburgh Committee of the Order in 1949; and in 1954 he became a Knight of Justice and Director of Ceremonies at Priory. Subsequently he held the office of Receiver-General before being appointed Chancellor in January 1963. The Chancellorship is the office which imposes perhaps the heaviest burden s of all, because its holder is our equivalent of a managing director, in d ay- l o-day executive control, subject of co ur se to the Prior's authority. Sir Andr ew, therefore, is in a real sense the man behind all the advances [ have described in this column. The patronage of mountain rescue services, the establishment of new area committees, the appearance of new projects these are the external signs of his success. But an office like his demands from its holder duties and responsibilities which, if properly carried out, attract no attention. Projects in trouble h ave to be made viable, occasional differences of opinion must be resolved and all members of the Order given purpose and encouraged. This side to Sir Andr ew's activities has rightly escaped noti ce, since only failure would be newsworthy, but we should remember it, just as we should take note of the way he has often made efforts far beyond the normal call of duty. How many members of the Order know that he himself worked on the interior decoration and in the garden of Skerrybrae to save expenses?

The Preceptorate of Torphichen is an ancient office, dating at least from 1214. The medieval preceptors were the leaders of the Order in S co tland and many of them were also important figures in

Scottish political lifc. The most famous of these was the great Sir Wi lliam Knolli s (Preceptor 1466-1508), who was L ord of the Council, Lo rd High Treasurer of Scotland, Master of the King 's H ousehold, Keepe r of Blackne Castle and Sheriff of Linlithg ow, and severa l times ambassador on his king's behalf.

The Preceptorat e is our equiva lent of the Engli h Bailiwick of Egle and it i. only right that it shou ld be granted to the man who has done more for the Order in Scotland than any other in the last two decades.

Cla ss room Cr usa d ers

Th e chi ldren of Castlehill Prim ary School, Bea rsden, have just finished a project-study of the cru ades. They dici

their own researches, built a model castle in their clussroom and painted murals and rictures illustrating the crusades and the crusaders' occuration of the Holy Land. I ncluded in lheir exhihition wa a representation of the Cross of St. J ohn and a de crirtive notice explaining the links between it and the Venerable Order. This sort of study is not only good education in that the children find it fun to learn: it also h e lp s to sow the ground for the success of our future efforts. It underlines a point I have made often in this column that our hi tory and t ra ditions are pnceles a' ets with universal appeal which can and hould be exploited by us for the benefit of the sick.

OVERSEAS NEWS

SABAH

On a very memorable, s unny February 28

Kota Kinabalu re ceived a brief visit from HM Queen Elizabeth accompanied by Prin ce Philip , Prin cess Anne and Lord Louis Mountbattcn. 80 members of the Brigade from Kota Kinabalu, Pap a r , Penampang and Taml 1aruli, with 5 ambulances, covere d the first-aid requirements of the vi sit.

Lord Loui s altered his plan for u very welcomed visit t o the St. John Headquarter s. It was fortunate that hi s arrival was preceded by the r eturn of a number of members from the first round

NEW ZEALAND

LORD LOUIS IN SABAH

of duties, so that an impromptu parade of 67 members was formed up under the memorial flag pole outside the new h eadquarte rs. Lord L ouis was met on a rriv al by Dr. E. R Dingley, and D.S.O. R ajah I ndnln M, who accompanied him on an inspection of the members. Lord Lo ui s spoke hriefly about the spIrit of service and devotion to duty which was the chan.lteristic of St. John, exemp li fied by the work of Lady Mountbatten who died here on duty on Fehruary 20 1960.

Lo rd L oui en t ered the headquarters to see the memorial plaque and signed the visitors book. (Pictures on next page).

'I know what to do With yOU a very capab le competitor in the indiVidual first aid event

The third Open ational Competitions were held at Wellington recently, with members from 19 dIviSIOns competing.

The team winners were: Auckland Waterfront lndu trial Ambulance Division and Brooklyn Nursing Division; and team leaders: Tuwharetoa Ambulance Division (Turangi) and Brooklyn ur ing Division.

The foundation stone for an extension to the St. John Nursing Home Aberdeen, was laid recently by Mrs Eli zabeth Swapp, widow of Dr George Swapp, warden of the home from its opening in 1950 to 1969

Photo Aberdeen Journals ) w , <

Com ing out of the scrub, in the Transport Test

(Left) Lord Lou is Mountbatten in familiar su rr oundings - inspecting members at Kota Kinabalu. (Below) The memorial plaque to his late wife EdWina in the St. John headquarters. Lord Louis is with Dr. E R. Dingley

Easy, boys Test

News f,.om the Divisions

CROYDON CENTRE -The 18th annlla l meeting of Croydon Centre held during March was attended by nearly 50 members and marked a special occasion for Mr. J ohn (Jack) E. Dane, of Shi rl ey, w h o retired from t he Centre Chairman hip after holding office since the Centre's formation in 1954.

Mr. Dane was presented with the 6th, 7th and 8th bars to his Service Medal of the Order of St. J ohn by Mr. Norman Mar h on behalf of the Director-General. This award marked the comp letIOn of a record tota l of 55 years in St. John work, and Mr. Dane was told by Mr Marsh that this was a unique achievement and he joined a 'very distinguished company'.

Reporting on the year's work in 1971, Centre Sec r etary Mr. Trevor Constable said that no than six Croydon teams had gained places in ational First Aid Competitions 'What an achievement in one year, defy any other Centre in the country to beat that' said Mr. Constable. During 1971 346 sLiccessful candidates on 35 first aid and other cour:.es obtained certIficate' in the Croydon area, bringing the total number of certificates is ued by the Centre slIlce its formation to 7..+76.

DERBYS -the 1972 Brigade Cuunty Iinals wcrc held at Chcsterl'ield durlllg fan: h, \I Ith thc Commander/Commissione r Capt P. 1. 13. Drury l.owe presiding and assistcd by Deputy Commissioner Col. Peter Hilton. Winning teams \Verc Ambulance DIVISions. I, 335pts .C13. Area

Meet Tina Hunt of Suffolk's Brandon Cadet Division - their 1972's best junior nursing cadet. P hoto' StudiO Five, Thetford)

Ltd) 'Y

Workshops (Duckmanton) Dobson Cha ll enge t rophy; 2, 256pts A lvaston Division; 3, 235pts Cheste r field Tube Division.

Nu rsing Divisions: I , 270pts Long Eaton

Nu rsing Division the Tibs hc lf Ward le Cha ll enge trop hy; 2, 204pts Pilsley Nu r sing; 3, I 70p s Whaley Br idge Nursing

Ambulance Cadet Divisions: I 293pts

Bo lsovc r Cadets the II. C. Chamben trophy; 2, 239pts Chaddesden & Spondon Cadets; 3, 151 pts Bux ton Cadets.

Nursing Cadet Divisions: 1, 243pts Ha r dwick Cadets Mr s. G. A. Chambe rs trophy; 2, 224pts Chaddesdcn & Spondon Cadets; 3, 218pts Sheepb ridge Cadets.

Thc County Officers' cup for nursing cadet individual tests was won by Hardwick Nursing Cadets. The Col. Bearn cup for ambulance cadets Individual tests by Chaddesden & Spondon Ambulance Cadets.

The cOlin ty'5 two speeial trophies 1) the Sir John Crompton-Inglefield trophy for the best act of first aid by an am bu ance cadet was won by 12-year-old Cadet Paul Ro herham of Eckington; and 2) the F rank Pa r ker memorial rophy for the best act of first aid by a nursing cadet was won by 16-year-old Sergeant Christine Simpson of Ilkeston.

PL YMOUTH -A retirement presentation of an electric blanket and an e lectric toaster was made to Mrs M. Peterson by Mr. P. E. L. Foot, Chai r man of the Plymouth and District Council of St. John. at the anllual dinner and dance of the St. John Ambulance at the Duke of Cornwall Il otel In Plymou tho Mr. Foot said Mrs. Peterson had retired last August after 19 years helping the Order of St. John

\1rs. Peterson joined the Brigade a' a nurslIlg officer with the Co-operative Nunlllg DiviSIOn in March 1952, and was appolilted a County Staff Oftker in April 1967. She was admitted to the Order as a Serving Sister in May 1962. She was a former matron of Lockyer Street Hospital and deputy regional adviser at G reenbank iIospital, Plymouth

(COII/inlled 01/ lIext page)

REVI EW CROSSWORD No.5 (72) Compiled by W. A. Pott er

ACROSS

1. Bad blood of one affected by malaise? (3-7). 6. A giant in a state of excitement. (4). 9. Saint is confused about morning ability to withstand physical hardship. (7). 10 Tap many used for drums in the temporal bones. (7). 12 Partially dige ted food passing from stomach to duodenum. (5). 13 He art valve with cusp near the centre. (9). 14. Whit e powder on pink lint. (5.4). 17. Pigmented layer of the eye. (4). 21. Go in front for poisonous metal. (4). 22. Exactly 141b is absolutely lifeless. (5-4). 25. Tropical parasite is just a fluke. (9).28. Unusual zone containing nothing for sterilising gas. (5). 30. Before Easter [ go for a freckle. (7). 31. Death not due to natural causes. (7). 32. Taken by drug addicts. (4).33. My lack of strength is muscular debility. (10).

DOWN

1. Is vector of many tropical diseases a member of a religious body? (6). 2. Describes slightly incompetent heart valve. (5). 3. Pied mice giving disease spreading rapidly through a community (8). 4. Smallest lieutentant is found around rough sea. (5). 5. Incorrectly run into it for nourishment. (9). 7. Small weight and poisonous snake to seize by hand. (5). 8. Major epilepsy sounds tQ be an imposing illness. (5.3). II. Heavy wooden hammer to handle roughly. (4).15. Eggs in Czechoslovakia. (3).16. Cause of disease. (9). 18 By way of Latin. (5). 19. Artificial denture a hindrance for tiny blood cell. (8).20. Mad on his arrangement to reprove mildly. (8). 23. Parts of mandible and os pubis. (4). 24. Convention aimed to protect medical services in war. (6). 26. Listlessness concealed by unseen nuisance. (5). 27. Relieves pain a nd discomfort. (5). 29. In the raw it stimulates lacrin ation. (5).

SOLUTION TO CROSSWORD No 4 (72)

ACROSS

1. Kiss of life ; 6. D.is .c: 10. L.inen ; II. Throw; 12. Can : 13. Ace.tone; 14. Na .sa l; 16. A cidosis: 18. Nordic: 21. O.rn.ate; 22. H ang-nail; 24. R . up.ia; 26. Mankind: 29. Art: 30. Tar.si; 31. In.ure; 32. Dose 33. Bone-shaker.

DOWN 1. K.ale; 2. Sensation; 3. Ounce ; 4. Lithosis ; 5. Furred: 7. In cus: 8. Canaliculi; 9. Swan-song ; 15. Labour ward; 17. Outlasts; 19. Dead drunk; 20. Jaundice; 23. Embryo; 25. Pott 's: 27. [ri s.h: 28. Bear.

News from the Divisions (contd .)

WOReS -The Countess Beauchamp MBF, who recently resigned aftcr 29 years as Cou nty Pre s id en t, Sl. J oh 11 Am bulancl.:, Worccstcfshirc and Chairman of the Council, has becn succeeded by Mrs. Hugo Hunting ton-Whiteley, as County PreSident, and Lt Col. C. P ))SO as Chairman of the Council.

Lt. Col. C. P Vaughan DSO, resign cd as Commissioncr, Worce'ltcrslllrc but remains as Commander. l. J. Won:es tershire.

Mr. I. W The Court House Blflington, Pershorc, Wor cs. appointed as Commissioncr.

Mr. K. II. Billingham, 80 Court Kingswinford, Stalls, appointed Deputy Commissioner.

Mr. B. Roper, 24 Briery Road, Il alcso\\'cn. appointed County Cadet Officcr Ambulance.

OBITUARY

Miss Frances Ingram, Divisional Officer (Retired l. 48 th (Grays) "\f u rSlOg Division,joincd the DIVISion in 1<)23, Divisional Officcr in 1940 An Ofrieer of thc Order.

Mrs. Violet Wigley, Divisional Superin tenden t, 48th (Gray,) urslIlg Division. Divisional Officer in 1957 and Divisional uperintcndent in 1966 Serving Sister of the Order.

Meet Mr C G. Warren, of Rugby Town Division who has been a Brigade member for 50 years the last 42 years with Rugby. A Serving Brother of the Order, Mr. Warren attends the Grand Finals and St. John Day In London every year

NATIONAL FIRST AID COMPETITIONS

ELECTRICITY SUPPLY AMBULANCE CENTRE

RESUL TS

\-1 EN

l. South Western (Pool, Redruth)

2. London (l3attersea)

3. North Western (\\anchcster)

4. Yorkshire (Skelton Grange)

5. South Eastern (Brighton)

6 Eastern ( o[\\'lch)

7 Midlands (Southern Area)

8. East ;"1idlands (1Ilgh :vtarnham)

9. South of Scotland- (Tongland)

10. South Wales (West Wales /Ca rmarthan)

I I. North Eastern (Blyth)

12. Southern (;"1archwood)

13. Mcrseyside & N Wales (Fiddle r's Ferry)

WO:vtEN

I London (South East London)

2. Mcrseysidc & North \'v'ales (Chester)

3. Yorkshirc (Leeds)

4. South Western (Bristol)

5. Southern (Marchwood)

6. North Western

7. Midlands (Northern Arca)

8. East Midlands (Cottam)

9. South Walcs (St. Mellons) 10 Eastern (Ipswich)

II. North Eastern (Tynemouth)

DO YOU NEED THE "BREATH OF LIFE"?

What can the ambulance man do about pain?

5T. JOHN REVIEW

AT RANDOM

by Watkin W. Williams Deputy Commissioner-in-Chief

pain without masking ymplom. The oxygen ensures its complete sa fet y, as well as often being a life- saver, especially for certain respiratory and coronary conditions. For more information plea e contact:

Contents

Training our Leaders, part 2, by P. Adams p.2

From Deities to Diabetes, by B Allpoint p.4

Volunteers - to the Rescue, by Patrick G. Bowen p.6

Around and About, by the Editor p.8

Burns - the cause, nature and treatment, by R. W. Barker, MB, BS, M ReS, p.12

Kolossi Castle, by Alan Sharkey p,14

Readers' Views p.16

News from Scotland - Wales - Northern Ireland p.18

Overseas News p,19

Films p.21

News from the Divisions p.22

Harlow Essex Telephone: 027 96 29692

*EnlOnox

EDITOR FRANK DRISCOLL, 26 Pembroke Garders, London , W8 6HU. (01 6038512)

ADVERTISEMENTS Dennis W. Mayes Ltd

Price 12p

COVER : 69 Fleet St ., London, EC4 (01·3534447 and 4412)

£1 70 per annum, Including postage, from Treasurer , Order of St John 1 Grosvenor Crescent, London SW1 X 7E F

Oh Dear - what's he going to say to me? The problems of beino one of the most junior Juniors when one of those 'Bi g Wigs comes to inspect you. The scene IS at SJA Ashford, Kent

(Photo Tuesday Express, Ashford, Kent

A VERY BUSY six weeks have passed since last I wrote to you. As well as many less exciting routine duties they have included visits to Malta and Cornwall and to the final stage of a new type of officers' training course held jointly by the counties of Oxford and Buckingham. I also had the quite undeserved privilege of being one of the two official representatives of St John Ambulance attending the Football Association's Centenary Banquet on the eve of the cup final - and I wish I could adequately convey to all Brigade members who go on football duties the warmth of gratitude and praise with which my neighbour, who was Chairman of the Football League Trainers and Coaches Association, spoke to me of their unfailing help and the high quality of their voluntary service. And, finally, I have twice seen the new 20-minute documentary film 'The Order of St John ', with commentary spoken by the Lord Prior. Any film which attempts to cover so vast a stlbject in 20 minutes lays itself open to criticism for omitting this or that particular aspect or activity, and it' anyway hard for us who are 'inside' St John to view it objectively. But I confidently believe that, given the chance. its impact on the public who are 'outside' St John will be immense, and I hope it will soon be widely hown throughout the country, e pecially to those attending Association classes. Though essentially a documentary and, as such, making no direct appeal either for money or for recruits, I believe that if shown on suitable occasions and skilfully introduced it will in fact produce both.

MALTA

My vi it to Malta wa a brief (and successful) attempt to get some holiday sunshine in an island that I already knew and loved, but 1t was an added JOy to visit the District Headqu arters of the Brigade in Valletta and to renew acquaintance with many friends there. 1 a l 0 managed to take some colour transparencies of the hat and sword worn by Grand Master Jean de la Valette during the final days of the Great Siege in 1565. which now hang on a wall in St Joseph's Oratory in Vittorios a: and I'm particularly glad to be able to add one of these to the set of Malta slides that I ometimes show to St John audiences.

HELSTON

The treets of Helston were already 'dre sed overall' for the f10ral dance on the sunny Sunday afternoon when. in an impres ive ceremony which wa well attended by the public and

(Co ntinlled on page 11)

IN LAST MONTH'S issue of the Review

we traced some of the factors affecting eadership training. As a result, we came to the conclusion that most people possessed certain qualities of leadership, and that training involved the d e v elopmen t of these qualities by p r actice and, largely, experience. Our main task is to start off the processes w h ich will eventually make him a leader.

We also saw the need for a leader to u n d erstand what is required to produce a team an d how to meet the needs of the in d iv id uals in it.

In this issue, let us consider in more d etai l what a leader has to DO in order to meet these needs, as well how we will set about training him

CLASS REQUIREMENTS

Consequently, leadership training needs a very persona l approach. The instructo r 's task is to work on qual ities which mayor m ay not be exhibited in each of his class. In any case the better and more in t imately h e knows them the easier it will be for him to know where to start.

No doubt if the student's qua l ities are hid den, the instructor may never find the m ; but i f they a r e merely inert, he will t ry to activate them. Where an instructor is a comp l ete stranger to the class, it will ine vitab ly take time to discover even the more blatant characteristics of an in d ivi du al. Where this occurs, time spent

Training our Leaders

b y Pa t Adams

(Colonel P A. Adams rece ntly joined Headquarters Staff to be respo nsible for leadership training within the Brigade).

sinis t er meaning often accredited to it. I is not a popular word , conjuring up in many minds a 'master/servant' comp l ex, due no doubt to the days when people obeyed their 'superiors and betters' because either they had no option to do otherwise, or they were born and bred to do so without question or argument.

The result of this kind of enforced discipline had two adverse effects It produced re luctant worker s, lacking a ense of purpose in what they were doing , often ignorant of the plan and the reasons behind it. It often re s ult e d , too , in bad planning due to insufficient preparation and thought, knowing that it co uld not be cha llenged

Times have c hanged a great deal since those days We are living today in what is said to be the Permis sive Age' , o ne in which many people wish to do wha t they want with apparent disregard for others' feeling s or opinions. There is a natural tendency to query every request or command. I suggest that this is not basically due to a mere s tubbornne ss, but is a consequence ..If the c hange of attitude. People are no longer machines '; they are born and bred to TH I NK. To satisfy their need to understand what they are doing and why it I necessary is of utmost importance. Once satisfied, they will work with greater enthusiasm and efficiency. This willing acquiescence

and obedience produces a natural discipline.

Discipline, therefore, 'happens' when a group of people co-operate and work happily together, with a willingness and common purpose. It is the method by which discipline is obtained that matters ; it depends on mutual understanding and the leader's power to comm unicate.

THE ART OF COMMUNICATING

Perhaps the first time we com muni cate is when we disc o ver fairly soon after birth that we pos sess a voi ce. We may not be able to form words, but at least we can make a variety of noi ses; a gurgle to indi ca te joy; cry ing to denot e pain or anger, depend ing on its tone ; or perhaps it is just to attract attention. What ever it is, it is our means of communicating a mes sage.

As we grow up, we learn to spea k and are able to express our meaning more clearly. We even lea rn to use other organs to express meaning the hands , nodding or shakin g the head, the wink of an eye or even an ogle at a pretty girl. All of these are means of communicating.

When however, we mature further, we find there is a need to com municate more precis e ly and to express ourselves more clearly if we are to get others to ca rry out our wishes

There is, however, anot her side to communicating - communicating our

personality or character. One of the first requirements of a leader is to be able to mix to 'get on' with others, to be popular , to be liked. A leader must, of course, possess the right kind of character, but more important he must be able to express it in his mode of s peech and other mannerisms.

This form of co mmunication might be said to provide the leader's background or 'image' by which he will be able to earn respect and confidence from others. We now co me to the need to communicate in the more liter a l sense. We have already seen the importance of di scussion which promotes understanding welds together the team and leads to a natural discipline. Discussio n , however , is a two sided affair; it includes the art of listening. A leader must be patient and prepared to listen to (and perhaps accept) the views of others; he must be flexible and prepared to adjust his plan if necessary. Acceptance of a good idea - of giving credit where due - w ill only increase the respect of the team to their leader and enhance the feeling that they are all part of one team, sha ring in the planning of the task and not only in its execution. It will, above all, cultivate an attitude of 'We' rather than You' and '1' aturally it is most important that the leader is able to communicate his plan clearly and concisely. For no plan -

From this three factors emerge.

First, that leadership training is most effective at local level, where the instructor knows his students, and can ensure the 'follow up' to the course in their normal duties; second, that where this is not possible, the residential course offers considerable advantages over the non -residential one; third, that classes must be manageable - small enough to allow the instructor to give each student personal attention.

THE INSTRUCTOR

The instructor is, of course, a leader. His class is his team, and as leader, he too is part of the team. He must avoid, therefore, talking 'down to' the class but must communicate 'with' them, using the art of discussion, rather than the more common practice of lecturing

As leader, he must practise what he preaches. He must always set an example and must understand as must his class - what goes to make a team, the meaning of discipline and how it is achieved.

Above all, he must know how to comm unica teo

Let us consider each of these aspects in more detail, as each is an intricate function of leadership.

2 on getting to know the class is never wasted and is often better done durmg leisure activities - at mealtimes, in the bar, or between training sessions.

THE TEAM

'Ten good soldiers wisely led Will be a t a hundred without a head' EURIPIDES

A team is a co-ordinated group whi c h works in unity with a common motive towards a common objective. To satisfy our definition of leadership, all members must work willingly, implYll1g that their needs must be satisfied. Mo Important among these needs is the need to atisfy their minds their inquisitiveness For unless they are satisfied that they are doing the right thing in the right way, that they understand the plan and its motivation, they will work with a certain reluctance which might destroy the efficiency of the team and jeopardise the successful execution of the task.

Thus it is of prime importance that the leader is able to communicate with h.is team, clearly and coherently, by which means he ' is able to elici t tha twilling co-operation ne cess ary to carry out the task in accordance with his instructions. In doing this, he produce a natural discipline without which no team can work effectively.

DISCIPLINE

Discipline however, is a subject often taken for granted and too often overlooked. I t is a word that is often misunderstood, and I feel that it is worthy of comment if only to dispel the

'Ambulance for Ulster

Mr. C. A . Towle, SJA Nottingham a rea tran port officer (left), an d Mr. Christopher O'Leary loading up one of the three ambulances bought by the orthern Ireland St. John Ambulance Brigade.

Mr. Towle later issued an urgent ap(3-eal on behalf of his colleagues 111 Ulster for medical equipment or donations. 'They are de perate for anything we ca n send themblankets, bandages anything you can think of that can be used by the Brigade'. ( Ph o to : Guardian Journal)

however good it is will succeed if the leader incapab l e of explaining it to his team. Misunderstanding will invariably lead to muddle and failure.

In training, the ability to communicate is of special significance. In the ma tter of instruction it i imperative that the instructor is expert in putting across his meaning and in the use of visual and other aids. A good instructor is often one who knows how to do this , though he may be less know ledgeable than the technical expert who cannot communicate.

TRAINING METHODS

Having considered many of the factor affecting leadership training, it must be accepted that however we set about it, training must be as practical as possible. The evolution of a leader will depend on what he does after a course - on experience. The object, therefore, of a course is to start off this process, by leading the student on to the right lines, helping him to discover and develop whatever qualities he has, relating them to the functions of leadership.

Much use can be made of case studies 'role' plays, discussions and debates : working in syndicates of 4 to 5 students in each. Observation exercises are also useful, where one group under their leader carries out a simple task One of the students is selected as the leader makes his plan, communicates it ro team, and controls progress of the task. The rest of the class, or one of the other syndicates watch, analyse and criticise the actions of the leader - his planning, briefing, control, communication and

evaluation of the team's performance.

If we consider Leadership Training to mean 'Training Leaders' - which after all is our ultimate aim training must embrace a number of subjects with which leaders need to be con versant, s ubject s which may not be purely 'leader hip' but are closely allied to it. One of the most important is Administration

Nearly every operation of any kind relies on one or more administrative actions such as the provision of transport, stores, accommodation and food, or matters concerning promotion and pay. All these must be adequately dealt with by a leader for careful attention to such details is nece sary to sati fy the needs of both the team and the individual. It is very necessary, therefore, that leadership courses include training in such administrative duties as are befitting to the particular grade or category of le ader being trained.

In running leader ship courses, however, we must not lose sight of the fact that the main object is to train the student in the u e of his talents and to exercise his qualities. He will, of cour e, be doing this throughout the course, by being encouraged to participate in discu sion and pra ctical exercises. I suggest that on any kind of course, the more the cla s participates the better , for whatever we are teaching - be it first aid, administration, drill, camping or any other subject we can give members the chance to exercise their talent and improve their powers of leadership.

I further suggest that, generally speaking, a discussion is far better than a lecture. There are few le ct ure s· of an

From Deities to Diabetes

THE ANCIENT GREEKS had gods and goddesses for almost everything; one of them, Mnemosyne, was the Goddess of memory. She had several daughters, just how many is debatable, but they were the goddesses of the various forms of art.

Now the one thing all artists must have in common is a good memory. The painter who cannot recall shades the musician who is unable to reme'mber notes, or the actor who forgets his lines will not get very far. At least they wouldn't in these days. Since the deities could not allow themselves to be excelled by their followers in this or any other way we may be sure that Mnemosyne taught her children every trick of memory she knew.

These m emory aids, known as mnemonics, are of the utmost value to first-aiders. At some time, in an examination, a competition or when dealing with the real case, we probably all have had the horrible experience of 4

instructional nature which cannot be replaced by discussions o r even debates. I often feel that the best way to give a lecture is to get the class to do it for you! By asking question and drawing ou the answers, by posing problems and promoting discussion, and by lelling the class discover the solutions th emselves one can put across all the points would have b ee n covered by a le cture. It involve s participation by the class, requires their co-operation, exercises their minds and breaks down their shyness all vitally important in dev eloping their leadership qualities. A boring lecture can be turned into an enjoyable, lively debate.

In having to think and work out for themselve the answers to the problems, students will not only keep awake but will remember far more far longer.

In every walk of life where there is group activity in Governmen t, in the Forces, in industry, in every kind of organi ation training leaders i a vital and most important problem which must be tackled. a matter how proficient we are in our technical skills, we will fail ir there is not good and efficient leadership and direction.

LeadershIp training is certainly not easy, an d much will depend on the efforts of the individual. But we can and must - help our future leaders by slarting off the processes which will enable them to develop their qualitie and eventually make them leaders processes which will continue throughout their lives und wlllch will ultimately depend on PRACTICE and EXPERIENCE. by B Allpoint.

wondering 'What next?' and finding o ur minds a complete blank Many books have been written full of mnemonics for first aid but to memorise these is very little different to trying to learn the rules direct from the manual and it is just as easy to forget them. It is far better to make your own.

Mnemonics take many forms, the best being to understand the reasons for what you have to do. To take a simple example: the novi ce first-aider may forget to raise a severely bleeding limb, but not once he realises that this causes gravity to slow the blood in the arteries thus reducing the pressure at the bl'eeding point and making rus task so much easier.

Learning 'parrot fashion' has gone out of favour to a large extent, but 'The proof of the pudding is .'. You will pro ba bly fin d that Grandad ca n remember his tables better th an your schoolboy son who has learned them by more modern, scientific (?) methods. This

remember th e order of bandaging a fractured knee cap.

Joke s and anecdotes hav e th e ir use s too Many years ago heard a boy refer to the bones of the ank l e and foot as the Tarzans and Mrs Tarzans. Wh en his mates stopped laughing he said with a grin; Well they have to be strong like Tarzan to support the weight of th e body.' Childish perhaps, but none of his class ever again confused the terms with the bones of the wrist.

I know some St. John men who make up phrases in which the initial letter of each word serves to remind them of an it em in a li st of signs and symptoms, or of the steps to be taken in the treatment of a specific injury. This is a good aid to the memory and my own favourite method is rather simi.lar except that I prefer to use a single word rather than a phra e. Such a word should have a connection, however vague, with the subject to be memorised. For example the word 'sear', meaning scorched or burnt, can be used to list the causes of burns thus:

S trong sunshine or other forms of dry hea l.

Electric current and lightning.

A cids and alkalies. The strong corrosive ones.

R ope i.e. friction burn

It may happen that the only suitable word you can think of has too few letters. In this case it may be possible to let one letter tand for more than one item. An extreme example is my mnemonic for the treatment of burns and scalds in which both the letter'S' remind

is why Grandad has difficulty In reulising that sixty pence IS no longer five shillings, and may explain why the proverbial 'tu ppeny pie' still costs two new pence.

Sketches can help fix detuils in tlte mind even if the quality of your drawing goes no further than indicating pin men.

When I was training sea scouts in flrst-aid I would show them a picture of a sailing dinghy with a broken mast which had been temporarily repaired by having an oar lashed secure ly to it. This made it easy for them to appreciate and remember the methods and rea ons for splinting a fractured limb.

Rhym es and jingles are of value. For instance:

There once was a first aider feller

Who tr eated a fractured patella

With bandages three Round thigh ankle and knee.

The splint was an o ld umbrella.

Byron never wrote anything lik e that, but he might have done if he wished to

me of several things, viz:

Should not prick bli sters, use lotions

o r remove clothing unless it is smouldering or is contaminated by corrosives, etc.

Cold water to cool the injury.

Apply a dry dressing and ample cotton-wool.

Lightly bandage if blisters are present, otherwise bandage fir ml y.

Drap e the casua lty in a bandage (i.e. treat shock).

Splint s and slings if a joint is involved and

Sip s of warm sweet tea if the casua lty can not be got to hospital for over four hours.

As you will have realised a good deal of paraphrasing is needed, and the order of the items must sometimes be changed. What might be termed cheating is permissible if it serves its purpose. have used 'N' for 'Ensure' and 'X' for 'Except'.

It is not always necessary to use a complete word, though this should be done if possible. However the signs and ymptoms of In sulin Lack fit beautifully into the first five letters of diabetic. should add that some of the following signs are from the 1958 edition of 'First Aid' and are not given in the second edition.

Dr y skin

Int o unconsciousness

A cetone smell on breath, which may al a be deep and sighing.

Boil and carbuncles which the patient may suffer from.

Ennui (The patient may be drowsy).

The state of the skin and the breath is of course, just the opposite in

overdose and the first three letters of 'insulin' can remind us of the treatment of both, like this:

I nsensibility - carry out the general rules for.

Need s urgent medical attention.

Sugar sweets or jam. Give a little of one of these if the patient can swa llow If his condition shows immediate improvement give more. Anyone who wishes to do so may memorize and use these examples in any way they wish. I could give many more but my object is to persuade you to work out your own. It is no more difficult than doing a crossword and becomes easier with practice. Jt is usually very easy to alter them when a new manual is published, so they do not become a wasted effort. Although your own vocabulary is probably enough, a dictionary is helpful and a thesaurus is invaluable but do not pick from words which are strange and unknown to you. Such words are themselves too easily forgotten. Other words which are familiar to you but seldom heard or used by you should have a note of their meaning written alongsi.de them. 'Ennui' in my memory aid for the signs of diabetic coma, o r insulin lack, is such a word. It means boredom or lethargy and since J normally use one or other of these rather than ennui have an explanation after it. ow, if there is anything in the book you have difficulty in remembering, work out a mnemonic of one sort or another. You only need patience, some thought and a sheet or two of scrap paper. When you have succeeded copy it into a note book - just in case you forget it again.

BELFAST FIRST -AlDERS

Hilary Ferguson (left) und Lee Moore, both IS-year old cadets of Belfa t's Forth River Divi ion, were on the scene of the Abercorn Restaurant bomb disaster in March. H ere is their story of what happened:

'We were walking down Castle Lane and there was this awful bang and everything seemed to fallout on the street,' said Le e

lIilary : 'At first I wu in a daze. The Army were telling people to keep clear but we ran forward and told them we were first-aiders.

'The ambulances hadn't arrived so a soldier threw us a first-aid box from a Land Rover and told us to take what we needed.

'The first man we helped had a bad cut on his h ead. We got him into the back-of a Land Rover or some vehicle and bandaged him .'

Lee - 'We got some of the people into shops. There was one woman and we suspected she had a broken leg. But we were Loa small to li ft her 0 we got a man

you go to classes to learn first-aid you never think about the time you have to use it'.

Photo Belfast Telegraph

Volunteers

THE NEED for voluntary organisations a nd effort will always be necessary however our Welfare State develops. This was proved r ecently in h e case of Hans Martin Meyer, a 17-year-oid German youth on a visit to Britain organised by the Int ernational Chu r ch Travel. One night in Jul y H ans accepted the offer of a ride on the pillion of an English friend's scooter; they wore no crash helmets and therefore the accident in which they were i nvolv ed was much more serious than it need hav e been

Both b oys were taken to St. Margaret's

to the rescue

IN THE BEST WELFARE SOCIETIES THERE ARE ALWAYS OCCASIONS WHEN ONLY PEOPLE CAN HELP PEOPLE

by Patrick G. Bowen St Margaret's Hospital Secretary , Epping

Hospital Epping, where for days both remained 'close to death'. Through Interpol, Essex County Constabulary notified the German boy's parents who were then brought to Epping in less than twelve hours from the time of the accident. This was the first time they had been abroad, and the efficient and sympathetic manner in which they were treated in Britain really impressed them. The police streamlined all formalities and provided their car with an outrider escort to get them to their son's bedside as quickly as possib e. The parents were

accommodated for the first few days in the relatives' flat of the newly opened Accident Unit of the ho pita!. Throughout these distressing day they were constantly comforted and helped by the Hospital Chaplain, vanous other religious groups, and the Rotary Club of Epping, who gave immediate financial help. The boy's father wa obliged to return to Germany after a week and the Rotarians of Epping made arrangements for Mrs. Meyer's accommodation as long as she wished to stay in England.

Mrs. Meyer worked voluntarily on one of the hospital wards when she wa not caring for her son, and soon endeared herself to everyone with whom she came into contact. It is hard to imagine her feelings being suddenly dropped into an entirely strange community, unable to speak a word of English, bu t almost immediately she was befriended by everyone, especially by one or two members of the staff who spoke her language. I n the weeks that followed Mrs. Meyer shared her time between caring for her son and her voluntary efforts for the patients in the ward.

Hans made very slow progress but after ten long weeks he was still in a coma although taking some fluids and specially prepared food. At this point the surgeon looking after him decided that it was in the interests of Hans, and his family, that he should be transferred to a hospital near his home in Germany.

Difficulties at once arose over the problem of repatriation, since the case was not one which fitted in with the official pattern. The o ld familiar story of prohibitive costs was followed by the suggestion that the parents must give an

undertaking to repay them in full (pos ibly £.300). At no time did official circ le s appear to be moved by compassion for the parents or by the surgeon's views about what would be best for the patient. This apparent indifference incensed a few of us at the hospital to such an extent that we became almost obsessed with the desire to prove that the impossible can be achieved, if there is a will to do it.

Originally the idea of seeking the co-operation of one of the Air Forces was considered bu again this would undoubtedly have produced a fresh batch of problems and delays. It was then decided to repatriate Hans by voluntary effort. His condition remained extremely grave and whatever mode of trasport was used there was the possibility of the patient not surviving the journey. There was a distance of 450 miles involved and unfortunately his home was situated in the Hertz Mountains where no major airport facilities exist.

Fortunately a very good relationship exi ted between the local hospital officers and Mr. Eric Thurston who is responsible for the nearby airfield at Stapleford Tawney. Only recently Mr. Thurston had added a orman Islander to hi fleet of aJrcraft and immediately he was approached 'on a mission of mercy'. He offered to undertake the return flight personally. It was essential for the surgical registrar and the ward sister, who had both cared for Hans, and his mother to travel with him. To achieve this it was neces. ary to take out part of the normal seating in the aircraft and to erect a suitable stretcher rack. It was also obvious that the airfield facilities in the area of the boy's home made it lmpoible to take the Islander beyond Hanover.

At this stage of the plans two major issues were paramount. Firstly , raising ufficient funds to meet the actual cost of the flight (already reduced to a minimum by Mr. Thurston), and secondly arranging for a suitable hospital in Germany to accept the patient. Thi is where the German Welfare Council came into the picture This voluntary organisation, based 111 London to look after the welfare of German nationals, responded immediately and magnificently. I t was due to the efforts of the ecretary and the ocial worker that both problems were soon overcome. A grant to cover the cost of the flight was made available. and through a medical contact on holiday in England the social worker was able to persuade the Profe sor of the euro-surgical Unit of Gottingen University to take the boy

There was still the problem of transporting the semi-conscious patient from Han over to Gottingen, a distance of some 80 miles At first an ambulance was

The beginning of a delicate journey back home to Germany.

contemplated, but when the story of our efforts appeared in the German magazine Stern the German Air Force made avai lable a large helicopter for the last leg of the journey.

The final days of anxiety in England for Mrs. Meyer were eased by a fantastic display of local goodwill and friendship. With great feeling she said farewell and thanks to her many friends in Epping.

The day of the flight was clear and fine. A special ambulance conveyed Hans, Mrs Meyer, the doctor, sister, and myself to the airfield some six miles from the hospital. This journey in itself was difficult, as any unusual vibration or shock might well have proved fatal to Hans. The pilot, Mr. Thurston, had obtained special clearance for the journey which, on medical advice, was not to be at a height exceeding 5,000 ft. Upon approaching Hanover the German helicopter was already waiting to make the final journey to Gottingen. The transfer was soon effected and in minutes the entire party were again in the air. The vibration and the noise in the helicopter undoubtedly upset the injured boy and the last ten minutes of the trip seemed a lifetime as his condition rapidly deteriorated.

The original landing area adjoining the euro-surgical Unit proved too small for the large helicopter and the pilot had to use an Army Base some two miles away. However an Army ambulance was waiting and soon Hans was in bed in the hospital, the Professor taking over his care and treatment from the Briti h doctor and sister. This very essential handing over would not have been possible had the helicopter not been available to return the British party to Hanover in time to fly back to a fog covered England the same evening.

The entire journey went like a military operation and at the end of a long and quite nerve-racking day the party reached home with a great feeling of satisfaction and achievement. There is no doubt that the trip was a classic example of what ordinary people can do if their intention is strong enough. Unfortunately there must be many such tragic cases occurring from time to time, and one wonders what happens to those less fortunate and for whom the official authorities appear to have no suitable machinery? Probably such patien ts are for mally discharged from hospital, leaving the distressed relatives to do the best they can, often involving themselves in debts which will take many years to repay.

Hans continues to make slight improvement since being cared for in his homeland; the Rotary Club of Gottingen has agreed to assume the resposibility for helping the Meyer family in the same way as did their colleagues in Epping.

The whole sequence of events which led to the repatriation of Hans by air through voluntary efforts was the seed from which the St. John Ambulance Air Wing sprung. Sixteen members of the Combined Division sponsored by our hospi tal had taken Air Attendant Courses, the superintendent was professionally connected with the Metropolitan Police Traffic Control, and gradually other pilots followed Mr. Thurston's example in offering us their services for 'mercy flights', whether for the transport or patients, or of organs for emergency transplant. Thus, by showing compassion to one gravely injured German boy and his family, we were privileged to take the first step towards bringll1g into being an ancillary service of St. John Ambulance which we believe has great potentialities for the future.

Hans is brought to the plane. Mrs. Meyer (right) with author. (Left background)

The pilot Mr. Thurston

CUP GLORY

Prince William of Gloucester, Comma ndan t-in-Chief SJ A Corps and Divisions, will be present at the first night of 'Cup G l ory', a film te ll ing the story of a hundred years of the F.A Cup. The film, presented by the Football Association, will be shown at London's Shaftesbury Avenue cinema on June 5, and the proceeds from the premiere will be given to SJA, at the request of His R oya l Highness, in recognition of their services to football.

WHERE ARE YOU JOHNNY?

Over the past 2V2 years as editor of your R eview I have been delighted by the many interesting and informative articles sent to me by readers for publication. Especially I enjoy r eceiving articles which cover their s u bject in detail - such as those on m obile first-aid units or new headquarters which explain exactly why this was put there and that was put here.

Fo r it is this detail which make the working of the whole a success or not.

And for anyone about to venture on similar projects, such articles can be of g reat va lu e. For they communicate ideas.

Com mun icate ideas. This, I believe, shou ld be the main function of a magazine for a far-flung organisation su ch as St. J ohn. As in d ividual units dotted throu ghout Britain and the world our strength is imited. But as one vast organisation tie d together by a system of

THE FIRST ...

AROUND and

ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

communication, each unit has the strength of the whole. So we must pass information to and fro.

The reason for these rather high-falutin' thoughts at lOam (the time of writing this) is that very few articles from readers have dropped through my letter box of late. Is this because everyone is too busy to put pen to paper at this time of the year? Or is it because I've failed to communicate with you of late?

Well, whatever the reason, I am wide open for articles. Articles on any subject no matter how remotely connected with St J ohn. I know very few of us have been to Turkey's Anatolia of late - what fascinating reading was the article Valley of a Thousand Churches , and fine photographs - but I saw a party of our members in a Suffolk lane the other weekend covering a sponsored walk: a

Cadet Sergeant Janet Stafford is the first G r and Prior badge winner of Badsey (Worcs) Combined Cadet Division, which was formed in 1969. Looking at the badge, Divisional Superintendent Mrs Jeanne Ramsbottom says they're hoping for 10 more winners soon. ( P hoto Evesham Journal)

APPOINTMENTS

Be r muda Chairman of Council, Dr. Simon Frazer, OBE , TD, MB, BS , DPH

Cey lon: Association President, The Honourable Minister of Health.

Chairman, Professor Milroy Paul.

E sex: Captain M Bendix appointed Commissioner S. E. Area

Gib ralta r Mr. H. Payas (former Secretary) to be Deputy

Commissioner. Me L. Edmond to be Hon Secretary.

G u yana: Secretary of Council, Mrs. J Williams.

In dia: Major General S. S. Maitra to be Commissioner-in-Chief retaining appointment of Secretary-Gene ral.

Ma awi : Brigade Secretary, Mr. Kidney Enoch Mamganda.

Association Chairman; Mr. A A. Nijirenda.

Nigeria: Mr. Yiga Benson to be Se c retary of Council.

No r folk: Major E. H. C. Garmer appointed Commissioner Central Southern Area vice H. V Bussal!.

No r thants: Lt. Cdr. 1. W Ford to be C St. 1.A. and Commissioner Notti n g h ams hir e: Chairman of Council, Mr. K. D Williamson

step-by-step report of such a duty , with one member taking along a camera (black and white film) , would al 0 make interesting reading.

I shall be waiting for the postman

GROWING PAINS

The main item under discussion at the recent annua l meeting of the Oxfordshire's Ambrosden Cadet Division was, [ hear, that they wou d like to start an adult division.

A sign for the future?

WORTHY

A man whose dream came true during his two years as superintendent of Worthing's SJA Divisions, Mr G. Austin Prime, was congra tulated on his successful appeal for money to buy two ambu lances, at the divisions' annua l dinner recently.

The Mayor of Worthing presented him with matching cufflinks and tiepin, and

BY THE EDITOR

SISTERS ALL

said he was proud to have been able to hand over the keys of the ambulances in January.

Mr Prime took over as s uperintendent in 1970 when Mr C. W Carlton became ill. This year Mr Carlton resumed hi s post.

A re co rd of seven brigade marriages witllin the past year at Worthing was mark e d by the pre entation or' gifts trom the Mayor to the young co uples.

SISTERS

I have news of a Leeds family which should have the name St. John. They are fOllr sisters of the Byrne family, who between them have 1 128 duty hours to their credit since joining the Leeds

THE BOYS IN WHITE

Jacqueline , Pauline, Theresa and Eileenfou sisters who won everything. See story SISTE RS.

Victoria Nursing Cadet Division. Their service totals 18 years as cadets, 4 years asjuniors.

Jacqueline, l3 Yz, is a cadet, while Pauline, a cadet leader , and Theresa, a sergeant, are both 16 The eldest of this SJA quartet, Eileen, aged 17 V2 and now a sec retary, is a nursing member. At one time all four girls were members of Victoria Nursing Cadet team and held all the Divisional trophies as well as the Simp on Individual Area trophy for bed-making; they also held the Area First-aid League trophy. For their duty SJA W,sbech members turned out the other day for the first time in their new white working gear at a stock car meeting. (Photo: John Day, Wisbe ch).

hours, they hold three Special Service shields and two stars. The sisters, as will be seen from the photogra p h, all hold the Grand Prior Badge. This may not be a record family connection with St. J ohn, but by gum, it's a fine one.

BITING IDEA

I hear that five thousand toddlers in Southwark, Lon d on, will receive an unexpected birthday card this yearfrom Southwark Council. It is all part of the Council's campaign to contact youngsters to remind them (or thei r parents) that an early check on the state of their teeth is important.

Altogether some 5,000 will have a ca r d on their third birthday from the Dental staff of Southwark inviting them to have their teeth examined. The address of the nearest clinic, together with a reminder that treatment is free, is given on all cards.

Some of us not-so-toddlers wou l d find this scheme useful. Me for one.

ROAD USERS' COURSE

Details of a four-hour course on first-aid for road users , organised by Dr. T. Simpson, County Director SJAA Wiltshire , at Devlzes' town hall recently, will interest those planning similar courses. Programme: 11.00 - 13.00 hrs. Road casualties, the magnitude of the problem, position in Wiltshire. The situation in other countries. The cost to the nation, the suffering and the disability.

The cause of traffic accidents: Relationship to age groups, illness, aggression and intoxication. The cause of death and how this may be prevented.

Some thoughts on the prevention of traffic accidents.

Conduct and general management at 9

p e n e d wi th a n in tro du c t ory t a lk of tw e n ty mi n u tes o n the pr ese nt d ay p os iti o n o f roa d tr affi c acc id e n ts. Sp ec ia s tr ess w as ma d e of the co ndu c t a nd ge n e ral m a n ageme n a t the sce n e of a n acci d ent. T he means of p r e v e n tio n w as emp h asised. The care and m anage m e n t of f r actures was illustrated by d iagrams, by actual bones and by x-ray p c tur es.

All candidates took par t in the p r actical work of imb immobilisation, bl ee d ing and it control was similar y r eated 111 a practical manner. The u nconscious casua lty: every road user, in d ee d everyone, should be able to turn t h e uncon ciou patient onto the r ecovery position. Each member of the a ud ience ac t ed both as rescuer and resc u e d

The afternoon ses ion started with the f il m ' D on't l et him Die'. Thi was fo ll owe d by a brief explanation of b r eathing, the air passages and asphyxia.

Wiltshire's 4 hour course for road use s. (Left)

Demonstration of a fracture below the knee, and (below) there was plenty of audience participation. See story ROAD USERS COURSE.

Mr John Dane and his wife Eleanor - he's President of (Surrey) Shirley nursing cadets, she's President of the nursing division - celebrated their golden wedding recently. Sharing more than 100 years' first aid perlence, they have formed six SJA divisions In Croydon (Photo' The Advertiser, Croydon).

A demonstratIon of the Exhaled Air and Silvester methods of artificial respiration preceded audIence particlpatlUn. When delegates had mastered these techniques they were gUIded Into the combIned operation of artificial and external curdiac

The final session included many questions and answers. As cxpeL'led questions from an intelligent audience were relevant, in many Imtances reqUIring considerable clil1lcal experience for their appraisal.

Support was given by the presence of Major A. R. Carr, County and Colonel R. L. County Surgeon.

The equipment included umerous charts and diagrams. Skull and long bones.

X-rays of fn:lclures.

Slide and cine proJectors.

"\line resu ci annes.

Traffic lamp.

Reflecting cloth. Posters.

Blankets, splInts and bandages were kept to a minimum to encourage improvi ation, though various splints and bandages were demonstrated to show the ideal that should be aimed at in improvisation.

Dr. Simpson suid he very much appreCiated assIstance given by hIS colleague Surgeon Commander D. 1:.. Day, many lay instructors and help from

o th ers too numero u s to men ion. Much appreciated features were short ta l ks by a Fire- B rigade Officer, 'Your car on f ire', a n d by a Po ice I nspector, Traffic Branch, 'Conduct at the scene of an incident'. The last words were left to the lady Chairman; 'A most enjoyable and worthwhile course.

WARM WELCOME

During the visit of the Queen and the Duke of Edinburgh to Mauritius during March 302 Brigade members turned out for first-aid duties, working 3,886 hours and treating 307 cases. But there were no serious casualties; most cases were fain tlllgs.

I AT RAN DO M

NURSES' WEEK

The next London nursing exhibitio n will be he ld in the Seymour H a ll , L o n don, WI , from October 16 20. The exhibition, the 57th year in the series, provides Britain's major display of new equipment, products and services for members of the nursing profession.

7pm and Fri d ay October 20, when it will open at 9 30am and close at 5pm, the dai ly opening ho u rs will be from 9.30am to 6.30am.

The London Nursing Exhibition and Nurses and Midwi ves Conference, which will be open to the nursing and medical profession only, is sponsored by ( ursing

The associated Nurses and Midwives Conference, taking place in the same hall throughout the duration of the exhibition, will again offer visitors the opportunity to altend lectures on specialist subjects by some of the most eminent authorities in the medical world. Mirror'.

A part from Monday October 16, when the exhibition will be open from II am to

(continued from page 1)

supported by a strong represenLaLion from other Divisions in We t Cornwall, the Mayor and Corporation honoured the I lelston Divl'iions of the Brigade by gruntJl1g them the Freedom of the Boruugh the first tIme, I believe, that such as honour has ever been accorded to L John DIVision.

I was deltghted WIth the warmth of the CornIsh welcome, and particularly enjoyed meeting and talking to so many Brigade members, from the olde to the youngest, at an informal tea-party after the ceremony. Cornwall is one of the very few places where the Brigade still takes a major share in operating the county ambulance service, and I had the special pleasure of being shown round the Helston Ambulance Station and seeing their vehIcles and equIpment, which brought me nostalgic memories of the days when I used to do ambulance attendant's duties

Then my kind host (r.lajor-General Hall, Commander S.l.A. and Commissioner) took me on to the lovely gardens at Boconnoc, near l.oSlwithlcl, which had been generously opened to the public that day in aid of St lohn Ambulance, and in spite of the counter-uttraction at lI elston had been Viewed by 700 visitors with estimated proceeds of well over .c 100. Altogether it was a very happy and heartening weekend.

PROMOTION TESTING

I hl' Oxon and Bucks truining course was a development, hared by two neighbouring countie of an experiment (tried by Bucks in two previous years) in tesLing the fitness of officer for promotion by assessment over J period of three days a residential weekend at an Oxford college, followed by a ingle day at a site lJ1 North Bucks a month later, with a little homework to do in between. 24 candidates altended and were divided into four groups of six, which howed them by practical experIence the value of working in mall group. a method of trainll1g and practice of which all Loo little use i made in our divl JOnal ll1strucllOnal meetings.

The programme of the course covered every section of the syllubus of parts I and II of the Officers' Promotion Examination, and although in the early stages of the course there were inevitably some lecture- es ions given to the cour e as a whole, the main empha is was on practice and practice in small group where individual attention could be given to each.

I was, in effect, a training in the development of leadership through putting across to others the various skill and activities with which every divi ion is involved; and it also included the pracUce of actually filling in the BPI forms of an imaginary division of which details were provided. Each group prepared, and described to the others, n six months' divisional programme; each half-group prepared in detai l the programme of one divisiona l instructional meeting, and then actually carried out part of it, Ll. ing the rest of the course as the division (for this item the course was subdivided according to whether they worked with

A FIRST Congratulations to S A nursing member Mrs I ris K night, who has been a City Councillor of B ristol for many years, upon her becoming the Sheriff of Bristol. This is the first time that Bristol has appointed a woman sheriff of the city.

adults or cadets); each candidate prepared a ten-minute talk and then gave it to the rest of his or her group.

The candidates were assessed on their performance throughout the course by a team of staff officers representing both counties, and a confidential report was afterwards sent to Area Com missioners (with co pie to Commissioners, County Superintendents and C.S.Os. for Cadets) indicating the candidates' standard of achievement and, where appropriate, any weaknesses observed. As with all such forms of training, an immense amount depends on the help that candidates have received from their Area staff before they attend, as well as on the follow-up that is given afterwards. But by and large, both countie seemed delighted with the experiment, and the candidates themselves were enthusiastic about the benefits of being assessed for promotion on a course of this kind, rather than undergoing the more conventional and often less effective type of examination; they particularly welcomed meeting and sharing their experiences with others on the course, and there is no doubt that they were all converted to the 'group' method of training and practice, which several admitted that they had never met before.

Certainly, if you want to know how any method of training works, there's no better way of finding out than by being subjected to

NEVER GIVE UP

I well remember, some fifteen years ago, a young P ost Office worker who came by direction of his employers on an Association course operated by my Division. He didn't easily a imilate the fir t aid training, and when it came to being examined he suffered badly from nerves and found that in pracLical work 'all his fingers turned into thumbs'; but he was very keen, and he just managed to scrape through. He at once joined the Division rather unpromi ing material, you might ay, especially when he had the misfortune to fail his first re-exam; but what he lacked in examination technique he made up for 111 determination, and with plenty of encouragement and further training he managed to pa s in a upplementary'. From that day to thi he never looked back: a few year ago he was awarded a Letter of Commendation for rendering fir't aid at a road accident in peculiarly difficult and distressing circumstances; he wa recently promoted to corporal, and mu now have nearly qualified for his Service Medal; and I've just heard that thi year he won the cup for the best performance in the individual test in his county competitions. If he should read the e words 1 hope he'll forgive me for telling his story as an encouragement to others never to give up trying, even in the face of etback and apparent failure, to give of their be t in the Service of Mankindand a uredly they will reap their reward.

BURNS the cause, nature and treatment

by R W Barker,MB , BS , MRCS

THIS ARTICLE, specially written for first-aiders, is an adaptation of a lecture given to the 210 (London Electricity) Combined Ambulance and ursing Division. Its aim is to enable a clear e r understanding of the underlying principles, and I hope it will help first-aiders to deal correctly with what is usually a frightening condition found in the office, home or work site: burns.

Summary of aspects to be considered:

Definition

Skin structure

Causes

Causation

Common sites

Aims of treatment

Method of treatment

Defin ion

There is much misconception and loose thinking about the term 'burn'.

Differentiation into the dry burns and wet scalds is unnecessary. An adequate definition of the 'burn' would be: the destruction of tissue (usually skin but possibly fat and muscle) caused by contact with heat or corrosive chemicals.

Understanding is further clouded by the classification into 1st, 2nd and 3rd degree burns. Only two terms are required: partial or full, and these terms relate directly to the extent of damage, severity and the processes of healing. Partial thickness burns are of a less serious nature and usually heal completely. Full thickness burns are serious in nature, heal very slowly, and may cause considerable sca rr ing

The nature of skin

This is the outer covering of the body. It is divided into several layers: the 12

outermost, the epidermis, horny and protective; the underlying layer is ca lled the dermis. At the junction of the two arc special cells known as the growing layer. These project into the epidermis, their function being to replace d amaged epithelium. Here is the link bet ween theory and practice It is in third degree or full thickness burns that these papillae have been damaged and thus regeneration cannot occur; only scarring.

C auses

These abound all around us in every day life and account for the frequency of burns in medical practice. They can be tabulated as:

Dry heat

Moist heat

Chemicals

Examples are: Fire Flame Friction

Steam Phosph or us

Acids Carbolic

Alkali Battery fluid

The eyes are particularly vulnerable to corrosive liquids, which cause a c hemi ca l burn. The first-aider really has a most important role to play in the treatment of these burns, for it is he or she who will save the sight of the affected person. Thirty minutes later in hospital , when the doctor sees the patient, perman ent damage will already have been done.

Cau s ation

This is of course a complex subject.

The first-aider however should realise that there are two elements. The first is the direct action of heat causing redness, and the cellular damage causing the release of chemicals which act in a vicious circle to cause more serious and perhaps irreparable damage There is no value in

antidote is COLD WATER.

[t is important to co nsid er one or two general direction s b e fo re we discuss specific Ircatment.

First aid s hould alw(lYs be rendered sensibly. This means thinking before acLing. Remember thal a fire u ses up oxygen, and a lack of oxygen will cause suffocation to the first-aider. If a patient ha s been e l ec tro c uted th e current mu st be turned off by some means before he can be touched.

The method of treatment, we hope, will achieve the aims of treatment. (a) Remove the sou r ce of bumlllg

This WIll mean r emoving a patient who has fallen on to an electric fire, washing away chemicals from the skin or eyes. This should always be done with water or a solution of normal saline (0.9 % aC I) , adequately and for some time in the case of the eye, and ammonia burns, for 5 10 minules.

Special r eference, at this point, should be made of hot compound burns. There is some difference of opinion regarding

listing the chemical involved, suffice it to say that hi stami n e is the prototype

The common sites for burns

These hardly need any mention They are the hands, face including the eyes, forearms and legs. It IS worthy of note that the incidence of this painful injUry is greater in young chi ldr en and the elderly

Aims of treatment

We should fir't consider what we hope to achieve by ollr treatment and by thiS means reach a rational method. The aims are simple and can be listed thus

a) Remove the SOLlrce of burnlllg.

b) H alt the action 01 the agent Jnd reverse the actlon of the agent, if possihle.

c) Reduce swelling and alleviate pain.

d) Pr event subsequent infection.

e) Obtain medical aid if neceSS<IrY.

This list has no order of importance or merit. It Just a plan of action. Most people would agree, especially if th ey have experienced a burn, that the IllOst important firsl aid measure is the reliej' of palll. One pOlnl not in the above li st is that of reassurance of the patient, especially in the case of a c hild To s uffer a burn L a most frightening exper ence and these accidents tend lo happen in the worst possible co nditions

Method of treatment

The motto for first aid tr eatment of burns , in IllOSt cases, s hould be: 'PUT THE FIRE OUT WITH COLD WATER.

This brings out two important points

The first is that human flesh can actually burn at quite low temperatures and, secondly, that the most readily available

their treatm ent but from the first aid point of view the co mpound should be left on the skin and the whole mass cooled with water.

(b) flalt and re ve rse the action of the agent

This comes down to putting the fire out and coo ling the tissues, a nd can be done by smothering the flames, i.e. wrapping the cas ualty in a fire blanket or a rug and cooling the part in cold water.

(c) R educe swelling and alleviate pain

Swelling can be reduced by removing any constricting band s such as straps, jewellery, rings, etc., and then by simple elevation of the part, e.g. a hand or arm should be placed in a high-arm s ling.

The pain of burns will be relieved by col d water and cooli ng, and is greatly ameliorated by strong rea ss uran ce. The la tter is of prime importance in c hildren.

(d) The prevention of subsequent illj'ectlO 11

This is essential and where most untrained first aid falls down heavily

MOBILE FIRSTAID UNIT FOR ...

A IllobJle first-aid unit, modified and renovated by Denby Dale Round Table, was handed over to the West Riding Yorkshire's Dearne Valley Combined Dlvi slon recently by the chairman of the Round rabie, \1r. John Bradley

The unit is a caravan wluch had been bought by the DlVI Ion With the idea of making it into a mobile fiL t-aid unit when funds would allow , but the Round Table offered to pay for the modifications (lnd re-fitting.

The unit is equipped with Calor Gas and factlitie for electric lighting while blankets were supplied by the Cadet Divi ions. Credit mLlst go to three members of the Division, Mr. M. eastwood, Mr. R Thompson and Mr. I. Morrison, for the tremendous work they put in to the unit , and without whose help the cost would have been much higher.

At the presentation was the Area Supt. C. Chappell (A) and Area Supt. I f. L. Pea ce (J ), and member and friends of the Divi sion.

The Dearne Valley Division must be one of the best equipped Divisions for their size in SL. John Alreudy they own two molor ambulance and now have the mobil e unit.

Contamination will be caused if the burn is touched or covered with any lotion. The temptation to prick blisters should be strongly resisted. If the burn has to be touched, please try to wash your hands first. The burn should be covered with a clean, dry, sterile dressing and if this not a vailable , a good alternative is a clean handkerchief that has been ironed this is almost sterile.

(e) Medical aid Mo s burns do require qualified treatment by a nurse or doctor. Minor burns are often treated by hou se hold remedies, i.e., acriflavine dressing s, and heal satisfactorily. One important exception is electrical burns. The se may initially only affect a small area but subsequently a large area of skin necrosi s may occur.

I h o pe that the above outline will be of some help to first-aiders, even if it is only for the treatment of their own burns in the kitchen.

( R eprinted j'rom the Electricity Council's Ambulance Bulletin)

(Above) The presentation. ( Right Div Supt. J. L Springer and 0 /0 A. Lockwood with Mr J. Bradley, chairman of the Round Table (Photo: top, Holmfirth Express right, HUddersfield Examiner)

Ko/ossi Castle

A VISIT TO KOLOSSI - A MOST MEMORABLE OCCASION

A PART OF THE ORDER'S HISTORY IN CYPRUS

by Alan Sharkey

KOLOSS [ CASTLE TODAY dominates the surrounding countryside of Cyprus much as it must have done five centuries ago. The remarkably well preserved keep presents a gaunt, formidable s ight for sever:.JI miks around. The peace and tranquillity of the impres ive ca tie is shattered only by the occasional roar of aircraft from the nearby RAF base at Akrotiri.

The name of Kolo si wa first brought to public notice in 1191 when destiny turned Richard the Lionheart aside from his long delayed journey to Palestine at the time of the Third Crusade. The hostile treatment of part of the Crusader fleet at the hands of Isaac Comncnus, the self-appointed ruler of Cyprus and ally of Saladm, caused Richard to determine that he would subjugate Cyprus before proceeding further. It was at Kolossl that Isaac Comnenus was defeated by Richard in battle. Shortly afterwards Richard and the Prince s Berengaria of avarre were married at the nearby port of LimassoL Kolossi and its estates were the h ome of the Knights Hospitaller of the Ord e r of S1. John of Jerusalem only from 1291 to 1309 but had first been acquired by the Knights in 1210 and remained an important possession of the Order for over three hundred years. Shortly before 1210 , when the headquarters of the Order were at A c re , a contingent of Hospitallers had been present in Cyprus for the purpose of helping to maintain the recently established Latin authority on behalf of the ruling Lusignan family. [n 1210 the Kolossi estates were given to the Order by fifteen year old King Hugh I of Cyprus, no doubt as a reward for the services of the Knight. If a castle did not already exist then one was certainly built at that time.

In 1291 Acre, virtually the last bastion of Frankish Outremer, finally fell to the Saracens. The Order of St. John and the Order of the Temple both established temporary headquarters in Cyprus at Limassol and shortly afterwards Kolossi Castle was established as the Hospitallers' headquarters. Kolossi came into the possession of the Templars for a short period, possibly in 1306 when King Henry II of Cyprus was deposed by his 14

brother Amaury of Tyre who was supported by the Grand Master of the Temple. The Templars however, no longer with a specific function to perform, rapidly lost s upport and finally in 1308 their property was confiscated and granted to the Hospitallers. K o lossi and its estates were thus returned t o the Hospit a ller s who had meanwhile been seeking a more suitable dom a in for a permanent headquarter s.

The domain sought by the Order was found at Rhodes, the little Island that became the Order's headquarters for two centuries, bridging the two great eras in the Order 's history. Meanwhile Kol ossi Cas tie, the villages, vineyards and sugar-cane plantations which together comprised the Grand Commandery of Cyprus thrived until they became one of the Order's riche s t possessions. A little of the history of the Order is kept alive today by the sale of wine still made from the grapes of the vineyards of Kolo ssi and sold under the name of 'Commanderie SL John'. This period of prosperity was however threatened by the continued struggle of the Genoese, V ene tians and Egyptians to gain control of the island.

[ n 1488 Queen Catherine Cornaro who then ruled Cyprus was persuaded by her brother, Giorgio Cornaro, to abdicate in favour of the Venetian Republic. He was rewarded by being granted the estate and property which then formed the Commandery of Kolossi. The estates were confiscated by the Turk s on their conquest of Cyprus in 1570 but the title of Grand Commander remained with the Cornaro family until 1799.

Following the Turkish conquest the estates became divided and like the castle passed through many hands. [n 1913 the Order of S1. John in England purchased a mall portion of t he castle and outbui ldings from ninety Turkish Cypriot villagers. The remaining portion was purchased in 1930 by the Government of Cyprus whose Department of Antiquities now undertake the resposibility [or the upkeep of the castle and its grounds.

Kolossi Castle is by no means suc h a spectacle as some of the Crusader cast le s, such as the Krak des Chevaliers, but is

nevertheless very striking. The keep's appearance of olid impr egnabi lity is no i llusion for the eventy five foot high walls are nin e feet thick. The keep consists of three toreys which at one time werc believed to have been divided by wooden flooring. 1 he three large rooms of the lower storey were oflginal ly sto rer ooms and the keep wa entered dlTe ct ly into the econd floor. An area in front of the keep contained hy a walled yard includes what was prohab ly storage space and stables. A postern gate lead s fro m the y.lr d to the remaining foundations of what was at one time a circular tower built over the castle's well. About thirty yards to the east of the castle is a vaulted building bearing greater resemblunce to a chapel than the sugJr-cane processing factory It once was ortll ot the sugar factor) is the mill, the fInal d estlJ1atlO n of a medieval aquaduct wllich today still carnes water from the flver K ouri to Irrigate the surrounding land.

K olossi IS seven mile. from the port of Lim assol, which could make access a little difficult without an Independent means of transport. There i no railway on the island and the bus services are suited to local market times and are unlikely to be of help. Having arrived. visitors will normally find the castle open during hours of daylight except for the early afternoon when in common with most of Cyprus It IS likely to be closed from noo n until 3 pm. 1 here IS a small admission c harge and a leaflet can be obtained for 50 mil (five new pence) which serves as a guide. Cyprus is rich in histoflcal tr easures and at Kolossl as elsewhere 011 the island there is no need for the commerclaltrappings to be found at similar sites in EnglJnd. Also there unlikel y to be more than a few vIsitors at anyone time.

A viSit to K olossl mllst always rcmaln a most memorable occasion to anyone connected with the Order of S1. John or its foundations. It is easy to recall the scenes of battle or of gloriolls pageant that o nc e took place at this very spot beneath the same c lear blue skies and generous Medit erranean sun. If walls cou ld speak, what s ories indeed the walls of K o lo ssi Castle would have to tell

sugar factory taken from the battlements

NEW STYLE DR ESSES

from Mrs Margaret Boothman Chairman of the Advisory Sub-Committee on Nursing Uniforms

R eferring to the comments on nursing members aprons by Miss Sampson and Miss Wilson in the February and April Revi e ws fashion, practical n ecess ity and economy have all to be considered.

When the new-style dresses were brought in everyday wear of the apron was discontinued primarily due to a change of fashion, but it remained essential to have some form of protection fo r the dre ss when doing 'dirty work' (p ractical necessity). To enable members to continue wearing their existing aprons (economy) the halter strap was ingeniously devised to hold up the bib, as buttons on the bodice of the new dress were obviously out of the question.

I am glad that Miss Wilson consider the new dress to be very smart. This was the majority view of members when a questionnaire was sent to all Counties before the new-style was introduced. It has also remained the view of the majority after the new-style has been in general use for four years. Margaret Boothman

HE OR SHE

from Lt. Col. R. B. Robinson , County Staff Officer, Ambulance Cadets.

I see in the Review, April 1972, Around and About, that a lady has been appointed to be an SJA Area Commissioner, a job which, [ suppose, most would assume to be open only to men. [ personally have never made the mistake of assuming this, well knowing that the English word 'he' means 'he or she' and that 'man' means, in a suitable context, 'man or woman '. To confirm this, one only has to go to the 17th century langl,lage of the Bible and Prayer Book: eg, 'If any man sin, we have an advocate with the Father' or 'thou shalt not covet thy neighbour's house , nor his ox,' etc where clearly both sexes are comprehended.

My object, however, is not to parade my English but to suggest that a corollary of 'Women's Lib' is 'Men's Lib ', ie, that appointments usually regarded as open only to women are in fact open to suitab ly qualified men as well. I refer, of course, to nursing appointments in the Brigade being open to male SRNs, Just as the Area Commissioner is referred to in GRs as 'he', superintendents and staff officers (N) are referred to as 'she'. If 'he' means 'he or she' so surely, in a suitable context , does 'she' mean 'she or he'!

A concrete case occurred in my county some years back. We wanted to appoint a male SRN as area staff officer, nursing cadets. The proposal had the full support of both ambulance and nursing sides of the county staff at all levels, including, of co urse, the county superintendent and commissioner. It was rejected by Brigade HQ on the sole ground, as was made very clear , of the sex of the candidate

Now that, as you say, history has been made by Mrs Jeanne Mercer's appointment in Kent, it will presumably no longer be in order for Brigade HQ to reject a male for a nursing appointment solely on the grounds of his sex? This, of course, in no way prevent s the C-in-C or Supt-in-C from rejecting the candidate after inquiry into his personal suitability. Pewsey, Wilts R. B. Robinson

CONFUSION?

from J. G. de Mesquita

A 'training exercise at a Divisional Meeting set me thinking that competitions at the moment can lead to confusion because of the changeover in First Aid books

For example, the question that started it all was : 'What method of resuscitation would you use if mouth to mouth/nose could not be used?' The correct answer for competition was 'Sylvester', but that is in the old book. The new book gives preference to Hob.!r Neilson. gave rise to my thoughts: what are we learning, first aid or com\Jdit;on work?

If we are all first-3.iders, surely that come into being ]6

READERS VIEWS

Readers' views and opinions, which should be sent to the editor, although published are not necessarily endorsed by the editor or the Order of St. John and its Foundations. Although readers may sign published letters with a pen - name, writers must supply their name and address to the editor

with a new book should be as imminent as possible for all purposes. I realise so far as first aid courses are concerned this migh be a problem, but we do know when the new book is expected to come out.

!lfo rd, Essex

MEDALS

from W. J. L. Gotch, County Pool Officer

1. C de Mesquita

[ would like to support Miss Wil son's comments on admissions to the Order (April Review) which I have recently heard described as like 'dishing out Sunday School medals'. [ have wondered myself what are the actual qualifi cations. When I attended my investiture after 42 years service, with five bars to my Service medal I was definitely the Odd Man Out. [ had been through it all - NCO a ll grades, divisional officer, divisional superintendent and was astounded to see people there without even the ServIce medal many with just the medal, and some with one bar to it. There were a number of officers and commanders to be made, but I could find no one else with more than three bars. My thoughts , on being told by one r ecipient '1 thought we got a gold cross', were very much removed from the precincts of the Pri ory Church.

And the Service medal too, in my opinion, wants further consideration. It is the only medal that [ know of where a bar is awarded for less time that that which earned the medal, and to grant such for five years detracts from its value. The medal itself is one of the finest ever mad e and the former silve r ones were well worth having

My first bar read '5 Ye ars service' (changed later [or one of the present design, also in silver). Now with the seven an d eighth bar in the offing, the ribbon of the medal looks as though it's of metal. No amount of effort can make the bars all look alike, and the silver ones are clear ly difterent from the present white metal ones. Could not something be done to obviate this?

[ know that a 45-year certificate is awarded but that cannot be worn to show such service, and ou tside the Brigade the Service medal on its 'metal' ribbon has no mean ing

WeUingborough W. J L. Goutch

FLANDERS'

FIELDS

from A. R. Jones

To mark the ca det Jubilee , and as part of a leadership traming

course, A/M W. P ope, i/c the Bromborough, Eastham and P ort Sunlight Combined Cadet Division, organised a visit for cadets and adults to Belgium over the Easter holiday. The party was centred on the beautiful town of Bruges and visited many medieval places of interest.

Members of the party attended Holy Communion at the English Church on Easter Sunday, after which a visit was made to many of the first world war battlefields in West Flanders. Among the places visited were Spion Cop, Lill e Gate Cemetary the Menin Gate and St. Georges Chapel, Ypres. The visit was officia ll y recorded in the visitors' register of the War Graves Commission, to whom tribute should be paid for the very excellent way which they care for the monuments in their charge.

The visit ended with a trip to the Ostend shops and beach. Birkenhead A. R. Jones

THANKS from W L Ashmore, County Staff Officer(R) Notts.

As the author of the 1969 SL John Diamond Jubilee Memoirs, Malta, r would like to record my appreciation to those Brigade members in different countries who responded to my request to include their experiences in the compilation. Since many of them were similar to others I tried to extract that section applicable without undue repetition Further, I am grateful to those who have already paid tribute to our Maltese friends by purchasi ng copies of the Memoirs, since the proceeds from sales is donated to

Where ever the public enjoy them elves, things can go wrong In this case, it's a speedway track at Sun d erland. Local Corps members arc there

To quote from the programme of the very aware organisers of this track :

'We may not be top of the league, but we reckon our St. John group are Keeping up the standards they started here thi season, they really earn our prai es and gratitude. Thanks very much.'

'TIlis afternoon we have the opportunIty of a isting a body of people who are among the greatest friends that Speedway possesses, the St. John Ambulance Brigade. ThIS great organisation, who give their services completely free of charge, enables the sport to continue in spite of the trcmendous physical dangers Involved. At Sunderland we are partIcularly fortunate in that our local Brigade is an extremely live and well traIned branch and our riders arc full of praise for the way in whIch they carry ou their du ties. So when they move among you WIth theIr collec tin g boxes I know that YOll will all give generously'.

'The collection for the St. John Am bulance Brigade last week rai ed almost £30 From uch a modest sized crowd such as we enjoy that is not a bad effort. Personally I consider that 0 important are these good folk to Speedway that we should take anothcr co lle ction for them in the latter part of the season. 1'1\1 su re you'll all agree with me.'

Are the organiser of your spor ts events as appreciative of SJA coverage? If not, Jog their elbow.

Malta Brigade funds.

I am sure we were, and still are, most appreciative of their great efforts to provide friendship and hospitality.

Perhaps we may pause and wonder how they were able to cater for our entertainment and pleasure, many of a personal character, and ponder on the material dIfferences, regarding our separate industrial backgrounds.

One of the most rewarding and pleasant outcomes of those ce lebrations has been the close ties and associations developed between divisions and individuals. I 've had the pleasure of including reports of some of these in the book. When, at the beginning of the ce lebrations I decided to record them as tangible evidence of what so many of the l200 Brigade visitors expressed, I used the phrase 'come thick or thin'. Little did I think so many frustrations would occur not least of an industrial nature and then involvement in a fire in the publication of the book. For those reasons I am most grateful to our members who were kept waiting so long for the Memoirs ; an apt title addition would have been 'Resurgence'. In this respect [ would like to pay a special tribute to the distributor of the book, Mr. (A/S/O) w. F. Shaw, for his steadfastness in assisting with publication. Copies may still be obtained from him, pnce 23p. each (20p. in bulk) at 40 Furlong Avenue, Arnold, ottingham.

Despite any other atmosphere , it is encouraging to know that the spirit of St. John remains true and faithful.

Thrills. .. Spills and SJA

Nottingham

W L. Ashmore

NEWS from SCOTLAND

Stirlingshire

A constitution for the Stirlingshire Br anch of the St. John Association has been approved and the Rt. H on Viscount Young er of Leckie OBE, TD, had agreed to become its Honorary President. There is a tremendous enthusiasm in the area and it is proposed to raise £5,000 in the coming year to supply and equip a vehicle for transporting invalids in wheel chairs.

Perthshire and Angus

In the coming months [ shall have more

WALES

Four boys narrowly escaped drowning when they were trapped up to their waists in water for one-and-a-half hours on a sand bank in the Loughor Estuary near Bynea during April.

They were rescued by the SJA inshore rescue boat as light was failing and a fast-rising tide threatened to drown them.

One of the rescuers said the boys , 14 and lS-year-olds from Llanelli , would probably have drowned within another half an hour if they hadn't been picked up

All four were walking together when they got up to a banking and then found themselves trapped by the incoming tide.

it was the S1. John Am bu lan ce inshore rescue boat which finally picked up the boys and brought them back to safety.

The Superintendent of the res cue boat , My. Wilf Pitman, of Loughor, said that he was called out by the police who said that the four boys were stranded.

'We launched the boat', he said, 'Myself, Mr. Malcolm Davies and a volunteer from the boating club, and when we got there the boys were up to their waists in water.

'We took them to the shore. They were suffering from exposure, and were all soaking wet', he added.

Once on the shore the boys were taken to Llanelli General Hospital, but were

Police were unable to reach them, a nd to report on development in this part of Scotland. We are now looking forward to the establishment of a new committee in Perth and there is a strong possibility that the Order will be able to link up with the Glenshee Ski Re scue Service in the same way as the Aberdeen committee is associated with the Mountain Rescue Team. One cannot emphasise enough the importance of this news. The work of bringing aid to the vi c tims of accidents in the mountains or on the ski runs is not unlike the duty of the early Hospitallers:

NORTHERN IRELAND

The role of the trained first-aiders and casualty problems arising from terrorist activities in the province were among the matters dealt with by the Brigade at their fourth annual joint residential training course held at Greenmount Agricultural College, Muckamor e, April 8 and 9, and organised by Brigade Di strict Headquart ers, Belfa st.

Some 200 officers and members of ambulance and nursing division s, as well as cadet officers from all parts of the province, were presen 1. Speakers included Dr. N. C. Nevin, who presented a paper on Genetics , and Mr. 1. G Kinley, on sur g ica l casualties. Six syndicates di scussed the problems.

On Sunday following an

the succour of travellers, for that is what pilgrims were. And it is work particularly relevant to Scotland , because mountain climbing and skiing a r e drawing more and more to urists here each year. The Order is therefore ca rrying out a task which is in accord with it ideals; it IS providing services in a field whcre there is a real need for them: and it is doing somet hing which can be particularly associated with Scotland. What could be better? J. R - S.

Edi t : What indeed?

aggressive off-duty programme trained almost half of its 40,000 emp oyees to S1. John ce rtificate levels. Commenting on the dramati c new policy Dr. Bews, the company medical director, state d that in spite of this extensive programme, 'we have not always been able t o have the tra1l1ca people in the right location when required'. The new policy is ai med at correcting this through near saturation training of its personnel for St. John emergency course certificat ion

All employees with two years or more service will be eligible for the training, and in some instances when the requirements of a job make it ne cessary the course will be included as part of an initial training package for new em ployees. Employees will continue to be encouraged to take further St. J ohn training in their own time.

Initially the programme will train some 8,000 employees a year. ln struction will be given by full-time instructors working both in travelling teams and at training centres.

allowed home after a change of clothes.

Mr. Pitman described how the boys came to be trapped on the bank 'The tide was out and they walked onto the bank. The tide came in so fast that it cut them off complete ly.

The police were unable to get to them, and with a spring tide of 27ft. 8ins., they would have drowned in another half an hour.' he said.

Three weeks earlier this SJA re cue boat, which came into operation in April 1971, rescued a 20-year -old man who fell into the river from Loughor Bridge.

This rescue service was obviously needed in the area. We only hope the area shows its appreciation.

SL J ohn 111 Canada views thiS ambitious new programme as further evidence of the importance of first aid training to J 0 w e r t h r 0 ugh res u tan t sa f e ty consciousness, the accident rates both on and off the job, and in materially reducing the direct and indirect cost of those that do occur.

GIBRALTAR

Captain William Henry Keith IIoare has been promoted to Commander (Brother) of the Order. Captain Hoare is Vice Chairman of the St. John CounCIl, Bngade Commissioner and Association Director of the St. John Ambulance Gibraltar.

The appointment is announced of Surgeon Captain E. H. Murchison OBE, R (Retd) as Deputy Director of the St. John '\mbulance Association Gibraltar. Cap tain appointed a member of the St. John Council Gibraltar in 1966, will be responsible o the Director for a ll training within SJA locally.

JERUSALEM

Nurses prizes and long medal were recently presen ted to the s taff of the St. John Op h thalmic Ilospital by the Ho spitaller of the Order, \1r. T. Keith Lyle. \Irs. Labid asir and Mrs. Antone Albina (standing ex tr eme left photo above) were promoted to As ociate Officers (Si ter). The Anglican Archbishop in Jerusalem, the Most Reverend George Appleton (Sub Prelate of the Order) was al 0 present. (Right) With the Hospitaller (left) and the Warden, Dr. K. L. Batten, is Mr. a senior orderly, who has completed 43 years service at the hospital and is an Officer of the Order.

KENYA

interdenominational service, Mr. C. Kinah an, CBE, presented Long Service awards to 22 Brigade members who had given more than 440 years serv)ce.

The Northern Ireland Commissioner, Mr. D. S. Stephens, with his deputy Colonel J Hughe s and the District Superintendent (Nursing) Lady Roden , were present, as well as Di st ri ct and Area Staff Officers.

t is a so announced that Mr. He ctor Payas has been appointed Deputy Commissioner of the SJA Gibraltar. Me Paya sjoined the Brigade in December 1954.

Another announcement made is the appointment of Mrs. Magdalena Soleci as PrinCIpal Superintendent ( ursmg), responsible for all the lI ome ursing side of SI. John Ambulance Gibraltar. Mrs. Solcci joined the Brigade Nu rsing Division in 1958.

Other appointments made include Mr. F. Fe li ces as Area Superintendent, Mr. J Santos Staff Officer (Grade II), and !vir. L. Edmonds as honorar y District Secreta ry in place of Mr. Payas.

The Rotary Club of Nairobi North sent two local carvings to 40 Rotary Clubs throughout the world one to the raWed or auctioned in aid of a charity of their own choice and the other in aid of St. John Ambulance, Ken} a. The object of the scheme was to provide trainmg equipment, a film projector and screen, and to start a library of first-aid traming films, for SJA. The re'iponse has been very good and the presentation of the projector and screen took place recently when the Rotary Club president John Lydall (right in photo) presented the equipment to SJA's Principal Surgeon Dr. L. R. \\'hlttaker and \Ir. Javan \Iavisi, SJA's training officer for Kenya.

CANADA

Bell Canada has announced a major policy change in that effective next year

18

employees will receive first aid training in company time L ong a staunch supporter of S1. J ohn,

the company will mark the 50th Anniversary of its St. John Special Centre during 1972. Bell has through an

With the merger of the Association and Brigade into one under the name of St. John Ambulance Gibraltar, following the line in Britain , other promotions and appointments have also been announced. Among them are seven divisional superintendents, ixteen divi ional officers, five sergeants, seven co rporal s and three cadet lead e s. There a rc e ight active Divisions in Gibraltar. These arc Central, Cen tr a l Cadet, Police 'A', 'B' and 'C', ity Fire Brigade and Admir a lty Fire Service.

OVERSEAS NEWS (Contd.)

FILMS

CHRONIC BRONCHITIS - THE ENGLISH DISEASE (1964) (Colour

Spon

e Labor a t o ri es.

T h is fi l m shows aetiology, pathology and treatment of chronic bronchitis and emphysema demonstrated by case studies.

The panel considered this somewhat over-long and out-of-date as a medical teaching film. one the less the diagrams are fi rst- r ate and the three case historie well portrayed. It does carry a strong anti-smoking message.

Audience: Mainly medical and nursing students although advanced first-aiders may find it of interest value

IT COULDN'T HAPPEN TO ME (1963) (Colour 16 m n s.l Free

Di st r ibu te d b y: C e n ral F ilm Libr a r y, G ovt. Bld g., Br o m ya rd Ave, A cto n , Lond o n W3.

Sp o n or: J L yo n & Co Limit ed

This film endeavours to examine the causes of various types of accident and endeavours to alert staff to hazards.

The panel considered this a very good afety film indeed all incidents portrayed appear to be every day occurences and the w h ole film carries convictIOn in its accident prevention message.

Audience : Safety officers, factory workers and all first-aiders engaged in occu pa tional hea Ilh

HAND TO HAND (1964) Colour 11 m i n s Free

Di s tribut ed b y: Bow a t er -S cott F ilm L ibr a r y, Knig h ts bridg e, Lond o n SWl.

Spon o r Bo w ate r -Sc ott Cor po r a t io n

This fllm portray an Investigation into bacteriological condition of towels in offices, restaurant , kitchens, hospitals etc.

The panel considered this a very good publicity film that carries its mes age of the advi ability of paper towel with clarity.

The use of hacterial culture plates is effective.

Audience : Of great interest to fir. t-aiders showing bactenological contamination in a simple manner.

BEYOND CONCEPTION (1968) ( C o lou 45 m n s)

D i tr but e d b y: Co n co rd F ilm Co u nci l Nacto n , J p wic h , Suffo lk

Pr o du ce d b y : Popul a r D y n a mi c, U.S.A.

Thi fi m links conservation, population and family planning a nd stresses the problems caused by the rapidly growing population of the world.

The panel considered the film of interest from an ecology view point, but it is too lengthy, with distracting background music.

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and with a s low tempo ; without being chauvinistic the American dialogue, too, grates somewhat.

they are driving.

The panel considered this a very inte r esting film that sho ws the conduct of the test to have been licit; the colouring good,

photography excellent but the film is too lengthy for its content. Fundamentally , a misuse of film for the scientific result of the test is what has importance not a filmed record of its occurrence; none the less, the test result is impressive as a warning to all drivers.

Audience: Of general interest to all drivers but no specific St. John aspect.

(1963)

This film illustrates the work of the Talygarn R ehabilitation Centre in South Wales.

The panel was impressed with the film. Although not new it has great value not only within its own industry but to all interested in rehabilitation work - it is a st raightforward account of a patient from time of accident to return to work.

Audience: All within the 1 CB - also me d ical rehabilitation officers and physiotherapists.

DENTAL FI RST AID, Part 1: PA L LIATIVE TREATMENT (1970) Colour32mins

D is tr ibut e d and produ ce d b y: Min ist r y of De f en ce ( Admiralt y), Old A dmir a l ty Bldg. Whit e h a ll L o nd o n SW 1.

The film illustrates, by live action and animation. elementary first aid dental treatment which can be given by medical staff in the absence of a dental officer.

The panel found this film to be of absorbing interest. The treatment. colour, animation, commentary are all first class: the producers are to be co mplimented upon creating such a brilliant film upon a ubject that might appear unsympathetic_ This is a model training film.

Audience: Medical, medical tudents, dental officers and dental staff. Not of particular intere t to St. John.

PEOPLE WITH A PURPOSE (1971) (Colour 19 mins Free

Di t ribu te d b y: Sh e ll -Mex & B P Film Libr a r y, 2 5 The Burrough s, H e nd o n. L o nd o n N W4 4A T

The young farmer movement i described in the film showing how they invent their own entertainment and have exchange vi it projects which enable young farmer to gain experience from variolls farms.

The panel considered this a glossy production with good photography: the purpose for which the film is made is not c lear it pre ent the wide range of activities of the young farmers movement and possibly ha a recruitment value to pro pective member: otherwise its interest i localised to farm personnel.

Audience: Of interest as a 'filler' to rural audience but no immediate value to St. ] ohn audiences.

Occupational first aid in Wiltshire.

At a recent examination at Swindon the examiner closely watches administration of oxygen to a collapsed and cyanotic casualty. P hoto: Wiltshire Newspapers)

Mrs. M. Boothman presents the first Grand Prior badges to cadets - Beverley Kreamer, Carol Batt and Andrew Neate - of Eton Wick Combined Cadet

(Photo: Slough, Windsor & Eton Gazette)

News from the Divisions

con tinued doing so to the presell t. She went on to say how pleased she was that the Division had it own ambulance which, during 1971 a lone, had covcred about 1 100 miles, carrying patients and helping the physically handicapped, During 1971 members had completed 800 hours of public du ties, and 150 hOllrs hospital duty

Among the guests at the dinner was one of the original member s of No. 17 (N) Mrs. Simpson, now a sprightly 88 years, who was the Divisional Superintendent before handing over to her daugh ter, Mrs. Marjory Sweet, the pre ent Superintendent.

HANTS -At the Andover Centre's AGM, chaired by Mr. Cecil 1I0me, secretary Mr B. R. Somerville reported that 154 certificates had been gained through the Centre during the year and also that the requests for training had increased.

For the Divi ions, D/Supt. Mr. A Kyte reported that they would be in attcndance at 28 motor race meeting s, 7 hIli clJmbs, 13 gymkhana and other events, and went on to mention that a second ambulancc would b e purchased in the near fu ture.

A third annual chcque for £500 wa presented to Lady Cuthbert by Bonhomie

chairman Mr. B. J Davies. Bonhomie hopc to hand over a further £500 next year to clear the ou tstanding debt on the Andover SJA Headquarters building Receiving the cheque Lady Cuthbert said TIllS is a sign of how much Bonhomie appreciates the work that St. John does, a very big thank you to Bonhomie '. (See Photo)

LONDON -About 80 guests, membcr and friend of No. 17 (N) Ley ton & Leytonstone Division sat down to dinner recently to celebrate the Diamond Jubilee of the DIvision.

The chief guest wa' Di trict Supt. (N) Mrs. D. Hoadly, who proposed the Toast to the Division, and said that in 1912, when the division was started, women were considered very brave to undertake voluntary work of thi. nature, yet No. 17 Division grew steadily and in its 60 years has given a high tandard of servIce to the public in the sphere of voluntary ursing and FIrst Aid. Mrs. Hoadly reminded the party that in 1913 the Division commenced duty on the Wanstead Flats Fairground, and has

Enrolment and presentation evening of Great Yarmouth Combined Cadet Division County Commissioner Brig F P Barclay congratulated the Division on its increased strength and large number of awards gained (Photo: Great Yarmouth P ress Agency)

The first of the area competi tions for the Northern Area was held recently at the Sou thga te divisional headquarters in New Southgate. TIle most sought after trophy, the Senior Citizen's Cup, was won by a team from the 145 Eastern Enfield and Waltham Cross Nursing DiviSion. The con test, which is open to teams of two nursing members without previous compe tition experience, was won by Mrs. Dori Gooch and Mrs. Josephine Oakley, who Joined the Brigade at the end of June la st year.

They were trained for the competit ion in only two weeks by th e diVIsional officer Mr Margaret Stevem, of 194 Lea Valley Nursing Cadet Division, and nlirslIlg member Miss Coral Seabrook.

Mrs. Stevens and MISS Seabrook them,elves won the Mountgarrett Cup in the London Distri ct finals in 1971, and the area trophy (Doctors' Comforts Cup) in 1970 -7 1, and for the third year running at Whittington Hospital last January

Continued on next page.

With eight local teams competing, Andover Nursing

Lad y Bet t y Cuthbert receives a £500 cheque from Bonhomie chairman Mr. B J. Davies (right). See HANTS (Photo C E Wardell

REVI EW CROSSWORD No.6 (72) Compiled by W. A. Potter

ACROSS :

1. Secretion coughed up. (6). 5. Goddess has nothing .for sinuses of the skull. (6). 8 Initially an international orgamsatlOn for relief of distress. (5). 9. Dress ing the S.panish found over a door. (6). 10 U.S. soldier takes mixed balm a joint. (6). 11. Tea passed round in fungus infection of sktn. (5). 14. Please change in state of suspended consciousness. (6). l6 Allergy of those having great enthusiasm for winter fodder? (3.5) 18. A change of rest home may undo allergic skin re actIOn tn tuberculosis. (8.7). 20. Condition in which signs andsympt?ms of illness are present without organic ca u se. (8).22. Tldler l ess water. (6). 25. Pole in Ind ian territory. (5). 27. Tea a mixture for tapeworms. (6) 28. Physical or mental power app li ed. (6). 29. High-bridge nose. (5). 30. Bacilli formed resIstant state. (6). 31. Constituent of antiseptic mouth-w ash. (6)

DOWN:

1. B egins digestion of food. (6). 2. Bone by wonderful nature. (4). 3. Mathemati ca l form of sc le r OSIS? (8). 4. Par oxysms of expiratory dy s pnoea due to spas m of airwa>:,s. (9.6). 5. For a whim, vary surroundings o f general (6). 6: Ornate spheres. (4). 7 Nitrate used to de stroy excessIve (?). 12 Examine spilt tea with a will. (7). 13. D octor found WIld surroundings for large artery. (7). l5 Pol e and ol d Manx ktng full of regret. (5). 17. Slowly discharge fluid. (5) 19. Unctuous medication for an injured part. (8). 20. Herm a of stomach through oesophageal opening of diaphr agm. (6). 21. Trader employed to delay growth (6). 23. Cartel broken up In "oute of anaesthesia. (6). 24. Hard drug of ad d ic ti on unused tn man of valour. (4). 26. Warrant Offi ce r Roy al Marines, is a parasIte possibly (4).

SOLUTION TO CROSSWORD No 5 (72) ACROSS:

1. lll-f eeling; 6. A.gog; 9. St.a.m.in a; 10. Tympana; 12. Chyme; 13 Tri. c usp.id; 14. Boric acid; 17 Urea; 2 1. 22. Stone-de ad; 25. Trematode; 28. Oz.o.ne; 30. LenLl.go ; 31. Suicide; 32. Trip ; 33. My .as thenia

DOWN:

1. In.s ect; 2. Leaky ; 3. Epidemic; 4 L.eas.t ; 5. Nutrition;? Gr.asp; 8. Grand mal; 11. Maul ; 15. Ova ; 16 AetIOlogy ; 18. 19. Plat e.let; 20 Admonish; 23. Rami 24. Geneva ; 26. En.nUl; 27. Eases 29. Onion.

24

from the DIVISIONS (contd.)

London District Northern Area winners - (L to R) M iss Seabrook (Mou ntgarrett cup) Mrs Stevens, Mrs Higgs (with Doctors' Comforts cup), Mrs Gooch and Mrs Oakley (Senio r Citizen's cup)

SOMERSET -TIle new ambu an c e r ecently pu cha sed b y the Ch eddar Divi sion was dedicated a t a servi ce he ld re cently a t the Well of St J oh n a t the foot of th e famous Cheddar Gorge and attracted a good crowd Lt. Col. W D. H. Duke, the County Commis sioner praised the Divi sion for th eir achievement in a new ambu an ce and thanked aIL con cerned with the appeal to raise £2500 for the vehi cle Ar ea Commi lOn

DenniS Clark pointed out the urgent need for an ambulance at whI ch vIsIt ed by thousand of people every year. The first am bulan ce 111 19 3 1 cost £5 and shortly a fterwards wa s taken oyer by the DIVI Sion The l as on e was damaged in the floods of 1968 when it wa s washed down the Gorge while attempting to remov e a s ck woman from a house. The new ambulance , a Ford, is fully equippped with troll ey str e cher and hand stretcher , and flashing indi cators to u se at the scene of accid ents

During slimmer weekend s it will be parked at th e Cliff Hotel, who se owner have very kindly arrangcd t h iS

OBITUARY

Henry Ellis, 64, Chesterfi eld D erwent Area Commissioner. 30 years in the BrIgade. Officer Brother of the Order.

Beryl B. Green, 40 Nursing Offi ce r of Ev esham Combin ed DIviSi o n and very good friend of Bad ey Combln cd Divi ion.

Redruth Ambulance Division's 1971 competition team are almost lost among the trophies they gained last year Give em a chance, lads

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FUND RAISING

First Aid Training Is Essential BROWNINGS lTD.

AT RANDOM

by Watkin W. Williams

Deputy Commissioner -in -Chief

(he had three sep arate d o ct o rate s - in medi cine , music and theology) has alw ay s been one of the greatest of my per sonal heroes The story of his medical work in Lambarene in Western Eq uatori a l Africa is an epic which I never weary of re-reading , and one o f my favourite LPs is a record of Schweitz e r in his old age playing Bach's Toccata and Fugue in D Minor BWV 565. So you can imagine how

One o f the last photographs taken of Dr Alber Sc hwe i tzer, OM

thrilled I wa s to he a r th a t the Goethe F o und a tion of Bas le had a warded the Albert Schweit z er Gold Medal of 1972 to my friend Mr. Ch a d V a rad , founder of the Sam a rit a ns , and - till more ex c iting for all of us in St. J ol1n had also a w a rded one o f thi ye ar five Albert Sc hw e it z er Prize s to the St. John Ambulance Cadets. Further det a ils of thes e a w a rds will be found on page 20 , so I'll add no more here beyond expres ing our most heartfelt thanks to the Goethe Foundation for honouring ou r Cadets by the award of this international prize and saying what a privilege and inspiration it will be to them to receive it in their Golden Jubilee year.

MORE AWARDS

Another honour acco rded t o the Brigade during the past month has been the award of an OBE in the Queen s Birthday Hon o urs to Mr. Leonard Lee (Commander StJ A and Commissioner for the counties of Leicester and R utland) and to Mi s C. M Orton (lately County Superintendent ( ) for Warwi c kshire) , to b o th of whom we offer our sincerest c ongra tula tions

(con till li ed 0 11 page 1 1)

First aid training need NOT be dull

by G O HUGHES ClliefMed cal Officer, North Western Gas Board

FIRST AfD is a practical subject. The student should take a very active part in the learning process. Tel l ing and exp laining are not enough. Showing and practical work are very important.

Most people on industrial first aid courses are not accustomed to learning. It is much more difficult to teach fi r st-aiders than it is to teach graduates; yet how often have we spent hours in preparing a paper for a scientific meeting, but only min u tes in preparing a first aid lecture.

Few doctors are trained instructors, a l though some of us went to instructors' cou rses in the Forces, and these have proved to be most valuable. Doctors, by the nature of their work, acquire a skill in communicating, but this is on an individual level. It is hoped, therefore, that some guidance in teaching techniques will not cause anyone to fee l ins u lted.

Role of the doctor

What is the role of the doctor in first aid training? It is:

(I) To provoke interest and enthusiasm, quoting (but not too much) from personal experience.

(2) To put first aid in perspective in re lation to treatment generally, and to make sure that the important things a re underlined.

(3) To speak with authority derived from experience rather than just knowledge of a text book.

(4) By partlC lpatmg in first aid teaching to recognise the value of the first ai d er to the community.

T here are doctors who criticise first a id methods and teaching without doing much to improve them.

There a re ma n y justifiab le critic isms of the standard teaching manual. First-aiders are genera ll y not good at learning from books. They learn from their teachers and instructors. [ n a practical subject the showing of things is mo r e important than the text book

We usual y try to teach too much to first-yea r first-aiders. We should concentrate on essentials. For example, a detailed analys is of the causes of

tha t five first aid priorities should form the frame work for the whole of first aid teaching.

The wh o le of the first session shou ld be devoted to priorities so that even after the first lecture the student has some idea of the subject as a whole.

The priorities, best expressed In the form of question, are:

I. I. there any further DA GE R ']

2. Is he BREATH ING?

3. Is he BLEE Df NG (seriously)?

4. Is he UNCONSC I OUS?

5. fs he SHOC KED (seriously)?

The practical part of the first session should be concerned with keeping the airway open, and resuscitation. The order in which the rest of the course is taken is of no great moment.

of course, an Assistant Chief Medical Officer to Sr. John Ambulance Association.

unconsciousness takes up an hour or so of the standard course. The important thmgs to know are:

H ow to keep the airway open.

How to put someone in the coma position and still keep the airway open.

These things are ost in a mass of largely useless detail.

The doctor in his role as teacher must teach the es entials and make them come alive by relating them to reality.

Preparation of t e aching ma t e ri a

Preparation of teaching sessions (thi term is used deliberately rather than lectu res) req uires pIa nning It is suggested

Anatomy and phy iology need be done in out-line on y, preferably related to the re levant first aid subject.

I n dealing with the circulation of the blood the simple outline diagram (Fig. I) is adequate to explain the principle. I t is of no help in practical first aid to he ahle to recite the course of the blood through the lungs, body and various chambers of the heart.

Each session should include tile presentation of at least one dramatic practical and Vital subject. Examples of these are: Swallowed poisons. Burns and scalds. Shock.

Wounds and bleeding.

Artificial resuscitation.

Heart attacb

For tractured femur the first-aider in industry will have to deal with 763 L".l..,es of headache and 187 cases of stomach-ache (these are hypothetical figures to make a point)

CIRCULATION

examination is best done by using multiple-choice questions. Three or four sets of twenty are enough. The questiom should be mainly on treatment. It is easy to devise questions on anatomy, but the examination is in first ald, not anatomy.

A multiple-choice question paper can be completed in twenty minutes. The practical work can then be supervised. ft is suggested that four practical procedures be chosen as IJ1dicated from the sections shown III Fig. 3.

least likely to hear you. Ill' WIll be at the back of the room, near a noisy open window, weanng a hearing aid. It is possible to tell by hls expression whether he is receiving loud and clear. It is important to watch the reaellon of pupils and to adapt the presentation accordingly.

Don't gaze fixedly at the ceiling or any other point. You will find all your pupils ga zIng fixedly at that pomt too, wondering what you can see.

l)on'1 read from the book or even your own notes. Try to make It lively.

Don'( pace up and down like a cdged tiger.

/)on't go on in a dreary monotone, sub!>tltutlng for clear simplicity

Interm inab ly lengthy polysyllabic words unintelligible except to intellectuJls. Somconc will go to sleep.

It IS not pOSSIble to be too simple or too direct.

We all have manneflSIllS. some show up on a tdpe recordll1g. Of hers Me pointed out by fflend. [here are some teachers who arc so good that they feel In no need of any helpful cntlclsm.

I IS usetul in preparing teaching material to put this material under three headings (see hg. :?). Alternatively, T.W I. techniques can be used, breaking the teaching material JJ1to stages with emphasis on key points.

Most first aiders read papers like the Daill' Mirror or the Dail) Express First aid information should b'e fed to them in the style of these newspapers many headlines, short paragraphs many illustrations, dramatic detail highlighted, the dull pro aic material drastIcally re-written. The style of the Tlllles leader is not suitable for first aid teaching

The subject of a session should always be announced at the beginning. Then the class will know what you are supposed to be talk ing a bou t.

General rul es about le cturing

Lectures are best kept to less than forty minutes The times of maximum learning a re said to he the first ten minutes and the last five mJJ1utes.

Fig.1

Although first aid is a practical subject some of the teaching is an explaining activity. Speak to the member of the class

file tape recorder is a valuable Instrument for improvll1g a teacher's delivery. It may be useful as an occaslonal substitute for a doctor. If uSll1g thIS deVIce it is better to record the teaching session 'lIve' In front of a L"lass than it IS to speak '0 a solitary microphone.

Questi ons may be used as part of a tedchlng technique In a number of ways

As part of pr:.:.ct Ical \\ork to ensure ( h,lt the pu pil u nd ersta nds wha t he IS doing.

2.]'0 hreak up lectures Questiom asked dunng lectures should be addressed to the whole dJs:; so that all the puptls will thlllk Ollt an answer. Only after a pause should a Pd[tll.:ular pupil be asked to gIve the answer.

3. SIX quick multiple-choice type questions may be given with every lecture session. Pupils remember the an 'we rs to these questions even though they forget much of the other teaching.

Ex am in ati o ns r he examination forms sent Olit hy the first aid organis;ttions ;lre intended only as a guide.

The theoretical part of the

Vi su a l ai d s

Dr. R Ollerenshaw, Medical Illustration at University, says:

D i rector of Manchester ever use a film where slides will d o. ever use a slide where a blackboard will do

Never use a blackboard where a simple statement will do

Slides. We have often been shawn slides which are unreadable and incomprehensible. when scientifIC papers are being read. There are hundreds of slJdes available for teaching first aid. A large number of them are anatomical slides wh ich would be very useful If we were teachlllg anatomy. Others are unsuitable for other reasons [here is a relatively small number of really useful slides. Camera Talks Ltd., have a very good series on road accidents and British Rail have some on general first aid.

Filmstrips are best cut up and mounted as slides. This enables them to used In any 35 mm. projector Doing this also makes selection of slides possible. There are Some excellent 8 mm. slngle-concept loop films available on practlcal procedures. The projector is rather expenSIve, hut very useful.

Fi/Ills lhere are two films which are very useful :

I. 'Don't let him die'. 16 mm. sound/colour. 20 mins

2. 'E mergency ReSUSCitatIOn' Parts I , II, 1[1. 16 mm. sound'colour. 35 mll1S. Admiralty Training Film. (Both obtainable on purchJse from the Secretary, Visual \Ids, SJ A Headq uarters.)

Models for Emergency Resuscitat io n I Resusci- \nne or Andy a life-size tnflatable manikin costin o about (45. l'he seams split Jnd "are not e,ls), to repaIr but replacement parts are avallable. Additional part' make it po slhle to practise closed-chest cardIac massage.

2 The Ambu IS a heJd and chest model, also life size. ThIS, too, can be used to practise c1osed-che t cardiac massage <Ind costs about (45.

3. file Bryant 1\1anlkl11 is a simplified head and shoulders model whkh celn be used for mouth-t o- mouth resuSCitatIOn practlce. It costs ab ut.[ 15.

4. The Cheshire Wilson trainer consists of a face-pIece, a valve, a tube and disposable plastic bag. I t IS used over the face of a volunteer subject. It is useful and at £5 is perhaps the best buy for those on d limited budget.

The real visual aids of first aId are the first aid materials and the volunteers who act ClS patients. Triangular bandages Bowls Roller bandages Blankets LInt Stretchers

Prepared sterile dressings. early all these visual aids are available from The Stores Department. There i an Instructors' Handbook published by SL ] ohn whIch all medical lecturers should read.

FIrst-aIder are very necessary in mo t industries It is essenttal that they eire well trained. The medical officer in industry ha unique opportunities for training He WI]] often have industrial trail1lng aId available.

It could be that Cl first-alder may come to your help 111 our car crash so teach him well.

Fir t aid training need not be dull if the following rules are ob erved' Keep i t lively. Keep it practical. Keep it simple.

., .J

This article is printed witll acknowledgement to the Transactiolls of tile Society of Occllpational Medicine.

Dr. G. O. Hughes is,

The Department's headquarters today

The Story of SJA Guernsey's Transport

(Land, Sea and Air)

Department

THE DEPARTMENT owes its origins and present renown to Reginald H. Blanchford (now its Chief Officer) who, in late October 1930, was a young man motorcycling home one wet and dark evening.

His motor cycle was involved in a terrific crash with a passing taxi, and after being flung against a wall Reg Blanchford was left unconscious with multiple injuries and virtually dead. He was taken to hospital by private car, as at that time Guernsey owned only one decrepit ambulance and its part-time driver was not qualified in first aid.

Reg remained unconscious for eight days. Several times he came close to death As the patient slowly recovered he wanted to know what had happened and how he had got to hospital. Gradually he drew the information from the nursing staff, which in turn led to more questions.

R eg Blanchford's condition gradually improved. He learnt that if he had received expert first-aid treatment at the scene of the accident and proper

The history of the St John Ambulanc e Guernsey 's Transport Departmen t writtell and compiled by Staff Offi cer Ronald J. Herve, was recently published in book form and will be serialised in future issues of the ReJliew.

transport to hospital (although the men who had treated him had done thelr utmost), his injuries would not have been so severe, and he would have been less shocked. He also learnt that many people suffered, even died, for want of an efficient am bulance service on the island.

Four years had elapsed since Blanchford's accident. He was still undergoing surgical treatment in a London hospital and was wrestling in his mind with the problem confronting him.

One evening, whilst looking through a Guernsey newspaper which had been sent to him, he saw a small paragraph stating that the St. John Ambulance Brigade had formed a division in Guernsey and req uired recruits.

He discharged himself from hospital and returned to Guernsey

After joining the SL John Ambulan c e Brigade, Blanchford's first thoughts were for an ambulance the an s wer to the problem which had bothered him since the days shortly after his accident. If the Brigade could buy such a vehicle they could set up a rival service to that of the States of Guernsey (the island government)

Years of hard work followed. Officialdom, lack of enthusiasm on the part of many and money to finance the venture were finally overcome. In May 1936 the cargo boat from England brought Blanchford's purchase from Southampton a second-hand Talbot ambulance

In spite of recurring symptoms from his accident some six years previously, Blanchford toiled unceasingly to build up the newly formed St. John Ambulance service With volunteer help he manned the vehicle night and day He scoured the island for funds to maintain it and 0btain equipment. For three months he worked without wages. He campaigned for support.

By 1937, the main resistance to the service was broken. Local doctors fully acknowledged his efficiency and the work streamed m. [n 1938 the service conveyed 625 patients, treated 60 accident cases and the ambulance travelled 3,794 miles In December of 1939 the States agreed that St. John take over the island's ambulance service and further agreed to pay a £200 per year grant to the unit and to bear the cost of a new ambulance when necessary. The service was established

War

The long drawn out days of the occupation commenced on June 30 1940 , when early that Sunday evening German transport aircraft landed at the airport.

A week earlier, during the three days ending on June 23 some 23,000 islanders had availed themselv es of the opportunity to leave the island under the free evacuation scheme provided by the States. Blanchf6rd 2nd his team had ele c ted to remain in the-island to keep the service going and were kept working round the clo c k to assist in the removal to the waiting ships of the many who were sick and infirm.

Tw o days before the o c cupation c ommenced the Germans bombed St. Peter Port, causing death and injury to t he local populace in all over 30 people died and 47 were seriously inj ured A S t. John ambulance was machine gunnedkilling an already wounded patient inside the vehicle.

Within hours of their arrival the German authorities attempted the requisition of the ambulances This was strenuously resisted by Reg Blanchford who was eventually permitted to retain them. He was issued with petrol coupons, and with curfew permits to be on the streets during the night hours. Shortages of petrol tyres and batteries soon became apparent. Some alleviation was obtained

The first Guernsey St. John ambulance -a Talbot in 1936. Its garage formed the nucleus of the future station. and another garage was joined to it and eventually (in 1947) both were converted to become offices. control room and staff room

Ambulance and members in 1939. The first aid room had recently been built with a donation of £100

The first control room measured 6-foot square and had one telephone Mobile crews early in the

from the German stores with clandestine visit late at night by Blanchford and his men. Replacement parts for vehicles became extremely difficult to find, and many had to be improvised In the station's workshop.

Although there were fewer Islanders left to require the services of the war-time department. the Germans themselve made frequent use of Sl. John to carry their accident victim and wounded airmen from the airfield. fn 1940 the department conveyed 1,650 patients, treated 75 accident cases and travelled I 1,461 miles. By 1941 these figures had increased to 2,498. 181 and 17.198 respectively What in time of peace wa a routine ambulance call became during these years a hazardous mission. Crews answenng night emergency calls were often threatened by trigger happy German sentrie '. At great risk to themselve Sl. ] ohn personnel were called upon to rescue both German s and islanders from the many minefields sown on the cliffs and beaches. In 1942 the The second horse drawn ambulance 1944 45

Germ<Jns required a ll prospective deportees to be medica ll y examined, and the service made 340 journeys carrying persons to and from the examination centres for this purpose.

By 1942 the petrol situation became aggravated ancl Reg Blanchford successfully sought permission to buy French equipment to convert a vehi c le to run on charcoal gas. A. furniture van was acquired from the States department, which had commandeered all ownerless vehicles, and the necessary alterations took place. its engine was difficull to start, however, and was therefore kept for non-emergency calls, but it did perform invaluable work for the remainder of the war.

At short notice the Germans ordered the evacuation of the mental hospital, the town hospital and Les Cotils Nursing Home The department on all three occasions beat the deadline set by the Military authorities by getting the pat i e nts, their belongings and the furniture to a new abode in time.

Towards 1943 the station first-aid room was kept busy with patients sufrenng from lI1fected minor cuts and abrasions. as people by then had not the normal bodily resistance to infection.

Early in 1944. with the petrol situation becoming almost impossible a second conversion to charcoal took place; but within a short space of time, even this commodity became scarce and two special horse drawn ambulances were brought lI1to service and contll1ued until the end of hostilities

On Liberation Day. May 9 1945 , Reg Blanchford was able to report that during the occupation period a total of 86, 188 miles had been covered, that no patient ha d die d for lack of immediate ambulance transport, and no call for assistance had ever gone unanswered.

(To be continued)

I nterior of the second horse - drawn ambulance

AMBULANCE AND RESCUE Sf RVICE

"" This fascillating record of the deJlelopmel11 oper more thall 40 years of SJA Cllemsel"s sen'ices to the island comJnllllitv is available ill book [orm. price 4Sp inell/dillg postage, from tire St. J 011 Il A 111 b ulance Transport Depart mel/t, A I11blllance Statioll. Rohais Cllemsel', CI.

The control desk, 1945. Th is was part of the combined control room and staff room used during the war years and until 1946

AWARDS

It's always good to hear when any of our St. John members receive a National Honour and two of those who received on The Queen's Birthday an Honour directly connected with their services to St. J ohn Ambulance are referred to o n page 1 But if there 's no such direct connection it's almost impossible for us to be aware that they have been honoured unless we hear about it from their friends.

Three cases of this kind have been brought to our notice , and the fact that there are no doubt others that we don t know about need not deter us from congratulating the following on receiving a BEM in the recent Birthday Honours: Mr. F. Copsey (Ambulance Member , Banstead & District Combined Division) , for services as a security patrolman in BP Chemicals International ; Mrs. J. Reynolds , QARNNS (formerly a St. John Ambulance Naval V AD), for services as a head nurse in the Royal N avy ; and My. W H. Sparey (Divisional Superintendent, SE Gas Board & Mitcham Ambulance Division), for services as a gas fitter, South-eastern Gas Board

CAUGHT

Overheard at a London lunch-table the other day (a lady talking) : '[ took my first aid certificate at the Regent Street Polytechnic in October 1914 - and haven't been able to get away from S1. John since.'

CADET JUBILEE

Princess Anne, Commandant-in-Chief of the St. John Ambulance Cadets, will review 6,000 cadets in London's Hyde

AROUND and ABOUT

Park, on Sund ay July 23.

The review is the most important event of the Cadet Jubilee year and cadets from a ll ove r England will be taking part. 3000 of them will be from the London area but most counties will be represented Also represented will be five of the seven Founder Divisions which have remained active since 19 22.

CHANC ER Y A PPOINTM ENT

The vacant appointment in the Chancery of the Order at S1. John's Gate will be assumed forthwith by Mr. R obert Linge QPM. Mr. Linge retired this year from the Metropolitan Police F orce with the rank of Deputy Assistant Commissioner.

BUSY LONDO N

During th e months of May an d June London District has been having a bu sy time , apart from the r egular routine duties.

Major duties included Chelsea Flower Show , The Derby, and Beating R etreat on Horse Guards.

Possibly the largest duty was Trooping the Colour, when over 650 personnel were on duty This included 14 Brigade surgeons, 18 nursing officers and representative contingents and mobile

units from Sussex, Bu cks, Surrey, Essex, H a nts, Herts, Kent and West Riding , Yorks. Al though crowds were much arge r than usual only 158 people needed our help, six of whom were taken to hospital.

At the Int ernationa l Air Show at Biggin Hill , attended by over 100,000 people, the Brigade as usual provided full cover both for the flyers and the spectators. A aval Wes sex helicopter was assigned to S1. J ohn and throughout the three days of the show, a surgeon, male nurses and radio operator augmented the crew. On the last day the helicopter with its S1. John crew assisted on two occasions when a priva te plane crashed, injuring its two occupants, and a lso when parachutists dropped outside the airfield.

It was a most interesting experience for all who took part, and once again indicated in a positive manner that S1. John are always in the fore front.

At very short notice London District were also asked to provide adequa te cover for 1,500 French ex-Serv ice men and women who visited London, Berkshire and Surrey for an 18-hour day.

This group and their friends served under the famous General Le c erc, and the visit was called 'Exercise Leclerc'

An ambulance met them at Tilbury when the contingent disembarked from the' orthern Star', their floating hotel.

Boarding 30 coaches, the convoy was escorted by the a m bulance to We stm in ste r A b bey, where two further ambulances and a mobile unit with twenty personnel were in position for the tour of the Abbey and later a service at the Cenotaph, which was led by the band of the Garde Republ icaine.

At the end of the service two of the visitors were taken to hospital but were later discharged. fl was therefore decided that each group of coaches should have on board a St. J ohn member with radio so that contact cou ld be maintained with the escorting ambulance.

London District liaised with Berkshire

SJ A to provide amb ulance and personnel at Ascot Ra ce Course, where the party had a picnic lunch and at Windsor Castle where the Queen gave a garden party for the visitors L ater they visited the Fr ee Princess Margaret pauses to speak to County Staff Officer (Cadets) Mrs. S. E Francis while inspecting a guard of honour of SJA Cadets and Ranger Guides at Pembrokeshire recently (Photo Western Telegraph)

BY THE EDITOR

French section of Brookwood cemetary, where Su rrey provided first-aid cover. The party then returned to London and the Royal Albert Hall for a concert. (St. John members are always on duty at the R oyal Albert Hall).

At 11 pm an SJA ambulance escorted the happy but by now rather tired French visitors back to Tilbury.

NEW GIRL

Dame Barbara Cozens DBE, RRC, Chief ursing Officer of the Brigade since 1965, has retired and the new Chief ursing Officer is Miss Rosemary E Bailey, SR SCN, RNT MTD, Dip Nursing (London).

Miss Bailey, who joined the Brigade in 1955 commenced her career with midwifery training in 1944 , her general training was at Guys Ho pital, and she is now Principal ursing Officer (Education) of The Royal Free Hosptial, London While at Guys, Miss Bailey was Charge Midwife on District , and has a very real interest in the work and problems of Health Visitors and District Nurses

FREEDOM

We wish her the best of luck in her new appointment.

MEDICAL CONFERENCE

Many sources have reported that the Medical Conference held at ottingham University last April was the best ever. The many excellent speakers included Lt .- Colonel J. Adam of the Royal Herbert Hospital, who spoke most entertainingly on 'The 3 Rs of Climate '; Dr. Ken Walker told us of his experiences at motor racing (an article appears in this issue); and the Royal avy not only gave an excellen t lecture on 'Hazards of Underwater Activities' (Surgeon-Commander D. E. Mackay) but also a demonstration of the re-compression chamber by a team of R personnel.

The Mayor of Helston, Cornwall, inspects members of the town s SJA Division and County Staff before the ceremony at which the D vision rece ived the Honour of Adoption (right) - which is the equivalent to the Freedom of the Borough. Well

The Saturday afternoon was given over in its entirety to a seminar on 'Major Accidents' by three members of the Working Party following the Ibrox Disaster of January 1971, who talked of their experiences.

The Patterdale Mountain Rescue Team gave a demonstration on the Sunday morning to support a first rate talk by the team's founder, Dr. J Ogilvie. A heart-warming address by the Baroness Masham of I1ton on 'Sports and Leisure Activities for the Disabled' was a highlight on Sunday morning.

Our own Dr. Roger Pardoe with a great sense of fun, wound up the programme by telling us of his experience in igeria where he was posted on

At the recent East Midland Area first aid competitions, the H alton Combined Cadet Division (above) entered three teams, and took 1 st and 2nd places in nursing and 2nd in the ambulance cadet section Formidable. (Photo: The Yorkshire P ost)

tem porary S 1. J ohn duty

Films shown at the conference were on Cold and H ot Climate (Army), Deep-sea Diving (Navy), the premiere of a new nursing recruiting film 'One Way of Helping ', and also the new 20-minute film on the Order of St. John

It is hoped to publish in the R eview over the next few m onths some of the lectures given at the Medical Conference

We must congratulate the Medical Conference working party that put together such a fine programme, and in particular its chairman Dr. J immy Graham, the Deputy Surgeon-in-Chief.

A special note for all County Surgeons and County Nursing Officers make sure that your county is well represented at the next Medical Conference which takes pla ce at Nottingham University March 30 - April I (inclusive) 1973

GALLANT

The fo ll owing l etter, sent to me by PRO S. C. Bishop, appeared in the Coventry Evening Telegraph:

would like to thank through your newspaper a gentleman of the St. John Ambulance not for first-aid rendered but for cleaning my car.

I arrived wtih two friends at Welford canal basin and parked my green Imp next to where this man was c leaning his car. I jokin gl y said that if he wanted some more practice he cou ld clean my car as well.

When I returned an hour later to t h e car park, he and his car had disappeared and mine was spa rkli ng clean. As I don't know his name or address I can't thank him properly

10

from Help the Aged, 8 Denman Sl. Lond on, WI, or Wilson Insurance Brokers, 431 Lord St., Southport, The Kingsway Club, The Pr omenade, Southport, and The Grand Casino, Lord St, Southport.

Sounds as though it's going to be a great ouling.

MERRY ENGLAND

A reader kindly sent me the following poem which he fou nd in his o ld files. I is dated Mar ch 18 95 - the days of M erry England:

THE FIRST PATIENT t occurred on the nigh t of the Ambulance Dance, When the Ambulances combined

To have a good time after passing exams, And to give them relief of the mind.

Th e dance had been opened by Dr. A. J.

With a promising pupil his wife, And all were happy as bees in a sack, Both joy and perspirement were rife.

When the dancing was over the wraps were pu ton,

And th e frivollers homewardly went,

But the foremost fell ove r a man in the road,

Who seemed to be curiou ly ben t,

Thenjoy filled their hearts as they scented a case,

The first of the kll1d they had had,

So they took off their glo ves to examine him well,

This proves that there are some very nice people about still. (Miss) 1. H. Ro sbottom.

Wroughton, Nr. Swindon, Wilt s.

KNIGHTS FIGHT

A real live jousting tournament plus falconry, ox roasting, archery, jesters, minstrels and players, and a host of other olde Englande activities make up the programme of the Battle of Knights, an outdoor spectacle organised in aid of Help the Aged and St. John Ambulance at Meols Hall , Southport, Lancs over the August Bank H oliday weekend.

The event will be held on August 26, 27 and 28, from noon till 5 pm. Tickets (covered grandstand) £1.50, adults £ I, children SOp can be booked in advance

And inwardly prayed he was bad.

The man was unconsciou 'twas plall1 to be seen,

So ten pairs of hands felt his bones

And jerked them for crepitus, hunted for wounds, And tumbled him over the stone'.

By sixes and dozens the Ambulance maid

Came along with the Ambulance men,

And all of them closely exam ined the case

And gave their opinions then

But all their opinions were strictly distinct,

Each one had a different plan,

To bandage and treat and render first aid

To help the unfortunate man,

He had 'fractures' and 'sprain' from his toe s his brains

'Dislocations' of every kind

And ' his spine was contused' so each one produced

A bandage and started to bind.

'We know you ve passed H ome Nursing, Mr And e rson but must you wear that uniform?' (From Crusader, SJA Auckl an d, NZ, District Journal)

And everyone bound as their consciences decreed, Made splin ts of fans 'brollies' and sticks,

So when it was done the unfortunate one,

Was in an immovable fix.

li e so bandaged had been , until the Doctor (their teacher) was brought.

When th e Doctor drew nigh, and the sight met his eye

Then the Ambulance Co rp some silently swo re , And some grew as pallid as death

Of a man like a mummified king For they all had forgot (Oh negligent lot)

To examine the patient's br ea th,

With the Ambulance maids and the ambulance men , And the doctor arose (so gazed on their toe)

All gathered around in a ring.

li e feared for the worst, but examined him first

And finding no injury's trace,

With cynical air, he bent him down there

And smelt at the pa tien t's fa ce

AT RANDOM (continued from page 1)

Mr. Lee joined the Brigade as an Ambulance Member - or Priv ate', as they were called in those days - in 1928 and was promoted to Divisional Officer in 1935 Since then he has held seven other officer appointments at divisional, corps and county leyel, and became a Knight of Grace of the Order of St. J ohn in 196 7. Her Majesty's recognition of his 44 years' devoted service to St. John Ambulance will give special pleasure to all our members in Leicestershire and Rutland and to a wide circle of Mr. Lee's friends extending far beyond the boundaries of his command.

Miss Orton joined the Brigade in 1939 and three years later became County Superintendent ( ) for Warwickshire, a post which she held for 29 of her 32 years' Brigade service until her retirement in 1971. H er award in the Birthday Honours was for services to the l ocal community in Warwickshire; but among all who know her, none will need to be told that her work for St. John Ambulance has taken pride of place in that splendid record of community ervice, and this recognition of it will give them special joy.

NEW CERTIFICATE

The Cadets Golden Jubilee is to be marked by the inauguration of a Grand Pri or's Badge Certificate which will be presented to all those who qualify (or have qualified) for the Grand Prior's Badge o n or after J anuary 1 1972. This certificate will be comparable to those granted to holders of the Queen's Scout and Queen's Guide Badges and the Duke of Edinburgh's Award Whether you are 16 or 60, when you've spent several years working towards some great objective and have at last attained it, it gIves extra pleasure and encouragement if you can receive the visible symbol of that attainment at the earliest possible moment; and converse ly it can be very frustrating if you have to wait several months perhap even a year or more before your receive (and, if appropriate, wear) the award that YOll have worked so hard to earn.

This principle applies equally to the presentation of Service Medals and Bars, warrants of appointment and badges of rank, Association certificates, Grand Pri or's Badge and Cadets' proficiency certificates and, indeed, to the actual enrolment of Cadets. It isn't always easy to strike a right balance bet ween speed in arranging the prompt presentation of the award and the delays caused by finding an important enough occasion for presenting it ; but I must confess to the belief that quite apart from occasionally failing to apply promptly for these awardswe in St. John have in the past often erred on the side of waiting too long before the presentation is made As far as the Grand Prior 's Badge is concerned, this need no longer be a problem, for the Commissioner-in-Chief has particularly requested that in future those who gain the Grand Prior 's Badge shall receive and wear their badge (of which a small stock may be obtained in advance by counties on an order personally signed by their Commissioner) as soon as possible aller the application has been returned as approved by the Registrar's department at HQ The supply of badges must be bought from the stores department but

And he said things he ought to have thunk,

['o r the man on the ground they'd so carefully bound,

Was simply most awfully drunk

the certificates will be issued free and may be held at county office until a sufficiently important occasion arises for their presentation by a VIP.

OBJECT OF TRAINING

I'm always saddened when [ hear that conflict has arisen between the claims of Brigade 'training' and those of Brigade 'duties', for there should never be any cause for conflict between these two vitally important claims - they should indeed be complementary, and [ hope that Col. Pat Adams's articles on 'Training our Leaders' in the last two issues of the Review will have helped to make this clear.

When disagreement and sometimes even hostile rivalry between these claims occurs, the fault is never so lely on one side, because we're all of us fallible human beings who are apt in our enthusiasm to get our sense of priorities a little out of focus. If we never go to imaginative training courses and 'refreshers', then we shall not be able to perform our Brigade duties including the duties of leadership - as well as we should; we shall become stale, and less efficient in consequence; we shall ne ver have a chance of learning new ideas or of adapting our techinques to meet the challenge of an ever-changing pattern of life; we shall never be able to ore-charge our batteries'. If on the other hand we become mere 'training course addicts' we shall defeat our own purpose, because the sole object of our training is to enable us to do our job better.

Many year ago, when I first became a Scoutmaster and my Commissioner wanted me to go on a training course, I told him that I couldn't do so that year because I couldn't spare the time for b oth a training course and a Troop camp, and I couldn't let the boys down over their camp. He wisely advised me to reconsider that decision, saying that in the long run I would be doing a better job for my Scout Troop by attending a ten days' training course, even if it meant disappointing the boys of their c amp that Summer. I'm thankful to say that [ took his adviceand somehow managed to fit in the camp as well! Since then, many years experience of helping with the training of leaders both in Scouting and in St. John has convinced me that training must never be neglected if we are to carry out our duties properly : and yet, somehow or other we must 1 EVER let it be a question of 'either or' ALWA YS of 'both - and'.

NOSTALGIA

Turning from th e possibly sublime to the undoubtedly ridiculolls, r was thumbing through the page of memory the other day and came across an item that brought a wave of nostalgia which may be shared by other 'oldies' in our ranks. It wa a little ong that went something like this :

At Much-Binding-in-the Mar h

We have a very keen St. John Division; At Much-Binding-in-the- lar h We diagn o e our ca e with precision.

We make our patient comfy and his pulse we alway che 'k, And if he starts to argue when to hospital we trek

We tie a very tight constrictive bandage round his neckAt Much-binding-in-the-Marsh.

(J. H. Brooking).

(R)

AS DAME Lady Starmer, OBE

AS COMMAND E R ( B o ther)

Frank Raine-Allan, MBE, JP

Stuart Thomas Gordon Gray, MB, ChB

Walter William Cashmore, MA, MRCS, LRCP

AS COMMAN DE R (S is t er)

Margaret Betty, Mrs. Train

Emily Marjorie, Lady Pagan Brynhild Catherine, Mrs. Jervis Read OBE

AS ASSOCIATE COMMANDER (B rother) Professor Isaac Michaelson

AS OFFICER Brothe r!

Lieut-CoL Rupert Murdoch Youngson, MB, ChB, DTM&H, DO

Col. Alexander Matthew, DL

John Wilfrid Pickard, MB, ChB

Richard Edward Stanley Boden

Fernando Riccardo Alberto Semprini

Wardmaster Commander Douglas James Lionel Vaughan, RN

J ames Charles Miller

Victor Albert Huntington

Richard Webber, AIAO, FICAP

George Edward Joseph Porter, MRCS, LRCP Arthur Alfred William Weston, BEM

J ames Dowdy

Edward Mosley Frede r ick Walter Witch

Cecil William Bowyer

John Moon

James George Reid, MVO, MA, FRCS, MRCS, LRCP

I an Thomas Gomm

Roger Soame Jenyns

William George Liggett, MB, BCh, BAO

AS OFFICER Si ste r) Frances Vida, Miss Bray brooks Cynthia Felicity

Gladys Ethel Mary, Mrs. Pearne

Marjorie Edith, Miss Chapman

My r a Elizabeth, Mrs. MaUett, SRN,

MB, ChB, DObst,

Order Investiture

Muir, MB, ChB

Reginald Brown, OBE, LRCS, LMSSA

Major The Hon. Jeremy David Alfonso Mon so n

AS S ERV N G S STER

Joan Elizabeth, Mr s. Morris

Patricia Doreen, Mr s. Purdue SRN Bessie, Mrs. Pascoe

Marjori e Alice, Miss Smith, SRN, SCM

Joan Mary, Mr Ran son

Mary Ann, Mrs. Hoy ak

Dorothy Evelyn, Mis' Clay don

Nora, Mrs. Phillips

Margaret Ann, Mrs. Biggs

Winifred Mary, Mr Ayling

Grace, Miss Ingham

Ada Elizabeth, Mrs. Andrews

Wendy, Miss Dalkin , SR

Sylvia Jean, Mrs. Gurney

Ruby Williamina Watson, Miss Easson

Lily, Mis s Taylor

Gladys, Mr s. Walpole

Diana Adelaide, Miss Hand coc k, SR ,SCM

Olive Ethel, Mrs. Truman

Kathleen Lillian , Mrs. Deuchar

Eileen Rose Mrs. Haste, SRN

Lola Mrs Wainwright

Louisa Elizabeth, Mrs. Bond

Betty Mrs. Merryweather

Beryl Elizabeth, Mr s. Foulgar

Kathleen Elizabeth, Mrs. Smith

Sylvia Anne, Lady Wilkinson

Katherine May, Mi s Pax ton

Phyllis Walter s, Miss Furr

Alison Rebecca Mrs. Dobson

Lily Miss Bri c her

Anne, Mrs Weston

Pamela Ruth, Mi ss Burden

Emily Mabel, Mrs. Reeve

Evelyn Grace, Mrs. Patterson

Maud, Miss Lord Eva, Mrs. King

Phyllis Jane, Mrs. Pryle

Jean Valerie , Miss Cheryy

Liliam, Mrs. Heron

Margaret Lorna, Mr' Kirby

Edith Kathl een, Miss Tombs

Sir Henry Austin Strutt, KCVO, CB, Knight of Justice and Member of Chapter-General, introduced to the Lord Prior his personal Esquire - Arthur Harry Green

Lieut-General Sir William Pike, KCB CBE, DSO, Chief Commander St. John Ambulance

and Member of Chapter-General, introduced to the Lord Prior his Personal Esquires - Captain Hew William Roy ston Pike, and Flight

Lieutenant Richard Geoffry Elwell Pik e.

Lieut -Co lonel Arthur Goring. Knight of Justice

introduced to the Lord Prior his Per so nal Esquire - Jonathan Jame s Valentin e Elwes.

Lady Starmer, from Darlington, being invested as Dame

Mrs Ada E. Andrews, from Canvey Island, Essex - Serving Sister

Lt.- Col. Arthur Goring, Knight of Justice, introducing to the Lord Prior his Personal Esquire, Mr J J. V Elwes

From Colne, Lanes, Mr. John W Pickard invested as Officer (B rother)

Serving Brother - Mr V T. J. Button, from Biggleswade, Beds

From Canada, Mrs. Mary Ann HoysakServing Sister

ASHUNT -and the motor race medical

team has 2 to 3 minutes to save a life

by K. A. WALKER, MB, FRCS

IN ENGLAND there are 17 motor race circuits registered by the R.A .C. At Brands Hatch alone 45 car meetings are held each year together with numerous other speed events. For some St. J ohn divisions most of their public duty is spent at race ci r cuits.

First aid work at a motor race ci rcuit may present itself in three ways :

1. First aid to the public : This presents the same problems as those normally enco unt e red in providing facilities for a crow d in an open space; the crowds varying in size from 5 to 10 ,0 00 at a small meeting, to 50,000 or more at a large meeting

2. Management of a major accident: which at a motor race meeting is always a real possibility shou ld a car eave the circuit, shoot the barriers and hurtle into the crowd.

3. First aid to the racing driver in the event of an accident or as it is known in the racing business, a shunt. It is this latter group whi c h I want to talk about for it presents problems which are unique in first aid work Unique in that the medical and rescue teams are actually expecting an incident to occur; unique in that we know the area in which it will occur. The responsibility of the medi ca team is therefore a heavy one, for they must initiate resuscitation within 2 to 3 minutes under difficult and highly dangerous conditions, such as are not met with in any other form of first aid. The General Pr actitioner Accident Service of K en Easton cannot improve on 10 minutes - by which time a driver could have died from asphyxia, from haemorrhage or from burn s As in all first aid work the three fundamental principals of first ai d and rescue are:

1 To preserve life by ensuring that n o person dies from an injury that need not have proved fatal.

2 To prevent the injury s u staine d from becoming worse.

3. To promote recovery.

14

This article was gillen as a talk bl' Mr K. A. Walker at the St. Johll An;bulallce Medical Conference 1972, at Nottingham UniJJersity in April. Mr. Walker is Registrar (O rth opaedic) at the Westminster Hospital, as well as being a Sl John Ambulallce Divisional Surgeon.

I Severe burns

2. Obstruction to the airway

3. Severe haemorrhage

4 Severe brain damage

Severe burns

Fire is the racing driver's biggest fear. A racing car at the beginning of a race may carry something of the order of 40 gallons of high octane fuel. In the event of a fire the driver is protected for a period of not more than 20 seconds by his protective c lo thing. This should consist of nomex underwear and a flame-proof overall, socks of a similar material , gloves which fit tightly around the wrist with no bare skin intervening, a balaclava covering the mouth and neck and a helmet comp lete with visor. If he is able to free himself from the car within this period of time he will not be burned. If , on the other hand, he is trapped or unconscious and remains in the car for a longer period he will sustain severe burns.

The Author On a ra c ing circuit we have a high risk accident situation, the a re a of which is strictly limited It is the responsibility of the medical organisation to ensure that the basic principles of first aid are adhered to, and because the risk area is limited a service must be provided which will cope with any eventua l ity that may occur with in an extremely short period of time. From the moment of impact a driver with an obstructed a irw ay can hope to live for no more than 3 minutes before irrepairable brain damage occurs.

It must be accepted that motor racing is dangerous, or that death may occur as a result of injuries sustained in an accident, but if we are to ensure that no person dies from an injury which need n ot have proved fatal then the medi ca serv ices must be mobile and fully operationa l well within this period of time.

Let us lo ok at the causes of death following race track injury. These are:

extingu ish the flames and the two ligh t water men immediately behind to spray th e driver and cockp it a rea and to deaden the entire fire area in order to prevent flashback.

With dry powder alone there is no means of rapidly cooling the skin surface (i.e. the cold water treatment for burns) an d worse still control is rapidly lost" as more petrol is spi ll ed from the tanks onto the hot surface and flashback occurs. Once an area is covered with light water foam this cannot occur. Light water as a primary extinguishant, however, is too slow.

Even with this technique it must not be forgotten that it is the 'man' who puts out the fire, not the extinguisher, and in order to be able to do this considerable training is required.

The cost of a fire extinguisher is approximate ly £23. A refill of powder costs a further £4 . It will take a fortnight's full-time training to train a man in the use of extinguishers so that he has confidence to go in to the fire. The cost per man for such a short period of training is at lea s t £300. T o train a team offourwouldcost£1200. Once these men have been trained then refresher courses would be required at east twice a year. If a driver has no more than 20 seconds before he sustains severe burns then it is imperative that wherever the accident OCCLlrs a full fire fighting team must be fully operational in only a fraction of this time. It takes a minimum of 10 seconds to extinguish a race fire and it takes a further 6 seconds to fire an extinguisher and put it into operation. There is very

little time left for running, even if one could run With a 20 lb extinguisher. Suggestions of using high speed landrovers and helicopters would be far too slow for they would not reach the scene of the fire within the 20 second deadline. The cost of training 150 marshalls to cover the 25 posts at a circuit such as Brands Hatch would be approximately £30,000. As these posts are some 300 yards apart an incident occurring between the posts co uld not be cop e d wit h wit h 0 uta d d i i 0 na I fully-manned fire points. A s uggestion that firemen should be employed again is not feasib le for the ordinary fireman is not trained in fighting petrol fires and is certain ly not trained in the use of dry powder extinguishers.

From what I have said it is painfully obvious that we are just beginning to learn to cope with racing fires ]f we can extinguish a fire in the very early stages then there is no problem. On ce a fire has taken hold it is almost impossible to extinguish it in sufficient time to save the driver. I think that the long term solution to this problem must come from the constructors in devising a means of containing the fuel.

Airway obstruction

This occurs most co mmonly as a result of simple concussion in which the tongue fa lls to the back of the throat obstructing the airway. Other cau es are inhaled vomit, blood and foreign bodies which have been inhaled suc h as teeth from small plates, chewing gum and pithy skin from around the se gments of an orange.

resulting in oedema of the respiratory passages and displaced soft tissues from severe facial lacerations may a lso obstruct the airway. In a recent series of motor racing accidents of 23 drivers who had sustained head injury, no less than 9 or 39 % would have died from airway obstruction had they not had immediate medical assistance.

S evere haemorrhage

In severe haemorrhage, with rupture of the heart or aorta or avulsion of the lungs, death is inevitable. With lesser degrees of internal haemorrhage as for example, following a rupture of the spleen, there is usually time for resuscitation with intravenous fluids prior to surgery and indeed once the abdominal cavity fills with blood the intra abdominal pressure would rise and the rate of bl-ood loss will considerably decrease.

The commonest cause of haemorrhage on the race circuit is in to the site of closed fractures. It must never be forgotten that a closed fracture of the shaft of the femur can result in the loss of approximately 6 pints of blood into the soft tissue. The most that I have had to give for such an injury is 13 pints and of course in the case of multiple injuries the blood loss is rapidly multiplied. Amputations in race track injury are extremely rare and indeed with the avulsion of a limb or part of a limb it is usual for the artery to contract down and bleeding is minimal. It is probably fair to say that if the patient suffers an internal

The caLlse of death in a racing car fire is invariably asphyxia and even if the driver is not severely burned, it must always be remembered that the inhalation of hot gases may well result in severe burning of the pharynx and respiratory passages which can lead to airway ob truction from oedema and outpouring of fluid A driver who ustains a burn covering between 40 and 50% of his body surface area will invariably die even if treated in a specialist burns unit.

It was not my intention to discuss means of fire fighting but in view of the number of deaths of notable drivers in the last year and especiallly with the recent tragedy at Brands H atch I feel that a few words on this topic would not go amiss.

Following recent experiments we now know that it is impossible to extingu ish a racing car fire unless a minimum of two 251b Monex dry powder extinguishers and two 2 gallon light water extinguis h ers are used simu lt aneous ly

The technique is to have two operators going In with the dry powder to

h a emorrhag e wh ic h is so great that h e c annot surviv e the f irs t 1 5 minut e s without intravenous fluid th e n d ea th is inevit a ble. In the c as e of ext e rn a ha e morrhage this can a nd mu s t b e co ntrolled immedia t el y.

Severe br a in d a mage

With sev e re d a m a g e deat h is ins t antaneous Following an y perio d of unconsciousness c on cu s si o n is present. A s tate of compression m a y f o llow f r om intra cranial h a emorrhage or oedema o f the bra n. This occurs o ver a period o f time and in order that a diagno sis m ay be made the patient requi re s to be o bserv ed carefull y a t frequent interval s. If i t is suspected that ther e is a n intra c r ani al haemorrhage , burr ho le s m ay n e ed t o b e c a rr ied out at the ra ce c ir c uit in o rd e r to save life. A fire situation and seve re e xt ernal bleeding must be dealt with imm e d iate ly and obstru c ti o n to th e airw a ys mu st b e cleared within 3 minutes

In order t o do his w e h ave d eve lo p e d a 4 stage fi rst aid o rga n is at ion.

Stage 1

At most meetings we h ave a numb er of doctors present who are pla c ed a r o und the circuit on the marshalls posts A S t. John member m a y also be present o r m ay be by himsel f. Fi nall y, the m arsh alls whi ch we e mpl o y in t h e B R S .C.C. have all been tra i n e d i n b as i c fi rst aid Th ese are the people wh o ar e fir st on th e scene a nd who have the r es p o ns ibili ty o f co p i n g with any fir e situati o n a nd w i th in i ti ati ng the proc ess of f r e eing the dri ve r if trapped in t h e ve hi cle. If they find t h at there is severe ha e m o rrhag e, t h ey sho uld try and co ntrol th is If th e driv er is n ot breath i ng or the airw a y is o b stru cte d t h ey should set ab o ut cl earing t a nd if necessary perfo r ming mouth to m o u th artificial resu sc itat io n

Stage 2

Stage 3 It is preferab le, h owever, to transfer the injure d d river to an a m bu l a n ce, which again contains a basic res u scitation kit.

T hi s a mbul a n ce is manned by a St. Jo h n c r ew and a so carries a doctor. Their job is to co nti n u e t h e resuscitative procedures a nd to tr anspo r t the driver b ack to the m e di c a u nit. On a rr iva l at the medical un it a d ecis i on is m ade by t h e chief m e di cal office r as t o whether or not the dr iver sh ou l d be moved from the a mbul ance and taken into the medical u n it for further examination and r es u scitation or whether he should be trans f erre d directly to hospital. It is my con t en t ion that a drive r sho ul d not die in the b ack of an am bul ance. If he is going to die t h en he shou ld do so whi l e the m e d ica l tea m are tryi n g to save him.

Stage 4

This takes place in the medical unit.

H ere a fu ll exa m ination is undertaken

I ntraveno u s fluids are given as necessary

Woun d s ar e cleaned an d s u tured. Burns are d resse d with P olyfoam dressings and if n ecessary an emergency tracheostomy o r b urr holes can be undertaken

This is carried ou t by the r esc u e vehicle and its c re w. Thi s is a hi ghl y specialised vehicl e with a c r e w of 6: a driver / rad io opera t or , a d o ctor skill e d in first aid work a nd re s us c itati o n , 2 fire mar shalls and 2 re sc ue m ars h a ll s. T he firemen are dre sse d in fl ame resis t a nt suits and their j o b is t o ac t as a ba ck up i n the case of a fire si tuation , o r in th e absence of fire to ensure that n o fir e occurs. Th e rescue marshalls are a rm e d with compressed -air cutting equipm e nt and their function is to free a ny tr a pp e d driver. In the meantime t he d oc t o r h as examined the driver , cl eared hi s airw a y and if nee e ssary carried o u t an endotracheal intubati o n. His b asi c k it consists of an ambu bag or sim il ar apparatus laryng os cop e a nd endo-tracheal tubes , a manually-op e rat e d suction apparatus , a nd f aciliti es for setting up an intr avenous infu sion. At th e same time any fracture s are s plinted with 16 infl a t a bl e sp ints f poss ibl e a nd ope n w o und s cove re d wit h a fie ld d re ssi ng T he r escu e ve h icl e is fi tte d wi th ra di o so t h a t a tw o-w a y co mmun ica ti on can b e establ ish ed b etwee n the site of the acci dent a nd the con ro l centre. Thus, arr a ngem e n t s ca n b e m a d e fo r h e r ece pti o n of t h e cas u alt y in the m edical uni t a nd if n ecessa r y s p ecia list facilities ca n b e m o bilise d at the nearby hospital. Sh o uld it b e n ecessa r y in the in terest of safety, th e inj ur ed dri ve r ca n be carr ied in th e r esc u e vehicle back to the m ed ica l uni t.

Following a carefu l assessment a decision can be taken as to wh ether o r not a driver needs h ospi t al treat m ent an d his disposa l carrie d o u t by mea n s of the St John am b ulance crew together with their d octor.

The m edical unit at permanent circuits must contain 2 beds in a rest room and a dressing station which is a separate room. Faci l ities for intravenous infus ion, sut uri ng, tracheostomy and ventilation of a patient m u st be available. The Grand P rix Me di ca l Unit contains an operating theatre, electrocardiograp h , defibrillator, and x-ray equipment, etc. Do we need these? Are they dangerous? They are nice to work in and create a good impression with the lay pub lic and the press, but unless properly supervised can be dangerous

In summary , the essence of the organisation is to have a team of trained marshalls St. John men, or doctors who are on the scene of an accident within seconds of it occurring, and who can initiate the basic resuscitative procedures necessary. This closely followed up by a mobile rescue squad who must be on the scene well within a period of 2 minutes.

Once the driver has been freed an airway established, and visible haemorrhage controlled , he is transferred to the medical unit for stabilisation before transfer to hospital.

This system can be applied to any race circuit throughout the world , the only variability being, of course, the number of rescue teams which may be required , and these should b.e duplicated so that each one covers a sector of the track. These vehicles, and indeed all the ambulances , must be equipped with a basic resuscitation kit and a doctor skilled in first aid and resuscitation

Must I have an anaesthetic P

by B. R. LITTLE, MRCS

As a first-aider you may find yourself involved with someone who has to have an anaesthetic, perhaps after an accident. This article from the Quarterly Newsletter of the Weston-super-Mare Corps may give you some guidance in what to say to an apprehensive patient.

Dr B. R. Little is an anaesthetist and Corps Surgeon.

TO FRED BLOGGS , Mrs Bloggs and their children operations and the anaesthetics that go with them have a lot of the mystery and excitement that is felt by archeo logists when they explore unknown areas.

We all know how important shock can be, and how important it is to treat it we ll. Fear and fright are the emotions on which shock thrives, so let's think about fear, what causes it, and how we can help. Fear is often described as being faced with the unknown. To all the Bloggs family, the approaching operation and anaesthetic is an unknow experience. They may have seen these things on television , but then they are necessarily dramatic and bear little simi larity to what happens in normal operations so do little to calm their fears

We will assume that the Bloggs family fear general anaesthesia The Bloggs children must be approached differently from their parents. Children are inherently trusting; they accept facts and reassurances, but an obvious untruth is catastrophic to their morale Anyone who app roaches a chi l d, ar m e d with a needle to give an injection, saying 'ft's not going to hurt' is lost from the word go The child knows they are talking nonsense and won't believe anything e lse that is said So if you are asked if it is going to hurt the answer must be 'Of course it is a little. Bu t not as much as when you prick

yourse lf sewing'.

What of Mr. and Mrs. Bloggs? They will have learnt to hide their fears but the chemistry of fear" will still be inside them, setting the stage for shock. Let us see what these fears have in common, and how it can be lessened by well informed facts.

Fear of anaesthetics fall into four main groups.

1. There is something special about me and the anaesthetic won't work.

2. Something will go wrong and I will wake up in the middle.

3. r won't wake up at the end

4. I'll talk about the skeletons in my cupboard whilst I am asleep.

Within these groups, Mr. and Mrs. Bloggs can be reassured by know ledge.

I.THE R E IS SOMETHI G S PEC I AL ABOUT ME A D THE ANAESTHETIC WO 'TWO R K.

It is true that different people react in different ways to the same chemicals. Each anaesthetic is tailor- m ade for each patient; it is started in a room apart from the ope rating roo m an d the patient does not get anywhere near the urgeon before he or she is fully un d er the influence of an appropriate anaesthetic

2. SOMET HI NG WILL GO WR O G A D I WI L L WA K E UP I TH E MIDD LE

Even suppose that there is an anaesthetist who does n 't k n ow his job, nature can g u arantee this will not ha p pe n The muscle activity r eturns qu i te a while b efo re consciousness re t urns. Suppose Mr. and Mrs. Bl oggs were coming round

fro m the anaesthetic, the surgeon woul d receive a hefty kick well before they were aware of what was happening around them, and su rgeons don't take kindly to this sort of thing. The autonomic nervous system is very sensitive to lightening anaesthesia and makes the pulse beat faster. As the pulse is always m onito r ed during operation, a rising pulse is very obvious.

3 I WO 'T WA K E UP AT T H E EN D

The risks in submitting to an anaesthetic can be compared to other activities Mr. and Mrs. Bloggs accept every day. There is far greater risk of being run over every time they cross the road. They don't think about that every time, do they? Even suppose the patient is desperately ill, the procedures use d i n anaesthetics are so similar to resuscitation that they are safer under anaesthetic than either before or after.

4 I'LL TA L K A B OUT T H E SKE L ETONS I MY CUP BOA RD WHILST I'M AS L EEP. P entothal and other anaesthetics given into veins have been used as 'truth drug '. To do this they are used in a very different dosa ge. Never have I been the unexpected rec ipient of dark secretsand everyone has a few skeletons around.

WHAT IS THE DUTY OF THE FIRST AIDER?

To reassu r e the patient. Y ou now have the knowle d ge to reassure all the Blog gs family if they are going to have an anaesthetic. One point , it is natural to b e frightened of the unknown, everyone i . If your Bloggs family are looking forward to the experience they should see a psychiatrist - there's something eriously wrong.

CADET TO DOCTOR

from W. Gwilt, Area Superintendent (A) r was most interested in the article 'In every ca det's haversack' (Review May 72) and must tell you of our Dr. K. J ones's success story.

One evening early in 1955 a smart young boy of 12 years old came to join the Stoke Ambulance Cadet Division He sat and pa sed his examination for the Preliminary First Aid on June 24, and was enrolled as a cadet on July 22 1955

During these early days hi ambition was' to be a doctor' Hi career with the Cadet Division was outstanding. In the year following his enrolment he captained a team which had the honour of bringing a county trophy to the North Staffs Area for the first time in its history. On two occasions he captained a team representing the County of Stafford at the Regional Finals, and at one of these the trophy was lost by Y2 point only. His keennes and enthusiasm was very evident at one Regional Final when although very ill with an abscess in the armpit, he led his team without a murmur. He did in fact have to have an injection from the county surgeon immediately after the competition.

During these years, although tied a great deal by his school studies and first aid work, he also learnt to fly an aircraft. The outcome of this was that the then Commissioner-in-Chief gave permission for him to wear the 'Wings' of his flying club on his cadet uniform.

In 1961 he was promoted to the Stoke Ambulance Division as an adult. The ambition to become a doctor was still predominant in his mind.

I n 1961 he went to St. Thomas's Hospital, London , as a medical student. During his training years at the hospital, he still maintained his Brigade efficiency.

Now, having successfully taken his medical degrees, he has returned to his parent Division and been appointed the Divisional Surgeon.

Can any other Divisional Surgeon equal thi achievement - a cadet in 1955 to Divisional Surgeon with his own Division in 1965 - without a break in service?

Surely a very commendable record to uphold the mottoes of the Order, 'Pro Fide' , 'Pro Utilitate Hominum '.

Congratulations to Dr. Keith Jones , Stoke Ambulance Division.

Stoke-an-Trent TV. Gwilt

THE SAME? (see letter)

READERS VIEWS

Readers ' views and opinions, which should be sent to the Editor, although published are not necessarily endorsed by the Editor or the Order of St John and Its Foundations Although readers may sign published letters with a pen name, writers must supply their name and address to the editor.

WHO'S WHO IN SJA

from Bruce M. Coltman

Re the article IN EVERY CADET'S HAVERSACK (Review May 72) I am pleased to be able to inform you that Dr. Richardson is new Divisional Surgeon to the Hamilt on Division and ha been given a Sedentiary post on the Di strict Committee and is getting really involved in Sl. John in Canada.

Further whilst taking part in a recent Brigade competition, 1 found that I was facing a doctor who was obviously of national rank. I should have known who he was, but did not and r began to wonder just how many people in SL John do know the faces and names of the senior officers at our Headquart ers. To hazard a guess I would say very few. Therefore I should like to suggest that the Review publish a pictorial Who 's Who of all the Headquarters officers. A printed name doesn't convey a gr eat deal. But a photograph and a name communicates on a mu ch mor e per onal basis. Those of us who do not move in the higher St. John circ l es would then know just who our leaders are.

After Headquarters had been shown off to their best advantage in the Review, a regular feature co uld then give similar treatment to all counties. Then every member who is wise enough to take your publication would have at his di posal a pictorial dossier of

who is dOlI1g what at national and regional levels. in supposing that the photograph on page 17 , of SJA Liverpool at St. George's \-Jail , is that used on the Christmas Day appeal poster? (Both are r eproduced on previous page).

The county charts cou ld show all County Staff plus Area Commissioners. This would be of great benefit l ocally, as new members would learn to recognise senior officers and their role in St.John.

New appointments at IIQ or the Counties would be published in the same way, so keeping everyone up-to-date on identities. Newcast/e-u/lo!1- TYl1e Bruc e M. Collman

Editor A good idea But it is surprising how difficult it is to obtain photographs in general, let alone of individuals on appointment. I will set the ball rolling with a Who 's Who at Headquarter.,. and trust that County Headquarters will start compiling their own for future submission for publication.

THE SAME?

from Barbara McMahon Cadet Sergeant I have just been looking through some old copies of the Review (as 1 so often do), in particular the August 1971 issue Am I right

Am J observant, or just slow In reahsing what many SJA members already know?

Bebingtof) Combined Cadet Divlsiun Barbara McMahon

Editor: You are definitely observant, Barbara Since receiving your letter I've learned that the drawing on the appeal poster was based on the photograph. The photograph was published because thought it vividly portrayed St. John members work.

LARGE DRESSINGS

from Dr. A J. Pim, Divisional Surgeon Ambulance Cadets

In the R eview Feb. '72 a reader asked about a commercial firm supplying large dressings. Vernon & Co. Ltd., Penwortham Mills, Preston, Lanes. make a 20 by

VISUAL AIDS

(b) Instructors' Kit

Illustrated liljuries I rom Canada, the PrIory AdViser has 1I1vited the attentIon 01 our Headquarters to publications by the Smith lIthograph Company Ltd., of BritIsh Columbia.

(a) Reference Booklet

TIllS booklet, sIze 81/"in by I 1111, comists of 24 coloured photographs of common injuries, and on each page adjacent to a photograph a compkte description of the approprIate 111jury is gIven together with a blank spaee for Treatment \lotes'

01' these 24 coloured photogruphs n111C are also accompanied by line draw1l1gs of relevant featu res from ,-rays The contents of these pho tographs include

Compound fracture of the sku ll

Multiple facial injurics

Severe head injuries

racturc of the spine

Crash I11ju rICS foracture of the kneecap

Burns

Lye Injuri es, etc.

Il is realised that the magnitude of these 1I1juri es is, 111 many Instances, beyond the scope of the average first aider and that some of the injuries portrayed arc by no means common, none the less the realism portrayed WIthin these reproductions might Cqlllp a first alder With foreknowledge should he find himself in the si tu a tion of being the sale person on hand to render immediate assistance.

The Medical Board, to whom these kits we re displayed, felt that they were not inexpensive and that a cheaper form of visual aids (e.g slides) could well have more value; nevertheless, for the keen in st ru c tor these booklets may be obtained at about $500 (or £2 00) from SmIth Lithograph Co. Ltd ., 1250 Vulcan Way, Richmond B.C. Canada.

111e Instructors' Kit comprises 24 page with 28 coloured Illustratiom (the same as the Reference Booklet in (a) above) but SIZe 22112 x 19 Y2 inches These illustrations are provided on an easel fastened With removable screws to allow ease of sequence change: each page is keyed to a description of signs and of the injury and with blank spaces for the inclUSion of Illstructors' notes.

The nj uries, inciden tally, have been compiled from actual cases at the acuity of \1cdicine, University of Bntish Columbia.

The Medical Board felt thnt these injuries were drama tiC bu that the format size was not suitabIc for vie\\ ing from the back of a large class. The kit costs $35.00 (£ 14.00). -

The Smith LIthograph Co. Ltd. , has kindly supplIed a kit and reference booklet to each of S1 A 's Development Officers in the UK so that members throughout the country have an opportunity of examining them.

Home Nursing: Tape/ Slide Presentation

111e Medical Recording Service Foundntion ha produced five tape/slide presentations under the generic title !lome Nursing

These program mcs may be listened to in an} sequence as they are designed for independent usc a lth ough each programme supports the others. They are not designed for nurses or professionnl people but arc aimed at the average housewife without nurslIlg e ,p cIIence and frightened by the idea of illness.

They arc:

(

B) Nursillg The Sick Child A (Home shows how to prepare a sick chlld\ bedroom, essential medical and nursing material needed, offers advice in respect of toys and play things for sick children, and gives a wealth of adVice in the home nursing situation when child ren are the invalids.

(C) I Room To Be III In shows how to prepare a room for a ick person, how to rai e a bed, essential nurslllg equipment required, how to make a bed with the patIent still in it, the bed bath, presentation of food, etc.

(D) Care Of The Elderly InJlaiid-emphasi es the Importance of making old people feel needed, their diet, urroundings and how to keep them occupied and active. -

(E) The Patient Who Is .Vot Going To Get Better shows nul. ing of elderly and the phYSIcally handicapped, and the importance of nuring aids, tells of grants f rom local authority and other essential information. These programme are produced at the correct intellectual level for the intended audience and deal with common en e matters in a practical way. They do contain a great deal of matenal, and lay instructors may \vish to stop programme · for discus ' ion at variou points: a summing-up will be a necessity and they could be used with advantage III conjunction with: ·Simple Hint on ursing and First Aid In The Home'. These programmes may be hired for seven at £ 1.1 0 each, or purchased, plus postage, at (A) £7.20. (B) £5 .75, (e) £7.80, (D) £5.40. (E) £5.40, from Medi cal Recording Service Foundation, Kitt Croft, Writtle. CHELM FORD, (Phone 421475) !:ssex.

(A) Could You Vllrse }'o llr Family ? This preliminary presentation deals in genera l term I\'ith minor home nursing by a housewife who is untrained in nursing and first aId, not only unskilled but In fact frightened by the thought of illness. It gives examples of medicines to be kep t in the home, offers advice in respect of hygiene and acciden t prevention, and in plain words tells the average young housewife how to cope wi til minor and indeed major emergencies.

Cadet Sergeant Barbara McMahon asks If the photograph (left) of a SJA casualty post at St Georges Hall Liverpool (pub lished in ReView, August 1971) is the same as the sketch used on the Christmas Day appeal poster (below)

1972 Albert Schweitzer Awards

T WO BR I T I SH AWA R DS : T H E R EV E R E ND CH AD VA R A H , OF

THE SAMARITANS , AND TH E ST . JOHN A MBU LANCE CAD ETS

The International Committee of the Albert Schweitzer Prize and Gold Medal of the Goethe Foundation of Basle (Switzerland) met recently at Strasbourg and announced the names of recipients for 1972.

The Albert Schweitzer Gold Medal, which honours an individual or collective action of which the essential purpose is to create or develop among young people a spirit of understanding and mutual responsibility inspired by the spirit and example of Dr. Albert Schweitzer, has been awarded to:

The R everend Chad Varah (Britain)

He has developed a new but simple and fruitful idea: to help those who either do not wish or are unable to open expression to their suffering or their despair, through the anonymous medium of communication by telephone. First conceived by Mr. Chad Varah in 1955, the idea has developed in thirty countries spread over five contintents (SOS-Amitie, in France; La Main Tendue, in Switzerland, Telefon Seelsorge, in Germany; Telefono Amico in Italy; Linka Duverny, in Czechoslovakia; Mran, in Israel; Telefon Z aufania, in Poland; The Samaritans, in En gland). The Paris Centre alone receives a hundred calls a day, of which more than thir ty are appeals of distress from young men and women whom a word of sympathy or friendship can help, and perhaps save, at a critical moment in their lives. Psychologists, doctors, and men and women whose sympathies are alert to human suffering, are permanently available to receive these appeals aBd brin g advice, sympathy or a life-saving proof of their understanding to thousands of human b eings.

T he Alb e r t Sc h weitze r Pr ize (25,000 Swiss francs) has been divided among five reci p ients. An individual prize has been awarded to:

20

Gerhard Klauda (Austria)

At the age of 17 (he was born in 1941) he walked and hitch-hiked round the world and decided to dedicate his life to the poorest among men - lepers and sick or handicapped people who were rejects from society. With this object, after the example of Dr. Albert Schweitzer , he completed his medical training and then returned to Ethiopia where he had been moved by the sight of lepers who were universally abandoned and who spent their last days in the Medhane Alem cemetery waiting for death. Gerhard Klauda collected them together, restored their hope in living and drew public attention to their misfortune, and was so successful in achieving his object that in January 1972 the Ethiopian Government placed 600 ha at his disposal and several hundred Ethiopian pupils and students devoted their holidays and free time to building a centre where lepers and handicapped people could find fresh hope and independence, and rediscover their human dignity.

Four other prizes were awarded to the following Youth Organisations : Developpement et Sante (France)

Th is Association which has no political or religious affilia tion, is the medical branch of the Freres des Hommes (Freres de nos Freres, in Switzerland ; Brothers to All Men, in England; Bruder aller Menschen, in Germany ; etc .), which specialises in helping the people of the Third World. It consists of a large number of young doctors who take turns, month by month, in freely giving to the Third World what no financial aid can supplytheir expert and sympathetic help. A hospital in the backwoods, built at great expense by the European Development Fund in 1967, had never been opened through lack of doctors, financial means , equipment and other necessities.

Developpement et Sante took it over. and from then onwards the hospital not only

A source for the study of the Order's possessions in the Middle Ages.

functioned bu t became the base for a health cherne for a region of 580,000 inhabitants where no doctor had ever practised. This hospital centre provides medical aid adapted to the needs of the local population, sends health-visitors to tour the bush country, provides maternity and child clinics, and gives instruction in hygiene and the prevention of disease, etc.

Internationale Bouworde (Belgium)

Known internationally by the abbreviation l.B .O., with groups in France, Belgium , Switzerland, Germany, Ireland, Algeria, Spain, italy, Austria, Portugal , etc., this international community of young volunteers devoted itself to building to help the homeless, the needy or exiles, withou t regard to race, religion or philosophical concept. Two methods are used by the groups short-term projects in which young people (15-25 years) devote their holidays to building housing accommodation, youth hostels, homes for abandoned children and cen tres for handicapped people; and long-term projects in which young people (25-30 years) devote at least a year to working in developing countries. Between 1953 and 1970 a total of 81,297 volunteers coming from 46 countries completed 1,961 short-term projects. Between 1957 and 1970, 36 development projects were completed in 19 countries in Africa, Asia and Latin America.

St. John Ambulance Brigade Cadets (Britain)

This Association, whose Commandant-in-Chief is Princess Anne, aims to strengthen in the so-called 'developed' countries a sense of human fellowship which is endangered by the circumstances of modern life If you are alone in a crowd, who will help you? If

(continued at foot of next page)

IN THE LIBRARY of the Priory of Scotland there is a folder entitled Tabill of the Templelands, containing photo-copies of nineteen folio sheets which were written in the seventeenth century. It is better known as the Register of Charters of T emplelands, 1 614 -1 632 and we also have a typewritten transcription of it. The words Temple (or Templar) lands are used in Scotland of possessions both of the Order of St. John and of the Order of the Temple. This practice has given rise to confusion. Both orders were 'exempt orders of the church', having exemption from tithes and being free form the jurisdiction of local bishops, but in 1312 the Pope ordered that the Order of the Temple be suppressed and that its possessions be handed over to the Order of St. John The estates of the Templars were individually small but they were numerous and together valued 50% more than those of the Ho pitallers.

The lands of the Order of St. John were scattered all over Scotland and the Register of Charters of Templelands has the following number of entries:

[n the north : Aberdeenshire 39, Kincardine 16, Banff 12, and Inverness 5.

In the east, north of the Forth : Fife 39, Perth I, and Clackmannan 1.

In the east, south of the Forth: Edinburgh 56, Haddington 22, Peebles 18, Linlithgow 12, Berwick 10, and Stirling 6.

In the west: Lanarkshire 19, Dumbarton 4, and Ayr 2.

In the south-west: Kirkcudbright 5, Dumfries 4, and Annandale I

you suffer a road accident, or are injured in a demonstration, or deserted in your old age, or become the victim of some catastrophe, there are those who will not be mere indifferent passers-by - the young people of the St. John Ambulance Brigade Cadets are there to help you and perhaps to save your life, with the technical skill and the watchful human goodwill which they place at the disposal of those who need their help.

Versohnung uber den Griibern (Germany)

NEWS from SCOTLAND

An extract from the Tabill of the Templelands

In 1911 the late Dr. John Edwards, the author of an earlier paper to the Glasgow Archaeological Society which is still one of the most au thoritative works on the Order in Scotland, wrote in the Scottish Historical Review that according to 1911 values there was 'a rental of £5,400 drawn by the Order from the estates in Scotland, after providing for maintenance of the three bretheren and the expenses of the preceptories and churches'. This gives some indication of the importance of the Order of St. John in Scotland in pre-reformation times.

J. H. Calder MacLeod

by Dr. Schweitzer and Pere Pire, is a token of human brotherhood

Aberdeen Mountain Rescue Team

On January 23/24 the team spent two days searching through the mountains on Lochnagar for a climber who had become separated from his companions in the grim weather and was later to be found dead. On February 20 the team was searching in vain for a missing man in the Ballater area. On April I six members helped to recover the body of a man from Ballater who had been found on a ledge on Craigendarroch ; and on the same day the team searched for and found a missing Army Cadet Force party from Edinburgh which had got lost on the bad weather of the Cairngorms. The party was taken in the team's landrover to the hostel in Braemar.

19 72 Albert Schweitzer Award s (cont) . At the moment the Mountain Rescue Team's strength is 25 persons, of whom 20 are active members. In the last year these spent a total of 7,620 man-hours engaged in mountain rescue and were called upon to assist fifteen people who were at risk. Twelve of these were missing or overdue and 6 of them were found dead ; 1 had broken a leg while ice-climbing; I was fatally injured while rock-climbing; and the last was slightly injured on a cliff face. Team officers in 197 I gave over 50 lectures in the Aberdeen and District area; and the team, with the help of a qualified engineer, undertook to survey and cost the building of a suspension bridge.

They have as their motto 'Let Nations unite, let Mankind be human' Their way of setting to work is symbolic: they tend the deserted graves of former enemies buried in their lands, as a sym bol of reconciliation and to provide a meeting-point for young people where the hatred of former times can be overcome. In Europe, more than 5,000 boys and girls devote six hour a day during their holidays to sharing this solemn duty which, in the pirit inspired

The question may be asked: Why were these chosen? The Goethe Foundation says : Because the future of our human race depends not only on the discoveries of wisdom and genius which are advertised by their spectacular nature, but also by simple, new and fruitful ideas devised by anyone whose heart and soul are alive to the problems of his brother-men. We are rich in cientific discoveries, but poor in human progre s. Those who dedicate themselves to rediscovering the spirit of brotherhood love and fellOWShip between all mankind, they too deserve to be encouraged. And they also deserve to be recognised in an age when people talk so much about juvenile delinquents, juvenile drug-addicts and juvenile layabouts that they forget about the others - the young people who are building for the future.

The cost of running the team is about £1,200 per annum, of which £500 is provided by the team itself. Members of the team provide their own equipment and about £100 towards the cost of petrol. But they feel that the amount of time taken up with fund raising is too great and, if maximum efficiency is to be maintained, it could be used to better purpose on training.

News from the Divisions

Deputy District Commissioner, was accompanied by Di"trict Supenntendent ('iurs111g.) \Irs D Hoadley

A demonstration of first-aid treatment and disposal \\ hich was to have been performed by squads of member from cach of the three companies on parade, unfortunately had to be cancelled because of rain which persisted during the afternoon

OBITUARY

Roderi c k William Betteridge ambulance member 86 (\\estmillster) DiviSion. JOined Brigade 1949 Serving Brother. \\ J Hodgson PreSident Bromborough a nd Llstham DIVISion Cheshire lormed firt ambulan ce diVISion at Bromborough in 1914. \1['; Iris Weaver SR ,County 'ursIng Offi c er , Dorset \lember of St John for 28 year s, a nd nursed at the Ophthalml (; Hospital, J e ru "alem. Serving Sister. Leonard H e nrv Wreford 59, Sergeant and founder member I. ,mouth JOined Brigade in 1926

Yorks' Driffield and District nursing cadets' first Grand Prior badge is presented to Jane Fetchers by the Chief Commander, Sir William

REVIEW CROSSWORD No.7 (72) Compiled by W. A. Potter

ACROSS:

1. Casualty station used by sportsmen. (8.4). 8. Golf club essential for blood formation. (4). 9. Demonstrated a fabric. (5). 10. Stare at deep open wound produced by torn page. (4). 11. Abdominal support remains. (5). 12. One drink too many? (4).

13. Bone which is an integral part of safe murder. (5). 15. Leave out typhus spread by 31 Across in the Far East. (5). 16. Meet one tiny variation of occulentum. (3.8) 21. Nerve fibres linking parts of brain often free in psychoanalysis. (11). 24. Sort of accident that doesn't happen to a person twice. (5). 26. Suffering from metabolic disorder characteristically giving pain in the great toe. (5). 27. Eastern ruler taken from mire. (4) 28. A long time after small advertisment for an old saw. (5). 30. Record part of vertebral column. (4). 31. Times are changed for small insects sometimes carrying disease. (5). 32. Scottish stream gives injury due to heat. (4). 33. Reconstitute a salve curing spotty face. (4.8).

DOWN:

l. Payed son to produce difficulty in breathing. (8). 2. Held out and straightened a flexed joint. (8). 3. Sound in mind. (4).4. Fail to give proper care. (7). 5. Burst a hernia. (7) 6. 16 Across contracting the pupil. (6). 7. Many with suppurative discharge in pedunculated tumour of mucous surfaces. (7). 14. Lad returns to village ladies with reaction diagnostic of typhoid fever. (5) 15 Residue from corn giving warts if used wrongly. (5). 17. Mother has nothing for red leader. (3). 18. Covering of brain by a mat in middle of pier. (3.5). 19. Involuntary passing of urine ensures I reform. (8). 20. One can grasp no more. (7). 22. Boy caught between points produces muscular relaxation in anaesthesis. (7). 23. Each cut gives astringent extract of acacia (7). 25. Pain in the chest or throat. (6). 29. Self-satisfied dental tissues from below ( 4)

SOLUTION TO CROSSWORD NO.6 (72)

ACROSS:

1. Sputum 5. Ven.o.us; 8. UNRRA; 9. Lint.el 10. G.i.mbal; 11. T.in.ea; 14. Asleep; 16. Hay fever; 18. Erythema nodosum; 20. Hysteria; 22. Neater; 25. Totem ; 27. Taenia; 28. Effort ; 29. Roman ; 30. Spared ; 31. Thymol.

DOWN: 1. Saliva; 2. Ul.na; 3. Multiple; 4 Bronchial asthma ; 5. Va .ga. ry ; 6. Orbs; 7. Silver; 12. Test.ate ; 13 Fe.m.o.ral; 15. S orry; 17. Exude; 19. Ointment 20. Hiatus 21. Retard; 23. Rectal ; 24. Hero(in) ; 26. W.o.Lm.

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Every Division should read the

ST. JOHN REVIEW

Order now - £1.70p. for a year's subscription including postage , and don't forget bulk orders of 6 or more

copies a month (minimum 3 months) at a special rate of 10p. a copy including postage

The Treasurer, Order of St John, 1 Grosvenor Crescent

AT RANDOM

by Watkin W_ Williams Deputy Commissioner -in-Chief

THE ST. J OHN'S DAY SERVICE in St. Paul's Cathedral was, as always, a very moving experience , made all the more so by Mr. Stanley Pritchard's inspiring sermon . But we should be letting down Mr. Pritchard and everyone else who contributed to the inspiration of that service if we allowed it to fade into nothing more than a cosy and heart-warming memory_ A friend of mine was once approached by a gushing young man who said 'Thank you so much , I did so much enjoy your most inspiring address' , to which my friend replied 'Good ; what has it inspired you to DO?' Receiving no answer, he found that the gushing young man had suddenly vanished in the crowd. Whether we were at St. P aul's or not , I think it' s most important that whenever we have an inspiring experience we should at once ask ourselves wh a t we're going to DO about it , and not be satisfied until we've found the answer.

It has been my good fortune to attend four other services connected with Sf. John's Day during the past month, foremost among which was the Eucharist at the Priory Church in Clerkenwell on the morning of June 24_ At the conclusion of a service for members of the Order in Essex , held in the ancient Hospitallers' church at Little Maplestead, Mr. George Newman spoke in simple , moving words when presenting for the first time the annual p r ize for the 'Nurse of the Year' which he has given in memory of his wife , Lady Joan Newman who had long been a much-beloved Vice-Pre ident (Nursing) of the Brigade in Essex and a most active member of the National Appeal Committee of the Order. And it was my privilege to conduct a Cadet Enro l ment Ceremony during the course of a similar se r vice of the Order in Lincolnshire , held in the open air on the site of the ancient Templars' and Ho pitallers' church (of which only the tower remains standing) at Temple Bruer.

( continued on page 11 )

(Left) SJA Guernsey's headquarters in 1947. The old garages had now been converted into offices and control room, while vehicles were garaged in a building at the rear (Right) the headquarters today. On

The Story of SJA Guernsey's Transport

(Land, Sea and Air)

Department

PART 2

THE RETURN to peace in 1945 saw the need for the consolidation of the now established am bulance service in the island.

The station was, however, inadequate, and there were insufficient vehicles and staff.

The Order of St. John at their headquarters in Lond on provided loans of £7,000 towards the re-building programme. Reg Blanchford was able to persuade the local Brigade committee to purchase a plot of land and a bungalow in the Rohais Road , at well below its actual value, to allow for building extensions. He talked the Guernsey States into buying a new ambulance and into allowing him to increase his staff to four ambulancemen and a secretary/nurse. He begged from the Joint St. John and Red Cross Committee in London two secondhand ambulances.

Soon after the war the need arose for an adequate plan to permit the flying of e m ergency cases to England for specialist treatment. [n the first decade after 1945, the majority of patients travelling went by sea, but it meant a ten-hour journey if their destination was London, too long for those seriously ilL Blanchford , with the co-operation of the airlines serving the island at that time, introduced an air 4

The history of the St. John Ambulance Guernsey's Transport Department, wn·tten and compiled by Staff Officer Ronald 1. Herve, was recently published in book form and will be serialised in future issues of the Rel,jew. a mbulance service which since has provided transport for many thousands of persons.

It required many more years of persuasion , argument and yet more persuasion in order to achieve what today is the accepted standard. In the immediate post-war years, Guernsey St. John , like ambulance services generally, was looked upon as a 'Cinderella Service' - the poor sister of the community which did not require the equipment necessary to perform its duties to the population at large.

Overcoming official disinterest, and in many cases even obstruction, the service improved. Two-way radio communication was fitted to the fleet in 1947, paid for by a legacy. The island ambulances were the first in the U.K. to be so equipped!

The first marine ambulance, the 'Flying Christine', was launched in 1952 amid protests that 'she was unseaworthy', and 'her hull was rotten'! These remarks were soon to be disproved to the i m m ense satisfaction of the many hundreds who had subscribed to her

purchase. In her first year of service the launch completed 20 missions, the first within a week of her commissioning, the second a fortnight later in gale-force winds.

The service expanded to include the transport of infectious cases - formerly the duty of the isolation hospitaL An emergency oxygen service was introduced. Staff had increased by 1954 to 11 men and 2 women.

Vehicles. however, wp.re a continual source of concern they were 111 many cases old and one needed urgent replacement.

Cash was still hard to come by. Blanchford toiled unceasingly in his attempts to persuade (without success) the States to increase their assistance to the service. Although their annual grant had increased, it was not sufficient to purchase new vehicles or to pay lhe staff an adeq ua te wage. The enthusiasm of the men and women was high ; they often worked a 70-hour week with no overtime payments.

[n 1956 the service underwent a complete survey by an independent expert from London. All aspects, from vehicles to staff working condilions were examined, and when the report was completed later that year, it proved that the Department's claims were fully justified.

The States recognised the report and all its recommendations were implemented. Since that date the island authorities have given the service ever increasing support.

The service today

The Department today is vastly t ra nsfor med from the early days following the war.

ft has an ever widening range of responsibility. No longer is it solely responsible for the removal of the sick and injured to and from hospital, although it must be remembered that this is still its most important function

The control room staff are fully occupied between their telephone calls and radio messages. There are letters to type, accounts to po t and reports to complete. The Department maintains the island's blood transfusion register, and is responsible for calling the donors when required by the hospital pathology department, and if necessary providing tran port.

Each year the control room staff arrange for the travel of two to three hundred patient These are either islanders going to the mainland for specialist t rea t ment, or perha ps visitors returning home after accidents or illness while on holiday. Their journey is meticulously arranged medical certificates, tickets, seats or stretcher accommodation, road or rail transport to and from the airports. A member of St. John may be called upon to accompany them. Although the majority of the patients travel on the scheduled passenger flights, some are emergencies arranged after Guern ey's airport has closed for the night. Then, airport staff are recalled, a plane hurriedly chartered, and within a short time of the alarm call to ambulance headq uarters, a seriously ill pa tien t airborne.

A complex marine section is in existence with a high speed ambu lance laun ch, inshore rescue boats, and an aqua-lung search and rescue team.

Cliff rescue and rescue by breeches buoy form other facets of the Department's work

Transferring the sick fr om home to hospital is the greater part of the staff's ambulance work

Entonox' beIng gIven to a road aCCIdent patIent to relIeve paIn from a badly fractured leg

With thousands of visitors flocking to Guernsey every summer, the rugg ed coastline neces sitates cl iff res cue service. This res cue is on the c r aggy cliffs of P etit Point Bay

First aid theatres at the station and recompression treatment facilities provide a first class service to visitors and islanders a like, and the availability of medical comforts to assist in the after-care of patients upon discharge from hospital or with illness at home is yet another link in the chain of assistance.

The service itself is a self-contained unit. Many of the staff, apart from their first aid and para-medical training, are tra desm en, mech anics, e lectricians, ca rpenters, etc., who willingly apply their skills on duty; th us useful and essential tasks are performed when their first aid services are not required. The eight vehicles, the marine laun ch and tenders, as well as the equipment, must be repaired and overhauled.

Much of the maintenance work is highly specialised, especially in the field of radio, electronics and engineering. The station requires rede coration and repair. All this is undertaken by the men during the course of their day's work.

Training in the use of the complex equipment and practice in the increasingly skilled techniques now requir e d of ambulance c rews is programmed for all staff. Courses held on the mainland are attended by se lecte d personnel.

Members of the Department are expected to take an active part in their own time in the voluntary si d e of the work of St. 10hn in the island, where they may as a consequence attain ranks which are not applicable to their position in the Department. To avoid confusion, therefore, all full-time staff are issued with uniform of a different co our with separate rank markings. They wear grey while carrying out their paid duties and black while on voluntary St. 10hn wo rk.

In addition, the letter 'T' is worn on the shoulder straps of the grey uniform.

(To be cOl1flllued)

The charm of the island's winding country can be marred anes

The headquarters is frequentlv visited by senior officials of other services and Government departments. Here, the Director of Telecommunications of Britain's Home Office comes to see the radio equipment

The paint spray shop

A staff engineer in the engineering workshop

CITY OCCASION

The annual 'Presentation of St. John Awards' at the Mansion House is always a popular feature in the activities of the Ci ty of London Centre, and the innovation this year of a cup of tea after the ceremony provided a welcome opportunity to move about and chat, thus bringing together again instructors and pupils for a short spell.

First Aid and nursing certificates gained by employees of City firms and organisations were presented to 193 recipients by the Lord Mayor, Sir Edward Howard, President of the Centre, together with trophies competed for earlier in the year. The Lord Mayor was accompanied by the Lady Mayoress, Vice-President of the Centre, the Sword-Bearer, Brigadier Popham, and Mr. Sheriff Neville Rayner and Mrs. Rayner, while St. John dignatories on the platform included Sir Gil b ert Inglefield, Chancellor of the Order, Lady Inglefield, Mr. F. G. Thomas, Assistant Director of the Association, Mr. Nevill F. Marsh, District Director, and Mr. Alderman Alan Lamboll, Chairman of the Centre. The recipients comprised workers in the City who had successfully passed examinations at Centre classes together with members of the Brigade from the City divisions The whole of the very efficient stewarding was undertaken by uniformed Brigade members under the guidance of Divisional Officer E. T. Hawkins.

The Mansion House, the official residence of the Lord Mayor of London, was built in the years 1739 - 53 and the ceremony took place in the resplendent Egyptian Hall, an 18th-century style state room 90 ft. in length. Tea was served in an adjoining state room to the recipients and their friends, a gathering in all of some 300 people among whom the Lord Mayor and Lady Mayoress mingled freely.

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST . JOHN

APPOINTMENTS

Essex: Captain M. Bendix, Commissioner S.E. Area (new Area). Isle of Man: Sir Roderick Parkes, Chairman of St. John Council in succession to Lady Stallard.

THANKS

The following letter appeared recently in a Londonderry newspaper: Sir - I would like to express the thanks of the people of Ballymurphy, Turf Lodge and Rodney areas, to the members of St. John's Ambulance, who worked day and night at the week-end of May 15 to help us.

From the time of the explosion at Kelly's Bar, these people opened up centres and worked right through the night until day-break. I myself saw members running through the estate and fields,

ducking bullets, trying to help peoplewhether it was injuries due to rubber bullets or faints or heart attacks.

They also helped to comfort old folk, who had to be evacuated from their homes into St. Thomas's schooL

I admire these people who showed so much courage. Many of them have families of their own, yet they braved the shooting and gave a public service to everyone, young and old.

I overheard one member, a woman, stating that the men deserved a medal, but 1 say the nurses were as valuable to the men, for they on their part did tremendous work and I would hope that St. John's Ambulance recognise and thank the members of this group who worked so courageously.

We, the people, will always give our support to this group of St. John's, who operate seven nights a week, and during the day - when duty calls.

They are always there, from cadets to nurses and men. I salute you and thank you.

Yours, etc., GRATEFUL MOTHER Ballymurphy.

BITERS BIT

Chatham (Kent) ambulance cadets' recent fishing competition produced not a tiddler after 5 hours of continuous casting from the banks of a local river.

SAVED

Area Staff Officer A H. Cole, of Gloucestershire's Mitcheldean ambulance and nursing cadets, reported recently :

While on duty with the Ross-on-Wye Division at the Gloucester Jalopy Club meeting held in Talbot Meadow, Ross-on-Wye, during June, we were called to the river bank where we found two men in the river rescuing a small boy

The boy was passed from the rescuer to Pte. H. Spencer of Ross Divison 1 examined the boy He was not breathing B Y T H E ED IT OR

and was extremely cyanosed. We immediately began resuscitation and after approximately two minutes the boy began to show signs of life He started to vomit, (I must admit I was amazed at the quantity of water which came from his tomach). We were relieved to hear' him say '1 don't want to fall in'. He then looked up an d enquired Where am IT , then began to cry. We knew by this that we had surely saved a life.

The police were in attendance, and I asked them to contact the County Ambulance Service by radio Although we had the Ros s amb ulanc e in attendance, it is not equipped with oxygen and I thought this may have been needed We had str ipped the boy of his wet clothing and rubbed him dry with a towel, then wrapped him in a blanket ready for ho pitaL

A

COMB

Warren,

I NED D IVISION

Divisional Officer Mrs E. Forrest writes: No. 349 Teddington Combined Division , the first combined division in London's SW Area, is now a year old. The problems and advantages, of a combined division will interest many readers.

The first major step towards achieving this objective was taken by Div. Sup. P Howard , of No. 175 Teddington

Am bulance Division (a division formed in 1943) when he had to con vince his men most of them long-serving Brigade stalwarts, that an injection of womenfolk would do the Division a lot of good. Some of the veterans raised their hands in

ADVENTURE WEEK

despair and cried 'Progress!' Nevertheless, they agreed to the suggestion. The first attempts to amalgamate with a nursing division failed, as the nurses preferred to remain on their own, but subsequently sufficient new women members were recruited together with a divisional officer from District Pool. And so No. 349 Teddington Combined Division was in business.

I cannot imagine what the male mem bers of the Division really thought about women invading their realm, but they willingly accepted them and their ways and some of the men were even

Joy

Bembridge)

encouraged to take an Initial Nursing Course, which was one of the first major functions to be embarked upon.

The Division is very fortunate to have two nursing officers (State Regi tered Nurses) - one man and one lady, and so the course was very well presented. One of the ambulance members gave the Division a bed and mattress; the nurses were able to provide 'professional' equipment, and a considerable amount of other goods and chattels was purchased.

The course, while quite well attended, unfortunately did not gain any new members, but that seems to be the sad trend these days. What with summer holidays, house-to-house collections and flag-day chores, the nursing course, etc., members of the Division did not get much of a chance to become socially acquainted, but a Christmas social soon put that right.

It was a grand 'do', obviously enjoyed by all, and the efforts of the two newly appointed auxiliary members (catering) were much appreciated, as was the excellent home-made wine provided by Nursing Officer M r. Carver. This was followed in January by a first aid course, based on the new First Aid Manual, which unfortunately coincided with the miners' strike and power cuts, but 32 members of the public braved the rigours of the winter and learned how to treat themselves for hypothermia - as well as everything else. Various lecturers including Assistant Commissioner Dr. C. Osborn and Area Surgeon Dr. M. Bamforth, came along and gave most interesting talks. During the course of the lectures the divisional members had been working hard among the class members encouraging them to join us. After a 100% pass of the 27 people taking the examination three women and one man were enrolled, with others showing interest.

So as a new Division we are in a very healthy state.

Already definite advantages are evident in belonging to a combined division. The men can learn from the women, and the women can certainly 10

learn from the men Apart from that, the mixing of the sexes m akes the sessions more agreeable and less formal than is possible in a single sex division AI 0, the most important point is that the greater the numbers atten ding drill nights, the more ambitious and rewarding can be the programme. How often in your Division, when only 4 people turn up and the evening programme (prepared half-heartedly in case 8 arrive) is abandoned until another evening, do you just sit over a cup of tea and discuss the weather , a football match, or the cat's new kittens to go home disillusi oned about a wasted evening? If you are contemplating joining forces with another Division and can't quite make up your mind I can assure you, you won't regret it.

WALTER

Manningtree (Essex) Ambulance and Nursing Division (formed in 1902) reports the death of their last founder

member, Supl. Walter E Salmon, at the grand age of 92. (See photo.)

Placed on the reserve in 1948, Walter never really retired from the Brigade but took a great interest in the Division and attended annua l lnspections, the la t in 1971. Being efficient' to 1966 gave him a wonderful total of 66 years serVlce.

During the early days and before ambulances ca me on the cene, Walter dId first aid the hard way. While the maltings were being buill at nearby Mistley there were quite a number of serious aCCidents, some fatal among the workmen. To get a patient to hospital entailed co llecting a 'litter' from Manningtree, pushing it a mile to Mistley, then with the patient, two miles back to Manningtree station, boarding a train for a 9 mile Journey and then a 2 mile push, including a long steep hill, to Essex County Hospital at

Colchester. And of course n ot AFLOAT AGAIN forgetting the return journey' Walt er was truly wonderful co ll eague, says a Manningtree member, and will be remembered bv us all.

Readi ng SJ A s ri ver rescue service came to a halt la st month when thieves broke into their boat store and stole three outboard motors worth about £750,

AT RANDOM (continued from page 1)

Finally, in my own home parish church which is dedicated to St. John the Bapti t, I had the privilege of preaching at the Sunday Fvensong of our Patronal Festival , which was attended by local units of the St. John Ambulance Brigade and the British Red Cross Society , and the two lessons were read by the St. John and Red Cross Presidents respectively. An amplified recording of the solo and chorus 'Prepare ye the way of the Lord' (from 'Godspell') was played immediately before my address, and I used thIS recording as my text.

And now that the month of June is over and another St. John's-tide is past shall try as I'm sure we all shall to step forward into a new year of St. Joh n activities with fresh determination to make our service 'Pro Fide' and 'Pro Utilitate llominum ' all the more effective a a result of the inspiration that we have received.

FOCUS 72

I was thrilled to hear the other day that the cadets in Surrey had set tllemselves, as the chief event of their Golden Jubilee Year to earn (not beg, mark you, but really earn, giving good value in labour for the money they received) a minimum of £500 a a gift to the Hospital at Jerusalem. They et St. John's Day as their target date: and in the course of their most successful 'Focus 72 Fun Day' held at Guildford on June 25 and attended by 1,000 cadet, each of whom had undertaken to try and earn at least sap, the Hospitaller wa present in person to receIve their total gift of £520. What a splendid way of s h owing our thanks by earning money, not [or our elves, but to help others whose need is far greater than ours! I know that other counties are undertaking similar projects, and I don't doubt that they're meeting with equal succes but if you hayen't tarted something of the kind by the time that you read thIS, and if you feel inspired by the example that I've quoted. there are till five months of our Jubilee Year left in which you could translate that inspiration into action.

RETIRING

A most heartfelt 'thank you' and 'God speed', which I know that many of you will most sincerely echo, to three people who have recently felt obliged to give up doing the particular job for St. Joh n that they have done for a number of years. First, to Sir lIugh Stephen on, who 'e health l1a proved unequal to his continuing his arduous task as Director-General of the Association. The tremendou advances made in the work of the Association during his all-too-short tenure of office have been very largely due t o his inspiration and wi e leadership, and the Foundation owes him a far greater debt of gratitude than I can find words to express. Personally and as friend, I am particularly grateful for all the help and encouragement that he has given me since I joined the taff at Grosvenor C re cent, and especially for hi keen interest in the production of a Clas Secretaries' Handbook designed specially for those who organise first aid courses sponsored by Brigade divisions, which is due to appear shortly. I hope that the recent improvement in his health will be steadily maintained and that he'll soon be well enough to help t. John in some other role ess exacttng than the one that he has a lr eady filled so well.

During her seven years as Chief Nursing Officer, Dame Barbara Cozens has endeared herself to all those In the Brigade and they

An appeal through local newspapers for replacements produced 12 outboard engines within 24 hours! 'The response was terrific',' said Divisional Superintendent Leo Smith, in charge of tne river service.

have been many who have had the good fortune to meet her. He r quiet voice and unassuming manner could never wholly conceal the strength of character and purpose and the wise guidance with which she has led her team of nursing officers at every level in the Brigade. We wish her many years of happiness in her 'second retlrement' at her horne in Canterbury. And though I hope she'll now have more time to enjoy the leisure that she deserves, I'm quite sure that she'll never be inactive, nor ever cease to bring out the best qualities in all who come her way.

After fifteen years as Assistant Commissioner-in-Chief, Colonel Arthur Goring retired recently on his 65th birthday. His greatest and most treasured reward will be in the lasting friendships of those whom he trained as leaders in the ranks of St. John. This was well expressed by someone who remarked to me the other day : 'Even though Arthur mightn't bother to cross the room to chat to you or me at a cocktail party, he'd travel the length or breadth of the country to attend the wedding of one of his K.G.Vl trainees or the ch ri stening of one of their children'. That is typical of him, and that's why in the year 2000 there'll still be leaders in the Brigade who owe their inspiration to what they learned from him.

DISASTERS

Within a space of three months the emergency disaster procedure of three St. John counties has been put to the test, each on two out of three occasions - at the motorway disaster at ewport Pagnell (Bucks), the train disaster at Eltham (London and Surrey) and the tragic air disaster at Staine (London, Surrey and Bucks) and has not been found wanting. Reports are still coming in of the plendid work done by Brigade members who re ponded to the calIon the two latter occasions, of the way in which they co-operated with the police, fire and ambulance services and were accepted as welcome members of the relief teams, and of the particularly gruesome conditions in which they work.ed at no small risk to their personal safety in removing the bodies of the victims of the Trident crash. These counties will be the fir t to recognise the need to learn the lessons of their experience and to make their call-out procedures even more efficient than they already are. But perhap the most important lesson is that such tragedies can occur anywhere, and that every county should try to ensure that if a imilar event occurred on its own doorstep it could bring it volunteers into action with equal promptne and efficiency. Meanwhile, the magnificent example of those to whom the call ha already come makes every man and woman, boy and girl in the Brigade proud to be their fellow-members in St. John.

REALIST HE

In a characteristlc311y charming speech at the Lord Prior's Dinner on St. John' Eve Lord Caccia ended by telling a story from 'The pleasantries of the incredible Mullah asr udin which 1 feel should be passed on to a much wider circle than tho e who heard it that evening. On a certain day, the Mullah gathered together a crowd of hi followers and addre ed them thus: '0 people, do you desire knowledge without difficulty, truth without falsehood, attainment without effort, progre without sacrifice'?' And joyfully the whole a em bled throng shouted 'Yes!' 'Good,' replied the Mullah: 'I only wanted to know. And you may rely on me to tell you all about it if ever I discover'.

Col. R. Ollerenshaw, Brigade Surgeon in Chief talking at recent Regional competitions at Chorley, Lancs.

Thelbrox Disaster

by C. BAINBRIDGE, OBE, MB, FRCP(Glas.), BHy, DPH

THE YEAR 1971 was certainly an eventful one in the history of the hospital and accident service in the City of Glasgow.

On January 2 1971 a major disaster occurred at Ibr ox Football Stadium when there were 66 fatalities and 150 people injured.

On October 21 1971 a further major disaster occurred due to an explosion of gas in a large shopping centre of Clarkston, a suburb of Glasgow, when 22 people were killed and 54 injured.

On the Sunday morning of January 17 1971 the whole of the ward accommodation of 115 beds plus theatres and ancillary accommodation of the Glasgow Eye Infirmary were destroyed by fire; fortunately there were no casualties.

In each of these incidents help was provided and welcomed by voluntary organisations.

At Ibrox volunteers of the St. Andrew's Ambulance Association were present in organised force

At Clarkston help was provided by first-aid volunteers, including the Red Cross and W.R. V.S.

At the Glasgow Eye Infirmary help came from a passing territorial army unit who stopped and helped in the evacuation.

In this article I will concentrate on the Ibrox Disaster but, for some aspects will also refer to that which occurred in Clarkston.

As I am sure you know, New Year is the traditional holiday of the Scot - not that he is always able to remember it! It is also a tradition that local rival football teams should play each other, a tradition which has spread to many areas south of the border.

Football tradition

Although Glasgow suppo rt s four 12

The St. John Ambulance Medical Conference 1972 was honoured by this talk from Dr. C. Bainbridge, the Senior Administrative Medical Officer of the Western Regional Hospital Board (Scotland) and chairman of the working party established by that Board following the Ibr ox Disaster in January 1971.

Dr Bainbridge is well known on television north of the Border.

profeSSional teams and one major amateur team, the great rivalry is between Glasgow Rangers and Celtic and any game between these two 'ol d firms' attracts capacity crowds. The venue for these games alternates between Ibrox Stadium, the home of Rangers , and Celtic Park.

On January 2 1971 the venue was Ibro x Stadium.

It is perhaps significant that the disaster which was to occur was not the first at this stadium. On September 16 1961, nearly 10 years previously , a wooden crash barrier collapsed and spectators fell over each other on to the pitch. There were 2 fatalities and 83 injured, most of which were chest injuries and after effects of traumatic asphyxia.

The injured were treated at the Southern General Hospital and the Victoria Infirmary. At the Southern General, on the initiative of the Matron and the Medical Superintendent a chest cliOlc was cleared of furniture and beds were installed to create a temporary ward

This same hospital was to receive the brunt of the 1971 disaster.

I will try to build up the picture for you Glasgow is a City of approximately one million people. There are 5 major general hospital, the R oyal Infirm ary, the Western In firmary, Stobhill Hospital, the

( I) The collapse and disaster was virtually after the end of the game.

(2) The game was on January 2 and it was dark by the end of the game.

(3) First-aid workers were on the inside of the terracing, by the pitch, therefore the scene of the disaster was not visible to them.

(4) Ground floodlights were of no use as these are focused on the pitch itself and cannot swivel to illuminate the outside of the terracing and its exit.

(5) The majority of the spectators, including many doctors were on their way out of the ground unaware of the disaster.

(6) The location of the disaster meant some delay in notifying police control and first-aid workers.

(7) Roads outside the stadium were packed with cro wds going home, hampering incoming rescue vehicle

Southern General Hospital and the Victoria Infirmar y, the latter two being on the south side of the river. There is , however, a double road tunnel under the Clyde, providing extremely easy and quick communications between the Southern General Hospital and the Western Infirmary

The city's two major football stadiums, that for Rangers at lbrox, i on the south side of the Ri ver in very close proximity to the Southern General Ho spital, whilst that for Celtic, at Parkh ead, is in reasonable travelling distance of Glasgow Royal Infirmary.

Ibrox Stadium must be regarded as one of the quite modern football grounds in Britain.

As well as the stand, the terracing rises upwards from the pitch, and then on the exit areas outside the terracing further steps lead down to the exits themselves.

The disaster occurred virtually at the end of the game, with many spectators leaving, when a final crucial goal was scored. The outcome of this dramatic finish to the game was that many spectators on their way out tried to turn ba ck to see what had happened, while the others continued to make their way out.

One of the exit stairways (the superstitious may note that it was stairway No. 13) was the scene of this heavy congestion. Protection barriers gave way, spectators fell, tumbling over each other, and a mass 01 people landed on top of the faIlen spectators. As was discovered later, bodies were littered on this stairway.

The barriers which gave way were of steel construction, the wooden ones whic;h broke in 1961 having been replaced The fact that these stee l barriers gave way is an indication of the tremendous pressure which can be exerted by crowds.

I must stress the following points:

police and to drivers of fire and ambulance vehicles in managing to get to the scene as promptly as they did. The fire service, fortunately, were able to provide the lighting to the exit areas but as can be appreciated, it was some little time before this could be available.

With the problems I have already mentioned in regard to the location of the disaster , the lack of reasonable illumination and the problem of crowds, I am sure you will appreciate the problems which beset the first-aid workers and the police in handling casualties at the site.

The nature of this particular disaster, with its high incidence ot asphyxia and suffocation, create problems in the handling of the dead. As a fir t measure , bodies were taken over the top of the terra cin g back on to the football pitch and then into accommodation cleared within the stadium where a temporary mortuary was established.

In some ways this disaster was unique; but it is the type of disaster which can occur among crowds, and its nature must be appreciated. If you can imagine some hundreds of people falling over each other and compressing many of their number under their own weight , [" think you will appreciate that the problem for those underneath is one of inability to breathe by expanding their chest owing to pressure which we call traumatic asphyxia, or such congestion that they are suffocated by lack of air. If the weight of people can be taken off the victims in a short enough time there is obviously a chance for the patient to revive, and of course if any life is present then methods of resuscitation, with artificial respiration, must commence with the minimum of delay.

The first intimation of the accident to police con trol headquarters came via the police walkie-talkie network; this alerted a nd enabled first-aid workers, the majority of whom fortunately had not left the stadium, to proceed to the scene of the accident, together with available police. From Police Headquarters ca lls were sent out for ambulance, fire and re cue services and for mobile surgical units which came from the Southern General Hospital, the Vi cto ria Infirmary and the Royal Alexandra In firmary, Paisley , which is within quite reasonable di tance of the lbrox ground.

Despite the crowds on the roads the maximum of credit must be given to the

Casualties were evacuated to both the Southern General Hosptial and the Victoria Infirmary , the first ones going to the Southern General Hospital and later when it obviously appeared that the largest numbers were going to this hospital others were diverted to the Victoria Infirm ary which is a little further away but still within reasonable distance.

The Southern General Hospital which has a mixture of old and new accommodation, but altogether is a first class general hospital, received 9 cases brought in dead and 97 others injured

The Victoria Infirmary, likewise a hospi tal of mixed accommodation, received 3 patients brought in dead and 49 injured.

The total number who died from traumatic asphyxia (inability to breathe) was 56; one further was a mix ture of traumatic asphyxia and suffocation; 8 died due to suffocation; and I to the effects of suffocation and asphyxiation by inhalation of vomit.

The casualties coming to hospital reflected this same form of injury and, perhaps fortunately for the hospital service, very few required surgery. The emphasis was undoubtedly on resuscitation, treatment of shock and the like

The timing of this particular disaster was such that many of the radio and television commentators had not left the ground when information about the disaster occurred. As a result, information was very rapidly spread to the public at large via radio and television, giving news

RAILWAY DISASTER

Eltham, Sou th London, rail crash, ] une 11. Local SJ A divisional members were on the scene within 4 minutes of the cra h. London District's S.E. Area Emergency Scheme was in operation within 7 minutes , sending 4 doctors, 2 SRNs, about 40 members and 3 ambu lan ces to the scene with many other members standing by A first-aid post was set up in a waiting-room at E lth am Station and staffed mainly by Eltham Nursing Divi ion members. Ambulance members recovered casualties handing them over to the London Ambulance Service fo; evacuation. A party of Brigade members all with NHSR experience, assisted in the casualty department of a lo cal hospital. The two SJA members in the photograph are (left) AIM Stan Hagan and (recently promoted sergeant) Frank Walker, both of No. 41 (Royal Arsenal and Woolwich) Ambulance Divi ion. (Ph oto: A socia ted Newspapers)

of the disaster and conveying some size of its magnitude. As a result of this the response from all members of the staff of hospitals likely to be affected, especially the Southern General Hospital and the Victoria Infirmary, was most dramatic.

Clinicians, nurses laboratory technicians, catering staff, clerical staff, porters and volunteers, all made their way to the hospital as rapidly as possible One Consultant Orthopaedic Surgeon, encountering some difficulty in motoring, managed to get behind an ambulance going to his own hospital, and as he later reported he arrived at the hosptial faster then he had ever done. The turn out of members of clerical staff and telephone operators proved to be a godsend in the light of the large number of requests for information from the public. Offers of help from nurses, not associated with the hospital, were quite numerous and many others turned up of their own accord at the hospitals. One nurse arrived complete with her husband and two sons who became most valuable porters and messengers.

It always amazes me the tremendous depth and strength of goodwill and assistance that is given by the public in times of emergency. With this tremendous response the hospital service was able to deal in a satisfactory manner with the disaster casualties.

Naturally there were some problems, and with a similar disaster 9 years previously but fortunately not so grave, we did make efforts to study the situation which had arisen, to evaluate our activities, to see what lessons could be learnt, and to make recommendations for alterations which would improve our emergency arrangements in the light of other major disasters of any type. By trying to expand our investigations to take into account other disasters which may have included patients severely injured or trapped in wreckage (train disasters or the like), we endeavoured to determine what further problems would have originated at each stage of the handling of casualties, and of the further services, including laboratory aids, heavy use of theatres, services of anaesthetists, blood transfusion facilities and the like, being involved.

The first step in these investigations was the holding around mid-day on the Monday , following the disaster of a teach-in at the Southern General Hospital of all the staff of the hospital who were involved in the disaster. Organised by Mr. Sillar, Senior Orthopaedic Surgeon of the hospital, this was a most valuable exercise and provided useful information, especially as it was obtained at a red-hot level when memories were fresh and the whole objective throughout the teach-in was aimed at learning lessons which would improve efficiency; the result was that people were very out-spoken and were ready to criticise actions, including 14

their own, which had been taken.

We then decided it would be useful to establish a working party, again of people who wer e concerned in the disaster to investigate the ma tter in further depth and see what recommendations cou ld be made. This was a working party of which I hCld the honour to be chairman.

Our objective wer e:

(I) To review previous reports of major accidents.

(2) To study the information obtained from the teach-in at the Southern General Hospital

(3) To obtain help and have discussions with representatives of: telephone and ambulance services, police, fire service and voluntary bodies,

(4) To arrange discussions and visits to other ce ntres involved in accident service, whi ch included: Derby, Bath, Carlisle, Birmingham, Luton and Dunstabl e, Bri sto l an d Lond on (King's Ccllege)

(5) A visit and discussion at Ambul ance He adquarters

(6) A trial of a mobile unit to be present at a maj or football game.

(7) To organise a symposium with o ver 100 represen tatives of hospital staff, surgeons. anaesthetists, blood transfusion officers, physicia ns. laboratory staff, nur es, pharmacists and technicians to c r t i cise our proposed report before its presentation to the hospital authorities.

We gave copies of the report to the St. John Ambulance Association and there are further copies still available if anyone wishes to read one.

The main problems we encountered on which we submitted recommendations were :

(1) Communications at hospital level

The problem of com munication s has been stressed in previous reports on major accidents, the Lewisham train disaster and others.

The first intimation the Casualty Department of the Southern General Hospital received about the extent of the disaster wa s from a porter who had h eard a report. of about 2 0 injured o n the ambulance radio This was followed by a demand for m o rtuary accommodation, again submitted by an ambulance at the scene of the disaster.

Later the hospital exchanges became blocked with incoming ca ll s enquiring about friends or rel atives and such special outgoing lines as were reserved for this special purpose were soon being u sed by members of hospi tal staff to communicate with adjacent hospi ta ls or even intimating to re latives or friends that they would be on duty for some time to come. It was not a case of a shortage of telephone exchange lin es, although

admittedly with the increase in size of t.his hospital some further lin es are required. Appreciating that thi s accident was on a Saturday, the hospital had 35 exchange lines, 15 of which are normally reserved for outgoing ca lls only and of co urse. on emergency, these can be utilised for incoming calls or adjusted to meet differing need.

In Oll r report we made pecial recommendations regarding the provision of direct lines between major ho spitals an d with Ambulance H eadquarters, also methods whereby trolley telephones, normally for the use of patients, could be brought into specia l use for calling out staff, and the like, and also by special arrangement, which the telephone authoritie would put into effect, certain coin boxes could be utilised without continua lly having to replenish them with coin.

Further u e of extra directory !ines was advocated but the knowledge of these numbers must be everely restricted as personnel soon learn them and put them into u e if any difficulty is encountered with the main telephone exchange.

(2) Communications at the site

The need for radio links within hospitals arises so infrequently that we are convinced the correct proced ure is to liai e with police or ambulance networks which are in constant u e and manned by individuals experienced in their technique. Poli ce will relay messages, and ambulance headquarters, if on a direct l\I1k to major hospitals, can pa s nece sary informatIOn

We do suggest. however, that a responsible administrative medical officer should report to ambulance headquarters

In the event of an emergency so that he can as ist in assessing the importance of messages, e nsu re that appropnate ho pitals are kept informed of development, and al 0 be a relocating force \11 directing cCisualties if one hospital should tend to be overloaded, as well as, of course, being responSible for ensuring that calls for ' uch things as additional blood are pa sed to transfusion cen tres etc.

Also, and we think this Vitally important, we recommended thut a SCI/lOr medical officer should rcpor( to the scene of the disaster H e should be a lIIember of tlze starr of the nearest Accident Unit. be cO/lveyed to the site b I {wilee transport, be respol1Sible j()J' assessing the /lii/nber and {l pe of casualtl' and for passing Ihis lIlforlllatio/l to Ihe nearest liospital or 10 Ihe Central Co-ordinator at alllblllance headquarters lie should concentrate his energies on the direction of patients and their selection for priority and transport to hospital.

(3) Treatment at site

We received most valuable information at the teach - In from those members of

the Mobile Surgical Unit.s who rep orted to the scene of the disaster. For this type of dLaster they reported that they felt of little value ; that the first-aid volunteer was the person best equipped to provide rapid and skilled assistance and they felt that medical and nursing staff would probably have been better utilised by remaining in hospital to deal with those casualties which were sent to them. J think there is little doubt that this statement is of vilal importance The first-aid worker is ski ll ed and can appreciate the difference between minor and severe cases, He can give rapid and effective first-aid and he is in a uniform which co mmands re pect from the public . Admittedly the position might have been different if many casualties had been trapped in wreckage,

Generally we would hope that the mobile surgical unit would only be called out by the senio r medical officer at the scene of the disaster and he would certainly be In a position to advise on the extent of equipment which might also be brought, especially where thiS had to deal With amputations.

Professional equipment

We do stress the need for simplicity in the equipment to be available on the ite

Arrangements for the dead

There is no doubt that the correct arrangement is to en ure that facilities are

ROYAL VISIT

made available as close to the scene of the disaster for the immediate assem bly and protection of the dead. Police will make the necessary arrangements for the transport of bodies to either police mortuaries or other centres with which we think the majority of police forces have some contractual arrangements.

At hospital level we found it necessary to open up some part to act as an additiona l temporary mortuary and in the case of the Sou them General Hospital which re cei ved the largest number of dead a Phy siotherapy Department, which fortunately is located in a building adjacent to the major accident unit, was utilised.

Distribution of patients

As I mentioned earlier, we would also envisage that one of the main duties of the medical officer at the scene of a disaster would be to try and ensure that patients were distributed to different hospitals so that no particular hospital would be overloaded and have numbers of patients waiting for treatment when other hospitals could perhaps deal with some of these casualties quite quickly after their arrival at hospital.

One further lesson we learnt after the Clarkston Disaster was that our recommendations and good intentions do not always bear fruit.

We had made recommendations to try and ensure that no one particular hospital

Among the nine displays put on by St Helens (Lanes.) cadets for a recent visit by Prince Ph ilip were fOl'k songs and guitar music by Maria Lynn, cadet leader (silver award), Stella Critchley, Sgt, and Ann Greenall, Cpl, both bronze awards

would be overloaded with cases requiring treatment or s urgery and thus have casua lties waiting whilst an adjacent hospital would probably be in a position to treat many of these Immediately after their arrival at that particular hospital. We therefore devised a formula, based on the number of patients recorded as being serious, in that they would require surgical treatment. If the number requiring surgery be 4 or less, then we thought it only necessary that I major hospital be alerted. If the number be between 5 and 10 then we believed that 2 hospitals should be alerted and cases should be distributed accordingly. If the num ber requiring surgery were over 10 then 4 major hospitals should come into operation simultaneously and patients directed towards all these hospitals more or less in turn. In the event at Clarkston, I am afraid practically all the patients arrived at the one hospital, the Victoria Infirmary , and it is perhaps fortunate for them that the time of the accident was in the middle of an afternoon when full staff, including surgeons, anaesthetists, nurses, etc, were still present in the hospital and normal theatre lists had been completed for the day.

Transport home

After the bulk of the casualties, following the Ibrox Disaster, had been treated and many patients were told that they were now able to go home, we sud den lye n coun tered one further problem which had not been anticipated and which I think is probably not well appreciated by many of the individuals or organisations called upon to cope with large numbers of casualties. owadays, youths do not wear shoes that are laced and close fitting but are of a casua l type which can be easily slipped on and therefore easily s lipped off in any time or trouble.

Many shoes had been lost in the removal of the casualties and in the general clearance many jackets had also I think come off or been taken off to cover the casualty, with the ultimate result that many of our patients were unable to go home because they were either insufficiently clothed or had no footwear.

Once again, in the Southern General Ho pital the chest clinic which had been pressed into use some 9 years previously was converted to help these unfortunate people to give them some warmth and refreshment while arrangements were made for transport to get them home. Here we were grateful to the police and the Corporation of Glasgow who, without formality or cost, brought into use transport to get these people home-some as far as 60 or 70 miles away We all felt that they deserved it , having had a most harrassing and terrible experience, which I am sure they, nor we, who has some little part to play in that disaster, will ever forget.

HE OR SHE?

from La d y Moyra Br owne, Su perintend ent-in-Chief

In reply to Lt. Col. Robinson (June Review) there is a clear distinction between the duties of officers holding executive appointments and those holding appointments as Brigade surgeons and nursing officers. Thus, the executive appointment of a staff officer or a superintendent (at any level) is given to a person of the same sex as those of whom he or she is appointed to be in charge; the profession of the officer appointed is not relevant to the appointment. Surgeon and nursing officers, however, may and are appointed (at county, area, corps or divisonal level) to give first aid and nursing training to Brigade members of either sex or both. Consequently, while a county/area surgeon and a county/area nursing officer may be of either sex, and a female doctor may be appointed divisional surgeon to an ambulance division or a male nurse appointed divisional nursing officer to a nursing division, this does not apply to executive staff appointments. The area staff officer for nursing cadets is female because she has executive responsibility for girls; the fact that she happens to be a trained nurse is irrelevant.

Headquarters

LEADERSHIP TRAINING

f ro m Alan Sh a r key

The recent articles about leadership were certainly most interesting as was also the reference in the June Review to the Oxon and Bucks training course. This is a matter which should be very relevant to St. John Ambulance today but is it in fact so?

Most of us who join St. John soon realise that a lifetime of service will probably mean no more than a lifetime of fulfilling various public duties, usually of a most routine nature, as an ambulance member.

It is not surprising that St. John fails to attract the intelligent and capable people who would be so valuable to us They soon realise that they are unlikely ever to be expected to know much more than how to apply a sticking plaster.

Yet there are opportunities within divisions for leadership training at NCO and divisional officer level. Too often these opportunities are not taken - most divisions could probably make several promotions within the limits of the official complement. Most modest sized divisions could have, in addition to the divisional superintendent, a divisional officer, a transport officer, a sergeant, corporal, transport sergeant and transport corporal, plus in combined divisions a nursing officer.

These are the means by which some degree of responsibility and leadership training could be given to those capable of using the opportunity. Promotion should not be simply a reward for long service.

I do however think that a more suitable name could be found to and 'corporal'. The last thing that is wanted within a modern civilian voluntary organisation is the suggestion of military disciplines that those names imply. Perhaps this is the present stumbling block to the proper use of promotions at divisional level.

H avant, Hants.

THE NUGENT FAMILY

f r om A. E. N u ge n t A Ian Sharkey

H ow pleasing to read such stories as 'Sisters' (Around and About, R eview, June), thus proving that the Order of St. John can draw such a gathering.

My wife and I are classed in our Division as mother and father of the nursing and ambulance cadets, because all nine of our family (my wife, myself and our 7 children) are, or have been , members of the Division

My wife sits on the Parents' Committee and has helped in the Division for about 15 years; we formed a new adult division last year, of which I am a serving member.

Ou r eldest son A n thony served 10 years un til his marriage (still persuing his knowledge of first aid in his employment) and attained the rank of sergeant; as did our daughter Patricia with 7 years service; they were both awarded special shields.

16

READERS VIEWS

Readers' views and opinions, which should be sent to the Editor, although published are not necessarily endorsed by the Editor or the Order of St John and its Foundations Although readers may sign pllblished letters with a pen·name, writers must supply their name and address to the editor.

The Crash

by Dr . P. N. K. Heylings, Divisional Surgeon, Hull

Next we have Robert , 13 years service. now a divis i onal officer i/c ambulance cadets of this Divison ; followed by Linda as cadet leader of nursing cadets, with 10 years ervice ; again both have special awards. Linda hopes to gain her Grand Prior s badge this year.

Karen follows with 5 years service and a special service award trailed by Paula who has just 3 years servi ce Last of th e ugent line is Rona who, at 21 2 years old , has been used by the nursing cadets as a patient , etc

This gives a total of approximately 60 year e rvi ce Maybe even this servi ce can be beaten el sewher e, but a o ur officers say there is alway on c of the family ' on call' fo r duty , which in our Divison includes assi ting in hospital wards, old peoples' homes. fetes jP. mkhanas, sh o ws , et c all of whi c h ar e excellently organised by our officers m e mbers and co mmitt e es Wendov e r, Bucks A. 1::. Nug e nt

BOOKS

ORTHOPA E DIC APPLIANC ES

by Brian H. Day. Faber and Faber

This compact little book with Its numerou s line d ra wi ngs of all types of orthopaedic splints and appliance s is ea s y to read and very explicit. Intended mainly for Hou semen and Regi s trars, it will obviously prove useful to a wider field of practitioners S t rangely enough the versatilty of Pla s ta z ote is conspi c uou by its absence, although appliances ranging from cervical collars to insoles are described.

A chapter is devoted to Upper Limb Applian ces but it is a pity that the various modern lively s plint s fo r such conditions a ulnar claw hand' 'combined median and unlnr palsy' and 'dropped wrist' have' been omitted. Thesc we re designed and developed at the Joint Services Medical Rehabilitation Unit at R A F. Chessington and fully described in The £land' in March 1970

Mention could also have been mad e of the 'flail-arm' splints, a variety of which are issued by the Artificial Limb & Appliance Centres of the Department of Health & Social Security, which also deals with many different exten s ion prostheses for the lower limb which have outdated the O'Connor Boot (incorrectly illustrated in this book).

Apart from these few adverse criticisms the book certainly supplies a need which IS long overdue and should be welcomed by those interested in orthopaedic applian ces [an Fl e tcher

WHY SHOULD WE REHEARSE? Why should we have exercises in first aid ? Because however much we know does not necessarily mean that we can apply that knowledge when it is most needed

During the last 4 years I have frequently lectured on What to do at the scene of an accident', although r have attended relatively few su c h accidents myself. Then, returning with my family by car and towing a trailer from holiday in the Lake District cir c umstan ces taught me some lessons whi c h may be useful to others.

I had noticed earlier that our trailer lights were not working too well and as we drove through the late evening [ was worried about whether they were still on or not Suddenly my wife s shout brought me back to reality - Look out!' as our lights picked up the scene of a crash ahead. People were wandering to and fro across the road two cars against either verge. Now [ mustn't stop here, I said to myself, [ must park so as not to obstruct the road which may cause another crash. r found a suitable place and got out to check the trailer lights. They were clear and bright, so I went back to the crash sc ene r was immediately asked by so meone 'Please don't ring the poli c e! ' It was quite obvious that despite the two wrecked vehicles they hoped to avoid confrontation with authority [ examined one casualty's knee (he was very sensibly sitting in a car) Then [ asked if everyone was accounted for and was told yes. I returned to my car to use the radio telephone (a new acquisition , by the way ) but this proved useless as I was out of my own area and was not picked up by the local station, as I expected Suddenly there was a frightening scream of brakes nearby A van shot past, sliding and fish-tailing, wheels locked. The approaching driver had seen the crash at the last moment and slammed on his brakes. Fortunately he stopped before hitting anyone or anything. [ went to him and suggested he take the red triangle from my trailer beyond the crash scene, and to park his van safely but with its headlights shining on the crash. As we were arranging this one of the victims asked if the casualty in the crashed car could smoke. Knowing he had only a knee injury, I agreed I also suggested that

the crashed car lights be switched on.

I then went back to have another try at the radio-telephone when my 12 -year-old son (who had attended my road -accident lectures, by the way) said :

'I've put your two-way flasher on, Dad!' 'Thanks,' I said, feeling rather small.

'Dad' , he went on 'Why did you say the casualty could smoke? Couldn t that cause a fire from spilt petrol? 1 quickly reassured him that [ had not seen or smelled any spilt petrol ; but r knew he was right. Then he asked : 'And why did you tell them to put the car lights onwhat about fire if there's an electrical short?'

I was relieved when a member of the Harrogate road accident after care scheme arrived a medi-flash on top of his new GP saloon clearing the way for him - shortly to be followed by an ambulance fire-tender and police. What had gone wrong with my accident drill? Simply - lack of practice. What did I do right? I reassured the casualties and made them leave the road,

Prince Philip calls.

so that when the

unexpectedly arrived on the

it didn't cause more damage. I protected the scene , and I parked my own car carefully and correctly

This experience was invaluable to me. And I can say that my mistakes on that occasion have not been repeated

The following conclusions can be drawn

1. What is learned must be practised in as real-life situations as possible.

2. Practise what you preach.

3. A 12-year-old adequately taught is a very useful addition to any first-aid team. My 12-year-old son brought me down to size, or himself up to my size

4. The first person at an accident is the crashed car occupants. St. John must keep on teaching the general public what to do in the crash situation

The big question is : Why is not first aid taught as part of the school curriculum?

Moyra Browne

Mama

FILMS

FI RST AI D NOW (1963) (Colour 30 mins) Free

Di str ibuted by : British Medical Association, Tavistock Square, London WC I.

This eight year old film portray s first aid as it was taught in 1963 it sub-divides its content under Breathing, Bleeding, Broken Bones and Burns.

aspect of visual aids Previews of those 16mm films recommended by the panel are regularly published in the St. John Review.

accidents.

The panel considered that this old black and white film should be declared obsolete - its teaching is out of date.

Audience : ot recommended

WHE ONE SURVEYS the assembly of cadets presenting themselves weekly to delight us with their company, it is a sobering thought to realise that each and everyone of them has in the background someone who thinks that she alone is the only child who really matters. Natural, of course, and understandable; but those of us who have other people's children in our charge would do well to keep this very firmly in mind.

How easy it is in the hustle and bustle of meeting nights to let fall the odd thoughtless word, the one remark that will be seized upon and taken home to mother, likely as not out of context; and who would dare to challenge the power of Mama behind the scenes? No, some way must be found to harness this powerful background force, to convert it, so to speak, to work for us for our own well-being.

This sounds selfish. It is not meant to be. Look at it this way.

Paren ts usually fall into three categories. With the first, it is Mother who usually makes the overtures, telephoning or turning up at a practice night, enquiring when daughter may join. So many of her friends are here, it would be so nice for her. I'm sure she wants to be a nurse.' And so on. This type of Mum often turns into a faithful ally, supporting everything and encouraging daugh ter in such matters as Grand Pri or Badges and Special Service Shields. Daughter can usually be recognised by her relaxed manner, immaculate uniform and cheerful acceptance of responsibility.

The second category of Mum is more acquiescent than enthusiastic. She is perfectly willing for her girl to join Nursing Cadets, quite happy to hear about and comment upon all that takes place, just as long as no demands are made on her spare time and personal effort. The daughter of this type of parent is sometimes rather untidy. Her uniform, worn happily when remembered, lacks perfection, her SUbscriptions are frequently forgotten. Promises fall from her lips like rain. Like her Mother she means well.

Parents falling into the third category might as well, as far as St. John is concerned, never exist. They offer no objection to their daughters joining our organisa tio n, but are rarely seen afterwards. They give no encouragement, show no interest. The matter is closed.

They couldn't care less. Rather strangely, cadets with this kind of background are frequently regular attenders and their uniforms are neal (by their own efforts, one supposes). Their subscriptions are paid with an anxious expres ion, as befit someone wondering how pocket·money i going to last the week. In fact an aura of anxiety surrounds such cadets the whole time. And ometimes they are very good workers.

So there we are. Parents of every description, all forces to be reckoned with

Members of No. I group are tower of strength. othing is too much trouble for them, and many remain active members of the Parents' As ociation long after their own daughters have left to go out into the world.

But what can be aid about the indifferent parent? Oh, the horrid situations uch can put us in. At one in pection I shall never forget, when the Perfect Attendance Cup and replicas were being presented, a mother who had previously shown no intere t at all, stood up and in a loud voice protested that her daughter had nev er missed one meeting all the year and should have a cup. It took the hard-worklJ1g Secretary much tactful explantion to convince her that while a girl can leave home ostensibly to come to cadets, it does not necessarily mean she actually arrives.

Indeed, as everyone says: '1t's n great life if you don't weaken.' To thi could be added: 'And keep your balance on the edge of the word.'

(Reprinted [roln SJA East, South and North DeVOll '71/72 Year Book).

Apathetic parents, on the other hand, are more difficult. They never actually hinder anything, but they never help either. I remember one such parent allowing her long-legged young thing to return a uniform so dirty that it filled me with horror. Who, I thought furiously, i going to render this fit for re-issue? Me? Resentment possessed me and I charged round to the cadet's home with the offending uniform over my arm. When Mama opened the door I handed her the garment with wide-eyed wonder. 'Why Mr s your maid must have brought this back without your knowledge. I know you would never have allowed her to return it unwashed.' Mama snatched the dress to her bosom indignant in self-defence. 'The naughty girl. I'll see it's done at once.' [n this case it gave a fillip to the mother's interest, and [ am pleased to say that we are still grea t friends.

AN SJA MAMA

The panel considered that this film was excellent in 1963 but that its teaching, in the light of modern experience, makes its screening of very doubtful value. Our medical experts consider the lack of the recovery position, cold-water treatment for burns, nose pinching in emergency resuscitation alarming; the placing of an unconscious patient on his back is, too , bad teaching. Other faults are apparent such as ECM being performed on an elastic stretcher. This film should be declared obsolete.

Audience : Not recommended.

THIS IS YOUR LUNG (1963) (Colour 16 mins) Free

Di tributed by: British Medical Association, Tavistock Sq., London, WC 1.

Produced by : Allen & Hanbury

A film designed to discourage smoking. The progress of a patient with a co ugh is shown from his doctor's consulting room to hospital for X-ray bronchoscopy, biopsy, radio-therapy and finally the cemetry.

The panel considered this a very good film that gets its anti-smoking message across with force. Diagrams are good and the whole produ ctio n convincing.

Audience : Universal as a 'filler' but specifically to St. John cadets.

A CLASS OF YOUR OWN (1966) (Colour2Smins) Hire.

Distributed by: Guild Sound and Vision Limited, Kingston Rd., Merton Park London, SW 19.

Produced by: Ministry of Defence (Navy)

The importance for an instructor of preparing a lesson thoroughly in advance, of planning questions and using aids and class activity to make the subject interesting

The panel con idered that this film should be made obligatory viewing on all lay-instructors courses. This excellent production teaches the art of instruction with clarity and force the diagrams are good and the story-line logic impeccable ; it is, in fact , a model of what an instructional film should be.

Audience: All instructors, whatsoever their subject, would derive benefit from viewing this film.

HELP (1952) (8 & W 13 mins) Hire.

Distributed by : Educational Foundation for Vi ual Aids, 33 Queen Anne St., London, WI.

The film attempts to portray the chief principles of first-aid in

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ONE WAY OF HE LPING (1972) (Colour 20 mins)

Distributed by: Central Office of Information, Hercules Rd ., Westminster Bridge Rd., London, SE 1.

Produced by: Dept. of Health and Social Services.

This film shows various nurses following their several careers and with commentaries by those officers on their work, ambitions and attitude to life both in and out of the service.

It employs a disjointed and somewhat kaleidoscopic technique in presenting the separate nursing officers - the film appears disjointed at first but finally an impression of the whole field of nursing emerges. This is a well-produced film that employs a muted re cru itment message.

Audien ce: All school girls contemplating a nursing career and specifically of value to St John ( ) cadets.

KEY TO CLEANLINESS (1971) (Colour 21 mins)

Di stributed by : Guild Sound and Vision Ltd., Kingston Rd., Merton Park London , SW 19.

Produced by: J. Lyons & Co. Ltd.

The development of a bacteria growth on food and the effect of food poisoning.

Although this beautifully produced film is made for Lyons' employees it has far-reaching application in the field of hygiene. The script is concise, visuals excellent and the use of photomicrography very good. The film in fact turns what might be thought a dull subject into entertaining and instructive material.

Audience : Of great value to St. John for all hygiene courses and most useful for any type of film programme.

THE GRIM STATISTICS (1970) (Colour 22 mins) Free.

Distributed by: Rank Film Library, P.O. Box 70, Great West Rd , Brentford, Middlesex.

Sponsor : Clark Equipment, U.S.A.

A safety film, relating to the dangers when operating heavy earthmoving equipment, intended for construction industry.

The panel considered this a somewhat melodramatic and unconvincing safety film; the incidents portrayed are very obvious and have little impact except to emphasise lack of first aid within the U.S.A. construction industry. It is, too, a little too American for our audiences who may indeed feel themselves very much out of sympathy with the incidents therein.

Audience : 0 value to St. John audiences. Of possible limited use as an accident prevention film within the UK construction and similar indu try only_

PAIN (1962) (Colour 30 mins) Free.

Distributed by: F.B.A. Pharmaceuticals Ltd. Burrell Road, Haywards Heath, Su ex.

Sponsor: F.B.A. Germany.

A film describing the different types and qualities of pain. It also hows methods of measuring pain.

The panel considered thi an excellent film, with splendid graphics and diagrams that covers its subject with both clarity and impact. The recapitulation is specifically good and concise but it is a pity to employ a commen,tator in English whose pronunciation of medical terms is faulty.

Audience: This film i too technical for St. John audiences but is for profes ional audiences. medical and nursing students etc.

TH E POWE R BEH I ND THE CADET SCEN E by Mrs. G. MATH EWS, Div. Stlpt. Killgsbridge Nllrsing Cadet Divisioll

A mama and papa, for that matter - of th ree Derbyshire cadets who Mrs. Mathews, writi ng above, need have no qualms about. For this is the Palmer family, Mr. and Mrs. and sons, Alan. Colin and Michael

The St. John Ambulance Film Appraisal Panel which maets fortnightly at Headquarters consists of doctors, first aidars and visual aid experts who offer their services for this important

NEWS from SCOTLAND

reception in Murray House also meant that those who had not already seen St. John's House could visit it.

OVERSEAS UGANDA

News from the Divisions

NORTHANTS -A

WI

Winners of the new Jubilee Shield was the Warminster (Wilts) Combined Cade DIVISion team, with Corsham (Wilts) ambulance cade t s 2nd, and Ablllgdon nurslIlg cadets 3rd.

The idea, which needs a lot of organising, was reported by a Wilts' member as 'putting a shot into the a rm' of lo ca l cadet compe tition enthusiasm.

REVI EW CROSSWORD No . 8 (72 ) Compiled by W. A Potter

ACROSS :

I R oom for sports casualties ? (8) . 5 Bone of thora c i c ca ge (6 )

10 Po isonous British snake. (5) II. System of weight s a pplied to p ull fractured femur into satisfactory position. ( 9 ) 12. Infe c tion of sebaceous gland of eyelid in first year. (4). 13. Irritating p a r asite from leaf. (4). 14. Clenched hand is in foo t. ( 4). IS

Insane d og with rabies. (3). 17 Indication of spread o f infe c ti o n thro u gh lymphatics of forearm. (3.4) 19. Imply fin e r form req u ire d (5). 23. Muscular incordinatlOn produced almost entirely by a tax (5) 24. Injure by a little c o ntinued use. (7 ).2 5. Use one's eyes in the diocese (3) 28. He t a kes aluminium t o c ure d isease. (4). 30 Urban area to west a nd north (4 ). 31. D i lated vein of anal canal. (4) 34 Applied to preserve life, prevent aggr avation and promote recovery (9). 35. Ch a r a cteris ti c fe atur e of a finger. (5). 36. Type of animal giving malignant ulc e r. ( 6) 37. P ha l anges articulating with metacarpal s (8 ).

DOWN:

I . Contrive to bequeath property by scattering seed ab o ut six . (6). 2 Presence of air in the tissues, c ommonly due t o injury t o a lun g (9). 3 From the back , Eros is tender to the touch (4) 4 Ma nipulation of leg end in operation for removal of cataract. (8) 6. T urn another way for dwarf. (4) 7 Sa c cules of s ecretory c ells in 5 across (5) 8. Alcoholic solution of drug in tin c ruet. ( 8 ) 9. Gas liable to cause severe scald s. (5 ). 16 Legislative asse mbly ti e d to food regime regulated to needs of b o dy. (4). 18 Assume s a recumbent posture. (4) 20 Height of the fever. ( 9 ) 21 Cat destroyed 26 down to empty the bladder. (8) 22 Bottl e bringing re lief from pain (3-5). 26 Hesitan c y about articl e for anaesthetic. (5). 27. Lament a change of the mind ( 6 ). 2 9 Make a c h a n ge for the better at 12 noon. (5) 32 Con c uss slightly by h aving te m perature in sun (4) 33. Beat felt against the c he st w a ll. (4).

SOLUTION TO CROSSWORD No.7 (72) ACROSS

1. D ressing room 8. Iron ; 9 SaLin ; 10. G a pe ; 11. Sta ys ; 12. Nin e; 13. Fe.mur ; 15 Scrub ; 16. Eye ointment ; 21. Asso c iation 24 Fata l ; 26 Gouty ; 27 Emir 28. Ad age ; 30 Disc; 31. Mit es; 3 2 B urn; 33. Acne vulgaris.

DOWN: 1. Dyspnoea ; 2 Extended ; 3 Sane; 4 Negle c t ; 5. Rupture ; 6. Miotic; 7. Poly pus ; 14 W.i dal; IS Straw ; 17 Ma o ; 18 Pi.a.mat.er ; 19. Enuresis ; 20 Handful; 22. S colin e ; 23. Catechu ; 25. Angina; 29 Smug. 2 4

3)

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First Aid Training Is Essential

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Overseas News p 21

News from the Divisions p.22

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EDtTOR

ADVERTISEMENTS

DenniS

ears' to what 11 year·old Helen Lawless, from Rochdale Lancs, had to say during the Golden Jubilee review of cadets in Hyde Park

by Watkin W. Williams Deputy Commissioner -in-Chief

TIlE OUTSTANDI G EVE T of the Cadet' Golden Jubilee programme was the Royal Review in Hyde Park on Sunday July 23, when HRH Tlle Prince s Anne reviewed and addressed more than 5,000 Cadets, presented the Life-Saving Medal (in bronze) of the Order to Hilary Ferguson and Lee Moore for their promptness, courage and efficiency in rendering first aid to victims of the Abercorn Restaurant disaster in Helfast, and then presented the new Grand Prior's Sadge Certificate to a repre entative party of its first recipients.

From chance remarks made to me, not only by members of the awards party but by some of tho e in the rank of the parade whom I met in the tube on the way home afterwards, I gathered that our cadet as a whole have quite lost their heart to their new Commandant-in-Chief: their unsolicited comment was 'Prince Anne is What impressed me most of all was the way in which Hilary and Lee. who were naturally feeling pretty tense in anticipation of the honour that they were to receive, instantly relaxed when they came face to face with Prince Anne. and from that moment they were just three girl chatting together.

The weather was far kinder than we feared it would be, though we co uld hardly have had a more sultry afternoon if we had ordered It specially. Maybe the absence of any dail) paper in m o st of the c ountry for the next few day wa able mg in disgui se the TV new reels gave us good publicity of the best kind but if there had been London papers on Monday their headlines might have been tolen by the number of those who pa ed out on parade. [t seems that b) far the largest number of casualties wa among those who had had no proper breakfast or lunch, and th a t this was aggravated in the case of tho e who were either (a) dehydrated by having had nothing to drink for everal hours , or (b) made ill by slaking their thir t witl1 fizzy drinks on an empty stomach.

I want to empha i e that what I'm now going to ay is an e entially per onal and lay opinion; but it's ba ed on a pretty wide experience of being in charge of bodies of teenagers on a number of comparable occasion, including four World Scout Jamboree, at orne of which (as in Hungary in 1933) the temperature was mllch hotter and the air at lea t as humid a it was in Hyde Park. A much more firm in i tence. by individual officers in charge of individual group of cadets, on adequate food and moderate (and suitable) drink would have greatly reduced the casualty-rate. and 0 would have the ugge tion that while tanding on parade they hould 'wiggle their toes' and do an imper c eptibly slight 'heel rai e and knee bend'lI1 time with the rhythm of the band ( Co lltillll e d 0 11 page 11 )

Cadet

ON JULY 23 4000 SJA CADETS FROM THROUGHOUT BRITAIN

WERE INSPECTED IN LONDON'S HYDE PARK BY PRINCESS ANNE

Jubilee Review

COMMA DA T-l -CIIlEF of Ambulance and Nursing Cadets Princes Anne spent an hour and a quarter reviewing cadets, meeting their officers and presenting awards at the highlight of this year's 50th anniversary of SJ A Cadets in London's Hyde Park

In her speech to the gathering, Pnncess Anne said:

As you all know, this year marks the fiftieth anniversary of the formation of the St. John Cadets, and as your Commandant-in-Chief I am happy to be with you today, to share with yOLl the celebration of our Golden Jubilee

The St. John Cadets are by now well known, not only by their uniform, but for the great service they have performed both in this country as well as throughout our Commonwealth; for service to the sick; the disabled; the blind; and the needy.

I have heard of your great crusades which have been undertaken by cadet in two counties, and through whose efforts gifts of more than £.700 have been made to our Ophthalmic Hospital in Jeru salem.

Today I have been pleased to present the first of the new certificates signed by the Grand Prior , His Royal Highness: the Grand Prior 's Badge. To all holders of the badge let me say that the determination and perserveran ce you have shown in achieving your aim is a splendid example to everyone.

It is most appropriate, therefore, that in this Jubilee Year, the St. John Cadets should have been chosen as a winner of the Albert Schweitzer Prize, awarded annually by the Goethe Foundation in Switzerland to individuals and to organisations for service to humanity. This indeed, is something of which you may be justly proud, and you may rightly feel that you have lived up to the motto of the Order of St John " Pr o Utilitate Hominum" "For the Service of Mankind"

You wear a un iform which is recognized everywhere as the uniform of those who are always ready to help other. Wear it with pride and at all times be determined that your thoughts and actions make you worthy of it. And when YOLl reach your 16th birthday, I hope that many of you will continue your efforts to erve mankind by joining adult divi ions. For the older members look to you to carryon the splendid work which S1. John h3 been dOIng ever since the day of the Crusades.

To YOll, and to S1. ] ohn Cadets everywhere, I send you good wishes.

Chief Commander Sir William Pike introduces the Princess to count y an d area officers

( Ph oto: Keystone Press Agency)

(Below) Reviewing ambulance cadets

( Below) The Order of St. John Br onze Cr oss for life-savin g and gallantry was presentea to Hilary Fergu son and Lee Mo ore (left), 1 5 -year-o ld Northern Ireland cadets, for their service in the Abercorn restaurant explosion last March.

(Photo Keystone Press Agency)

Re viewing nursing cadets

Photo Keystone Pres s Agency)

Three cheers for the Commandant in Chief

Due to heavy, sultry weather there were fainting casual Displays of cadet ties among the ranks of cadets - but the Commandant activities over 50 met them too years

/receiver featuring modular construction on printed circuit boards. Transmitter power output is 25w wit h 12.5k Hz channel separation. The aerial is also at Les Pointes Lane and comprises a 100ft high lattice-braced tower constructed of galvanised steeL At the top of the tower are an end-fed VIIF aerial and one high-gain aerial array. Two red electric lamps fixed to its extreme tip act as navigation hazard warning.

Radio facilities provided by this system give full station-vehicle-station and limited vehicle-vehicle coverage on a si n gle freq u en cy. All ambulances ambulance cars, officers' private cars, well as those of key personnel, are so equipped. The mobile first-aid theatre also has a similar tran , mitter/receiver. There are six pocket-size portables equipped with two freq uencies, powered by detachClblc nickel-cadium batteries which are re-charged with the aid of a special u nit. Vehicles are of lOw transmision output, the portables are of 500 mW.

The Story of SJA Guernsey's Transport (Land,

Air) Department

Communications are, of course, an important part of the Department's island headquarters. The telephone system consists of direct lines, with separate coloured instruments, in the control room, and sub-control to the police, fire brigade and the Prin cess ElizClbeth Hospital ; and a private automatic branch exchange (PABX) with two lines available for incoming and outgoing calls, two for outgoing only, and eighteen internal extensions. This system also allows for direct access to the exchange lines by all the ex tensions, ex tension dialling, and transfer of incoming calls from one extension to another. Stand-by batteries allow uninterrupted operation in the event of a mains failure. Four instruments are connected to two 'ex-dire ctory' lin es for administrative work.

I nternal Communications

There is also an internal loudspeaking telephone system with its own private automatic exchange throughout the Department consisting of twenty-six

The history of the Sf Johl1 Ambulallce Guerllsey·s Transport Department, wn·ften and compiled by Staff Officer Ronald 1. IferJ Je, was recently published in book forl11 alld is beillg serialised ill (he R el'iew

instruments and providing the following facilities:

Direct communication between all instruments by individual push-button dialling; further push buttons on each instrument provide automatic answering, increased volume, etc; and the exchange has four connectmg circuits, which permIts four simultaneous conversations.

'Paging' by selected instruments, i.e. those in the control room, sub-control, chief officer's office, Clnu workshop areCl, for simultaneous announcements. When 'paging' is operated, increased amplitication through a 40-watt amplifier is introduced to all instruments as well as to loud-speakers in selected areas. When a reply is required a red lamp lights on

instruments and does not extinguish until the reply ha been made, when ir doc so automatically. (Thi ensures that the originator of the call experiences no delay in receiving acknowledgments, and also avoids duplication of replies).

'Conference facilities instigated from the chief officer's office, Wlth the other officers' instruments.

'Ab ent ervice' on all instruments. Used when a person desires his calls transferred automatically to another extension.

'Foyer priOrIty' enables control, by means of pecial warning tone to determine when the foyer instrument used by a member of the public, and thus enables priority to be given to them.

Radio

The main-station equipment is hOllsed at Les Pointes Lane, some three miles from the ambulance station. This is connected by land telephone line to the control and sub-control rooms from where it is remotely operated. The main station is a fully transistorised transmitter

\1onitoring equipment on the VHF shipping bands and the FM bands are held in the control room. A radio link on the Air Emergency Frequency is maintained wit h Guernsey airport's air traffic control.

The marine launch is equipped with tran mitter/receivers on the same frequencies as the control room's monitoring equipment, and a VHF ship to station set with two working frequencIes.

Closed Circuit TV

With the aid of a clo ed circuit televi ion camera and monitor using the 625 lines tandard, taff in the control room and sub-control are able to monitor the approaches to the station entrance and garages, giving early warning of first-aid theatre ca es, dangerous parking of vehicles, etc.

The camera, fitted with a 25mm fO.98 lens, is operated by a remote control panel on the main control-room desk. Movement of the camera on a vertical or horizontal plane are pos.ible, and ajustment to the lens aperture are also made from thi point.

A switch permits the transfer of vision to a second camera, with a f2.8 lens, fixed with a non-movable mounting at ceiling level in the garage, With a view of the duty board providing information on staff movement. The same switch simultaneously light two flood lamps providing sufficient illumination to the board. [t is often essential for controllers to be aware of who i on duty and where, and this system provide a quick answer to their questions.

Air Emergency

In the event of an emergency involving aircraft, Air Traffic Control at Guernsey airport have a direct telephone link with

T

the Llclnd's Fire Brigade at their Sl. Peter Port headquarters.

The lifting of the Air Traffic Contro l telephone handset automatically actuates an alarm y tem at the ambulance station, sounding a control-room buzzer and garage k laxon. This signal is automatical y timed and recorded by the Vehicle State' Indicator system which also transmits a warning tone to all vehicles on the road. Thus the whole station is promptly alerted.

The 1wo-way conversation between Air Traffic ontrol and the Fire Brigade, when details of the emergency are given, is then heard over loud-speaker both in the control and sub-control rooms, making immediate turn out of men and vehicles possible. (N.B. The Island police at their headquarters are linked to the system in a similar way to the ambulance service).

Pn e um at ic Tub e

Connection with the control room (on the first floor) and the garage is made with a pneumatic tube which provides facilities for the transmission of case sheets and similar documents between the two points_

Veh icle Stat e Indicato r

The Department was first in the field in 1969 when it introduced as an aId to efficiency a fully automatic vehicle state indicator system.

By u ing this system, the control staff can rely on electronics to handle all routine radio reports. It dispense with the need for voice transmission for standard messages, and with the control room handling something like 50,000 each year it save a tremendou amount of time and paper work, as previously each message was timed and recorded by hand in a report book_

Controllers can tell in seconds the position of all vehicles, their state of availability, i.e. free, committed or available, and whether they are at, or proceeding to, an incident.

If the controller is faced with an emergency in a particular spot, he or she is able by means of the Ma ter Control Unit to interrogate the system which will instantly show if there is a vehicle in the area, and if it is available.

Simp le radio reports of vehicle movements are cut to 300 millisecond pulses which are fed through the system. This checks, stores, times and records the messages and then pulses back an acknowledgment to the originating vehicle. At the same time a coded visib le record is printed on a paper roll by the printer unit.

Meanwhile, on an illuminated wall map of the island divided into 28 grid squares, a lamp lights to show the vehicle destination and its state of availability (each grid contains three separate coloured lamps).

The E lectronics Bay, a 6ft 6in high stee l cabinet, houses solid state (transistorised) p l ug-in printed circuit boards, etc. The internal control circuits use semi-conductors throughout with no relays or moving contacts , en uring silent operation and long life. It also contains the power supply pack, i.e_ a transformer rectifier unit and stand-by batteries, together with their associated charging and switching unit, which automatically maintains the equipment in operational use for a minimum period of one hour after the occurrence of a mains failure.

A clock circuit is also provided consisting of a master clock, two 24 hour digital slave clocks , one in each of the control and sub-control rooms, and timing for the printer unit. These continue to operate from the system battery in the event of a power failure.

Re sid e nti a l bung a low ome 50 yards from the control room yet still on station property, is the residence occupied by the chief officer. This is connected to the private automatic branch exchange and has conference and paging facilitie on the internal communications system. It is also equipped with a closed circuit television monitor and has a remote control facility on the main station radio.

Th e Control Room

This room may well be termed the

nerve centre of the station. Situated on the first floor of the building it is wood panelled and thickly carpeted to assist in sound absorption. Acoustic tiles cover the ceiling. The windows, double-grazed as insulation against loss of heat and to keep outside noise to the minimum, are lined with a reflective film which considerably reduces heat and glare from the sun during the summer months.

The control desk dominates the room. Seated here are three members of the control taff who have , within easy reach, the instruments and switches necessary for the prompt handling of communications The desk contains all the telephones, radio handsets, internal communication instruments, vehicle state indicator master controller, and closed circuit television control panel. On the wall facing them is the vehicle state indicator map and indicator panel, closed circuit television monitor , windspeed and direction indicator (for marine activities), and on a shelf below the map are radio monitoring sets. The vehicle state indicator electronics bay stands on one side.

Desk accommodation is provided for the fourth member of the control room staff; the remainder of the available space contains typewriters, photo copier and sundry items of office equipment.

The control room is staffed continually during the hours 9am to 6pm on week days ?nd during major incidents

at other times. Outside of these hours control is switched electrically to the sub-control room on the floor below.

Sub -control

This versatile room situated adjacent to the garage serves many purposes. It is first and foremost a sub-control where after the day control staff (female) have gone off duty telephone and radio calls are taken hy the men who are on the evening and night shifts. The men are also 'controllers' on Sundays

Telephone and radio equipment are immediately to hand at the three - position specially-designed desk. An internal communications instrument is within easy reach, and a vehicle state indicator panel is on the wall nearby. Maps of the island divided into grid squares are on the walls. At this desk, drivers complete their log sheets and emergency call reports. Monitoring sets on the shipping frequencies are here and a closed circuit television monitor projects a view of the station frontage.

A BBC/ITV television receiver is observed on a table - signifying another purpose of this room - that of staff rest room. It is comfortably furnished with easy chairs and is fully carpeted - again for reasons of sound absorption.

Yet another use, whilst not being used as sub-control, is as a lecture room or venue for staff meetings. (To be continued)

Cadets at work in Northern Ireland

TO N. IRELAND

At a recent London District surgeons' conference the Commissioner for orthern Ireland spoke of the problem of the Brigade in Ireland due to lack of ambulances. Commissioner R. T. Bax, of Eastern Area, and A. Bone of S.E. Area, Lo ndon, quickly got together and decided to send an ambulance as a gift to replace one put out of action.

Fortunately Southend St. John Division had an ambulance to dispose of, and although it had been promised to Grays (Essex) Division they agreed to release it. The ambulance was put in first class condition and filled with a large amount of useful first aid equipment. A member from orthern Ireland flew to London and drove the ambulance to Liverpool , where it was shipped to Belfast , and by 8 o'clock the following morning it was on duty.

This co-operation between various units of the Brigade is in the highest traditions of St John.

CRASH

A quiet Sunday afternoon S.ISpm newsflash: Air Disaster at Staines.

No. 121 Richmond SJA Divi sion put into practice its emergency procedure which has been in operation for three years. I understand that since the Barnes Rail crash in 19 S 3 there has been a SJ A rule of procedure; however I think it fair to say that this has tended to lapse. With this in mind, three years ago the Division began to prepare itself for just such an emergency as arose at Staines.

Members of No. 121 have been involved in three practice emergencies at London Airport, anticipating the day when their services would be needed. The Division is now on the official notification list for maj or incidents in the Borough of Richmond At London

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

BY THE EDITOR

APPOINTMENTS

The Order Fund R ai er/PRO: Mr. Geoffrey

Press Secretary: Mrs. Theodosia Anne Ellert.

Both will be joining Headquarters in September.

Barbados : Captain Farmer has resigned as CStJ A. Isle of Man: The Grand Prior has approved the appointment of Sir Richard Parkes as Chairman of Council.

India : Chairman Association and Brigade: Shri S. Ranganathan.

Commissioner-in-Chief: Major General S. S. Maitra. Sri Lanka (Ceylon): Commissioner: Lt.-Col. D. N. Jilla, ED. Airport the necessity for trained first-aiders at the scene of an incident is becoming more obvious, and this is where SJA could playa large and responsible part.

On the Sunday of the recent Trident crash members of o. 121 moved swiftly into action. Our ambulance, which had

been on duty all day at Syon Park, rushed to the scene with its crew. The re t of the Division were notified by telephone and made their way to the scene by car. On arrival, members reported to the Ambulance In cident Officer; unfortunately there wa little else anyone could do other than help with the removal of the bodies. The bodie were taken to the temporary morturary set up in buildings on the airport, The po t mortems were carried ou t by our divisional surgeon, Dr. Burton, who is coroner for the area. In the crash 118 people died. Of the plane there was little left but the engines.

The site of the crash, a small field, was a difficult one to get to; it was bordered on one side by trees, a wooden fence, and a ditch, and at the other end by a stream and boggy ground. The fence had to be knocked down and a temporary bridge built acros the stream. The bodie were moved acro this stream to the ambulance parking area. Many organisa tions were re p resen ted at the scene, each playing its carefully 'rehearsed' part, and going about the job

quietly and efficiently. The AA directed traffic with the police, and kept the road clear of breakdowns and bottle-necks

The Salvation Army made tea for the rescuers and distributed food. Members of the Air Cadets guided res c uers up and down the muddy slope of the dit c h Local SJ A members, and Divi sion as far away as Ealing and Weybridge, turned out and formed first ald parties. Seven Sl. John ambulances and four mobile units arrived at the incident. It wa interesting to see how quickly so many Brigade personnel got to the scene, approximately 60. The SJ A contmgent must have been one of the largest there. Weybridge SJA were a ked to stay all night to provide first aid cover for the rescuer

At thi incident there was nothing to be done but recover the bodies. If however the plane had been larger, or there had been survivors, the rescue operation would have taken longer and been much more dIfficult. Statutory emergency services i e the Fire Brigade would be concerned with rescue ; the Police with crowd control, traffic control,

DOWN

EVERYONE ALMOST

festival)

injury and organisation ; the Ambulance Service with transport to hospital. Who then deals with the first aid on the scene? The gap between rescue and expert treatment is where the role of St. John would seem to lie.

As a result of this experience we of Richmond Division have tried to improve our call-au t system and iron out any snag 0 that next time we shall arrive even sooner. Call-out practices have already been arranged using our improved system, along with mock incidents, rescue techniques, and lectures.

R. A Jackman PRO Richmond SJA

CRACK TEAM

In the recent :--J E regional finals of the Ca ualties Union held at Gateshead , I hear the winning team N'orthumberland Police 'B' is one which would cause organisers of any SJ A competition a real headache. For the team comprised members of both the newly-formed Northumberland Police Combined Division and the ewcastle City Division, an occasion for putting aside their St. John rivalry to produce a reaUy 'crack' team. In last year's Buxton Final they were second and took the diagnosis trophy, which they've nicknamed 'The Blood Bow]

Team members are: ewcastle City Division, J Hepworth, J. Inverarity and B. M. Coltman: and :\Torthumberland Police Divi ion, R. Rail ton and G. Spencer.

MEDAL

During a recent visit with his wife to the Johanlllter UnfaH Eilfe in Germany, Deputy Commissioner Derek R Fenton (London Di trict) had the distinction of being pre ented with the medal of the town of Mun ter. Only 11 of the SO medals minted in 1958 have been presented. These medals were struck to commemorate the rebuilding of the Town Hall. They ymboli e friend hip and affection and the desire for everlasting peace.

Graf Peter Bentheim (President of the JUH) al 0 received the medal.

CADET HELPS

A 14-year-old SJ A cadet recently saw a young cycli t eriou ly injured and gave medical aid until an ambulance arrived. 9

He is David Paulton, of Romford , who was on his way to the cinema in uniform when he saw the accldent between a car and a boy on a bike.

He stopped passers-by from moving the boy, instructed them to top traffic and to call an ambulance. Then he treated the boy 's injuri es until help arrived. But the injured boy, who had serious head injuries and arm and leg fractures, died in hospital.

David Paulton has been a member of C154 Division for about two years.

CLEAN-UP

Du ring August , I hear that cadets from six Nuneaton area divisions descended on a local churchyard, armed with shears, sickles and any other cutting implement they could lay their hands on, for a sponsored clean-up a nd grass cutting operation. The local vicar, overwhelmed with the problem of maintaining the churchyard, had willingly accepted an offer made by the cadets through Divisional Superintendent D Gould of St ockingford Ambulance Cadet Division.

Cadets were sponsored for every 71bs of 'cuttings' they collected, which were duly weighed and recorded.

DISABLED GUIDE

The AA has just published a new edition of its excellent little book Guide for the Di sab led , which includes accommodation throughout Bri tain (with full details of access, door widths, turning space in toilets, etc, for the chair-bound), highway and traffic information, breakdown assista n ce and organisations in Britain and on the Continent who give travel advice to handicapped visitors. This book is free to memb ers of the AA , otherwise lOp from AA, Fanum House, Lei cester Sq ., London WC 2 H 7LY.

EATS

The Norfolk SJA pUblication Recipes from Norfolk Hom es has as I hop ef ully 10

WATER FAIR

COMMUNITY CARE

'Co mmunity Care' is the general title for a sequence of tw enty-five BB C programme which starts at 7. 00pm on We dne day, O ctober 4 ( Radi o 3) The programm e are intended primarily as a contribut io n to the training of student nurses in 'com mun ity care' - a ubject of gro wing importance in the nurses curricu lum which d ea ls with the care and treatment of patients at home and in the communi ty. Although primarily intended for nurses, the programmes should also be of considerable intere t to all tho e who are professionally involved in the provision of social welfare and health ervices within the community.

even with

yachtsman Chay Blygh right in photo) predicted when I read it last year, proved a best seller and has now been reprinted. Copies of thi little book, that should be on the kitchen helf of every womanand man who thinks they can cook, can be obtained price 55 p, including postage and packing from SJA II/Q, 59 King St., Norwich OR OlB Vive la orfolk!

FILMS

A book which no division hould be without is the new SJA publication A Guide to Films, a catalogue of films available on first aid, nursing and allied subjects, and their distributors. Pr epared by the Vi sual Aids Committee of the SJA Medical Board , every film listed has been seen and commented on by the panel of experts who meet regularly at headquarters for film viewing.

A Guide to Films costs 35p, including postage , from the Stores Dept., Order of St. John, St. John 's Gate, Lond on, ECIM 4DA.

PARKING

There's free parking for members visiting the Farnborough Air Show, Sept. 8/10, at SJA Division's Some set Road HQ (see map), a few yards from the airfield They're also invited to call in at the local division 's HQ at the Control Centre by the main gate

DIRECTOR-GENERAL

The fo ll owing letter is from the Dire cto rGenera l of the Asso c iatio n Branch Sir Hugh Stephenson: I am so rry to have to t e ll you th at, following my re cent illness, it has become clear t o m e, that J shou ld r e linquish my appoin tment as Dire c tor-G ene ral ; and, according l y, I have proposed that J should be relieved of these duties with effec t from September- 1 1972

J t is a matter of great reg r et to me that J thu s feel obliged to bring to a n end my association with you, which I have greatly valued and e nj oye d.

) am mor e grateful than I c an express easily for the ex tremely clo sc and ready co-ope rati on you have given me, and for th e sen itive response to an expanding sit uati o n , which has made my task as Dir ector-Genera l so pleasant. I look forward with confi d ence to a con tinuation of this spir it with my successor.

We have been fortunate enough to secure the services of Mr. Nevill F. Marsh , County Dir ector (Greater London) to s u ccee d me and I know I can rely on all his present co lleagu es to lend him the same loy alty and support which has b een so readily acco rded to me

'The Chief Commander has asked me to join a small Advi sory Group in his HQ and I have accepted this invitation with great pleasure. In this way J hope to retain some link with the stlmulating atmosphere of Association development, which is constantly opening up new avenues of opportunity for u to exp loit for the good of the whole Foundation.'

NCB NATIONAL COMPo

The National Coal Boa rd 's first aid competitions 1972 , postponed during April, are now to be held at Belle Vue Manchester , September 30.

The sequence i divided into four uni t. Unit 1 deals with Community Health and consist of five programmes Unit 2 (starting ovember 8) con ists of seven case-studies under the title Community Care: Phy sical run e s. Unit 3, Community Care : Mental Illn ess and H andicap (starting Janu ary 10, 1973)

The final unit, Unit 4, (starting Mar c h 7, 1973), deals with Centres for Special Care and con ists of five documentary programme.

All of these programmes will provide mat eria l suitable for use in teaching situations; and nursing tutors will be encouraged to record them off-air to use the recordings in co nne ct ion with their own tutorial group and classes. In addition, Units 2 and 3 will each be accompanied by a 64 page publication specifically designed for nurses i n training.

The television eries 'urse in Training' will be shown again, at 3.45pm on Thursdays, starting on October 5 ( BBC-I ).

H 0 s pi tals and other professional bodies needing further details of either series should apply to the BB C Further Education Offi ce, Broadcasting Hou se, London WI A 1 AA

AT RANDOM (continued from page 1)

LI FETIME CHANCE

How about three months abroad on a Travelling Fellowship offered by the Winston Churchill Memorial Trust? This Trust, raised by public subscription a a memori a to Sir Winston Churchill in 1965, enables men and women who might otherwise never have the chance, to travel abroad, to widen their knowledge in their own field of activity and their experience of other people's live and work in different parts of the world, and thus enable them to contribute more to their profession or their voluntary ervice in the community.

Each year, the Trust select a different choice of subjects, in anyone of which the Travelling Fellowships are offered. in cluded in the choice of subjects for 1973 are 'Voluntary and Charitable Work' (which is right up our street, since it covers all forms of St. John Ambulance activities) and 'The Ambulance Service '. The grant cover all expenses for travel and study for an average period of three months. The closing date for applications s ovember 6 1972 and applicants will be interviewed in L ondon in J anuary 1973

I f you want more information, lose no time in sending your name and address (only) on a postcard to The Winston Churchill Memorial Trust, 10 Queen Street, Mayfa ir London W I X 7PD. By o doing you'll commit yourself to nothing ; but when the further information reaches you, you may find that it offer you the opportunity of a lifetime

FIRST AID FILMS

A very worth-while new booklet called 'First Aid Film (price 35p) has just been published by the Order of St. John It gives 1l1formation about nearly 150 films, all of which have been seen by a panel of doctors, nurses and first aider appointed by the Visual Aid Committee of the St. John Ambulance Medical Board. The booklet give the panel's frank appraisal of each film and usefu l information about it contents, how far it can be taken as authoritative , the sort of audience for which it is uitable, and how it can be obtained. 'First Aid Film' supplies a very real need, for it i many years since we produced anything of the kind and an up-to-date a nd thoroughly informative film catalogue i much overd u e.

I have no doubt that it will be of immense value to County Director, Centre Secretaries, County Staff Officer for Brigade Training, and (not least) Divisional Superintendents though to the latter [ would make bold to say 'Don'[ let your Division become film addicts: n o a m ount of watching even the best of films can ever be a valid s ub titLlt e for practising reaListic Ji"rst aid, though an occasio n a l good fi lm will add a spice of variety to your d ivisional programme , stimu lat e u eful discu ion and help you to practise fir t aid better.'

In cidentally, the work of our St. John Ambulance Film Appraisal P a nel has become 0 well known and re peeled that we

have been invited to become the official Health Education Film Appr aisa l Panel of the British Medi cal Association, and at the moment of writing I have just come from the first viewing by the panel in this capac ity Th e B"1A has established a certificate for films which have been judged suitable for medi ca l or health education, the essential qualification being that the film presents up-to-date , accurate information which can be confidently expected to achieve the aims for the audience for which it is advertised. For St. John Ambulance to have been given this task is a great honour and a great responsibility of which we all hope that we shall prove worthy.

INVESTITURE

The other day I had a letter from someone who had just returned from an Investiture in the Priory Church of Clerkenwell, at which she was admitted a a Serving Sister of the Order , and r should like to pas on to you what she wrote : 'During the ceremony, my mind went back over the centurie to the time when, in that arne c hurch , the monk of the Order made their solemn vows to serve God and all mankind. My deep feeling of pride in our Order is now tinged with humility that I should be found worthy to be admitted as a Serving Sister. I feel that the name Serving Sister is it elf very beautiful - a Sister belonging to a most noble family with the great Christian privilege of sel\fing those in distress ; and 1 should like to take this opportunity of thanking all who made thi s po ible for me ' PS Albert Schweitzer had doctorates in four ubjects. not three (July Review): [ 'm sorry I forgot philo ophy.

Sir William Taylor , Bt , CBE, DL, JP

The sudden death of Sir Willi a m Taylor on July 26 carne as a great hock to all Brigade members in the West Riding, coming as it did so soon after his retirement on St. John's Day

Sir William led a very full life; he was a magistrate the enior De puty Lieutenant of the West Rid ing, a Freeman of the City of London. a Member of Parliament from 1950 to 1964 and Under Secretary of State for the Air Mini try. A a founder member of the ir Training Corp he wa appointed Honorary Air Commodore in recognition of his exceptional services to the Corps. The e attribute made Sir William the ideal head of the Brigade in the West Riding when he wa appoll1ted Commissioner in 1965 and later Commander, and in the compartively short time he held the e positions he endeared himself to his officer and members . Sir William had a dynamic personality and the Jbility to encourage and in , pire other' to give their be t: he was alway approachable and no one appealed in vain for hi help or advice: of him it can truly t e said: .[ thank my God upon every remembrance of you.'

Hazards of Underwater Activities

by D E M ackay, Surgeon Commander RN

THE UNDERWATER MEDICI E SECTION of the Institute of Naval Medicine has a to provide specialist advice in this field to anyone who needs it. The better educated a nation is, the less likely will the request be relatively trivial. There have been innumerable films of underwater activities made for entertainment.

Broadly these are of two types - first the Cousteau and Hass films wh ich are primarily of photographic or scientific concern and second the underwater adventure series or feature often on television. The first group always reminds one that the environment is hostile ; the second are often guilty of dangerous, even impossible situations disguised in the film-making process. Both may be guilty of risky propaganda in their own way, because the spectator is deluded into a feeling of false security through the high skill shown in the first group and by umntentional over-simplification in the second part. Like driving a motor vehicle, diving is a skill which is not difficult to acquire with proper instruction and which gives a great deal of pleasure to those who are adept. Ideally one always concentrates when driving but is there anyone who on a lovely day with a good road and little traffic has not relaxed a little? Even such a small degree of relaxation in diving is unforgiveable

The conditions that might be present in a casualty in more than 90% of diving accidents are certainly familiar to most trained first aid workers The commonest action needed is the resuscitation of the drowned or near drowned. That is the first priority - and only then does one consider how it happened, and any further specific therapy.

First there may have been some predisposing illness. Any condition whi c h leads to a lapse of consciousness in or on the water leads rapidly to drowning. One may faint when one is on solid ground with little chance of doing even minor injury to oneself; in the water such a faint would lead to death in more than 50 % of 12

At the Medical Conference 1972 held ea rli e r this vear at Nottingham Unive rsity, Commander D. E.

Mackay R.N., IVho is senior medical officer (unde rwat er medicine) at th e Institute of Naval Medicine at Gosport, delivered the following talk. The Royal Navy also screened their training film Requiem for a Diver' alld a team of R. N. personnel gave a first-class demonstration of the workings of a recompr essioll chamber.

cases.

Coronary artery thrombosis in a 21-year-old has been reported with onset underwater ; the victim may hav e been a stabilised diabetic. Reputable clubs demand medical certificates on joining and some on an annual basis - but often the certifying doctor does not realise what is entailed. Recentl y advice was requested by a patient receIvmg maintenance steroids for a chronic skin condition as to whether his practice of stopping treatment for 2 days pre-dive was a good idea. Such a routine might have led to a withdrawal c risi s and was infinitely worse than maintaining his treatment. Peopl e may purchase and use equipment without having received any training or becoming members of a club and be ignorant of the implications of their medical con dition s. Casualties belonging to this group will need specific first aid. Any medical incident that may arise on land, may also arise underwater. Secondly there may be factors arising during the diver's descent to the bottom.

Disonentation from cold water 111 the external auditory ca nal has occurred. Pain in the middle ear and sinuses may be relieved when bleeding commences and this does not then indicate a fracture of the skull but a burst haemorrhagic bulla.

Haemoptysis may be shown by skin divers who use no breathing sets in hunting their finny prey. All these are examples of reduction of volume of the air spaces by haemorrhage into the tissues

pain but is rare except for badly-filled teeth. In the lungs the situation is more dangerous be ca use tears of the alveolar wall would permit gas to track to produce a p n e u mot h 0 r a x 0 r m e d i as ti nal emphysema or arterial air embolism, or any comb inati on of these. The embolism case is the one likely to need assistance. Hi s sy mpt oms will depend on the site of embolisation and the amount of gas present. The range is from immediate co l laps e with gross paraly is and uncon ciousness to a headache 8 hours later or, a i noted in the record, a patch of anaesthesia on the dorsum of the foot I 6 hours later which cleared on recompres ion. Pneumothorax and interstitial emphy ema can be treated in an orthodox fashion. Embolism must be treated by recompression as soon as pos ible as a general principle.

personality changes. Shock may also occur - but it must be emphasised that the treatment here is recompression when complete resolution of all signs and symptoms in seconds is the common result. fn fact the only safe rule is that any signs or symptoms that have no clear cut cause known (not intelligently guessed) must be considered a form of decompression sickness. This does make the deception practised by the Munchausen case less easy to diagnose.

out at about the 10 foot dep,th and the problem is agai n loss of consciousness in the water.

because there is no inrush of air to equalize pressure. The relatively harmless example i two lovely black eyes from a facemask with too rigid a rubber skirt. If the diver is wearing a dry suit, he may be 'pinched' by the c reases producing linear bruising.

ThIrdly there may be problems ari ing at the depth of the dive He may sustain venous type of wounds. Stonefish or sting rays object to handling or being stood on. Coral can damage the skin. The wise diver avoids those risk, nor doe he incur fore eeable problems with his equipment. These problems cover such points as running out of gas, polluted gas , or equipment failure. Recently the set of a man who dived in 15 feet of water with a pressure gauge known to be erratic at lower pressures and showing 100 lb p.s.i. wa examined. lIe was wearing 40 lbs of lead to make himself heavy, and had refused a line from his companion. Within 10 no bubbles were seen; hi companion found him in about 5 minutes but cou ld not lift the dead weight for another 10. The cause of death was 'drowning' but perhaps it should have been 'suicide by carelessness'.

There is another risk at depth and that concerns the physiological ac tivi ty of oxygen. One hould not breathe 100% oxygen deeper than 25 feet. The attraction of endurance and noiselessness of the rebreathing equipment are more than outweighed by the acute toxic effects of the oxygen. On one naval operation, the safety team suddenly found 5 out of 8 divers arriving at the surface round about them in epileptiform convulsions unpleasant at any time but nearly lethal in the water. Fortunately recovery is usually rapid and apparently complete - but the diver must be out of the water.

Fourthly one must l eave the bottom and star t the ascent. Any airspace which contai n ed gas at pressure equalised a t depth must be able to vent the excess at the right speed. Failure to do this in the sinuses of the head and neck will produce

There is a second risk at this stage which varies with the depth/time relation hips of the dive. This is the famous 'bends'. 80 % of the cases present as pains of varying severity associated with the major limb joints. The rest may show nervous system involvements such as 'lagger' for vestibular, 'spinal' for lower neurological signs, 'cerebra l for unconSClOU ne , visual dIsturbance, and

There is a special risk in the spearfisherman or breathhold diver - or indeed underwater swimmer in a swimming pool. The reduced volume of the ches t due to the external pressure means that the partial pressure of the oxygen inside the chest is increased; in urn this means that more oxygen is dissolved in the blood. As exercise continues, this oxygen is used up but may still be at an adequate tissue tension. As the subject comes to the surface , the partial pressure drops and there is a rapid reduction in tissue oxygen levels with loss of consciousness If excessive hyperven tllation preceded the immersion, it may be that there is no CO 2 stimulant to respiration till the hypoxia is too great to sustain consciousness. Such cases pass

St. John Returns

SJA Lin co ln shire celebrated the cadets' golden Jubilee recentlv with an open ilir ervicl' in the shadows of Temple Bruer Preceptory, near Sleaford, which wa occupied from 1312 for over 200 years by Knights Hospit a ller of the Order of St. John.

Depu ty Commissioner-in-Chief Watkin Williams pr ese nt ed first aid certificates to the cadets, and the Bailiff of Egle, Lord Cozens-Hardy, addressed the gathering (p hoto above). Accompaniment for the hymns wa provided by nursing cadets of Cherry Willingham Division (photo right).

The last period of risk is when post-d ive precautions must be taken. Hypothermia should be recognisable to trained personnel - a diver has been immersed in a cold medium; his clothing affects the slope of heat gradient without altering the essential element of outflow. Treatment is orthodox rewarming. Some 25% of divers report transient vertigo post-dive for which there is at present no explan tion, but this obviously must be considered for those driving after their dive.

In conclusion, drowning is the major risk. Hypoxia , hypothermia and puncture wounds may occur but treatment is orthodox. There are a very few cases of inj uries which need expertise. If there is any suspicion or desire for assurance then phone Port smouth 22351 and ask for the Superintendent of Diving (during the day) or the Duty Lieutenant Commander, HMS Vernon (at night). These gentlemen will contact the Duty Diving Team and a special doctor who will call you back if you give a telephone number and advise you on what to do and where to go for your nearest help.

Ambulances FROM

THE PAST TO THE PRESENT

The litter or wheeled stretcher, the forerunner of the present ambulance, was strongly favoured by Sir John Furley, a founder of St John Ambulance (Association in 1877, Brigade in 1887), for use in carrying patients to hospital in towns, and in villages via the railway to a town hospital. As many as 6000 Furley -designed litters were produced by a company at Ashford, Kent hence the Ashford litter. A litter had solid rubber tyres, and the legs hinged up to be come handles. No tice (centre picture) the 'cranked' axle, so that when the legs were locked in position (lower picture) the stretcher could be removed by the bearer stepping over the axle. Incidentally, litters were used by the police until about 1922 for 'arresting' incapable drunks. A com pie teA s h fo rd litter will be on view in the new SJA museum at the Gate

WIIAT is an ambulance? The definition in my dictionary is : a vehicle for the sick or injured; a unit of SllCCOur for wounded in the field; a movable field hospital. So the word really covers all forms of vehicle fitted out and used for medical or fir t aid work.

Today, of cour e, the word i u ed in a stricter ense and usually mean a vehicle fitted with a tretcher, seats and medical equipment and used for transporting patients from the scene of an accident to hospital. SJA in Britain owns an? operates some 500 ambulances of thl type and operates a further 150 (but doe n't own them) for local uuthontJes But in addition to many mobile first-aid units and other equipment are also operated by the Brigade. Thi serie of articles on ambulances (in its broadest sense) Will show s ome of the earliest J A vehicles together with those that are on the market today.

In cidentally, the photographs of early SJA equipment have been obtained from the library at St. John's Gate, where a St. John Ambulance mu eum being

Practice loading of a horse ambulance at a Brigade camp of instuction at the turn of the century. Forage caps denoted members of the cycle corps (mobile units) and we understand these members paraded with their bikes The two men in 'mufti' have obviously just joined the Brigade

AMBULANCES Continued)

pr e par ed ; f re ader s h ave a n y o ld photographs of SJ A w o r k o r ind ee d any old St. John Ambul an ce vehicles o r equipmen t, th e cu rato r of th e mu se u m, Miss Ni cho ls, O r d er of St Jo hn, St.

J o hn 's G ate, L o nd on, EC I M 4 DA, would b e pl ea se d to hear f rom them.

MOBILE EYE CLINIC

Two fully equipped mobile eye clinics, both of which include facilities for surgical treatment and living accom m odation for a medical team, have now been completed by IBIS M3 Limited, of Kendal, in readiness for a

AMBULANCE SPECIALISTS

REEVE (COACHBUILDERS) LIMITED

Models in our range extend from the simplest inexpensive conversions to the most sophisticated

to u r of Iran later this year. The major purpose of the tour is to tudy and treat trachoma a virus disease of the eye which can l ead to blindness preva lent in the Middle East. Trachoma is o ne of the mo t widespread eye diseases in the world the World Health Organization estimate that many million of people are affected by the disease.

The clinics have been produced for the I nstitute of Ophthalmology in London, and are being financed by the Order of St. John who have, of course, helped to pioneer a great deal of ophthalmic research work at their Ophthalmic Hospital in Jerusalem. The medical team will be lead by Professor Barrie J ones, Profe or of Clincal Ophthalmology at The In titute of Ophthalmology, and one of the leading international experts on viru diseases of the eye.

Pl ans are to drive the clinic overland to Iran, and tour village where medical attention of thi nature would not normally be available to the population. They are equipped not only for the tudy of trachoma but also to carry out eye operations, such a the removal of cataracts, a service which would not otherwise be available in these remote villages.

The units are mounted on Mercedes L608 chassis, are 12ft 6in long internally, and provide sleeping accommodation for six people in addition to shower, toilet, storage and cooking facilities. I n addition the units have been specially designed to carry medical and laboratory equipment, and electric generators, and can be con verted to undertake eye opera tio n The vehicles are air conditioned and drop-down tentage i incorporated at roof level so that covered pace is available outside the vehicle to provide for examination and waiting areas.

The medical team will leave London at the end of August 1972.

DORMOBILE

The latest Dormobile first line recumbent ambulance ha a complete GRP body except for the engine hood and grill panel.

Based on the 25cwt CP and available

with automatic transmission and 2.3 litre L engine, this new development is a clual purpose arrangement wlth l wo trolleys which may be used to seat elght with pull down arm rests.

In addition there are lWo attendant seat plus the driver and front passenger accommodation.

There is Sft 9 Yzins headroom, two external tool locker, a fuel tank with clearly marked filler on the left slue for a Kerosene heater, a large over-cab locker and man) other detail features.

This new model is in addition to the G RP bodied eight-seater and the van conversIOn wheelchair and stretcher models produced hy Dormobile Ltd. Dormobile Ltd., the largest

people on a l6-acre factory site.

(Ambulances, past and present, continues next month)

COMMER, KARRIER, AND ROOTES MAIDSTONE LTD.

An Ideal Combination to provide the right vehicle as a Stretcher Case Am b ulance, Sitting Ca se Ambulance, or f or conveying the incapacitated, designed and equipped to suit your requirements.

On the Commer we offer three roof heights, on Karrier three wheelbases. Up to 32 seats and up to 10 wheelchairs with centre gangway or 16 small whee lchairs.

The latest equipment for handling and securing wheelchairs is incorporated in our designs. The comfort, care and safety of your passengers is our main consideration.

We have been privileged to supply London Boroughs, Co unty Ambulance Authorities, various S o cie t ies throu g hout the country and Overseas Markets. Each enquiry receives expert attention by a dedicated staff who h ave made a ca r efu l study of this very specialised form of transport.

READERS VIEWS

exciting dutie to attend, many of which are for older ca d ets anyway.

Competitions such as an easier crossword, e c, co uld be fun (perhaps awarding cer tificates to the winners), and finally a quiz co lumn on first aid and home nul' ing, giving the a nswer in the following issue.

This is just an id ea to extend the name of est. John Cadets' and their services and to com muni cate ideas between divisions.

I look forward to reading any comments, especially fro m ca dets

Croydol/, Surrey Valerie Bettridge

TIMELY

from Mrs. Irene Lappage

Readers' views and opinions, which should be sent to the Editor, although published are not necessarily endorsed by the Editor or th e O rder of St John and its Foundations Although readers may sign pllblished letters with a pen name, writers must supply theIr name and address to the editor

I must thank you for the well-timed article on ge neral anaesthesia (Must I have an a n aesthetic by B. R. Little) in the July R eview.

This came in very handy for me last Sa turday when my 9-yea r-old on Andrew fell off his bike and broke his arm (radiu to be precise) and had to have a general anaesthetic before having it reduced. He was convi n ce d h e would 'wake up in the middle', and as I had already read the article I was ab l e to exp lain to him that this would n ot happ en. By t he time r h ad finished my explanation one or two other waiting patients also looked slightly more relieved!

After some time had passed and the anaesthetic had worn off and Andrew was told he could go home, imagine how pleased he was to be taken home in K ingston's' 106' St. John ambulance!

Kingston upon Thames Irene Lappage

DAME BARBARA

from S ir Hu g h S te p henson retiring Director-General

I was glad to see the reference to Dame Barb a ra Cozens, DBE., R CC., in the July Review , but it is high time that tribute was paid to her publicly for a little-known aspect of her great work on behalf of St. John.

Until the appointment of Miss P. Nuttall as Chief ursing Adviser of the Association on May 5 197 1 the Association had no permanent professional nursing advice available to it, and in these circumstances, we were obliged to resort to Dame Barbara on innumerable occasions over the years for technical and ot h er advice. This must, inevitably, have added a not inconsiderable burden to her duties as Chief Nursing Offi cer of the Brigade, and the quality of the new nursing manuals and the soundness of nursing examination arrangements are due testimony to Dame Barbara's extra-mural work in this respect.

Quite apart from the general excellence of her co un sel, the whole of the Association Bran c h would wish me to acknowledge the charm and human understanding which made her s u ch a va lued colleague.

I am delighted that she has found it possible to accede to my request that she should remain a member of the Association Committee in her own right, and we are thus able to look forward to a continuation of this relationship with her, which we prize so much.

Hugh Stephenson

BLOOD DO NO RS

from Ambulance Member

I am writing to ask if members would be interested in becoming blood donors. In case of emergency (ie the recent South London rail crash) divisional superintendents cou ld then have a list of blood donors as well as their emergency call-out list. With this list, local hospitals or doctors could replenish blood stocks for operatio n s th e following day.

The address for blood d onors in this area is : Regi ona l Transfusion Director, South Lond o n Bl ood Transfusion Centre, 75 Tooting Grove, Tooting, Lond on, SWl7 7 YB

There are region a l blood centres throughout Brit ain and [ would suggest that divisi ons send a list of names, addresses and phone numbers of members willing to be donors . Sidcup, Kent Ambulance lIfember

WHO ' S WHO ?

from R A. Fielding, County Staff Officer (Cadets) (A)

As a regular reader of th e St. John Revi ew, may I uggest that an extremely useful series of pictures signifying Wh o's Wh o' including high officers of the Order and Brig ade headquarters staff would be both of interest and value to many readers, particularly those who d o not have the opportunity to meet these people.

DISAPPOINTED

from N/M Mr M. J. Hanks, member-in-charge

I would lik e to put forward a few views and comments about the review of the St. J ohn Ambulance Cadets by HRII The Pnn cess Anne in Hyde Pa rk on July 23. Having taken cadets. to Lond on for what promised to be a very exciting day, my assistant an d r were turned away from the actua l parade because we are not officers of the Sl. J ohn Ambulance Brigade and the number of our was sufficient without us, despite the fact that we have run the Shrivenham division for over a year. lI owever, we were sen t by the Contro l Post to aSSIst the Lo ndon Transport Corps, and from then on we cou ld been made to feel more welcome. They were running the fust aId po t and I have never met such a cheerful group of men and I would like to thank them for making our day such a happy one. From the star t of the parade we were 0 busy and treated some 130 casualties.

I travelled back from L ondon fee ling that although I dld catch sight of Prin cess Anne, 1 had spent a very good day dOlllg what Sl. J oh11 Ambulan ce members are for.

ShrivenlwllI

Margaret Hanks

Editor: First, Mrs Hank, an apology from with the royal review. We can understand your dlsappomtment

and can only say that not permitting you to be on parade was an error by someone on a very busy day for everyone: The rally was for cadets and their officers including memberS-In-charge. The T)eputy Parade Commander tells me that on the day t!,ere was some 'necessary pruning' of officers and member -1l1-charge allocated to groups of cadets ; but these were or s hould have bee n allocated positions elsewhere on the parade. Unfortunately It seems that you were overlooked in this re-allocation.

CADE T TO DOCTOR from G S Hoggett , Vice President July Readers' Views letter Cadet to Doctor prompts .me. to mention Dr. L awrence Dunn Lawrence joined the Cadet DIVI Ion when it was formed in October 1943; gaining his certificate in 1944 he took a team of cadets to the fmals 111 Lond on in 1949 and 1950. Although they gained only 9th and 7th place respectively we thought it was a good effort. [n 1952 left the cadets to take up training to become a doctor. After hIS training he came to Middle brough and took a and joined the Middlesbrough Central Ambulance DlvlslOn as Divisional Surgeon , a post he has now held for several Doctor Lawr ence

Order I nvestitu

AS C H APLAIN

The Rev William Pye Ba ddeley BA.

AS COMMANDER (BROTHER)

Lieut- 01. James Ho ward Sydenham

The Lord Wakehur s

Capt. Robert Alastair In gham Cook

Harol Frederi ck Mulligan

George Flton Bates

A S CO MMAN D ER (SISTER)

I ranees \lary , \1i ss Dean MBE. SEN

1I1arJorie Avi ce, 'v1iss ic holson, SRN, C\1

AS OFFICER (BROTHER) (SUB CHA P LAIN)

The R ev. Canon Cosmo Gabriel Riv ers Poun cey

A S OFF I CER (BROTHER)

Raymond Le li e Jill e tt TO, MS. BS, TDM

George Mackay Gibson MB ChB

The Lord C r oft

Charles evJ! le Pa ckett, FRSA, FRGS, JP

Frank Reginald FreWin

Bright Ilenry William Tullett, MBE

Surgeon-Comm William Boyd Jack, [B E, R

Walter John Allingham

Vincent John Lane

Denni Edward Thomas

George 01arlton

Raymond Lewis J auncey

Robert James McDowell

John Jo seph Griffin

Benjamin William Owston

Albert Michael Thomp 'o n

John EdWin Varty

J ohn I farner

Rudolph Stevenson

Harold Hayes

Arthur John Ernest Taylor, OBE Le lie Fullerton

Lawrence edward Dunn, 1\18, BS

Frank

Raymond John Luton

Ernest Lowe

Aneurin LJewlyn Evans J oseph Anthony

Will iam Gorge Dawe

Bertram Richard Thoma Sharp

J ohn Russell Freeman MB, ChB. RCOG. \[RCGP

Dr. R. B Pardoe

William Duffy, BSc, SR

Herbert James Sargen t William Joseph Saunder

Stanley Stephen Stinchcombe

Cyril Leslie Stock

Thomas Venables

John George \Vhyman

Rear-Admiral James Humphrey Wah\. ". CB, OBE

AS ASSOCIATE SERVING BROTHER Ryszard Hencz

AS SERVING SISTER

Joan Evelyn. \lr s. :o.1aurice, SR

El ie \1 ary , \1rs Pailing

Floren ce Am} Faulks

Alison \[ary. \[ rs. Payne, \IBE. JP Sheila \1rs. POWlS Olive Rita. !llrs. Davie. SR 1 Tuge la Eliza, ,\[r s. Squire Grace Mrs. Whitehouse, SEN Nellis ;o.[uriel. Liddiard. SR \[argaret \Iichell , \t rs.

CADET MAGAZINE

f r o m V a leries B e ttr id ge, ca d et

I think it would be a good idea if there were a cheap magazine just for cadets (priced, say, between 5 p and 7 Y2p), for even if the cadet section of the Review is increased many youngsters wouldn't want to pay for other articles many of whi ch are beyond their scope.

S u ch a magazine would provide a link between divisi ons, and cadets could show their friends and parents that SJ A is a very large youth organisation. This might encourage friends to join when they read about the variou s activities.

Articles giving information about first aid and Grand Prior badge subjects would prove very useful. There should be reports about major competitions, events, camps and successful e venings at divisional meetings. A section showing w ays in which the younger cadets can develop their 'service to mankind' in everyday life also would be helpful s ince not all of u s have abundant and 18

I would the refore be grateful if you would consider publishing such a series in the St. J o hn Review?

Stockport, Cheshire R. A. Fielding Editor: Certainly . Such a series is being prepared.

D RESS

from S. C. Mallalieu, Area Superintendent (A)

For years I have ob e rv ed many discrepancies in the dress of uniformed officers and members of the Brig a de How ever, I feel attention should be drawn to the photograph o n page 23 of the july (August in fact, e ditor) edition of the St. John Review The Earl of St. Aldwyn is shown as th e Vic e Pr esi dent of the County and wearing the badge 77 on the shoulder s trap and n ot the left lapel as laid d ow n in the Dre ss Regulat io n s page 23. (T he Earl St. Aldwyn - my mistake: editor).

It will be appreciated the badge is very similar t o that of Commander an d co uld c reate confusion.

Bury, Lan cs. S. C. Mallalieu

A S OFFICER (SISTER)

Jane lIill, Mi s [ut ehin.on

Minnie, Mrs. Archer

Joan Mrs. Shaw, S RN

Ursula \1ary , \Irs. Fidler

AS SER VI NG BROTHER

J oh n Ro gnovald Anderson, B [, Cit B

Andrew Maxwell Dickson. ChB

Kenn e th Edward Smith

Walt er Glover

Raymond Stanley Green

Denis flenry Doble

Willi am Cowe n

Roy We s tw ood

lIarold Edward Loveless

Walt e r Robert Kempton

Willi am George Burgess

Donald Clifford

oseph Frederick Cu thbert Gerald Norman Febry NrB, CllB, DPII

ohn Raymond FLlfber

Arth ur James Il ayes

llillm an

MRCYS Itar o ld Frederick Torcombe. J P

Alastair Rennie

NEWS from SCOTLAND

The Order of St. 10hn in Northern Scotland before the Reformation.

In m e di eval d ays t h e co u nties a r ou nd Ab e rd een w e re ve r y imp o rt a n t t o t h e

Order o f St. 10hn, as ind e ed t he y are today. Th e A b tr ac t o f th e Chartulary of Torphi chen 15 8 1- 96 h a s 78 e ntri es concerning th is a re a and in the Registers of Ch arter s 1614-3 2 the numbers o f en tries for Ab e rde e n ar e 3 9 fo r Kincardine 16 , f or Invernes s 5 a nd fo r Banff 12: a t o tal o f 72 Of t h e sev e n church es p o ssessed by th e Ord e r in Scotland four were in the Aberde e n s hir e district. These wer e Maryculter , Abo y n e, TuLlich ( n o w united to Glenmui ck ) and Kilbathock (the old name for Towie on the river Don)

The largest pr o p e rty w a s th e b a rony o f Maryculter which c ontained a bout 8, 000 acres of ara ble land It h a d c o me int o the hands of the Knights Templ a r b efore 1239 by gift of Walter Bisset , wh o also presented the church of Aboyn e a bout 2 5 miles further up the Dee. In 1900 th e l a e Dr. 10hn Edwards measured the foundations of the old c hur c h of Maryculter and es tablised that it wa s 84ft long and 30ft wide , with wall s about 3 ft thick. It lay near the m a nsion house of Maryculter and was used as the parish church till 1782 when a new churc h was built about a mile to the s outh. Maryculter had been one of the two preceptories of the Templars in Scotland the other being Balantradoch (Temple). In 1312 the Pope ordered that they should pass t o the Order of St. 10hn and , so far as these properties were n ot despoiled , they c ame under the P receptory of Torphichen.

Although the Scottish H o spitall e rs were members of the English Langue, Torphichen had a direct link with the Grand Master himself in Rhodes and later in Malta. The Exchequer Roll s of Scotland sh o w that the Lord S t. John (the Pre c eptor of Torph ic hen ) was excused the payment of the standard export duty o f 4 / - per barre! o n salted salmon sent to the Grand Master in Rhodes as part of the responsions due from Scotl a nd: responsions were the annual contributions from the provinces to the Order's revenue , amounting to one-third of the produce from Ho s pit a ller properties. For example c ustoms duty o f £66-16-0d was ex c used on 27 lasts 10 barrels of salmon exported from Aberdeen in 1501-2 and of £61-12-0d on 25 lasts 8 barrels in 1502-3 (A last was twelve barrels). In ]520 Lord St. John was exempted from the payment of £76-16-0d , being the duty on salmon exported from Aberdeen 'for making hi s responsions to the Grand Master in R hodes' We cannot accurately assess the 20

Bish

Chan c ellor of t h e Order o f St John n Scotland Sir Andrew Murray ( 2nd from left) is shoyvn a model of the new town by the General Manager of East Kilbride Devel o pment Corporation, Mr George Young With them s c h a irman of the Corpor a tio n Mr George Walla c e a member of the Order a n d Mr Andrew Lawson, Re c eiver Genera of the Order

Some 200 Denbighshire m e mb e r s of t h e Brigade, including a r eco rd turn o ut of 100 young s ters belonging t o ca d et divisi o n s, p a rad ed at Llanrwst o n Jun e 25 for the annu a l co unt y se rv ice and inspecti o n

Th e y were insp ecte d b y th e Lord Lieuten a nt o f th e co unty , Sir Wa tk in William S-Wynne , wh o wa s a cco m pa ni e d by Maj o r Gen e ral Lewi s Pugh th e Brigade ' s deputy chi e f co mmiss i o n e r fo r Wales , Lt. Col. Nann ey Wynn e, assis ta nt chi e f co mmi ssio ner ; Mrs. Ann Pen nan t , ass ist a n t chi ef sup e rint e nd e n t, a nd C o un c ill o r Llewelyn Phillip s, c h a irm an of

wa ll s of S1. Mac h a r 's cathe d ra l a nd e r ec t e d th e two w es t ern towers. A t he ti m e t he Pr eceptor of Torphic h en, who gave conse nt to the pet i tion as P atron of Ki nke ll was anot h er de L ychto n, A le x a n der. It would be interesti ng to know the re la t ions h ip of the t h ree de Lychtons. Y ears la t er the Archb ishop of S1. Andrews an d the P receptor of Torph iche n both claimed t he pat r onage of K inke ll, which i. a parish now united wit h K eithhall in the Garioch of A b erdeenshirc.

J H Ca l der MacLeod

NOR T H ERN IRELAND

A prominent Brigade personality In L ondonderry, 34-year-old A lbert S m a ll woods (photo right), attributes much of the growth of SJ A 111 thIS area to good pub lici t y, and he with much of t oday's critiCIsm that the Press IS responsib le for a lot of woes and for wrongly manipulating public opinion.

I feel I have proved this through my pub licity work for this and other said Mr. Smallwoods. [ th ink a pUblicity officer for any vo lun1ary organisation can really use the ne ws mediJ to promote their image.' Mr. Smallwoods said a lot of other

OVERSEAS

vo l untary organisations in the city were not getting sufficie n

themse lves.

lI e be lieves a measu r e of his success

Ll a nr ws t Cou n ci l.

T h e eve n t was held in L1 anrwst t hi year because the local St. John division a r e ce ebrating their 35th anniversary.

T he pa r ade, unde r t he comman d of the co un ty commissioner, Sir William Lowther, m arched to t he service in the parish chu r c h and were l ater inspected a t Y sgo l Dy f fryn Conwy fie d.

T he rec t o r of Ll an r ws t t he R ev. Ri c h ar d R ober t s, co nducted the service an d gave an nddress, and th e lesson was rea d by Mr. E. C. Mars h a ll - Ilu gh es, who was t h e f irst superintenden t of L1 a nrws t di vis ion.

A the bl essing of Shoreham (Sussex) Ambulance Nursing Division's new mobile first aid

News from

the Divisions

included the words: Cadet Jubilee Year

Mascot-time (right) Cheshire Bebington cadets C Sgt Aider the First, with rosette of the division's 'A' team, (below) Wakefield nursing cadets' Ted d y Wakefield, their youngest membe r (5 yea rs) ( P hoto: Wakefield Express)

and Port Sunlight Combined Division was recently pre sented with a mob I e first aid caravan by

1922-72. The well collection box raised L 17 t owa r d a mobile physiotherapy unit to come into operation this autumn. An enrolment ceremony was held in the c hur c h during the week.

DEVON -Exmouth nur sing and cadet divisions are proud of the many former members who have become nu rsing sisters and SENs; it has just been learned that ex-nursing member 24-year-old Mis s Juliet Holt, who joined SJA as a cadet in 1959, recently graduated in medicine gaining triple degrees MRCS, LRC P and M BCh B. Miss Hoi t is now a houseman at Goodhope General lIe pital , Sutton Coldfield, Birmingham. When 9-year-o d Exmouth junior cadet Martyn Baker was involved in a recent cycle accident, sustaining a broken arm and leg, did the ambulance men find him in tear when they arrived on the Definitely not. !fis first words to them were: 'Now don't forget aJl reef knots'

LONDON -Eighteen memben of \\hitehall ursing Divi ion celebrated the diVision's golden jubilee early this year a St. John HOll e, Eaton Square which was attended by Area Commissioner Dr. Seccombe.

NORTHANTS -Although commercial traffic has practically ceased on the River Nene , at Wellingborough the river is still extensively used by pleasure craft. Wlth the idea of being ready for a unforeseen boating tragedy, Wellingborough Headquarters Ambulance DIVIsion recently staged an exercise at a wharf involving an 'e'<pl0 ion' with a number of casualties, one being blown onto a girder some feet above the ground and had to be lowered in a Neil Robertson stretcher. Further problem came with others who had to be removed from a boat. All went most satisfactorily,' said Divisional Sup!. C. Sturgess. 'And a lot wa learned '.

A 20-milc sponsored waJk for SJA in the grounds of Castle A hby recently raised £.530.

YOR KS -Ilallamshire Area Appropriately it was a poolside presentation at the Rotherham Oasis C l ub where the fund had been rai edwhen the Sheffield Junior Chamber of Commerce recently handed a Resu ci-Anne to Dr. J. R. Shortland. Sheffield Corps Superintendent.

OBITUARY

Mrs E. R. Allwright, Div Supt. (R), Wimbledon and Merton Nursing Division. Member sinee 1949. Serving Sister. Ra l ph Austen (Dick) Clapson, Ambu lance Member. Braintree and Brocking Ambulance Division.

Harold W. Drabb e, 71, Div. Sup!. (R), Shirley, Croydon Ambulance Division; founder member. Serving Brother.

E. H. E. GrtlTiths Ambulanee Member. Te l ephonc lI ouse Ambulance Division , Birmingham. 2 1 years service.

Frederick King, Div. Supt (R), Addiscombe, Croydon Ambu ance Division. Founder member C r oydon Ccntre. Officer Brother.

Char es F. Peddie MBE, 8 1, for many years coun t y secretary and treasurer Yorkshire North R iding SJ A Joined Bermondsey (London) DiYis ion in 1910. 62 year service.

Compiled by W. A. Potter

ACROSS :

I. Mazes in the petrous bone. (10). 6. Poisonous sap of Javanese tree each year is found in the United States. (4). 10. Roman hammer in the middle ear. (7). II. Lowest rank of patient? (7). 12. Factories producing flatulence? (9). 14. Refer to the coloure.d layer of the eye. (S). IS. An unusual pleasure to apply remedies for disease. (S). 16. Tropical danger minimised by wearing suitable headgear. (9) 18. A source to use for origin of the trouble below ground. (4-S). 20. Slight blow he applied to ridge of connective tissue. (S). 22. Turnip from Northern Europe. (S). 23. Producing fever. (9). 2S. Simple unsophisticated state of tea vine. (7). 27. They are paid for a disturbance of the game. (7) 28. Inflammatory condition always occurring in first year. (4). 29. Fungi set back for aspiring members. (10).

DOWN:

1. A lkaline solution turning milky in presence of carbon dioxide. (4.5). 2 disturbed by affections of I Across. (7).3. Febrile condition characterised by acute inflammation of the joints. (9.5). 4. Alan's broken bones. (5). S. Joint of Hippocrates. (3). 7. Place with unpleasant smell provides medicine prescribed to humour patient. (7). 8. Enlarge as a result of injury or disease. (S). 9. Endocrine organ at the base of the brain. (9.S). 13. Meaning one of the five faculties. (5). l6. Collapse produced by second lump.(5) 17. Manoeuvres supervised by the physiotherapist. (9). 19. Boys tie required in overweight condition. (7). 21. Play on words with refined fellow sharply stimulates the olfactory nerve. (7). 22. Venous channel of brain and heart. (5). 24. Artist with offer for dog likely to transmit hydrophobia (S). 26. Period in therapeutics. (3).

SOLUTION TO CROSSWORD No 8 (72) ACROSS:

I. Dressing; S: Breast; 10. Viper ; 11. Extension; 12. Stye: 13 F lea; 14. F.is.t; IS. Mad 17. Red line ; 19. Infer 23. A.tax.y ; 24. Cont.use; 2S. See ; 28. He.al; 30 To.w.n ; 31. Pile; 34. Treatment ; 3S. Pnnt; 36. Rodent ; 37. Proximal.

DOWN:

1. .D.e.vi.se;. 2. Emphysema; 3 Sore; 4. Needling; 6. Runt ; 7. ACll11; 8. Tmcture; 9. Steam; 16. Diet; 18. Lays; 20. Fastigium; 21. Cat.heter; 22. Hot-water; 26. E.the.r; 27. Mental; 29. A.m.end; 32. Stun; 33. Apex. 24

from the Divisions (continued)

CLASSIFIED ADVERTISEMENTS

Savlon cleans, kills ger111s and helps healing. In one operation.

'Savlo n ' Liquid and 'Savlon' Cream are indisp e nsable to your first-aid kit. They ge ntl y clean away dirt. killing the germ.s that would infect the wound. The antlseptics in both products are powerful, safe. They were discovered by ICI and are now u sed extensively by doctors and hospitals in this co untr y and overseas. SAY

CPS AVIATION SERVICES

COMMA , DER St. J ohn Ambulance 1 wou ld like to pay tribute to the active participation of Pr ince William of G loLlcester in the work of the Order of St. J ol1n, and al 0 to expres our deepest ympathy to his parents respectively G rand Prior of the Order of St. rohn an d Depu ty Commandant-in-Chief of Nursing Corps and Divisions.

His Roy:ll Highness first became interested in St. John in 1958 when he gained a First Aid Certificate while a boy at Eton and joined the local Divi ion a an ambulance member. He became Commandant-in-Chief of Ambubnce Corps and Divisions just before he went to Tokyo in 1968, and throughout hi time the r e he expected to be kept fully informed about our activities. On his return to tlli country in 1970 he immediately re-emphasised hi interest by visiting our Headquarters and meeting many of the stafr. Thereafter he gave generou ly of his time and attended St. John events in various parts of thi country and oversea, bringing to our affair a refreshing and original outlook. He did not to be asked to do thing for u : he ju t went ahead and did them whenever opportunity offered. He combined In active mind llnd an enormou intere t in the history and tradition of St. J ohn with a friendly and engagingly informal manner which captured the hearts of everyone he met and particu l arly of our younger members. He is indeed a great 10 to our movement and we honour hi ' memory greatly.

Wil liam P ike, Chief Comman d er

AT RANDOM

by Watkin W. Wi ll iams. Deputy Commi ioner-in -Chief

GOT BACK at the beginning of September from a fortnight's holidny on the -:ontinent, rna t of it spent re-visiting the enc han i ng hill-castles and valley tream, pastures, villages and vineyard of Lu'Cembollfg , and walking on the beech-clad slopes (colITintled 011 page 11 J

Glouc estershi re More than 300 nursing and ambulance cadets from throughout the cOLlnty, under Miss J Ash, County Staff Offi cer for Cadet were reviewed by the Earl St. Aldwyn, Vice-President SJA and chairman of the St. John Council for Gloucestershire , at Gloucester on May 7. Foll owing the inspection Earl St. Aldwyn congratulated the parade and pointed out that there were 2,500 cadet divisions in the country with a t otal of 98,000 members; he h oped GloucestersJJire would give a lead to the country with a drive to increas e m embership to 100 , 000. Recruits were desperately needed to keep up with the ever increasing demand s on SJA for public se rvi ces.

The in spect ion was followed by a service and enrolment ceremony at which 90 cadets were enrolled. At the presentation of awards 9 nursing cadet re ceived their Grand Pri or's badge.

London

Eighteen cadets from Canada, B er muda,

A cadet and her flag. Braintree an d Bocking Nursing Cad et Divi sion's flag bearer H elena Mess enger, now In the adult diVISion when the

Cadets Celebrate Jubilee

Australia, R houesia, St. Vin cent and Maltl were guests at L o ndon District 's annual cadet camp from ugust 6 13 as part of the Golden Jubilee celebrations.

The camp, at the Isle of Wight 's Totland Bay, was vi ited by Sir Il iiton Poynt o n, Director or St. J ohn Overseas, and inspected by the Commissioner and Di s tri c t Superintendent ( llrsing) of London Di strict Col. H A. L ewis and Mrs. D. ll oadley. Two Austr<llian cadet officers <llso visited the c<Jmp Most of the overseas cadets had been guests in the homes of London District members ince mid-July.

Cadet Jubilee Year celebrations began in th e Eastern Area of London District with a c<lmp from \pr il 14 16 at the E sex County Council youth camp Site, Danbury Park near h elmsford. 37 boys, 49 girl, and 42 adult (ll1cluding the Commissioner, :vir. R T. Bn, and -+ member of his staff) spent a very fine weekend under canvas 111 this lovely park. and everyone enloyed the weeh.end, which included sport events, a sawdus t chase and a discotheque.

rhc tlrst St. .Iohll \llliJu lalll'l' Hm:ade cadd diVision to lx' torlllcd Ila, C:Jlcsl'lCd d NUNng Cndets 011 25 1l)22, but the dil i\ 110 IOllgc r in l',bll'llL'l'. The Ill',t dlvl\lons lo bl' i{; rlllcd Ilerl' '\Id ershol AlllbulanL'l' Catlc'h on JUJll' 14 19 22 .llld Shiple) (I\ R '{or" \) Nursing C:Jdl'h Oil .Iune 27. Hoth 01 (hcsl' division, arl' sllli II Ith us, f\ld ershot ha, 15 I1ll'lllbl'rS, Shlplq I I. or the 19 cldL'l division, slarled In 1922, Sl'ven arl' ,1111 In e'\lsll'llce. Thl' 19 dll isil1n\ Wl're: Dall' of formallon In 1922

Gall'shead Sall\\'L'1I -";Cf) (l)lIrhalll) 25. 5 i\ldershol ACD (lIunls)" 14 6. Shlple) 1\\ R York.,)', 27. 6. Springwl'll Collier\' ACD (Durham) 30. 6. ACf) (\h!r"s)' 7 9.

\\ iliinglon "ICD ("Iorlhumb)

Illlh cr Gn:en ACJ) (London) London Posl Officl' ACD (London)

Bradt'on (Qul'cll.,bur) ACD i\\ R Yur"s) 2(). Y. 5.10. 26.10. 3.1 I 3

I\ddisL'olllbl' I\CI) (Sum') ) Rochdak (ROl he) \CD (Lancs)' Ro chdale (Rochl') CD (Laill's)+ Gall'shead Borough :--CD - 23 11

1I1111 \Veslnn ACJ) (I R Yor"s) 24.11. o rt il:Jlllplon (orlhs)* 2H.11. Devonpor( I\CD (Devon) -+ 12. limbur y CD (London) 512. Pcrq \13111 \CD ('\forlhulllh) 9 12. Ilcllon-iL'-lIoiL' I\CD (Durham) 24 12. denoles diVISions \( ill In L'\:J\tl'l1L'C.

Norfolk

As p<lrt of the Cadet Jubile e celebration', a challenge race tooh. place on Sunday, Jun e 2') between Y armouth and Gorleston ambulance cadets. rhe race, along Yarmouth's 'Goluell Mile' from the I:3ntannla Pie r to the pleasure h l ,h: il, started by Ir Norman Burtensilaw, ce ebrated international referee, whose [ather was o nc e supcrintendcnt of Gorleston Divi sion.

A cadet from each division progressed <It the rate of one step per penny u onated, while te<l m members with collecting boxe persuaded the watching public to spo n sor their particui:lr team.

The race was won by Yarmouth Division, who were pre se nted with a £5 note for Brigade funds by Mr. A. Botton, c hairm<ln of the Pl easure Bea ch Company. lI e then distributed free tickets for pleasure beach rides, much to their del ght.

The event was televised by the BBC and shown in the local news programme Look East.

The organiser, fJiv. Supt. A W. Child of Gorleston, believes that this method of raising funds ha s not been tried before and offers the idea to other divisions who arc inter ested.

Northants

It was a great disappointment to Northamptonshire cadets that the weather ll1terfered with thelT Golden Jubilee review on June 19

What wa· to have been an impre sive display 011 Northampton Racecourse :lad to be 1ransferred to the T.A V.R. Drill Hall because of rain which also effected the attendance

Special attention had been given to the review as the county, in the Northampton ursing C<ldet Divisi on, posse ses one of the few division in the country which was formed in 1922 and has continued for the fifty years.

The parade was Inspected by the Lord Lieut enant of orthamptonshire, Lt. Col. J Chandos-Pole, who complimented the boy and girls on their smartne s. Later, he presented R Grand Pri or Badges and a Special Service Shield.

fllr. Chando - Pol e, the Mayor and Mayoress of orthampton, Alderman and Mrs. K Pear on, and the county vice-pre Ident, the Ma rchione s of Northampton were pre ent.

J osephine Thompson, of Kingsth orpe ursing Cadets, is the second of three isters to receive the Grand Prior' s badge, and her younger sis ter is working towards making a third in the family.

Suffolk

On Sunday May 7 over 600 cadets paraded at Bury St. Edmunds for the celebrations. A service of dedication wa held 111 the cathedral, the addres!> being given by the Bishop of St. Edmund bury & I pswich, the Rt. Rev. L. W. Brown , Chaplain & Sub-Prelate of the Order of St. J ohn. The lessom were read by a nursing and an ambulance cadet. County Director The Rev H G. Eade took the prayers. Th e packed congregation in their uniforms made a most impressive sight and the rousing singing of the last hymn

The Cross of St. John made it an unforgetta ble occasion.

After the service the cadet were formed up for parade under the command of Deputy Commander C. W Leverett , OBE, and ed by the voluntary band of RAF Honington they marched past the aluting base in the Abbey Gardens, The alute was taken by the Lord Lieutenant of Suffolk the Earl of

No rf olk ambulance ca d ets a r e ready for the 'off' of a new st yle race as the starte r addresses the c rowd See NORFOLK

Suffolk's Bury St. Ed munds parade was attended by a proud member - 16 - yearold Cadet Leader David Hilton of Felix sto we who has been paralysed in his legs since he was four. (Photo East Anglian Daily Times)

At Surrey's Focus 72 cadets del iver their co lle c ions, which totalled £572, tot h e Hospitaller Mr. T. Keith Lyle for the Ophth a lmic Hospital

of ST JOHN CADETS (JHALl.ENtJE /lAOl..

Overseas cadets joined Londo n District's ca det camp this summe r

Photo Frederick Ja ckson, Cowes)

trudbrok e (President, Sl. John ( olincil or Suffolk), who was accomp;)nled by the Muyor und Mayoress of Bury Sl. Edmunds ,lnd other civic c1ignituries, M:1jor R. S. Schreiber , Commander for Suffolk, Lady Blunchc Cobbold. County Pre sident, and other county stafr.

The cadets were then addressed by the Earl of Stradbroke. Major SclHelber conc luded the proceed ings by thanking aJl for their attendance and appreciation in particular of the work of ASOs W. Pe ck. Mrs. D Mann and A. G Feaver, und DO Mrs ntt'r. who in co-operation Wit h the local authority made the cekhrution., slich u succes!>. One felt that. [he eight-pOinted cross, the Cross of l. J ohn, stili shines like a st:lr the years pass by.

S urrey

Under the ehJlrmanship of Mr. R J Gristoek. County uperintendent ( \), a committee 'AdS set up to Inaugurate programme 01 events to eelehruk the Golden J lIbilee. A knockout l'Ol11pl'lltion was planned tor the morning period ulld separate Divisions entering theil own contrihutions ror lhe

Each CJdd had been asked to carn at least SOp and on the afternoon the monies would be prcsented to the Hospltaller ot the Order, Mr. T. Keith Lyle, ;)S ;) gift for the Ophth;)lmlc Ho pltal In Jerusalem The commlttee was astounded at the response : the cadets worked hard and the total handed to the flo spitaller was £572.

Miss P. N Morrison, Chief Officer for Cadets, In :J letter to the CommiSSioner for Surrey, wrote It really a most outstanding event. To thlllk of all those hundreds of cadets from throughout the county being present all day ever have I seen such a thoroughly keen, enthUSiastic and effIcient g:Jthering'

Among the guests were Sir Peter Studd. County President : lormer County Vice-President (T\ursing Cadets) Lady Osborn : The Mayor of Guildford, Sir George Scott, Commander for Surrey; Barry R oblllson, Commissioner for Surrey: and members of the County :Jnd Area Staff. •

The story of SJA Guernsey 's Transport

Programme s of the Hyd e Park cadet jubilee reView, which readers may like to have as souvenirs, ,He availahle price lOp each including postage from London District SJA lIe adquarters, 29 Weymouth St., London, WI 4DR.

This fascln ilti ng re co rd of SJ A Guernsey's services to the Island community, which IS being serlalised in the ReView, is available in book form, price 45p In c luding postage, from the St John Ambu lance Transport Department, Ambulan ce Station, Robals, Guernsey, C I

Decompression Sickness (the Bends) and its treatment

FOR SOt\.'Il: YLARS concern was expressed in Cuernsey at the lack of t'acilil1es avail:1hle for the treatment of the Bends, but it wa not until 1969 that the Department , through the generosity of The Ilay ward of England able to a ((Flire a [",ortable recompre 'slon chamber and Its cqlllpment 01 air storage bottles and compressors. Accommodation at the ambulance ')tation increased greatly by 1972 With the addition of a complete treatment room Incorporating the portable ch:Jmber.

The type or person in Guernsey most likely to encounter the Bend * is an aqua-lung diver and the treatment of a confirmed c:Jse is urgent. It is also trlle to st:Jte th:Jt diagnosis can on ly be confirmed in some instunces by recompression The effect· can be particularly unpleasant, with stiffness and pain in the Joints, weakne of the limbs, difficulty in breathing. y rtigo. disturbances of speech and viSion. etc., and unless treated promptly, permanent paralysis or even death. It is a seriou conditIOn which can have tragic conscq uc nccs.

Wit h the amenities now ayailable, a casualty can receive prompt first aid treatment by specially trained staff. A specialist do ·tor i ca lled in who contlllues the examination and treatment. Upon reaching the deCision t o admit

* Burst lung or air embolism may cause Similar symptoms but the treatment IS the same.

Patients viSiting the department's first aid theatres from 1948 to 1971

the casualty to the chamber. the doctor mllst decide whether or not treatment can be carried out in Guernsey. This will entail keeping the diver in the chamber for some hours at carefully controlled pressures. He is placed on a special stretcher inside the chamber which is then sealed and pressurised; subsequent voice contact is via a two-way intercom, with food, drink and medical supplies being passed through the air lock

The doctor in charge of the case decides upon the pressure at which treatment must be carried out. This is dependent upon muny factors, C.g. the depth und duration of dives recently undertaken, the eyerity of ymptoms, etc. Air is then introduced into the chamber from the storage cylinders and allowed to build up to the required pressure a maximum of five atmospheres. The St. John operator, by carefully monitoring the dials set on the chamber's control panel and by regularly adjusting the cur yalves, ensures that a flow of air is maintained and the correct pressure sustained.

If. however, owing to the nature or scyerity of the ca ualty's condition local treatment is not advisable, he i still placed as quickly a pos ible in the chamber :lI1d compressed. Arrangements are then made by telex with the French naval authorities at Cherbourg to admit the sick diver to their static multi-place chamber at the dock yard. An aircraft is chartered to transport the Guernsey chamber to France where it is locked on to Its larger counterpart, the pressures in both equalised, and the ca ualty

transferred to roomier surroundings where he may remain under pressure for some two or three days. More elaborate treatment can then be carried out by the French medical team.

Within a few weeks of the arrival of the chamber in Guernsey the first diver was admitted to its confines. Since that date a total of 16 men have been treated, 6 of whom have had to be flown from the island to receive more complex treatment.

The Portable Chamber

This one-man portable recompression chamber has been manufactured to facilitate prompt recompression of a casual ty, and to enable, should the need arise, his transport (still under pressure) to a multi-place static unit.

It is designed to lock onto the French static chambers and in our case the casualty would be transferred to Cherbourg for this purpose.

I ts specifica tions are:

Interior volume

Weight

Working length

Max. working pressure

Test pressure

Dimensions of lock:

Working height

Minimum diameter

5

The chamber is equipped with :

1 Entry door with interrupted thread and 0' ring seal.

2. Coupling ring for multiple chamber (French ize).

3. Lock for admitting food, medical supplies or equipment.

4. Battery operated two-way telephone.

5

5. Three plexiglass windows situated near the div er's head.

6. An adjustab le air pressure regu lator with si lencer.

7. An exhaust valve drawing air from the bottom of the chamber.

8. A flow meter to monitor the ven tilation.

9. Two pres ure gauges indicating the internal pressure; the first, for precise low pressure readings, 0 2 atmo pheres, which must be tUrned off when u ing the higher pres urcs indicated on the second, 0 6 atmosphere gauge.

10. Safey valve.

11 Pressure equalisation valve in the door nec e sary when coupling to a larger cham ber.

12 Battery operated interior light.

13. A stretcher, the head of which can be raised and lowered.

14. Two hand mils for carrying.

15. Blanked hole for extra connections.

For ease of operation and increased safety all the controls are grouped on a covered control panel.

Additional equipment includes : 24 hour clock.

In terval timer.

Sl eeping bag, etc.

Treatment Room

ThIs carpeted room, warm but well ventilated, is part of the building extension completed in 1972 and is fully competent for the reception of casualties suffering from the Bends.

Its equipment includes the portable re-compression chamber, hospital type bed, oxygen trolley, drug cabinet, sphygmomanometer, phy iological monitor , etc.

Compressed air from the air torage bottles in the compressor room adjoining is piped to a point above the chamber which is connected to the outlet valve by flexible high pressure hose.

Compressor Room

AdjOIning the recompression treatment room is the small room hou ' ing the main compressor used for filling the air storage bottle. When in use this compressor room requires large volumes of clean, perfectly [iltered air which will be inhaled by the casualty. I t is a three stage compresso r, water coo led (mains supply) and vee belt driven from a single electric motor of 30 BHP.

Inter and After coo lers are provided to cool the air between the stages. A high pressure water tap, dryer bottle and a carbon filter are also fitted. Its maximum working pres. ure is 3800 p .i. with air delivery approximately 30 cu. ft. free air per minut e.

Four large air storage bot lies are retained here; each can be filled in approximately 15 minutes by the compressor. Two are held in readiness for travel with the portnble chamber and are

fi ll ed to 2500 p.S.1. The n:mainlng two at 3650 p.s.!. arc l inked, easily disc onnected, via Tungul11 I [i gh Pressur e piping (maximum working pressure 6000 p.s.i.) to the chamber next door.

A small reserve compressor is also available and alongside it a small water tank, used when filling divers ' air bottles to keep them cool.

Static Chamb e r

A thorough re-appraisal 01 the whole system 01 treatment of the Bends outI!ncd recently cum pleted by the scrvice in consultation with the specialist dodor concerned.

The problems relating to treatment and care of Bends casualties, along with the problems of emergency air travel. were cardully considered and it was dccided that a static c1ulmber was imperative at Guernsey.

The [[ ayward I-oundation was and very kindly agreed to donate the sum of £12,000 to enable such a unit to be and installed at the station It became operational by mid-sulllmcr IY72 ([his type of ch,lll1ber weighs approximately 5 tons, IS over 12ft. long and 6ft. 6ins. in diamderl.

The static chamber enables recompression of casualty to be commenccd more speedily and conSiderably reduces the necessity to fly Jnyone from Guernsey. l\1ethods now differ ina:-.much JS the patient is usually c1dmitlcd to this new chamber soon after arrivJI at thL' bccause doctor Jnc! atlenddnt L·;111 _lIso be admitted tu undertake and tre<l(lllent.

In instances a casuJlty can be put Into the portable chamber at the docks, or some other pOint of landlng, be pressurlsed Without delay ambulances have been converted to C_lrry the cqulpment. [Ie would then be taken to the station's sLltic unit and thruugh the lad., the door of which has been speCially adapted to permit this while III both chdmbers Me maintained. A further report of thl' usc of thi· static L'hamber will appear In the \-{eview next

Th e Rescu e Room

The rescue room s itu ated ,II the rear of the garage easy loading illto veh icle s of equipment which I stored on 71l. racks around the \\alls of rool11 so to safely and eiliciently effect thl' which the service i upon to t'xecute.

This equipment Includes rescul' line ' ropes. 'iaret) "nd protective boots for c liff rescues. Coggles ;lIld gloves to give protection from, m<lchets and knives to cut, thL' thld. gorse and brambles which often grow profu ely to a height of g kel ,1Illl n1lHL' 011 tilt.' cliff edges wht'l"e rescue teams orten han:' to

work [[ elmcts, too, arc necessary; the danger of loose rock falling on both rescuer and rescued is very real, and ski ll and care on the part of the team is cssential to avoid this eventuality.

Ilydrauli c rams and wedges with up to a ten-ton lift are in their box, along with thc hand pumps required to operate them; persons trapped in cars or machinery need spccialised tools for their extrication if futher injury is to be avoided. Compressed air cutting equipment; saws and chisels are readily available for the same purpose: and a pair of hydraulic cutters (which will cut mild steel up to 5/8in. diamcter) are also at hand. eil \-{obertson stretchers, used often In an island community, as accidents happen too readily in Inaccessible places in holds of ships, on rocks in quarries.

There a re powerful f100dlamps and torches, including a speciali ed lighting set Lonsi<;ting of two floodlights, two t rip 0 cI san d n g e n era tor. Th ese floodlights, one filled with a 1000 watt

lamp ancl thc other a 750 watt, project a constant, brilliant light out to the edge of the total a rea of illumination some 32,000 sq. ft. for each floodlight. Power is supplied by the portable generator weighing approximately 30lbs which provides current to the floodlights nt 110 volts AC.

There are also self-contained breathing apparatus protection for the rescuers should they be required to enter gas-filled sewers or wells polluted with foul air and breeches buoy equipment. [n the United Kingdom this is the work of H .M. Coastguards but as Guernsey IS outside their sphere of uperation St. John is responsible for this form of rescue. Consequently boxes of rope whips, jackstay, rocket lines, the 121b. rockets and their projector, the tripod, stakes and breeches are all hel d in read in ess. Automatic resuscitators, disaster kits, portable generators, protective clothing, spare stretchers, do not complete the inventory of this room: but all are necessary for one form or other of rescue.

(Above) Recompression treatment room

(Below) Just some of the equipment In the rescue room

RECEIVER-GENERAL

The Grand Prior has approved the appointment of Mr. Angus Murray CBE, as R eceiver-General of the Order in succession to Mr. Parshall, whose resignation on grounds of ill health has h ad to be accepted. For many years Mr. Murray ha been the Chief In vestment Manager of the Prud ential Assuranc e Company and is on the Board of that company.

WELCOME

Th e new Director-General of St. Jo hn Ambulance is Mr. eville F. Marsh, CBF, MA a former Deputy C h airman of the Electr icity Council , who suc cee ds Sir Hugh Stephenson.

PARADE FAINTINGS

Lond o n Western Area Commissioner Dr. G. 1. P. Se cco mb e writes:

The march onto the parade area and the long files of correctly sized cadets was a m ost impressive feature of the Hyd e Park jubilee parade. Planning such an event requires great detail but even so a plan can on ly give deadlines for time and pl ace and mu st l eave to each can tingen t-leader to ensure a fit contingent able to survive the excitement an d strain of the day. It took half-an-hour to 'size' a company. The flag parties, coming from all parts of England , had to be rehearsed. Sund ay transport can be infrequent. Those superintendents who arrived early enough to ensure that they and their ca d ets ate a reasonable meal and had a drink before the parade found that few of their members fainted.

The number of fainting casua lti es on this parade was greater than expected, especially as warnings concerning the import ance of food had been issued The weather was not to blame. It was a fine day with some wind, not too hot or sultry. Ther e was rain at the close.

It is esti m ate d that of over three thousand cadets o n parade about four hundred required first aid at the two mobile units or at the two emergency points that had to b e se t up.

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST . JOHN

London Transport mobile unit did outstanding work in very difficult circumstances and dealt with about one hundr e d cases. They had no doctor until [ was ca lled to help. Since their mobile unit has a capacity for only two upine patients the majority of the patients had to be dealt with in view of the public eye, in the open and on the grass. The few plastic ground sheets and blankets were soon used up.

Apart from the si mple faint the commonest comp laint was difficulty in breathing This led to overbreathing with the onset of pins and need l es in the limbs, cramps and tetany or spasm of the hands.

Vomiting, sweating and headache were not noticed in the casualties r saw. or was there a raised temperature.

Thei r symptoms were a new phenomenon to many of the casualties and they attempted to relate them to some previous medical experience, ie hay fever or asthma (no cJimcal evidence), a medical examination concerning their heart or even past kidney infection. This added to the natural anxietie of first - aiders in dealing with the cadets. Of the four hundred casua ltie s eight were sent to St. Georges Ho spital, and of these only one case was detained over night.

proportion of the available facllitie It was conSidered to be in the best interest of all concerned to remove the patient to hospital where a fuller and more complete examination cou ld be made.

Treatment of these casualties was directed towards then removal from the scene: Re assurance With firmness and tact in interesting the children in mallers other than themselves in order to stop the overbreathing. the i. sue of drinks at fir water but later it was possible to make lip from powdered-milk !::tced with sugar a very benefiCial medicine. The termination of the parade accelerated recovery and it was learned latt:r that many who had been so prostrate at the parade recovered and became the life and soul of the party on the homeward Journey.

A proportion of any large parade is certain to drop out and sheltt!r must be provided for them The cantcen tent and the exhibition tent at Hyde Park were both commandeered as soon as possible for this purrose When the proces Ing of the parade is likely to be lengthy some system of Issuing food and drink IS essential. A biscuit and drink should be provided at; late as possible. Any large gathering of people require not only first-aid points but also adequate numbers of stretchcr parties.

BY THE EDITOR

THE No.1

AU VOIR

A group of overseas cadets who have been visiting Britain said goodbye to their ho ts of London District at a party at St. John H ouse Club on August 18. The cadets stayed with London District members dunng the Jubil ee Review period and later visited London District 's Isle of Wight camp.

The day had begun with DSO Miss Robinson leaving Worthll1g at 9am to take the party of 34 uniformed cadets to place of interest in London. This included a conducted tour of St. John's Gate and its mu eum by the curator, Miss icholls They also made another trip on the underground, an unusual experience for some of the vi itors but thoroughly enjoyed by all of them.

Colonel Payne JP, Deputy Commi ioner of London District, caught the spirit of the party when he said that some of the world-wide friendships which had been formed as a result of this visit would be lasting and that the happy results were lI1calculable He hoped that further Similar visit would be arranged.

AI 0 pre ent at the party was Mrs. Huntingt on now in her 80s who had been at the Coronation camp In 1953.

Speaking for all the overseas young people, the 16-year-old cadet from Rhodesia said the highlight of the visit had been the friendship extended to them by St. J olm members in Lond on.

SJ HOUSE CLUB

The AGM will be at 6pm, October 18, at the club, and all members are welcomed to a ttend. The chairman of the management committee Rear-Admiral R S. Wellby, Commander SJA Bucks, will hand over to the new chairman Mr. Watkin Williams, Deputy Commissioner-in-Chief, on October 19. Unfortunately Mr. Watkin Williams is unable to attend the AGM.

NEW BOOK

A new publication entitled The Class Secretaries' Handbook has just appeared,

price 35p from the Stores Dept. This is a guide for Brigade members who organise Association courses in first aid, and has been written by the Deputy Commissioner-in-Chief and contains a forewo rd by the Chief Commander.

It is an extremely valuable publication and, if foHewed to the letter , should eliminate all possibility of friction between Centres and Brigade-run courses. It deals also with the vexed question of differentials in fees. Apart from this. the book is a very useful guide to the efficient organisation of any course, and the Director-General very much hoJies that County Directors will ensure that a copy is in the possession of each of their Centre Secretaries, and that a copy is provided for each further Centre Secretary appointed

EXHIBITION

42

by on a

SJ Warwick Association's exhibition at the 1972 Royal Show, Stoneleigh, consisted primarily of Marler Haley panel and film shows. The theme this year was the work of st. John in general. with pecial emphasis on overseas units and the Cadet Jubilee year. Shortage of staff unfortunately precluded a staged accident. Four dummies dressed in adult and cadet uniforms were a great attraction. Perhaps they could be kept in London HQ with other vi ual aids equipment and loaned to exhtbitors?

The films shown were the Lord Pri or's new film 'The Order of St. John', 'First Aid Flashes', 'Emergency Resuscitation' and 'Don't let him die '. All attracted good audiences and keen interest. But 'Don't let him die' was outstanding in drawing an audience and holding it, including young people, in enthralled silence throughout its 20 minutes run.

After a qUIet opening day of the Show, business became brisk With up to

500 visitors a day. On July 4 we were honoured by a visit from the Marchioness of Abergavenny , whose husband is Deputy President of the show. Lady Abergavenny showed great interest in the exhibition and obviously thoroughly enjoyed her visit, which was much appreciated by everyone on duty.

Our permanent pavilion building is proving a great success and each year structural improvements are being made. Thanks are due to Mr. Hopkins Divisional Officer of the Bilton Cadet Division, and his helpers, not only for their efforts during the four-day show, but for all the preparatory work which starts weeks, if not months, ahead. Mr. Burton, with the help of his volunteer ladies from Rugby, again managed to produce wonderful meals for everyone concerned, particularly of course for the St. John and Red Cross personnel providing the first aid services on the show ground.

For County Deputy Dire c tor Major R C Warlow-Harry this was his last year wi th overall responsibility for the exhibition and catering arrangements.

Started ten years ago when the Royal Show moved to its permanent site at Stoneleigh, the SJA contribution has grown and improved with the show itself, and is now a permanent and popular feature. Some of the helpers, such as Mr. Burton and Mrs. Robinson, have been with the SJ A exhibition from the start. Thanks to everyone, says Major Warlow-Harry.

IATRANDOM

COVERED ?

Three new insuran ce schemes for hospital staff are announced by insurance brokers Harrison, Baggaley As ociates Ltd who have made a special study of present day insurance needs of hospitals.

The first scheme provides 'all ri ks' cover for personal effects bel onging to any member of a Management Committee's staff (administrative, nursing, maintenance , etc.) whilst on premises under the co ntr o l of the Committee. Up to a value of £200 the annua l premium is approximately £ 1.56.

The second scheme provides accident cove r for teams of nurses and attendants sent emergencies. personal doctors, out 111

The third scheme has been introduced following the recent publication concerning the incidence of hepatitis in haemodialysis units in the UK.

Details from the brokers at 21 Greys Road , Woodthorpe Nottingham or Hospital Management Committees.

SLIMMER HE

A 26-year-old, Leyland Motors e mplo yee, I hear, is cutting out his nightly lager to help multiple clerosis victims and SJ A.

He IS Tony Cow burn an SJA divisional officer, who is hoping to knock more than two stones off his present weight of 18 stones lIb and make money for charity by collecting 2p for each pound he loses from sponsors in the factory.

Said Tony, '] am hoping to get to 16 stones for charity, but even lower than tha for my own benefit.'

D I STRESS PENNANTS

A new disabled driver's di tress pennant, made and available from the Teeside Spastics Society, Spastic Work Centre, Acklam Rd., Mlddlesbrough, Teeslde, has the following features:

(a) Immediate visual il1lllcation of a vehicle failure.

(b) l:,asily stored when not in lise.

(c) Easily displayed from the vehicle side window.

(d) In expensive. Only £.1 plus 8p rost and pacbging.

(e) Durable. Made from 'Dayglo' orange plastic approved by the MlJ1istry

(f) Can be seen readily during hours of darkne s.

(g) Re cognlsed by motoring organisations ie, the Joint Committee o n Mobility for the Disabled Dnver, the Poli ce, Disabled Drivers Clubs, etc

(continued from page 1)

and among the granite crags of 'La Petite Suisse Luxembourgeoise'. For me, an essential ingredient of such a holiday is to cut-off completely from newspapers and radio, so it was not till I reached Paris to spend a final weekend with an old pupil that I heard of the tragic death of Prince William several days previously.

When a boy of 16 at Eton, Prin ce William expressed a strong desire to take an Association first aid course run by the local Brigade Division of which I was then superintendent. !li s parents permission was given on condition that i f it was a course for the public as indeed it was the Prin ce's lIlcugniw should be strictly preserved so that as a normal schoo lb oy he could gain the 10

fu ll ex perience of the course without any risk of press publicity or of anyone g iving him specia l treatment as a member of the Royal Family. lIe decided to enro ll as Willi am EdwardS' , so that those few of us who knew him could ca ll him William without any fear of giving away his identity by a slip of the tongue It was quite a large course, and as far as I can remember it consisted of our usual annual mixture of poliCemen and WPCs, shop assistants and office workers, newly-joined members of the County Ambulance Service, local Scouters and Guiders , Senior Scouts and Rang ers, and a few people connected with the school. The secret was well kept, and not one sll1gle non-school member of the course had the least suspicion that the friendly youth with whom they were practising bandaging, resuscitation, transport and so forth was the Queen's first cousin. The only person who spotted him was the Area Surgeon who gave the lectures, a Scot who had seen him while on holiday at the Braemar Gathering: he guessed the sltuation, asked me on the quiet if hi ' guess was right, and then kept his mouth shut! It wa not till a fortnight after Prin ce William had pa sed hi exam that the new leaked out I believe during the processing of his certificate (which had to be inscribed wi th his correct name and style) by someone who had no Idea that there was any secret about it and for several hours I was continuously being rung up by press representatives hoping for a 'scoop', one of them, I regret to say, threatened that if I wouldn't give him a good story (about the Prin ce taking part in a first aid course of both sexes and mixed social classes) he would invent one; but I managed to hand him off with the minimum of information, all of it strIctly factual, and all that appea red was a one-inch paragraph at the bottom of an inside page. ot huving been a cadet, Prin ce William couldn' join an adult divi ion till he was 17, but he joined the Eton & District Combined Division on IllS 17th birthday and at once applie d for training JS a voluntary ambulance attendant with the County Ambulance ervice. which was one of the regular Brigade duties done by member of the division at weekends, and the school authorities at Fton allowed those few senior boy who were Brigade members to take their share of these duties with others in the division 1 he full-time at Slough Ambulance Station were told that It would be very embarrassing for their new volunteer recfLlIt if his identlty were publlcly known while he was on the job, and they played up very well. lle oon fell into the routine at the station and made great friends with the staff, all of whom called him Wtlliam and treated him exactly ltke anyone else. I well remember one day when the nursing attendant on duty was preparing the perIodic 'cuppa' all round, and when it arrived one of the ambulance driver exclaimed 'Oh, these women! We'd just got William nicely trained in swabbing down the floor, and then she goe and give him a saucer.!' I'm afraid that he didn't happen to get any particularly exciting or horrific emergency during hi turn of duty; but he was at least enabled fo go Inside the sometimes ad ly squalid homes of humble people 111 back sf reets and help to transport the ill and the injured by carrying-sheet down their narrow stairs into the umbulance, and then on to the hospital wards or casualty departments.

1Ie was also very keen to do a football duty, so J took him with me on duty one Saturday afternoon at the Dolphln Stadium In Slough It so happened that we were ca lled onto the ground whl'n one of the players was injured, and I felt secre tly amused by the thought that not J soul In the crowd had the least idea who the smart young umbulance member wa '. On another occasion, at t he Divisional inspection. a member of the division was presented with the Life Saving Medal of the Order. There were of course reporters and press photographer present, flashing their cameras in all direCtions, but they never discovered that Prin ce William of GloLlcester was on parade in the ranks of the division.

I feel sure he wouldn't mind my telling that when hi first re-exam came round, at a time when he was heavily involved in A Levels and inter-howe Cricket matches, he fai led It was probably a mistuke on my pari to let him be re-examined without more opportunity for revision; but he was keen to do so, and I didn't

want to discourage him He himself insisted that he wouldn't do any more public or transport duties till after carefu l revision and practice he'd passed in a "supplementary' some weeks later when the examiner remarked to me on his exceptionally high standard; and he sailed through the exam for his Medallion the following [ have always felt that this story did him great credit, and I quote it as an example and encouragement to all others who suffer a like experience. After leaving Eton he continued to take an interest in his old division, and wrote in his own hand and at some length both to the then superintendent (whom he'd never met) and to myself in reply to the message sent from past and present members of the division to congratulate him on his appointment as Commandant-in-Chief of Ambulance Corps and Divisions.

We may be tempted to feel that Prince William 's death in a flying accident at the early age of 30 was a tragic waste of such a promising young life But despite the inscrutable mystery that attends an early death, I am utterly convinced that such a life is never wasted, and J have tried to show by these almost trivial reminiscences that those who knew him in St. John will always be the richer for the memory and inspiration of his friendship and example, and I 'm sure that this is equally true of all who knew him in his many other fields of activity.

HE L P ! - RE SPO N SE

On my return from holiday I at once became involved in plans for the reception of Ugandan Asians and for next month's presentation of the Schweitzer prizes (about both of which you will hear more later ), as well as in the latest doings of the St. John Ambulance Air Wing Having been warned by the DHSS that as a last line of reserve our Air Wing might expect a couple of calls a year to transport kidneys for emergency transplant, it's most encouraging to record that in the past seven months it has in fact received 20, all of which it has accepted, though for a variety of reasons (such as the death of the prospective recipient) only ten of these actually became airborne. All ten reached their destination in time for an initially successful operation to be performed.

At 0705 Tuesday September 5 a call came to the Air Wing to transport a 20-year-old tetraplegic casualty from Montpellier hospital in the south of France to Stoke Mandeville. one of our Air Wing pilots had an aircraft suitable for the job, and for the second time in the Air Wing's history Mr. Eric Thur ton of Stapleford Tawney came to the rescue with his 'Islander' and his most experienced pilot asking £350 for basic expenses, which was £ I 00 less than his normal cha rge would have been. Our St. John Air Attendant, a male SR who had previously looked after spinal cases during air travel, accompanied the pilot and the patient's father to Montpellier. During the return flight he had regularly to check the patient's pulse and respiration (which was solely diaphragmatic as his intercostal mus c les were paralysed) and to give oxygen from time to time, to attend to his pressure areas and hi urinary catheter, and to turn him (with the father's help) once every two hours. The patient was particularly cheerful during the journey and reached Stoke Mandeville in good condition, being con veyed there from Benson aerodrome in an RAF ambulance The total period of the attendant's duty was 17 14 hours and the total distance covered by air was 1070 miles. But that was not the whole story. The cost of £350 was far beyond the father's means, and, although we should not have delayed the flight till the money came in, an appeal for help wa broadcast by Radio London on the 0900 news. A mother of four children, who e husband had recently recovered from a fractured pine, heard the appeal while washing up the breakfast things. Having just received a totally unexpected legacy he at once responded to the appeal, and by noon she had handed over a cJ.leque for £350 to the officer in charge of the Air Wing who took her out to lunch and then brought her rollnd to Grosvenor Crescent to meet some of us and receive our thanks on behalf of St. John She in isted on remaining completely anonymou '. It does boost one's faith in the basic goodne of human nature, doesn ' t it?

Disabled driver's distress pennant

Major Accidents

by P A. FREEMAN , MA , MB , BCh i r (CAMB ). FRCS ( ENG )

Mobile Surg ical Te am s an d F i rst Aid Ba g

THE IBROX DISASTER on January 21 1971 was a unique accident from the medical point of view in that 66 persons died , all males, from anoxia. Fifty-six of these were due to traumatic asphyxia and ten from other forms of suffocation.

Traumatic asphyxia is relatively rare and the clinical picture develops when the chest is crushed and blood from the right side of the heart and large vessels is forced into the head, neck and upper part of the chest. The skin capillaries become paralysed due to over-distension and an extensive red discolouration occurs over the skin with small haemorrhages. There is often very extensive sub-conjunctival haemorrhages with oedema of the eyelids. The physical signs noted on the skin are a reflection of the changes that occur in and around the brain. It does not indi ca te in itself serious soft tissue damage necessarily, but is often associated with other injuries of the chest, such as fracture of the rib cage, pneumothorax or haemothorax. Where clothing has been resting tightly against the skin the underlying capillary network does not become involved with this massive distension and the marks of the clothing are left on the skin and remain clearly visable, until the generalised discolouration subsides some days later.

Eight cases of traumatic asphyxia were admitted to the Victoria Infirmary two of whom were comatose, but both slowly recovered once the airway was cleared

The cause of so many cases of asphyxia centres round the fact that many of the patients, who were on Staircase 13 , suddenly turned while descending the stairs to leave the ground, fighting their way back again with their heads down to see the crucial goal, which was scored in the dying minutes of the match.

A number of these patients had extensive abrasions on their forehead and face, caused by the increasing pressure of the descending crowd crushing them d own agai.nst the concrete steps. Once they had fallen down a number of the 12

Following the article Ibr o x Disast e r (A ugust 72 ReView ), this article was given as a talk at th e St J ohn

Ambulance Medical Conference

1972 b y Mr. P. A. Freeman.

Consultant Orthopaedic Surg eon to the Victoria In firmary. Glasgow, and a member of the working party set up o enq uire into the Ibr ox football stadium disaster in 1971.

Th e Surge o n-in-Chi eFs advisory co m mitt ee on equip m ent alld training is currentl), studying th e recommendations made by the working party.

patients stated that provided they could keep their arms flexed at the elbows and verti ca l up in fron t of th ei r c hests , they were able to breathe, even though they were flat on the ground or the steps, but they noted others lying beneath them with their arms spread out, struggling momentarily and then becoming still.

Once the oncoming crowd had been checked by a police chain, and there was estimated to be nearly 220 persons trapped on Stairway 13 at this time, it was necessary to remove them as quickly as possible and in this role the police, ambulance service and other voluntary workers did a remarkable job. Many patients vouch for the s peed in whi ch they were dragged from the mound , pulled by any hold that the re scuers co uld obtain. Coats and shoes were toril off and seven patients had traction lesions of the brachial plexus , all of which recovered and in fact this was a mall price to pay for survival.

Once removed from the pressure of the crowd, those patients in whi c h an airway had remained open or could be rapidly achieved, survived but many others were already dead. Betwe e n the se two groups some partially asphyxiated patients presented s igns of de ce rebrate rigidity, making it very difficult to ensure an airway since thl!Y had laryngeal spasm and trismus. In such cases

mouth-to-m outh or mouth-to-nose artificial respiration or m anua l artificial respiration, using methods such a Schafer or Holg er- eilson, cou ld not be effective. Three of these cases arrived together at the Victor ia Infirmary one hour after the acc ident and were still alive. An adequate airway was achieved simply by using a mouth gag to open the jaw and the insertion of an airway followed by positive pressure from an Ambu-bag. Once this was achieved the patient s condi ti on improved rapidly and after a few hours had returned to normality ; and further it i of interest to note that once the airway was opened, blood gas estimations were found to be normal after only a few minutes, howing that in a ll probability, the air itself was adequate for resuS Citation of these patients provided ventilation could be maintained.

This accident was abo unique in that, alrhoug h there were 216 casualtie', only one was required to be taken to the operating theatre for surgery and he wa a haemophiliac, who was a dmitled to the Southern General Hospital.

An acci dent of this natur e today, therefore, would not really benefit materially from mobile surgical teams intervening on the site and the only way help could be offered to these patients was by e tablishing an airway by the s implest possible procedure after the rescue services had pulled the m ou t of the mound There w oul d seem to be littl e need for these patients to have specific oxygen therapy, inee 20 % of oxygen in normal air is adequate and makes the resuscitation equipment to be described very much easier to carry; and the changes which prevent the ready diffusion of oxygen across the pulmonary barrier following ehes t injuries do not develop until some hours sub equcntly when traumatic wet lung may develop, by which time all cases would be in hospital and an automatic respirator would be available. Traum atic asphyxia unrelieved would be fatal in 5 to 10 minutes, and

the time taken for any team t o reach this site, particularly under the crowded conditions that Dr. Bainbridg e has d escribe d , would be at le as t 30 minute s. It was with this in mind that we had suggested that a s impl e resuscitation kit s h ould be made availab le; it should be easily portable and a number of them should be kept at sites where there is a high risk of this type of accident occurring. Ther e would then be a need for first aid and medical personnel to have a d equate experience with the use of the apparatus; facilities should be availab le during the normal teaching Cll rriculum for instruction in resuscitation with special reference to the use of this simple equipment and similar instruction made available in the hospitals for members of th e ambulance crews, first aid workers police a nd fire services to include even' the passing of an tub;. This: after all, is the only certain way of keepll1g an airway open in seriously anoxic cases.

We felt as an accident team that we were better utilised on this occasion in the hospital receiving these patients and initiating the definitive treatment as they were admitted.

Clarkston Disaster

On October 2 1 1971 a very different type of major accident occurred at 2.50pm when a ga' explosion ripped a shopping area apart, an area normally very crowded at tillS time of day, but fortunately on a cold, wet, windy afternoon many fewer people were around than usual and the children from the junior choo opposite, due to come out at 3pm had not yet done o. A o.

180 bus drew in to its stop with a member of hospital s t aff on board, when SUddenly she described a sensation of vibration and a cloud of choking dust rose into the air, blinding people momentarily, to be followed by a tremendous roar as buildings collapsed and concrete slabs landed on top of the bus. She commented that there was difficulty in breathing for a time due to the dust and heat, but she was one of the few people remaining seated in the bus after the explosion. When she alighted she described the scene of chaos with numerous bodies lying on the pavement and the road some obvious ly already dead and others dying. It was surprising that no loud bang appears to have been heard by any witness. Re scue workers soon appeared, going into action to remove the patients as quickly as possible and bringing them to a site where a passing ambulance had stopped. The seriollsly injured were put into the ambulance and taken quickly to the Victorta In firmary. Other less seriously injured patients were brought to the hospital by cars and vans. Twenty-four people died in this accident. Re scue work went on into the night under the glare of arc .Iamps, and prior to heavy excavating equipment coming in to remove the debris, police dogs searched the site for any possible survivors beneath the debris.

ThiS was a completely different type of accident and there was a great deal more violence with numerous injuries that we a sociate with vertical compression and crushll1g with exten ive oft tissue and bony injuries. The rescue services requested a site medical officer to go to the area and he left the Victoria

Infirmary immediately in the company of two nurses. They used ambulance transport and took only the minimal resuscitation kit with them. They felt that they were basically of little practical value on the site, but did feel that they were helping to keep up morale and were able, where necessary, to confirm death. No active resuscitation was needed at the site and only minimal dressings were applied to the compound fractures, since the Victoria Infirmary was only three miles distant. A surgical team was alerted at another hospital not immediately involved with the casua lties to be ready with a resuscitation kit and amputation kit, an anaesthetist, a surgeon and two nurses were ready if summoned. The site medical officer did not feel the need for a team and did not call them ou t.

The Royal Infirmary , the Southern General, the Western Infirmary , Hairmyres Hospital and the Royal Alexandra Infirmary in Pai sley, were all put on the alert. As a result of this accident some 45 patients were brought into the Victoria Infirmary One was found to be dead on arrival, suffering from extensive blast injuries. Eighteen, however, had relatively minor injuries a nd were subsequently allowed home after treatment, these being in the form of glass cuts, bruises, abrasions and concussion. Twenty-five were admitted to the wards and one child with a brick impacted through the skull was transferred to the Institute of eurological Sciences at the Southern General Hospit a l. It is of interest that this child got better and prior to the accident was retarded having never spoken, but subsequently learnt to speak a few words

reinfor c ed t h e co n c e pt t hat o nl y a SMO is r e quired o n th e s ite initi a ll y a nd he alone should ca ll out th e m o bil e t ea m if necessary , a nd thi s is se ld o m required. It is inter es ting t o n ot e th a Mr. Rutherglen at th e Vi c t o ri a In f irma ry, Belfast, has c ommented th a t o ver th e pa st three years no local surgery w as r e q ui r e d on the site in any of the maj or in c id e nt s in that city. The only report s o f l oca l surgery on the sit e of a maj o r di sa st e r a r e from the Lewish a m train disa s t e r , wh e n one a m pu t a ti o n was ca rri e d o u t the patient un fo rt u n a t e ly subs e quently d y n g and more recently in a relativ e y min o r a c cident, bec a us e o f a c rumbling bu i ldin g, leg amputati o n was necessitated on the site when a tru c k c rash e d into a s h o p in Glasgow

Resuscitation Bag

Most ca ses , who die between he s it e of an a cc id e nt and h o spital di e fr o m cardiac or pulmon a ry f ailur e a nd therefore the mo s u s eful tre at m e nt is simple resus c itation therapy whi c h ma y well prove to be invaluabl e in li fe sa vi n g without using a ny c ompli c ated a pp a ra tu s The type of e quipment w e h ave recommended is ve ry simpl e a nd economi ca l and will I am sur e, in th e future be kept in e very doctor s car (I hope in other cars as well ) and sh o uld accompany first aid workers wh e r e ve r they go

Three types of r es uscitation kit w e r e therefore recommended The first b a g which is mainly for first aid worker s should contain :

* 1 Ambu resuscitator

Child's Mas k

1 Adult s Mask

* I Ambu foot opera ted su c tion pump

1 No. 12 s uction cath e ter

I No. 16 s uction catheter

's mask

1 Adult s ma s k * I Ambu f oo t o p e rat e d su c ti o n p um p

1 o 12 s u c ti o n ca th e t er No 16 s u c ti o n ca th e t er o 1 8 oe o ph a g ea tu b e

I Capon Heat o n i n f u s io n set

I E ach o f No s. 1,2, 3 a nd 4 a i r w ays

3 x 2 m!. sy ri n ges and n ee dl es

I fergu so n's m o u t h g ag

I Set o n t o urn iq u e

2 x 5 00 ml. p astic co n tai n er of Ring e r s l acta t e

2 Angi ocat h

I o I S ca lp el bl ade

2 Sm a ll m i n es d ress i ngs (I c u i n eac h )

I Roll 1/2i n z in c oxi d e ad h esive tape

I Pai r q f scisso r s

I Fil e Th e t h ird b ag m a in ly fo r spec ia l ists in resuscitat i o n sho uld co n tai n the fo ll o wing :

2 x 100 ml. bott es so d ium bicarbona t e 8.4 %

2 Boxes 100 m g. hy d rocort isone

2 x 5 0 ml. sy r i n ges an d nee d les

I x 5 ml. Sy ri n g es } d d l I x 10 ml. sy r i ng e a n nee es

Lar y n gosco p e wi th I l a rg e an d I s m a ll blade

E nd o tr ac h ea l co nn ecto r

I p a ir ph a ry ng ea l fo r ceps

I pa ir a r te r y fo r eep

1 ub e K.Y je ll y

I o. 2 e n dotracheal tll b e o 5 c u ffe d e nd o tr ac h eal tube

I NO .8 c u ffe d e nd o tr acheal tube

I 0. 9.5 cuffe d en d o tr achea l tube

I Ampl. sco ine 100 mg

Fil e 2 Am p !. a t ropine s u lphate 0.6 m g.

2 x 2 0 mL b ot tl es pr ocaine H C I, 1%

2 x 5 mL a mpL calc iu m ch o r i d e, 10 %

2 x 2 m L a mp!. a d re n a li ne, I i n 1 000

2 x 10 m!. w ate r

Am p L isop r e n a li ne HC I , 0 1 mg .lml.

Insulin s y r ing e

I Lumb a r p un ct u re n ee dl e (disposa bl e)

Hum a n pla s m a prote in so luti on

HOSPITAL HELPERS

Cad e s R o der ick Cable a n d Martin S alm o n, o Low est o , h ave been helping o u at wee k ends a the r lo c al hospi a sin c e ast Jan u ary - 3 hours o n Frid a y ni ght, all day S atu rd a y an d f o m 2 p m 8.45pm o n Sunday R o deri ck is in th e cas u a l y de p ar ment, Mart n n t he men s ward s, and

FILMS

4 .3 % bu t m ore than 92 % of thi s is a l b umi n. I t has a she l f ife of one t o fou r years, so t11at its storage repre e nt s lit lle pro bl em, but it is not yet ge n era ll y available throughou t the country.

P rotective c oth ng i n the fo r m of the standa rd f ib re·glass, c iv il enginee rs' p rotec t ive h ead gea r , wa er-proof tracksui a n d we lli ngto ns are an essentia pa rt of th e surg ical team's equipment, as are s II pplies of se d atives for tile o nl ookers, w h ich seemed necessary at C la r ks t on w i th an x io u s rela t ives standing by , and V a ium, 10 mg should be avai lab le

The dres ings recom m ended are simple shel l dressings in variab le Sizes, Mines dressings, which arc com pres ed and easy t o carry, and jet-type splin s. I.::.conomy of space is necessary in th is type of kit and for covering the patient the advent of the space blanket has helped fhls has resulted from the American spa c t' experimental work where it was found that this Simp e app l iance helps to retaIn body heat reflecting 90 % of it. and at the same t im e keeps out the rain, wind and snow. T h e pack IS small. a l though unfolding to to 7ft. r he only active surgica l kit reqlllrecl woulc..l be an amputation kit and a pre-packed outfit should always be available with tourniquet.

SUMMARY

A lt ho u gh we have a duty to have an experienced mobile surgica tedm ready with relatively simple equipment, they w ill probably seldom be required to go to the site of a major accident and their erVlces will, in all probability, be beller served at the base hospital and most of the casualties better c1ea t with and more readily transported away from the site by the fi rst a iel workers and the pohee, a m bu a n ce and fire services.

THE SUBNORMALITY PICTURE (1964)

(Bl a ck a nd White 14 min s) Free Di s lribul ed b y: Bri t is h Me di ca l A ssoci a tion BMA Hou s e Tavi s lo c k Squar e, London WC I

Spon s or : Th e Ro y al Me di c o P syc holo g ical A ss o c iation

The range of symptomatology presented by the whole field of menta l sub-nornl1li t y is shown and how these conditions relate to cause and to each other.

The panel considered thi 8-year-old film still to be up-to-date. Its explanation of dIfferent types of subnorma lity is l ucid but the b lack and white photography and its static approach to the ubject make this a somewhat 'clinical' film; the r e are no diagrams and no re-capitu lation bu t the fi l m still has va lidity

Audience Men t a l and socia l we l fare workers, medica l an d menta l nursing students but of strictly limited interest to St. J ohn.

CONCRETE STEPS (1972) ( Colour 27 min s ) Hir e

D is tribut ed b y: Conc o rd Film s C o un ci N ae ton , Ip sw ic h Suff o lk

Sp o n s or : Nati o nal Soc e t y f o r M e nt a ll y Handi ca pp e d Childr e n

Shows the importance of langllage stimu l us in the education of mentally hamllcapped children, and how parents can help their children. Three aspects are shown the cont r ol and exercise of muscles usee! in breathing and feeding , environmenta l stimulus, and the growth of languagc

The panel conSidered this a good, well produced film that covers its subject at length perhaps too great a length. H owever, it is ll1terestll1{.!, informatIve and has the virtue of clarity. I t will be of great to parents of mentally handicapped children.

Audience 'v1cdical and nursing audiences interested in this fie ld; SOCIa l workers, p<lrents and to 1. J ohn Ambulance nursing me 111 b ers

THE X FACTOR - TAPE PROGRAMME

Fr o m : Inf otape Pr o du c ti o n , 5 0 F r i t h Str ee t , London WI V 5TE

A 24 mInute audio cas ('Lte or tape In the f orm of a radio play deSigned to Inform teenagers of the causes, ymptoms, effects and treatment oC sexuall} tran milled dlsea es

The pane l considered this an excellent teaching aid. Without being mealy-mouthed. it conveys in modern IdlOm a sympathetic understanding of a ll factors surrounding VD and answers clearly m ost of the questions arising. rhe radio p ay neither preaches nor moralises but does et out all fncts clearly and the inferences agmnst rromlseulty are there to be regarded or indeed di regarded by the indiVidual.

The opening somewllat dramalic and out of key but otherwise the tape is well nigh faultless.

AudIence: rhis tupe is reco mm ended for all hea l th e d ucationa lists and shou ld be played to enior S t. J ohn ca d e t ; it is a good teaching tool for youth lead rs, etc., and will promote live l y group discussion.

Tape £3.45

Cassette: £3.20 } I ncluding postage and pucklng in U.K.

A NEW LOOK AT FIRST AID - Tape slide programme (35 illus 30 min s )

T h e au hority of th e di tingui hed au hor. Mr. P S. Londo n a membe r of the S t. J o h n Ambu lance Medica Board is clea rl y d e m onstrated in this presentatIOn: the co m mentary and teac h ing th e result of Mr. L ondon's great experience, res ul JJl the creation of an i nva lu ab le teac h lllg too l in a realm where nothing co m parable exists. fI owever, the t it le is a misnomer; the

The metamorphosis of teacher to evangelist as soon as inflatable plints are screened is noticeable. I t might have been preferab l e for a separate presentation to be created upon thIS specific type of splint. The presentation is at variance with S t. J ohn teaching which advocates inflatable splints for lower im b only.

Audience T h is presentation, showing a va r iety of injunes, w il l be of great va ue to senior first-ai d ers, nursing and industr ia medicine staff. S t rongly recommended.

The programme may be purchased (£7.20 plus postage) o r hired (£1 pill po tage) from The Medical R ecording Se r vice Foundation, K itts C r oft, Writtle, Chelm ford, Essex. (Chelmsfo rd 421475)

MARLBOROUGH HOUSE (1958)

Ambulances

FROM THE PAST TO THE PRESENT

AS WELL AS the use of litters to transport the sick or injured to ho pital, as mentioned last month, textbook of St John Ambulance published 1880-92 also advised the use of 'horsedrawn wagons or car ts filled with straw, hay , or other soft substance, on which the patient shou ld be carefully laid'. The natural development [rom this , of course, was the covered van, and by 1908 a St. John Ambulance price List of 'Horse drawn ambulance carriages and wagon' said several specimen were on view at St. John' Gate, varying from a light vehicle to be drawn by two men or a pony, with [ndia rubber tired wheels, costing £32.10s, to a large wagon accommodating three patients in the recumbent position and an attendant.

Many of these ambulances were designed by John Furley , who was the first director of the St. John stores at the Gate

In fact, the ambulance and the uninhibited enthusiasm of Furley might well be said to have put the St. John Ambulance Brigade 'on the map'. The Brigade' fir t public duty was at the Golden Jubilee of Queen Victoria in London in 1887. Under the command of Furley, 50 members complete with horse-ambulance and full equipment set up three stations on the royal processi o nal route for the then novel purpose of givll1g immediate treatment to any casualties among the hordes of excited spectators. The St. John contingent had but limited official approval. But they treated 200 cases. One man with a seriou injury was lifted into the ambulance. He needed immediate hospital treatment but the royal procession was passing the ambulance post, which was hemmed in by crowds. John Furley had to make a decision. With a brisk command he sped the ambulance straight through the ranks of the procession just ahead of the royal princes The Prince of Wales was most impressed, and when the Order of St. John was royally incorporated in 1889 Ilis Royal II ighness became Grand Prior and was soon very involved with the work of St. J ol1n. To the Press he said of the St. John uniform : 'Gentlemen, this is a good uniform. [ believe that much good will come of it.'

Herbert Lomas Ltd.

This Cheshire company is currently producing the Ford / Lomas ambulance which has a Ford Transit SVO chassis windshield with full length van floor fitted with a G RP or composite body.

The G RP body IS fitted to Tr<Jnsit 130 150 and 175, while the compo'ite body is filted to Transi I I 5. Special fea tu res to both include low floor height for ease of access; choice of interior finish and layout, exterior finish to customer's requirements (colour, labels, etc); and v<Jrious interior equipments are available, as are window arrangements and rear doors.

Another of the company's models is the Range Rover / Lomas ambulance, which is produced in co-operation with Rover Co. Ltd. Thi GRP constructed ambulance is built for all-round performance and conditions likely to be met in the UK and throughout the world A 10 inch extension built into the chassis affords various interior layouts for recumbent and sitting patients. There is a

COMMER, KARRIER, AND ROOTES MAIDSTONE LTD.

An Ideal Combination to provide the right vehicle as a Stretcher Case Ambulance, Sitting Case Ambulance, or for conveying the incapacitated, designed and equipped to suit your requirements On the Commer we offer three roof heights, on Karrier three wheelbases. Up to 32 seats and up to 10 wheelchairs with centre gangway or 16 small wheelchairs.

The latest equipment for handling and securing wheelchairs is incorporated in our designs. The comfort, care and safety of your passengers is our main consideration.

We have been privileged to supply London Boroughs, Co unty Ambulance Authorities, various Societies throughout the country and Overseas Markets. Each enquiry receives expert attention by a dedicated staff who have made a careful study of this very specialised form of transport.

ROOTES MAIDSTONE LTD.

St re et , M ai d st one, Ke nt

(Above and right)

Ambulances

singl e, cen tr a l r ear-door with a wide, fo ld i ng flu s h-fitt in g s ep. Th e i nterior is lined in G RP A ir-con ditio n ing an o pti o nal extr a.

Wadham Stringer Ltd.

Wa dh a m Strin ger ( Co ac hb u il de r s) Ltd. is a c ompany whi c h ha s be e n close l y assoc iated with a mbul a n ce bu i ldi ng for ma n y years , sp eciali s ing i n t he fie d since 19 4 8.

Th e ir pio n ee r d e ve lop m ent of a co mp le e GRP bo d y in 1958 laid the f o undati ons fo r th e co mp a n y's ambu-

lan ce o f o d ay. T h e G RP method of co n st ru c t io n wi h i ts co lo u r impregnated n o n- c orr o siv e f in i sh h as ce r tai n ly withstood t he t es of ti m e and offers co nsid e r a b le m ain t ena n ce cost saving to a mbul ance u sers.

Th e co m pany h as a lso been in the fo r e fron t of t h e deve l opment of modern patient hand ling eqUIpment, designing and patenting many item. most important of which has been the self-elevating stretcher bed, the Wad ham turnover seat and stretcher carrier, and more recently the widely accepted Wadham l11ultiposture stretche r tro ll ey. The l1lultiposture stretcher tro ll ey is avai lable in several models. through backrest-only adjustment to full posture movement. including the Trendelenburg postural drainage position.

The company's first GRP ambulance body was ba cd on the \ mtin-Morris U) chas is. and some 2.000 of these vehicles were made. fhe success of this model led to development of other all C; RP ambulances on British Leyland chassis. mainly the FG and b\, which arc still available. Further developments have recently ta\...en place on the Ford Transit and the Bedford CF Ch.1SS1S WJdham's ambulance is the new Series I X body on the Bed ford CF

Wadham Stringer the ambulance specialists

The latest addition to the Wadham Stringer range, the Series I X Structural Plastic Ambulance Body on the Bedford C F chassis, sets new standards in functional design and moves yet closer to the ultimate requirements of the Ambulance Service.

Ambulance bodywork also available on British Leyland and Ford chassis.

Specialists also in Welfare and Wheelchair transport vehicles

HAMBLEDON ROAD

WATERLOOVILLE P07 7UA

TELEPHONE 2661 and 2585 (COACHBUILDERS) LIMITED

chassis, which is avai lable with 2.3 litre petro l!ngine and automatic transmission. This body offers a low- oading floor line, particular ly suitab le for stretcher trol eys. The trolleys can be carried either over the rear axle or between the wheels and the access to the rear compartment and the cab is extremely good. A demon tration mode l of this vehicle is operated by the company. A n ew ambu lance/mini-bus,

Locomotors Ltd

Ambulances

BALL PENS BALL PENS

The GRP Range Rover/Lomas ambulance

NEWS from SCOTLAND

The Lordship of the Sick Some months ago I considered a few of the practical problems which must be faced when we try to give effect to our ideals. ow I would like to examine those ideals themselve, for obviously among the criteria for an acceptable charitable scheme must be the convict ion that it conforms to the spirit of the Order.

[n the Middle Ages the official documents of the Order of St. John its Rule and Statutes and the letters of it Masters con tently proclaimed J new ideaL the Lordship of the Sick. J 0 the brothers of St. John the sick poor were to be owed that reverence and obedience which in secular society magnate were accorded by their subordinates. But they went further. At his reception a fourth oath, besides those of poverty, chastity and obedience, was demanded of a brother; he swore to be the serf and slave of his lords the sick. To co ntemporaries serfdom was a condition in which the serf was tied to the lands he tilled, unable to move away from them without his lord's consent and treated in law as a chat tel in the same way as a cow or horse The status of a slave was even more degraded: serfs had rights in law, slave practicLilly none. The cLi ndidate for Ho spitJ ller brotherhood, therefore, was committed himself to regard the sick poor as his superiors in the most absolute way of which he could co nceiv e. In this , of course, he was only following the m essLige of the Gospels. The s ick poor represented for him, in a reJI sense, the person of Christ and must be given that respect c.lI1d love which a Christian would give hi s Saviour. This feature of HospitJll e r spirituality must be e mphasised. Many people in the Middle Ages like many now - performed acts of charIty because 20

heneficiaries are inferi or to their benefactors. To the If ospitalkl'> this would have bl'en unthinkable , the b e neficiarIes represl'nlL'ti Christ.

OVERSEAS

Brigad e in Canada, sLicceedIng Judg e J Re dmond - Roch e.

Pre sentat ion on June 25 of a special pipe banner to Pipe Sergeant Sammy Stein of the Torphi chen and Bathgate Pipe Band by Sir Andrew Murray the Pre cepto of Torphichen, in the presence of Provost John Hardy and the Rev Tom Crichton chai rm an of the Torphicnen Committee Mr Crichton had cO'lducted a special service in the Pre cepto ry of Torphichen. The band laft for a tour of Canada on August 15 (Photo: West Lothian Courier)

tlley felt that these were owed to those less fortunate thJn they were. This view was, and is, prLliseworthy, but it was OT that of the brothers of St. John and ind eed runs counter to the pirit of the Order, for it implies, If only in we:Jlth or physical or mentLiI health, that

WALES

This spirituality ha" relevance for If we are to remain t rue 10 thc Itkals of the Order of St. John we must always put thl' needs of the sid: poor before everything else. rhat is obVIOUS. But we must not on y be forevl'r asking whetl1l'r we Lire properly dlr el' llng our mLln(J l)wer ;Ind f inances t o that end: we must also he particularly caref ul t o sec that ou r enterprises givc expression to an ideal according to whiL'h thl' sick pOOl are rendered the respect we would natur,I1ly give our superior".

Yea r Book

The new Year Book, With histoncal 'e<.:tions, a description of the role 01 the Order in Scotland today, the reports from the committees Lind associatIOns, and the accounts, IS now available. It has been sent to all memb ers of the Order and was given to eyeryone who attended the General Assembly. Although there are obviou ly improvements to be made In future editio ns we LIfe still In I he experimental stage it ha s generally been voted a success. Anyone wanting a copy has only to write to the PrlOry -SecretLlfY. S t. J 0 h n .s H 0 u 'ie S 1. 0 h n' sSt. I:dinburgh .I

An el1linentlega l and milit:Jry figure, John Redm ond Roche. OBr , Judge of the fl.10ntrt'.11 Court of St'ssions. has been Llppolnkd Chancellor of the Priory of Canada The retiring ChJncellor IS L. 1-1 icllOhon, !\)J'mt'r lOllll11is,ioner of the Royal Can :ld ian \1 oun ted PollL'l?

Jud ge Roche ha<; <;ervcd the t. John OrcIer In 1ll.lny cJpacilIes over the years dnd IS a wel -J...nown authority on first-a id Jnd other a'>pects of the Order worJ... in emcrgency situations. PrI or to hiS rt'cent elev-ltion he Chief or the S1. John \mbulance in (',1I1Jd.!. Quebec Pr ovll1ciJI Pr esl(lent and a Knight of Ju tice of tht' Order.

The new Chancellor was born in Ottawa Lind studied law at till' nlversity of \I ontreal. He IS a member of the Quebec bdr and 01 tile bar of englJnd and WJles. lie is a Queen's Counsel.

DUring World W,n II Judg e R oche st'rved as command ing officer of th e first batlallon of tht' Reglm t'nt de Maisonneuve. Jild is now the regiment's Ilon ordlY Colol1el. He was untIl recently national president of the Ro yal Canadian Legion.

Brigadier I.- rIC Snow. OBE, ha been apPointed as Chief COll1mlSSIOner of the

The new Chief Commissioner has been associated with St. J ohn since 1960 and has held many positions of responsibility.

[n 1971 he was promoted to Knight of Grace in the Order.

F rom 1924 to 1960 BrIgadier Snow 's military career Involved service as an active Commander and Officer in many areas of Canada and

Yv ette LOiselle IS the new Superintendent-in-Chief of the Brigade in Canada

MISS LOiselle's association with the Order of St. John , which parallels a notably successful business career, began in 1944 when he joined the Brigadt' as a nursing member. Subsequently she advanced to serve as head of the lyJontreal divisIOn and as Quebec Pr ovincial

TRINIDAD

a rl d TOBAGO

New chai rm an of the St. John CounCil, Dr V Massiah meets HE the Governor General Sir Solomon Hochoy, GCMG, GCVO, OBE, KtStJ (left). Others (I to r) Mr Basil Jackson ( retiring chai rm an), Mr Joseph D Arcy (vice chairman), and Dr Davie Wyke (president).

( Ph oto Trinidad Express)

Chancellor Mr J Redmond Roche

Chief Commissioner Brig. Eri c Snow

Superi n ten dent in Ch ief M iss Yvette Loiselle Superintendent (1\). [n 1956 she was awarded the Service lyJedal of the Order. In the Montreal business world Miss L Oiselle IS well known as an expert in administrative and employee relations matters. She is actiYe In the Soroptimist Club and the :vrontreal COLined of Women

UGANDA

Brigade Deputy Commissioner Lt. Col Gideon Bogere presenting first-aid certificates to 61 of the 177 prison warders who were successful in the recent courses held at the Pris ons Staff College

News from

the Divisions

CHESHIRE -The 24th county cadet camp - a mixed camp was held during Augu t at Ll anfairfechan, N. Wale: cadets in camp had either a first aid or home nursing certificate. Competitions this year were on a k nockout' basis, and in one game a bucket had to be filled with water from a bow l with an egg cup! Everyone had a great time, it seems.

DERBYS -Results of the Stanton Divisions open first-aid competitions held recently were . Final ' Manchester and Salford Police (175 marks), A lvaston Combined Div ( 171), Shafton Workshop 'B' ( 163) Westhorpe Colliery ( 136). Adu lt individual test: J. Burton, Cheshire (32 marks), D. Spencer, Killamarsh (31), R Spencer, Killamarsh (29), J unior test· Bolsover Colliery Amb. Cadet D i v. (91 mark), Chaddesden and Spondol1 A/ Cadd Div. (84), ll keston (CB) ursing Cadet Div (66). J unior I ndividual Test: E l speth Whlte, Cheddesden, (19 marks), Christopher Shone, Bolsover (19) after a further test E lspeth White adjudged first, Yvonne Fisher, Il keston (181/2).

SUR R EY -Cobham Division recenLly received u letter of thanks for taking a

palient to the Isle of Wight und fort n ight la ler back to Surrey. With a crew of two and u nurse, the ambu lance Journeys took approximately I I hours each, W III excellent free ferry service from British Rail.

H EREFORDSHIRE -'lhe first R oss-on-Wye cadet to win a Grand Prior's badge, and the second in t he county, is Ei leen Chandler, to whom lhe badge was presented by Commander SJ A S. 1 Mayall.

OBITUARY

Fr e d e ri c k Br o mf ie ld ASO, L incolnshire. J oined Brigade in 1922. Serving Brother.

Da v id C a nt y, aged 20, ambulance member Malden and Coombe Division. JOined a cadet in 1963. Killed in a motor accident.

E ls ie Mab e R ose Go d f r ey ( Mrs.) former

Slip e r n ten den t B rom Ie u rSl11g Division, 36 years -;ervlce. erving Sister. Dr. J (Geo rge) Maize l '\! Derbyshire ( CB) I) Corps Surgeon 20 years service. Serving Brother.

Ch a rl e, John U pwa rd , divisional officer, l rome Division. Joined Brigade in 1939. Serving Brother.

REVIEW CROSSWORD No. 10 ( 72 ) Comp i led b y W A Po t t er

ACROSS:

1 A godde ss in bed b eco me s conf u se d. (7). 5 At te nd s to t h e patient in the kitchen (7). 9. Reli eve d pai ri by c ru shi n g a see d (5). 10 Conditi o n fo r whi c h o n e sits t h e p a ti e n t LIp w ith h ea d slightly forwards ( 9) 1 l. To o th l i k el y t o g ve p a in (7). 12 A fter all, grey mixture will produ c e h y p e r se n s itivit y to fo r e ign pr ote in s. (7) 13. The South American varie ty i s a sh ock in g f ish (3) I S Artist is edit o r re stor e d t o li fe. (6). 17 Go upw a rd s as m a n y finish. (6) 19 Men in o utsi ze sign s of t h e f u tu r e. (5). 2 0 Adm it casualty patient t o a ward. (6 ). 22. Sa i nt ho ld s one o f fiv e w i th a deviation of o ne eye ( 6) 2 4 . Fisc al m eas ure fo r br e w er s. (3). 25 . Sugar present in the bl oo d (7). 28. Qu o t e see n i n 17 d ow n implies free fluid in th e p e ri to n ea l ca vit y. (7 ) 3 0 Ch an ge to red meat produces fluke par as it e (9) 3 1. Sp o r t s m an is u n know n quantity in South Afr ic an . ( 5 ).32. Pay s h ee d t o wh a t s sai d (7). 33. Try an addendum in pr o te in fe rm e nt. (7).

DOWN : 1. H aemophiliac cut vesse l in w o und ( 7). 2. He ta k es d eli ght in pain. ( 9 ). 3 Mournfully l eft i n d is turbed d ays. (5) 4 Traumati cally r e mov e th e skin fro m a p art. (6) 5 Ph a la n x at t h e tip o f each finger and t o e (6 ). 6. Bl oo d b o rn e clo or fa t gl o b u le obstructing a ve ss el. (7 ). 7. Sergea nt - Major w i t h se n se orga n use d for blood test. (5) 8. T i r e d a nd s u fferi n g fro m co nj un ctiv it is. (3-4) 14 Administered to ev ac ua te th e l owe r b o w e l. (5 ) 16 A n o ld penny on university profes so r t o put on w e arin g a p pa r e1. ( 3). 1 7 A n imal in p a ss a ge with pag e r e m o ve d (3 ). 18. l O ac r oss me d ically spe a king. ( 9 ) 2 0 Mod e rn c loc k for arte r ies of fi n ge r s an d toes. (7 ) .21. Put into quar an in e ( 7) 2 3 S co r e i n imp o r ta n cricket game for trial wi t h n e w ca r. ( 4 -3 ) 2 4 Bl ee ding f r o m varicose ulcers will be ( 6). 2 5

form. (6) . 27 . Those wh

being designed (5) 2 9

except for the head. (5)

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ORGANISERS OF FETES AND FUNDS We welcome both persona buyers and ma ll ord ers fo ou r ex t ensive ange of T oys and St ationery an d ChrIStmas Cards at who esa e prices, sen d fo r p r ice l ists. ALSO pre· se l ecte d parcels - 144 2!1, p Toys OR 72 5p To ys OR 38 lOp T oys O R se ection S ationer y. Each Parce £2. 70 plus 2 7p postage. T w o or more parce l s 35p postage. J E. T homas & Son (Cuff ey) L d 2a Handswor t h Road, London N 17600. T el 01 80869 4 8 (94)

MOORFIELDS EYE HOSPITAL CITY ROAD , LONDON, E C 1

V acancies exist for St ate Enrolled Nurses to enter for the Post Enrol ed rai ning i n Ophtha mic Nu Si ng. T welve months' course, of w hich two mon hs ar e spent n the School of Nu r sing. M o orfie ld s Ce rti fica t e

Savlon cleans, kills gerllls and helps healing. In one operation. 'Savlon' L iq u id and Savlon' Cream are i n d ispe n sable to your first-aid kit. They gently clean away dirt. killing the germ s t h at wo u ld infe ct th e wound. Th e antis epti cs i n bot h products are powerful, sa fe. T hey were discov e red by ICI and are

ST. JOHN

REVIEW

in his double session on 'T he Man Behind the O ne of the two most moving moments in the weekend was v" hen a more or less 'captIve' audience of nearly 500 (which \>,as certainly not selected for its capacity for musical appreciation) spontaneously rose to its feet to thank !\1r. and \1r s. J oseph Cooper \Vilh a warmth and vo lume of applause that seemed a though it wou ld never end T he other very special moment came during an interval in the dance 011 Saturday night when (to her ut ter surpnse and, I' m sure, infil1lte pleasure) Miss \1 0rison was presented with a scroll bearing the signatures of everyone pre ent. a silver rose bow l an d a cheque for £50 as a parting glft from all tho e to whom throughout the whole senes of '\f ottinghams' and of K G .VI courses, she has over the years contributed so much. '\" either v\ords nor gifts can adequatel)- express what the St. J ohn famIly as a who le owes to P am !-. l onson in gratitude and Jffection: but we ;]11 wish her a fu ll me,asure of happines in her retirement. enr iched by the man)- St. J ohn friendships \vh ich \\e k n ow \\ ill be main tained throughout the years.

Asians

I want to pay a most sincere tribute to the S1. J ohn members of al l r3nks and in l11an) parts of the COUlltr) \\ho , in addition to fulfil li ng their norma l responsibilities at horne and at work. ha\e responded so uperbly to the emergency ca ll for help in t he recept ion of sians who have been expe lled from 1 ganda and n ot least among these [ \\ ou ld thank rhose who (espeCIally during the st3ges of the emergenc) ) spent long both by day and b) night \\ ;Jiting at airports and reception centres for plane which were expel'ted bur in (;Jct did not 3rrive 1 he Home Office reJdrl;. JCl' epled our offer of "ef\ IL e. ;Jl1d a very earl;. stJgL' II W;lS lllutllJlly Jgreed tilJt St. John Jnd till' R ed dnd the WR VS should \\ ork togethe r ;JS J closely integr;]ted ,' en ice and t h;]t the Chairman of the \VR VS should be our Joint representative on the Uganda Resettlement Board rhus there ha. from thL' start beL'n tilt' L'o-oper;]tion between nur three organi ations at Headquarters, and this ha been reflected in the outstanding respome from our members in most counties where 3irports or reception centres arc situJted. but it has been noticeJbk th.lt the l1L's t results hJ\"e come from countie:; where dose liaison bet \\ een Sl. J ohn. the BRe'S and the \\ RV S IS a I/ o rlllal (' tll/drf/tllI: It is too lalt' to co-opL'rate effecti\ el \ if the process on l;. starts whL'n an is alread y upon us' O n e of t hL' best l''(.llllpk, of L'O-()11l'ratlon thJt I\ e yet heard \\;]s \\hen an \ SI3n wOll1an L'ollL1psed as shL' clllergL'd from a plane at StJnstt'd, and a S t John ambulance \ehicle inst.lntly dro\e up to Ihe spot with a Red en)SS dri \ t'r :11 (ile \\lll ci r emll/lIl/cd (III IJllg<' II

SINCE

Asians

Arriving

Our

Other

(part of the hand-luggage)

helping hand and a big smile from

(Photo Re f 7437/72 Brenard Photos, London Airport )

to the airport to see for herself how things are progressing (Photo: Keystone)

An interpreter (left) puts Essex County Surgeon M. A Weller's queries

The design of the launch's hull is based on the seaplane tenders used by the R .A.F. during the last war, but considerably strengthened and with a keel added. The overall length of the boat is 42 ft., beam 12 ft., draught 3 ft., and weight approximately 8 tons. The bottom, which is nylon heathed up to the waterline, is of double diagonal 3/8 in. and Ih in. iroko planking with oiled canvas between the two layers. Certain parts of the hull were treated by a water repellant, rot resistant wood preservative. The top sides are of acajou (mahogany). Extensive use was made of 'G ripfa st' nails for fa tenings. The deck is double planked, the lower of iroko and the upper of hydroply, and fin 1- hed with a covering of simulated teak planking. The cabin and wheelhouse exterior were designed by a local draughtsman to meet the requirements of an ambulance and rescue launch. The sides are built of v.; in. hydroply with 3/8 in. marineply tops lined with nylon. The front of the wheelhouse is of 1 Y-! in. hydroply. A 4 in. rubber 'D' fender around the gunwale protect the boat ngninst damage.

The Story of SJA Guernsey's Transport

Department

SJA Guernsey's ambulance launch

THE SJA GUERNSEY'S ambulance launch Flying Christine II, built in a Guernsey boatyard, was launched on July 6 1964 by Lady Coleman, wife of the Island's then Lieutenant Governor.

The vessel was constructed to replace the Flying Christine, which was irreparab ly damaged in harbour during a storm on Januar y 10 the previous year. The new launch was built, and is entirely maintained, by voLuntary contributions.

Used as an ambulance craft, she regularly visits the neighbouring islands to bring sick and injured patients to hospital in Guernsey; and the transfer of medical and sur gical emergency cases from oceangoing vessels using the sea lanes around the Channel Isl ands is not uncommon. These patients are comfortably accommodated in the Launch's stretcher cabin, which has the appearance of the carpeted interior of a large road ambulance.

under the stretcher platform. Transfusion boWe holder and drip feed stand are attached to the side of the cabin and stretcher respectively, when in use.

Above the tretcher, fixed to the bulkhead , is a spotlight; this is in addition to two 3 ft. transistorized battery-operated fluorescent lights. On the starboard side is a 6 ft. 6 in. instantaneou ly-convertible upholstered settee with indiVidual arm rests. This unit can be quickly changed into a stretcher p Iat for m to accommodate another recumbent patient. A collapsible stretcher, blankets and pillows are housed behind and below the ettee for this purpose. At least three other recumbent patients could be in the wheelhouse and cabin in an emergency.

On the same side towards the wheelhouse is a fitted chart table with adjustable lamp, and a hand bearing compass. The large scale charts cover the whole of the Channel Island s area and the French coast from Cherbourg to Carteret.

On the bulkhead Itself, the radio and radar packs are mounted for ea y access.

Perkin s. All engines are ventilated and housed in sound-proofed boxes.

The wheelhouse is 7 ft. 3 ins wide and from cabin bulkhead to dashboard 4 ft. 6 ins. Floor space extends beneath the dashboard forward to the forepeak bulkhead. Anchor, chain and rope are stowed in the forepeak. The wheelhouse windows give all round vision, the three front ones being of 12 in. toughened glass, two of them fitted with 13 in. 'Clear View Screens'.

The legend RESCUE in 17 in.-high letters on her cabin top make the launch very distinctive from the air. A flashing blue lamp, the same as that used on road

ambulance, can be switched all to assist in her recognition Other navigational aids allow the craft to help land-based St. John per onnel of the Departmen in cliff rescues, often along Guern ey's treacherou south coast, unfortunately the scene of a number of fatal accidents.

The launch has also been modified to carry the portable recompression chamber.

On service calls her crew can ist of:

(1) An honorary cox wain a member of a panel of pilots and local boatmen with an extensive knowledge of island waters who have volunteered to be 'on call':

(2) Department staff consisting of an officer, a member fully experienced in navigation and radar/radio opera tion, an engineer, and sufficient ambulance staff to care for the patients. Additional doctor, divers, search team, etc are taken when necessary.

AND RESCUE SERVICE ""- -':Ji": This fascillating reco rd of the deJle!opment oller more than 40 ye ars of SJA Guernsey's services to the island community is available in book form, price 45p including postage, frol11 the St. John Ambulance Transport Department, A mbulance Station, Rohais, Guernsey, c.1.

As a high speed rescue launch (20 knots), the Flying Christine 1 I is part of the Channel Islands' Air / Sea Rescue Service, and with her radar, searchlights and flares is able to assist the Guernsey based R.N.L.I. vessel on searches. The radio equipment carried on board enables her to keep in close touch with re cue 4 authorities, aircraft and ship as well a with the ambulance station control room.

The launch , which is moored in St. Pet er Port IIarbour, is boarded daily by members of the service for routine maintenance. All major overhaul, with the exception of certain specialist work to the hull, is carried out when necessary by the Department.

The cabin is 11 ft. long, 7 fl. wide, 6 ft. 2 ins. high, and has been specially constructed to meet the many requirement for the removal of the ick Lind Injured. On the port side is the load1l1g tray and stretcher, fitted with detachable safety rail, and de igned to promote ea y loading. At the head of the tretcher is an oxygen cyltnder with flow meter and gauge. Above the head and fixed to the wheelhouse bulkhead is a Minuteman Resuscitator ready for immediate use: this apparatu can be detached in second if required elsewhere. On the port side are cupboards with perspex sliding door, which allow prompt recognition of surgical and first-aid requisite, rockets and magnesium flare which are towed here. Cupboard space for rocket line apparatus. transistorized loudhailer, eil-Robertson stretcher, portLible searchlights etc., is

The double bulkheads, and the sliding doors of the cabin and wheelhouse are packed with sheets of plastic foam to deaden sound, and a thick carpet with a foam backing ha al 0 been proVided for the same purpose.

The launch is powered by two 125 h.p. turbo-charged Perkin T6.354 0.'1) die el engines fitted with Borg Warner 72 type hydraulically operated rever e gearboxe. Aft of the port engine i a generator giving a maximum output of 35 amps, in additlOn to the 60 amp output given by the two alternators fitted to the Stretcher cabin of F lying Christine II

There are twenty one gauges under the glass-covered dashboard panel. The steering wheel is on the port side with engine controls near at hand. A steering indicator is mounted directly in front of the wheel. Also in the wheelhouse and in full view of the cox wain are the compass, echo sounder, and wll1d direction indicator. One automatic bilge pump is installed in the wheelhouse and one in the welldeck with alarms terminating in the wheelhouse, and two hand-operated pumps are fitted under floors fore and aft. A comprehensive tool and repair kit, carried for emergency use, is contained in a sealed box which is always kept on board. A tool kit for general maintenance is also availab le

The launch is equipped with four masts of different design and purpose.

The first, forward on the wheelhouse roof, carries the riding and masthead lights, halyards, St. John flag, wind dire ctio n indicator and ship-to-station aerial.

The second, further aft on the cabin roof, is equipped with the radar scanner, and blue flashing light.

To the third, amidships, are attached the V.H.F. aerial, and the ship-to-shore F l /Al\ / aerials, which are twin wires

(Below) The wheelhouse showing helmsman's position

lea di ng to the mast at t h e stern. A radar reflector is bo l ted to the third to increase the radar reflective qualities of the F lying C h ris t ine.

The launch's radio com m u n ication sets con ist of:-

(I) VH F ship-to-station on the two frequencies used by the service.

(2) VH F sh ip-to-air on the air emerge n cy frequency.

(3) VHF marine radio telephone on c h an n e ls 6, 12, 14 and 16.

( 4 ) Sh i p- to-shore radio telephone with crystal control. T h is set is of 100 watt transmisslOn output and has D F f aci lities.

(5) Decca 202 radar with ranges from V2 m ile to 24 mile

All the equipment works off the la un c h 's electricity supp ly of 24 volts.

E q u ip m e n t o n the w h ee lh ouse and ca bi n tops is a remote ly-contro ll ed s e a r c hl i gh t, twin wind horns, D .F. loop, 2 li febuoys and boa t hooks. A s liding hatch

is s tuated above the cox wain's head for a dd itio n a l observation purposes. All deck

fi t ti n gs are of stain less steel, including h an drails on cabin and wheelhouse roof.

Th e boat is protected from fire by built- n C 0 2 extinguishe r s an d portab e foa m u ni ts.

Th e we ll deck, flanked on either side by the engi n e boxes and storage lockers

fo r fe nd -offs, ropes, etc., a lso contains an 8 ft. by 8 ft. sc ramble net, which can be q u ick ly attached a n d drop p ed over t h e

si d e. An eig h t man self-inflating survival

di ngh y operate d by a C0 2 cylinder is a so ke p t h e r e.

Inshore life-boat

Th e service h as operate d inflatab le rubb e r d inghies for insho r e rescue work

si n ce t h e early d ays fo ll owing the war. I n 1953 it was invo ve d in consultations 6

purchased its first powered model, complete with 1 8 h.p. outboard engine and trailer, in 1961.

The present 16 ft. inflatable inshore life-boat i housed at the ambulance station, on a trailer, ready for immediate u e on any point of the coa t where its services are required. Powered by an Evinrude 40 h.p. outboard engine with electric start, it has a speed of 21 knots.

G a nn e

A 13 ft. fibre glas dory is moored in St. Peter Port harbour as a tender to the Flying Christine I I but it also takes part in rescues on its own, having a speed of over 20 knots. It is powered by a Mercury 35 h.p. outboard engine.

Div e rs' boat

life bo at at sea. A second 13 f1. fibre gla s dory, powered by a Mercury 200 outboard engine (20 h.p.) and with a peed of 15 knots, is kept basically for the u e of the aqua-lung search/rescue team. This boat is used for other re cue purposes, a. well a relief tender in place of 'Gannet'.

wit h manufactu rers of these craft concerning the production of a heavy - duty boat for rescue work and as a result a ten-man model was introduced to the Department in 1958.

The Department then played a significant part in the introduction of inshore rescue boats (now termed inshore life-boats), and went a stage further in the development of the earlier craft and

Inflatabl e boat

A 9 f1. inflatable boat, constructed from tear-resistant nylon fabric proofed each side with synthetic rubber, is carried on board the Flying hristine 1 I. This boat provides mean whereby in hore searche , or ferrying to and from the parent launch, etc may be undertaken. (Continued next month)

of continuous care. I n other words, while giving appropriate first-aid treatment, the actuul condition of the patient, and changes therein, must be paramount in the mind of the first-aider. 'These notes apply to all the tests. In some case specific comments can be made.'

D ew a r T ea m T est ( Ambul a nc e)

The main error made by competitors in this test was inadequate support of fractures during actual plinting procedures and ulso before appropriate splinting had taken place. There is no doubt that in real-life situations consciou casualties would have expressed their feelings in no uncertain manner. Some splinting had been ineffective through insufficient pudding and loose bandaging; an elementary Inability to tie a reef-knot had also been apparent.

THE SURGEON-IN -CHIEF'S VIEWS ON

1972 Brigade Finals

AT T H E 1972 Brigade Final Competition held at Croydon on July I and honoured by the presence of the Secretary of State for Social Services, the Rt. Hon. Sir Keith J oseph, who presented the awards, the Surgeon-in - Chief crystallized the comments of the medica l and nursing experts who had judged the competition tests.

Co lonel O ll erenshaw said that the standard of first aid at this year's competition had been good. All the doctors judging the tests had told him that had they been unfortunate enough

to suffer the injuries so ably portrayed by the casualties they would have been satisfied by the treatment rendered by our first-aiders. However, tJle old A.rmy adage 'appreciate the situation' is most important willlln the field of first aiJ; indeed appreciation is the first priority and it is important for competitor, as no doubt they would in real-life situations, to make a rapid situation assessment before beginnIng treatment of the casualty.

Another point of constructive criticism was that competitors in the individual tests should bear in mind the importance

White- Knox Team Test (Ambulance Cadets)

Comments on the ambulance teams also applied to cadets: some of the fracture treated had been supported most inadequately. Some patients had not been handled in a gentle manner and before treatment, at the diagnostic stage, casualties had been moved overmuch.

Nursing Individual Tests

Possibly through nervousness competitors did not concentrate enough on the card. In general terms the approach to the patient had been first-class but, somewhat surprisingly, the standard of bed-making was by no means as high as in previous years.

Perrot Team Test ( Nursing)

It was a great suprise to see how many

Visit to Ambulance Service

BY LONDON DISTRICT MEMBERS

CO , TJ UI G their close association with the London Ambulance Service, London District members of 215 (Royal Borough of King ton upon Thames) Division recently visited the existing and new control of the L.A at Waterloo.

In the existing control, the system of receiving emergency and other calls was explained by the senior control superintendent. These call were followed through, some being transnlltted via private land-line direct to ambulance tations, others by radio to ambulance that were mobile. Particular interest was hown in the messages beIng transmitted to the ambulance operated for the L.A.S. by the Division.

The new IlQ and control i some 200 yards along Waterloo Road from the old llQ.

In the spacious new control the London District members were shown the new system for controlling the service's ambulances by sub-dividing London into control areas, each with its own control staff; at night various sections of the control con oles are to be closed down and their function transferred to the central console. When there is a major emergency certain sections of the control only receive and transmit messages appertaining to the incident. When the new control becomes operational in late 1972 all ambulances will have been fitted with new radio, so programmed that the number of voice tran missions will be reduced. When an ambulance leaves its station the crew presse a button, presses another when arriving at the call, and yet another when

(Left) 'We'll take th IS one: says AIM A. Boreham to colleagues in L.A.S. vehicle depot

teams had reached the correct diagnostic conclusion, without making a full and detailed examination, more by good luck than good management. All procedures should be followed in a logical pattern, especially examination of patients. In general, the applicatIOn of dressings was not as good as it should have been, and the entrance to the First Aid Post was cluttered with inessentials.

Dunbar - Nai s mith Cup (Nursing Cadets)

In this very specific test several teams failed to appreciate the severity of the bleeding, and failed to take the obvious step of elevating the limb. Again, the inadequate support of the fractured elbow was apparent, and the handling of the patient was far from gentle. Lack of observation led some to overlook the black eye, which was fairly obvious.

(Right) As a GPO engine e r, AIM B. Merry tries to

arriving a t the hospital. Each time a button pressed the call sign of the ambulance and the time is recorded on a magnetic tape in the control, thus recording automatically facts of each case. The only voice transmlSSlOns required are when the ambulance is again available at hospital or for important message during a Journey.

Members were also shown the latest ambulances being introduced into service by the L.A.S together with the mobile control unit.

The SJ A mem bers were very pleased to meet members of the control staff, whQ previously had been either sets of initials on a message or voices over the radio. 7

APPOINTED

Mr. R S. B. Madeley ha been appointed Director of Service of St. John to co-ordinate the work of the Trea ury. Stores Department, public relations and all those activities that operate for the benefit of St. John as a whole.

IN SCHOOL

T h is article on first-aid inadequacie by Mr s. S. D. Tunnicliffe appeared in The Times Educational Supplement re 'ently.

Treatment of children who have had accidents at school gros Iy inadequate. Schools are not covered by the Factorie , S hop and R ailway Premises Act. Such a situation would not be tolerated in industry.

Some schools have no medical room.

W h ere they do exist medical rooms can be fou n d in use as teaching rooms, stores for visual aid. games equipment and statione r y. Frequently they have at least dual roles. l njured children are treated in heads' tudies, staffrooms, busy offices and corridors. There may be no couch available.

Supervision of first-aid equipment, o rd eri n g of new stock, access to existing eq u ip m ent at all times of the school day is ll -defined. Situations do arise when this equipment is locked during the lunch h our, the key possessor, eg, the secretary, is off the premise, and access impossible.

A p a r t from the precautions necessary fo r h e school to cover itself legally, the trea t ment of the casualty and further line of action to be taken is carried ou in a h aphazard way, and very rarely by anyone who has any real knowledge of h e most appropriate action. Frequently ambu l ance are called out for the most minor injuries, at high cost to the community.

AROUND and ABOUT

WHAT'S GOING ON IN THE WORLD OF ST. JOHN

BY THE EDITOR

APPOINTMENTS

Cornw a ll : Dr. Lawrence to Area Com.

I Western Hert s: Mr. Longmore relinquished appointment of Commis ioner but continues as C St. J.A.

Mr. F. G. Holmes to Commissioner.

Major Schofield to Dep. Commissioner.

N orth a n : Mr. T. Wilkin on to A/Cty.

Dir.

Bermud a: Dr. Simon Frazer to Chairman. S t. John CounciL

Very few teacher training cour es include first aid a part of the training for a teacher. I t was never mentioned in my postgraduate course, though l was also goi ng to be teaching children 111 laboratones where unpleasant accidents can occur.

It would seem ensible to eq Ulp science teachers with the knowledge of what to do in an emergency in a laboratory, uch as to immerse burn in water immediately. Many PE teachers do study first aid as part of their course but there is no incentive for them to keep their first aid certificate up to date. PE

teachers are frequently not available to cope with accidents as they may for instance be taking team practice in the lunch hours and they may not be willing to be consulted.

I sugge t that it be mandatory for schools to have a fully equipped medical room and al least one person fully qualified in fir t aid on the staff. This per on hould be IJ1 charge of lhe medical room dealing with the injured children, and should be paid a pecial allowallce.

All teachers, training for whatever level, should take a first-aId course as part of their health education studies during training. and there hould be an incentive for them to keep up the validity of their certificate

WITHOUT

The Department of Health and Social Security has indicated thal eye ointment containing sulphacetamide sodium included in fir t-aid boxes or provided in first-aid rooms may be upplied without prescription.

A GUIDE

Most Centre ecretaries, write the Secretary. sociation Branch, experience difficulty WIth incorrectly completed class and examiner's report forms by new or ll1experienced class secretarie , which causes fru tration, expenditure on 'phone calls and delay.

So we have prepared correctly completed pecimen forms which can be given to new cia s . ecretaries as a guide. A stock of them can be obtained from the Association Branch at cost.

CRASH

An exercise 'Air Crash' was held al the ational lown and Country FestivaL Kenilworth on August 26 and 27. The purpo e of these demonslrations was to show the public (A) How they could best assist in a real life emergency, (B) fhe value of on the spol first aid knowledge:

Surrey Hersham DiVISion's ecent crazy cricket followed by a chips-with everything party. Cricketers

(L to R) K Marques, Mrs. E. Penfold, Mrs. K. Willis, Mrs. F Pickering, G. Allen, Mrs. P. Shore, T. Shore, T. Henderson, and a supporter (Photo: Esher News)

(C) How t. John work dovetails with that of professional ambulance serVIces Jnd fire ervices at a large incident: (D) The use of eq ulpment carried by ambulance services. and (E) The work of the Fire Bngade.

The setting \n Auster aircraft. after being invohed in a mid-air collision, is supposed to ha\'e ,I tree then cra hed onto J CJr parked on a rOJd Two o h er CJrs swerving to ;]VOIU the de-;cending plane have heen involved in Q he;]d on collision, one of them overturning. The pIlot of the econd plane esclped b) parJchuting and is found suspended by hiS 'chute on the of grJln

12 Associ;]tlon member'> panicip;]ted in each exercise. f-our ;]s first-;]Iders arming In one C;]r. t\\'o JS unqualIfied sunders (one hysterical) trJ\ ellll1g in a econd Lar. four cJ,>u,iltie., (pilot .1l1d In plane urners of the two cra.,hed cars) The other two members pro\'lded maJ..e-up ,Ind aSSIsted With s tagll1g.

Two 35-minUle demonstratiom which included hre fightlllg Jm.! freeing with cutt lIlg equipment per<,om trapred in \\reL J...lge. \\ ere given each d ,l}' With commentJnes b) of John, the \mbul.lI1ce and Fire ervlCes. I::stimaled nn \ugmt 26 were 1,000 Jnd 700. on \ugust 2"'7 3.000 Jnd 4.000.

POP

The fJcts a t SJ \ entrJI (ReadlI1gl \reJ '. attendance at ReJdlI1g Pop dUring \ugu'>t .Ire :

Casualties to hospital : ases treated : -+ 6-+0

H 0 u rs 0 d u t y \mbulances on duty Reading I Theale

CQse treated Friday 37 • aturdJ) 302. unday 30 I Total 640

All area dlv ISlons were represented, Illcludll1g TheJlt'

Synopsi of treatment.: dog bite, headache, toothache. cut foot, blister, sprained anJ..le, slings, burn on hand, upset stomaL'h, faints. scabies (I) , sore throat, splinter in foot, burn on WrIst,

Hersham Division aga n Nursing Me m b e The r esa Evans recently became Mrs. Lawrence Soarer, flanked by local members

mild sunstroke, insect bites, diabetic injection, electric shock. tonsIiitls scald. cut finger. peTlod pains, brui es, asthma, rash on body, foreign body in eye, scald right shoulder blade. unburn, ha}' fever. swollen glands. painful ear lobe.,. vomiting, strained back, sprained knee, foreign body in hand, friction burn. bronchitiS and eye infection.

SJA river boat patrol [lours of duty 272. cases rescues (would have drowned) k. minor rescues, fatigue and exhaustion (one at 2am) 36. first aid CJses treated 7, assistance to poliL'e 3

RadiO conli.lct with Police and Fire Brigade \VJS maintained throughout Fe lIval.

R ECOM M END

Wheelchairs for the disabled \', hlch have heen is ued the Department of Health Jnd Soci:J1 Security only on the recommendJlIOn of a hospital consultant, trom September 1 be recommended by general medical practitioners in the '<ational Health en ICe and by doctors employed by Local --\uthorities

The Department supplies about 40,000 wheelchairs each year, about half to new applicant and the remainder in exchange or renewal of existing chairs. {'here are over 130.000 wheelchair., on issue in I:::ngland and Wales.

HO M E

How can one possibly mall1tain a llUrSll1g home for the aged on a non-profit basis in 1972 and yet provide lhe residents With first-class care'?

It is With pnde that the committee of management and staff of the t. John Home. Tankerton. Kent (the only other SJ home for the Jged in the L.K. outside Sc.otland is 111 Guern ey), do lust that. The 'rock' upon which the management of the home stands is the matron. River S SU. SR\", and her staff. whose devotIOn to duty and excellent relationship with the residents is superb. The c are and attention given to the aged in this home are admini tered most thoroughly In the name of SL John. and Kent IS truly proud of service to its ex-members Jnd other, which given at .I minimum cost.

Founded nearly 20 years ago by the

second ambulance for Salisbury Division was dedicated recently by Bishop A C Macl nnes, Sub Prelate of the Order. The Chief Commander was present (Photo Salisbury Times)

late Sister Sharman (its first matron) and others who contribu ted to the purchase of 1 Gloucester Road, Tankerton, Countess Mountbatten of Burma, 'Lady Louis' took a keen interest in the home and i; 1955 persuaded the Order of S t. John to make it a generous donation, and so the house was extended to a 19-bed nursing home.

To the Order and those few who started the venture is owed a great deal. With a 'full house' and a long waiting list, the home now ticks over with a minimal margin of cash reserve for unexpected repairs and rising costs which effect eve rything connected with it. The management committee is very grateful to those who thought of the home in their wills the donors , and those who persuaded various charities to help. For without these the home might not exist today. It has been run on a 'shoe-string' for years, as it still is. But the comfort an d service to the residents has never

St. John Home, Tankerton (See story HOME)

been allowed to suffer through these financial stresses .

The St. John Home is truly 'Pro Fide' and 'Pro Utilitate Hominum' practised to the full. It will continue, we hope , for ever. But the day is eagerly awaited when greater things can be done to improve this holding of the Order in this small corner of Kent.

LYN T ON

County Director Devon Sqd . Ldr. W. H. Scorer writes:

Lynton, Devon, St. John Ambulance must be one of the few units which staffs a service directly descended from the days of the horse ambulance.

I have a photographic slide, which unfortunately will not reproduce in print, showing the last horse am bulance in use in Lynton and Lynmouth. The date of the picture is some time round 1919 ; it was taken at a fund-raising event outside the Lyndale Hotel Lynmouth , at the First motor ambulance SJA Lynton, Devon, in 1928 See story LYNTON (Photo; Montague Cooper, Lynton)

bottom of the notorious Counti bury HiU

Many accidents occurred there before the improvements following the flood of 1952. The Lyndale Hotel was owned by Mr. Tom Bevan, a Serving Brother of the Order who is still a n active member of the As ociation after 53 years. Ca ualties were taken by the horse ambulance to the cliff railway and transferred on stretchers, two at a time, to the Lynton Cottage Hospital. Horses came from a local livery stable.

On one occasion when there was a serious accident the horses happened to be out on private hire. This prompted the Association about 1922-23, to provide a motorised ambulance, and my picture shows a vehicle replacement ceremo ny outside the Lynton Town Hall about 1928.

Mrs. Hope Pedder, of Lynton, recently made a Serving Sister, can well remember the first motorised ambulance, which by modern sta ndards would be regarded as too primitive to put on the road.

S t. John Ambulance work till flourishes in the twin villages of Lynt on and Lynmou lh , thank to the devotion of a small number of dedicated volunteers. Yet the need ha never been greater. Thousands of cars pour into the Lynton area every day, e pecially during the summer. Short-tempered and hara sed by families who want to stop, drivers tour around frantically seeking parking pots. In these condition accident proliferate, and the services of the ambulance were never more needed.

Our Mr. I. Durman is the second generation of his family to undertake the duties of superintendent-in-charge proof that the spirit of ervice which inspired the early worker till very mu c h alive.

A FI RST

SJ A Chichester, Sussex, recently attracted 1,000 vi itor to Goodwood for its first-ever horse show.

The idea of holding a horse show started when members were looking for new ways of raising money for St John Ambulance funds.

It turned out to be uch a succe s that Mr. Edward Croucher (divisional superintendent) promises it will now be an annual event. Thi show will probably have raised abou t £.160 when all the accounts are settled.

As well as the horse show, which brought in 150 riders, events also included a dog show, which attracted 79 owners, and a fete.

ADDITION

In addition to the names published of those invested by the Order on Feb. 24 1972 is George Stanley Hoggett, of Middlesbrough, a Serving Brother.

VISIT

215 (Kingston upon Thames) Division was selected by London District to act as hosts to members of J ohanniter Unfall-Hilfe when they visited England to compete for the Buxton Trophy on October I

The team, comprising 3 men and 3 women , was met at London Airport on the Saturday prior to the competition by Deputy Distri c t Commissioner D. Fenton and members of the Division. To familiarise the vlsitors with British equipment, they spent the afternoon with members loading ambulances and practising first aid. [n the evening there was a reception attended by Area Commissioner Dr. C. A Osborn , during which the guests presented Kingston Division with a plate of contemporary design.

At the co mpetition teams from Holland, Canada and their German guests used KiJ1<>stnT1's ambulance for the loading

stay here

On the Monday Kingston members accompanied their guests on a visit to the Chapter Hou se of the Order at Clerkenwell, and then to the London

AT RANDOM (continued from page 1)

Among the chief jobs that our members are now regularly doing are the following: (a) meeting Asians off planes at Hea throw, tan ted and Gatwick, and seei.ng them through the airport procedure and off to their destination ; (b) manning first aid posts at Stansted and Gatwick, and caring for mother with babies, the old and the sick; (c) helping the medical staff with the medical screening at airports and reception centres; (d) helping to staff the sick bays at reception centres, and (in at least one case) running an ambulance service for the centre; (e) perhaps the most exacting task of all, providing escorts for the long train and bus journeys from airports to reception centres; the actual journey time may be anything from 4 to 8 hours, and the escorts carry a very heavy load of responsibility and usually have to be away overnight.

The emergency has revealed one weakness that we must contrive to overcome. There are still some counties where it is impossible to contact any responsible St. John representative during working hours, or which cannot produce a telephone contact that can be guaranteed at any time. As I've already mentioned in the context of local road, rail or air disasters, we can't expect to play our full part in any major emergency unle s each county has within it a proper communication network and guaranteed contacts with Brigade HQ , the Local Authority, police , etc.

A dj ustment

Thi whole que tion of co mmuni cat ion and co-operation at county level with Local Authorities, hospitals , police and ambulance services and our partners in the BRCS and WR VS is very closely related to the boundary and other changes foreshadowed in the new Local Government Bill to which I referred in the April Review (p.ll). Many counties are, I know, facing the problems of reorganisation in the most realistic manner and are already engaged in plans to solve them some, where S1. John Area will b e able to transf er a complete entitie from one county to another, are already getting to know and to work with the St. John set-up (and that parti c ularly inv o lves getting to know and make friends with individ u a l people) in the counties t o which they will transf e r ; others have even reached the stage of mutual agreement over such matters as continuing to cover big public duties which a reduced county might be unable to cover on it own .

to a return visit to Ravensbourg in the near future.

But J confe s to feeling some slight uneasiness at the implications of a point of view that one sometimes hears expressed in such words as: 'Yes, of course we'll do our be t to co-operate loyally and olve the problems involved: but please give us a couple of years to adjust our elves gradually after the new Bill has become law'. Surely the time to start that gradual adjustment is now - or rather it was six months or more ago - which will very nearly give the suggested two years' ' grace' without waiting for the new Bill to become law Granted that in some places a slightly longer period of adjustment will be needed than in others, it'sju t another example of the need to co-operate before an emergency anses and not wait till it upon us.

Camp

I had intended to say last month how immensely I enjoyed my two-day visit to Bexhill camp in August, and to express on behalf of the Commissioner-in-Chief and the Brigade as a whole our most heartfelt thanks to Mrs Rose and Sister Dance for the splendid way in which they came to the rescue and 'emerged from retirement' to enable the tradition that Mrs. Rose has built up for just over a quarter of a cent ury to continue in 1972. But the delay enables me to add the most welcome news that i\1iss Willis (who has a very wide experience of Bexhill and was Camp Commandant in the year when Mr Ro e went to u tralia) has most kindly agreed to be Camp Commandant in 1973.

She has asked me to make known one matter of urgency to which reference will al 0 be made in the November Brigade General Circular. The po ition of Head Cook at Bexhill i a very exacting and responsible one, involving catering for a camp of up to 300 people. It i right and proper that it hould be a paid appointment, and it might well be hared by two or more per on either on a shift-work ba i or for part of the camp period only (provided that each could offer a minimum of one week' tay). And it i obviously desirable, though not e entiaJ, that tho e in charge of the cooking and ca tering should have 'o rne exi ti ng or previous experience of and connection with the Brigade Plea se make this known widely a pos lble and encourage uitablc applicant who would be available during part or all of the period Jul y _1 to ugu t _5 1973 to apply to eek further information from) 1is W. E. Willi, 179 Ha ze lbank Road, Catford, London SEb I LU.

Johanniter UnfallH ilfe team members with their hosts of Kingston Division Volkswagen (GB) Ltd loaned them a minibus for their

tests. Ambulance Service HQ at Waterloo.

This visit was a memorable four days for Kingston Division, who now look forward

VAN C ATS or 'swimming cat' as they are p o pul a rl y ca ll ed, come from Turkey. The Tur ki h' peop l e do n ot a a rule make gre a t fu about an i mals unless they serve o rn e useful purpose B ut there are two

ex c e ptio n s th e An kara cats and the Van ca t s b ot h of w hich h m'e bee n kept

a s d o me s t ic pe t for hu n d r e d s of vear

[ c a m e ac r oss the V an cats years ago when I w as t rave ll ng i n T ur k ey. r \\'as given a fe m a le in so uth eas t ern Turkey and a m a l e by the m a n a g er of the ho t e l in wh ic h 1 s t a ye d in I s t a n b u l. b u I certainly didn t r ea li e a t t he ti me that the\ wer'e a nything s p ecial. It w as on ly ,;fter I brough th e m ho m e and the fema le ha d g i ven birth t o t hr ee w h ite kittens with identi ca l h ea d a nd tai l m a r kin g that I reali s ed tha h ey mll st b e thorou g hbred c at The Van c at is nam e d after L ake V a n in eastern Turk ey, o n lv 10 0 m il es or so fr o m the Ru ss an b or d er. In this region there is dee p s n o w fo r a b out si x month o f the ye a r , a n d e x treme heat d u ri ng the summer m o n h s. Wh IC h probab ly a c count s f o r t he gr ea t har din es of the breed.

Quite distin c tiv e in a pp eara n ce t he Van cat h a s a m e d i um-l o ng c h al k white c oat whi c h fe el m o r e l i k e mink than anything els e. Th e o nl y co lour m ar k ings are th e a uburn m a r ks on its head (sometim es it h as a d arke r f ur l n e f r om the out e r co rn e r s of i t s eyes to it c h eeks ) and it s bushy a uburn-r i ng e d ta il. T he V an e a t s eye a r e a lwa y a r ge a nd a mb er i n colour, its sk i n is sh e ll p in k . a n d i ts ears have l o ng delic ate ly c urv e d in ner u f t ing, sometim es with ' f ea th e rs o n t h e tip.

Van ca t s ca n b e eas Il y t r ai n e d if treated s en s ibl y a nd a pp are ntl y l ove to be with hum a n b e in gs. T hey d o n o have the 12

SWIMMING CATS

same tendency to ·talk · as. iamese cats.

It i' important to treat them gently. I f one will not do a" it IS told. or 111 ea t ing food intended for hUI11Jr. C'onsumption. it IS best to peak fIrmly to it rather than use force. [ f a hand I'> rJi-;ed in a ng er apint It or. \\or 17 till used to 'lap it. the V an cat will bo x: back \\ lth Its pa \\ [ f driH'n too far It may re ort to nipping. 1 h Jve found V an extremely affectionate and they purr Jlmost continuously. They cun be trJlIled WIthout difficulty.

unusual cats are called swimming CJt , The) certainl) d) s\\ im and unlike most cats they actllJlly enJoy being in the water plaYlllg \\ Ith it. or sitti n g out 111 the ram. ThIS LunOtl'chJracteristlL' apparently peculiar to the breed. ask me if it is n ot true that all cats can In fact. '>" IIII and m) answer IS thJt uti cats CUll 1m but only .1 few lIf.:..l It.

I first dlscO\ ered this liking for \\ ater on the driye back from Turkey \\ ith m) or ig i na pair. Th e two k i tte n eeme d to suffer from the heat as much as 1 did, and often lay panti n g limply in the hack of

HOW ALANYA , A SICK KITTEN

FROM TURKEY , CURED HERSELF AND REVEALED A STRANGE LIKING

to drink a.., I hought for the? first time In five Sut I \\L1 mistaken. I nste?ad of drinking the kitten dahhed her pa\\ In the \\.ller .lnL! ..,Io"hed it .dl over her head and back. 1 hen she turned o\,er the water dl"h and sal In the spreading puddle. 1 tllkd a pla"tlc bowl with tepid \\,ltcr Jnd plaL'eLi It near the kitten dlld the? puddle. She snJtfeLi it peered In. ,1I1d finally stepped Into the four il1Lhe" of water \\ here "he snuggled down pUrring. o\fter three mInutes in the WJter she got out. 1 hastdy dned her \vith a towel In front of the fire. feJring pneumonia. but .,he soon got too hal :.lI1d jumped out 01 m) arm into the water ag.11l1 1 he we?nt through this procedure three time'> in SUCL'e.,. Ion, gl\ Ing me time to photogr,lph her and bring wltne.,se., to thIS strange scene. ", ot long- :.Jfterwards I took kitten' temperature Jnd found it only a fraL'llon abo\'e normal. I don't know if this pro\'es the efficJc\ ot WJter :,h J eure. If not. it Lerrainly \\'J'-, .1 str,mge coincidence.

I n order to proVIde the dUJI breeding line. I obtallled another pair of

Van Cdts when I returned to Turkey. Ithough the J urks were ver} plea-.ed at 1m interest in their famou. 'Van Kedi' th'ey couldn't understand why r should WJnt to Like them back to Britain 'as they dn not catch mice'.

I mJnaged to find another pair of cats although it \\ as not easy ( I only saw eight in more than 5.000 mi e of driving). and I have been breedll1g from these and the origl11a l pairs ever since. [n 1969, having achieved full pedigree status (CCCF) Van Alan) a ha' '>l11ce become (in 1970) the first champion Turki h cat in the world. This has reqUlred great and slngle-mlndedness becau5e so many thlng5 CJn go wrong uch as all-male litters (thIs seem to be quite common with Van cats!. Caesarian births, udden epidemics, and kmporary terility due to nutritional expe riments carried out for pet-food compal11es. I also lI1S1 t on no more than one litter ever ten months for. after all. the) are not factofle ome people advocate that I should cro's breed my Van cats WIth some other

similar pe such as White P ersIan' or 'Chinchi ll a' because V an cals do not conform to the Br itish standard for long-haird cats, but whether it conforms or not I maintain that the Van cat is alread) an established type of Ih own with its long straight asiatic nose, no woolly undercoat, high cheekbone an d ears hich are. ometimes enormous whe n they are kittens Therefore r and my oth'er hreeders will never cross-b r ee d them.

Experime n tal cross-breedlJ1g to ac h ieye this or that perfection may be interestin g but to me it is infinitely more vital to help to preserve this ancient breed of Turkish Van cats. \\ Ith Turkish name Ii k e Va n GLizelli I skenderun, Van T emmiiz, or Van K ehri B ar since Full Status P edigree, t h e word 'Va n is n ow o n ly my breede r s ken n el ·prefix'. I should like them to become kno w n as the Turkish ( V an) Cat because of their history and location.

Reprinted {mm (he Somersel S t John COllilf.) Year Book}.

(R ight) Mothe r V an Antalya tolerantly watches the antics of he r female kinen, Van Bayan

P

0\ CUrIOUS incident \\'hiC'11 hJppened not long Jgo made me wonder \\ hether .'heer enjoyment h the onl) reJson \\ hy Van cats take to the \\Jter so Three or eight-month-old kittell' \\ere extremel) III With stom3ch catarrh. l hey were suffering lrom complete loss of appetIte Jnd had temperatures ot 0\ er 10.-" \\ hiC'h the full antIbIOtic tre:.ltment of the :-.urgeon could not reduce to 3 cat's normJl temperJture of [0 I 5°

I notlced the moq ill of the three kittens gOIng to the dog' \\-Her dish

Wr itten by the CJr. t one pomt I l'ame to a big river with .1 "hallow tnbutary running mer clean gr:n ('I :.lnd shJded by large H ot. dust) and bad tempered :.lS [ \\ 3S I did not he:-.itJte bl'fore \\'Jdll1g Into the shallo\\ Jnd sittIng down in the "'Jter. letting it flo\\ 0\ er m) tired feet 3nd dry burning 3rnh Then '\udden'y to my atonishment the \' an kItten" strolled into the water Jnd ,\vam out of their depth enjoying themsehes. T Im \\ere dubbed 'swlmming cat': the Pres,> on my return to BritaIn

La ura Lushington

(Left) Van A til a Stamboul shows off fine bushy r inged tail

Ambulances FROM THE PAST TO THE PRESENT

1915

Superi ntendent

Jo nes' idea eft) a specia frame for carrying str etcher patien ts on a touring car. ( Below eft) with the hood u p and st re tch er fitted ( Ph otos N. & L Clark)

wrTH THE DEVELOPMENT of the motor car in the early part of thi century as a more or Ie s reliable form of transport, forward-looking first-aiders and ambulancemen quick ly realised that here was the type of ambu ance vehic l e that they required . rt had greater speed, tamina and comfort for the patient than a horse-drawn vehicle , but the stumb ling b ock was the co t of motor ambulances.

By 1915 a Divi ional Superintendent

H. Langley J one, of South end, wrote an article in the magazine First Aid entitled 'A Useful Imp rovised Motor Ambulance

Simply, Mr. Jones' idea was to fix tandard Furley stretchers on a 4-seater touring car by means of a specia l frame. Such vehic les, he wrote, were willingly loaned 10 his area by local owners. He sugge ted that Brigade units throughout the country might take up the idea.

1972

Bel ow)

Toda y's style - based on a Range Rover chassis. The interio r of this p articular vehicle shows t he electro ca rdiogr aph mach ine and difribillator installed on the bulkhead partitio n above the Fer n 0 W ashington trolley stretch er

The photograph on this page show the device being used, with the hood of the car down and up.

Motor ambulance were of course in u e with the Army during the 1914-18 war, but the earliest catalogue of civilian ambulances available seems to have appeared in 1920. Iso in that year advertisements for an Austin ambulance costing £800 appeared in the magazine First Aid.

NEW CRASH-ACTION AMBULANCE

Extreme versatility in operation ha been the design philosophy for the new Ibis M3 Ltd., ambulan c e which i ba ed upon t he highly successful Range Rover

The new IBIS M3 rescue ambulance designed to international standards Built on the Range Rover extended chassis, the vehicle has independent suspension and four wheel drive suitable for cross-country travel or high speed motorway work. There is a winch fitted and space for carrying a selection of rescue equipment.

IBIS M3 Limited - the specialist manufacturers of mobile medical units - also design and manufacture ambulances for more conventional duties They are designed on the principle that speed to the pick-up point is essential, but that care and skilled attention to revive and sustain life in transit to the Hospital is the most essential requirements.

IBIS M3 Limited design and manufacture equioment dedicated to this principle.

READERS VIEWS

AMBULANCES Continued)

extended chassi. Witll a top speed of 96 mph (I S4 5 kph), four-wheel drive and live axle suspension, the vehicle has l)een engineered to combine in one ambulance the capabilities for high speed motorway work and rough cross-country travel. (see photos)

Pow ered by a 3.5 litre V8 petrol l:ngine to gIve high road peeds with top payload capabilities, the vehicle has four wheel drive and duty tyres (:v li chelin XMS x 16) to provide the best traction over rugged terrain fhe Illclusion In the specification of a Winch With a line pull of J,086.51b at 16ft (1400kg at 5m) per minute and a comprehenSive t(101 kit, mak.es the unit eminent 1: suitable tor emergency operations With military and mountain rescue teams, authorities, industrial welfare and pub li c ambulance services.

The first new model to he designed and built at the 's factory in Kendal following the 01" manufJcluring operations from Newhaven earlier ) ear, the Rangt' R over ambulance nude Its deput at tht' Cerman lndustne,> 1 xhibltlon 111 Berlin during September 19'-'2.

WIth a wheelbase of 1 I Din (2.794111) and ,I turning Circle of than 40ft (12.19m) thl' unit hlghl;, and extremely stable in handling. In order to llllnlmise nsl-. of discomfort and aggravation of injuries of LICCllient victims, the ambulance is equipped with live a-<.:le WIth l'oll springs and radius arms ll1dependentl} to lront and re<lr whel'ls.

Additionalh ·. the rear .lxlt' IS fit led with a Bogt' Ilvdr Olll,lt self-energisi'ng le\elling device whil'h mainlall1S saloon In a level attituclt' rt'gardless of Irregular weight distflbution.

In ternal dimt'nsions of the <;aloon art' 7ft (.2 13m) long, Sf! (1.524m) WIde and Sft (1.524m) high , DIS,: brLlkes are prmlded on all four wheels and are piped for dual opnatlOn as a said), precaution.

1--or the Berlin exhibition. the ambulanL'l' Wel fitted out With the following equipment: ,\ Ferno-Washll1gton model 409 11 with facility, pt'rmitting the patient to be ttlted by 10 In a head down 40 Celrr y ing 'stair with securing pOints within the s:tloon, all attendant' drop-down seal. and an electrl1L'ardiograph nWl'hine and difribillator coupled to a radio transmitter \\ hlch enable, th2 patient's heartbeat to be transmitted to the receivll1g hospital during transIt. thus enabling the cOlrecl trl'alillent to be illlmedlately available on arrival.

Standard safe[;, features and ell1ergenC). eC]lIlpl11l'nt of the new ambulance includes lockns for medical suppllt's: prm iSlon fOI oxygen cylinders: intenor lights With swikhes: fhermos fL1Sk with paper Clip dispell'.el and paper towel holder: electrical terminals III tht' saloon for cardiac equipment, resuscitator, incubator etc, bell pllSh in the saloon wllh buner in the driver's cab: earthed aerial for radio communJcation equipment: night blinds to bulkhead and saloon windows and a full length plastiL' curtain to SL'rcen the trolky /s tretcht'!". rh e ambulance is built to standards and filted with a portable searchlight. blue flashIng roof light: air two tone horns: twin spot ;1J1d tog lalllps, rellt'L'live number plates: mud flaps: wing mirrors and a large lllumln,lted sign to the front.

Readers' views and opinions, which should be sent to the Editor, although published are not necessarily endorsed by the Editor or the Order of St. John and Its Foundations Although readers may sign pIJbllShed letters With a pen -name, writers must supply their name and address to the editor.

adventure and where possible the more adventurous their adult training can be made then the more likeJy they are to stay. Both sexes will enjoy stretcher exercises over difficult terrain and miniature emergency exercises. Promotion and continuance of the Duke of Edinburgh Award Scheme would help. Tolerance of modern fashions is also required by the older members. The Surrey Youth Column is a fine example of what can be achieved along these line s.

Finally, probably the biggest single reason for lo sing cadets is their age' As youngsters grow older they are presented with more opportunities, studying, commencing a new career, new friends. With employment comes more spendi ng money. owadays there are so many more distractions for youngsters outside voluntary service. Also boys become more interested in the opposite sex, and vice-versa. For older cadets going on duty can be frustrating; they hold the adult certificate but are often still treated as cadets, and may be told what to do by adult members of the same age or even younger than themselves.

If cadets of either sex can be persuaded to transfer as 16 year o ld s and be accepted as young adul ts, can mix socially with their opposites, and life in St. John's is made more interesting for them long before their 18th birthdays, then St. John will become a way of life for them. The effects of their covering duties may not be evident initially, but after they have settled down into a routine, the young male and female members will cove r duties together, perhaps eventually to marry and start a new generation of SL John Ju nior.

Southend-on-Sea

CADETS - LET NATURE TAKE A HA f\lD

from M V. Moring , Divi siona l Secretary

It seems a great pity to me that with many thousands of youngsters in the cadet divisions throughout the country, the greater number of them fail to tran fer to their adult division: a fact that can no doubt be sub taniated by Brigade HQ statistics. [n the Southend area there are 3 ambulance and 3 nursing cadet divisi.ons to one ambulance, one nursing and a combined division. Of over 150 cadets that onc ambulance cadet division recruited in the past twelve years only J 5 transferred and remained in the Brigad e. Agreed even 15 seem a high figure, but our division has over 100 members'

One of the objectives of the cadet divisions is to form a nucleu of ncw member for the adult divisions. With the proviSion for cadet to take the adult first aid certificate at 15 years old, all hould be ready for their tran fer at the recommended age of sixteen. But where do they all go?

The problem is many-fold:

1) Cadet superintendents promote only the older cadets to NCOs and thus (a) the cadets are not anxious to transfer and l ose their new found statu., and (b) cadet officer do not wish to 10 e the 'e rvices of their older tru ted cadet.

2) Officers in charge of adult division: (a) do not liaise enough with the cadet officers and encourage the tran fers 'as soon as possible after their 16th birthday', (b) do not continue to recognise those that do transfer a ex-cadets and adjust their training accordingly.

3) Cadets are often allowed, under one guise or another, to remain in the cadet divi ion until nearly theIr 18 th birthdays.

Many of lhe solution are obvious: promotion of younger NCOs in the cadet divisions; allocation of sma ll responsibilities in the adult diviSions and greater liaison between cadet and adult division officers (the adult s up crintendent shou ld know how many transfers from the cadets to expect during the year and fo ll ow up defaulters),

On transferring ex-cadets should be encouraged to contin u e for their Grand Pri or Award if this has not been gained and also to assist as DULT h elpers with their old cadet division (alth ough, it is stressed, thi must not be allowed to 'upcrcede their comrnittments to their new adu lt divi ion). Youth need

HOLIDAY DUTY

from R Gib son, Corp s Officer Transport o doubt there are many St John members like myself who have visited the various seaside resorts around the country during the summer holiday and found St. John first-aid posts closed. I know that the residents in the resorts have to work for their living (as we all do) and have few members to spare for duties during the busy summe r days, and the posts are kept locked as a result.

But members on holiday are still on duty should their services be required. The point is h ow many members would be prepared to give up a morning, afternoon, or 2 or 3 hours of their holiday in manning these first-aid posts?

If on ly something on thf:'se lines could be worked out I feel that our movement would benefit by co ntacts not only with injured holiday-makers but by meeting other members while on holiday.

Is this a practical proposition?

St Helens, Lanes. Ri cha rd Gibson

LEADERSHIP

from V. S Smith, Divi ional Officer

Having been a di ciple of Mr Watkin Williams whilst he was in Bu cks, and being o ne of the officers who were assesed on the Oxon. and Bucks cou rse , it was with great interest that [ read Alan Sharkey 's letter in the August Review How superficially true it all sounded, but what a defe at ist attitude.

If the so- 'ailed intelligent people we all need are attracted to St. John, and are content to do routine jobs and stick on plasters, then 0 much for their 'intelligence',

Every county needs its leaders, but with a little initiative a group of thwarted ambulance and nursing member can make them e lves felt in an influential manner. For someone so keen to get rid of military term uch as sergeant and corporal, Mr. Sharkey is very rank conscious in appointing all the subsidiary job in the division. Rank in St. John should be immaterial (Mf. Williams illustration of a sideways ladder of rank rather than vertical, hould be borne in mind). Enthusia m, skill, time available and eadership potential mll t rise above rank and para-military ideas. (continued on next page)

M. V. Moring

Work as a group, and quite soon a natural leader will emerge from within as experience grows.

You can busy yourselves in organisi ng training of the adventure type at divisional , area and county level; organising county camps a nd all that they entail; organising co unty sports d ays, socia l activities and co unty com petit io n whilst carrying out your divisional job and doing the routine public duty

It is apparent that St. John is fast becoming a 'dea d man s shoes' organisation for promotion to jobs outside the d iv isi ona l level. How often is the promotion' to area staff wa ted on a superintendent who has found his / her particular niche with a division , on ly to be lost in the wilderness of a large area?

Numer ous young people with great leaders hip potential float away between 15 and 25 due to a la c k of direction and a feeling of futility at not being ab le to get things done quick ly enough.

Another reason is that they don 't quite fit the pattern of a previous generation's idea of an officer.

Take heart , find a bunch of fellow baffled revolutionaries an d you will soon be embarrassing your county with your obvious keenness a nd skill and then perhaps your dedication will be recognised with rank if you want it, or more fittingly with the pleasure of seeing St. John Ambulance getting into motion in an attempt to keep up with modern teaching an d learning techniques

High Wycomb e, Bu cks. Vil7celll S. Smith

HIGHER AND ADVANCED CERTS

from Miss K. D. Wilson , Divisional Offi cer

I wonder what members think a bout these new certificate? I can t see a ot of point in them All nursing members will, it seems, automatically be able to apply for a Higher becaus e they must do first aid and nursing each year, unless nursing is not allowable be cause it is not optional. Perh aps someo ne can clarify?

Workingt ol1 K. D Wilson

UNIFORM AGAIN

from Bruce M. Coltman

[ was l ooking at some very old Brigade photographs in which officers were wearing white hat covers and this set me thinking about Brigade headgear once again [n a n earlier letter 1 did not think that a black and white striped hat band was suitab le for officers as it was possible at a distan ce for this set of co lours to cause mistaken identity with the sillitoe tartan used by the police

How e ver, I do think that everyone in SL John could wear whi te hat covers without too much mistaken identity. That badge of our unity, the white hat band, which is difficult to keep w hit e these day, co uld eve n be rep l aced by the hat cover.

J would further advocate that the Dr ess Uniform hats for nurses and nursing officers should be changed to h e s tyle recen tly adopted by the Salvation Army, which is much smarter an d available with a detachable cover.

Yes , some police forces do have white hat covers mainly for t raffic patrols and at some airports.

We hav e martened up the men's uniforms, now let us smarten up our nurse headgear.

I advocate the wearing of a white hat cover by every a dult member of the Brigade. A common badge does away with the Offi ce rs and us theory. You can always tell officers from a distance; they are the ones with the drooping shoulders.

Another point that crossed my mind. Why d o we not have on our uniforms for officers, just below their county flash, a furt her flash which state their duties, i.e. County Secretary, Area Cadet Officer , Competitions. Publi c duties etc. Naturally th e senior ranks of Commissio n er and Deputy need not be so marked a they are distinguishable by their ilver braid.

Newcastlc-on-TYI7(' Bruc e If Coltman

SHIRT SLEEVE ORDER

from M. Newbold, Divisional Officer (T)

Many thanks indeed for the fine article' '\mbulan ces from the past to the pre ent', well illustrated, Jnd well written, although the author is not credited! (Edit; A compilatJOn by myself)

1 would lik e to take thi opportunity of mentioning ambulance memb ers' 'Shirt Sleeve Order' Can we please have a firm ruling : are A /Ms allowed to wear shoulder straps on shirts or not? I h ave een photographs in the Review of A / Ms wearing traps in shirt leeve order but when we tried to purchase these from tores we were told that no decision on this had been made. 1ay we have an official ruling?

WeST Af olesel', Surrcl'. Mi chuel Nell'hold

Edit : The official ruling is in Dre s Regulation s (Ambulance), paragraph 13 , page 10 , wh ich reads 's hirt sleeves are rolled flat 2 inches above the elbow'.

From this wording , it is not intended that anything (including shou lder straps) i added to the shirt. In other words, they should not be worn according to regulations

A rescue exercise on the bank of the River Mersey at Eastham Ferry, Cheshire, for members from local divisions, meant bringing 8 casualties from a boating aCCident up the 20 toot high river bank either by sling lift or Neil Robertson stretcher. Organised by Area Training Officer A R. Jones, the exercise also in c luded the use of Bromborough, Eastham and Port Sunlight Combined Division's new treatment ca ravan (Photos: Bob Bird, Wallasey)

COMMUNICATIONS

from 1. C Bradbury-Williams, Lay Instructor

The Ibr ox Disaster paper by Dr. Bainbridge published in the August R eview identifies a need for communications within hospitals and to a nd at the disaster site. There is in existence an emergency comm unications voluntary service (the Radio Amateur I:omergen cy. network ca lled RAY ET) run under the spo nsorship of the RadiO Soc.lety of Great Britain, which i s aV3ilabie within a regional organlsailon and with an emergency ca ll-out procedure The radlO operator'> have the equipment in their cars or h omes and it c.an easily be transported to hospital and incident site at sho rt I sugge s t that HQ and cO Llnties could with beneflt get In touch with RSGB IIQ or the local co ntroller of RA YNET and work out local arrangements for an emergency plan.

Maidenhead 1. C. Bradbury-WIllwms

LAY INSTRUCTORS

from M W. Harri s, Area Superintendent

Now that lay instructors are being used to give the le ct ures as well as the pra c tical demonstrations for the adult first aid has the time not come for rethinking on the need for such In tructors to go through the formality of taking a first aid exam at least every third year? If they are capable of taking the e they mu t surely be up to the required standard for the FlfSt Aid certificate.

The matter co uld be dealt with quite simply by granting them a pass' in any year for which they were responsible for giving a cour e of lecture. In the case of Brigade personnel, the number and date of the course could be Cluoted on the BF 11 , thus ensuring their efficiency for that parti c ular year.

I suppose they could take the exam with .t heir own trall1ees, but I would consider that such action would ll1evltably lead to a los of dignity in the eyes of the other can didate. Thes e in tructor are held in high esteem by the trainees, and if they are good enough to do the job then why not recognise it in the manner suggested?

Hove, Sussex

F. A. BADGE

from L. S Walker

M. W. Harris

May I encourage every first-aid instructor or cl.as secretary ,o adopt the practice of presenting a First Aid H older s Badge with every certificate obtained by cand.ldates the [mt examination'? 115,526 such certificate were I sued m England alone during 1971

The (optional) extra co of 15p per badge could be mcluded in the elas general cost and afford our gOOd. free pUblicity from the wearer. who alway proud to dl.splay It , a well as stimulate further intere t from the general publlc.

'qualified professional', the treatment of such my bread and butter. Likewise I am unable to If. my s uperior is also thus qualified. Apart from these occaSional slJghts on my abi li ties, similar recognition as that t? nurses and trainee nurses would enable offIcers on major publlc duties and/or emergencies to pJace the qualified members to the best advantage.

*Members qualify for a 'Millar' certificate initially on being recommended by their employer following five continuous years employment on an Ambulance Service or after. a recognised training course of two to six weeks duratlOn accordIng to length of service, and passing the assessments. ew recruits are not awarded their certificates until they have served for twelve months following the course.

Southend-on-Sea

ROAD SAFETY

from R. R. Farrow

M V. Moring

I was interested in Alan Sharkey s comments on ranks (August Reader s' Views) What [ would like to see is for St. John to have safety officers (prevention of accidents). I feel that when cadets are learning first aid, why not learn a about safety? Motorways and fast traffic roads are spreadll1g throughout the country.

Sed bergh, Yorks.

AUCKLAND

from E. C Phipps

R. R. Farrow

Delighted to see the photograph of our lodge or tra111111g centre near Auckland in the June Review (see below). The grounds are known as John Pearce Park Dr. John Pe arce, an English gentleman who was a member of the Brigade back home, came out here to retire but took up a small practlce. He commissioner a nd was instrumental in obtaining the land which IS only 15 miles from the centre of Auckland. Dr John , .who is in high esteem, resigned from the Brigade and now lIves here 111 retirement.

I made two pairs of gates, which took two years of spare to make, for the new training centre. The other pair, at the eXIt, are not shown in the photograph.

Auckland, New Zealand

E. C. Phipps The gates referred to by Mr Ph pps

Many nationalised , industrial and commercial undertakmgs have adopted this standard practice LOlldol7, S .E.9

RECOGNITION

from M V Moring, Divisional Secretary

L. E. Walker

With the recognition of the qualificat ions of personnel i .e. the Ambulance Pr ?flClency ( Millar) not on l y as a certificate for jo mmg the Bngade but also as an exemption for members (whil t being employed Ol? A:nbula.nce Service work) from their annual first aid re-exammatlOn, time must now surely have come for the recognition of these profe sionals in their voluntary uniforms by some insignia or other?

As a professional Ambulance Aider (the new designation of holders of the 'Mi llar cerllficate) I have on numer,?u.s occasions been o n voluntary du tie with members, usually of dlvlslOns other than my own, who being of enior rank and age to me h ave expressed the way they wish a patient to be treated a n d tran spo rt ed. Whil e they may have very good reasons for theIr in structions, they are unabl e to recognise the fact that [ am a

PEN PALS WANTED

from J M. Windsor, Divisional Officer

Milton urs1l1g Cadet Divi ion members are very keen to enter for their [nt ernational Friendship Profici ency Badge and we should ?e interested to hear from cadets within the Commonwealth cOll ntn.es who would be intere ted in corresponding with the cadets? One grrl has particularly asked for a coloured child. I was thinking of Kenya, so that I can help her out with the geography of the country. I have a ls o vi ited which would help in any problem they could not work out for them elves.

5 Hunter Rd, SOtlthsca, Hants, Englllnd.

1. M. Windsor

19

NEWS from SCOTLAND

T h e other day I wa ta lking to someone

we ll -ver ed in St. John affairs. He was saying that he knew of one association

w hic h was fairly well-off; and it was p r oud of the fact that it had kept a substantial sum of money in reserve. This

set me thinking, for whi e it is surely a l audable example of thrift and economical management, I began to wonder whether, quite unconsciollsly and in all sincerity, benefactions were being

u sed as they shou d. P erhaps the best way of directing the thoughts of my reader

a lo n g the lines I wish to pursue might be

b y s u ggesting to them an analogy. If we were shareholders in a business and its m a n agement carefully hoarded away its assets instead of using them to the full and then borrowing to the hilt to finance further enterprises we wouid

u n d erstandably be annoyed We might go to the A n nua l General Meeting and

co m p l ain, b u t it is far more likely that we would sell our shares and have nothing m ore to do with the company, however exciting its products, until it had reformed itself. N ow of course compariso n s between business practices

WALES

On a beautiful mid-August day, 250 officers and cadets arrived at Tan Troed A d venture Centre, Llangorse , in the Br econ National P ark, to spend a most e njoyable and instructive week camping an d learning new ski ll s such as caving, po n y trekking, sai li n g, canoeing and hill wa l king the highlight of cadet jubilee year in Wales.

Th e joint camp commandants Asst. C h ief Commissioner for Wales Dr. D K. W Picke n and the Chief Officer of Cadets

Mr s. J D Smith, welcomed cadets from all corners of Wales, a l ong with officers a nd ca d ets fro m G l oucestershire and as fa r as G u ernsey, who had been guests in t h e h omes of B rigade members the night pr ior to camp.

On Su nday a Drum Head Service, co nd ucted by the Officiating Chaplain of th e Pr iory for Wa es, Canon W. E. C Th o m as, and the camp chap lain R ev. C. R ic h ar d s, was held in the sports area and atte nd ed by the C h ief Commissioner for Wal es, Lt. Co l. J . R L. T r a h e r ne, and Mrs. Tr a h e rn e.

Th e h ig hli ght of the cam p was the visit on T u esday of the Sup e r in t e nd e n t-in-C h ief, Lady Morya Brow n e, accompanied by the Chief 20

and the running of c haritable organisations can be taken only so far. And there are alway case this particular association might be one of them for Jll [ know in which the accumulation of large sums neces ary: a charity might have ome pecific plan, not yet reali ed, which would require the injection of a large sum; or it might be living on the in come from and borrowing against invested capital. Bul my feeling is that as far as the general run of local associations go these sorts of cases do not usually apply.

One could take this even further and propound two rules for financial management :

I. Any m oney in the hands of a charity should be committed to the limit in the work of that charity.

2. Commitment should be tJken o n as a matter of course for which there would be at the time 0 financial resources the job of members and associates being to raise the mon ey to pay for them.

Of course a corollary mu t be that any project should be one which

Superintendent for Wales , Lady Crawshay. Later, Lady Moyra joined cadets at the sailing base, where she took part in the sailing activity. She was piped aboard a new laun c h, aptly named Lady Moyra , by members of the camp sta ff.

Camp evening entertainments included concerts, b arn dances discotheque, and, the grand finale of camp, a carnival and camp fire.

H was a most enjoyable week, which had taken a year to plan, and was appreciated by all who attended.

J P Harris

the plann e rs are Sure would raise enough enthusiasm to generate the cash.

Actually [ myself hav e very little head for bu iness as my bank manager would confirm. I may have been talking non ense here , in which caS8 I lo o k forward to being c rushed by Some top city financier But I would give three reasons for my attitude. The first is practical. I n an inflationary ituation money should be fully s pent and m o re money borrowed it is c lear that a given sum will buy more today than it will tomorrow. The second is p ychologicaI. I do not believe that if the or dinary workers for a c harity know there is a comfortable Sum in the bank they will feel the need to struggle for more Prospective benefa c tors, moreover, may well be put off giving money to an organisation which they feel does not really need it and anyway 0 unsure of its aims that it has not already committed all that it ha. The third rea on ideological. We are members of a religious order for whom the me sage of the Gospels well-known on this subject must a pply. But we should aJ 0 remember the history of the Church and above all the feeling arou ed against other religious institution whi ch in the slxteenth century were suspected, sometimes unfairly but often fairly, of not using their re ources to the limit.

1. R-S

OVERSEAS

CANADA

NIGERIA

Mr W. J Joy ce, c hairman Elder Dempster Agencies (Nigeria) Ltd, hands a £750 cheque on behalf of Phillip Henry Holt C h

(Liverpool)

A

Th e new Priory Secretary is Dougla Wightman Cunnington, CD, who re cently retired from the Canadian Armed Forces with the rank of Brigadier-Genera l after 35 year service.

HIS e,n ly mllitary service was in operational units and in an engineering capacity. For the past 14 or 0 year he has been on staff work, malllly in admimstration, in such fields as Survival Operati ons and Plans (l:.mergen cy Measur es), with .A.T.O. forces 1I1 Paris, with the United ations Emergency Force in the Middle East, personnel administration ul Ottawa (Headq uartersl, and with the Canadian High Commission in London Douglas Cunnington was one of the first Canadian to be decorated in World War I I when he received the George tvledal for bom b di posal work in 1940. He is married, with two children.

MAU R ITIUS

Mr. J. G. Ohis , Commissioner JAB, has been awarded a Commonwealth l:.ducation tudy Fellowship at Reading University for a course eadi ng to a diploma in Science Education . Mr. Ohis will be in England until July 1973, during which time Mr. LUCien Tranquille MBl:. will be acting as Commissioner.

New Priory Secretary Douglas Cu n n ngton.

News from

the Divisions

BER KS - Results of the Central (Reading) I\rea first aid competitions held Sept 16 were' AMBULA CF : I st Reading Greal Western 26 i (Team Cup); 2nd Southern Combined 'A' Team :!27; 3rd Southern Combined '13' Team 225; 4th Reading Town '1\' 217. NURSI G: Southern Combined 276 (Team Cup). A 1BULAN .c CADET: J st Reading Great Western 144 Cream Cup); 2nd Reading A/N Cadets 126; 3rd ReadingTown A' 121.

NURSI G CADET: I sl Southcote uning Cadet DiVision 242 (Team Cup); 2nd Reading South Nursing Cadet Division 194 (Runners-Up Cup). CADET I DIVIDUAl : Southcote ;-.JLlfsing No.4 (lull:) Ir eland) 49 (Cup).

C o DURHAM -On August 25 South Durham Area cadets held their first ca mp for ten years \\hen 24 nUf'ilng and 56 ambulance cadets under 13 officers pitched tents for the weekend on lhe banks 0 r the river 1 ccs at Dinsdale \Ianor, near Darlington

Lack of equipment was overcome b) IO Hm from parcnts, lIartlcpool Education Committee, WR VS Darllllgton, and local divisions. Particular!) useful were the marquees and hired from a nearby ci rclIs the nominal charge for \\hleh eo uid hardl) have paid the wages of the three men \\'ho came to erect the marquees

A successful featurl' \Va, the c:Jm p tuck shop, for no less than seven t y dozen bottles of pop were consumed dunng the \\ eekend I

DERBYS -On Sept. 3 at the annual inspection of '0' Corps, North Derbyshire, the inspecting officer was Dr. Latham Brown, Deputy Director (Association). Some :!:!O members took part and were co ngratulated b) Dr. Latham Brown on ihelr smart turnout.

Shirebrook Ainbulance Division were led in their mareh past by a father and son, DiviSIOnal Officer S. C. Drabble (40 years service) and Divisional Nursing Officer S. R. Drabblc Dr. Latham Bro\\n presented the McKay Shield to the Silifebrook Nursing DIVision.

Abo on Sept 3 the South Derbyshire Area hl!ld its annllal inspection, attended by 280 members who Wl!re inspected by Colonel Peter II ilton, Commander/Com III i sSloner for Derbyshire.

Col. lIilton presented many awards, among them a 5th bar for 40 service to Area Staff Officer S. Kl1Ighton

On Sept 10 at the annllal Inspection of 'I" Corps, at I1eanor, a ltnost 200 personnel were on paradc With Corps Supt. R. Hamilton as O/e. The inspe c ting olTicer was Col. Peter Ililt on, MC', Commander/Commissioner for Derbyshire

After an exc\.!llent march past Col. Hilton presented many awards, the oublandlllg ones being to ' Corps Starr Officer (now retired) J. II. Bradley 45 years service; Amb. member H [lallam, Ilkeston Div., also 45 service, Amb member .I. II. lIunon also of Ilkeslon DIV. 30 years service, and warrant of appointmcnt as J leanor Divisional Surgcon to Dr. P. K il1uckergee. Ther e were also 6 awards of Lay Instructors' Certificates.

LONDON -During September the Mayor of Enfield opened the new S1 A first aid post in Broomfield Park, Southgate.

OBITUARY

SIDNI: Y CROU!:lE, 63, ambulance member, 86 (\\estminster) Divison, 33 years service.

Mrs. W. A RAY, London Transport Corps, 22 years service. Secretar} to the Corps. Serving Sister.

Worcestershire's County Surgeon Dr. M Wickam presents a silver salver to retiring Northern Area PreSident 85 year·old John A Harris (right), who joined Dudley Ambulan ce Division In 1905. founded 4 divisions between 1914 and 1926, became a corps officer In 1929 Serving Brother in 1933, Officer Brother in 1965, and President 21 years ago. (Photo Midland United Newspapers)

Area Commissioner Lt Col. C. M. Townsend is stretchered, as a trial run, into Torquay Div ision's first new ambulance, the cost of which £1400 came from the Division's funds. (P h oto: West of England Newspapers)

(Right) Derby's ret r n g C 0 mmanderl Commissioner Capt. P. J. B. Drury Lowe (2 n d from left), with (L) Sir John Crompton Inglefield Kt, Viscount Scarsdale, and (R) the new Co mmanderl Commissioner Col. Peter Hilton - at a farewell dinner for Capt Drury

(Below) Col. Peter Hilton with award winners at the Heanor parade. See DERBYS report

REVIEW CROSSWORD No. 11 (72) Compiled by W A Potter

ACROSS:

1. Condition in which pain and rigidity typically localise in the right iliac fossa . (12). 10 Lascivious. (7) 11. Carpets provide colourful phenomena. (7). 12. Hindrance between 25 Down and 19 Down is infectious disease (3) 14. Stimuli to the first c ranial nerve. (6). 15. American state in pond in Eastern Europe. (6) 16. His balsam is compound tincture of b e nzoin (5) 17. Amusingly clever direction to incision (4). 20. Large gull of the north (4). 21. Eager to use dislocated knee. (4) 22. Pain in ea ch ear. (4) 23

Formerly a central feature of concert. (4) 26 Region whe r e sapper is in motoring organisation. (4). 28. Make involuntary, ineffectual attempts to vomit. (5). 30. Ran back to the palmar muscles. (6). 31. The way by which things are done. (6). 32 Historical period of therapy. (3). 34. Uncomfortable resting-pla ce on a digit. (4-3). 35. Timid physiological system. (7) 36 Appliance one might improvise for immobilisation of fracture in street accident? (6 6).

DOWN:

2. Temporarily lose consciousness and leave (4 3).3. Physi ca l o r mental power applied. (6) . 4. Plant providing carminative water. (4). 5. The actors throw plaster for immobilisation of fra c ture (4). 6. Thrill of fine, involuntary muscular movement. (6). 7. Relap se with arthrodesis of spine? (3-4) 8. Process defective in haemophiliacs. (5.8).9. Emergency requiring immediate a ction to maintain the circulation. (7.6). 13. Sense organs on e may he ask ed to lend. (4). 15. Repair a test for a llergy (5) 18. Stret ch ou t in b o th directions. (3) 19. Ill ness charactised by high temper a ture , ra pid pulse, and headache. (5) 20. Sickness common ab o ard s hip. ( 3 ) . 2 4. Initi al preparation of food for digestion. (7). 25. Mark o f wo und would be colourful with 12 Across. (4) 27. Feeling unwell after injury on the road? (3-4) 28. Poor player is ra pid multipli er. ( 6 ) 29. Fused vertebrae taken from Lascar. (6) 3 2. Sh a rpn ess o f appetite (4).33 Terminal part of alirnentary canal. (4).

SOLUTION TO CROSSWORD No 10 (72)

ACROSS:

1. Be.muse.d ; 5 Dresser; 9. Eased ; 10 Nosebleed; 11. Decayed : 12. AIl.ergy; 13. Eel; IS. Ra.is.ed: 17. As. c.end; 19 O.men s ; 20 ; Detain; 22. S.quin.t 24. V.a t ; 25. Glu c ose ; 28. As .c ite.s ; 30 Trematode; 3 1. Bo.x.er; 32. Listens ; 33. Try . ps.in . DOWN:

1. Bleeder; 2. Masochist ; 3. Sad.l.y ; 4. Denude; 5 Distal ; 6. 7 S.m.ear; 8. Red-eyed; 14. Enema; 16. D.on: 17. Ass ; 18. EpIstaXiS; 20. Digital; 21 Isolate ; 23 Test-run ; 24 Ven o us ; 25. Talent; 27 Users ; 29. Cabby

NATIONAL FIRST AID COMPETITION FOR INDUSTRY

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AT

RANDOM

by Watbn W. Williams Deputy Commissioner-in-Chief

through my diary for the past four weeks, I f1J1d that sll1ce last I wrote to you I've been involved in St. John activities of one sort or another in seven counties. Bucks, Dorset, Es ex, London, Northants, Shropshlfe and Somerset. Three of these were conferences and / or social occasions. at each of which there w e re from 100 to 350 St. John member present: three we.re to meet and become identified with the work of Bngade members helping to receive and care for Asian refugees ; and one was to help to organise a . and adventurou outdoor programme of first al? trdll1lng for r3rigade members in the] 5-2] age group, wItnessed by Gmf zu Bentheim. head of the J ohanniterUnfall-Hilfe (the Brigade equivalent of West Germany's of St. John - see pA). In addition. I have met, eIt her at HQ or during my travels rOLlnd the country, members from at least seven other English countles and from orthern Ireland. Wales and Canada and have po ken about the Brigade to a mlSSIOn of senior officials of the Norweoian Red Cro b This isn't meant to be a big-headbed exercise one-upman hip: it' typical of the monthly programme of qUlte a number of u at HQ, and though a little more than my average monthly quota of visit and other engagement. it almo t certainly Ie s tlwn that of ome o ther member of HQ taff Incidentally. during the arne peliod the ioner-inChIef ha included in hi programme vi it to St. J 01111 Ambulance in Torthern Ireland and Canada. I think it' right that you who read this hould know that even if yourself have never met and talked with dn "',...' lle tr?m HQ. other people have. and perhap your Uil1 Wlll come 0011. We aren't ju t d batch of visionJries living secluded in an ivory tower: we really do care for you a rnem bers of our S t. John family. we value the work that YOll are doing and we try to get around aa we can 0 that we can become personally ll1volved in it.

Refugees M Y vi s its o h\(1 A.si a n Re ettkment Centre s in omer et Jnd O I:C ll1 Dorst>!, Jnd tansted a irp o rt o meet tw o of th e la came In from f i lled me WJth even greater admir a tI o n o r the plendld work thal o ur members Jre d o ing ull(kr c o n Ider a ble di ff ic uILie ;)nd the excellent WJ" III w!l1 c h th e ) have bL'c o me 0 happil) ;)nd su c cess f ull\' intear;ted WJth the B RC'S and tlle \\'R \' III c arrying o ut our j o in't JJ k "" ( c V l/f ill l/ c d ti ll {l age / 1 )

Jerusalem Conference

1961 an alliance was formed between the four Internati ona lly recognised Orders of St. John of the Reformed Churches:

I) The Most Ven erab l e Order of St. John in the B r itish Re alm; 2) The Johannit erorde n , whose headquarters is in Bonn, and which ha branches in five European cou ntries; 3) The Johannit e rord en of Sweden : 4) The Johanniterorde of the etherland.

The aim of this alliance is to co-ordinate the different activitie of th e four Order and to facilitate the exec ution of their international ta ks. Re cently the alliance undertook to com bin e in the sustenance of the great St J oh n Eye H ospi tal which has been maintain ed by The Ven erab le Order in Jeru salem since 1882, and this year, for the first time, the annual conference was held in Jeru alem on October 4 and 5 to enable representative to ee at fir t hand the work which th ey are upporting

Att ending the conference trol11 Bntaln were the Lord Prior, Lord Caccia, th e Chancellor, Sir Gilbert In glefield, the Secretary-General, Mr. C. r-.lcClintock, and the llo'>pil ailer.

Air Commodore T. Keith Lyle.

Also attending were Prince Wilhelm Karl of Pru,>sia, The H erren mei ster of the lohanniterorden, representatives of the American Society or The Order 0 1 st. Jolln (an Integral part of The Venerable Order) and from l inlallll, S\\ctlen, Hungary, H oiland, France and Swilleriand

THE

ALBERT

SCHWEITZER GOLD MEDAL AND PRIZE 1972

Cadet Award

TIlE PRESe T ATIO ceremony of The Albert Schweitzer Gold Medal and Pri ze 1972 was held in Lond on on OCLober 12 when the St John Ambua n ce CadeLs received a fifth share (as announced earlier) of the prize of 25,000 Swiss Francs awarded by the J ohan n-Wolfgang-von-Goethe Foundation of Ba Ie.

The awards were presented by the daughter of the late Dr. Albert Schweitzer, Mrs. Rhena Miller Schweitzer.

The J ohannlter-Unfn ll-Hil fe the eq uivalent of the Brigade in Germany won part of the Albert Schweitzer Prize 1971. This year the President of Johanni ter-Unfall- Hilfe was at the London ceremony a<; parL of his visit to St. John Ambuance, as reported in Around and About in this is ue.

Ph otos:

(Top) The Chief Commander Sir William P ike (left) with Dr H. C. Alfred Toepfer, Founder President of the Johann Wolfgang von - Goethe Foundation

(Right) President of the Johanniter Unfall Hilfe P eter Graf zu Bentheim - Tecklenburg Rhed a with the two cadets chosen to re ceive the prize : Corporal Irene Cunningham, from CN 130 (Little Thurrock) Division Essex' and Sergeant David Coombe, from C 102 (H'ithe Green' Division, Kent

(Below) At the ceremony (L to R) Grafin zu Bentheim Lady Moyra Browne, the Chief Commander Mrs Miller Schweitzer, Countess of Brecknock, 'an d Graf zu Bentheim

invested by the Lo r d Prior, Lord Caccia

(Below) Canon Edward West, of the

ican Society of the Order,

plaque of the chi ldren s

which is to be maintained by the

r ican Society

Hasan Abul Teen, a nurse at the hospital for many years, was among those

JUHPresident's Visit

GERMANY'S NUMBER ONE ST . JOHN MAN

COMES TO SEE THE BRIGADE IN BRITAIN

PRESIDENT Graf zu Bentheim or the J ohannitcrUn fall -Hilfe , the equivalent in Germany of our Commissioner-in-Chief, visited Britain I'ro111 October 11 to 15 to see [or him elf how the Brigade in Britain functions. Our Chief Commander , who, with senior officers,accompanied the Pre ident throughout his 4-day visit , made a similar visit to the 10hanniter-Unfall-Hilfe in Germany in 197 L

On tlleir two-day stay in London, the Graf and Grafin, accompanied by an interpreter, attended the Albert Schweitzer prize presentation ceremony (see page 3), toured St. 10hn's Gate , lunched at St. 10hn House, and visited St. 10hn Ambulance

On October 14 they travelled to the Country to attend the Order Service in Exeter Cathedral, and over-night at Lady Brecknock's home in Hump hire.

On the last day of their visit to the Brigade , the JUH party watched Brigade members on adventure training at Aston Clinton in Buckingham hire.

On his departure Graf zu Bentheim said how much he had enjoyed the visit , and that he hoped to return in the near future for a much longer stay with the Brigade

Gr af a n d Graf in z u Bentheim, with Lady Moyra Browne,

shown

crypt of

Priory

Absorbing interest in the museum at St. John's Gate

Deputy Commissioner in Chief Mr Watkin W. Williams explained, through the interpreler, details of the Incidents at the adventure training in Buckingham shire

Photographs by N C ark

During the tour of St John's Gate

The Graf and Grafin with Sir William and Lady Pike at an incident involving three serious cas ualties, one of whom had fallen from a t ree

The Graf joins a team receiving instruction in the use of the Paraguad stretcher, which is specially designed for use in difficult and c om p c ated situations

The G rafin was invited by Miss Sale, Cou nty Trai ning Officer , to present the prizes to the winning team

Welfare and St. John

casework or new 1cgi 13tion and to keep them within the 'circle' of S1. John.

An average division cou ld probably usefully emp lo y six to a dozen members for this task As the reputation of the divi ion for providing rCCicicnt welfare workers increa cs 0 will tI e work and so will the members! There is 3 tremendous amount of social welfare work to be done more than enough to go round for everybody in the divi ion. Then a lso there will be that many more at social events, and indeed to help with the ever necessary fund raising l

HAVE WE A NEW ROLE?

by D. J. Lafferty , MBE

AFTER PRESENTING the awards at this year's Brigade National Final Competitions, the Secretary of State for Social Services, Sir Keith Joseph, told members that he would like to see St. John personnel doing more to help in the field of social welfare.

Having met Sir Keith on several occasions, I suspect that he had in mind the rapid expansion of the Social Services, and the fact that central and local government cannot cope with the increasing demands from aged and disabled people of all kinds without the aid of the voluntary societies engaged in this sort of work. What is more important, being an astute politician he appreciates that the very basis of our present Health and Welfare Service was almost entirely due to the foundations laid by so many charitable bodies in the past. Anyone studying social history will quickly learn that it was charities like S1. John that did the pioneer work in their particular fields of activity, and once a successful pattern was established central or local government followed and expanded the service.

For example, during the First World War St John divisions of East Ham in London raised the money and bought a motor ambulance - a rare thing in those days The ambulance was later handed over to the County Borough to become the basis of the Borough's own ambulance service. Indeed, throughout the country, St. John Ambulance manned the ambulance services on a full-time basis; many of the vehicles were taken over in 1948 when the Health Service was established but some have continued to the present day.

Now the pendulum is swinging back. Having made such a· success of its offers

6

of assistance, Authority is finding that paid staff cannot alone cope with all the varying fa ce ts of social service.

Of course many divisions of St. John have not 'stuck to the book', and confined activities to first aid and nursing.

We have not waited to be told officially that there was a particular j ob to be done. Nearly every division has become involved in some way; for example by providing members to help with outings and holidays for the disabled and pensioners , running clubs for the mentally handi ca pped and the blind, etc.

All these very important activities have, however , been neatly tucked away on the BF I and 4 under the heading of 'Other Duties ', if they have been mention ed at all. Perhaps it is now time that S1. John took a long hard look and evaluated the situation in relation to Welfare , and brought the whole thing into its proper perspective.

It must, however, be remembered that pushing a wheelchair, making tea for the old folks, etc, is only a very small part of welfare work. The real meat of the job is to be able to advise someone of their statutory rights in relation to State Benefits, both monetary and services. For this work like any other, training is ne cessa ry and should be considered serio usly and with enthusiasm. The minimum full-time training period for the National Certificate of Social Work is two years. St. John members undertaking welfare work in their spare time will undoubtedly have to learn the hard way by experience. If it is any consolation, e ven the top professionals do not know it all! But at least they know where to tind o ut the relevant facts, and that is equally important. Not everybody is suited for welfare

work, but then not everyone is ulted for fir t aid and nursing. rf St. John do accept the challenge, 'Welfare' members must be very carefu ll y se lected for their tact, patience, and above all perseverance. At times the results can be depres ing and frustrating, but one ha to be prepared to accept the failure a well as the successes.

It is quite po sible that there may not be suitable members in the divi 'io n already , either with the time or the inclination for this work [f so, we must be prepared to accept happily a new and entirely different kind of recruit. We all know that there are a lot of people who show an interest in St. John. They come to first aid classes and when the lecturer gets to 'haemorrhage' they literally faint awayl Many others will complete the whole course, but the reasons for not joining are varied. Some dislike wearing uniform, other will not tie themselves to attending regularly every week. part from assistance with fund rai ing there i little else to offe r these in tere ted persons.

I do not think that it is really necessary for welfare workers to wear uniform po ssib ly it is better that they do not appear to be too 'officia l'. Probably they need not attend 12 meetings each year, or take a re-examination, except possibly in welfare matters. If such condition were imposed , the special recruitment might prov e abortive. The naturally happy family atmosphere of St. John divisions should, in the course of time, be a source o f encouragemen t to these 'special members' to join in with other activities. The senior welfare officer of a division (or divisions!) would, however, require to hold meetings of the workers to discuss

ion of many charities may well be the implementation of Part IV of the TJe alth Services and Publ ic Health Act of 1968.

The Minister has discretionary powers under Section 64 of the Act to make grants or loans, for example to charities that find income has fallen or costs spiralled as a result of inflation. Section 65 enables local authorities to do likewise This section even allows Councils to make premises available for use, and if necessary, give or loan furniture, equipment or vehicle s. In typical parliamentary language the qualifications for financial assistance are described:

This is another aspect to be considered. We all know how difficult it is to keep the 'books balan ce d', becau e rising cos ts put more on the price of uniforms and equipment, vehicles and co ts of running headquarters. In years gone by the majority of charities would not have dreamed of a king for financial help from the Government. It wa felt that some sort of stigma would be attached to taking money in this way, or the charity might suffer from official 'snoopers'.

Furthermore some testators specifled in their wills that if a charity was receiving money from Government source the beq uest w-a to become invdid. It was the proud boast of many charities, when fund raising, that money was nat received from the State!

Today the attitude is qUIte different, and worthwhile voluntary and charitable societies are now being 'officlally' recognised by the giving of grants from ce ntral and local government sources. The salvat-

VISITING CANADA

This section applies to a voluntary organisation whose activities consist in or inclllde , the provision of a service slmllar to a relevant service, the promotion of the provision of a relevant service or a similar one, the publicising of a relevant service or a similar one or the giving of advice with respect to the manner in which a relevant service or a similar one can best be provided.'

Two further sub-paragraphs then go on to describe the meaning of 'relevant service' and a 'voluntary organisation'.

My personal interpretation of this Act is that any voluntary organisations which carry out work in the health field similar to that carried out by the Government or Local Council qualify for financial assistance. I also hold the view that since the Ministry of He alth is now combined with the Ministry of Pensions to become the Department of Health and Social Security, it is extremely dlfficult to separate 'health' from 'welfare'. Further-

more, the emphasis today is on integration, and a subt le example is that hospital almoners have now been designated 'Social Workers '. There are, of course, other Acts of Parliament which give discretionary powers to local authorities to enable them to make grants to voluntary organisations. Some local councils are generous in their attitudes, others decline to give because they claim resources, although in principle they are sympathetic to the organisation concerned. Now that the Minister of State can give grant-aid direct to national voluntary organisations, the situation should improve. So the door is now open, even though, from time to time, it may be necessary to give it a little push!

Looking ahead a bit, St. John welfare work might be expanded to help industry and commerce. Few firms employing less than a thousand workers have a welfare officer, full time or part time. One third of the industry of this country is made up of such small firms. Possibly for an agreed annual donation St. John could establish a scheme for home visiting in times of illness or domestic upset. The firm may be in one locality, but the employees scattered over a wide area. Since S1. John divisions are nationwide, it should not be difficult to arrange for a local welfare worker to make a visit and report back to the initiating division.

I should be very interested to hear the views of other readers of the Review on this subject.

NEW PLAY

Princess Margaret , Grand President of Sl. John Ambulance, has graciously consented to attend the charity preview of Peter Ustinov's new play 'The Unknown Soldier and His Wife ' on Tuesday, January 9 1973, to mark the opening of the ew London Theatre in Drury Lane

This Royal Gala Evening is being held entirely for The Order of St. John and its Foundations , and all possible support would be appreciated. Ticket prices are £25, £10 and £5 and, together with full details about the occasion, can be obtained from The Director of Public Relations (Mr. Geoffrey Meek) , Order of St. John, 1, Grosvenor Crescent, London S.W.1.

VISITS

The German Ambassador HE KarlGunther von Hasse, asked London District to provide members for duty at the German Embassy during the recent state visit of the President of West Germany

London District has been privileged to receive many groups of J ohanniterUnfall-Hilfe members during recent months and it has been found that the interchange of ideas has been of great benefit to both organisations.

From Ratingen came Herr S Schenker and two of his young members who visited cadet and adult divisions in Ealing, Paddington and Willesden and also attended a number of public duties.

Another group (reported last month) from Oberschwabben, composed of members from Leutkirch , Friedrichshafen and Ravensburg under the leadership of Fraulein Inge Brossel, came to London to compete in the annual Casualties Union competition.

The largest uniformed group of 19 JUH members to ever visit London came from Mannheim and were led by Herr H. Mantel. Their hosts were members of Paddington , Willesden and Fulham, who for two successive years have been to Mannheim as guests of the JUH and performed many public duties at the Mai Market, road-side first-aid stations and hospitals.

AROU ND and ABOUT

WHAT'S GOING ON IN THE WORL D OF ST. JO HN

BY TH E EDITOR

APPOINTM E NT S

Co rnwal l : Mr. J. J . Pear ce to Dep . Com. vice Dr. W. L. Stewart.

CSO T. Fox to Area Com. Eastern Area vice Mr. Pearce

Som ers et: Mrs. J. M. Hodge to Cty. Supt. ( ) vice Mrs. Bes t to County Pool.

During their stay in London the JUH mem bers j0 '1ed their St. John colleagues on duty at t11e London Zoo, the Tower of London, Chelsea Football Ground and the Queensway Ice Rin k , as well as being taken on sight-seeing tours.

Frau M Zinn-Merz brought a small group from Hirzenhain (Frankfurt), and although their visit was short they were able to visit Madame Tussaud and la ter in the evening to go on duty in Trafalgar Square for the Guy Fawke celebrations, when they inspected mobile unit s and ambulances and saw the close co-operation which exists betwe en the Metropolitan Poli ce and St. John.

THANKS

Hull Pier Division 's Arthur Bu rton, who is on regular duty at the local rugby club ground 's fine first aid post , had this said about him in a recent club programme : 'St. John Ambulance Brigade man Arthur Burton did a grand job at the astleford game when head inj urie to both .Phil Coupland and John Millington necessitated their removal to hospital for treatment. Arthur not only accompanied them in the am bulance but took care of them in the waiting room and later in the ward. He then took John Millington home by taxi after he had been discharged and finished somewhere around midnight. Phil was detained overnight and wa allowed to go home on Saturday morJ1lng Well done, Arthur , and thanks very mLlcll

NEW RESCUE SERVICE

The coast lin e of Cornwall is beautiful and attractive, particularly to ummer visitors, but it can also be a danger to the foolhardy and unwary, as incidents involving personal inj ury occur here every year. So the S1. Ives Ambulance Divi ion

has for many years taken an active interest in cliff rescue work, purchasing climbing equipment and arranging for the younger members to be trained in cliff climbing by ex-Royal Marine commandos.

But during the past few months, after meetings between officers of the Ambulance Division and the local Coastguard, a new combined First Aid and Rescue Service has been established in the St Ives area. Under this scheme, immediately a report is received that a person has fallen over a cliff, the Coastguard pass full details to the St. lves Ambulance Division. Two Brigade member s then collect their equipment from the local headq uarters and go to the incident by their own transport, independent of the Coastguard. The St. Ives ambulance is not then waiting at the incident while the rescue takes place but available for any other emergency which migh t arise.

A t the incident Brigade personnel descend the cliff with first-aid equipment and blankets, pending the setting up of

RESCUE SERVICE

At the recent investiture. The authoress Mrs Barbara Cartland invested as Dame , and The Revd Stanley Pritchard who produ ce d the new St. John film as Officer (Brother) Sub - Chaplain

heavier rescue equipment by the Coastguard. A report on injuries and condition of the casualty is passed to the senior Coastguard presen t together with advice on the transport required for removal to hospital, e.g. ambulance, inshore rescueboat (RNLI) or helicopter ; the appropriate authority is notified by radio and telephone. If an ambulance is summoned the casualty is brought to the cliff top by the Coastguard Rescue Team, and the Brigade member is in charge of the casualty until he is handed over to the ambulance crew.

Last September this scheme was put into practice with a public demonstration on a 50ft cliff at St . Ives, and photographs show a Brigade member starting to descend the cliff while another waits to follow him; both are wearing safety helmets while an additional helmet is taken for the casualty. In this photograph the Coastguard team can be seen pre-

St Ives new combined first aid and rescue service. (Below) At the open ing public demonstration, two Brigade members are to be lowered down the cliff by coastguard. (Right)

The casualty being hauled to the cliff top

paring their heavier rescue equipment in the background. The second photograph shows the actual rescue, with the 'casualty' nearing the top of the cliff.

In order to operate this scheme the St. Ives Division has recently purchased a 300ft length of purlon rope with a high breaking strain , safety belt, etc., all of which is extremely light in weight. With this equipment and eight or nine men fully trained in cliff climbing, the Division is capable of giving essential first-aid assistance at any cliff accident in the area.

Refreshm ents were laid on for the party in the medical library, where they were joined by the base commander and other staff, who, in true American let'shave-no-misunderstandings spirit, were ready for all questions

1914 WINNERS

It was a wonderful 3-hour visit to a US airfield, and Brandon SJA can only say how sincerely they echo the b ase commander's words when he expressed the wish that a firm link would be now established between USAF Lakenheath and the Brigade.

DREAMS

Disheartened by a small, drab, depressing room in a derelict town hall, DIO H. G. Barnett had a dream, a dream of a new SJA Headquarters, one the whole town would be proud of.

The Brigade has been very strong in the collieries for many years. This picture is of the Frickley Colliery, York · shire, No.2 South Ambulance team, who won the Warde Aldham challenge cup in 1914. like the pose of the lad on the stretcher

USAF VISIT

Sup erintendent of Suffolk's Brandon Cadet Division Mr. R. Birkitt obtained permission from the Commander USAF Lakenheath for a party of cadets and adult members to visit the air-base and its has pi tal last summer. After being welcomed at the base, the party first visited the ambulance centre, admiring the vehicles and first-class equipment. Mrs. Birkitt (D.O. Brandon Cadets) sat behind the wheel of an ambulance for press photographs.

The party visited the hospital emergency receiving room, a small but

superbly equipped unit with everything at hand. During the visit a minor casualty was dealt with.

The hospital bus took the party to see the rescue helicopters, where the stand-by pilot explained these magnificent machines and how the service picks up injured personnel from difficult locations with a special lifting device. The pilot then got into the plane, and to the delight of the cadets, took off to show at first hand how exactly the lift was executed. It was carried out with perfect skill and accuracy so essential in the emergency situations that the service has to cope with.

See 0 REAMS. (Left) 'Bert Barnett's nightma re, the division's present ambulance.

(Below) But Bert, communing with the ambulance in question, has another dream

Starting off unaided, he raised the first £200 in one night. He followed this with a covenant for £1,000. £1,200 in two moves' Other ideas soon followed, and his lone efforts were noticed by the Round Tablers, who decided he could do with some help They backed him wholeheartedly.

Over £ 1,4 00 came in through his work, and with the help of the Round Tablers the sum grew over the next three years to £7,000. Three years of hardwork, many lost meals, large phone and petrol bills.

Early this year, the handing over ceremony of the shell of the new HQ took place. There's still a lot to be done

The present Division and future members can be very proud of this new Headq uarters, which without the vision and long , heartbreaking work of D/O. Barnett might never have been started, and Hemel Hempstead could easily have been a division of 'no fixed abode'

And all this from a man who still suffers from his unhealed war wounds!

Very shortly it is hoped to hold Opening Day, when D/O Barnett sure ly deserves to be one of the V[Ps.

The end of a dream well not quite. He is still dreaming , this time of a serviceable ambulance to replace the ageing one at present suffering from all the pre-retiring ailments well-used vehicles get. A replacement would enable about the busiest division in the county to carry out its many duties more satisfactorily.

Recording this sma]] piece of St. John history is the very least we can do to show our sincere appreciation to D/O 'Bert' Barnett.

BOOKLET

Copies of the booklet written by County Staff Officer (R) L. Ashmore on the Diamond Jubil ee Celebrations in Malta in 1969 are still available from Area Staff Officer W F. Shaw, 40 Furlong Avenue, Arnold, Nottingham, NG5 7 AP, price 23p including postage.

AT RANDOM

(continued from page 1)

I should like to describe a few of the memories that stand out very clearly from these visits two gleeful Asian girls who as volunteers had taken over the making of chupatties for the whole of a camp of about 800; the catering manager who had taken time off from his previous job to qualify himself by working for three days in an Indian restaurant; the St. John division whose members had regularly travelled 40 miles each way to help at a Resettlement Centre at the far end of their county, until diverted to another Centre which was later opened near their home ; the 17-year-old AIM, recently promoted from cadets, who spent the whole of each day during his mid-term holiday week working as a medical orderly at a Centre ten miles from his home ; the County Superintendent who, being by profession an SRN , visited one of the camps daily and more than once did a 12-hour stint at its Medical Centre. And I should like to pay tribute to the outstanding qualities of the three Camp Administrators whom I met-; all of them had extremely difficult tasks to perform - in one case, tasks which any normal person might well have thought insurmountable, and yet they were done. All of them expressed very sincere gratitude for the help of St. John, though the extent to which they were able to make use of our help varied with the circumstances of each camp.

My more personal memories of Stansted included the nostalgic experience of being an ordinary member of a totally integrated team consisting, besides myself, of a County Superintendent, a young AIM , two young Red Cross men and a WR VS membermeeting the Asians as they came to the air terminal , helping with the aged, the infirm and the babies, piloting whole families through passport and immigration formalities, baggage and customs, to the building where (with the help of other volunteers , including St. John) they were fed and documented and given whatever clothing, baby-care, first aid and medical attention they needed.

After the last of all the Asian flights had come in to Heathrow, a young N/M said to her father (also a Brigade member) something like this: 'The oddest thing about it all is that at this moment we are suddenly cut off from an experience which for the last six weeks has been our life , something in which we had become totally involved.' How true that is! Her reaction to an unforeseen emergency had enriched her life and the lives of countless others, and then in a sudden moment the thread had been cut and the experience had taken its place in past history But history has a future as well as a past, and although as the weeks go by we are a lr eady finding our help less often and less urgently needed in the Rehabilitation Centres, that need may at any moment (e.g. if there were a flu epidemic) become more acute, and is anyway likely to continue on at least a small scale for some time to come.

Readers' Views

I read with special interest the contributions to Readers' Views in the November Review. If all the suggestions put forward by M. V. Moring in a letter on 'Cadets - l et nature take a hand' could be read , digested and adopted by everyone concerned with both adu lts and cadets, I believe that the problem of stemming the leakage between cadets and adults would be reduced to acceptable proportions overnight.

[ should jusl like to add one further thought which I hope the

writer will not think hair-splitting. 'Transfer' is essentially a sideways move, while 'promotio n' is a move upwards. So if we always refer to 'promoting' (an d never to 'transferring') cadets to adult divisions , the psychological effect can be considerable, for promotion implies something that is an honour , something to look forward to and, when it comes, accept with proper pride. Some years ago r made the same mistake myself when writing to the Revi ew, and Colonel Goring lost no time in very courteously pointing out my mistake. I only hope that I can equal his courtesy as well as sharing his conviction!

Miss Wilson asks for some clarification of the conditions for gaining the Higher and Advanced St. John Certificates. I can well understand that, in common perhaps with many other Brigade members, she 'can't see a lot of point in them'. But those of us in the Brigade need to remember that as members of the uniformed branch of the Foundation we are only a tiny percentage of all those for whose needs the Association branch has to cater. To many workers in industry it is a real advantage and convenience to be able to show on one single document their qualifications in a broad range of subjects. And it is the view of our professional advisers, who have long and carefully studied the subject, that all of us are better qualified in the service of mankind if we have a sound basic knowledge of a wide range of related subjects than if we have a deeper quasi-professional knowledge of first aid only. Many of the skills taught in the Higher and Advanced First Aid Certificate courses which are now being discontinued were not first aid at all, but 'seco nd aid' - which is no part of our business. The fact that all nursing personnel, since they are obliged to hold certificates in both first aid and nursing, are automatically entitled (but not compelled!) to apply for a Higher St. John Certificate is correct. This information was circulated to counties in February and appeared in the Brigade General circular for July. M. W. Harris is mistaken in believing that lay instructors are not required to hold a valid certificate in first aid (i.e to be re-examined at least once in three years). Evidence of possessing a valid first aid certificate is an essential qualification for renewing the validity of a lay instructor's certificate. I can assure you of this because I've recently gone through the process of renewing my own lay instructor's certificate! In the past, I've more than once taken a re-exam with my own trainees, and it never struck me as involving any loss of dignity. The only time when I felt I hadn't had my money's worth' was many years ago when the examiner, taking me last , said 'A m I right in thinking that you trained all the e?' And when I answered 'Yes', he said 'That's good enough for me' and signed me up without giving me any further test.

Christmas

Christmas will soon be upon us. To all of you who read the Review and have borne with my 'random' comments month by month (and even encouraged me to persevere), as well as to all those who don't read the R eview but ought to - and what about a Christmas present of a year's SUbscription to the ReFiew for someone who do e n 't take it, or a new year resolution to find one new subscriber in 1973? - to all of you I send, both personally and on behalf of all my colleagues at Grosvenor Crescen t our best wishes for all the joys and bles ings of Chri tmas, and prosperity to you and your familie and your St. John activities in the new year.

The Old World

Part one: Rhodes

THE 1972 SJA TOUR TO RHODES, CYPRUS, BEIRUT AND DAMASCUS

by Joyce Hamilton

THE BEAUTY of Lindos on the island of Rhodes will long remain a wonderful memory for our party of St. John members who arrived there early last May. Along the road from Rhodes we gloried in the bright sunshine, having left behind a cold spring in England. White villages appeared, and hanging on the doors of most houses were garlands of spring flowers which had been gathered in the countryside for May 1 - the Feast of Spring.

We came to Aphandou, the invisible village. Cleverly hidden from one-time marauding bands of pirates, the houses are invisible from the sea, their flat roofs covered in clay to keep them cool in the summer and waterproof in winter. Further on is Archangelos, in a broad valley where walnuts, apricots, pomegranates, mandarins and oranges grow. The women here still wear the traditional goatskin boots which once protected them from snakes and scorpions of which there are few left on the island now. In these villages traditions still persist. For instance, girls are not allowed to show their teeth, so when they go out they wear a scarf over their mouths. The young men communicate with the girls only with the eyes, and a kiss is allowed only after the wedding. And only then does he see her teeth - or how many she has! Among the rows of white houses we noticed that a few were painted pink, blue, green or yellow. A coloured house means that the daughter of the house is looking for a husband! When she becomes engaged the house is painted white again. We were told by the guide of the legend of Mount Tsambika and the white monastery on its summit.

'All the women who cannot have babies go barefoot up the mountain to 12

Mrs. Joyce Hamilton was in the party of 20 people who went on the 1972 St. John Tour of the Eastern Mediterranean, which was led by Headquarters Registrar George Woodhill. Mr Woodhill will be leading another 15-day tour, visiting Rome and Israel, from September 15 to 29 1973, which is not yet fully booked

spend the night there praying. Many babies are born this way. That is why so many boys on the island are called Tsambikos and so many girls called Tsambika'.

Suddenly, before us lay the great

headland of Lindos with the ancient walls of the acropolis The temple was dedicated to the goddess Athena who was born in the cave below it.

On the summit of the citadel of Lindos, thou art 0 Athena, the glory of this ancient city.

When the island of Rhodes was in danger from the Persians,Athena appeared to the Lindians and led them to victory. Half bird, half goddess, she was venerated for her powers to still tempests She was the protectress of the Lindians who were sailors and adventurers and to this day the sailing ship is the sign of Lindos. Unitl the 17th-century Lindos

The harbour entrance, Rhodes

was famoLls for her long , slender ships and her shipyards . Cleobulos of Undos became one of the Seven Sages of Greece , pleasing Apollo so much with the words 'Nothing in excess' that they were engraved on the forecourt of his temple in Delphi

The a c ropolis of Lindos is one of the most ancient in the Mediterranean, dating from the 4th-century B .C. In one c orner of the headland is a castle built by the Knights of SL John and a ruined Byzantine c hurch but they do not interrupt the view of the temple of Athena. Somehow they emphasize the dignity of the scene

We stood among those spl e ndid ruin s on the c liff-top looking down onto the inten se blue of the sea , des cribed by our guide as the mirror of a cloudless sky

The acropolis was built on three levels. The first wa s for storing food the se c ond for an aqueduct and the third for the temple. We saw the altar where f ruit was sacrificed and learnt that the ac orn was the first meal eaten by man. On the farther side of the c liff we looked down onto a small enclosed bay where St. Pa ul landed to preach the gospel. A small white chapel looked lonely among so mu c h plendour. The stillness and beauty of the scene was breathtaking.

Longing to return to this sc ene, an opportunity presented itself the following day when a f riend and r joined another tour , but instead of returning to the

acropolis with the tourists we walked through the village , wind ing our way through the narrow , tortuous, pebblemosaiced streets , passing the sad-looking donkeys waiting to carry the tourists to the acropolis and the tourist shops bright and gay with local wares , until we came to a rough track leading down to St. Paul s Bay Not another person was in sight as we swam in the pure , clear water merging from colours of aquamarine to peacock and Pruss ian blues The acropolis towered above us on the clifftop and the chapel of St. Paul nestled into the side of the bay.

We were in Rhodes for five days and most afternoons were spent on the long sandy beach at Faliraki, with its .."nall restaurants It was so hot that we were glad to shelter under the umbrellas, or to cool off in the sea. One day we returned from Faliraki to Rhodes by boat, entering the harbour of the ancient port which is now called Mandraki. Here , it is believed , stood the Colossus of Rodos astride the narrow harbour entran c e. The god of Rhode s was Helios the Sun God. The first inhabitant s were sons of Helios and the nymph Rhoda. The early Rhodians flung a chariot and four horses into the sea each year for the use of Helios. Their celebrated Colossus was a bronze statue to the sun god , made by a man called Chares He worked twelve years on the comm ission and then di covered a

ST. JOHN AMBULANCE TOUR SEPT. 1973

Rome: Sept 15th, 16th, 17th including a visit to THE VATICAN

Jerusalem: 18th-26th. Pater Noster Church Gethsemane, the Spring of G ihon. Bethlehem, Shepherds Fields, and ST. JOHN OPHTHALMIC HOSPITAL Mt. Calvary, Church of the Holy Sepulchre.

mistake in the arithmetic, so he killed himself. The work was completed by another man called Laches who reaped all the honour. It was one of the most celebrated statues of all time and was known as one of the seven wonders of the world. Completed in 290 B C ., it stood approximately 100-126 ft high and was destroyed in an earthquake after it had been standing for 70 years. On the harbour pier are three Byzantine windmills and a 15th-century tower which serves as a light-house.

On our second day , we spent the morning visiting the capital of the island, which is actually two towns - the ew and the Old. On our way to the ancient acropolis of Rodos, the driver stopped the coach so that we might take photographs of the scenery. The mountains of Turkey loomed mistily in the far distance across a stretch of Reckitt's blue sea. Suddenly across the cliff a camel appeared led by a gentleman with what seemed to be a ladder balanced across his shoulders. Most of us, thinking how lucky we were to have a little local colour for our cameras started clicking away , not realising that the whole set-up had been arranged. In no time at all the camel was posed and the ladder placed against it. Then we were invited, one by one, to clim b and perch astride the docile but superior looking beast, while the professional photographer clicked away.

Led by Mr. G. Woodhill

We were then taken to the summit of a hill now known as Mount Smith. Here are the foundations of temples dedi ca ted to Zeus and Athena , a temple of Apoll o with restored columns, a gymnasium and a small restored theatre. All the ruin s d ate from the 2nd-century B .C. It is said that the Knights of St. John used the stone from these ruins to restore the old city.

Our guide told us th a t Rhodes wa s sold to the Knights of St. John after they had been driven from the Holy Land by the Moslems. The Knights fortified the city and established themselves in this stronghold, occupying it for more than two hundred years until , in 15 22, Suleiman the Magnificent laid siege to the island. Soon we were passing through the impressive defen ce system of walls , ramparts and bridges, to the medieval world carefully restored by the Italians; for Mussolini believed that he was descended from the Knights.

On either side of a street named the Street of the Knights are the Inns (or palaces) of the seven nationalities into which the Order was divided each Inn with its own coat of arms, and the architecture a combination of Norman, Venetian, Tudor and Byzantine. Glancing through a door of one of these Inns, we saw cascades of purple bougainviUaea and scarlet geraniums tumbling over ancient walls into a tiny secluded courtyard.

The street led to the massive palace of the Grand Masters, which is now used as a museum. The large, beautifully proportioned inner courtyard is adorned with Greek and Roman statues. Among the three thousand statues taken by Cassius, the Roman general, to Italy in the 1stcentury B.C. was one representing a priest of Apollo. He and his wife committed an impurity so Apollo sent serpents to kill them. The original statue is in the Vatican. Recently the Pope sent a copy of it to the people of Rhodes and it now stands at the entrance to the courtyard where the air is filled with the exotic scent from a syringa climbing the old wall of the palace

The hospital of the Knights in Rhodes , which was their second, the first being in Jerusalem , was equipped with a hundred beds. There was a chapel in the ward and mass was said every day. For it was considered that prayer was the best medicine. We entered a tiny cour ty ard sheltered by trees Our guide pointed o ut the Benjamin tree before taking us to see further exhibits : vases for the collection of tears ; coins of 4th-century B.C., engraved with roses which some say are the blooms of the pomegranate flower; a chapel dedicated to St. Nicholas whi ch has windows of alabaster. Everywhere were mosaics brought from Kos, the island of Hypocrates. An excellent one was of the Medusa , still in its original colours. Another was of Jupiter father of the twelve gods. He was very fond of the girls we were told Exquisite wrought iron

work formed handsome holders for candles, br acketed to the sto n e walls. Sea shells could be seen in the restoration stone which was taken from the beach.

We were fascinated by the o ld city, with its labyrinth of narrow cobb led streets charming small squares with usually a fountain or a m arket, and it minarets and squat domed churches. The fortifications a re 21/2 miles long We walked along the ramparts one evening; the public are a llowed to do so o n certain evenings at 5 pm. We had superb views of the city and the sea, and wild flowers grew everywhere.

Some of us d ecided to taste the delight s of Greek cooking at a promenade cafe, and in n o time our table was laden with salads, crusty bread , ice-cold lager and piping hot earthenware dishes of moussaka.

On e evening we went to the Son et Lumiere in the garden ground of the castle of the Knigh ts of St. John With nightfall the imagination was awakened. Pictures of the past appeared and assumed reality , taking us back five centuries. In the warm night we learnt how the 43rd Grand Master, Phillip Villiers d e L Isle Adam, and hi brave knights were betrayed by Chancellor AmaraL He thought the crusades of the knights were insane and corroded Christianity. Sulieman the Magnificent, so impressed by the Grand Master, offered to make him leader of his own armies but Phillip had one request to make: that those who wished to leave the i land should be free to do so. The Knights of St. John a nd the people of Rh odes were proclaimed everywhere for their bravery in the face of the enormous force of Sulieman. Eleven years later when Phillip Villiers de L Isl e Adam died the whole of Europe mourned for him and Sulieman the Magnificen t d ec reed that the story of his heroi c deed s sho uld be read in the mosques throughout his emp ire

Our last day in Rhod es brought us to the Valley of the B uit erflies and to

N.Bucks Now and

the Future

Kam iro. On the way we passed fields bright with poppies and white marguerite; shocking pink convolvulus grew along the ro a dside leading to charming villages

We came to the Valley of the Butterflies, but alas we were too early in the year for butierflie '. They appear from Jul y to September, and even then they cleverly camouflage themselves against the foliage of the maple trees. It is the resin from these trees which attracts them.

On we went to K a miros, an ancient city lying in the bowl of the hillside. A complete plan of this city is exposed to view. The roofless walls, flights of steps, fallen stones and tumbled pillar re t white and ilent in the sun. The ciLy has been exten ively excavated.

Our stay on the island would not have been complete without a visit to the Greek folk dancers. We watched dances from Macedonia, the Dodecanese island, from Cyprus and rete The dancers sang while they danced, songs of Thessaly a nd Roumeli , and of the islands Every regional dance, in its music and cos tumes , reflect characteristics of the life, customs and in many case the qua lit y of the people, Other dances reflect profe sions or trades, u c h as the mechanical dance of the sponge fishermen or the harvesters. Others have a war or a religious background. We watched the dancing feeling the fascination of the Greek rural a reas, her scenic islands and her glorious blue skies.

Yet, it Lindos which will remain in our hearts, sLirring the imagination with its ancient past and busy little square, where long clumsy coaches disgorge tourists. Where narrow cobb led streets lead fo the rough goat track, then down into the stilln ess and seclusion of St. Paul 's Bay with the acropolis towering above on the cliff top, remaining a perpetual memorial to the blue-eyed goddess Athena, daughter of Zeu s, protectress of the Lind ia ns

OVER the n e xt 6 or 7 years the approximately 8-mile-square Milton Key s new city development will bring 250,000 more residents to north Buckinghamshire SJA Bu c ks, northern area has 13 divisions in Bletchley, Wolverton, New Bradwell and Newport Pagn ell the four towns bordering the new c ity and already one new combined ca det division with 40 members has been register ed at Lakes Estate, Bletchley on the new development. Two more training groups have also been tarted, which should mean a further two divisions shortly in thi area of rapidly expanding population. An area which will need and is obviously getting the services of St. John.

Lindos the donkeys wait to carry tourists up to the acropl is

The proud new Lakes Estate Combined Cadet Division under their Superintendent, Mr. K. Lee. On left is ASO Mrs. J. Mylam (Photo' Bletchley Gazette)

Newport P agnell ambulance, nursing and nursing cadet annual inspection

(Below) New B r adwell cadets and a junior at work

Photos : Mrs. B. Edwards

Below) SJA Commander, Bucks, Rear Adl R S. Wellby Inspects Wolverton members and cadets

Area members on combined training with the fire brigade

The Story SJA Guernsey's Transport

(Land, Sea and A i r ) Department CONCLUSION

Div ing Team

THE DEP ARTMENT'S aqua-lung search and rescue team was formed only recently. The team members qualified for their British Sub-Aqua Club's and Aquatic Club's diver s certificates in 1971 after passing the stringent examinations for entry. Training continues to improve the standards so far attained.

Their NCO leader has qualified for Diving Instructor's Certificates issued by the British Sub-Aqua Club, the Aquatic Club and the Confederation Mondiale des Activites Subaquatiques (CMAS). He is also a certified snorkel instructor of the BSAC.

Work undertaken by the team is as follows:

(a) Examination and survey of the Flying Christine II below the water line whilst on moorings

(b) Maintenance of the launch's moorings.

(c) The search for and retrieving of occupants of motor vehicles falling into harbour or quarry wa ters.

The rescue of casualties whilst still alive is recognised as unlikely if not affected immediately by witnesses of the accident , as some time must elapse before properly equipped rescue personnel can arrive on the scene.

Cd) The search for persons following suspected drowning acciden ts in the sea , quarr ies or cisterns, etc.

(e) Participation in the c rewing of the inshore lifeboat when the need of a rescuer to enter the water is anticipated.

(f) Stand-by duties on the Flying Christine II when in attendance at air events and parachute jumping displays.

(g) The team also play s a significant part in the reception and treatment of cases of the Bends.

Medical Comfor ts S t or e

Although a medical comforts store has been organised by the Department since pre-war days, the momentum of its growth has increased considerably over the past five years.

The increased incidence of home nursing and the tendency to encourage the mobility of the sick and injured has led to a greater demand for the hire of such items as wheelchairs , crutches, commodes and back rests, to name but a few.

During 1971 a total of over 1,100 items were hired and at December 31st a 16

ThiS faSClmlting re co rd of SJA Guernsey's se r vices to the island community, which has been se ri alised in the Re View, is available in book form, price 45p including postage from the St. John Ambu lan ce T r ansport Department, A mb u a n ce Station, Rollals, Guernsey, C I

For this service, which is available to anyone between the hours of 8 am and 6 pm, the De r;.rrt ment makes charges of a small refundable deposit and a nominal monthly hire fee for each item.

Profits accruing from the hire of medical comforts are used for the purchase of replacement articles and to increase the total stock.

Mobile First-Aid Theatre

This caravan, brought into service in 1972 to replace an obsolete model, is not truly the property of the Department but of the voluntary divisions of St. John in Guernsey. It is maintained by the fulltime personnel of the Service, however , and is housed within the building occupied by the Transport Department. Its prime function is to provide a high standard of first-aid accommodation and equipment at public gatherings. It is staffed by voluntary personnel who have direct contact with the station's control room by means of the VHF transmitter/ receiver with which the unit is equipped. This enables ambulance or ambulance car assistance to be afforded without delay.

Other usages envisaged for the unit is to attend major disasters, where it would provide treatment faciliUe for doctors or as an ambu lan ce control centre under similar conditions.

The mobile unit is 23 ft long and 7 ft. wide with internal head room of 7 ft. For insulation it i lined throughout with J,4 in. polystyrene. A fully equipped treatment room measuring 18 ft. by 7 ft. and containing two trolley stretchers occupies the forward area of the unit. Curtains provide privacy for the patients when receiving attention. The whole width of the front of this room contains a built-in cupboard and drawer unit with a laminated top, a stainless steel s ink with draining board, and two gas rings The cupboards and drawer are well stocked with first-aid requi ite

Instant hot water is supplied by a gas water heater. Cold water is obtained from a second tap over the sink. Use of eitheJ tap automati ca lly operates a 12v e lectric pump which produces the water under pressure from a 30 gallon copper storage tank in the centre of the unit. An accumulator tank also forms part of the wa ter system. Ancillary equipment contained in the treatment room can. i ts of an automatic re uscitator, oxygen, dressing trolleys , etc.

The rear of the un i t, some 5 ft. by 7 ft is partitioned to provide a small coat cupboard, toilet and reception room. The latter, which communicates with the treatment room via double doors, has a separate outside entrance. In this room are chairs , a fitted table and the radio se t.

The whole unit is wired for mains voltage and its principal source of lighting is from fluorescent tubes Power points

Flying Christine II at the 1965 London Boat Show

and adjustab le lamp s are also fitted. The e le c tricity supp ly is obta in ed from the nearest point to the unit and fed into its wiring sy ern. In the absence of a mains upply portable generators are availab le to provide a similar voltage into the same inlet plug.

He ating is provided by a ally controlled gas convector with a capacity of approximately 7200 Btu/hr. Two bottled gas containers fixed to the towing bracket of the caravan provide fuel for the geyer, heating convector and boiling rings.

Subscription Scheme

Persons so desiring are able to insure under the Department's Ac ci dent and [nv alid Transport Scheme to provide free ambulance and car transport in Guernsey:

(a) On receipt of a telephone message from patient , relative or public in cases of ACCIDENT MATERITY or COLLAPSE, and

(b) Under direct instructions of a doctor for surgical, medi ca l x-ray and ho use-to-ho use removal of patients unfit to travel by other me a ns

The minimum annual SUbscription of 40p covers hu band, wife and c hildren up to the time they leave school. Old Age Pensioners are transported free of c h a rge without membership of the scheme, provided their pension is their only means of income.

Transport is provided during the financial year January 1st to December 31st.

Depots are open for two week each October at various points throughout the island and the St. John caravan is parked near the Town Church for the same period to receive subscriptions for the following ca lend ar year. People who are unable to visit the depots during this time may ca ll at the ambulance station until December 31 but subscriptions must alway be paid before January 1, i.e. in the latter part of the pre ceding year, as the books have to be closed at the end of December.

The opening of the 'SUbscription fortnight' each year is alway well adverti ed in the local press, on television and through the medium of posters, and peop e taking advantage of the cherne avoid receiving a charge for ambulance removal and also a sist the ervice financially by making thi ub cription.

Sub cribers to the scheme are reque ted to produce their receipt a t the time of removal or to notify the tation of the receipt number as soon as convenient.

Establishment

STAFF : Chief Officer : Are a Commi sioner R H Blanchford, OBE. , GM 3 officers, 28 men and 4 women

The Department is 1l1debted to the voluntary workers of St. J ohn men, women and cadets, who so ably supple-

ment the full-time establishment by performing unpaid duties at the station throughout the year.

VEH1CLES :

4 Bedford Ambulances ; Lomas bodies on J I chassis, 3519 c.c. petrol engines.

2 Peug eot 404 Estate vehicles, ambu lan ce conversions by 'Carrier' of Pari s.

1 Sin g e r V 0 g u e t s tat e , a m b ulance conversion by Rootes of Maidstone.

1 Series 88 Land Rover short wheel base, 2.25 litre petrol engine. Fitted with winch at front of vehicle

Statistics 1971

Total mileage cove red by ambulances and cars: 58 ,926

Number of patient s transported ; 6,683 of whom 1, 157 were accident cases. First-aid theatre cases: 2,696.

Bl ood donors on panel: 1,128

Bl ooel donors used during year: 783. Mainland cases arranged· 20 4. Cliff rescues: 6. Pe ople rescued: 7, and 1 dog. Marine ambulance ca es: 41. Cases covere d by relief boats: 2

In shore lift-boat missions: 12 Dory Missions: 4.

Upkeep of the Service

1 0 assIst in the running of the land' part of the service the Department receives an annual subsidy from the States of Guernsey. 0 claim can be made to the States however for the marine ambulance, the diving team or for the purchase of special eq uipment (e,g. the re-compression chamber). Such finance has to be found from public support.

Members of the diving team in 'pool' training The

PRIORITIES

from Edward T o rtell, Corps Superintendent I hav e been worrying for some time about prioritie of treatment in case of 'Profuse bleeding' and 'Asphyxia' occurring simultaneously when you are alone with the patient. Some lo ca l Brigade surgeons have opted for asphyxia, but I .contend that If.a patient lose s much blood it would not be possIble to It immediately and he will never recover, Whilst the reactlVatll1g of the breathing mechanism is easier to operate and could be ack led immediately without any equipment. Some medical practitioner argue that if there is no oxygen in the blood the brain cannot function; this is perfectly correct, but I believe that it would be worse if there is no blood in the brain be ca use the heart is un a ble to supply it.

The 1965 Edition of F A. Handbook pages 18 and 154 glves preference to Resuscitation and the R.L.S .S. Handbook 2nd Edition 1969 page 69 recommends tackling bleeding first. The opinion of surgeons and others would be appreciated. Sliema, Malta EdlVard Tortell

FAINTING

from Lt. Col. R B. Robi nson, County Staff Officer, Cadets

In Around and About October Dr Seccombe discusses the rather high incidence of fainting at the Cadet Review in Hyde Park. Personally I did not find it unexpectedly high, in view of the extremely oppre sive type of heat prevailing on that day in London.

There is one measure , however, which can be taken which markedly reduces the occurrence of this casualty. I was in command of a company on this occasion and anticipated that fainting would be a problem. I therefore addressed the company before we marched onto the parade ground to the effect that they must keep the weight off the heels and on the ball of the feet.

As a result as far as I could observe we had much fewer faints in my than others. I feel sure that we had nothing like the 13 % which Dr Seccombe quotes as the official estimate (one in seven or eight cadets). I do not know the full medi ca l explanation but no doubt it is a simple one, connected wi.th the mechanism which can cause concussion to result from fa lllng on the heels.

feel that this simple precaution, which believe I must have been taught 45 years ago in the OTC at school or later as an officer cadet, ought to be more widely known. Pewsey, Wilts. R B. Robins on

CADET HISTORY

from John E. Dan e, Di visional Pr esident

The Golden Jubilee Review of the Cadets was to me reminis ce nt of a similar occasion in Hyde Park when Prince Henry, later tbe

READERS VIEWS

Readers' views and opinions, which should be sent to the Ed i tor although published are not necessarily endorsed by the Editor or the Order of St John and Its Foundations Although readers may sign pllbl lshe d letters With a pen name, writers must supply their name and address to the editor

Duke of Glouce er an d Grand Pri or of the Ord er, was the inspecting officer at the London Di strict annual inspection in 1926 J attended with about a d oze n of my Cadet Divisi on, C4 (Croydon), and being the se nior cadet officer present was placed in charge of the ambu lan ce cade t contingent, about eighty strong, which J proudly marched pa t th e ll luting base. This may have been the first royal occasion for th e cadets.

I have been looking through my a [ chives to see if 1 could contribute something to the Review about the cadets during this Jubilee Year, and 1 h ave discovered an article published in 'F irst Aid' in 1923 in which th e unnamed a uthor describes a vi it to St. John s Gate for a preview of the fir t a mbul a nce cadet uniform.

1 am enclosing a photostat copy of thi article (too lengthy to reproduce: edit.) as part of Chapter One of the history of the cadet movement , which is not on ly historical but topical, in view of the revision of this uniform now being contemplated.

I did not keep the pictures of the uniform mentioned in the article, so I am se nding you a photograph of some of my cadets taken when on duty on Whit - Monday 1926 on Shirley Htll s.

In 1924 as a young cor poral in the 51 (Croydon) Ambulance Division [ was asked to train the boys who wished to become cadets.

Two of them are still serving and attended th e annual inspection of CN 49 (Shirley) Cadet ursing Division in May this year, when the second photograph was taken Area Staff Officer (Cadets) Bob Harri s is on my left and Ambulance Member Ernie Smith of the Croydon Divisi on on my right. Croydon JolIlI E. Dane

INSURANCE

from Miss K. D Wilson Divisional Officer

Earlier thi s year an office r wrote an artic le in the Revi ew on the legal implications of Brigade members work, which were hi personal VIews, I believe. Could we have the officia l leg al view in the event of member (valid FA certificate holders) stopping at

Photographs (left) in 1926 and ( belo w) this year, referred to in Mr Dane's ette CADET HISTORY

the scene of a road or other accident? What is the ri sk of being sued and how mu c h do es Brigade insurance cove r on or off duty?

Workington K. D. Wils on

Headquarters reply :

The whole question of the in su rance of members of the Brigade is fully described in Brigade General Regulations, under Regulation Number 135 and Appendix A A close study of Appendix A will give all the information required concerning the particulars of cover, and the amounts payable under the Per sona l Accident section of the policy, etc. It would appear that the correspondent

is concerned with regard to the legal position involved, in the event of Brigade members stopping at the scene of a road, or other accident, and the danger of them being sued for negligence in their treatment of a casualty. This matter wa raised in an article by a contributor in a recent issue of the Reveiw It is confirmed that enrolled members of the Brigade on or off duty, would be covered for this contingency under the Third Party Legal Liability section of the policy, the indemnity being £] 00 000 for anyone claim, unlimited in the year. In the event of such a claim being made against a member , it would be necessary for negligence to be proved by the third party concerned.

ORDER INVESTITURE HELDONOCTOBER191972

AS DAME

Barbara flamilt on, Mrs. Cartland. (f[erts.)

AS COMMANDER (BROTHER)

Surg Rear-Ad!. Nicol Sin c lai r Hepb urn, R ( Hant s.)

Surg. Vi ce-Ad!. James Walt , QIIS, \fi) MS 1 - RCS , (London)

Arthur Hambl eton. OBE. MC, (Dorset)

Sir Desmond lJeap , LLM (Kent)

Jam es Oaverhouse Graham, "'IRCS, LR CP. Dill (London)

Air dre. John WiIJiamson Soutar, MBE , MI3 I3S LMSSA, DPH DIH (l3u cks)

Major-Gen. Desmond Spencer Gordon, CB, C BL DSO (London)

Sir Joh n Pagan , CMG, MBE, ED

AS COMMANDER (SISTER)

Mary DiXIe, il-liss Groom (London)

Annie ElIzabeth, 1rs Grcen (Isle of Man)

CecIlle Babette, Mrs Dutfi eld (Wiltshire)

Agnes Ma} , Mr s. Lawrence (C heshi r e)

AS OFFICER (BROTHER) SUB-CHAPLAIN

The Revd Stanley Pritchard (Scotland)

The Revd \Iatth ew Nelon, MA (Lancs.)

AS OFFICER (BROTHER)

Col. Ilar old Wray Whitcher, OBE, TD MB (Scotland)

Thomas Francis Blackwell, i\IBE (Suffolk)

The Lord Tryon, KCB, KCVO, DSO (Wilts.)

L1. Col. William Cameron Moffat, MB, ChB, FRCS (Ken!.)

Lt. Col. Francis John Hebbe rt E RD, \lD, MRCP (Essex)

Lt Co l. Pet cr Stuart. MB ehB, DA. FFARCS (Cumb.)

orman Leonard Paro s, MB , BS, MRCGP, DObst RCOG (Essex)

Leonard Arthur John O'Brien (Guernsey)

Stephen Henry Knibbs (London)

William George Po yner (Worcs.)

The Lord Savilc, DL, lP (Yo rk s, WR)

George Law rie Sm th (London)

Rob e rt Scott ( otts.)

John Rob c rt Pca eham (Essex)

Norman Whyte ( Lane )

Frank Ilenry llalls (London)

William Walter Ke y (Notts )

Caleb llancourn Carpenter (Worc<;.)

Prank l!edley Il ewson (Lancs.)

Arthur Wad e Dilk (Notts.)

ll enry John Le ste r OBE, JP (Kent)

Conrad Marsha ll John Fisher Swan, PhD, MA (London)

PI. Lt Arthur Ro y Vatcher, SRN, R I T (Bucks.)

Col. Gordon lIiggs, ERD (Stalls.)

George Henry Charles Melotte FRCGP (Middx.)

AS OFFICER (SISTER)

E li zabeth Steen, MISS Pa yton ( B'h am.)

Gertrude, Miss Payton (B'ham.)

Vera Constance Mrs. Davies (London)

Margaret Mabel, Mrs. Sampson (Bri s tol)

Margaret Diana, Mrs. Lavers (Devon)

Dorothy [arg aret, Mrs. Edwards (Yorks, ER.)

Beatrice, Miss Le Huqu et (Jersey)

Graee E leanor, Miss Knowles (Lanes.)

Winifred Ethel, :v[iss Willis (London)

Dorothy May, Mrs. Clements (P lymouth)

Viol et Doris Edith , Miss Gee (Suffolk)

Muriel Mary, MIs. Webb (Surrey)

Jo an, Miss Barker (Yorks, ER.)

Doris, Mrs. Ayrton (Lanes )

Wing Officer Cathrine ] ane Grey Gumley, PMRAFNS (Bucks.)

Sq. Officer Aileen o rah Williamson, PMRAI S (Bucks.)

AS SERVING BROTHER

Gerald I lodkin son (Lanes.)

Geoffrey Drew Glanville (IIants.)

Raym ond Charie'i Thoma. Bellamy, :-'[B, BS , MRCS, LRCP (Hants.)

George Edward (Lancs.)

Albert Illin gworth (Yorks, WR.)

Charles Batho (Warwicks.)

Cyril Pawson (Yorks. WR .)

Harry William Buck (London)

John James Robson (Warwick .)

Rob e rt Ian (Lanes.)

Ralph Bell (Yorks, WR.)

Thom as Beardsworth (Lane .)

Jack Clamp ixon (\\'arwicks.)

Bri an Jame s Cooke (York, WR.)

Sidn ey Clifford Spence (Lanes.)

Sqd Ldr. Raymond -"!ill s

Ian Temple Holl oway, (Suffolk)

Arthur Boynton (Yorks, WR )

Douglas Alfred Brooks, SR , , OH C (lIants.)

Eric Whawell (Yo rks , WR .)

Paul Jeremy Burton (Lancs .)

Ri chard Stanley Wilson (York" WR.)

Kenne h Manchester (Yorks, ER )

Alb e rt Edward Buttle ( Orlhd.)

Thoma s In gha m 'I1c ish (York WR)

Bcmard Steventon (Sh ropshire)

The Revd Edric George Close (Linl".)

Jack Schofield. :VIBE, TD

John Bette rid ge (Lanc,.)

George Alan Adamson ( orthd .)

Willi am Frederick Barton (Kent)

Herbe rt Willi am Basford (London)

Ronald Ernest Bat eman (Bristol)

Alfred Raymond Beards (StaITs.)

George Bucknell (Yorks, \\ R .)

Albert Edward Carr (IIant, )

Eric Reev es Carter, 'I[B, ChB, j\IR CGP (Cheshire)

Anthony Denis Cassidy, MB, BCh, BAO, 0.1 (Lanes.)

Kenneth Cha rl es Brian Chan tier (Sussex)

Owen Stephen Connolly (London)

George Dawson (Yorks, \VR .) Harr y (Du rh am)

PhllIp Sidney Field, FAIA, FCCS (Wores.)

George Charles Storer (London)

Frank Gadsden (Dorset)

James Ronald Alexander Stanley (Lanes.)

AS ASSOCIATE SERVING BROTHER

Nathan Lipman Cannon, MB, BS (Northd.)

AS SERVING SISTER

Ruth Ylargery , Mrs. Hodgki ss (Som .)

JOy ce, :vIr,. Knight (Su rr ey)

Helen Margaret Agne ., Ylrs. Hawkins, SRN (\Vilts. )

'Ilargard Denholm, '1[1"'>. Leith ('I.Iorthd.) 'Iluriel, Ascough (Lanes .)

Jean 'Ilargaret, :--lrs. Gillingham (Bristol)

Lilian, 'Ifiss Evans (Lanes.)

Sheila Winifred 'Ilis HaggI (Staffs .)

Gladys, Miss orthin (Yorks, \YR .) Hope , :-'Irs. Pedder (Devon)

Blanche, \1iss l-erguson SRI\' (London)

Elsie, \Irs. Robert (York, \YR.) ;'\ora , ",llss Hooker (Su se'<)

Hilda Jane, Mis .· Hall, SR I (London)

Olive Elizabeth, Bourton (1 orthan ts.)

Frances Brierlc)" 'I[rs. Bailey (Somerset)

Elizabeth Lilian \[ad elaine, Dr. Perkin s (Susse x )

Vera Rose \[ar jorie, 'I[r. U herwood (\Varwicks.)

Thora, 'I[r\. Hames (York, \\'R. )

Kath leen Joan, Henley SR (\Vor cs.)

Doris Joyce, 'Ilrs. KIrwin ( 'Iliddx.)

LetItia ibelJ Lad} Hotham (Yorks. ER.)

Alice Elizabeth Grace, Steven, (Sussex) Ro,e 'Ilatilda, Barritt orfolk)

Beryl. 'III". Powell (\\'arwicks.)

Joyce Jackson, ;"lrs. Waslin , SE'\f ( Yorb ER.)

Violet Evdyn, :-'[r5 Sanderson SR (Yorks, \\,R.)

Hilda Florence ilIary , Warr (Warwicks.l

Annie Ethcl Burmide, Mrs. (Kent)

JO) cc 'Ilary. Mrs. Barrie (Somerset)

Ph} Llis, Wilce (\Vorcs.)

\\ inifred :-'[ay \[i ss Sollitt (Yorh ERJ

Rosina. :-'liss Smart (I orthants.)

Frances ,'Iliss myth (l otts.)

Vera Pamel a. Freeman (Suffolk) n, ;"Irs. mith (Surre y )

Pl1yllis i\lary. \[n Palm er ( orth3nts.)

AS ESQUIRE

Mr 1 ('\\ i, C Whyte, Bailiff Grand Cross, introduced to the Lord Prior his personal hqlllre. Dominic Diarnlllld C3mpbt'll. 19

NEWS from SCOTLAND

OVE R THE LAST YEAR I have drawn attention to the various ways in which we express the ideals of the Order. This month want to turn to an aspect of our activities which has a greater effect than we might at first realise.

We live in an age in wh ich the churches are not merely growing tolerant of one another but are also beginning to work actively for closer union. Although Christians nowadays hold many different views on doctrine and on the nature of the future structure of the Church, mo st would accept, I think, that some cIo er union, organic or inorganic, would be a good thing. Local groups arrange combined discussions and services; priests and ministers stand before the same congregations; moderators and bishop share the same pulpits It is generall y accepted that any professedly Christian body which draws its membership from various denominations is praiseworthy and there are all sorts of deliberate - and

often rather ponderous attempts to set such organi at ons up. It i often forgotten that th e Venerable Order is inter-denominational in theory and in practice : In Scotland there are Pre sbyterian, Episcopalian and Roman Catholic members of chapter. It sho uld be stres ed that this state of affairs has not come about because of any policy but has developed naturally and ea ily without anyone really being con cious of it. In fad one ca n go so far as to say that at meetings of the Order religious differences are irrelevant. We are faced here by a paradox. The Order is an effective example of ecumenicity in action, but at the same time thi is something about which no-one ever thinks, in spite of the fact that the Order's Christian ideals might be supposed to exaggerate differences rather than mask them. I think the answer to this lies in the aims to which our members are committed. Of the two Great Commandments - Lov e God and

Love your neighbour as yourself Our ideals concern the second; but it is arguments about the first, involving as they do the whole question or man's relationshlp to God and the Church as a vehicle for sa lvati on, which hav e l ed to doctrinal and sectarian differences. In other word ou r concern, Christian Charity, re t on a basic premise to which all Christians subscribe. It is so uncontroversial that th e r e can be nothing for us to differ about.

This highlights one important facet of the Order's activities. Its mere existence and its effectiveness showed long ago that Christians of diff e rent denominations could not only come together to work for a common religious cause, but also cou l d do so without being conscious of the differenccs between them or of the profound significance of what they were doing. In fact by drawing attention to thi matter here I may have put that blissful ignorance at risk. [t is therefore my llOpe that readers will forget what 1 have written this month even sooner than they usually do

WALES

Brigade Secretary for Wales, Mr. C J. Parry, and his son Michael, Cardiff's you ngest city co u n c liar, at the festival of the Priory for Wales.

100 Cadet NCOs from all parts of South Wales attended the 12th weekend course held at St. Athan Boys Village and arranged by the Training Offi cer for Wales. The theme was 'Leading Within' and cadets were put through their paces in every facet of leadership.

The course, opened by the Asst. Chief Commissioner (R) Brigadier J. G Morgan, who opened the first course in 1960, was divided into 5 groups and questions of cadet interest were answered. Speakers included the Brigade Secretary for Wales, Mr. C. J Parry, who with the use of slides showed the cadets all the relevant forms and explained the proced ure for filling them in correctly; Headquarter Staff Officer (Cadets) Mrs B L ewis , who asked the question 'Why be a Cadet NCO?' and outlined what was 20

expected of a good leader and the Chief Cadet Officer for Wales, Mrs. J. D . Smith , who was attending for the last time in thi ca paci ty

The Training Officer for Wal es led a session where Cadet NCOs did a playlet, 'unrehearsed,' on duties that could be carried out by NCOs in a division, which prompted good discussion.

On the Saturday evening there was a dance, and at the end of the course a plaque was presented to the warden of the centre in recognition of his kindness to St. John over so many years. This will be proudly displayed in the Conference Hall.

140 office rs and memb ers wh o descended on Llandudno for the annual training course a t the end of September were welcomed by the Chief Commissioner for Wales, Lt Col. J. R L. Traherne.

of th e Mayor made it a civic occasion. The inspecting officers were Assistant Chief Commissioner for Wal es, Li. Col. E. R Nanney-Wynn, and the Chief Superintendent for Wales , Lady Crawshay

They were invited to in s pect the Brigade by the Lord Lieutenant and Presldent of the St. John in Montgomeryshire. Col. J L. Corbett-Winder who also took, the salute at [he March Pa st. The parade under the command of County

OVERSEAS

PAKISTAN

Mr. Sohrab K II. Katrak , Assistant Commissioner, St. John Ambulance Brigade , Karachi , died on July 1 1972 He was a great humanitarian and social worker a nd wa as ociated with St. John Karachi, for well over 25 years.

TRINIDAD AND T O BAGO

Three members of the Order of St. John in Trinidad and Tobago Mr. Basil Jackson, Mr. J0 eph D'Arcy and Mr. B. I. Lalsingh. received awards of Merit dUring the r e c e n t lOt h In d e pen c.le n c e Anniversary celebrations.

The theme for the course was Rural First Aid and the guest speakers were Mr. R obert Owen. Consultant Orthopaedic Surgeon, Clwyd & Dee ide Management Board, who lectured on Rural Injuries, which proved mo t inreresting and stimulating; and Mr. Wyn Thomas, Safety Inspector , Ministry of Agri culture, who spoke on the Ha zards and ACCIdents on the Farm, illustrated by a film and lides.

On the Saturday evening the cour e was guests of the Llandudno UDC to a civic reception and dance

On Sunday, after a ervice at St. Paul's Church the Deputy Chief Surgeon, Dr. L. T. L ewis, spoke on the 3 rd Edition of the First Aid Manual, which was followed by a forum of surgeon answering question.

Part of the Sunday afternoon was devoted to the Chief Superintendent, Lady Crawshay, meeting the divi ional superintendents and orficers, and nursing members to discuss mutual problems , which proved very successful.

The Deputy Chief Surgeon for Wales , Dr. C. W. L. J ones, presided over all the sessions.

Mr. J P. Ham es, the Training Officer for Wale s, pointed out that th is was the best attended course fo r many years, the Brigad e in Wal es welcoming our friends from Cheshire.

The Annual Review of the Am bulance, Nursing and Cadet Divisions was held at Ll anidloes during July and the presence

Commissioner Mr. C. V. Davies marched to and from the service held at the St. [dl oes Pari sh Church.

The County Brigade Colours, a gift by Mrs. W Davi es- Jone s. Assistant Chief Superintendent for Wales (Retd.), in memory of her late husband and former Comm issioner for M ontgomeryshire, Dr. R Davies-Jon es, were dedicated by the Yen. Archdeacon D.E.M. G1ynne Jones,

ChapialO of the Order of St. John. After tea the Commissioner presented the Machynlleth Ambulance and ursing Cadet teams who represented Wales at the Brigade Finals at Croydon on July 1. The ambulance team gained first place in their competitlOn winnlOg the White Knox Cup; Jervis Cup; Barne Cup and the ew Zealand Cup

The nursing team gained joint third place and holders of the Pownall Cup.

MALTA

ursmg members of St. Albans , Leicester, this summer renewed old friendshIps made during the 1969 anniversary celebration in the Pawl a-Tarxien Divi ions. During a get-together at the headquarters of the divisions, St. Alban nursing member Mrs. E. ewton presented a photograph of her division to Corps. Supt. C. Garzia, who in return presented St. Albans DIvision with a replica of 'The Malta Coat of Arms' (Photo below left)

Apart from a late evening at the headquarter enjoying themselves with young local members (below right), the Leicester visitors were taken on an excursion- and other activitie by their hosts during their fortnight on the land.

JERUSALEM

The Ophthalmic Hospital was recently presented with a new car, an Opel Rekord , by the Swiss Commandery of the J ohanniter Order. The car was delivered to the hospital warden, Dr. Batten, by M. Fernand Oltramare (right in photo above), a member of the Swiss Commandery and vice-president of the Alliance of the Orders of St. John in Jerusalem.

This generous gift comes from a small body of Swiss knightsthere are less than SO of thern, 111 fact.

Courses

News from the Divisions

HERTS -A comp lete reorganisation of the H ertfordshire SJ A Association and Brigade, which takes effect immediate ly, has been carr ied out by the H erts. commander ige l Longmore and the county commissioner Gordo n H olmes.

In a statement Mr. Longmore said t h at h is pre d ecessor as com m issioner, assisted by two area commis ioners, had had executive re ponsibility for the who le county. Under the new organisation the county wi ll have three areas instead of two, covering north, south and west. This will enab le the officers responsible to h ave much clo er contact with the divisions under their command. I t shou ld a l so per m it ear l ier promotion so encouraging younger members. 'Finding replacements for senior officer due to retire has proved extremely difficult in the past', he continued. 'We believe the reorganisation will go a long way to overcoming this problem and at the same time will re l ieve both me and the commlSSlOner from day to day executive responsibility so that we can concentrate on policy matter

A new director of the Association, appointed to replace Mr. Holme who previously held the post, is Mr. William App leton, who was for many years the area commissioner for east Herts.

LONDON -No. 4 1 ( R oyal \ rsenal & Woo lwich) Division, started in 1902, ce lebrated its 70th birthday in October.

D uring October ulso 86 Westminster Ambulance Divi. ion celebrated its golden jubilee with a dinner at which the Lord Mayor of Westminster was the guest of honour. A number of founder members was present.

SURREY -900 members from throughout the county and 110 guests attended the recent transfer of co lour ceremony at Guildford Cathedral.

SHROPSHI RE -As p ar t of Cadet Jubilee Year a weekend camp was held during September at lIawkestone by permission of ir Alexander Stanier, a member of our Council. Ambulance and nursing cadets al tended from almost every division in the county. The ca mp tents were erected and dismantled by members , and the WRVS were a great help in seeing that no-one returned home hungry ow everyone here wants a camp next year but [or longer than a weekend!

OBITUARY

A W 1300R\\ \1\, Pre\luenl Laporte ( ulficld) Ambulanu' DiviSion. I' LD, Arca Slall Officer. Lincoln. N. LlD])1 \I\D, '\ILmll1g Otli ccr Tunbridge Wells ursing Division.

J 1 1 \RSDf ,Area OCricer, Che,hirc. W. R I· V f- R50'\, Su rgeon foru / '\1 Division r-lrs. L. D. Donisthorpc ILOR J'1I0LSL, Supainrendcnl, urslng Cadet Dlvi,lon, Leicester.

REVI EW CROSSWORD No. 12 (72) Compiled bv W. Potter

ACROSS:

1. Mobile organ in a common cold? (7.4). 7. A United Kingdom sea-bir d (3).9. Surgical technique for control of arterial bleeding. (7). 10 Use of intellect after initial temperature is a serious offence. (7). 11. P a r of digit 2Y2in in length (4). 12. Learn incorrectly of the kidney. (5). 13 Noise of fracture. (4). 16 Int oxicated and incorrectly applied bandage. (5). 17. Baldness concealed by disorganised police in A.A. (8). 19. Moral ban is basis of unusual finding. (8) 21. Alcoholic drink for the obese. (5). 24. Pr epare solid food for digestion. (4). 25. Offered for thoughts. (5). 26. P owder from neat alcohol preventing chafing of the skin. (4). 29. Malevolence when sick both before and afte r Wednesday (3-4). 30. Drugs producing vomiting. (7). 32. Attenuat e d form of matter for anaesthesia. (3). 33. Arrange to make plain an irresistible urge to steaL (11).

DOWN:

1. De cay present in corotid. (3). 2. Run back and entertain vocally in healing profession (7). 3. Girl controls amount of light entering the eye. (4).4. Dash for carminative produced by nigger. (6). 5. Variety of foul salt where sewers discharge. (8). 6. and water container found in sewers. (4). 7. Poisonous element associated with old lace. (7). 8. Amputation stump designed so that remaining muscles can be used t o control artificial limb. (11) 11. Affection of poor c ricketer is unlikely to become epidemic. (3.8) 14. Begin sudden reflex movement in surprise. (5). 15. Convulsive an d involuntary cont raction of muscles (5). 18. Girl embraced by malformed male makes tiny medi cated discs for the eye. (8).20. Surgical implements seen by visitors to the Isle of Wight. (7). 22. Turbulence of Avon air makes abdominal cyst. (7). 23. Use 20 down to administer drugs. (6). 27. Good mark for blood-su cking parasite. (4).28. Origin of disease-producing organism. (4). 31. Curative waters in 15 down SOLUTION TO CROSSWORD No 11 (72) ACROSS:

1. Appendi citis; 10 Lustful; 11. 12. Let ; 14. Odours; IS. Po la.nd 16 Friar; 17. Cut.e: 20. Skua; 21. Keen; 22. Ach.e; 23. Once ; 26. A.re.a; 28. Retch ; 30 The.nar; 31. Manner; 32. Era; 34. Nail-bed; 35. Nervous; 36. Gutter sp l int. DOWN:

2. Pass out; 3. Effort; 4. Dill ; 5. Cast; 6. Tremor; 7. Set-ba ck; 8. Blo o d clotting ; 9. Cardiac arrest; 13. Ears; 15. Patch ; 18. Eke; 19. Fever; 20 Sea ; 24. Chewing; 25. Scar; 27. Run -down; 28. Rabbit ; 29. Sacral; 32. Edge; 33. Anus

National First Aid Competitions NATIONAL COAL BOARD

MANCHESTER, SEPT. 30

Results

Men

1. Seafield (ScoL N .)

2. St. John's (N. yorks)

3. Pentremawr (S. Wales)

4. Littleton (Staffs.)

5. Grimethorpe (Barnsley)

6. Parkside (N. W.)

.Junior Miners

1. ewmarket (N. yorks)

2. Lea Hall (S taffs)

3. Bolsover (N. Derbys)

4. orth Gawber (Barnsley)

5. Bentinck (S. Notts)

6. Westoe (N. Durham)

NATIONAL ROAD PASSENGER

TRANSPORT AMBULANCE ASSOC.

BIRMINGHAM, OCT. 1

Results Stirk Trophy (Men)

1. London Trans. (Chiswick) 2.

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